WorldWideScience

Sample records for uk national centre

  1. UK National Data Centre archive of seismic recordings of (presumed) underground nuclear tests 1964-1996

    Science.gov (United States)

    Young, John; Peacock, Sheila

    2016-04-01

    The year 1996 has particular significance for forensic seismologists. This was the year when the Comprehensive Test Ban Treaty (CTBT) was signed in September at the United Nations, setting an international norm against nuclear testing. Blacknest, as a long time seismic centre for research into detecting and identifying underground explosions using seismology, provided significant technical advice during the CTBT negotiations. Since 1962 seismic recordings of both presumed nuclear explosions and earthquakes from the four seismometer arrays Eskdalemuir, Scotland (EKA), Yellowknife, Canada (YKA), Gauribidanur, India (GBA), and Warramunga, Australia (WRA) have been copied, digitised, and saved. There was a possibility this archive would be lost. It was decided to process the records and catalogue them for distribution to other groups and institutions. This work continues at Blacknest but the archive is no longer under threat. In addition much of the archive of analogue tape recordings has been re-digitised with modern equipment, allowing sampling rates of 100 rather than 20 Hz.

  2. Electron Bio-Imaging Centre (eBIC): the UK national research facility for biological electron microscopy.

    Science.gov (United States)

    Clare, Daniel K; Siebert, C Alistair; Hecksel, Corey; Hagen, Christoph; Mordhorst, Valerie; Grange, Michael; Ashton, Alun W; Walsh, Martin A; Grünewald, Kay; Saibil, Helen R; Stuart, David I; Zhang, Peijun

    2017-06-01

    The recent resolution revolution in cryo-EM has led to a massive increase in demand for both time on high-end cryo-electron microscopes and access to cryo-electron microscopy expertise. In anticipation of this demand, eBIC was set up at Diamond Light Source in collaboration with Birkbeck College London and the University of Oxford, and funded by the Wellcome Trust, the UK Medical Research Council (MRC) and the Biotechnology and Biological Sciences Research Council (BBSRC) to provide access to high-end equipment through peer review. eBIC is currently in its start-up phase and began by offering time on a single FEI Titan Krios microscope equipped with the latest generation of direct electron detectors from two manufacturers. Here, the current status and modes of access for potential users of eBIC are outlined. In the first year of operation, 222 d of microscope time were delivered to external research groups, with 95 visits in total, of which 53 were from unique groups. The data collected have generated multiple high- to intermediate-resolution structures (2.8-8 Å), ten of which have been published. A second Krios microscope is now in operation, with two more due to come online in 2017. In the next phase of growth of eBIC, in addition to more microscope time, new data-collection strategies and sample-preparation techniques will be made available to external user groups. Finally, all raw data are archived, and a metadata catalogue and automated pipelines for data analysis are being developed.

  3. National Centre for Ag

    African Journals Online (AJOL)

    USER

    2014-10-08

    Oct 8, 2014 ... Technology and Research in Irrigation and Drainage/Food and Agriculture. Organization of the United Nations. Bralts, V.F., Edwards, D.M. and Kesner,. C.D. (1985). Field Evaluation of. Drip/Trickle Irrigation Submain Units. In: Drip/Trickle Irrigation in Action. Proceedings of the Third International. Drip/Trickle ...

  4. Lively Bureaucracy? The ESRC's Doctoral Training Centres and UK Universities

    Science.gov (United States)

    Lunt, Ingrid; McAlpine, Lynn; Mills, David

    2014-01-01

    This paper explores the changing relationships between the UK government, its research councils and universities, focusing on the governing, funding and organisation of doctoral training. We use the Doctoral Training Centres (DTCs) funded by the Economic and Social Research Council (ESRC) as a prism through which to study the shifting nature of…

  5. UK Renal Registry 17th Annual Report: Chapter 10 2013 Multisite Dialysis Access Audit in England, Northern Ireland and Wales and 2012 PD One Year Follow-up: National and Centre-specific Analyses.

    Science.gov (United States)

    Rao, Anirudh; Pitcher, David; Fluck, Richard; Kumwenda, Mick

    2015-01-01

    Dialysis access should be timely, minimize complications and maintain functionality. The aim of the second combined vascular and peritoneal dialysis access audit was to examine practice patterns with respect to dialysis access and highlight variations in practice between renal centres. The UK Renal Registry collected centre-specific information on incident vascular and peritoneal dialysis access outcome measures in patients from England, Wales and Northern Ireland (EW&NI), including patient demographics, dialysis access type (at start of dialysis and three months after start of dialysis), surgical assessment and access functionality. Centres who had reported data on incident PD patients for the previous 2012 audit were additionally asked to provide one year follow up data for this group. The findings were compared to the audit measures stated in Renal Association clinical practice guidelines for dialysis access. Fifty-seven centres in EW&NI (representing 92% of all centres) returned data on first access from 3,663 incident HD patients and 1,022 incident PD patients. A strong relationship was seen between surgical assessment and the likelihood of starting HD with an arteriovenous fistula (AVF). Twenty-four centres were at least two standard deviations below the 65% target for incident patients starting haemodialysis on AVF and only eight centres (14%) were within two standard deviations of the 85% target for prevalent haemodialysis patients on AVF. There was wide practice variation across the UK in provision of both HD and PD access which requires further exploration.

  6. The UK Centre for Astrobiology: A Virtual Astrobiology Centre. Accomplishments and Lessons Learned, 2011–2016

    OpenAIRE

    Cockell, Charles S.; Biller, Beth; Bryce, Casey; Cousins, Claire; Direito, Susana; Forgan, Duncan; Fox-Powell, Mark; Harrison, Jesse; Landenmark, Hanna; Nixon, Sophie; Payler, Samuel J.; Rice, Ken; Samuels, Toby; Schwendner, Petra; Stevens, Adam

    2018-01-01

    Abstract The UK Centre for Astrobiology (UKCA) was set up in 2011 as a virtual center to contribute to astrobiology research, education, and outreach. After 5 years, we describe this center and its work in each of these areas. Its research has focused on studying life in extreme environments, the limits of life on Earth, and implications for habitability elsewhere. Among its research infrastructure projects, UKCA has assembled an underground astrobiology laboratory that has hosted a deep subs...

  7. UK Renal Registry 15th annual report: Chapter 5 survival and causes of death of UK adult patients on renal replacement therapy in 2011: national and centre-specific analyses.

    Science.gov (United States)

    Steenkamp, Retha; Shaw, Catriona; Feest, Terry

    2013-01-01

    These analyses examine a) survival from the start of renal replacement therapy (RRT) based on the total incident UK RRT population reported to the UK Renal Registry, b) survival of prevalent patients. Changes in survival between 1997 and 2011 are also reported. Survival was calculated for both incident and prevalent patients on RRT and compared between the UK countries after adjustment for age. Survival of incident patients (starting RRT during 2010) was calculated both from the start of RRT and from 90 days after starting RRT, both with and without censoring at transplantation. Prevalent dialysis patients were censored at transplantation; this means that the patient is considered alive up to the point of transplantation, but the patient's status post-transplant is not considered. Both Kaplan-Meier and Cox adjusted models were used to calculate survival. Causes of death were analysed for both groups. The relative risk of death was calculated compared with the general UK population. The unadjusted 1 year after 90 day survival for patients starting RRT in 2010 was 87.3%, representing an increase from the previous year (86.6%). In incident patients aged 18-64 years, the unadjusted 1 year survival had risen from 86.0% in patients starting RRT in 1997 to 92.6% in patients starting RRT in 2010 and for those aged ≥65 it had increased from 63.9% to 77.0% over the same period. The age-adjusted one year survival (adjusted to age 60) of prevalent dialysis patients increased from 88.1% in the 2001 cohort to 89.8% in the 2010 cohort. Prevalent diabetic patient one year survival rose from 82.1% in the 2002 cohort to 84.7% in the 2010 cohort. The age-standardised mortality ratio for prevalent RRT patients compared with the general population was 18 for age group 30-34 and 2.5 at age 85+ years. In the prevalent RRT dialysis population, cardiovascular disease accounted for 22% of deaths, infection and treatment withdrawal 18% each and 25% were recorded as other causes of death

  8. Audit of the job satisfaction levels of the UK radiography and physics workforce in UK radiotherapy centres 2012.

    Science.gov (United States)

    Hutton, D; Beardmore, C; Patel, I; Massey, J; Wong, H; Probst, H

    2014-07-01

    Workforce planning reports identify a staff shortfall that jeopardizes the ability of UK radiotherapy centres to meet future demands. Obtaining an understanding of the work experiences of radiotherapy professionals will support the development of strategies to increase job satisfaction, productivity and effectiveness. A quantitative survey assessed job satisfaction, attitudes to incident reporting, stress and burnout, opportunities for professional development, workload, retention and turnover. Clinical oncologists were not included, as the Royal College of Radiologists, London, UK, had recently assessed their members' satisfaction. All questions were taken from validated instruments or adapted from the "UK National Health Service Staff Survey". The survey yielded 658 completed responses (approximately 16% response rate), from public and private sectors. Over a third (36%) of respondents were classified as satisfied for job satisfaction with 11% dissatisfied and the remaining 53% ambivalent. A significant proportion of clinical staff (37.5%) report high emotional exhaustion. Presenteeism was an issue with 42.4% attending work despite feeling unable to fulfil their role. Radiotherapy professionals are prone to the effects of compassion fatigue and burnout. Attention must be paid to workload and its impact on practitioners' job satisfaction. Professional development that is supported and informed by a performance development review is a simple and effective means of enhancing satisfaction. Individuals have a responsibility to themselves and their colleagues as their behaviours and attitudes influence job satisfaction. This work identifies areas for future research to enhance the professional resilience of practitioners, in order to provide high-quality treatments.

  9. UK Renal Registry 16th annual report: chapter 14 2012 multisite dialysis access audit in England, Northern Ireland and Wales and 2011 PD one year follow-up: national and centre-specific analyses.

    Science.gov (United States)

    Briggs, Victoria; Pitcher, David; Shaw, Catriona; Fluck, Richard; Wilkie, Martin

    2013-01-01

    Dialysis access should be timely, minimise complications and maintain functionality. Good functional access is required for renal replacement therapy (RRT) to be successful. The aim of the combined vascular and peritoneal dialysis access audit was to examine practice patterns with respect to dialysis access and highlight variations in practice between renal centres. The UK Renal Registry collected centre-specific information on vascular and peritoneal access outcome measures including patient demographics, dialysis access type (at start of dialysis and three months after start of dialysis), surgical assessment and access functionality. The combined access audit covered incident haemodialysis (HD) and peritoneal dialysis (PD) patients in 2012 from England, Northern Ireland and Wales. Centres who had reported data on incident PD patients for the previous audit in 2011 were additionally asked to provide one year follow up data for this group. Fifty-one centres in England, Wales and Northern Ireland (representing 82% of all centres) returned data on first access from 3,720 incident HD patients and 1,018 incident PD patients. A strong relationship was seen between surgical assessment and the likelihood of starting HD with an arteriovenous fistula (AVF). Type of first access was related to the length of time known to renal services with higher numbers of AVFs and PD catheters used in patients known to renal services for at least one year. Three month and one year outcomes of HD and PD access were poorly reported. This audit provides information on important patient related outcome measures with the potential to lead to an improvement in access provision. This represents an important advance, however data collection remains suboptimal. There is wide practice variation across the England, Wales and Northern Ireland in provision of both HD and PD access which requires further exploration. © 2014 S. Karger AG, Basel.

  10. The UK Centre for Astrobiology: A Virtual Astrobiology Centre. Accomplishments and Lessons Learned, 2011-2016.

    Science.gov (United States)

    Cockell, Charles S; Biller, Beth; Bryce, Casey; Cousins, Claire; Direito, Susana; Forgan, Duncan; Fox-Powell, Mark; Harrison, Jesse; Landenmark, Hanna; Nixon, Sophie; Payler, Samuel J; Rice, Ken; Samuels, Toby; Schwendner, Petra; Stevens, Adam; Nicholson, Natasha; Wadsworth, Jennifer

    2018-02-01

    The UK Centre for Astrobiology (UKCA) was set up in 2011 as a virtual center to contribute to astrobiology research, education, and outreach. After 5 years, we describe this center and its work in each of these areas. Its research has focused on studying life in extreme environments, the limits of life on Earth, and implications for habitability elsewhere. Among its research infrastructure projects, UKCA has assembled an underground astrobiology laboratory that has hosted a deep subsurface planetary analog program, and it has developed new flow-through systems to study extraterrestrial aqueous environments. UKCA has used this research backdrop to develop education programs in astrobiology, including a massive open online course in astrobiology that has attracted over 120,000 students, a teacher training program, and an initiative to take astrobiology into prisons. In this paper, we review these activities and others with a particular focus on providing lessons to others who may consider setting up an astrobiology center, institute, or science facility. We discuss experience in integrating astrobiology research into teaching and education activities. Key Words: Astrobiology-Centre-Education-Subsurface-Analog research. Astrobiology 18, 224-243.

  11. UK intussusception audit: A national survey of practice and audit of reduction rates

    International Nuclear Information System (INIS)

    Hannon, Edward; Williams, Rhianydd; Allan, Rosemary; Okoye, Bruce

    2014-01-01

    Aim: To define current UK reduction practice and the reductions rates achieved. Materials and methods: Electronic surveys were sent to radiologists at 26 UK centres. This assessed methods of reduction, equipment, personnel, and protocol usage. Standardized audit proforma were also sent to evaluate all reductions performed in 2011. Results: Twenty-two of 26 centres (85%) replied. All used air enema under fluoroscopic guidance. Equipment was not standardized but could be broadly categorized into hand-pumped air-supply systems (seven centres) and pressurized air systems (15 centres). Seventeen centres followed a protocol based on British Society of Paediatric Radiologists (BSPR) guidelines. In 21 of the 22 centres a consultant paediatric radiologist led reductions and only 12 centres reported a surgeon being present. Three hundred and ten cases were reported across 22 centres. Cases per centre ranged from 0–31 (median 14). Reduction rates varied from 38–90% (median 71%). The overall perforation rate was 2.5%. Caseload did not significantly correlate with reduction rate, and there was no significant difference between the two types of equipment used. Median reduction rates were 15% higher in centres with a surgeon present at reduction (p < 0.05). Conclusion: Intussusception care in the UK lacks standardization of equipment and personnel involved. National reduction rates are lower than in current international literature. Improved standardization may lead to an improvement in reduction rates and a surgeon should always be present at reduction

  12. A survey on the progress with implementation of the radiography profession's career progression framework in UK radiotherapy centres

    International Nuclear Information System (INIS)

    James, Sarah; Beardmore, Charlotte; Dumbleton, Claire

    2012-01-01

    Aim: The purpose of the survey was to benchmark the progress with implementing the radiography profession's career progression framework within radiotherapy centres across the United Kingdom (UK). Methods: A survey questionnaire was constructed using the Survey Monkey™ tool to assess implementation of the career progression framework of the Society and College of Radiographers. Once constructed, an on line link to the survey questionnaire was emailed to all radiotherapy centre managers in the UK (N = 67) who were invited to provide one response per centre. The survey comprised twenty nine questions which were grouped into nine sections. Key results: The workforce profile indicates that increases in assistant, advanced and consultant level practitioners are required to meet National Radiotherapy Advisory Group recommendations with only a small number of centres having fully implemented the career progression framework. The overall vacancy level across the therapeutic radiography workforce was 4.6% at the time of the survey. Conclusions: and Recommendations: The survey has highlighted some progress with implementation of the career progression framework across the UK since its launch in 2000. However the current level of implementation demonstrated is disappointing considering it is a key recommendation within the NRAG Report 2007 with respect to England. It is recommended that all centres undertake a multi-professional workforce review to embed the career progression framework within their service in order to meet the workforce challenge associated with the required anticipated large growth in radiotherapy capacity.

  13. The UK Centre for Astrobiology: A Virtual Astrobiology Centre. Accomplishments and Lessons Learned, 2011–2016

    Science.gov (United States)

    Biller, Beth; Bryce, Casey; Cousins, Claire; Direito, Susana; Forgan, Duncan; Fox-Powell, Mark; Harrison, Jesse; Landenmark, Hanna; Nixon, Sophie; Payler, Samuel J.; Rice, Ken; Samuels, Toby; Schwendner, Petra; Stevens, Adam; Nicholson, Natasha; Wadsworth, Jennifer

    2018-01-01

    Abstract The UK Centre for Astrobiology (UKCA) was set up in 2011 as a virtual center to contribute to astrobiology research, education, and outreach. After 5 years, we describe this center and its work in each of these areas. Its research has focused on studying life in extreme environments, the limits of life on Earth, and implications for habitability elsewhere. Among its research infrastructure projects, UKCA has assembled an underground astrobiology laboratory that has hosted a deep subsurface planetary analog program, and it has developed new flow-through systems to study extraterrestrial aqueous environments. UKCA has used this research backdrop to develop education programs in astrobiology, including a massive open online course in astrobiology that has attracted over 120,000 students, a teacher training program, and an initiative to take astrobiology into prisons. In this paper, we review these activities and others with a particular focus on providing lessons to others who may consider setting up an astrobiology center, institute, or science facility. We discuss experience in integrating astrobiology research into teaching and education activities. Key Words: Astrobiology—Centre—Education—Subsurface—Analog research. Astrobiology 18, 224–243. PMID:29377716

  14. National Centre for Radioactive Ion Beams (NCRIB)

    International Nuclear Information System (INIS)

    Chintalapudi, S.N.

    1999-01-01

    Radioactive Ion (nuclear) Beams have become prolific recently. Nuclear physics and associated subjects have staged a comeback to almost the beginning with the advent of RIB. A dedicated National Centre for RIB (NCRIB) proposed, discussed at several forums and under serious consideration is described

  15. National Centre for Radioactive Ion Beams (NCRIB)

    International Nuclear Information System (INIS)

    Chintalapudi, S.N.

    1999-01-01

    A dedicated National Centre for RIB (NCRIB) proposed discussed at several forums is presented. The production of (RIB) radioactive ion beams and applications of beams leading to competitive studies in nuclear structure, nuclear reactions, condensed matter, bio-science and radioactive isotope production etc. are mentioned

  16. Cancer Research UK | CRDI - Centre de recherches pour le ...

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

    Cancer Research UK. https://www.cancerresearchuk.org/. Initiative de recherche sur la dimension économique de la lutte antitabac. L'Initiative de recherche sur la dimension économique de la lutte antitabac finance la recherche novatrice sur les politiques fiscales qui appuient la lutte antitabac dans les pays à faible revenu ...

  17. Energy efficiency in U.K. shopping centres

    Science.gov (United States)

    Mangiarotti, Michela

    Energy efficiency in shopping centres means providing comfortable internal environment and services to the occupants with minimum energy use in a cost-effective and environmentally sensitive manner. This research considers the interaction of three factors affecting the energy efficiency of shopping centres: i) performance of the building fabric and services ii) management of the building in terms of operation, control, maintenance and replacement of the building fabric and services, and company's energy policy iii) occupants' expectation for comfort and awareness of energy efficiency. The aim of the investigation is to determine the role of the above factors in the energy consumption and carbon emissions of shopping centres and the scope for reducing this energy usage by changing one or all the three factors. The study also attempts to prioritize the changes in the above factors that are more cost-effective at reducing that energy consumption and identify the benefits and main economic and legal drivers for energy efficiency in shopping centres. To achieve these targets, three case studies have been analysed. Using energy data from bills, the performance of the selected case studies has been assessed to establish trends and current energy consumption and carbon emissions of shopping centres and their related causes. A regression analysis has attempted to break down the energy consumption of the landlords' area by end-use to identify the main sources of energy usage and consequently introduce cost-effective measures for saving energy. A monitoring and occupants' survey in both landlords' and tenants' areas have been carried out at the same time to compare the objective data of the environmental conditions with the subjective impressions of shoppers and shopkeepers. In particular, the monitoring aimed at assessing the internal environment to identify possible causes of discomfort and opportunities for introducing energy saving measures. The survey looked at

  18. UK public attitudes to the nuclear industry: the effect of the Sellafield visitor centre

    International Nuclear Information System (INIS)

    Jackson, D.; Rogers, J.

    1993-01-01

    Public support for the nuclear industry appears to be growing in the UK at a time when environmental awareness is also prominent. Perceived advantages from nuclear power range from conservation of scare fossil reserves through to maintaining a worldwide technical competitiveness. Within the UK, the Sellafield Visitors Centre has proved to be a large tourist attraction, as well as successfully presenting information in a form that is easy to understand. (author)

  19. Open Innovation, Triple Helix and Regional Innovation Systems: Exploring CATAPULT Centres in the UK

    Science.gov (United States)

    Kerry, Christopher; Danson, Michael

    2016-01-01

    Through the lens of UK CATAPULT Centres this conceptual paper presents an examination of the links between open innovation, the Triple Helix model and regional innovation systems. Highlighting the importance of boundary-spanning intermediaries, the combined role of these concepts is explored in detail. A conceptual model is then proposed which…

  20. Going private: clinicians' experience of working in UK independent sector treatment centres.

    Science.gov (United States)

    Waring, Justin; Bishop, Simon

    2012-02-01

    With increased possibility that public healthcare services in the UK will be outsourced to the private sector, this study investigates how clinicians working in Independent Sector Treatment Centres perceive the differences between public and private sectors. Qualitative interviews with 35 clinicians recruited from two ISTCs. All participants were transferred to the independent sector from the public National Health Service. Interview data were analysed to identify shared experience about the variable organisation and delivery of services. Clinicians perceived differences between public and independent sectors in the areas of 'environment and facilities', 'management', 'work organisation and care delivery', and 'patient experience'. The independent sector was described as offering a positive alternative to public services in regard to service environment and patient experience, but there were concerns about management priorities and the reconfiguration of work. Clinicians' experience of moving between sectors reveals mixed experiences. Although some improvements might legitimise the growing role of the independent sector, there remain doubts about the commercialisation of services, the motives of managers and the impact of clinical roles and capabilities. With policies looking to expand the mixed economy of public healthcare services, the study suggests clinicians will not automatically embrace a move between sectors. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  1. UK Renal Registry 18th Annual Report: Chapter 11 2014 Multisite Dialysis Access Audit in England, Northern Ireland and Wales and 2013 PD One Year Follow-up: National and Centre-specific Analyses.

    Science.gov (United States)

    Rao, Anirudh; Evans, Rebecca; Wilkie, Martin; Fluck, Richard; Kumwenda, Mick

    2016-01-01

    Data are presented from the third combined vascular and peritoneal dialysis access audit. In 2014, 53 centres in England, Wales and Northern Ireland (out of 62) returned data on first access from 4,339 incident haemodialysis (HD) patients and 1,090 incident peritoneal dialysis (PD) patients. Of the 5,429 incident patients, 20.1% started dialysis on PD, 27.8% started with an arteriovenous fistula (AVF), 1.0% with an arteriovenous graft (AVG), 27.1% on a tunnelled line (TL) and 24.0% on a non-tunnelled line (NTL). Older patients (565 years) were more likely to start haemodialysis using AVF compared to their younger counterparts (36.2% vs. 32.8%). Thirteen of the nineteen centres (68%) using the physician led percutaneous insertion technique had over 20% of their incident patients starting on PD when compared to only seven out of fourteen centres (50%) which used single technique (open surgical or laparoscopic) for their PD catheter insertion. Wide variations were apparent between centres for use of AVF as the first haemodialysis access ranging from 10–54%. Eight of the 49 centres were achieving close to the 65% target for AV fistula in their incident patients. Length of time known to nephrology services and likelihood of commencing dialysis using either an AVF or a PD catheter are strongly associated. Patients who were known to a nephrologist for over one year were more likely to start dialysis with AVF, as compared to those who were referred between 90–365 days (39.2% vs. 24.6%). Similarly, patients who were known to a nephrologist between 90 days and one year were more likely to start on PD when compared to patients who were referred report demonstrates wide variations in practice between centres across several domains in the provision of dialysis access and further work will be required to understand the underlying reasons.

  2. The haemtrack home therapy reporting system: Design, implementation, strengths and weaknesses: A report from UK Haemophilia Centre Doctors Organisation.

    Science.gov (United States)

    Hay, C R M; Xiang, H; Scott, M; Collins, P W; Liesner, R; Dolan, G; Hollingsworth, R

    2017-09-01

    Haemtrack is an electronic home treatment diary for patients with inherited bleeding disorders, introduced in 2008. It aimed to improve the timeliness and completeness of patient-reported treatment records, to facilitate analysis of treatment and outcome trends. The system is easy to use, responsive and accessible. The software uses Microsoft technologies with a SQL Server database and an ASP.net website front-end, running on personal computers, android and I-phones. Haemtrack interfaces with the UK Haemophilia Centre Information System and the National Haemophilia Database (NHD). Data are validated locally by Haemophilia Centres and centrally by NHD. Data collected include as follows: treatment brand, dose and batch number, time/date of bleed onset and drug administration, reasons for treatment (prophylaxis, bleed, follow-up), bleed site, severity, pain-score and outcome. Haemtrack was used by 90% of haemophilia treatment centres (HTCs) in 2015, registering 2683 patients using home therapy of whom 1923 used Haemtrack, entering >17 000 treatments per month. This included 68% of all UK patients with severe haemophilia A. Reporting compliance varied and 55% of patients reported ≥75% of potential usage. Centres had a median 78% compliance overall. A strategy for progressively improving compliance is in place. Age distribution and treatment intensity were similar in Haemtrack users/non-users with severe haemophilia treated prophylactically. The Haemtrack system is a valuable tool that may improve treatment compliance and optimize treatment regimen. Analysis of national treatment trends and large-scale longitudinal, within-patient analysis of changes in regimen and/or product will provide valuable insights that will guide future clinical practice. © 2017 John Wiley & Sons Ltd.

  3. SYNBIOCHEM Synthetic Biology Research Centre, Manchester – A UK foundry for fine and speciality chemicals production

    Directory of Open Access Journals (Sweden)

    Le Feuvre RA

    2016-12-01

    Full Text Available The UK Synthetic Biology Research Centre, SYNBIOCHEM, hosted by the Manchester Institute of Biotechnology at the University of Manchester is delivering innovative technology platforms to facilitate the predictable engineering of microbial bio-factories for fine and speciality chemicals production. We provide an overview of our foundry activities that are being applied to grand challenge projects to deliver innovation in bio-based chemicals production for industrial biotechnology.

  4. Hydroxyurea therapy in UK children with sickle cell anaemia: A single-centre experience.

    Science.gov (United States)

    Phillips, Kate; Healy, Laura; Smith, Louise; Keenan, Russell

    2018-02-01

    Despite the demonstrated efficacy of hydroxyurea therapy, children with sickle cell anaemia in the UK are preferentially managed with supportive care or transfusion. Hydroxyurea is reserved for children with severe disease phenotype. This is in contrast to North America and other countries where hydroxyurea is widely used for children of all clinical phenotypes. The conservative UK practice may in part be due to concerns about toxicity, in particular marrow suppression with high doses, and growth in children. We monitored 37 paediatric patients with sickle cell anaemia who were treated with hydroxyurea at a single UK treatment centre. Therapy was well tolerated and mild transient cytopenias were the only toxicity observed. Comparative analysis of patients receiving ≥26 mg/kg/day versus hydroxyurea as a disease-modifying therapy, which we advocate for all children with sickle cell anaemia. © 2017 The Authors. Pediatric Blood & Cancer Published by Wiley Periodicals, Inc.

  5. UK national consensus conference on radwaste management

    International Nuclear Information System (INIS)

    Craven-Howe, Andrew

    2000-01-01

    UK CEED organised a consensus conference to debate radwaste disposal. It lasted from 21-24 May 1999. Among the witnesses called to give evidence were UKAEA, BNFL, Nuclear Industries' Inspectorate, Department of the Environment, Transport and the Regions, Friends of the Earth and Greenpeace. The end result was a report produced by the panel of members of the public, recording their views and recommendations. Conclusions are presented. (author)

  6. An evaluation of the utilisation of the virtual environment for radiotherapy training (VERT) in clinical radiotherapy centres across the UK

    International Nuclear Information System (INIS)

    James, Sarah; Dumbleton, Claire

    2013-01-01

    Aim: The purpose of the survey was to evaluate the utilisation of the Virtual Environment for Radiotherapy Training (VERT) in clinical radiotherapy centres across the UK. Methods: A survey questionnaire was constructed using the Survey Monkey™ tool to evaluate the utilisation of the Virtual Environment for Radiotherapy Training. Once constructed, an online link to the survey questionnaire was emailed to all radiotherapy centre managers in the UK (n = 67) who were invited to provide one response per centre. The survey comprised forty-five questions which were grouped into eleven sections. Key results: The results indicate that 61% of UK radiotherapy centres have VERT installed, twenty centres are currently without a VERT installation and only 1 centre is intending to install a system in the near future. The results also indicate that the use of VERT varies considerably in differing radiotherapy centres with the most frequent use of VERT being for the training of staff, specifically for the training of pre-registration therapeutic radiographers and preparation time for trainers. The majority of centres using VERT for any of the purposes investigated feel it provides benefits. Conclusions and recommendations: The survey highlighted the varied use of VERT in radiotherapy centres across the UK and indicated that when VERT is used in clinical radiotherapy centres, a wide variety of benefits are experienced. Because of the variation in use, it is concluded that the benefits of the VERT installations in radiotherapy centres across the UK are not being fully realised. It is recommended that all radiotherapy service managers commit adequate resources to develop and implement VERT fully and effectively so that its full potential is realised in all radiotherapy centres across the UK

  7. Establishing a National Nuclear Security Support Centre

    International Nuclear Information System (INIS)

    2014-02-01

    The responsibility for creating and sustaining a nuclear security regime for the protection of nuclear and other radiological material clearly belongs to the State. The nuclear security regime resembles the layers of an onion, with the equipment and personnel securing the borders and ports representing the outer layer, and nuclear power, research reactors and nuclear medicine facilities representing the inner layers, and the actual target material representing the core. Components of any nuclear security regime include not only technological systems, but the human resources needed to manage, operate, administer and maintain equipment, including hardware and software. This publication provides practical guidance on the establishment and maintenance of a national nuclear security support centre (NSSC) as a means to ensure nuclear security sustainability in a State. An NSSC's basic purpose is to provide a national focal point for passing ownership of nuclear security knowledge and associated technical skills to the competent authorities involved in nuclear security. It describes processes and methodologies that can be used by a State to analyse the essential elements of information in a manner that allows several aspects of long term, systemic sustainability of nuclear security to be addressed. Processes such as the systematic approach to training, sometimes referred to as instructional system design, are the cornerstone of the NSSC concept. Proper analysis can provide States with data on the number of personnel requiring training and instructors needed, scale and scope of training, technical and scientific support venues, and details on the type and number of training aids or simulators required so that operational systems are not compromised in any way. Specific regulatory guidance, equipment or technology lists, or specifications/design of protection systems are not included in this publication. For such details, the following IAEA publications should be consulted

  8. "Getting Practical" and the National Network of Science Learning Centres

    Science.gov (United States)

    Chapman, Georgina; Langley, Mark; Skilling, Gus; Walker, John

    2011-01-01

    The national network of Science Learning Centres is a co-ordinating partner in the Getting Practical--Improving Practical Work in Science programme. The principle of training provision for the "Getting Practical" programme is a cascade model. Regional trainers employed by the national network of Science Learning Centres trained the cohort of local…

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

    Science.gov (United States)

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

    2012-04-01

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

  10. Engaging nurses in genetics: the strategic approach of the NHS National Genetics Education and Development Centre.

    Science.gov (United States)

    Kirk, Maggie; Tonkin, Emma; Burke, Sarah

    2008-04-01

    The UK government announced the establishment of an NHS National Genetics Education and Development Centre in its Genetics White Paper. The Centre aims to lead and coordinate developments to enhance genetics literacy of health professionals. The nursing program takes a strategic approach based on Ajzen's Theory of Planned Behavior, using the UK nursing genetics competences as the platform for development. The program team uses innovative approaches to raise awareness of the relevance of genetics, working collaboratively with policy stakeholders, as key agents of change in promoting competence. Providing practical help in preparing learning and teaching resources lends further encouragement. Evaluation of the program is dependent on gathering baseline data, and the program has been informed by an education needs analysis. The challenges faced are substantial and necessitate international collaboration where expertise and resources can be shared to produce a global system of influence to facilitate the engagement of non-genetic nurses.

  11. 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.

  12. An audit to assess awareness and knowledge of nutrition in a UK spinal cord injuries centre.

    Science.gov (United States)

    Wong, S; Derry, F; Graham, A; Grimble, G; Forbes, A

    2012-06-01

    A single centre survey. To test: (i) awareness of nutrition screening tools and related care plans and; (ii) nutrition knowledge of doctors, nurses and dietitians working in spinal cord injuries (SCI) centres. The 14-item questionnaire was sent to 102 nurses, 17 doctors and 15 dietitians working in UK SCI centres during January-March 2010. Sixty-two (46.5%) questionnaires were completed and returned for analysis. The present audit demonstrated that awareness of the need for nutritional screening is good: 83% of staff reported that they are aware there is a nutrition screening tool. This audit also demonstrated areas of poor knowledge, such as calorie content of intravenous fluids, indicators of malnutrition, and choice of nutritional support in malnourished patients. All doctors, but only 38% of nurses, knew how to calculate body mass index. Surprisingly, nearly half (49%) of the participants thought that at least 20% weight loss was required to indicate malnutrition. This high-perceived cut-off point suggests that malnutrition is likely to continue to be undetected and unmanaged. The overall scores (median) showed clear differences in nutritional knowledge between groups (median: dietitians 92.8%; doctors 53.5%; nurses 35.7; Pnutrition. This study highlights the need for further education in SCI medicine in order to improve the efficacy of feeding and nutrition therapy for SCI patients.

  13. 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.

  14. Impact of the introduction of weekly radiotherapy quality assurance meetings at one UK cancer centre

    Science.gov (United States)

    Brammer, C V; Allerton, R; Churn, M; Joseph, M; Koh, P; Sayers, I; King, M

    2014-01-01

    Objective: The complexity of radiotherapy planning is increasing rapidly. Delivery and planning is subject to detailed quality assurance (QA) checks. The weakest link is often the oncologists' delineation of the clinical target volume (CTV). Weekly departmental meetings for radiotherapy QA (RTQA) were introduced into the Royal Wolverhampton Hospital, Wolverhampton, UK, in October 2011. This article describes the impact of this on patient care. Methods: CTVs for megavoltage photon radiotherapy courses for all radical, adjuvant and palliative treatments longer than five fractions (with the exception of two field tangential breast treatments not enrolled into clinical trials) were reviewed in the RTQA meeting. Audits were carried out in January 2012 (baseline) and September 2013, each over a 4-week period. Adherence to departmental contouring protocols was assessed and the number of major and minor alterations following peer review were determined. Results: There was no statistically significant difference for major alterations between the two study groups; 8 alterations in 80 patients (10%) for the baseline audit vs 3 alterations from 72 patients (4.2%) in the second audit (p = 0.17). A trend towards a reduction in alterations following peer review was observed. There has, however, been a change in practice resulting in a reduction in variation in CTV definition within our centre and greater adherence to protocols. There is increasing confidence in the quality and constancy of care delivered. Conclusion: Introduction of a weekly QA meeting for target volume definition has facilitated consensus and adoption of departmental clinical guidelines within the unit. Advances in knowledge: The weakest areas in radiotherapy are patient selection and definition of the CTV. Engagement in high-quality RTQA is paramount. This article describes the impact of this in one UK cancer centre. PMID:25251520

  15. 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.

  16. The role of the National Physical Laboratory in monitoring and improving dosimetry in UK radiotherapy

    International Nuclear Information System (INIS)

    Thomas, R.A.S.; Duane, S.; McEwen, M.R.; Rosser, K.E.

    2002-01-01

    In the UK, the National Physical Laboratory, in collaboration with the Institute for Physics and Engineering in Medicine operates an audit programme to ensure national consistency in radiotherapy dosimetry. The present programme covers dosimetry of megavoltage photons and electrons (3-19 MeV) and low and medium energy (10-300 kV) photons. The aim of each audit is to verify the local measurement of absorbed dose at the radiotherapy centre. The audit measurements - principally beam quality and linac output - are made following the same protocol as the clinic but using different equipment. The audit is not an absolute measurement of the absorbed dose but amounts to a check that the equipment used by the centre is operating as expected and that the Code of Practice is being followed correctly. The protocols used in the UK are IPSM 1990 for high-energy photons, IPEMB 1996 for electrons and IPEMB 1996 for low energy photons. For the purpose of these audits, NPL maintains a set of calibrated ionisation chambers

  17. 20th ANNIVERSARY OF THE CHILDREN'S HEALTH AND EXERCISE CENTRE, UNIVERSITY OF EXETER, UK

    Directory of Open Access Journals (Sweden)

    Craig Sharp

    2007-09-01

    Full Text Available 20th ANNIVERSARY OF THE CHILDREN'S HEALTH AND EXERCISE CENTRE, UNIVERSITY OF EXETER, UK In recent years, partly because of the ever-younger exten-sion of high quality sport representation and partly, para-doxically, due to ever-increasing levels of obesity in the young, the discipline of paediatric physiology has moved from being an interesting curiosity to an extremely impor-tant area of practical knowledge. For example, children thermoregulate qualitatively and quantitatively differently from adults - before puberty their sweat rate per square metre of skin is less than half their adult level - and they may well have, proportionate to mass, 40% greater body surface area than an adult. On the musculo-skeletal side, they come late into 'kinetic-balance', into an appropriately economic mode of running or walking, so such effort is harder for them. In many other areas children, especially younger children, differ importantly from adults, and those involved in any aspects of their exercise, sport or medicine should be well aware of this. Hence the impor-tance of the discipline, and hence the reason for a very hearty celebration of the 20th anniversary of the Chil-dren's Health and Exercise Centre (CHERC, which, as is demonstrated here, has pioneered and expanded the entire discipline, as one of the world's leading paediatric labora-tories.To celebrate the 20th anniversary of the Children's Health and Exercise Centre (1987-2007 past and present mem-bers of the centre were invited to contribute a review article on paediatric exercise science. The collection of reviews, written by current and former PhD students, visiting research fellows and professors, visiting interns and current members of CHERC, discusses an array of topics, which have helped shaped the work of our centre. We would also like to take the opportunity to acknowl-edge all those associated with CHERC over the past 20 years, in particular the many children who have partici-pated in our

  18. The National Centre of Systems Reliability and some aspects of its future activities

    International Nuclear Information System (INIS)

    Bourne, A.J.

    1975-01-01

    The National Centre of Systems Reliability (NCSR) has been set up to enhance the work of the Systems Reliability Service (SRS), which during its four years of operation by the UKAEA has offered to industry expertise in the quantification of reliability of systems in various technological applications. An outline is presented of the background to the establishment of the NCSR, including a brief summary of the work of the SRS. Certain aspects of the future activities of the NCSR particularly in relation to research and collaboration with universities are discussed. (U.K.)

  19. Building National Infrastructures for Patient-Centred Digital Services

    DEFF Research Database (Denmark)

    Thorseng, Anne; Jensen, Tina Blegind

    2015-01-01

    Patient-centred digital services are increasingly gaining impact in the healthcare sector. The premise is that patients will be better equipped for taking care of their own health through instant access to relevant information and by enhanced electronic communication with healthcare providers. One...... infrastructure theory, we highlight the enabling and constraining dynamics when designing and building a national infrastructure for patient-centred digital services. Furthermore, we discuss how such infrastructures can accommodate further development of services. The findings show that the Danish national e...

  20. The UK National Prolapse Survey: 10 years on.

    Science.gov (United States)

    Jha, Swati; Cutner, Alfred; Moran, Paul

    2018-06-01

    To assess trends in the surgical management of pelvic organ prolapse (POP) amongst UK practitioners and changes in practice since a previous similar survey. An online questionnaire survey (Typeform Pro) was emailed to British Society of Urogynaecology (BSUG) members. They included urogynaecologists working in tertiary centres, gynaecologists with a designated special interest in urogynaecology and general gynaecologists. The questionnaire included case scenarios encompassing contentious issues in the surgical management of POP and was a revised version of the questionnaire used in the previous surveys. The revised questionnaire included additional questions relating to the use of vaginal mesh and laparoscopic urogynaecology procedures. Of 516 BSUG members emailed, 212 provided completed responses.. For anterior vaginal wall prolapse the procedure of choice was anterior colporrhaphy (92% of respondents). For uterovaginal prolapse the procedure of choice was still vaginal hysterectomy and repair (75%). For posterior vaginal wall prolapse the procedure of choice was posterior colporrhaphy with midline fascial plication (97%). For vault prolapse the procedure of choice was sacrocolpopexy (54%) followed by vaginal wall repair and sacrospinous fixation (41%). The laparoscopic route was preferred for sacrocolpopexy (62% versus 38% for the open procedure). For primary prolapse, vaginal mesh was used by only 1% of respondents in the anterior compartment and by 3% in the posterior compartment. Basic trends in the use of native tissue prolapse surgery remain unchanged. There has been a significant decrease in the use of vaginal mesh for both primary and recurrent prolapse, with increasing use of laparoscopic procedures for prolapse.

  1. Incisional hernia in pediatric surgery - experience at a single UK tertiary centre.

    Science.gov (United States)

    Mullassery, Dhanya; Pedersen, Ami; Robb, Andrew; Smith, Nicola

    2016-11-01

    Incisional hernia (IH) is a recognized complication of open and laparoscopic visceral surgery, with reported rates of 10-50% in adult surgical literature. There is a paucity of data relating to incisional hernias in children. The aim of our study was to analyze the incidence and treatment of IH in children. Retrospective review of all patients admitted for incisional hernia repair at a tertiary pediatric surgical centre in the UK more than a 7-year period was performed. Data collected included age at initial surgery, time to IH repair, and type of IH repair and postoperative complications. Twenty one patients (14 male) underwent IH repair during the study period. The incidence of IH among children who had primary abdominal surgery in our institution less than the age of 6months was 2.3%. Median age at repair was 7.9months (range: 18days-5years). Median time from primary surgery to diagnosis of IH was 2months (range 0day-3years), with 81% (17/21) diagnosed within 1year of the preceding abdominal procedure. The most common pathology necessitating the primary operative procedure was necrotising enterocolitis (n=9) in babies of gestational age less than 30weeks. The highest rates of IH were noted in infants following closure of stoma (7.5%) and pyloromyotomy (2.52%). Primary closure was undertaken in all cases. Two children had recurrence of IH, one of which underwent surgical repair. Incidence of IH in children is low but significant. IH was most commonly diagnosed following closure of stoma for NEC in this study. Copyright © 2016. Published by Elsevier Inc.

  2. The South African National Accelerator Centre and its research programme

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Y. [Kyushu Univ., Fukuoka (Japan)

    1997-03-01

    An overview of the South African National Accelerator Centre and its research activities is given with emphasis on medium energy nuclear physics and nuclear data measurements for medical use. Also presented is a preliminary result of {sup 40}Ca(p,p`x) spectrum measurement for 392 MeV which has been carried out at RCNP, Osaka University, under the South Africa-Japan collaborative programme. (author)

  3. Assessing Quality Outcome Measures in Children with Coeliac Disease—Experience from Two UK Centres

    Science.gov (United States)

    Ross, Alexander; Shelley, Helen; Novell, Kim; Ingham, Elizabeth; Callan, Julia; Heuschkel, Robert; Morris, Mary-Anne; Zilbauer, Matthias

    2013-01-01

    Improved diagnosis of coeliac disease has increased incidence and therefore burden on the health care system. There are no quality outcome measures (QOM) in use nationally to assess hospital management of this condition. This study applied QOM devised by the East of England paediatric gastroenterology network to 99 patients reviewed at two tertiary hospitals in the Network, to assess the quality of care provided by nurse led and doctor led care models. The average performance across all QOM was 96.2% at Addenbrooke’s Hospital (AH), and 98.7% at Norfolk and Norwich Hospital (NNUH), whilst 95% (n = 18) of QOM were met. Patient satisfaction was high at both sites (uptake of questionnaire 53 of 99 patients in the study). The study showed a comparably high level of care delivered by both a nurse and doctor led service. Our quality assessment tools could be applied in the future by other centres to measure standards of care. PMID:24284612

  4. Assessing Quality Outcome Measures in Children with Coeliac Disease—Experience from Two UK Centres

    Directory of Open Access Journals (Sweden)

    Alexander Ross

    2013-11-01

    Full Text Available Improved diagnosis of coeliac disease has increased incidence and therefore burden on the health care system. There are no quality outcome measures (QOM in use nationally to assess hospital management of this condition. This study applied QOM devised by the East of England paediatric gastroenterology network to 99 patients reviewed at two tertiary hospitals in the Network, to assess the quality of care provided by nurse led and doctor led care models. The average performance across all QOM was 96.2% at Addenbrooke’s Hospital (AH, and 98.7% at Norfolk and Norwich Hospital (NNUH, whilst 95% (n = 18 of QOM were met. Patient satisfaction was high at both sites (uptake of questionnaire 53 of 99 patients in the study. The study showed a comparably high level of care delivered by both a nurse and doctor led service. Our quality assessment tools could be applied in the future by other centres to measure standards of care.

  5. Rosatom's Crisis Response Centre within the national nuclear safety system

    International Nuclear Information System (INIS)

    Smirnov, S.N.; Komarovskij, A.V.; Moskalev, V.A.

    2011-01-01

    The Rosatom Corporation includes a number of subsidiaries associated with nuclear energy use as well as with the military, scientific, technological, nuclear and radiation safety management aspects. The Rosatom Corporation has a well-established and efficient industry-wide system of emergency prevention and response, whose purpose is to ensure safe functioning of the nuclear industry, protection of personnel, the public and nature from potential dangers; it is also a functional subsystem of the unified national system of emergency prevention and response. Overall management of the system is performed by Director General of the Rosatom Corporation, overall methodological management - by the Department of Licensing, Nuclear and Radiation Safety; everyday management of the emergency prevention and response system, round-the-clock monitoring and informational support - by the Rosatom Crisis and Response Centre (CRC). CRC acts as the national focal point for warning and communication in Russia, which provides continuous round-the-clock preparedness to cooperate with the IAEA's Incident and Emergency Centre using the formats of the ENATOM international emergency response system, similar national crisis response centres abroad [ru

  6. Virtual colonoscopy training and accreditation: a national survey of radiologist experience and attitudes in the UK

    International Nuclear Information System (INIS)

    Burling, D.; Moore, A.; Taylor, S.; La Porte, S.; Marshall, M.

    2007-01-01

    Aim: Expert consensus recommends directed training and possibly in the future, formal accreditation before independent virtual colonoscopy (VC) reporting. We surveyed radiologists' experience of VC training, compared with barium enema, and assessed attitudes towards accreditation. Materials and methods: A questionnaire was sent to 78 consultant radiologists from 72 centres (65 National Health Service hospitals; seven independent primary screening centres) offering a VC service. Results: Fifty-four (69%) eligible radiologists responded. They had interpreted 18,152 examinations (range 3-1500) in total versus 232,350 (13 times more) barium enemas. Twenty-two (41%) deemed their VC training as inadequate [including five (45%) of screening centre radiologists], and only 14 (26%) had attended a training workshop due to lack of availability (54%) or financial/study leave constraints (24%). Eleven (20%) radiologists routinely double-reported VC examinations versus 37 (69%) barium enemas, yet 21 (39%) considered requirements for VC training were greater than barium enema. Thirty-eight (70%) favoured accreditation beyond internal audit for VC versus 15(28%) for barium enema. Of these 38, seven (18%) favoured 'one-off,' and 18 (47%) periodic testing, with 16 (42%) favouring external audit alone or in combination with testing. Overall, 42 (78%) considered specific accreditation for reporting screening examinations appropriate and 45 (83%) respondents preferred a national radiological organization to regulate such a scheme. Conclusion: There is wide variability in reporting experience and recommendations for VC training have not been widely adopted, in part due to limited access to dedicated workshops. UK radiologists are generally in favour of VC accreditation, governed by a national radiology organization

  7. The UK's National Programme for IT: Why was it dismantled?

    Science.gov (United States)

    Justinia, Taghreed

    2017-02-01

    This paper discusses the UK's National Programme for IT (NPfIT), which was an ambitious programme launched in 2002 with an initial budget of some £6.2 billion. It attempted to implement a top-down digitization of healthcare in England's National Health Service (NHS). The core aim of the NPfIT was to bring the NHS' use of information technology into the 21st century, through the introduction of an integrated electronic patient record systems, and reforming the way that the NHS uses information, and hence to improve services and the quality of patient care. The initiative was not trusted by doctors and appeared to have no impact on patient safety. The project was marred by resistance due to the inappropriateness of a centralized authority making top-down decisions on behalf of local organizations. The NPfIT was officially dismantled in September 2011. Deemed the world's largest civil IT programme, its failure and ultimate demise sparked a lot of interest as to the reasons why. This paper summarises the underlying causes that lead to dismantling the NPfIT. At the forefront of those circumstances were the lack of adequate end user engagement, the absence of a phased change management approach, and underestimating the scale of the project.

  8. Specialist perioperative allergy clinic services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project.

    Science.gov (United States)

    Egner, W; Cook, T; Harper, N; Garcez, T; Marinho, S; Kong, K L; Nasser, S; Thomas, M; Warner, A; Hitchman, J; Floss, K

    2017-10-01

    Guidelines for investigation of perioperative drug allergy exist, but the quality of services is unknown. Specialist perioperative anaphylaxis services were surveyed through the Royal College of Anaesthetists 6 th National Audit Project. We compare self-declared UK practice in specialist perioperative allergy services with national recommendations. A SurveyMonkey™ questionnaire was distributed to providers of allergy services in the UK. Responses were assessed for adherence to the best practice recommendations of the British Society for Allergy and Clinical Immunology (BSACI), the Association of Anaesthetists of Great Britain and Ireland and the National Institute for Health and Care Excellence (NICE) Guidance on Drug Allergy-CG183. Over 1200 patients were evaluated in 44 centres annually. Variation in workload, waiting times, access, staffing and diagnostic approach was noted. Paediatric centres had the longest routine waiting times (most wait >13 weeks) in contrast to adult centres (most wait specialist nurses and 18/44 (41%) an anaesthetist] and provision of information [18/44 (41%) gave immediate information in clinic and 5/44 (11%) sign-posted support groups]. Most centres were able to provide diagnostic challenges to antibiotics [40/44 (91%]) and local anaesthetics [41/44 (93%)]. Diagnostic testing is not harmonized, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres. Poor access to services and patient information provision require attention. Harmonization of diagnostic approach is desirable, particularly with regard to a minimum NMBA panel for identification of safe alternatives. © 2017 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2018-02-27

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

  10. Much of the variation in breast pathology quality assurance data in the UK can be explained by the random order in which cases arrive at individual centres, but some true outliers do exist.

    Science.gov (United States)

    Cross, Simon S; Stephenson, Timothy J; Harrison, Robert F

    2011-10-01

    To investigate the role of random temporal order of patient arrival at screening centres in the variability seen in rates of node positivity and breast cancer grade between centres in the NHS Breast Screening Programme. Computer simulations were performed of the variation in node positivity and breast cancer grade with the random temporal arrival of patients at screening centres based on national UK audit data. Cumulative mean graphs of these data were plotted. Confidence intervals for the parameters were generated, using the binomial distribution. UK audit data were plotted on these control limit graphs. The results showed that much of the variability in the audit data could be accounted for by the effects of random order of arrival of cases at the screening centres. Confidence intervals of 99.7% identified true outliers in the data. Much of the variation in breast pathology quality assurance data in the UK can be explained by the random order in which cases arrive at individual centres. Control charts with confidence intervals of 99.7% plotted against the number of reported cases are useful tools for identification of true outliers. 2011 Blackwell Publishing Limited.

  11. Audit of the use of IVC filters in the UK: experience from three centres over 12 years

    Energy Technology Data Exchange (ETDEWEB)

    Hammond, C.J. [Leeds General Infirmary, Leeds (United Kingdom)], E-mail: chris.hammond@doctors.org.uk; Bakshi, D.R. [Royal Liverpool University Hospital, Liverpool (United Kingdom); Currie, R.J. [Royal Devon and Exeter Hospital, Exeter (United Kingdom); Patel, J.V. [Leeds General Infirmary, Leeds (United Kingdom); Kinsella, D. [Royal Devon and Exeter Hospital, Exeter (United Kingdom); McWilliams, R.G. [Royal Liverpool University Hospital, Liverpool (United Kingdom); Watkinson, A. [Royal Devon and Exeter Hospital, Exeter (United Kingdom); Nicholson, A.A. [Leeds General Infirmary, Leeds (United Kingdom)

    2009-05-15

    Aim: To audit the use of inferior vena cava (IVC) filter insertions at three UK centres over 12 years to assess whether trends in filter use in the UK mirrored those seen elsewhere. Materials and methods: Radiology department databases were interrogated for IVC filter insertions and removals between 1994 and 2006. Reports for these interventions, along with prior and subsequent imaging reports, were analysed. Follow-up data were obtained when available. Results: Five hundred and sixteen filters were placed with a significant year-on-year trend towards increasing use. Fifty-seven percent of filters placed were for absolute indications and 37% for relative indications. The filters were used for prophylaxis in 6% of patients in the absence of proven pulmonary embolism (PE) or deep vein thrombosis (DVT). A retrievable filter was used in 74% of cases with retrieval attempted in 40% of these and no evidence of an increasing rate of retrieval over time. A significant complication related to insertion or retrieval was encountered in 0.4 and 1% of procedures, respectively. Mean 24 h and 30 day mortalities were 1 and 8%, respectively. There was an absence of organized follow-up at all three centres. Conclusion: IVC filter use in the UK is increasing. The use of retrievable filters has not resulted in increased filter retrieval. Filter insertion and retrieval is associated with a low risk of significant complication, but lack of systematic follow-up limits conclusions regarding safety and efficacy.

  12. Resource variation in colorectal surgery: a national centre level analysis.

    Science.gov (United States)

    Drake, T M; Lee, M J; Senapati, A; Brown, S R

    2017-07-01

    Delivery of quality colorectal surgery requires adequate resources. We set out to assess the relationship between resources and outcomes in English colorectal units. Data were extracted from the Association of Coloproctology of Great Britain and Ireland resource questionnaire to profile resources. This was correlated with Hospital Episode Statistics outcome data including 90-day mortality and readmissions. Patient satisfaction measures were extracted from the Cancer Experience Patient Survey and compared at unit level. Centres were divided by workload into low, middle and top tertile. Completed questionnaires were received from 75 centres in England. Service resources were similar between low and top tertiles in access to Confidential Enquiry into Patient Outcome and Death (CEPOD) theatre, level two or three beds per 250 000 population or the likelihood of having a dedicated colorectal ward. There was no difference in staffing levels per 250 000 unit of population. Each 10% increase in the proportion of cases attempted laparoscopically was associated with reduced 90-day unplanned readmission (relative risk 0.94, 95% CI 0.91-0.97, P colorectal ward (relative risk 0.85, 95% CI 0.73-0.99, P = 0.040) was also associated with a significant reduction in unplanned readmissions. There was no association between staffing or service factors and patient satisfaction. Resource levels do not vary based on unit of population. There is benefit associated with increased use of laparoscopy and a dedicated surgical ward. Alternative measures to assess the relationship between resources and outcome, such as failure to rescue, should be explored in UK practice. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  13. Proposed medical applications of the National Accelerator Centre facilities

    International Nuclear Information System (INIS)

    Jones, D.T.L.

    1982-01-01

    The National Accelerator Centre is at present under construction at Faure, near Cape Town. The complex will house a 200 MeV separated-sector cyclotron which will provide high quality beams for nuclear physics and related diciplines as well as high intensity beams for medical use. The medical aspects catered for will include particle radiotherapy, isotope production and possibly proton radiography. A 30-bed hospital is to be constructed on the site. Building operations are well advanced and the medical facilities should be available for use by the end of 1984

  14. The role of the national physical laboratory in monitoring and improving dosimetry in UK radiotherapy

    International Nuclear Information System (INIS)

    McEwen, M.R.; Duane, S.; Thomas, R.A.S.; Rosser, K.E.

    2001-01-01

    There are approximately 60 radiotherapy centres in the UK. In 1999, these centres carried out over 102,000 treatments in 1.2 million fractions. These centres are organised by IPEM into eight geographical regions for the purpose of inter-departmental audits, which have been carried out on a regular basis to check the uniformity of dosimetry, treatment planning, record keeping, etc. Thwaites et al (1992) carried out a dosimetric intercomparison of megavoltage photon beams in all UK radiotherapy centres obtaining a mean value for the ratio audit/local dose of 1.003 with a standard deviation of 1.5%. The present programme covers dosimetry of megavoltage photons and electrons and low and medium energy (10-300 kV) photons. Megavoltage photon audits have the longest history, while electron audits began in 2000 and kV audits are only at the pilot stage

  15. The CTBT National Data Centre: Roles And Functions

    International Nuclear Information System (INIS)

    Faisal Izwan Abdul Rashid; Noriah Jamal; Mohd Azmi Sidid Omar; Azlinda Aziz

    2013-01-01

    Following the signature of the Comprehensive Nuclear-Test-Ban Treaty (CTBT) on 23 July 1998, Malaysian Nuclear Agency (Nuclear Malaysia) was designated as the CTBT National Authority in Malaysia. Subsequently, Malaysia ratified the treaty on 17 January 2008. Following the ratification, a CTBT National Data Centre (CTBT-NDC) was established at Nuclear Malaysia. The objective of this paper is to elaborate the unique roles and functions of CTBT-NDC which provide technical support to the CTBT National Authority in carrying out its roles under CTBT as well as promoting the uses of International Monitoring System (IMS) data and International Data Centre (IDC) products for civil and scientific applications. With regards to the verification of events suspected to be a nuclear weapon test, CTBT-NDC performs waveform data analysis using IMS data and IDC products produced by IDC in order to verify the nature of such event. The waveform data analysis could include seismic, hydro acoustic and infra sound data. In addition, an atmospheric transport modeling on possible release of radionuclide particles originated from the nuclear weapon test location is also performed to forecast the global dispersion of radionuclide smoke. The findings from these analyses will be used as technical advice to the CTBT National Authority. Apart from verification purposes, CTBT-NDC also promotes the benefits of IMS data and IDC products for civil and scientific applications such as earth studies, improvement of disaster management and etc. In summary, CTBT NDC plays a unique role in supporting CTBT National Authority to carried out its functions under CTBT as well as promote the full use of IMS data and IDC products for civil and scientific applications. (author)

  16. Social marketing ethics: report prepared for the National Social Marketing Centre

    OpenAIRE

    Eagle, L.; National Social Marketing Centre

    2009-01-01

    This report has been developed by Professor Lynn Eagle from the Bristol Social Marketing Centre, Bristol Business School University of West of England with contributions from\\ud staff at the National Social Marketing Centre.

  17. Constructing a National Higher Education Brand for the UK: Positional Competition and Promised Capitals

    Science.gov (United States)

    Lomer, Sylvie; Papatsiba, Vassiliki; Naidoo, Rajani

    2018-01-01

    This article examines national branding of UK higher education, a strategic intent and action to collectively brand UK higher education with the aim to attract prospective international students, using a Bourdieusian approach to understanding promises of capitals. We trace its development between 1999 and 2014 through a sociological study, one of…

  18. An analysis of two separate quality audits in UK radiotherapy centres

    International Nuclear Information System (INIS)

    Aird, E G A

    1995-01-01

    The CHART quality assurance programme has been used to audit 2 groups of radiotherapy centres for the delivery of radiotherapy: 1. those involved in the CHART Clinical Trial (1991-1995) 2. all London radiotherapy centres (1994-1996) Machinery Tests This paper will seek to illustrate improvements in meeting the criteria set by the QA programme as older linear accelerators are replaced. Phantom Tests The residual errors between measured and calculated doses in anatomical phantoms will be analysed to demonstrate where there are still weaknesses in treatment planning and delivery of radiotherapy

  19. 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

  20. Regional Centres for Space Science and Technology Education and ICG Information Centres affiliated to the United Nations

    Science.gov (United States)

    Gadimova, S.; Haubold, H. J.

    2009-06-01

    Based on resolutions of the United Nations General Assembly, Regional Centres for Space Science and Technology Education were established in India, Morocco, Nigeria, Brazil and Mexico. Simultaneously, education curricula were developed for the core disciplines of remote sensing, satellite communications, satellite meteorology, and space and atmospheric science. This paper provides a brief summary on the status of the operation of the regional centres with a view to use them as information centres of the International Committee on Global Navigation Satellite Systems (ICG), and draws attention to their educational activities.

  1. 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.

  2. Seismological investigation of the National Data Centre Preparedness Exercise 2013

    Science.gov (United States)

    Gestermann, Nicolai; Hartmann, Gernot; Ross, J. Ole; Ceranna, Lars

    2015-04-01

    The Comprehensive Nuclear-Test-Ban Treaty (CTBT) prohibits all kinds of nuclear explosions conducted on Earth - underground, underwater or in the atmosphere. The verification regime of the CTBT is designed to detect any treaty violation. While the data of the International Monitoring System (IMS) is collected, processed and technically analyzed at the International Data Centre (IDC) of the CTBT-Organization, National Data Centres (NDC) of the member states provide interpretation and advice to their government concerning suspicious detections. The NDC Preparedness Exercises (NPE) are regularly performed dealing with fictitious treaty violations to practice the combined analysis of CTBT verification technologies. These exercises should help to evaluate the effectiveness of analysis procedures applied at NDCs and the quality, completeness and usefulness of IDC products for example. The exercise trigger of NPE2013 is a combination of a tempo-spatial indication pointing to a certain waveform event and simulated radionuclide concentrations generated by forward Atmospheric Transport Modelling based on a fictitious release. For the waveform event the date (4 Sept. 2013) is given and the region is communicated in a map showing the fictitious state of "Frisia" at the Coast of the North Sea in Central Europe. The potential connection between the waveform and radionuclide evidence remains unclear for exercise participants. The verification task was to identify the waveform event and to investigate potential sources of the radionuclide findings. The final question was whether the findings are CTBT relevant and justify a request for On-Site-Inspection in "Frisia". The seismic event was not included in the Reviewed Event Bulletin (REB) of the IDC. The available detections from the closest seismic IMS stations lead to a epicenter accuracy of about 24 km which is not sufficient to specify the 1000 km2 inspection area in case of an OSI. With use of data from local stations and

  3. UK National Survey of Practice Patterns of Fluid Volume Management in Haemodialysis Patients: A Need for Evidence.

    Science.gov (United States)

    Dasgupta, Indranil; Farrington, Ken; Davies, Simon J; Davenport, Andrew; Mitra, Sandip

    2016-01-01

    Fluid management in haemodialysis (HD) affects patient experience, morbidity and mortality. Standards for best practice are lacking. A national survey of the United Kingdom was undertaken to define prevalent practice. An online questionnaire was distributed to all UK renal centres. Forty-five of 74 centres (173 dialysis units), serving 62% (n = 14,697) of UK HD population responded. Seventy-eight per cent had no agreed policy for managing fluid balance in patients on HD; 44% did not assess fluid status routinely. Clinical assessment was the norm; 27% used bio-impedance-based device. To achieve a target-weight, 53% reduced weight as far as tolerated. Twenty-two per cent measured residual renal function (RRF). Ninety-one per cent had no policy for fluid overload. Sixty-four per cent restricted salt and water. Ninety-three per cent used diuretics in patients with RRF. Thirty-eight per cent felt management was adequate; 77% felt there was a need for better evidence. Ninety-one per cent would participate in a study addressing this. There is an urgent need for establishing an evidence base on the optimal approaches to fluid management. © 2016 S. Karger AG, Basel.

  4. [The National Reference Centres and Reference Laboratories. Importance and tasks].

    Science.gov (United States)

    Laude, G; Ammon, A

    2005-09-01

    Since 1995, the German Federal Ministry for Health and Social Security funds National Reference Centres (NRC) for the laboratory surveillance of important pathogens and syndromes. Which pathogens or syndromes are selected to be covered by a NRC depends on their epidemiological relevance, the special diagnostic tools, problems with antimicrobial resistance and necessary infection control measures. Currently, there are 15 NRC, which are appointed for a period of 3 years (currently from January 2005 through December 2007). Towards the end of their appointment all NRC are evaluated by a group of specialists. The assessment of their achievements is guided by a catalogue of tasks for the NRC. In addition to the NRC, a total of 50 laboratories are appointed which provide specialist expertise for additional pathogens in order to have a broad range of pathogens for which specialist laboratories are available. Their predominant task is to give advice and support for special diagnostic problems. Both NRC and the specialist laboratories are important parts of the network for infectious disease epidemiology.

  5. National audit of radioactivity measurements in Nuclear Medicine Centres

    International Nuclear Information System (INIS)

    Ravindra, Anuradha; Kulkarni, D.B.; Joseph, Leena; Babu, D.A.R.

    2014-01-01

    Routine activity measurements of radiopharmaceutical solutions in Nuclear Medicine Centres (NMC) are carried out with the help of radionuclide calibrators (RC). These solutions are either ingested or injected to the patient for diagnosis or therapy. However, for the realization of an optimized examination, the activity of these radiopharmaceuticals must be determined accurately before administering it to patients. The primary standards are maintained by Radiation Standards Section, Radiological Physics and Advisory Division. National audit programmes of Iodine -131 activity measurements with RCs are conducted biannually to establish traceability to national standards and to check the status of nuclear medicine practice followed at the NMC. The results of fifteenth audit of 131 I activity measurements with RC are presented in this paper. Questionnaires were sent to two hundred and thirty three NMCs in-the country. One hundred and nine NMC's agreed for participation and accordingly, glass vials containing radioactive 131 I solution of nominal activity of 100 MBq were procured from Board of Radiation and Isotope Technology, Mumbai. The radioactivity in each vial was determined with high pressure re-entrant gamma ionisation chamber (GIC), a secondary standard maintained by this laboratory. The sensitivity coefficient of GIC is traceable to the primary standard. The standardized radioactive solution of 131 I in glass vial was sent to each participant. Measurements results were reported in the reporting form sent. This audit was conducted in four schedules in Jan 2013. One hundred and sixty six results were received from one hundred and nine participants as many participants took measurements on more than one isotope calibrator

  6. Physiotherapy and occupational therapy for juvenile chronic arthritis: custom and practice in five centres in the UK, USA and Canada.

    Science.gov (United States)

    Hackett, J; Johnson, B; Parkin, A; Southwood, T

    1996-07-01

    Physiotherapy and occupational therapy are widely accepted as being of central importance for the treatment of juvenile chronic arthritis (JCA). However, these approaches have rarely been subject to critical scrutiny. The aims of this report are to highlight some of the inter-centre similarities and differences observed in the implementation of physical and occupational therapy for JCA, and to emphasize the need for scientifically controlled research in this area. During a series of visits to several paediatric rheumatology units in the UK, USA and Canada, three aspects of the service were noted: treatment philosophy, physical interventions used for the treatment of JCA and quality-of-life and independence training activities. There was general consensus with the philosophy that early physical intervention was a vital part of the treatment plan for JCA, although all therapists were concerned that compliance with treatment modalities was poor. Differences between units in the approach to acute arthritis, the use of foot orthoses and wrist splints, the treatment of joint contractures and the use of general quality-of-life training activities were noted. Although it was widely recognized that controlled research into the efficacy of physical intervention was needed, no centre had a co-ordinated plan for such investigations.

  7. A national benchmarking survey of student counselling centres/units ...

    African Journals Online (AJOL)

    The present study further found that the majority of counselling centres/units had one or more staff members with specialised training in areas such as HIV/AIDS counselling, sexual abuse counselling and multicultural counselling. In 2007, these counselling centres/units saw on average 18 per cent of enrolled students as ...

  8. National Student Feedback Surveys in Distance Education: An Investigation at the UK Open University

    Science.gov (United States)

    Ashby, Alison; Richardson, John T. E.; Woodley, Alan

    2011-01-01

    National student feedback surveys are administered in a number of countries, and several of these encompass both campus-based and distance learning students. The UK Open University achieves a high ranking in the annual National Student Survey (NSS), but there are some anomalies in the results. The NSS questionnaire was administered to three…

  9. Should we Investigate Gastroenterology Patients for Pancreatic Exocrine Insufficiency? A Dual Centre UK Study.

    Science.gov (United States)

    Campbell, Jennifer A; Sanders, David S; Francis, Katherine A; Kurien, Matthew; Lee, Sai; Taha, Hatim; Ramadas, Arvind; Joy, Diamond; Hopper, Andrew D

    2016-09-01

    Pancreatic exocrine insufficiency may be under recognised in gastroenterological practice. We aimed to identify the prevalence of pancreatic insufficiency in secondary care gastroenterology clinics and determine if co-morbidity or presenting symptoms could predict diagnosis. A secondary aim was to assess response to treatment. A dual centre retrospective analysis was conducted in secondary care gastroenterology clinics. Patients tested for pancreatic exocrine insufficiency with faecal elastase-1 (FEL-1) between 2009 and 2013 were identified in two centres. Demographics, indication and co-morbidities were recorded in addition to dose and response to pancreatic enzyme replacement therapy. Binary logistic regression was used to assess if symptoms or co-morbidities could predict pancreatic insufficiency. 1821 patients were tested, 13.1% had low FEL-1 (<200µg/g). This prevalence was sub-analysed with 5.4% having FEL-1 100-200µg/g (mild insufficiency) and 7.6% having faecal elastase readings <100µg/g. Low FEL-1 was most significantly associated with weight loss or steatorrhoea. Co-morbidity analysis showed that low levels were significantly associated with excess alcohol intake, diabetes mellitus or human immunodeficiency virus; 80.0% treated with enzyme supplements reported symptomatic benefit with no difference in response between high and low dose supplementation (p=0.761). Targeting the use of FEL-1 in individuals with specific symptoms and associated conditions can lead to improved recognition of pancreatic exocrine insufficiency in a significant proportion of secondary care patients. Intervening with lifestyle advice such as smoking cessation and minimising alcohol intake could improve outcomes. In addition, up to 80% of patients with low faecal elastase respond to supplementation.

  10. UK national guidelines on the management of syphilis 2015.

    Science.gov (United States)

    Kingston, M; French, P; Higgins, S; McQuillan, O; Sukthankar, A; Stott, C; McBrien, B; Tipple, C; Turner, A; Sullivan, A K; Radcliffe, Keith; Cousins, Darren; FitzGerald, Mark; Fisher, Martin; Grover, Deepa; Higgins, Stephen; Kingston, Margaret; Rayment, Michael; Sullivan, Ann

    2016-05-01

    These guidelines are an update for 2015 of the 2008 UK guidelines for the management of syphilis. The writing group have piloted the new BASHH guideline methodology, notably using the GRADE system for assessing evidence and making recommendations. We have made significant changes to the recommendations for screening infants born to mothers with positive syphilis serology and to facilitate accurate and timely communication between the teams caring for mother and baby we have developed a birth plan. Procaine penicillin is now an alternative, not preferred treatment, for all stages of syphilis except neurosyphilis, but the length of treatment for this is shortened. Other changes are summarised at the start of the guideline. © The Author(s) 2016.

  11. Injuries among talented young dancers: findings from the U.K. Centres for Advanced Training.

    Science.gov (United States)

    Steinberg, N; Aujla, I; Zeev, A; Redding, E

    2014-03-01

    The aim of the present study was to characterize the injuries of young dancers attending Centres for Advanced Training. 806 dancers, ages 10-18 years responded to surveys regarding their biological profile, dance experience and injury history, and were examined for their anthropometric profile. Of the 806 dancers, 347 reported an injury. Based on 4 age groups, the total hours of practice per week increased significantly with increasing age. Incidence of injuries per 1000 h of dance practice for dancers ages 11-12 were found to be significantly higher compared to the incidence for dancers ages 13-18 (p<0.05). Foot and ankle and other lower extremities were the most common injury location, and muscle injuries were the most common type of injury. Total months in CAT training (OR=1.044, 95% CI=1.014-1.075) and hours per week in creative style practice (OR=1.282, 95% CI=1.068-1.539) were found to be significantly associated with injuries. In conclusion, both young and mature dancers are exposed to extensive risk of injury. The intensity of training (such as number of months and number of hours of training per week) is important factor that should be taken into account in order to decrease future injuries among young dancers. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Addiction research centres and the nurturing of creativity: National Drug Dependence Treatment Centre, India--a profile.

    Science.gov (United States)

    Ray, Rajat; Dhawan, Anju; Chopra, Anita

    2013-10-01

    The National Drug Dependence Treatment Centre (NDDTC) is a part of the All India Institute of Medical Sciences, a premier autonomous medical university in India. This article provides an account of its origin and its contribution to the field of substance use disorder at the national and international levels. Since its establishment, the NDDTC has played a major role in the development of various replicable models of care, the training of post-graduate students of psychiatry, research, policy development and planning. An assessment of the magnitude of drug abuse in India began in the early 1990s and this was followed by a National Survey on Extent, Patterns and Trends of Drug Abuse in 2004. Several models of clinical care have been developed for population subgroups in diverse settings. The centre played an important role in producing data and resource material which helped to scale up opioid substitution treatment in India. A nationwide database on the profile of patients seeking treatment (Drug Abuse Monitoring System) at government drug treatment centres has also been created. The centre has provided valuable inputs for the Government of India's programme planning. Besides clinical studies, research has also focused on pre-clinical studies. Capacity-building is an important priority, with training curricula and resource material being developed for doctors and paramedical staff. Many of these training programmes are conducted in collaboration with other institutions in the country. The NDDTC has received funding from several national and international organizations for research and scientific meetings, and, most recently (2012), it has been designated as a World Health Organization Collaborating Centre on Substance Abuse. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  13. Organ Preservation Using Contact Radiotherapy for Early Rectal Cancer: Outcomes of Patients Treated at a Single Centre in the UK.

    Science.gov (United States)

    Dhadda, A S; Martin, A; Killeen, S; Hunter, I A

    2017-03-01

    Contact radiotherapy for early rectal cancer uses 50 kV X-rays to treat rectal cancers under direct vision. We present data of a series of patients treated at a single centre with prospective follow-up and functional assessment. All patients were treated at the Queen's Centre for Oncology, Hull, UK between September 2011 and October 2015. Patients received a biopsy, magnetic resonance imaging (MRI) of the liver/pelvis, computed tomography of the chest and endorectal ultrasound. Patients were deemed to be either unfit for radical surgery or refused it due to the need for a permanent stoma. Follow-up consisted of 3 monthly flexible sigmoidoscopy and MRI of the liver/pelvis and 12 monthly computed tomography of the chest. In total, 42 patients were treated with contact radiotherapy ± external beam chemo/radiotherapy without any primary surgical excision. The median age was 78 years (range 50-94 years). Local recurrence-free survival was 88%, disease-free survival was 86% and overall survival was 88% with a median follow-up of 24 months (range 5-54 months). The median time to recurrence was 12 months (range 4-14 months). The estimated 30 day surgical mortality for this cohort with radical surgery was 12%. Mortality from the contact radiotherapy procedure was 0%. Functional outcomes as investigated by the Low Anterior Resection Syndrome (LARS) score were good, with 65% having no LARS. Contact radiotherapy for early rectal cancer is a safe, well-tolerated outpatient procedure, allowing organ preservation, with excellent oncological and functional outcomes. For elderly co-morbid patients with suitable rectal cancers this should be considered as a standard of care. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  14. Literacy: State of the Nation--A Picture of Literacy in the UK Today

    Science.gov (United States)

    Jama, Deeqa; Dugdale, George

    2012-01-01

    Literacy is the combination of reading, writing, speaking and listening skills we all need to fulfil our potential. These life skills are essential to the happiness, health and wealth of individuals and society. "Literacy: State of the Nation" provides a coherent picture of literacy in the UK today. It reveals that: (1) One in six people…

  15. A New Measurement and Ranking System for the UK National Student Survey

    Science.gov (United States)

    Canning, John

    2015-01-01

    Despite numerous criticisms of the UK National Student Survey (NSS) institutional managers still strongly support its use in informing student choice, quality and assurance and quality enhancement activities. This article outlines a granular and nuanced benchmarking system for the NSS which provides both a "raw" score (weighted student…

  16. Credentialism, National Targets, and the Learning Society: Perspectives on Educational Attainment in the UK Steel Industry.

    Science.gov (United States)

    Fuller, Alison; Unwin, Lorna

    1999-01-01

    The UK's National Learning Targets for Education and Training, embracing 11- to 21-year-olds, adults, and employers, promote a credentialist approach to economic and social development. This article shows how the steel industry measures up. Using qualifications-based targets as a proxy for adult workforce capability is misguided. (Contains 40…

  17. Current practice and recommendations in UK epilepsy monitoring units. Report of a national survey and workshop.

    Science.gov (United States)

    Hamandi, Khalid; Beniczky, Sandor; Diehl, Beate; Kandler, Rosalind H; Pressler, Ronit M; Sen, Arjune; Solomon, Juliet; Walker, Matthew C; Bagary, Manny

    2017-08-01

    Inpatient video-EEG monitoring (VEM) is an important investigation in patients with seizures or blackouts, and in the pre-surgical workup of patients with epilepsy. There has been an expansion in the number of Epilepsy Monitoring Units (EMU) in the UK offering VEM with a necessary increase in attention on quality and safety. Previous surveys have shown variation across centres on issues including consent and patient monitoring. In an effort to bring together healthcare professionals in the UK managing patients on EMU, we conducted an online survey of current VEM practice and held a one-day workshop convened under the auspices of the British Chapter of the ILAE. The survey and workshop aimed to cover all aspects of VEM, including pre-admission, consent procedures, patient safety, drug reduction and reinstatement, seizure management, staffing levels, ictal testing and good data recording practice. This paper reports on the findings of the survey, the workshop presentations and workshop discussions. 32 centres took part in the survey and there were representatives from 22 centres at the workshop. There was variation in protocols, procedures and consent processes between units, and levels of observation of monitored patients. Nevertheless, the workshop discussion found broad areas of agreement on points. A survey and workshop of UK epilepsy monitoring units found that some variability in practice is inevitable due to different local arrangements and patient groups under investigation. However, there were areas of clear consensus particularly in relation to consent and patient safety that can be applied to most units and form a basis for setting minimum standards. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  18. Performance of the ocean state forecast system at Indian National Centre for Ocean Information Services

    Digital Repository Service at National Institute of Oceanography (India)

    Nair, T.M.B.; Sirisha, P.; Sandhya, K.G.; Srinivas, K.; SanilKumar, V.; Sabique, L.; Nherakkol, A.; KrishnaPrasad, B.; RakhiKumari; Jeyakumar, C.; Kaviyazhahu, K.; RameshKumar, M.; Harikumar, R.; Shenoi, S.S.C.; Nayak, S.

    The reliability of the operational Ocean State Forecast system at the Indian National Centre for Ocean Information Services (INCOIS) during tropical cyclones that affect the coastline of India is described in this article. The performance...

  19. A multi-centre study of interactional style in nurse specialist- and physician-led Rheumatology clinics in the UK.

    Science.gov (United States)

    Vinall-Collier, Karen; Madill, Anna; Firth, Jill

    2016-07-01

    Nurse-led care is well established in Rheumatology in the UK and provides follow-up care to people with inflammatory arthritis including treatment, monitoring, patient education and psychosocial support. The aim of this study is to compare and contrast interactional style with patients in physician-led and nurse-led Rheumatology clinics. A multi-centre mixed methods approach was adopted. Nine UK Rheumatology out-patient clinics were observed and audio-recorded May 2009-April 2010. Eighteen practitioners agreed to participate in clinic audio-recordings, researcher observations, and note-taking. Of 9 nurse specialists, 8 were female and 5 of 9 physicians were female. Eight practitioners in each group took part in audio-recorded post-clinic interviews. All patients on the clinic list for those practitioners were invited to participate and 107 were consented and observed. In the nurse specialist cohort 46% were female; 71% had a diagnosis of Rheumatoid Arthritis (RA). The physician cohort comprised 31% female; 40% with RA and 16% unconfirmed diagnosis. Nineteen (18%) of the patients observed were approached for an audio-recorded telephone interview and 15 participated (4 male, 11 female). Forty-four nurse specialist and 63 physician consultations with patients were recorded. Roter's Interactional Analysis System (RIAS) was used to code this data. Thirty-one semi-structured interviews were conducted (16 practitioner, 15 patients) within 24h of observed consultations and were analyzed using thematic analysis. RIAS results illuminated differences between practitioners that can be classified as 'socio-emotional' versus 'task-focussed'. Specifically, nurse specialists and their patients engaged significantly more in the socio-emotional activity of 'building a relationship'. Across practitioners, the greatest proportion of 'patient initiations' were in 'giving medical information' and reflected what patients wanted the practitioner to know rather than giving insight into

  20. Magnetic imaging: a new tool for UK national nuclear security.

    Science.gov (United States)

    Darrer, Brendan J; Watson, Joe C; Bartlett, Paul; Renzoni, Ferruccio

    2015-01-22

    Combating illicit trafficking of Special Nuclear Material may require the ability to image through electromagnetic shields. This is the case when the trafficking involves cargo containers. Thus, suitable detection techniques are required to penetrate a ferromagnetic enclosure. The present study considers techniques that employ an electromagnetic based principle of detection. It is generally assumed that a ferromagnetic metallic enclosure will effectively act as a Faraday cage to electromagnetic radiation and therefore screen any form of interrogating electromagnetic radiation from penetrating, thus denying the detection of any eventual hidden material. In contrast, we demonstrate that it is actually possible to capture magnetic images of a conductive object through a set of metallic ferromagnetic enclosures. This validates electromagnetic interrogation techniques as a potential detection tool for National Nuclear Security applications.

  1. Magnetic Imaging: a New Tool for UK National Nuclear Security

    Science.gov (United States)

    Darrer, Brendan J.; Watson, Joe C.; Bartlett, Paul; Renzoni, Ferruccio

    2015-01-01

    Combating illicit trafficking of Special Nuclear Material may require the ability to image through electromagnetic shields. This is the case when the trafficking involves cargo containers. Thus, suitable detection techniques are required to penetrate a ferromagnetic enclosure. The present study considers techniques that employ an electromagnetic based principle of detection. It is generally assumed that a ferromagnetic metallic enclosure will effectively act as a Faraday cage to electromagnetic radiation and therefore screen any form of interrogating electromagnetic radiation from penetrating, thus denying the detection of any eventual hidden material. In contrast, we demonstrate that it is actually possible to capture magnetic images of a conductive object through a set of metallic ferromagnetic enclosures. This validates electromagnetic interrogation techniques as a potential detection tool for National Nuclear Security applications.

  2. Pakistan’s national Centre of Excellence contributes to sustaining nuclear security

    International Nuclear Information System (INIS)

    Dixit, Aabha

    2016-01-01

    Pakistani front line officers and first responders are in a better position to fight illicit trafficking in nuclear and other radioactive materials, as well as to use advanced radiation detection and monitoring equipment, thanks to training they have received at the country’s Centre of Excellence for Nuclear Security. This is just one of the benefits the country has reaped from the Centre, which is collaborating with the growing International Network for Nuclear Security Training and Support Centres (NSSC Network), building national capacity through training and strengthening technical and scientific support programmes. Since the establishment of the Centre of Excellence, Pakistan has organized training courses on nuclear security for personnel from national and regional organizations. The Centre of Excellence also offers technical support to personnel involved in the maintenance and upgrade of facilities, with a focus on enhancing technical and scientific skills and quality control of equipment.

  3. Towards Establishing of National Centre of Synchrotron Radiation in Poland

    International Nuclear Information System (INIS)

    Kolodziej, J.J.; Szymonski, M.

    2004-01-01

    Synchrotron radiation facilities (SRF) are established part of contemporary world research landscape. They facilitate fast advances of life, health, and physical sciences as well as development of new technologies. The extent of synchrotron radiation (SR) use has been growing up steadily for the last two decades all over the world and it is anticipated that the growth will continue in future. Growing community of SR users has generated increasing demand for the beam-time in infrared, vacuum UV and X-ray ranges. In response, many new SR facilities are now being constructed and planned, not only in large countries of strong economy but also in developing countries. It is expected that such trends will be followed in other parts of the world. No doubt, the ''cutting edge'' of research activity will continue to create the demand for beams of higher brightness, flux and photon energy but it is predictable that the increasing fraction of research done presently with laboratory radiation sources will be shifting towards small-scale SR facilities. Several hundred Polish scientists, a meaningful fraction of all SR users, take part in experiments using synchrotron sources all over the world. Many of them belong to the Polish Synchrotron Radiation Society - an active body promoting the use of SR. Present European Union priorities include knowledge, research and innovation as the key priorities and a pillar of development and stable welfare of Europe. Poland as a new member of EU will have to conform to the EU policy. The government strategy assumes a fast increase of investments in research and development sector starting from 2005. No other scientific research installations has had such major impact on advances in science an technology as the SRF. It is obvious that the time is ripe now for establishing a National Centre of Synchrotron Radiation in Poland. Recently, several Polish educational and research institutions constituted around the idea of Polish SRF. The initiative

  4. The UK Functional Assessment Measure (UK FIM+FAM: Psychometric Evaluation in Patients Undergoing Specialist Rehabilitation following a Stroke from the National UK Clinical Dataset.

    Directory of Open Access Journals (Sweden)

    Meenakshi Nayar

    Full Text Available The UK Functional Assessment Measure (UKFIM+FAM is the principal outcome measure for the UK Rehabilitation Outcomes Collaborative (UKROC national database for specialist rehabilitation. Previously validated in a mixed neurorehabilitation cohort, this study is the first to explore its psychometric properties in a stroke population, and compare left and right hemispheric strokes (LHS vs RHS. We analysed in-patient episode data from 62 specialist rehabilitation units collated through the UKROC database 2010-2013. Complete data were analysed for 1,539 stroke patients (LHS: 588, RHS: 566 with clear localisation. For factor analysis, admission and discharge data were pooled and randomised into two equivalent samples; the first for exploratory factor analysis (EFA using principal components analysis, and the second for confirmatory factor analysis (CFA. Responsiveness for each subject (change from admission to discharge was examined using paired t-tests and differences between LHS and RHS for the entire group were examined using non-paired t-tests. EFA showed a strong general factor accounting for >48% of the total variance. A three-factor solution comprising motor, communication and psychosocial subscales, accounting for >69% total variance, provided acceptable fit statistics on CFA (Root Mean Square Error of Approximation was 0.08 and Comparative Fit Index/ Tucker Lewis Index 0.922/0.907. All three subscales showed significant improvement between admission and discharge (p0.5. Total scores between LHS and RHS were not significantly different. However, LHS showed significantly higher motor scores (Mean 5.7, 95%CI 2.7, 8.6 p<0.001, while LHS had significantly lower cognitive scores, primarily in the communication domain (-6.8 95%CI -7.7, -5.8 p<0.001. To conclude, the UK FIM+FAM has a three-factor structure in stroke, similar to the general neurorehabilitation population. It is responsive to change during in-patient rehabilitation, and distinguishes

  5. The effect of trade between China and the UK on national and global carbon dioxide emissions

    International Nuclear Information System (INIS)

    Li, You; Hewitt, C.N.

    2008-01-01

    We estimate the amount of carbon dioxide embodied in bi-lateral trade between the UK and China in 2004. Developing and applying the method of Shui and Harriss [2006. The role of CO 2 embodiment in US-China trade. Energy Policy 34, 4063-4068], the most recently available data on trade and CO 2 emissions have been updated and adjusted to calculate the CO 2 emissions embodied in the commodities traded between China and the UK. It was found that through trade with China, the UK reduced its CO 2 emissions by approximately 11% in 2004, compared with a non-trade scenario in which the same type and volume of goods are produced in the UK. In addition, due to the greater carbon-intensity and relatively less efficient production processes of Chinese industry, China-UK trade resulted in an additional 117 Mt of CO 2 to global CO 2 emissions in the same one year period, compared with a non-trade scenario in which the same type and volume of goods are produced in the UK. This represents an additional 19% to the reported national CO 2 emissions of the UK (555 Mt/y in 2004) and 0.4% of global emissions. These findings suggest that, through international trade, very significant environmental impacts can be shifted from one country to another, and that international trade can (but does not necessarily) result in globally increased greenhouse gas emissions. These results are additional to the environmental consequences of transporting goods, which are not robustly quantified here. (author)

  6. The UK Functional Assessment Measure (UK FIM+FAM): Psychometric Evaluation in Patients Undergoing Specialist Rehabilitation following a Stroke from the National UK Clinical Dataset.

    Science.gov (United States)

    Nayar, Meenakshi; Vanderstay, Roxana; Siegert, Richard J; Turner-Stokes, Lynne

    2016-01-01

    The UK Functional Assessment Measure (UKFIM+FAM) is the principal outcome measure for the UK Rehabilitation Outcomes Collaborative (UKROC) national database for specialist rehabilitation. Previously validated in a mixed neurorehabilitation cohort, this study is the first to explore its psychometric properties in a stroke population, and compare left and right hemispheric strokes (LHS vs RHS). We analysed in-patient episode data from 62 specialist rehabilitation units collated through the UKROC database 2010-2013. Complete data were analysed for 1,539 stroke patients (LHS: 588, RHS: 566 with clear localisation). For factor analysis, admission and discharge data were pooled and randomised into two equivalent samples; the first for exploratory factor analysis (EFA) using principal components analysis, and the second for confirmatory factor analysis (CFA). Responsiveness for each subject (change from admission to discharge) was examined using paired t-tests and differences between LHS and RHS for the entire group were examined using non-paired t-tests. EFA showed a strong general factor accounting for >48% of the total variance. A three-factor solution comprising motor, communication and psychosocial subscales, accounting for >69% total variance, provided acceptable fit statistics on CFA (Root Mean Square Error of Approximation was 0.08 and Comparative Fit Index/ Tucker Lewis Index 0.922/0.907). All three subscales showed significant improvement between admission and discharge (p0.5). Total scores between LHS and RHS were not significantly different. However, LHS showed significantly higher motor scores (Mean 5.7, 95%CI 2.7, 8.6 pLHS had significantly lower cognitive scores, primarily in the communication domain (-6.8 95%CI -7.7, -5.8 pLHS and RHS. This tool extends stroke outcome measurement beyond physical disability to include cognitive, communication and psychosocial function.

  7. Snakebite enquiries to the UK National Poisons Information Service: 2004-2010.

    Science.gov (United States)

    Coulson, James Michael; Cooper, Gillian; Krishna, Channarayapatna; Thompson, John Paul

    2013-11-01

    To describe trends regarding snakebite enquiries to the UK National Poisons Information Service (NPIS) from 2004 to 2010. The NPIS telephone enquiry database, the UK Poisons Information Database, was interrogated for enquiries to the four NPIS units from 2004 to 2010. Search terms used were 'snake' and 'snakebite'. Information from the national dataset was available from Cardiff and Edinburgh units from 2004 onwards, Birmingham from June 2005 and Newcastle from September 2006. Five hundred and ten cases were identified, of which 69% were male and 31% female. Average age of cases was 32 years (±1 95% CI). The snake was identified as follows: British Adder in 52% of cases, an exotic species in 26%, unknown in 18% and another UK snake in 4%. 82% of cases occurred between the months of April and September. Cases peaked during August (19%). Forty-two per cent of enquiries involved features of envenoming. Eighty-five cases were assessed as requiring antivenom. Eighty-four cases received treatment with antivenom. No adverse reactions to the antivenom were reported and resolution of clinical features was reported in all treated cases. Advice to use an antidote was followed in 98.8% of cases. Snakebites account for one to two NPIS cases per week. Adder bites account for over half of cases. A quarter of cases were due to non-UK snakes kept in captivity within the UK. Envenoming was said to have occurred in just under half of all cases. Advice given by the NPIS appears to closely reflect national practice guidelines.

  8. The UK National Quantum Technologies Hub in sensors and metrology (Keynote Paper)

    Science.gov (United States)

    Bongs, K.; Boyer, V.; Cruise, M. A.; Freise, A.; Holynski, M.; Hughes, J.; Kaushik, A.; Lien, Y.-H.; Niggebaum, A.; Perea-Ortiz, M.; Petrov, P.; Plant, S.; Singh, Y.; Stabrawa, A.; Paul, D. J.; Sorel, M.; Cumming, D. R. S.; Marsh, J. H.; Bowtell, R. W.; Bason, M. G.; Beardsley, R. P.; Campion, R. P.; Brookes, M. J.; Fernholz, T.; Fromhold, T. M.; Hackermuller, L.; Krüger, P.; Li, X.; Maclean, J. O.; Mellor, C. J.; Novikov, S. V.; Orucevic, F.; Rushforth, A. W.; Welch, N.; Benson, T. M.; Wildman, R. D.; Freegarde, T.; Himsworth, M.; Ruostekoski, J.; Smith, P.; Tropper, A.; Griffin, P. F.; Arnold, A. S.; Riis, E.; Hastie, J. E.; Paboeuf, D.; Parrotta, D. C.; Garraway, B. M.; Pasquazi, A.; Peccianti, M.; Hensinger, W.; Potter, E.; Nizamani, A. H.; Bostock, H.; Rodriguez Blanco, A.; Sinuco-Leon, G.; Hill, I. R.; Williams, R. A.; Gill, P.; Hempler, N.; Malcolm, G. P. A.; Cross, T.; Kock, B. O.; Maddox, S.; John, P.

    2016-04-01

    The UK National Quantum Technology Hub in Sensors and Metrology is one of four flagship initiatives in the UK National of Quantum Technology Program. As part of a 20-year vision it translates laboratory demonstrations to deployable practical devices, with game-changing miniaturized components and prototypes that transform the state-of-the-art for quantum sensors and metrology. It brings together experts from the Universities of Birmingham, Glasgow, Nottingham, Southampton, Strathclyde and Sussex, NPL and currently links to over 15 leading international academic institutions and over 70 companies to build the supply chains and routes to market needed to bring 10-1000x improvements in sensing applications. It seeks, and is open to, additional partners for new application development and creates a point of easy open access to the facilities and supply chains that it stimulates or nurtures.

  9. Regional Centres for Space Science and Technology Education Affiliated to the United Nations

    Science.gov (United States)

    Aquino, A. J. A.; Haubold, H. J.

    2010-05-01

    Based on resolutions of the United Nations General Assembly, Regional Centres for space science and technology education were established in India, Morocco, Nigeria, Brazil and Mexico. Simultaneously, education curricula were developed for the core disciplines of remote sensing, satellite communications, satellite meteorology, and space and atmospheric science. This paper provides a brief report on the status of the operation of the Regional Centres and draws attention to their educational activities.

  10. A new risk prediction model for critical care: the Intensive Care National Audit & Research Centre (ICNARC) model.

    Science.gov (United States)

    Harrison, David A; Parry, Gareth J; Carpenter, James R; Short, Alasdair; Rowan, Kathy

    2007-04-01

    To develop a new model to improve risk prediction for admissions to adult critical care units in the UK. Prospective cohort study. The setting was 163 adult, general critical care units in England, Wales, and Northern Ireland, December 1995 to August 2003. Patients were 216,626 critical care admissions. None. The performance of different approaches to modeling physiologic measurements was evaluated, and the best methods were selected to produce a new physiology score. This physiology score was combined with other information relating to the critical care admission-age, diagnostic category, source of admission, and cardiopulmonary resuscitation before admission-to develop a risk prediction model. Modeling interactions between diagnostic category and physiology score enabled the inclusion of groups of admissions that are frequently excluded from risk prediction models. The new model showed good discrimination (mean c index 0.870) and fit (mean Shapiro's R 0.665, mean Brier's score 0.132) in 200 repeated validation samples and performed well when compared with recalibrated versions of existing published risk prediction models in the cohort of patients eligible for all models. The hypothesis of perfect fit was rejected for all models, including the Intensive Care National Audit & Research Centre (ICNARC) model, as is to be expected in such a large cohort. The ICNARC model demonstrated better discrimination and overall fit than existing risk prediction models, even following recalibration of these models. We recommend it be used to replace previously published models for risk adjustment in the UK.

  11. Clinical features, microbiology and surgical outcomes of infective endocarditis: a 13-year study from a UK tertiary cardiothoracic referral centre.

    Science.gov (United States)

    Marks, D J B; Hyams, C; Koo, C Y; Pavlou, M; Robbins, J; Koo, C S; Rodger, G; Huggett, J F; Yap, J; Macrae, M B; Swanton, R H; Zumla, A I; Miller, R F

    2015-03-01

    Infective endocarditis (IE) causes substantial morbidity and mortality. Patient and pathogen profiles, as well as microbiological and operative strategies, continue to evolve. The impact of these changes requires evaluation to inform optimum management and identify individuals at high risk of early mortality. Identification of clinical and microbiological features, and surgical outcomes, among patients presenting to a UK tertiary cardiothoracic centre for surgical management of IE between 1998 and 2010. Retrospective observational cohort study. Clinical, biochemical, microbiological and echocardiographic data were identified from clinical records. Principal outcomes were all-cause 28-day mortality and duration of post-operative admission. Patients (n = 336) were predominantly male (75.0%); median age 52 years (IQR = 41-67). Most cases involved the aortic (56.0%) or mitral (53.9%) valves. Microbiological diagnoses, obtained in 288 (85.7%) patients, included streptococci (45.2%); staphylococci (34.5%); Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella (HACEK) organisms (3.0%); and fungi (1.8%); 11.3% had polymicrobial infection. Valve replacement in 308 (91.7%) patients included mechanical prostheses (69.8%), xenografts (24.0%) and homografts (6.2%). Early mortality was 12.2%, but fell progressively during the study (P = 0.02), as did median duration of post-operative admission (33.5 to 10.5 days; P = 0.0003). Multivariable analysis showed previous cardiothoracic surgery (OR = 3.85, P = 0.03), neutrophil count (OR = 2.27, P = 0.05), albumin (OR = 0.94, P = 0.04) and urea (OR = 2.63, P < 0.001) predicted early mortality. This study demonstrates reduced post-operative early mortality and duration of hospital admission for IE patients over the past 13 years. Biomarkers (previous cardiothoracic surgery, neutrophil count, albumin and urea), predictive of early post-operative mortality, require prospective evaluation to refine algorithms, further improve

  12. Critical Care Health Informatics Collaborative (CCHIC): Data, tools and methods for reproducible research: A multi-centre UK intensive care database.

    Science.gov (United States)

    Harris, Steve; Shi, Sinan; Brealey, David; MacCallum, Niall S; Denaxas, Spiros; Perez-Suarez, David; Ercole, Ari; Watkinson, Peter; Jones, Andrew; Ashworth, Simon; Beale, Richard; Young, Duncan; Brett, Stephen; Singer, Mervyn

    2018-04-01

    To build and curate a linkable multi-centre database of high resolution longitudinal electronic health records (EHR) from adult Intensive Care Units (ICU). To develop a set of open-source tools to make these data 'research ready' while protecting patient's privacy with a particular focus on anonymisation. We developed a scalable EHR processing pipeline for extracting, linking, normalising and curating and anonymising EHR data. Patient and public involvement was sought from the outset, and approval to hold these data was granted by the NHS Health Research Authority's Confidentiality Advisory Group (CAG). The data are held in a certified Data Safe Haven. We followed sustainable software development principles throughout, and defined and populated a common data model that links to other clinical areas. Longitudinal EHR data were loaded into the CCHIC database from eleven adult ICUs at 5 UK teaching hospitals. From January 2014 to January 2017, this amounted to 21,930 and admissions (18,074 unique patients). Typical admissions have 70 data-items pertaining to admission and discharge, and a median of 1030 (IQR 481-2335) time-varying measures. Training datasets were made available through virtual machine images emulating the data processing environment. An open source R package, cleanEHR, was developed and released that transforms the data into a square table readily analysable by most statistical packages. A simple language agnostic configuration file will allow the user to select and clean variables, and impute missing data. An audit trail makes clear the provenance of the data at all times. Making health care data available for research is problematic. CCHIC is a unique multi-centre longitudinal and linkable resource that prioritises patient privacy through the highest standards of data security, but also provides tools to clean, organise, and anonymise the data. We believe the development of such tools are essential if we are to meet the twin requirements of

  13. Managing conflicts of interest in the UK National Institute for Health and Care Excellence (NICE) clinical guidelines programme: qualitative study.

    Science.gov (United States)

    Graham, Tanya; Alderson, Phil; Stokes, Tim

    2015-01-01

    There is international concern that conflicts of interest (COI) may bias clinical guideline development and render it untrustworthy. Guideline COI policies exist with the aim of reducing this bias but it is not known how such policies are interpreted and used by guideline producing organisations. This study sought to determine how conflicts of interest (COIs) are disclosed and managed by a national clinical guideline developer (NICE: the UK National Institute for Health and Care Excellence). Qualitative study using semi-structured telephone interviews with 14 key informants: 8 senior staff of NICE's guideline development centres and 6 chairs of guideline development groups (GDGs). We conducted a thematic analysis. Participants regard the NICE COI policy as comprehensive leading to transparent and independent guidance. The application of the NICE COI policy is, however, not straightforward and clarity could be improved. Disclosure of COI relies on self reporting and guideline developers have to take "on trust" the information they receive, certain types of COI (non-financial) are difficult to categorise and manage and disclosed COI can impact on the ability to recruit clinical experts to GDGs. Participants considered it both disruptive and stressful to exclude members from GDG meetings when required by the COI policy. Nonetheless the impact of this disruption can be minimised with good group chairing skills. We consider that the successful implementation of a COI policy in clinical guideline development requires clear policies and procedures, appropriate training of GDG chairs and an evaluation of how the policy is used in practice.

  14. National Deployment of Domestic Geothermal Heat Pump Technology: Observations on the UK Experience 1995–2013

    Directory of Open Access Journals (Sweden)

    Simon Rees

    2014-08-01

    Full Text Available Uptake of geothermal heat pump technology in the UK and corresponding development of a domestic installation industry has progressed significantly in the last decade. This paper summarizes the growth process and reviews the research that has been specifically concerned with conditions in the UK. We discuss the driving forces behind these developments and some of the supporting policy initiatives that have been implemented. Publically funded national trials were completed to assess the performance and acceptance of the technology and validate design and installation standards. We comment on both the technical and non-technical findings of the trials and the related academic research and their relevance to standards development. A number of technical issues can be identified—some of which may be particular to the UK—and we suggest a number of research and development questions that need to be addressed further. Current national support for the technology relies solely on a tariff mechanism and it is uncertain that this will be effective enough to ensure sufficient growth to meet the national renewable heat target in 2020. A broader package of support that includes mandatory measures applied to future housing development and retrofit may be necessary to ensure long-term plans for national deployment and decarbonization of heat are achieved. Industry needs to demonstrate that efficiency standards can be assured, capital costs reduced in the medium-term and that national training schemes are effective.

  15. A national UK survey of radiology trainees special interest choices: what and why?

    Science.gov (United States)

    Parvizi, Nassim; Bhuva, Shaheel

    2017-11-01

    A national survey was designed to better understand factors influencing special interest choices, future aspirations of UK radiology trainees and perceptions of breast radiology. A SurveyMonkey questionnaire was developed and distributed to all radiology trainees in the UK through the British Institute of Radiology, RCR Junior Radiologists Forum and by directly contacting UK training schemes as well as by social media between December 2015 and January 2016. From 21 training schemes across the UK, 232 responses were received. Over half entered radiology after foundation training and 62% were ST1-3; one-fifth of trainees intended to leave the NHS. The most popular special interests were musculoskeletal (18%), abdominal imaging (16%) and neuroradiology (13%). Gynaecological and oncological imaging proved to be the least popular. Strong personal interest, a successful rotation during training, a mix of imaging modalities, direct impact on patient care and job prospects were the most popular factors influencing career choice. Research and potential for private income were the least influential factors. Respondents detailed their perceptions of breast radiology, selecting an awareness of career prospects (41%) and a better trainee experience (36%) as factors that would increase their interest in pursuing it as a career. Understanding the factors that influence special interest choice is essential to addressing the alarming staffing shortfalls that will befall certain radiology special interests. Addressing trainee's preconceptions and improving the trainee experience are key to attracting trainees to breast radiology. Advances in knowledge: This is the first survey of its kind in the UK literature designed to evaluate special interest career choices and the factors that influence those among radiology trainees.

  16. Ethical dilemmas of a large national multi-centre study in Australia: time for some consistency.

    Science.gov (United States)

    Driscoll, Andrea; Currey, Judy; Worrall-Carter, Linda; Stewart, Simon

    2008-08-01

    To examine the impact and obstacles that individual Institutional Research Ethics Committee (IRECs) had on a large-scale national multi-centre clinical audit called the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study. Multi-centre research is commonplace in the health care system. However, IRECs continue to fail to differentiate between research and quality audit projects. The National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes study used an investigator-developed questionnaire concerning a clinical audit for heart failure programmes throughout Australia. Ethical guidelines developed by the National governing body of health and medical research in Australia classified the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study as a low risk clinical audit not requiring ethical approval by IREC. Fifteen of 27 IRECs stipulated that the research proposal undergo full ethical review. None of the IRECs acknowledged: national quality assurance guidelines and recommendations nor ethics approval from other IRECs. Twelve of the 15 IRECs used different ethics application forms. Variability in the type of amendments was prolific. Lack of uniformity in ethical review processes resulted in a six- to eight-month delay in commencing the national study. Development of a national ethics application form with full ethical review by the first IREC and compulsory expedited review by subsequent IRECs would resolve issues raised in this paper. IRECs must change their ethics approval processes to one that enhances facilitation of multi-centre research which is now normative process for health services. The findings of this study highlight inconsistent ethical requirements between different IRECs. Also highlighted are the obstacles and delays that IRECs create when undertaking multi-centre clinical audits

  17. Realization of Data Archiving for CTBT Beijing National Data Centre

    International Nuclear Information System (INIS)

    Wang Juan; Shi Jianfang; Wang Xiaoming; Liu Junmin; Qiu Hongmao; Zhang Bo; Lu Yuanglei; Xu Jin

    2009-01-01

    It is very important issue for the large scale real time data processing system to archive data. The method of data are archiving in the paper is to facilitate the permanent storages and retrieval of all data arriving at the NDC. The data in the operation file system and the database references to the data in the operation database will be deleted automatically after the system has verified archived data is identical with original data. The data archiving operations have been realized in China National Data Center. (authors)

  18. Taking the UK's national LLW programme from strategy development to implementation - 59059

    International Nuclear Information System (INIS)

    Rossiter, David; O'Donnell, Rachel

    2012-01-01

    In 2008 UK Nuclear Waste Management Ltd (UKNWM) became the Parent Body Organisation (PBO) at the Low Level Waste Repository (LLWR) in the UK. LLWR is the primary disposal facility for the UK's LLW, supporting a wide range of industries across the nuclear power generation, reprocessing, defence, health care, education, and oil and gas sectors. One of the key tasks following the appointment of the new PBO was to work with the Nuclear Decommissioning Authority (NDA) to develop a national strategy for LLW generated in the UK, predominantly in the NDA estate. The new National Strategy for LLW was required to address the gap between the forecast waste arisings and predicted capacity at LLWR. The National Strategy for LLW Management was published in August 2010 following an 18 month development period. The main focus of the strategy is on three areas: - Application of the waste management hierarchy to extend the life of LLWR and ensure waste is managed in a risk-based, fit-for-purpose manner - Making best use of existing assets such as transport, packaging, treatment and disposal facilities - Opening up new fit-for-purpose waste management routes to divert waste away from LLWR Developing a robust strategy is vital to provide strategic direction to Government, waste producers, regulators, and stakeholders. Once the strategy is developed and approved, the key challenge is then to implement the strategy on a national scale in an efficient and cost-effective manner that delivers maximum value for money to the UK taxpayer. As well as developing the strategy, LLWR has been actively working to develop the enablers to implement the strategy. Since the publication of the strategy in August 2010 LLWR has been re-organised to reflect the shift in focus, from strategy development to implementation and delivery of the strategy. New resources have been brought in with international waste management experience to help integrate delivery with waste producers. This paper covers the

  19. Evaluation of the implementation of the Meeting Centres Support Program in Italy, Poland, and the UK; exploration of the effects on people with dementia.

    Science.gov (United States)

    Brooker, Dawn; Evans, Simon; Evans, Shirley; Bray, Jennifer; Saibene, Francesca Lea; Scorolli, Claudia; Szcześniak, Dorota; d'Arma, Alessia; Urbańska, Katarzyna M; Atkinson, Teresa; Farina, Elisabetta; Rymaszewska, Joanna; Chattat, Rabih; Henderson, Catherine; Rehill, Amritpal; Hendriks, Iris; Meiland, Franka; Dröes, Rose-Marie

    2018-07-01

    MEETINGDEM investigated whether the Dutch Meeting Centres Support Programme (MCSP) could be implemented in Italy, Poland, and the UK with comparable benefits. This paper reports on the impact on people living with dementia attending pilot Meeting Centres in the 3 countries. Nine pilot Meeting Centres (MCs) participated (Italy-5, Poland-2, UK-2). Effectiveness of MCSP was compared with Usual Care (UC) on outcomes measuring behavioural and psychological symptoms (NPI), depression (CSDD), and quality of life (DQoL, QOL-AD), analysed by ANCOVAs in a 6-month pre-test/post-test controlled trial. Pre/post data were collected for 85 people with dementia and 93 carers (MCSP) and 74 people with dementia /carer dyads' receiving UC. MCSP showed significant positive effects for DQoL [Self-esteem (F = 4.8, P = 0.03); Positive Affect (F = 14.93, P < 0.00); Feelings of Belonging (F = 7.77, P = 0.01)] with medium and large effect sizes. Higher attendance levels correlated with greater neuropsychiatric symptom reduction (rho = 0.24, P = 0.03) and a greater increase in feelings of support (rho = 0.36, P = 0.001). MCSPs showed significant wellbeing and health benefits compared with UC, building on the evidence of effectiveness from the Netherlands. In addition to the previously reported successful implementation of MCSP in Italy, Poland, and the UK, these findings suggest that further international dissemination of MCSP is recommended. Copyright © 2018 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

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

    2009-05-01

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

  1. Paediatric post-burn scar management in the UK: a national survey.

    Science.gov (United States)

    Liuzzi, Francesca; Chadwick, Sarah; Shah, Mamta

    2015-03-01

    Thermal injuries affect 250,000 people annually in the United Kingdom. As burn survival improves, good scar management is paramount to help individuals living with the resultant scars lead a life without restrictions. Post-burn hypertrophic scars can limit growth in children, interfere with function and cause psychological problems. In the current literature there is great variation in post-burn scar management across the world and in the evidence available for the efficacy of these management modalities. The aim of this study was to investigate the variances if any, in the management of post-burn scarring in children across the UK. A telephone survey of UK paediatric burn services was conducted to obtain information on post-burn scar management and advice given to patients/carers. Of the 19 burn services that participated, all advised moisturising of scars but with variable emphasis on massaging. Silicones and pressure therapy were used by 18 services but commencement of use varied from soon after healing to onset of hypertrophic scarring. Laser therapy, ultrasound therapy and steroid therapy were used sporadically. This study highlights the common modalities of post-burn scar management in children across the UK. However, there is marked variation in timing and selection of the commonly used modalities. Although this study did not investigate the outcomes of scar management, it clearly identifies the need for a well-designed multi-centred study to establish evidence-based best practice in the management of post-burn scarring in children as these modalities are time consuming and not without potential complications. Evidence based practice could potentially lead to significant financial savings to the health service. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  2. Preventing work-related stress among staff working in children's cancer Principal Treatment Centres in the UK: a brief survey of staff support systems and practices.

    Science.gov (United States)

    Beresford, B; Gibson, F; Bayliss, J; Mukherjee, S

    2018-03-01

    Growing evidence of the association between health professionals' well-being and patient and organisational outcomes points to the need for effective staff support. This paper reports a brief survey of the UK's children's cancer Principal Treatment Centres (PTCs) regarding staff support systems and practices. A short on-line questionnaire, administered in 2012-2013, collected information about the availability of staff support interventions which seek to prevent work-related stress among different members of the multi-disciplinary team (MDT). It was completed by a member of staff with, where required, assistance from colleagues. All PTCs (n = 19) participated. Debriefs following a patient death was the most frequently reported staff support practice. Support groups were infrequently mentioned. There was wide variability between PTCs, and between professional groups, regarding the number and type of interventions available. Doctors appear to be least likely to have access to support. A few Centres routinely addressed work-related stress in wider staff management strategies. Two Centres had developed a bespoke intervention. Very few Centres were reported to actively raise awareness of support available from their hospital's Occupational Health department. A minority of PTCs had expert input regarding staff support from clinical psychology/liaison psychiatry. © 2016 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

  3. Product development within the framework of a National Casting Technology Centre

    CSIR Research Space (South Africa)

    Du Preez, WB

    2006-01-01

    Full Text Available The need for a state of the art advanced National Casting Technology Centre (NCTC) has been widely supported throughout industry and recognised as an important facilitator in the growth of the foundry industry. This initiative also aligns itself...

  4. National data centres and other means of regional cooperation in Africa: prospects and benefits

    International Nuclear Information System (INIS)

    Masawi, L.

    2002-01-01

    Participation in regional cooperation by Bulawayo National Data Centre in Zimbabwe is noted. East and Southern Africa Working Group (ESAWORG) is given as an example of such cooperation. The coming of CTBT is expected to strengthen the said group together with regional cooperation. Expected new developments are listed

  5. 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.

  6. Assessing national nutrition security: The UK reliance on imports to meet population energy and nutrient recommendations.

    Science.gov (United States)

    Macdiarmid, Jennie I; Clark, Heather; Whybrow, Stephen; de Ruiter, Henri; McNeill, Geraldine

    2018-01-01

    Nutrition security describes the adequacy of the food supply to meet not only energy but also macronutrient and micronutrient requirements for the population. The aim of this study was to develop a method to assess trends in national nutrition security and the contribution of imports to nutrition security, using the UK as a case study. Food supply data from FAO food balance sheets and national food composition tables were used to estimate the nutrient content of domestically produced food, imported food and exported food. Nutrition security was defined as the total nutrient supply (domestic production, minus exports, plus imports) to meet population-level nutrient requirements. The results showed that the UK was nutrition secure over the period 1961-2011 for energy, macronutrients and key micronutrients, with the exception of total carbohydrates and fibre, which may be due to the loss of fibre incurred by processing cereals into refined products. The supply of protein exceeded population requirements and could be met with domestic production alone. Even excluding all meat there was sufficient protein for population requirements. The supply of total fat, saturated fat and sugar considerably exceeded the current dietary recommendation. As regards nutrition security in 2010, the UK was reliant on imported foods to meet energy, fibre, total carbohydrate, iron, zinc and vitamin A requirements. This analysis demonstrates the importance of including nutrients other than energy to determine the adequacy of the food supply. The methodology also provides an alternative perspective on food security and self-sufficiency by assessing the dependency on imports to meet population level nutritional requirements.

  7. National data centre preparedness exercise 2015 (NPE2015): MY-NDC progress result and experience

    Science.gov (United States)

    Rashid, Faisal Izwan Abdul; Zolkaffly, Muhammed Zulfakar

    2017-01-01

    Malaysia has established the National Data Centre (MY-NDC) in December 2005. MY-NDC is tasked to perform the Comprehensive Nuclear-Test-Ban-Treaty (CTBT) data management as well as providing relevant information for Treaty related events to the Malaysian Nuclear Agency (Nuclear Malaysia) as the CTBT National Authority. In the late 2015, MY-NDC has participated in the National Data Centre Preparedness Exercise 2015 (NPE 2015) which aims to access the level of readiness at MY-NDC. This paper aims at presenting the progress result of NPE 2015 as well as highlighting MY-NDC experience in NPE 2015 compared to previous participation in NPE 2013. MY-NDC has utilised available resources for NPE 2015. In NPE 2015, MY-NDC has performed five type of analyses compared with only two analyses in NPE 2013. Participation in the NPE 2015 has enabled MY-NDC to assess its capability and identify rooms for improvement.

  8. Cost of assessing a child for possible autism spectrum disorder? An observational study of current practice in child development centres in the UK.

    Science.gov (United States)

    Galliver, Mark; Gowling, Emma; Farr, William; Gain, Aaron; Male, Ian

    2017-01-01

    UK guidelines recommend that diagnosis of autism in children requires assessment by a multidisciplinary team. With growing numbers of referrals for assessment, diagnostic services have been under increasing pressure to meet the level of need. This study aimed to explore the number of hours of professional time required to complete such an assessment based on current practice in secondary care child development centres across the UK, and from this we calculate the cost of assessment. An online questionnaire, using SurveyMonkey.com, was sent to 20 child development centres asking them to retrospectively record team members involved at each stage of assessment and time taken, including report writing and administration for a typical assessment. Costs were estimated based on the hourly rate for each team member, including salary, on-costs and trust overheads. 12 questionnaires (60%) were returned. 10 centres adopted a two-stage approach to assessment with an initial 'screening' clinic determining whether the child needed to proceed to full multidisciplinary assessment. Median professional time involved was 13 hours (IQR 9.6-15.5 hours). This resulted in a median cost of £809 ($1213, based on conversion rate £1 equal to US$1.5 (November 2015)), (IQR £684-£925) ($1026-$1388)). This study confirms that multidisciplinary diagnostic assessment of a child with possible autism requires significant professional time, with staff costs of approximately £800 ($1200) per child. This does not include costs of intervention, parent psychological education, investigation and assessment and management of comorbidities. If growing waiting times for diagnostic assessment are to be avoided, funding for diagnostic services needs to reflect the human resources required and the resulting costs of that assessment.

  9. National Service Frameworks and UK general practitioners: street-level bureaucrats at work?

    Science.gov (United States)

    Checkland, Kath

    2004-11-01

    This paper argues that the past decade has seen significant changes in the nature of medical work in general practice in the UK. Increasing pressure to use normative clinical guidelines and the move towards explicit quantitative measures of performance together have the potential to alter the way in which health care is delivered to patients. Whilst it is possible to view these developments from the well-established sociological perspectives of deprofessionalisation and proletarianisation, this paper takes a view of general practice as work, and uses the ideas of Lipsky to analyse practice-level responses to some of these changes. In addition to evidence-based clinical guidelines, National Service Frameworks, introduced by the UK government in 1997, also specify detailed models of service provision that health care providers are expected to follow. As part of a larger study examining the impact of National Service Frameworks in general practice, the response of three practices to the first four NSFs were explored. The failure of NSFs to make a significant impact is compared to the practices' positive responses to purely clinical guidelines such as those developed by the British Hypertension Society. Lipsky's concept of public service workers as 'street-level bureaucrats' is discussed and used as a framework within which to view these findings.

  10. Vegaphobia: derogatory discourses of veganism and the reproduction of speciesism in UK national newspapers.

    Science.gov (United States)

    Cole, Matthew; Morgan, Karen

    2011-03-01

    This paper critically examines discourses of veganism in UK national newspapers in 2007. In setting parameters for what can and cannot easily be discussed, dominant discourses also help frame understanding. Discourses relating to veganism are therefore presented as contravening commonsense, because they fall outside readily understood meat-eating discourses. Newspapers tend to discredit veganism through ridicule, or as being difficult or impossible to maintain in practice. Vegans are variously stereotyped as ascetics, faddists, sentimentalists, or in some cases, hostile extremists. The overall effect is of a derogatory portrayal of vegans and veganism that we interpret as 'vegaphobia'. We interpret derogatory discourses of veganism in UK national newspapers as evidence of the cultural reproduction of speciesism, through which veganism is dissociated from its connection with debates concerning nonhuman animals' rights or liberation. This is problematic in three, interrelated, respects. First, it empirically misrepresents the experience of veganism, and thereby marginalizes vegans. Second, it perpetuates a moral injury to omnivorous readers who are not presented with the opportunity to understand veganism and the challenge to speciesism that it contains. Third, and most seriously, it obscures and thereby reproduces exploitative and violent relations between human and nonhuman animals. © London School of Economics and Political Science 2011.

  11. Data on Income inequality in Germany, France, Italy, Spain, the UK, and other affluent nations, 2012.

    Science.gov (United States)

    Dorling, Danny

    2015-12-01

    This data article contains information on the distribution of household incomes in the five most populous European countries as surveyed in 2012, with data released in 2014 and published here aggregated and so further anonymized in 2015. The underlying source data is the already anonymized EU Statistics on Income and Living Conditions (EUSILC) Microdata. The data include the annual household income required in each country to fall within the best-off 1% in that country, median and mean incomes, average (mean) incomes of the best off 1%, 0.1% and estimates for the 0.01%, 0.001% and so on for the UK, and of the 90% and worse-off 10%, the best-off 10% and best-off 1% of households for all countries. Average income from the state is also calculated by these income categories and the number of people working in finance and receiving over €1,000,000 a year in income is reported from other sources (the European Banking Authority). Finally income distribution data is provided from the USA and the rest of Europe in order to allow comparisons to be made. The data revealed the gross household (simple unweighted) median incomes in 2012 to have been (in order from best-off country by median to worse-off): France €39,000, Germany: €33,400, UK: €36,300, Italy €33,400 and Spain €27,000. However the medians, once households are weighted to reflect the nation populations do differ although they are in the same order: France €36,000, Germany: €33,400, UK: €31,300, Italy €31,000 and Spain €23,700. Thus weighting to increase representativeness of the medians reduces each by €3000, €0, €5000, €3300 and €3300 respectively. In short, the middle (weighted median) French household is €4700 a year better off than the middle UK family, and that is before housing costs are considered. This Data in Brief article accompanies Dorling, D. (2015) Income Inequality in the UK: Comparisons with five large Western European countries and the USA [1].

  12. Bico 2: second national intercomparison campaign of WBC centres working in Italy

    International Nuclear Information System (INIS)

    Castellani, C.M.; Battisti, P.; Tarroni, G.

    1998-01-01

    During the period November 1994 - May 1995 the coordinating group of WBC centres working in Italy organised the 2. national intercalibration and intercomparison campaign. A BOMAB phantom was used filled with four radionuclides gel solution with gamma energy emissions ranging between 100 keV and 2 MeV. 17 out of 21 Italian WBC centres took part in the campaign. Through the intercalibration, organised according to internationally accepted methodologies, each WBC centre could check its own calibration procedures. many intermediate data, collected for the methodologies and measurement procedures intercomparison, permitted analyses and comparison of uncertainly causes in a WBC measurement of the internal contamination. A proposal of MDA definition and assessment procedure resulted from the intercomparison campaign [it

  13. Managing conflicts of interest in the UK National Institute for Health and Care Excellence (NICE clinical guidelines programme: qualitative study.

    Directory of Open Access Journals (Sweden)

    Tanya Graham

    Full Text Available There is international concern that conflicts of interest (COI may bias clinical guideline development and render it untrustworthy. Guideline COI policies exist with the aim of reducing this bias but it is not known how such policies are interpreted and used by guideline producing organisations. This study sought to determine how conflicts of interest (COIs are disclosed and managed by a national clinical guideline developer (NICE: the UK National Institute for Health and Care Excellence.Qualitative study using semi-structured telephone interviews with 14 key informants: 8 senior staff of NICE's guideline development centres and 6 chairs of guideline development groups (GDGs. We conducted a thematic analysis.Participants regard the NICE COI policy as comprehensive leading to transparent and independent guidance. The application of the NICE COI policy is, however, not straightforward and clarity could be improved. Disclosure of COI relies on self reporting and guideline developers have to take "on trust" the information they receive, certain types of COI (non-financial are difficult to categorise and manage and disclosed COI can impact on the ability to recruit clinical experts to GDGs. Participants considered it both disruptive and stressful to exclude members from GDG meetings when required by the COI policy. Nonetheless the impact of this disruption can be minimised with good group chairing skills.We consider that the successful implementation of a COI policy in clinical guideline development requires clear policies and procedures, appropriate training of GDG chairs and an evaluation of how the policy is used in practice.

  14. 100 years of STIs in the UK: a review of national surveillance data.

    Science.gov (United States)

    Mohammed, Hamish; Blomquist, Paula; Ogaz, Dana; Duffell, Stephen; Furegato, Martina; Checchi, Marta; Irvine, Neil; Wallace, Lesley A; Thomas, Daniel Rhys; Nardone, Anthony; Dunbar, J Kevin; Hughes, Gwenda

    2018-04-13

    The 1916 Royal Commission on Venereal Diseases was established in response to epidemics of syphilis and gonorrhoea in the UK. In the 100 years since the Venereal Diseases Act (1917), the UK has experienced substantial scientific, economic and demographic changes. We describe historical and recent trends in STIs in the UK. We analysed surveillance data derived from STI clinics' statistical returns from 1917 to 2016. Since 1918, gonorrhoea and syphilis diagnoses have fluctuated, reflecting social, economic and technological trends. Following spikes after World Wars I and II, rates declined before re-emerging during the 1960s. At that time, syphilis was more common in men, suggestive of transmission within the men who have sex with men (MSM) population. Behaviour change following the emergence of HIV/AIDS in the 1980s is thought to have facilitated a precipitous decline in diagnoses of both STIs in the mid-1980s. Since the early 2000s, gonorrhoea and syphilis have re-emerged as major public health concerns due to increased transmission among MSM and the spread of antimicrobial-resistant gonorrhoea. Chlamydia and genital warts are now the most commonly diagnosed STIs in the UK and have been the focus of public health interventions, including the national human papillomavirus vaccination programme, which has led to substantial declines in genital warts in young people, and the National Chlamydia Screening Programme in England. Since the 1980s, MSM, black ethnic minorities and young people have experienced the highest STI rates. Although diagnoses have fluctuated over the last century, STIs continue to be an important public health concern, often affecting more marginalised groups in society. Prevention must remain a public health priority and, as we enter a new era of sexual healthcare provision including online services, priority must be placed on maintaining prompt access for those at greatest risk of STIs. © Article author(s) (or their employer(s) unless otherwise

  15. Improving National Capability in Biogeochemical Flux Modelling: the UK Environmental Virtual Observatory (EVOp)

    Science.gov (United States)

    Johnes, P.; Greene, S.; Freer, J. E.; Bloomfield, J.; Macleod, K.; Reaney, S. M.; Odoni, N. A.

    2012-12-01

    The best outcomes from watershed management arise where policy and mitigation efforts are underpinned by strong science evidence, but there are major resourcing problems associated with the scale of monitoring needed to effectively characterise the sources rates and impacts of nutrient enrichment nationally. The challenge is to increase national capability in predictive modelling of nutrient flux to waters, securing an effective mechanism for transferring knowledge and management tools from data-rich to data-poor regions. The inadequacy of existing tools and approaches to address these challenges provided the motivation for the Environmental Virtual Observatory programme (EVOp), an innovation from the UK Natural Environment Research Council (NERC). EVOp is exploring the use of a cloud-based infrastructure in catchment science, developing an exemplar to explore N and P fluxes to inland and coastal waters in the UK from grid to catchment and national scale. EVOp is bringing together for the first time national data sets, models and uncertainty analysis into cloud computing environments to explore and benchmark current predictive capability for national scale biogeochemical modelling. The objective is to develop national biogeochemical modelling capability, capitalising on extensive national investment in the development of science understanding and modelling tools to support integrated catchment management, and supporting knowledge transfer from data rich to data poor regions, The AERC export coefficient model (Johnes et al., 2007) has been adapted to function within the EVOp cloud environment, and on a geoclimatic basis, using a range of high resolution, geo-referenced digital datasets as an initial demonstration of the enhanced national capacity for N and P flux modelling using cloud computing infrastructure. Geoclimatic regions are landscape units displaying homogenous or quasi-homogenous functional behaviour in terms of process controls on N and P cycling

  16. Management of gout by UK rheumatologists: a British Society for Rheumatology national audit.

    Science.gov (United States)

    Roddy, Edward; Packham, Jon; Obrenovic, Karen; Rivett, Ali; Ledingham, Joanna M

    2018-05-01

    To assess the concordance of gout management by UK rheumatologists with evidence-based best-practice recommendations. Data were collected on patients newly referred to UK rheumatology out-patient departments over an 8-week period. Baseline data included demographics, method of diagnosis, clinical features, comorbidities, urate-lowering therapy (ULT), prophylaxis and blood tests. Twelve months later, the most recent serum uric acid level was collected. Management was compared with audit standards derived from the 2006 EULAR recommendations, 2007 British Society for Rheumatology/British Health Professionals in Rheumatology guideline and the National Institute for Health and Care Excellence febuxostat technology appraisal. Data were collected for 434 patients from 91 rheumatology departments (mean age 59.8 years, 82% male). Diagnosis was crystal-proven in 13%. Of 106 taking a diuretic, this was reduced/stopped in 29%. ULT was continued/initiated in 76% of those with one or more indication for ULT. One hundred and fifty-eight patients started allopurinol: the starting dose was most commonly 100 mg daily (82%); in those with estimated glomerular filtration rate <60 ml/min the highest starting dose was 100 mg daily. Of 199 who started ULT, prophylaxis was co-prescribed for 94%. Fifty patients started a uricosuric or febuxostat: 84% had taken allopurinol previously. Of 44 commenced on febuxostat, 18% had a history of heart disease. By 12 months, serum uric acid levels ⩽360 and <300 μmol/l were achieved by 45 and 25%, respectively. Gout management by UK rheumatologists concords well with guidelines for most audit standards. However, fewer than half of patients achieved a target serum uric level over 12 months. Rheumatologists should help ensure that ULT is optimized to achieve target serum uric acid levels to benefit patients.

  17. Introduction of the national centre for research and application of renewable energy sources

    OpenAIRE

    Smitkova, Miroslava; Eleschova, Zaneta; Hajducek, Peter; Janicek, Frantisek; Minovski, Dragan; Sarac, Vasilija

    2011-01-01

    Slovak University of Technology in Bratislava acquired financial support from the European Fund for Regional Development for the establishment of the National Centre for Research and Application of Renewable Energy Sources in the framework of the “Operation Program Research and Development”. Slovak University of Technology in Bratislava (STU) is a research oriented university contributing to the development and spreading of scientific knowledge. Paper deals with the presentation o...

  18. 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.

  19. The impact of the UK National Minimum Wage on mental health

    Directory of Open Access Journals (Sweden)

    Christoph Kronenberg

    2017-12-01

    Full Text Available Despite an emerging literature, there is still sparse and mixed evidence on the wider societal benefits of Minimum Wage policies, including their effects on mental health. Furthermore, causal evidence on the relationship between earnings and mental health is limited. We focus on low-wage earners, who are at higher risk of psychological distress, and exploit the quasi-experiment provided by the introduction of the UK National Minimum Wage (NMW to identify the causal impact of wage increases on mental health. We employ difference-in-differences models and find that the introduction of the UK NMW had no effect on mental health. Our estimates do not appear to support earlier findings which indicate that minimum wages affect mental health of low-wage earners. A series of robustness checks accounting for measurement error, as well as treatment and control group composition, confirm our main results. Overall, our findings suggest that policies aimed at improving the mental health of low-wage earners should either consider the non-wage characteristics of employment or potentially larger wage increases.

  20. The impact of the UK National Minimum Wage on mental health.

    Science.gov (United States)

    Kronenberg, Christoph; Jacobs, Rowena; Zucchelli, Eugenio

    2017-12-01

    Despite an emerging literature, there is still sparse and mixed evidence on the wider societal benefits of Minimum Wage policies, including their effects on mental health. Furthermore, causal evidence on the relationship between earnings and mental health is limited. We focus on low-wage earners, who are at higher risk of psychological distress, and exploit the quasi-experiment provided by the introduction of the UK National Minimum Wage (NMW) to identify the causal impact of wage increases on mental health. We employ difference-in-differences models and find that the introduction of the UK NMW had no effect on mental health. Our estimates do not appear to support earlier findings which indicate that minimum wages affect mental health of low-wage earners. A series of robustness checks accounting for measurement error, as well as treatment and control group composition, confirm our main results. Overall, our findings suggest that policies aimed at improving the mental health of low-wage earners should either consider the non-wage characteristics of employment or potentially larger wage increases.

  1. A national survey of the effects of fatigue on trainees in anaesthesia in the UK.

    Science.gov (United States)

    McClelland, L; Holland, J; Lomas, J-P; Redfern, N; Plunkett, E

    2017-09-01

    Long daytime and overnight shifts remain a major feature of working life for trainees in anaesthesia. Over the past 10 years, there has been an increase in awareness and understanding of the potential effects of fatigue on both the doctor and the patient. The Working Time Regulations (1998) implemented the European Working Time Directive into UK law, and in August 2009 it was applied to junior doctors, reducing the maximum hours worked from an average of 56 per week to 48. Despite this, there is evidence that problems with inadequate rest and fatigue persist. There is no official guidance regarding provision of a minimum standard of rest facilities for doctors in the National Health Service, and the way in which rest is achieved by trainee anaesthetists during their on-call shift depends on rota staffing and workload. We conducted a national survey to assess the incidence and effects of fatigue among the 3772 anaesthetists in training within the UK. We achieved a response rate of 59% (2231/3772 responses), with data from 100% of NHS trusts. Fatigue remains prevalent among junior anaesthetists, with reports that it has effects on physical health (73.6% [95%CI 71.8-75.5]), psychological wellbeing (71.2% [69.2-73.1]) and personal relationships (67.9% [65.9-70.0]). The most problematic factor remains night shift work, with many respondents commenting on the absence of breaks, inadequate rest facilities and 57.0% (55.0-59.1) stating they had experienced an accident or near-miss when travelling home from night shifts. We discuss potential explanations for the results, and present a plan to address the issues raised by this survey, aiming to change the culture around fatigue for the better. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  2. Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards.

    Science.gov (United States)

    Manley, Stephen; Last, Andrew; Fu, Kenneth; Greenham, Stuart; Kovendy, Andrew; Shakespeare, Thomas P

    2015-06-01

    Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients.

  3. Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards

    Energy Technology Data Exchange (ETDEWEB)

    Manley, Stephen, E-mail: stephen.manley@ncahs.health.nsw.gov.au; Last, Andrew; Fu, Kenneth; Greenham, Stuart; Kovendy, Andrew; Shakespeare, Thomas P [North Coast Cancer Institute, Lismore, New South Wales (Australia)

    2015-06-15

    Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients.

  4. Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards

    International Nuclear Information System (INIS)

    Manley, Stephen; Last, Andrew; Fu, Kenneth; Greenham, Stuart; Kovendy, Andrew; Shakespeare, Thomas P

    2015-01-01

    Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients

  5. Prostatic pathology reporting in the UK: development of a national external quality assurance scheme.

    Science.gov (United States)

    Harnden, P; Coleman, D; Moss, S; Kodikara, S; Patnick, J; Melia, J

    2008-01-01

    To develop a baseline picture of prostatic pathology reporting in the UK, identify areas of particular difficulty and assess the feasibility of a national external quality assurance scheme based on prostatic biopsy specimens using the same format as the National Health Service breast pathology scheme, as recommended by the National Institute for Clinical Excellence. Eight expert uropathologists and 32 randomly selected pathologists participated in four circulations each of 12 cases of prostatic biopsy specimens. A fixed text proforma was developed and responses were analysed for interobserver agreement using kappa statistics. Consistency of reporting the main diagnostic categories of benign and invasive carcinoma was good (kappa values 0.77 and 0.88, respectively), but only after excluding 19% of cases for which the experts did not reach 75% agreement. Areas of difficulty included the diagnosis of high-grade prostatic intraepithelial neoplasia and small foci of cancer. Prognostic factor reporting was more variable, with lower overall kappas for the assessment of Gleason grading (experts 0.55, others 0.50), perineural invasion (experts 0.64, others 0.50) and number of positive cores (experts 0.74, others 0.61). Given the difficulties in diagnosis of prostatic biopsy specimens and the assessment of prognostic factors, the expansion of the scheme could deliver important educational benefits.

  6. Current and future delivery of diagnostic electron microscopy in the UK: results of a national survey.

    Science.gov (United States)

    de Haro, Tracey; Furness, Peter

    2012-04-01

    Electron microscopy (EM) remains essential to delivering several specialist areas of diagnosis, especially the interpretation of native renal biopsies. However, there is anecdotal evidence of EM units struggling to survive, for a variety of reasons. The authors sought to obtain objective evidence of the extent and the causes of this problem. An online survey was undertaken of Fellows of the Royal College of Pathologists who use EM in diagnosis. A significant number of EM units anticipate having to close and hence outsource their EM work in the coming years. Yet most existing units are working to full capacity and would be unable to take on the substantial amounts of extra work implied by other units outsourcing their needs. Equipment and staffing are identified by most EM units as the major barriers to growth and are also the main reasons cited for units facing potential closure. In the current financial climate it seems unlikely that units will be willing to make the large investment in equipment and staff needed to take on extra work, unless they can be reasonably confident of an acceptable financial return as a result of increased external referral rates. The case is thus made for a degree of national coordination of the future provision of this specialist service, possibly through the National Commissioning Group or the new National Commissioning Board. Without this, the future of diagnostic EM services in the UK is uncertain. Its failure would pose a threat to good patient care.

  7. The Neutron Personal Dosimetry Service of the Centre for Radiation, Chemical and Environmental Hazards, PHE-UK

    International Nuclear Information System (INIS)

    Campo Blanco, X.

    2015-01-01

    The Centre for Radiation, Chemical and Environmental Hazards (CRCEH), that belongs to Public Health England (PHE), hosts the official Neutron Personal Dosimetry Service of the United Kingdom. They use etched-track detectors, made of a material called PADC (poly-allyl diglycol carbonate), to determinate de neutron personal dose. A two weeks visit has been made to this center, in order to learn about the facilities, the methods employed and the legislative framework of the Neutron Personal Dosimetry Service. In this work the main results of this visits are shown, which are interesting for the future development of an official neutron personal dosimetry service in Spain.

  8. Paediatric rheumatology: clinical practice review. Physiotherapy and occupational therapy for juvenile chronic arthritis: custom and practice in five centres in the UK, USA and Canada

    Science.gov (United States)

    Hackett; Johnson; Parkin; Southwood

    1996-07-01

    Physiotherapy and occupational therapy are widely accepted as being of central importance for the treatment of juvenile chronic arthritis (JCA). However, these approaches have rarely been subject to critical scrutiny. The aims of this report are to highlight some of the inter-centre similarities and differences observed in the implementation of physical and occupational therapy for JCA, and to emphasize the need for scientifically controlled research in this area. During a series of visits to several paediatric rheumatology units in the UK, USA and Canada, three aspects of the service were noted: treatment philosophy, physical interventions used for the treatment of JCA and quality-of life and independence training activities. There was general consensus with the philosophy that early physical intervention was a vital part of the treatment plan for JCA, although all therapists were concerned that compliance with treatment modalities was poor. Differences between units in the approach to acute arthritis, the use of foot othoses and wrist splints, the treatment of joint contractures and the use of general quality-of-life training activities were noted. Although it was widely recognized that controlled research into the efficacy of physical intervention was needed, no centre had a co-ordinated plan for such investigations. Keywords: Juvenile chronic arthritis, Physiotherapy, Occupational therapy

  9. France: National INIS Centre: New Directions and Main Achievements in an Evolving Context

    International Nuclear Information System (INIS)

    Surmont, Jérôme; Mouffron, Odile

    2015-01-01

    In a letter dated October 8, 1969 and addressed to the Director General of the IAEA, the French Governor of the IAEA Board of Governors gave his official consent for France to participate in the newborn INIS. At the same time, it was decided to establish the France National INIS Centre at the premises of the Central Documentation Department, located at the Saclay Nuclear Research Centre (French Atomic Energy Commission - CEA), near Paris. Forty-five years later, the Central Documentation has become the “Information Valorization Service” (SVI in French) which incorporates INIS, the CEA-Saclay Scientific Library and several other scientific and technical information-related activities (archives, scientific watch, collaborative work, bibliometric surveys, etc.). This brief look back over the last 20 years of the France National INIS Centre allows us to measure how far we have come and what choices we have had to make in a constantly evolving context. We have particularly stressed what, in our view, represents the most important mission of INIS, which is the preservation and dissemination of nuclear knowledge, in particular through the coverage and full text archiving of conferences and grey literature documents, with special attention paid to PhD Theses

  10. A mixed methods investigation of dropout among talented young dancers: findings from the UK Centres for Advanced Training.

    Science.gov (United States)

    Walker, Imogen J; Nordin-Bates, Sanna M; Redding, Emma

    2012-01-01

    The aim of this study was to understand reasons for dropout from a dance-talent program in the UK, using a mixed methods design. In-depth interviews were conducted with ten dropout students to explore the influencing factors in their decision to leave the program. In order to triangulate these findings, reasons for dropout were then examined from descriptive records of 147 young dancers who had withdrawn from the talent program over a four-year period. Overall, the most frequently cited reasons for dropping out were conflicting demands, change in aspirations, course content, difficulty making friends, and lost passion. Injury, financial factors, low perceived competence, and teacher behavior emerged as minor reasons. Intervention strategies that focus on changes in course content may be the easiest to implement and most effective means to enhance student retention.

  11. Bibliometric analyses of publications from Centres of Excellence funded by the Danish National Research Foundation

    DEFF Research Database (Denmark)

    Schneider, Jesper Wiborg; Costas, Rodrigo; Henriksen, Dorte

    2013-01-01

    research. The main focus of the evaluation is on the Centre of Excellence (CoE) scheme and the impact it has had on the Danish research system. The key topics addressed are the role of the DNRF in the Danish research funding system, research quality, research training and recruitment, internationalisation......, the interaction with host institutions, and the governance and management of the DNRF. The evaluation concludes that the DNRF has had a very positive impact on the quality of research in Denmark and recommends that the foundation is re-funded. The evaluation is based on a bibliometric study, self......-assessment report by DNRF, numerous interviews and desk studies. Appendix 5: Bibliometric analyses of publications from Centres of Excellence funded by the Danish National Research Foundation...

  12. Changing epidemiology of AA amyloidosis: clinical observations over 25 years at a single national referral centre.

    Science.gov (United States)

    Lane, Thirusha; Pinney, Jennifer H; Gilbertson, Janet A; Hutt, David F; Rowczenio, Dorota M; Mahmood, Shameem; Sachchithanantham, Sajitha; Fontana, Marianna; Youngstein, Taryn; Quarta, Candida C; Wechalekar, Ashutosh D; Gillmore, Julian D; Hawkins, Philip N; Lachmann, Helen J

    2017-09-01

    Systemic AA amyloidosis is a serious complication of chronic inflammation; however, there are relatively few published data on its incidence. We investigated the changing epidemiology of AA amyloidosis over a 25-year period at a single national referral centre. We conducted a retrospective study of all patients diagnosed with AA amyloidosis who had attended the centre between 1990 and 2014 inclusive. Six hundred and twenty-five patients were studied in three cohorts: C1: 1990-1997; C2: 1998-2006; C3: 2007-2014. Mean age at presentation increased from 46 in C1 to 56 in C3 (p AA amyloidosis over a quarter of a century, reflecting advances in therapeutics and overall management of complex chronic disease in an ageing population. AA amyloidosis of uncertain aetiology presents an emerging major problem. Newer techniques such as next-generation sequencing may aid diagnosis and effective treatment, thereby improving overall survival.

  13. Database INIS and up-grade of the INIS National Centre of the Slovak Republic

    International Nuclear Information System (INIS)

    Kuruc, J.; Rajec, P.

    2008-01-01

    Authors deals with the history, present and future of the International Nuclear Information System (INIS). The INIS is the world leading information system on the peaceful uses of nuclear energy. The INIS is operated by the International Atomic Energy Agency (IAEA) in collaboration with 119 Member States and 23 co-operating international organisations. In the INIS database there are about 3.0 million items and among them 700 000 non-conventional literature (scientific reports, dissertations, brochures and patents). The INIS databases can be obtained from Local INIS centre, trough Internet and by prescription. In the second part the operation and history of the INIS National Centre of the Slovak Republic as well as up-grade of its HW and SW are presented. (authors)

  14. Hazard of household cleaning products: a study undertaken by the UK National Poisons Information Service.

    Science.gov (United States)

    Williams, Hayley; Moyns, Emma; Bateman, D Nicholas; Thomas, Simon H L; Thompson, John P; Vale, J Allister

    2012-09-01

    To ascertain the reported toxicity of current United Kingdom (UK) household products following the launch of new products, such as liquid detergent capsules, and the manufacture of more concentrated formulations. Between 1 March 2008 and 30 April 2009 the UK National Poisons Information Service (NPIS) collected prospectively 5939 telephone enquiries relating to household products, approximately 10% of all telephone enquiries received over this period. The majority of enquiries (n = 3893; 65.5%) concerned children 5 years of age or less and were received predominantly from hospitals (n = 1905; 32.1%), general practitioners (n = 1768; 29.8%) and NHS Direct/NHS 24 (n = 1694; 28.5%). The majority of exposures occurred at home (n = 5795; 97.6%); most exposures were accidental (n = 5561; 93.6%). Liquid detergent capsules were most commonly involved (n = 647), followed by bleaches (n = 481), air fresheners (n = 429), multipurpose cleaners (n = 408), dishwasher products (n = 399) and descalers (n = 397). Exposure to household products occurred mainly as a result of ingestion (n = 4616; 75.8%), with eye contact (n = 513; 8.4%), inhalation (n = 420; 6.9%) and skin contact (n = 187; 3.1%) being less common; 5.1% (n = 313) of enquiries involved multiple routes of exposure. The most commonly reported features were vomiting (ingestion), pain (eye contact), dyspnoea (inhalation) and burns (skin contact). In 5840 of 5939 enquiries the Poisoning Severity Score (PSS) was known. The majority of patients (n = 4117; 70.5%) were asymptomatic (PSS 0), 28.0% (n = 1638) developed minor features (PSS 1), 1.3% (75 patients) developed moderate features (PSS 2) and 0.15% (nine patients) developed serious features (PSS 3). Four of these nine patients made a complete recovery, two died from exposure to drain cleaner and PVC solvent cleaner; the outcome in three was unknown. In the UK, advice from the NPIS is sought commonly regarding household products, but such exposures only rarely result in

  15. UK national clinical audit: management of pregnancies in women with HIV

    Directory of Open Access Journals (Sweden)

    S. Raffe

    2017-02-01

    Full Text Available Abstract Background The potential for HIV transmission between a pregnant woman and her unborn child was first recognized in 1982. Since then a complex package of measures to reduce risk has been developed. This project aims to review UK management of HIV in pregnancy as part of the British HIV Association (BHIVA audit programme. Methods The National Study of HIV in Pregnancy and Childhood (NSHPC, a population-based surveillance study, provided data for pregnancies with an expected delivery date from 1/1/13 - 30/6/14. Services also completed a survey on local management policies. Data were audited against the 2012 BHIVA pregnancy guidelines. Results During the audit period 1483 pregnancies were reported and 112 services completed the survey. Use of dedicated multidisciplinary teams was reported by 99% although 26% included neither a specialist midwife nor nurse. 17% of services reported delays >1 week for HIV specialist review of women diagnosed antenatally. Problematic urgent HIV testing had been experienced by 9% of services although in a further 49% the need for urgent testing had not arisen. Delays of >2 h in obtaining urgent results were common. Antiretroviral therapy (ART was started during pregnancy in 37% women with >94% regimens in accordance with guidelines. Late ART initiation was common, particularly in those with a low CD4 count or high viral load. Eleven percent of services reported local policy contrary to guidelines regarding delivery mode for women with a VL <50 copies/mL at ≥36 weeks. According to NSHPC reports 27% of women virologically eligible for vaginal delivery planned to deliver by CS. Conclusions Pregnant women in the UK are managed largely in accordance with BHIVA guidelines. Improvements are needed to ensure timely referral and ART initiation to ensure the best possible outcomes.

  16. Does national scale economic and environmental indicators spur logistics performance? Evidence from UK.

    Science.gov (United States)

    Khan, Syed Abdul Rehman; Qianli, Dong

    2017-12-01

    The aim of this study is to examine the association between national economic and environmental indicators with green logistics performance in a time series data of UK since 1981 to 2016. The research used autoregressive distributed lag method to understand the long-run and short-run relationships of national scale economic (foreign direct investment (FDI) inflows, per capita income) and environmental indicators (total greenhouse gases, fossil fuel, and renewable energy) on green logistics. In the short run, the research findings indicate that the green logistics and renewable energy have positive relationship, while fossil fuel is negatively correlated with green logistics operations. On the other hand, in the long run, the results show that FDI inflows, renewable energy sources, and per capita income have statistically significant and positive association with green logistics activities, while foreign investments attracted by environmental friendly policies and practices adopted in global logistics operations, which not only increase the environmental sustainability but also enhance economic activities with greater export opportunities in the region.

  17. Self-expandable metal stent placement for the palliation of malignant gastroduodenal obstruction: experience in a large, single, UK centre

    Energy Technology Data Exchange (ETDEWEB)

    Lowe, A.S. [Department of Clinical Radiology, Bradford Royal Infirmary (United Kingdom)]. E-mail: andy.lowe@bradfordhospitals.nhs.uk; Beckett, C.G. [Department of Gastroenterology, Bradford Royal Infirmary (United Kingdom); Jowett, S. [Department of Gastroenterology, Bradford Royal Infirmary (United Kingdom); May, J. [Department of Surgery, Bradford Royal Infirmary (United Kingdom); Stephenson, S. [Department of Clinical Radiology, Bradford Royal Infirmary (United Kingdom); Scally, A. [School of Health Studies, Bradford (United Kingdom); Tam, E. [Department of Clinical Radiology, Bradford Royal Infirmary (United Kingdom); Kay, C.L. [Department of Clinical Radiology, Bradford Royal Infirmary (United Kingdom)

    2007-08-15

    Aim: To assess the technical success rate, and evaluate the clinical outcome, length of hospital stay, and cost of palliative gastro-duodenal stenting in a single-centre. Materials and methods: Eight-seven patients referred for insertion of a gastroduodenal stent between April 1999 and April 2004 were recruited to a non-randomized, before and after intervention study performed in a single centre. Demographic data, diagnosis and symptoms along with clinical and technical outcomes were recorded. Results: The technical success rate was 84/87 (96.6%), with inability to traverse the stricture in three patients. No immediate complications were demonstrated. There was marked improvement after stent placement with resolution of symptoms and commencement of dietary intake in 76 patients (87%). Stenting resulted in improved quality of life as reflected by an increase in Karnofsky score from 44/100, to 63/100 post-procedure. Late complications included perforation (n = 1), migration (n = 1) and stent occlusions due to tumour ingrowth/overgrowth (n = 7; mean 165 days). Mean survival was 107 days (range 0-411 days). Median hospital stay post-stent placement was 5.5 days (range 1-55 days) with a majority of patients (75%) discharged home. The mean cost of each treatment episode was Pounds 4146 ($7132 $US, Euro 6,028 EUROS). Conclusion: The present series confirms that combined endoscopic and radiological gastroduodenal stenting is a highly favourable treatment for patients with inoperable malignant gastric outlet obstruction. The results suggest that this minimally invasive procedure has a very high technical success rate, whilst at the same time providing excellent palliation of symptoms with improved quality of life in the majority of patients.

  18. 'Smashed by the National Health'? A Closer Look at the Demise of the Pioneer Health Centre, Peckham.

    Science.gov (United States)

    Conford, Philip

    2016-04-01

    The Pioneer Health Centre, based in South London before and after the Second World War, remains a source of interest for advocates of a positive approach to health promotion in contrast with the treatment of those already ill. Its closure in 1950 for lack of funds has been blamed on the then recently established National Health Service, but this article argues that such an explanation is over-simplified and ignores a number of other factors. The Centre had struggled financially during the 1930s and tried to gain support from the Medical Research Council. The Council appeared interested in the Centre before the war, but was less sympathetic in the 1940s. Around the time of its closure and afterwards, the Centre was also involved in negotiations with London County Council; these failed because the Centre's directors would not accept the changes which the Council would have needed to make. Unpublished documents reveal that the Centre's directors were uncompromising and that their approach to the situation antagonised their colleagues. Changes in medical science also worked against the Centre. The success of sulphonamide drugs appeared to render preventive medicine less significant, while the development of statistical techniques cast doubt on the Centre's experimental methods. The Centre was at the heart of the nascent organic farming movement, which opposed the rapid growth of chemical cultivation. But what might be termed 'chemical triumphalism' was on the march in both medicine and agriculture, and the Centre was out of tune with the mood of the times.

  19. Wind Resource Assessment – Østerild National Test Centre for Large Wind Turbines

    OpenAIRE

    Hansen, Brian Ohrbeck; Courtney, Michael; Mortensen, Niels Gylling

    2014-01-01

    This report presents a wind resource assessment for the seven test stands at the Østerild National Test Centre for Large Wind Turbines in Denmark. Calculations have been carried out mainly using wind data from three on-site wind lidars. The generalized wind climates applied in the wind resource calculations for the seven test stands are based on correlations between a short period of on-site wind data from the wind lidars with a long-term reference. The wind resource assessment for the seven ...

  20. Recruiting ENT and Audiology patients into pharmaceutical trials: evaluating the multi-centre experience in the UK and USA.

    Science.gov (United States)

    Sanchez, Victoria A; Hall, Deborah A; Millar, Bonnie; Escabi, Celia D; Sharman, Alice; Watson, Jeannette; Thasma, Sornaraja; Harris, Peter

    2018-01-21

    Recruiting into clinical trials on time and on target is a major challenge and yet often goes unreported. This study evaluated the adjustment to procedures, recruitment and screening methods in two multi-centre pharmaceutical randomised controlled trials (RCTs) for hearing-related problems in adults. Recruitment monitoring and subsequent adjustment of various study procedures (e.g. eligibility criteria, increasing recruiting sites and recruitment methods) are reported. Participants were recruited through eight overarching methods: trial registration, posters/flyers, print publications, Internet, social media, radio, databases and referrals. The efficiency of the recruitment was measured by determining the number of people: (1) eligible for screening as a percentage of those who underwent telephone pre-screening and (2) randomised as a percentage of those screened. A total of 584 participants completed the pre-screening steps, 491 screened and 169 participants were randomised. Both RCTs completed adjustments to the participant eligibility, added new study sites and additional recruitment methods. No single recruitment method was efficient enough to serve as the only route to enrolment. A diverse portfolio of methods, continuous monitoring, mitigation strategy and adequate resourcing were essential for achieving our recruitment goals.

  1. Designing and implementing E-health Applications in the UK's National Health Service.

    Science.gov (United States)

    Bower, D Jane; Barry, Nessa; Reid, Margaret; Norrie, John

    2005-12-01

    Telemedicine/e-health applications have the potential to play an important role in Britain's National Health Service (NHS), including the NHS in Scotland. The Scottish Telemedicine Action Forum (STAF) was established by the Scottish Executive Department of Health in 1999 to take a range of applications, targeted on national priorities, into routine service. In the process it has provided insights into how advanced information and communication technologies (ICTs) can be moved from the research stage into routine service. In this article four of the projects are described and analysed focusing on the key issues that have emerged as critical for carrying projects successfully through to implementation in service as follows: 1. A multisite videoconferencing network linking 15 minor injury units to the main accident and emergency (A&E) centre. 2. A single-site neonatal intensive care "cotside" laptop system to assist communication between parents and clinical staff. 3. A single-site outpatient chronic disease management system. 4. A multisite software audit tool to support the care of cleft lip and palate patients from birth onward.

  2. The UK National Health Service's 'innovation agenda': lessons on commercialisation and trust.

    Science.gov (United States)

    Sterckx, Sigrid; Cockbain, Julian

    2014-01-01

    The UK National Health Service (the 'NHS'), encouraged by the 2011 report Innovation Health and Wealth, Accelerating Adoption and Diffusion in the NHS, and empowered by the Health and Social Care Act 2012, is in the process of adopting a new agenda for stimulating innovation in healthcare. For this, the bodies, body materials, and confidential health information of NHS patients may be co-opted. We explain why this brings the NHS into a moral conflict with its basic goal of providing a universal healthcare service. Putting NHS databases at the disposal of industry, without addressing ethical concerns regarding the privacy, autonomy, and moral integrity of patients and without requiring a 'kick-back' to enhance the service that the NHS provides, is inappropriate. As this article shows, with reference to the commercial arena of direct-to-consumer genetic testing, it is crucial that patient and public trust in the NHS is not eroded. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. The psychological contract: is the UK National Health Service a model employer?

    Science.gov (United States)

    Fielden, Sandra; Whiting, Fiona

    2007-05-01

    The UK National Health Service (NHS) is facing recruitment challenges that mean it will need to become an 'employer of choice' if it is to continue to attract high-quality employees. This paper reports the findings from a study focusing on allied health professional staff (n = 67), aimed at establishing the expectations of the NHS inherent in their current psychological contract and to consider whether the government's drive to make the NHS a model employer meets those expectations. The findings show that the most important aspects of the psychological contract were relational and based on the investment made in the employment relationship by both parties. The employment relationship was one of high involvement but also one where transactional contract items, such as pay, were still of some importance. Although the degree of employee satisfaction with the relational content of the psychological contract was relatively positive, there was, nevertheless, a mismatch between levels of importance placed on such aspects of the contract and levels of satisfaction, with employees increasingly placing greater emphasis on those items the NHS is having the greatest difficulty providing. Despite this apparent disparity between employee expectation and the fulfilment of those expectations, the overall health of the psychological contract was still high.

  4. Potential challenges facing distributed leadership in health care: evidence from the UK National Health Service.

    Science.gov (United States)

    Martin, Graeme; Beech, Nic; MacIntosh, Robert; Bushfield, Stacey

    2015-01-01

    The discourse of leaderism in health care has been a subject of much academic and practical debate. Recently, distributed leadership (DL) has been adopted as a key strand of policy in the UK National Health Service (NHS). However, there is some confusion over the meaning of DL and uncertainty over its application to clinical and non-clinical staff. This article examines the potential for DL in the NHS by drawing on qualitative data from three co-located health-care organisations that embraced DL as part of their organisational strategy. Recent theorising positions DL as a hybrid model combining focused and dispersed leadership; however, our data raise important challenges for policymakers and senior managers who are implementing such a leadership policy. We show that there are three distinct forms of disconnect and that these pose a significant problem for DL. However, we argue that instead of these disconnects posing a significant problem for the discourse of leaderism, they enable a fantasy of leadership that draws on and supports the discourse. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  5. Spent fuel reprocessing and minor actinide partitioning safety related research at the UK National Nuclear Laboratory

    International Nuclear Information System (INIS)

    Carrott, Michael; Flint, Lauren; Gregson, Colin; Griffiths, Tamara; Hodgson, Zara; Maher, Chris; Mason, Chris; McLachlan, Fiona; Orr, Robin; Reilly, Stacey; Rhodes, Chris; Sarsfield, Mark; Sims, Howard; Shepherd, Daniel; Taylor, Robin; Webb, Kevin; Woodall, Sean; Woodhead, David

    2015-01-01

    The development of advanced separation processes for spent nuclear fuel reprocessing and minor actinide recycling is an essential component of international R and D programmes aimed at closing the nuclear fuel cycle around the middle of this century. While both aqueous and pyrochemical processes are under consideration internationally, neither option will gain broad acceptance without significant advances in process safety, waste minimisation, environmental impact and proliferation resistance; at least when compared to current reprocessing technologies. The UK National Nuclear Laboratory (NNL) is developing flowsheets for innovative aqueous separation processes. These include advanced PUREX options (i.e. processes using tributyl phosphate as the extractant for uranium, plutonium and possibly neptunium recovery) and GANEX (grouped actinide extraction) type processes that use diglycolamide based extractants to co-extract all transuranic actinides. At NNL, development of the flowsheets is closely linked to research on process safety, since this is essential for assessing prospects for future industrialisation and deployment. Within this context, NNL is part of European 7. Framework projects 'ASGARD' and 'SACSESS'. Key topics under investigation include: hydrogen generation from aqueous and solvent phases; decomposition of aqueous phase ligands used in separations prior to product finishing and recycle of nitric acid; dissolution of carbide fuels including management of organics generated. Additionally, there is a strong focus on use of predictive process modelling to assess flowsheet sensitivities as well as engineering design and global hazard assessment of these new processes. (authors)

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

    Science.gov (United States)

    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.

  7. 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

  8. Automation and Networking of Public Libraries in India Using the E-Granthalaya Software from the National Informatics Centre

    Science.gov (United States)

    Matoria, Ram Kumar; Upadhyay, P. K.; Moni, Madaswamy

    2007-01-01

    Purpose: To describe the development of the library management system, e-Granthalaya, for public libraries in India. This is an initiative of the Indian government's National Informatics Centre (NIC). The paper outlines the challenges and the potential of a full-scale deployment of this software at a national level. Design/methodology/approach:…

  9. Action plan for the comprehensive nuclear-test-ban treaty (CTBT) Malaysian National Data Centre

    International Nuclear Information System (INIS)

    Bashillah Baharuddin; Alawiah Musa; Roslan Mohd Ali

    2007-01-01

    The Comprehensive Nuclear-Test-Ban Treaty (CTBT) is a keystone of the international regime on the non-proliferation of nuclear weapons and an essential basis for the pursuit of nuclear disarmament. Its total ban of any nuclear weapon test explosion moreover will restrict the development and qualitative improvement of nuclear weapons and end the development of advanced new types of these weapons. One of the key features of this treaty is the development of an International Monitoring System (IMS) to detect any nuclear weapon test. The IMS comprises a network of 321 monitoring stations and 16 radionuclide laboratories that monitor the Earth for evidence of nuclear explosions. It uses four verification methods, including seismic, hydroacoustic and infrasound, in addition to radionuclide monitoring of the underground, underwater and atmosphere environments, respectively, whereas, radionuclide monitoring can detect radioactive debris vented from atmospheric, underground or underwater nuclear explosions. Malaysia signed the CTBT on 23 July 1998, and is currently in the process of drafting a national CTBT Act to facilitate ratification. As provided for under the Treaty, one of the radionuclide-monitoring stations (Rain) under the IMS will be located in Malaysia. The station is under the responsibility of the Malaysian Nuclear Agency, as the National Authority for the CTBT. The operation of the IMS is supported by an International Data Centre (IDC) CTBT, which is based at the headquarters of the Preparatory Commission for the CTBT Organization (CTBTO) in Vienna. To facilitate the acquisition of data from the IMS for the purposes of verifying compliance with the Treaty in general, and to enable Malaysia to benefit from the scientific applications of the data obtainable from the IDC, a CTBT National Data Centre (NDC) is the process of being established in Malaysia , which is targeted to be fully operational by the third quarter of 2007. (Author)

  10. An evaluation on the impact of national cancer wait targets on a (UK) radiotherapy department

    International Nuclear Information System (INIS)

    Roberts, Neill

    2012-01-01

    The radiotherapy department in this evaluation has been working towards full compliance with national cancer wait targets (CWT) since their implementation. 31 and 62 day targets set a maximum time frame for cancer patients to commence treatment. This evaluation explored the impact of these targets on staff and patients within the radiotherapy department and their overall impact on the radiotherapy service. Methods: This evaluation followed a mixed method approach of sequential triangulation. Qualitative data collection and analysis dominate findings but existing quantitative data, available within the department, was used to support the overall findings. Staff and patient interviews were used to establish attitudes to and experiences of the CWT initiative in relation to radiotherapy treatment. Quantitative data was taken from the local Cancer Centre CWT database that tracks patients referred for radiotherapy. Findings and Conclusion: Qualitative data analysis identified four main themes: pressure, appropriateness of target lengths, quality of treatment provided and efficiency of working practices within the department. Responses within these themes were both positive and negative with patients mainly the former and staff the latter. Quantitative evaluation found an increased monitoring and management burden from the CWT initiative, primarily for administrative, clerical and managerial staff. The main impact of the CWT initiative was an increase in pressure on staff due to reduced time to prepare and deliver treatment. Patients felt the initiative had not impacted negatively on their care and experienced a reduction in anxiety due to a reduction in waiting time.

  11. Comparison of children’s food and beverage intakes with national recommendations in New York City child-care centres

    Science.gov (United States)

    Dixon, L Beth; Breck, Andrew; Khan, Laura Kettel

    2016-01-01

    Objective The present study compared foods and beverages provided to and consumed by children at child-care centres in New York City (NYC) with national nutrition recommendations. Design The study used survey, observational and centre record data collected from child-care centres. Food and beverage intakes from two days of observation and amounts of energy and nutrients were estimated using the US National Cancer Institute’s Automated Self-Administered 24 h Recall system. Setting Meal and snack time at 108 child-care centres in low-income communities in NYC. Subjects Children aged 3–4 years old in classrooms selected by the directors of the participating child-care centres. Results Foods and beverages provided to and consumed by children (n 630) met >50% of the Dietary Reference Intake (DRI) for most nutrients. Intakes of fibre and vitamins D and E were Foods and beverages provided >50% of the recommended average daily intake amounts for total grains, fruits and fruit juices, and dairy, but foods and vegetables. Intake of oils was below the allowance for energy levels, but foods and beverages with solid fats and added sugars exceeded the limits by 68%. Conclusions Providing more whole grains, vegetables and low-fat dairy and fewer foods with solid fats and added sugars may improve children’s diet quality when at child-care centres. Centre staff may need training, resources and strategies in order to meet the nutrition recommendations. PMID:27280552

  12. Patient satisfaction and non-UK educated nurses: a cross-sectional observational study of English National Health Service Hospitals.

    Science.gov (United States)

    Germack, Hayley D; Griffiths, Peter; Sloane, Douglas M; Rafferty, Anne Marie; Ball, Jane E; Aiken, Linda H

    2015-12-02

    To examine whether patient satisfaction with nursing care in National Health Service (NHS) hospitals in England is associated with the proportion of non-UK educated nurses providing care. Cross-sectional analysis using data from the 2010 NHS Adult Inpatient Survey merged with data from nurse and hospital administrator surveys. Logistic regression models with corrections for clustering were used to determine whether the proportions of non-UK educated nurses were significantly related to patient satisfaction before and after taking account of other hospital, nursing and patient characteristics. 31 English NHS trusts. 12,506 patients 16 years of age and older with at least one overnight stay that completed a satisfaction survey; 2962 bedside care nurses who completed a nurse survey; and 31 NHS trusts. Patient satisfaction. The percentage of non-UK educated nurses providing bedside hospital care, which ranged from 1% to 52% of nurses, was significantly associated with patient satisfaction. After controlling for potential confounding factors, each 10-point increase in the percentage of non-UK educated nurses diminished the odds of patients reporting good or excellent care by 12% (OR=0.88), and decreased the odds of patients agreeing that they always had confidence and trust in nurses by 13% (OR=0.87). Other indicators of patient satisfaction also revealed lower satisfaction in hospitals with higher percentages of non-UK educated nurses. Use of non-UK educated nurses in English NHS hospitals is associated with lower patient satisfaction. Importing nurses from abroad to substitute for domestically educated nurses may negatively impact quality of care. 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/

  13. Database INIS and INIS National Centre of the Slovak Republic. Past, present and future

    International Nuclear Information System (INIS)

    Kuruc, J.

    2007-01-01

    Author in this paper deals with the history, present and future of the International Nuclear Information System (INIS). The INIS is the world leading information system on the peaceful uses of nuclear energy. The INIS is operated by the International Atomic Energy Agency (IAEA) in collaboration with 117 Member States and 23 co-operating international organisations. The collection of inputs and the dissemination of outputs to users are decentralised. Data processing and output production are centralised in the INIS Secretariat. This is very comprehensive coverage and effective method of handling information on different languages. In the INIS database there are more than 2.8 million items and among them 700 000 non-conventional literature (scientific reports, dissertations, brochures and patents). The INIS databases can be obtained from Local INIS centre, trough Internet and by prescription. In this paper in detail the information that can be obtained from INIS database and how that can be done in Slovakia is discussed. The second part deals with the work and history of the INIS National Centre of the Slovak Republic (author)

  14. Designing better medicines delivery in the UK National Health Services (NHS

    Directory of Open Access Journals (Sweden)

    P. John Clarkson

    2009-11-01

    Full Text Available Background: Prescribed medicines are delivered through a variety ofroutes to patients in the UK National Health Service (NHSand are regulated by a host of health and trade related policy and law. These ensure the efficient and safe supply of medicines of appropriate quality from the pharmaceutical manufacturer through to the end-user, the patient. However, persisting medication errors and therecent discovery of counter feit medicines in the bona fide supply chain have meant there are growing concerns aboutthe timely, accurate and safe supply of medicines in the NHS. Methods: This study undertakes a systems design approach to processmodelling and understanding three key supply routes fromthe manufacturer through to the patient, across bothprimary and secondary care. A systems design approachwas deployed to investigate complex interactions betweenprofessionals, products and processes to improve patient safety in collaboration with twenty five clinical and non-linical stakeholders across the supply chain and six enduser patients.Results: Several system process models were developed from the literature, field observations and alongside the interviewees. The results reveal that risk to medication safety is perceived as occurring most at the patient-end ofthe medicines supply chain: the pharmacy and the ward.There are differences observed in the responses ofinterviewees when they engage with system models.Conclusions: This paper reflects on the use of a systems design, a mainly engineering approach, to understanding a health care domain problem of medication errors. The approach provided an enhanced insight into the complex set of system factors and interactions involved in generating medication errors. This study is among the first to develop asystems-wide view of the medicines supply process ‘as-is’and identify opportunities for re-design to improve patient safety.

  15. The UK National DNA Database: Implementation of the Protection of Freedoms Act 2012.

    Science.gov (United States)

    Amankwaa, Aaron Opoku; McCartney, Carole

    2018-03-01

    In 2008, the European Court of Human Rights, in S and Marper v the United Kingdom, ruled that a retention regime that permits the indefinite retention of DNA records of both convicted and non-convicted ("innocent") individuals is disproportionate. The court noted that there was inadequate evidence to justify the retention of DNA records of the innocent. Since the Marper ruling, the laws governing the taking, use, and retention of forensic DNA in England and Wales have changed with the enactment of the Protection of Freedoms Act 2012 (PoFA). This Act, put briefly, permits the indefinite retention of DNA profiles of most convicted individuals and temporal retention for some first-time convicted minors and innocent individuals on the National DNA Database (NDNAD). The PoFA regime was implemented in October 2013. This paper examines ten post-implementation reports of the NDNAD Strategy Board (3), the NDNAD Ethics Group (3) and the Office of the Biometrics Commissioner (OBC) (4). Overall, the reports highlight a considerable improvement in the performance of the database, with a current match rate of 63.3%. Further, the new regime has strengthened the genetic privacy protection of UK citizens. The OBC reports detail implementation challenges ranging from technical, legal and procedural issues to sufficient understanding of the requirements of PoFA by police forces. Risks highlighted in these reports include the deletion of some "retainable" profiles, which could potentially lead to future crimes going undetected. A further risk is the illegal retention of some profiles from innocent individuals, which may lead to privacy issues and legal challenges. In conclusion, the PoFA regime appears to be working well, however, critical research is still needed to evaluate its overall efficacy compared to other retention regimes. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. 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.

  17. The epidemiology and type of medication errors reported to the National Poisons Information Centre of Ireland.

    Science.gov (United States)

    Cassidy, Nicola; Duggan, Edel; Williams, David J P; Tracey, Joseph A

    2011-07-01

    Medication errors are widely reported for hospitalised patients, but limited data are available for medication errors that occur in community-based and clinical settings. Epidemiological data from poisons information centres enable characterisation of trends in medication errors occurring across the healthcare spectrum. The objective of this study was to characterise the epidemiology and type of medication errors reported to the National Poisons Information Centre (NPIC) of Ireland. A 3-year prospective study on medication errors reported to the NPIC was conducted from 1 January 2007 to 31 December 2009 inclusive. Data on patient demographics, enquiry source, location, pharmaceutical agent(s), type of medication error, and treatment advice were collated from standardised call report forms. Medication errors were categorised as (i) prescribing error (i.e. physician error), (ii) dispensing error (i.e. pharmacy error), and (iii) administration error involving the wrong medication, the wrong dose, wrong route, or the wrong time. Medication errors were reported for 2348 individuals, representing 9.56% of total enquiries to the NPIC over 3 years. In total, 1220 children and adolescents under 18 years of age and 1128 adults (≥ 18 years old) experienced a medication error. The majority of enquiries were received from healthcare professionals, but members of the public accounted for 31.3% (n = 736) of enquiries. Most medication errors occurred in a domestic setting (n = 2135), but a small number occurred in healthcare facilities: nursing homes (n = 110, 4.68%), hospitals (n = 53, 2.26%), and general practitioner surgeries (n = 32, 1.36%). In children, medication errors with non-prescription pharmaceuticals predominated (n = 722) and anti-pyretics and non-opioid analgesics, anti-bacterials, and cough and cold preparations were the main pharmaceutical classes involved. Medication errors with prescription medication predominated for adults (n = 866) and the major medication

  18. The epidemiology and type of medication errors reported to the National Poisons Information Centre of Ireland.

    LENUS (Irish Health Repository)

    Cassidy, Nicola

    2012-02-01

    INTRODUCTION: Medication errors are widely reported for hospitalised patients, but limited data are available for medication errors that occur in community-based and clinical settings. Epidemiological data from poisons information centres enable characterisation of trends in medication errors occurring across the healthcare spectrum. AIM: The objective of this study was to characterise the epidemiology and type of medication errors reported to the National Poisons Information Centre (NPIC) of Ireland. METHODS: A 3-year prospective study on medication errors reported to the NPIC was conducted from 1 January 2007 to 31 December 2009 inclusive. Data on patient demographics, enquiry source, location, pharmaceutical agent(s), type of medication error, and treatment advice were collated from standardised call report forms. Medication errors were categorised as (i) prescribing error (i.e. physician error), (ii) dispensing error (i.e. pharmacy error), and (iii) administration error involving the wrong medication, the wrong dose, wrong route, or the wrong time. RESULTS: Medication errors were reported for 2348 individuals, representing 9.56% of total enquiries to the NPIC over 3 years. In total, 1220 children and adolescents under 18 years of age and 1128 adults (>\\/= 18 years old) experienced a medication error. The majority of enquiries were received from healthcare professionals, but members of the public accounted for 31.3% (n = 736) of enquiries. Most medication errors occurred in a domestic setting (n = 2135), but a small number occurred in healthcare facilities: nursing homes (n = 110, 4.68%), hospitals (n = 53, 2.26%), and general practitioner surgeries (n = 32, 1.36%). In children, medication errors with non-prescription pharmaceuticals predominated (n = 722) and anti-pyretics and non-opioid analgesics, anti-bacterials, and cough and cold preparations were the main pharmaceutical classes involved. Medication errors with prescription medication predominated for

  19. Measurement strategies for the Dutch Nuclear Emergency Response System of the National Poisons Control Centre

    International Nuclear Information System (INIS)

    Van Oostrum, I.E.A.; Joore, J.C.A.; Meulenbelt, J.; Savelkoul, T.J.F.

    1997-04-01

    The measurement strategy applicable to Public Health in case of a Nuclear Emergency affecting the Netherlands is presented. Within the framework of the Dutch Nuclear Emergency Response System (NPK, abbreviated in Dutch) the National Poisons Control Centre of the RIVM/AZU has an advisory obligation towards the Ministry of Public Health, Welfare and Sports (WVS). This role comprises advice to relevant ministries, coordination of the measurement strategies and advice on persons to be reviewed, i.e. physical, biological and clinical dosimetry. The choice of dosimetric methods and measurements to be achieved in case of a larger scale nuclear emergency in the Netherlands is discussed. An actual plan of handling is presented for this measurement plan. Intervention levels defined in NPK 1991 serve as guidelines for successive actions to be performed by regional health services. 8 figs., 6 tabs., 81 refs

  20. Mushroom poisoning in Ireland: the collaboration between the National Poisons Information Centre and expert mycologists.

    LENUS (Irish Health Repository)

    Cassidy, Nicola

    2012-02-01

    BACKGROUND: Occasionally, mycologist assistance is requested to reliably identify mushroom species in symptomatic cases where there is a concern that a toxic species is involved. The aim of this study was to describe the epidemiology of mushroom poisoning in Ireland, to describe the working arrangement between the National Poisons Information Centre (NPIC) and professional mycologists and to present a case series detailing the circumstances when mycologists were consulted. METHODS: Computerised records from 1 January 2004 to 31 December 2009 were retrospectively reviewed and data on patient demographics, circumstances, and mushroom species collated. In 1999, the NPIC established a national registry of volunteer professional mycologists who are available 24 h\\/day for mushroom identification. The NPIC staff liaises directly with the mycologist and arranges transport of mushroom material. Digital photographic images are requested if there is likely to be a delay in arranging transportation of mushroom material, and the images are subsequently emailed to a mycologist. Five cases of suspected mushroom poisoning were chosen to demonstrate the inter-professional collaboration between the NPIC and mycologists. RESULTS: From 2004 to 2009, the NPIC was consulted about 70 cases of suspected mushroom exposures. Forty-five children ingested unknown mushrooms, 12 adults and 2 children ingested hallucinogenic mushrooms and 11 adults ingested wild toxic mushrooms that were incorrectly identified or confused with edible species. The mycologists were consulted 10 times since 1999. In this series, Amanita species were identified in two cases. In three cases, the species identified were Clitocybe nebularis, Coprinus comatus and Panaeolina foenisecii, respectively, and serious poisoning was excluded. Incorrect mushroom identification by a health care professional using the Internet occurred in two cases. The mycologists assisted Poisons Information Centres in Northern Ireland and the

  1. Mushroom poisoning in Ireland: The collaboration between the National Poisons Information Centre and expert mycologists.

    LENUS (Irish Health Repository)

    Cassidy, Nicola

    2011-03-01

    Background. Occasionally, mycologist assistance is requested to reliably identify mushroom species in symptomatic cases where there is a concern that a toxic species is involved. The aim of this study was to describe the epidemiology of mushroom poisoning in Ireland, to describe the working arrangement between the National Poisons Information Centre (NPIC) and professional mycologists and to present a case series detailing the circumstances when mycologists were consulted. Methods. Computerised records from 1 January 2004 to 31 December 2009 were retrospectively reviewed and data on patient demographics, circumstances, and mushroom species collated. In 1999, the NPIC established a national registry of volunteer professional mycologists who are available 24 h\\/day for mushroom identification. The NPIC staff liaises directly with the mycologist and arranges transport of mushroom material. Digital photographic images are requested if there is likely to be a delay in arranging transportation of mushroom material, and the images are subsequently emailed to a mycologist. Five cases of suspected mushroom poisoning were chosen to demonstrate the inter-professional collaboration between the NPIC and mycologists. Results. From 2004 to 2009, the NPIC was consulted about 70 cases of suspected mushroom exposures. Forty-five children ingested unknown mushrooms, 12 adults and 2 children ingested hallucinogenic mushrooms and 11 adults ingested wild toxic mushrooms that were incorrectly identified or confused with edible species. The mycologists were consulted 10 times since 1999. In this series, Amanita species were identified in two cases. In three cases, the species identified were Clitocybe nebularis, Coprinus comatus and Panaeolina foenisecii, respectively, and serious poisoning was excluded. Incorrect mushroom identification by a health care professional using the Internet occurred in two cases. The mycologists assisted Poisons Information Centres in Northern Ireland

  2. Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service

    Directory of Open Access Journals (Sweden)

    Aggarwal R

    2015-11-01

    Full Text Available Reena Aggarwal,1,2 Tim Swanwick2 1Women's Health, Whittington Health, London, UK; 2Health Education England, North Central and East London, London, UK Abstract: Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors in the UK who provide the majority of front-line patient care and form an "operating core" of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing "leaders", to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a "heroic" individual leader to a more distributed model, where organizations are "leader-ful" and not just "well led" and leadership is centered on a shared vision owned by whole teams working on the frontline. Keywords: National Health Service, junior doctors, quality improvement, management, health care

  3. Comparison of UK and US screening criteria for detection of retinopathy of prematurity in a developing nation.

    Science.gov (United States)

    Ugurbas, Silay Canturk; Gulcan, Hande; Canan, Handan; Ankarali, Handan; Torer, Birgin; Akova, Yonca Aydın

    2010-12-01

    To determine the incidence, risk factors, and appropriateness of differing guidelines in developed nations for screening for retinopathy of prematurity (ROP) in a single nursery in a large urban city in southern Turkey. The records of 260 premature infants born ≤34 weeks in a single tertiary unit were retrospectively reviewed for ROP risk factors and diagnosis. Applicability of UK and US criteria were assessed by the use of receiver operating characteristic curves. ROP of any stage was present in 60 infants (23%); ROP requiring treatment was seen in 30 (11.5%). Univariate analysis showed a significant relationship among the following factors: gestational age, birth weight, total duration of supplemental oxygen, duration of mechanical ventilation, respiratory distress syndrome, anemia, and intraventricular hemorrhage (p < 0.0001). Multiple logistic regression analysis showed gestational age (p = 0.039), birth weight (p = 0.05), respiratory distress syndrome (p = 0.05), and anemia (p = 0.004) as independent predictors of ROP requiring treatment. Area under curve for gestational age alone for diagnosing stage 2 or greater ROP was 0.824 ± 0.03 (p = 0.0001) and for birth weight alone was 0.808 ± 0.03 (p = 0.0001). UK screening criteria detected all stage 2 and greater ROP; US screening criteria missed 2 infants with stage 2 ROP but detected all treatment-requiring disease. Adoption of these screening criteria would have reduced unnecessary examinations by either 21% (UK) or 37% (US). UK and US criteria improved the detection accuracy for ROP requiring treatment in Turkey and should be studied for other developing nations. Copyright © 2010 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  4. A National UK Census of Applied Behavior Analysis School Provision for Children with Autism

    Science.gov (United States)

    Griffith, G. M.; Fletcher, R.; Hastings, R. P.

    2012-01-01

    Over more than a decade, specialist Applied Behavior Analysis (ABA) schools or classes for children with autism have developed in the UK and Ireland. However, very little is known internationally about how ABA is defined in practice in school settings, the characteristics of children supported in ABA school settings, and the staffing structures…

  5. Health information technology and sociotechnical systems: a progress report on recent developments within the UK National Health Service (NHS).

    Science.gov (United States)

    Waterson, Patrick

    2014-03-01

    This paper summarises some of the research that Ken Eason and colleagues at Loughborough University have carried out in the last few years on the introduction of Health Information Technologies (HIT) within the UK National Health Service (NHS). In particular, the paper focuses on three examples which illustrate aspects of the introduction of HIT within the NHS and the role played by the UK National Programme for Information Technology (NPfIT). The studies focus on stages of planning and preparation, implementation and use, adaptation and evolution of HIT (e.g., electronic patient records, virtual wards) within primary, secondary and community care settings. Our findings point to a number of common themes which characterise the use of these systems. These include tensions between national and local strategies for implementing HIT and poor fit between healthcare work systems and the design of HIT. The findings are discussed in the light of other large-scale, national attempts to introduce similar technologies, as well as drawing out a set of wider lessons learnt from the NPfIT programme based on Ken Eason's earlier work and other research on the implementation of large-scale HIT. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  6. Manche centre

    International Nuclear Information System (INIS)

    1997-05-01

    After a general presentation of radioactivity and radioactive wastes and of the French national agency for the management of radioactive wastes (ANDRA), this brochure gives a general overview of the Manche low- and medium-level radioactive waste disposal centre: principles of storage safety, waste containers (first confinement barrier), storage facility and cover (second confinement barrier), the underground (third confinement barrier), the impact of the centre on its environment, and the control of radioactivity in the vicinity of the centre. (J.S.)

  7. Career choices for radiology: national surveys of graduates of 1974-2002 from UK medical schools

    International Nuclear Information System (INIS)

    Turner, G.; Lambert, T.W.; Goldacre, M.J.

    2006-01-01

    Aim: To report on trends in career choices for radiology among UK medical graduates. Materials and methods: One and 3 years after graduation, and at longer time intervals thereafter, postal questionnaire surveys were sent to all doctors who graduated from UK medical schools in 1974, 1977, 1980, 1983, 1993, 1996, 1999, 2000 and 2002. Doctors were asked to specify their choice of long-term career and to identify factors influencing their choice. Employment details were also collected. Results were analysed using χ 2 statistics and binary logistic regression. Results: Seventy-four percent (24,621/33,412) and 73% (20,720/28,459) of doctors responded 1 and 3 years after graduation. Choices for radiology in year 1 increased significantly over time (1.7% of 1974 graduates to 3.2% of 2002 graduates; χ 2 test for trend = 15.3, p < 0.001). In particular, there has been a steady increase from the cohorts of 1993 onwards. Thirty-eight percent of those who chose radiology in year 1, and 80% who chose radiology in year 3, were still working in radiology 10 years after graduation. Hours and working conditions influenced long-term career choices more for radiology than for other careers. Conclusions: The proportion of UK trained junior doctors who want to become radiologists has increased in recent years. However, although medical school intake and the numbers making an early choice for radiology have risen, it is unclear whether sufficient UK graduates will be attracted to radiology to fulfil future service requirements from UK trained graduates alone

  8. The Hellenic National Tsunami Warning Centre (HL-NTWC): Recent updates and future developments

    Science.gov (United States)

    Melis, Nikolaos S.; Charalampakis, Marinos

    2014-05-01

    The Hellenic NTWC (HL-NTWC) was established officially by Greek Law in September 2010. HL-NTWC is hosted at the National Observatory of Athens, Institute of Geodynamics (NOA-IG), which also operates a 24/7 earthquake monitoring service in Greece and coordinates the newly established Hellenic Unified National Seismic Network. NOA-IG and HL-NTWC Operational Centre is linked to the Civil Protection Operational Centre and serves as the official alerting agency to the General Secretariat for Civil Protection in Greece, regarding earthquake events and tsunami watch. Since August 2012, HL-NTWC acts as Candidate Tsunami Watch Provider (CTWP) under the UNESCO IOC - ICG NEAMTWS tsunami warning system (NEAM: North-Eastern Atlantic, the Mediterranean and connected seas) and offers its services to the NEAMTWS system. HL-NTWC has participated in all Communication Test Exercises (CTE) under NEAMTWS and also it has provided tsunami scenarios for extended system testing exercises such as NEAMWAVE12. Some of the recent developments at HL-NTWC in Greece include: deployment of new tide gauge stations for tsunami watch purposes, computation of tsunami scenarios and extending the database in use, improving alerting response times, earthquake magnitude estimation and testing newly established software modules for tsunami and earthquake alerting (i.e. Early-Est, SeisComP3 etc.) in Greece and the Eastern Mediterranean. Although funding today is limited, an advantage of the participation in important EC funded research projects, i.e. NERIES, NERA, TRANSFER, NEAMTIC and ASTARTE, demonstrates that collaboration of top class Research Institutions that care to produce important and useful results in the research front in Europe, can facilitate towards developing and operating top class Operational Centers, useful for Civil Protection purposes in regions in need. Last, it is demonstrated that HL-NTWC collaboration with important key role Research Centers in the Security and Safety issues (e

  9. Drug-induced chest pain and myocardial infarction. Reports to a national centre and review of the literature

    NARCIS (Netherlands)

    J.P. Ottervanger (Jan Paul); J.H.P. Wilson (Paul); B.H.Ch. Stricker (Bruno)

    1997-01-01

    textabstractObjectives: To analyse reports of drug-induced myocardial infarction and chest pain sent to a national reporting centre. To review which drugs were suspected of exhibiting these adverse events and what mechanisms were involved. Methods: During the 20-year period 1975 through 1994, a

  10. Epistaxis and other haemorrhagic events associated with the smoking cessation medicine varenicline : a case series from two national pharmacovigilance centres

    NARCIS (Netherlands)

    Harrison-Woolrych, Mira; Harmark, Linda; Tan, Ming; Maggo, Simran; van Grootheest, Kees

    Purpose To present a case series of haemorrhagic events associated with varenicline identified from the New Zealand (NZ) and Netherlands national pharmacovigilance centres and propose a possible mechanism for these adverse events. Methods Reports of epistaxis and other haemorrhagic events (in all

  11. Research on the Danish Longitudinal Survey of Children (DALSC) at the Danish National Centre for Social Research

    DEFF Research Database (Denmark)

    Ottosen, Mai Heide

    2011-01-01

    This article reviews research results obtained using the Danish Longitudinal Survey of Children born in 1995 (DALSC), which is placed at SFI, the Danish National Centre for Social Research. DALSC aims to gain insight into children’s growing-up conditions in contemporary society. DALSC consists of...

  12. In Pursuit of a Multi-lateral Dialogue - the Swiss National Centre for Climate Services (NCCS)

    Science.gov (United States)

    Michiko Hama, Angela; Croci-Maspoli, Mischa; Liniger, Mark; Schwierz, Cornelia; Stöckli, Reto; Fischer, Andreas; Gubler, Stefanie; Kotlarski, Sven; Rossa, Andrea; Zubler, Elias; Appenzeller, Christof

    2017-04-01

    Kick-starting, fostering and maintaining a dialogue between primarily public and academic actors involved in the co-design, co-delivery and use of climate services is at the core of Switzerland's National Centre for Climate Services (NCCS), which was founded in late 2015 in recognition of the Global Framework for Climate Services (GFCS). This coordination and innovation mechanism is a concerted national effort comprised of seven Federal Agencies and Institutes and further partners from academia committed to implementing the Framework at national to subnational level and creating synergies the world over. The NCCS is to be regarded as vital alongside the Swiss National Adaptation Strategy, and it also contributes to putting words into action with respect to the UN's Sustainable Development Goals, the UNFCCC and the Sendai Framework for Disaster Risk Reduction. The services of the Centre provide information to support policy-makers from national to local level as well as the private sector and society at large in minimising their risks, maximising opportunities and optimising costs in the context of climate change and variability. They are indispensable for setting effective mitigation and adaptation measures and for instigating societal transformation. Hence, the goals of the NCCS are to bundle the existing climate services of the Swiss Federation, co-create new tailored solutions with users, act as a network agent and knowledge broker - to boost climate literacy and enable climate-sensitive decision-making leading to increased resilience. The services reflect the specificities and requirements of the Alpine region and its particular challenges and vulnerabilities. Pursuing a participatory approach, the NCCS has brought together essential key players, acted as a sounding board for governmental stakeholders and their needs, and accordingly defined and populated six priority themes in line with the priority areas of the GFCS. These themes are: natural hazards, health

  13. ELIXIR-UK role in bioinformatics training at the national level and across ELIXIR [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    L. Larcombe

    2017-06-01

    Full Text Available 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.

  14. Prevalence and socio-demographic correlates of cooking skills in UK adults: cross-sectional analysis of data from the UK National Diet and Nutrition Survey.

    Science.gov (United States)

    Adams, Jean; Goffe, Louis; Adamson, Ashley J; Halligan, Joel; O'Brien, Nicola; Purves, Richard; Stead, Martine; Stocken, Deborah; White, Martin

    2015-08-05

    Poor cooking skills may be a barrier to healthy eating and a contributor to overweight and obesity. Little population-representative data on adult cooking skills has been published. We explored prevalence and socio-demographic correlates of cooking skills among adult respondents to wave 1 of the UK National Diet and Nutrition Survey (2008-9). Socio-demographic variables of interest were sex, age group, occupational socio-economic group and whether or not respondents had the main responsibility for food in their households. Cooking skills were assessed as self-reported confidence in using eight cooking techniques, confidence in cooking ten foods, and ability to prepare four types of dish (convenience foods, a complete meal from ready-made ingredients, a main meal from basic ingredients, and cake or biscuits from basic ingredients). Frequency of preparation of main meals was also reported. Of 509 respondents, almost two-thirds reported cooking a main meal at least five times per week. Around 90 % reported being able to cook convenience foods, a complete meal from ready-made ingredient, and a main dish from basic ingredients without help. Socio-demographic differences in all markers of cooking skills were scattered and inconsistent. Where these were found, women and main food providers were most likely to report confidence with foods, techniques or dishes, and respondents in the youngest age (19-34 years) and lowest socio-economic group least likely. This is the only exploration of the prevalence and socio-demographic correlates of adult cooking skills using recent and population-representative UK data and adds to the international literature on cooking skills in developed countries. Reported confidence with using most cooking techniques and preparing most foods was high. There were few socio-demographic differences in reported cooking skills. Adult cooking skills interventions are unlikely to have a large population impact, but may have important individual effects

  15. The Ross Operation in Children and Young Adults: 12-Year Results and Trends From the UK National Database.

    Science.gov (United States)

    Zebele, Carlo; Chivasso, Pierpaolo; Sedmakov, Christo; Angelini, Gianni; Caputo, Massimo; Parry, Andrew; Stoica, Serban

    2014-07-01

    To determine UK national trends and results of the Ross operation in relation to all aortic valve interventions. Examination of the UK Congenital Central Cardiac Audit Database for all aortic valve procedures performed between 2000 and 2011 in children (0-16 years) and young adults (16-30 years). A total of 2,206 aortic valve procedures were performed in children and 1,824 in young adults, the proportions in the two groups being: Ross operation (19% vs 15%, respectively), surgical valvoplasty (9.5% vs 4%), surgical valvotomy (9.5% vs 1%), aortic valve replacement (AVR; 11% vs 55%), aortic root replacement (4% vs 18%), and balloon valvoplasty (47% vs 7%). The 30-day and 1-year survival after Ross is 99.3% and 98.7%, respectively, in the last four years achieving 100%. In children, the proportion of balloon valvoplasty increased from an average of 43% in 2000 to 2006 to 53% in 2007 to 2011, whereas the Ross operation decreased from 22% to 16% (P Ross (P Ross operations performed. The year-on-year changes show a significant decreasing trend locally and nationally. Despite an excellent track record, the Ross operation is performed less frequently in the United Kingdom. This report is a first step in comparing treatment modalities at national level. © The Author(s) 2014.

  16. The production of cyclotron radioisotopes and radiopharmaceuticals at the national accelerator centre in South Africa

    International Nuclear Information System (INIS)

    Walt, T.N. van der

    1998-01-01

    Accelerator radioisotopes have been manufactured in South Africa since 1965 with the 30 MeV cyclotron at the Council for Scientific and Industrial Research (CSIR) in Pretoria. After its closure in 1988, the radioisotope production programme was continued at the National Accelerator Centre (NAC) with the 200 MeV separated sector cyclotron (SCC) utilizing the 66 MeV proton beam, which is shared with the neutron therapy programme during part of the week. A variety of radiopharmaceuticals, such as 18 F-FDG, 67 Ga-citrate, a 67 Ga-labelled resin. 111 In-chloride, 111 In-oxine and 111 In-labelled resin. 123 I-sodium iodide and 123 I-labelled compounds, 201 Tl-chloride, as well as the 81 Rb/ 81m Kr gas generator, are prepared for use in the nuclear medicine departments of 12 State hospitals and about 28 private nuclear medicine clinics in South Africa. A few longer-lived radioisotopes, such as 22 Na, 55 Fe and 139 Ce, are also produced for research or industrial use. A research and development programme is running to develop new production procedures to produce radioisotopes and radiopharmaceuticals, or to improve existing production procedures. As part of a programme to utilize the beam time optimally, the production of some other radioisotopes is investigated. (author)

  17. MAAGs (Medical Audit Advisory Groups): the Eli Lilly National Clinical Audit Centre.

    Science.gov (United States)

    Baker, R; Fraser, R

    1993-01-01

    Outlines the framework for promoting audit in general practice, created as one part of the health service reforms. Medical Audit Advisory Groups (MAAGs) were set up in each district with the aim of participation in audit of all general practitioners by April 1992. The activities undertaken have included those recommended by the Department of Health; the most significant of these being the appointment of lay facilitators who are able to assist general practitioners and primary care teams co-operate over efforts to improve the quality of care, and may offer one means of introducing some of the methods of total quality management into general practice. Discusses the problems which remain: audit is not yet sufficiently systematic, interface audit with secondary care is at a very early stage, the ways to involve managers and patients in audit remain to be clarified, and there is little evidence of the consequences of audit in terms of improved care. The Eli Lilly National Clinical Audit Centre has been set up within the Department of General Practice, University of Leicester, in order to address these issues.

  18. Can EC and UK national methane emission inventories be verified using high precision stable isotope data?

    International Nuclear Information System (INIS)

    Lowry, D.; Holmes, C.W.; Nisbet, E.G.; Rata, N.D.

    2002-01-01

    The main anthropogenic sources of methane in industrialised countries (landfill/waste treatment, gas storage and distribution, coal) are far easier to reduce than CO 2 sources and the implementation of reduction strategies is potentially profitable. Statistical databases of methane emissions need independent external verification and carbon isotope data provide one way of estimating the expected source mix for each country if the main source types have been characterised isotopically. Using this method each country participating in the CORINAIR 94 database has been assigned an expected isotopic value for its emissions. The averaged δ 13 C of methane emitted from the CORINAIR region of Europe, based on total emissions of each country is -55.4 per mille for 1994. This European source mix can be verified using trajectory analysis for air samples collected at background stations. Methane emissions from the UK, and particularly the London region, have undergone more detailed analysis using data collected at the Royal Holloway site on the western fringe of London. If the latest emissions inventory figures are correct then the modelled isotopic change in the UK source mix is from -48.4 per mille in 1990 to -50.7 per mille in 1997. This represents a reduction in emissions of 25% over a 7-year period, important in meeting proposed UK greenhouse gas reduction targets. These changes can be tested by the isotopic analysis of air samples at carefully selected coastal background and interior sites. Regular sampling and isotopic analysis coupled with back trajectory analysis from a range of sites could provide an important tool for monitoring and verification of EC and UK methane emissions in the run-up to 2010. (author)

  19. Some Recent Technology Developments From The Uk's National Nuclear Laboratory To Enable Hazard Characterisation For Nuclear Decommissioning Applications

    International Nuclear Information System (INIS)

    Farfan, E.; Foley, T.

    2010-01-01

    Under its programme of self investment Internal Research and Development (IR and D), the UK's National Nuclear Laboratory (NNL) is addressing the requirement for development in technology to enable hazard characterisation for nuclear decommissioning applications. Three such examples are described here: (1) RadBall developed by the NNL (patent pending) is a deployable baseball-sized radiation mapping device which can, from a single location, locate and quantify radiation hazards. RadBall offers a means to collect information regarding the magnitude and distribution of radiation in a given cell, glovebox or room to support the development of a safe, cost effective decontamination strategy. RadBall requires no electrical supplies and is relatively small, making it easy to be deployed and used to map radiation hazards in hard to reach areas. Recent work conducted in partnership with the Savannah River National Laboratory (SRNL) is presented. (2) HiRAD (patent pending) has been developed by the NNL in partnership with Tracerco Ltd (UK). HiRAD is a real-time, remotely deployed, radiation detection device designed to operate in elevated levels of radiation (i.e. thousands and tens of thousands of Gray) as seen in parts of the nuclear industry. Like the RadBall technology, the HiRAD system does not require any electrical components, the small dimensions and flexibility of the device allow it to be positioned in difficult to access areas (such as pipe work). HiRAD can be deployed as a single detector, a chain, or as an array giving the ability to monitor large process areas. Results during the development and deployment of the technology are presented. (3) Wireless Sensor Network is a NNL supported development project led by the University of Manchester (UK) in partnership with Oxford University (UK). The project is concerned with the development of wireless sensor network technology to enable the underwater deployment and communication of miniaturised probes allowing pond

  20. Current management of pregnancy-related low back pain: a national cross-sectional survey of U.K. physiotherapists.

    Science.gov (United States)

    Bishop, A; Holden, M A; Ogollah, R O; Foster, N E

    2016-03-01

    Pregnancy-related low back pain (LBP) is very common. Evidence from a systematic review supports the use of exercise and acupuncture, although little is known about the care received by women with pregnancy-related back pain in the U.K. To describe current acupuncture and standard care management of pregnancy-related LBP by U.K. physiotherapists. Cross-sectional survey of physiotherapists with experience of treating women with pregnancy-related LBP from three professional networks of the Chartered Society of Physiotherapy. In total, 1093 physiotherapists were mailed a questionnaire. The questionnaire captured respondents' demographic and practice setting information, and experience of managing women with pregnancy-related back pain, and investigated the reported management of pregnancy-related LBP using a patient case vignette of a specific, 'typical' case. The overall response rate was 58% (629/1093). Four hundred and ninety-nine physiotherapists had experience of treating women with pregnancy-related LBP and were included in the analysis. Most respondents worked wholly or partly in the U.K. National Health Service (78%). Most respondents reported that they treat patients with pregnancy-related LBP in three to four one-to-one treatment sessions over 3 to 6 weeks. The results show that a range of management strategies are employed for pregnancy-related LBP, and multimodal management is common. The most common reported treatment was home exercises (94%), and 24% of physiotherapists reported that they would use acupuncture with the patient described in the vignette. This study provides the first robust data on the management of pregnancy-related LBP by U.K. physiotherapists. Multimodal management is common, although exercise is the most frequently used treatment for pregnancy-related LBP. Acupuncture is used less often for this patient group. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. National survey of clinical communication assessment in medical education in the United Kingdom (UK).

    Science.gov (United States)

    Laidlaw, Anita; Salisbury, Helen; Doherty, Eva M; Wiskin, Connie

    2014-01-13

    All medical schools in the UK are required to be able to provide evidence of competence in clinical communication in their graduates. This is usually provided by summative assessment of clinical communication, but there is considerable variation in how this is carried out. This study aimed to gain insight into the current assessment of clinical communication in UK medical schools. The survey was sent via e-mail to communication leads who then were asked to consult with all staff within their medical school involved in the assessment of communication. Results were obtained from 27 out of 33 schools (response rate 82%) and a total of 34 courses. The average number of assessments per year was 2.4 (minimum 0, maximum 10). The Objective Structured Clinical Exam (OSCE) was the most commonly used method of assessment (53%). Other assessments included MCQ and workplace based assessments. Only nine courses used a single method of assessment. Issues raised included, logistics and costs of assessing mainly by OSCE, the robustness and reliability of such exams and integration with other clinical skills. It is encouraging that a variety of assessment methods are being used within UK medical schools and that these methods target different components of clinical communication skills acquisition.

  2. Different approaches to the tasks of educating and training information systems professionals, within the National Health Service (UK).

    Science.gov (United States)

    Grant, R M; Horkin, E J; Melhuish, P J; Norris, A C

    1998-06-01

    In 1994, La Sainte Union College of Higher Education (LSU) developed an MSc in Health Informatics course, in conjunction with Southampton University NHS Trust (SUHT). The original part-time, 1 day per week mode of delivery has since been broadened to include a distance leaning route and recently a block release mode, by which students combine usage of the distance learning materials with attendance in College for an intensive 2-day taught element. Because the course was designed in close co-operation with a major teaching hospital, it has always been 'market led' to meet the needs both of the individual students and of the organisations that they work for. At the same time, students acquire a quality-assured qualification from a premier UK university, a qualification that holds credence outside the National Health Service (NHS). At the same time as LSU and SUHT were developing the MSc in Health Informatics, the UK NHS Training Division (NHSTD) started to promote a professional qualification for health service professionals. the so-called 'Statement of Recognition' (SoR). In contrast to the academic format of an MSc, the SoR was not a formal course, but a combination of modules designed to help candidates demonstrate their competence and achievement at work by portfolio evidence. This approach has national standing throughout the UK in a set of qualifications known as NVQs (National Vocational Qualifications). The NHSTD, through its successor, the Institute of Health Care Development (IHCD), has further refined this competency based model, culminating in the launch in 1996 of the Diploma and Advanced Diploma in Information and Technology (Health). Professionals within the area of Information Management and Technology (IM&T) in the NHS now have the alternatives of an academic or a competency route to achieve their goals. This paper traces the development of and the relationship between, these two approaches to the educational and training of healthcare professionals

  3. Do nurses wish to continue working for the UK National Health Service? A comparative study of three generations of nurses.

    Science.gov (United States)

    Robson, Andrew; Robson, Fiona

    2015-01-01

    To identify the combination of variables that explain nurses' continuation intention in the UK National Health Service. This alternative arena has permitted the replication of a private sector Australian study. This study provides understanding about the issues that affect nurse retention in a sector where employee attrition is a key challenge, further exacerbated by an ageing workforce. A quantitative study based on a self-completion survey questionnaire completed in 2010. Nurses employed in two UK National Health Service Foundation Trusts were surveyed and assessed using seven work-related constructs and various demographics including age generation. Through correlation, multiple regression and stepwise regression analysis, the potential combined effect of various explanatory variables on continuation intention was assessed, across the entire nursing cohort and in three age-generation groups. Three variables act in combination to explain continuation intention: work-family conflict, work attachment and importance of work to the individual. This combination of significant explanatory variables was consistent across the three generations of nursing employee. Work attachment was identified as the strongest marginal predictor of continuation intention. Work orientation has a greater impact on continuation intention compared with employer-directed interventions such as leader-member exchange, teamwork and autonomy. UK nurses are homogeneous across the three age-generations regarding explanation of continuation intention, with the significant explanatory measures being recognizably narrower in their focus and more greatly concentrated on the individual. This suggests that differentiated approaches to retention should perhaps not be pursued in this sectoral context. © 2014 John Wiley & Sons Ltd.

  4. ‘Smashed by the National Health’? A Closer Look at the Demise of the Pioneer Health Centre, Peckham

    Science.gov (United States)

    Conford, Philip

    2016-01-01

    The Pioneer Health Centre, based in South London before and after the Second World War, remains a source of interest for advocates of a positive approach to health promotion in contrast with the treatment of those already ill. Its closure in 1950 for lack of funds has been blamed on the then recently established National Health Service, but this article argues that such an explanation is over-simplified and ignores a number of other factors. The Centre had struggled financially during the 1930s and tried to gain support from the Medical Research Council. The Council appeared interested in the Centre before the war, but was less sympathetic in the 1940s. Around the time of its closure and afterwards, the Centre was also involved in negotiations with London County Council; these failed because the Centre’s directors would not accept the changes which the Council would have needed to make. Unpublished documents reveal that the Centre’s directors were uncompromising and that their approach to the situation antagonised their colleagues. Changes in medical science also worked against the Centre. The success of sulphonamide drugs appeared to render preventive medicine less significant, while the development of statistical techniques cast doubt on the Centre’s experimental methods. The Centre was at the heart of the nascent organic farming movement, which opposed the rapid growth of chemical cultivation. But what might be termed ‘chemical triumphalism’ was on the march in both medicine and agriculture, and the Centre was out of tune with the mood of the times. PMID:26971599

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

    Science.gov (United States)

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

    2016-11-25

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

  6. Patients' expectations of private osteopathic care in the UK: a national survey of patients.

    Science.gov (United States)

    Leach, C M Janine; Mandy, Anne; Hankins, Matthew; Bottomley, Laura M; Cross, Vinette; Fawkes, Carol A; Fiske, Adam; Moore, Ann P

    2013-05-31

    Patients' expectations of osteopathic care have been little researched. The aim of this study was to quantify the most important expectations of patients in private UK osteopathic practices, and the extent to which those expectations were met or unmet. The study involved development and application of a questionnaire about patients' expectations of osteopathic care. The questionnaire drew on an extensive review of the literature and the findings of a prior qualitative study involving focus groups exploring the expectations of osteopathic patients. A questionnaire survey of osteopathic patients in the UK was then conducted. Patients were recruited from a random sample of 800 registered osteopaths in private practice across the UK. Patients were asked to complete the questionnaire which asked about 51 aspects of expectation, and post it to the researchers for analysis.The main outcome measures were the patients-perceived level of expectation as assessed by the percentage of positive responses for each aspect of expectation, and unmet expectation as computed from the proportion responding that their expectation "did not happen". 1649 sets of patient data were included in the analysis. Thirty five (69%) of the 51 aspects of expectation were prevalent, with listening, respect and information-giving ranking highest. Only 11 expectations were unmet, the most often unmet were to be made aware that there was a complaints procedure, to find it difficult to pay for osteopathic treatment, and perceiving a lack of communication between the osteopath and their GP. The findings reflected the complexity of providing osteopathic care and meeting patients' expectations. The results provided a generally positive message about private osteopathic practice. The study identified certain gaps between expectations and delivery of care, which can be used to improve the quality of care. The questionnaire is a resource for future research.

  7. Patients’ expectations of private osteopathic care in the UK: a national survey of patients

    Science.gov (United States)

    2013-01-01

    Background Patients’ expectations of osteopathic care have been little researched. The aim of this study was to quantify the most important expectations of patients in private UK osteopathic practices, and the extent to which those expectations were met or unmet. Methods The study involved development and application of a questionnaire about patients’ expectations of osteopathic care. The questionnaire drew on an extensive review of the literature and the findings of a prior qualitative study involving focus groups exploring the expectations of osteopathic patients. A questionnaire survey of osteopathic patients in the UK was then conducted. Patients were recruited from a random sample of 800 registered osteopaths in private practice across the UK. Patients were asked to complete the questionnaire which asked about 51 aspects of expectation, and post it to the researchers for analysis. The main outcome measures were the patients-perceived level of expectation as assessed by the percentage of positive responses for each aspect of expectation, and unmet expectation as computed from the proportion responding that their expectation “did not happen”. Results 1649 sets of patient data were included in the analysis. Thirty five (69%) of the 51 aspects of expectation were prevalent, with listening, respect and information-giving ranking highest. Only 11 expectations were unmet, the most often unmet were to be made aware that there was a complaints procedure, to find it difficult to pay for osteopathic treatment, and perceiving a lack of communication between the osteopath and their GP. Conclusions The findings reflected the complexity of providing osteopathic care and meeting patients’ expectations. The results provided a generally positive message about private osteopathic practice. The study identified certain gaps between expectations and delivery of care, which can be used to improve the quality of care. The questionnaire is a resource for future research

  8. Clinical roles in clinical biochemistry: a national survey of practice in the UK.

    Science.gov (United States)

    Choudhury, Sirazum M; Williams, Emma L; Barnes, Sophie C; Alaghband-Zadeh, Jamshid; Tan, Tricia M; Cegla, Jaimini

    2017-05-01

    Background Using an online survey, we collected data to present a picture of how clinical authorization is performed in the UK. Methods A 21-question survey was uploaded to www.surveymonkey.com , and responses were invited via the mail base of the Association for Clinical Biochemistry and Laboratory Medicine. The questionnaire examined the intensity and function of the duty biochemist role and how different types of authorization are used to handle and release results. Results Of 70 responses received, 60 were suitable for analysis. Responses were received from every region of the UK. A typical duty biochemist shift started on average at 8:50, and finished at 17:25. The mean duration was 8 h 58 min. Clinical scientists are the most abundantly represented group on duty biochemist rotas. Higher banded clinical scientists and chemical pathologists covered out-of-hours shifts. Results were handled differently depending on the level of abnormality and the requesting area. Normal results tended to be released either directly from the analyser or after technical then autoauthorization (90%). A greater preference for clinical authorization was seen for abnormal and critical results originating from outpatients (49% and 69%, respectively) or general practice (51% and 71%) than for inpatients (33% and 53%) or A&E (25% and 37%). Conclusions The handling and authorization of biochemistry results varies greatly between laboratories. The role is clearly heterogeneous in the UK. Guidance from the Association for Clinical Biochemistry and Royal College of Pathologists may help to clarify the essential roles of the duty biochemist.

  9. 2015 UK national guideline for the management of infection with Chlamydia trachomatis.

    Science.gov (United States)

    Nwokolo, Nneka C; Dragovic, Bojana; Patel, Sheel; Tong, C Y William; Barker, Gary; Radcliffe, Keith

    2016-03-01

    This guideline offers recommendations on the diagnostic tests, treatment regimens and health promotion principles needed for the effective management of Chlamydia trachomatis genital infection. It covers the management of the initial presentation, as well the prevention of transmission and future infection. The guideline is aimed at individuals aged 16 years and older presenting to healthcare professionals working in departments offering Level 3 care in sexually transmitted infections management within the UK. However, the principles of the recommendations should be adopted across all levels, using local care pathways where appropriate. © The Author(s) 2016.

  10. Initiation of non-invasive ventilation in amyotrophic lateral sclerosis and clinical practice guidelines: Single-centre, retrospective, descriptive study in a national reference centre.

    Science.gov (United States)

    Georges, Marjolaine; Golmard, Jean-Louis; Llontop, Claudia; Shoukri, Amr; Salachas, François; Similowski, Thomas; Morelot-Panzini, Capucine; Gonzalez-Bermejo, Jésus

    2017-02-01

    In amyotrophic lateral sclerosis (ALS), respiratory muscle weakness leads to respiratory failure. Non-invasive ventilation (NIV) maintains adequate ventilation in ALS patients. NIV alleviates symptoms and improves survival. In 2006, French guidelines established criteria for NIV initiation based on limited evidence. Their impact on clinical practice remains unknown. Our objective was to describe NIV initiation practices of the main French ALS tertiary referral centre with respect to guidelines. In this retrospective descriptive study, 624 patients followed in a single national reference centre began NIV between 2005 and 2013. We analysed criteria used to initiate NIV, including symptoms, PaCO 2 , forced vital capacity, maximal inspiratory pressures and time spent with SpO 2 NIV initiation, 90% of patients were symptomatic. Median PaCO 2 was 48 mmHg. The main criterion to initiate NIV was 'symptoms' followed by 'hypercapnia' in 42% and 34% of cases, respectively. NIV was initiated on functional parameters in only 5% of cases. Guidelines were followed in 81% of cases. In conclusion, despite compliance with French guidelines, the majority of patients are treated at the stage of symptomatic daytime hypoventilation, which suggests that NIV is initiated late in the course of ALS. Whether this practice could be improved by changing guidelines or increasing respiratory-dedicated resources remains to be determined.

  11. Experience of the Irish National Centre for hereditary haemorrhagic telangiectasia 2003-2008.

    LENUS (Irish Health Repository)

    Ni Bhuachalla, C F

    2012-01-31

    Hereditary haemorrhagic telangiectasia (HHT) is a group of autosomal dominant disorders of vascular structure. The Irish National Centre for HHT at the Mercy University Hospital, Cork, Ireland was founded in 2003. From 2003 to 2008, screening of 164 patients with contrast echocardiography, thoracic computerised tomography (CT) and cerebral magnetic resonance imaging (MRI) has identified 88 patients with definite HHT, 72 (82%) of whom had epistaxis, 70 (80%) had telangiectasia and 81 (92%) had a first-degree relative with HHT. We sought to describe the manifestations of HHT in an Irish population and to determine differences between internationally reported data. The HHT patient database was analysed to describe demographics, clinical manifestations and interventional procedures performed in all referred patients. Contrast echocardiography and\\/or CT were performed in 86 patients with definite HHT, identifying 27 patients (31%) with pulmonary arteriovenous malformations (pAVMs). Nineteen patients with single or multiple pAVMs had 28 embolisation procedures performed, with 1-6 pAVMs embolised per procedure. Cerebral MRI was performed in 78 (89%) patients and 2 (2.3%) had cerebral arteriovenous malformations (cAVMs). HHT prevalence is thought to be 1 in 2500-8000, suggesting that there are many undiagnosed cases in Irish patients. Internationally published data suggest a prevalence of 15-35% for pAVMs and 10-23% for cAVMs in patients with HHT. While the prevalence of pAVMs in our group is consistent with these data, the prevalence of cAVMs is considerably lower, suggesting that Irish patients with HHT may differ genotypically and phenotypically from those in other countries.

  12. 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...

  13. Learning from Somaliland? Transferability of learning from volunteering to national health service practice in the UK.

    Science.gov (United States)

    Tillson, Esther; van Wees, Sibylle Herzig; McGowan, Charlotte; Franklin, Hannah; Jones, Helena; Bogue, Patrick; Aliabadi, Shirin; Baraitser, Paula

    2016-03-22

    Capacity building partnerships between healthcare institutions have the potential to benefit both partners particularly in staff development. Previous research suggests that volunteering can contribute to professional development but there is little evidence on how learning is acquired, the barriers and facilitators to learning in this context or the process of translation of learning to the home environment. Volunteers from a healthcare partnership between the UK and Somaliland reported learning in communication, interdisciplinary working, teaching, management, leadership and service development. This learning came from observing familiar practices in unfamiliar environments; alternative solutions to familiar problems; learning about Somali culture; opportunities to assume higher levels of responsibility and new professional relationships. There was variability in the extent of translation to NHS practice. Time and support available for reflection and mentoring were important facilitators of this process. The professional development outcomes documented in this study came directly from the experience of volunteering. Experiential learning theory suggests that this requires a complex process of critical reflection and new knowledge generation, testing and translation for use in new contexts. This process benefits from identification of learning as an important element of volunteering and support for reflection and the translation translation of learning to UK contexts. We suggest that missed opportunities for volunteer learning will remain until the volunteering process is overtly framed as part of continuing professional development.

  14. Digital pathology access and usage in the UK: results from a national survey on behalf of the National Cancer Research Institute's CM-Path initiative.

    Science.gov (United States)

    Williams, Bethany Jill; Lee, Jessica; Oien, Karin A; Treanor, Darren

    2018-05-01

    To canvass the UK pathology community to ascertain current levels of digital pathology usage in clinical and academic histopathology departments, and prevalent attitudes to digital pathology. A 15-item survey was circulated to National Health Service and academic pathology departments across the UK using the SurveyMonkey online survey tool. Responses were sought at a departmental or institutional level. Where possible, departmental heads were approached and asked to complete the survey, or forward it to the most relevant individual in their department. Data were collected over a 6-month period from February to July 2017. 41 institutes from across the UK responded to the survey. 60% (23/39) of institutions had access to a digital pathology scanner, and 60% (24/40) had access to a digital pathology workstation. The most popular applications of digital pathology in current use were undergraduate and postgraduate teaching, research and quality assurance. Investigating the deployment of digital pathology in their department was identified as a high or highest priority by 58.5% of institutions, with improvements in efficiency, turnaround times, reporting times and collaboration in their institution anticipated by the respondents. Access to funding for initial hardware, software and staff outlay, pathologist training and guidance from the Royal College of Pathologists were identified as factors that could enable respondent institutions to increase their digital pathology usage. Interest in digital pathology adoption in the UK is high, with usage likely to increase in the coming years. In light of this, pathologists are seeking more guidance on safe usage. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Digital pathology access and usage in the UK: results from a national survey on behalf of the National Cancer Research Institute’s CM-Path initiative

    Science.gov (United States)

    Williams, Bethany Jill; Lee, Jessica; Oien, Karin A; Treanor, Darren

    2018-01-01

    Aim To canvass the UK pathology community to ascertain current levels of digital pathology usage in clinical and academic histopathology departments, and prevalent attitudes to digital pathology. Methods A 15-item survey was circulated to National Health Service and academic pathology departments across the UK using the SurveyMonkey online survey tool. Responses were sought at a departmental or institutional level. Where possible, departmental heads were approached and asked to complete the survey, or forward it to the most relevant individual in their department. Data were collected over a 6-month period from February to July 2017. Results 41 institutes from across the UK responded to the survey. 60% (23/39) of institutions had access to a digital pathology scanner, and 60% (24/40) had access to a digital pathology workstation. The most popular applications of digital pathology in current use were undergraduate and postgraduate teaching, research and quality assurance. Investigating the deployment of digital pathology in their department was identified as a high or highest priority by 58.5% of institutions, with improvements in efficiency, turnaround times, reporting times and collaboration in their institution anticipated by the respondents. Access to funding for initial hardware, software and staff outlay, pathologist training and guidance from the Royal College of Pathologists were identified as factors that could enable respondent institutions to increase their digital pathology usage. Conclusion Interest in digital pathology adoption in the UK is high, with usage likely to increase in the coming years. In light of this, pathologists are seeking more guidance on safe usage. PMID:29317516

  16. Motivation for orthognathic treatment and anticipated satisfaction levels-a two-centre cross-national audit.

    Science.gov (United States)

    Patcas, Raphael; Cunningham, Susan J; Shute, Justin; Lloyd, Timothy; Obwegeser, Joachim A; Arjomand, Lida; Sharma, Sujata

    2017-06-01

    This audit investigated factors which motivate patients to seek orthognathic treatment, assessed how confident patients were that they would be satisfied with the outcome of treatment, and explored possible influencing factors. Questionnaires were distributed to pre-surgical patients at two centres (United Kingdom and Switzerland); questions asked what patients wished to gain from orthognathic treatment and how confident they were that they would be satisfied with treatment outcome. Gender, age and location were recorded as demographic variables, and type of malocclusion was also recorded. A total of 202 questionnaires were returned (UK, n = 149; Switzerland, n = 53). Reported motivating factors focused on improvements in aesthetics (specified and unspecified) (UK vs. Switzerland: 91.3% vs. 83.0%), function (72.5% vs. 66.0%), psychosocial health (51.7% vs. 20.8%), speech (4.0% vs. 7.5%), alleviation of pain (5.4% vs. 17%) and normalization of breathing (1.3% vs. 7.5%). No significant relationships were observed relative to patient age, gender or malocclusion. The anticipated satisfaction levels were generally high (86.5% vs. 89.9%). Although the distribution of motivational factors varied between the two sites, it did not affect the anticipated satisfaction level. Patients were generally confident that they would be satisfied with their treatment outcome and that their reasons for seeking treatment would be addressed. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. All rights reserved.

  17. Implementing UK Autism Policy & National Institute for Health and Care Excellence Guidance--Assessing the Impact of Autism Training for Frontline Staff in Community Learning Disabilities Teams

    Science.gov (United States)

    Clark, Alex; Browne, Sarah; Boardman, Liz; Hewitt, Lealah; Light, Sophie

    2016-01-01

    UK National Autism Strategy (Department of Health, 2010 and National Institute for Health and Care Excellence guidance (NICE, 2012) states that frontline staff should have a good understanding of Autism. Fifty-six clinical and administrative staff from a multidisciplinary community Learning Disability service completed an electronic questionnaire…

  18. Role of the national INIS centre in the knowledge preservation programme

    International Nuclear Information System (INIS)

    Rashkova, N.; Georgieva, A.

    2004-01-01

    Possible ways of involvement of a small INIS Centre (on the example of the Bulgarian Centre) in the IAEA Knowledge Preservation Programme are discussed. The specific of the INIS activities, experience, and established access to scientific resources in the country present a good base for the extension of the Centre's functions towards nuclear knowledge accumulation and providing information about research and training programmes, as well as access to factual information in the nuclear field. Approaches for organising of the resources identification and developing of tools for management of information not included in the INIS database are suggested. As a first step, Bulgarian INIS Centre has identified some of the areas with accumulated knowledge as well as universities and institutes with valuable ongoing research. A local database for technical and scientific documentation is under development. (authors)

  19. 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

  20. 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)

  1. The UK's Surplus Source Disposal Programme: successful management of a national radioactive legacy

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Clive [Environment Agency, Block 1, Government Buildings, Burghill Road, Westbury-on-Trym, Bristol BS10 6BF (United Kingdom); Burns, Philip [Formerly of the Environment Agency, Olton Court, 10 Warwick Road, Solihull B92 7HX (United Kingdom); Wakerley, Malcolm [Formerly of the Department for Environment, Food and Rural Affairs, Ergon House, 17 Smith Square, London SW1P 3JR (United Kingdom); Watson, Isabelle [Scottish Environment Protection Agency, 5 Redwood Crescent, Peel Park, East Kilbride G74 5PP (United Kingdom); Cook, Marianne [Scottish Government, Victoria Quay, Edinburgh EH6 6QQ (United Kingdom); Moloney, Barry [Safeguard International (now EnergySolutions), B168, Harwell Campus, Didcot, Oxon OX11 0QT (United Kingdom)

    2010-06-15

    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{sup 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)

  2. Gambling and violence in a nationally representative sample of UK men.

    Science.gov (United States)

    Roberts, Amanda; Coid, Jeremy; King, Robert; Murphy, Raegan; Turner, John; Bowden-Jones, Henrietta; Du Preez, Katie Palmer; Landon, Jason

    2016-12-01

    The relationship between violence and problem gambling in general population samples is under-researched and requires further attention to inform treatment and prevention efforts. We investigated the relationship between gambling problems and violence among men and sought to determine if the link can be accounted for by mental disorders, alcohol and drug dependence and impulsivity. A cross-sectional survey. A UK representative general population survey conducted in 2009. A total of 3025 UK men aged 18-64 years. Binary logistic regression was used to examine relationships. Outcome measures included gambling behaviour and self-reports of violence. Covariates included alcohol and drug dependence, mental illness, impulsivity and socio-demography. Problem gambling and probable pathological gambling were associated with increased odds of the perpetration of violence [adjusted odd ratios (AOR) = 3.09, confidence interval (CI) = 1.90-5.00 and 4.09, CI = 2.76-6.30, respectively] and a range of other behaviours, such as using a weapon (AORs = 4.93, CI = 2.52-9.63 and 6.33, CI = 3.52-11.38) and the perpetration of intimate partner violence (AOR = 9.80, CI =2.45-39.04). The results were attenuated when adjusted for comorbid mental illness and impulsivity, but remained statistically significant. Alcohol and drug dependence had the most impact; relationships were most attenuated when they added into the models, with the latter having the largest effect. Among men in the United Kingdom, self-reports of problem/pathological gambling remain predictive of a range of measures of violent behaviour after adjusting for alcohol and drug dependence, comorbid mental disorder and impulsivity; of the covariates, alcohol and drug dependence have the greatest effect in attenuating the gambling-violence association. © 2016 Society for the Study of Addiction.

  3. Trabeculectomy bleb needling and antimetabolite administration practices in the UK: a glaucoma specialist national survey.

    Science.gov (United States)

    Mercieca, Karl; Drury, Brett; Bhargava, Archana; Fenerty, Cecilia

    2017-12-06

    To evaluate, describe and quantify the diversity in postoperative antimetabolite administration and bleb needling practices among glaucoma specialists performing trabeculectomy surgery within the UK and Ireland. A cross-sectional online survey was distributed to all consultant glaucoma specialists who are on the United Kingdom and Eire Glaucoma Society (UKEGS) contact list. Participants were asked specific questions about their current practices for post-trabeculectomy antimetabolite administration followed by questions directly related to bleb needling procedures. 60 (83%) of UKEGS glaucoma subspecialty consultants completed the survey. 70% of respondents administered 5-fluorouracil (5-FU) in their clinic room while 30% used a separate treatment room. Doses of 5-FU varied considerably but 70% used 5 mg as standard. Techniques used to reduce corneal toxicity included precipitation with amethocaine (44%) or benoxinate (14%), saline wash (14%) and modified injection technique (8%). Topical antibiotics and/or betadine were used to prevent infection following 5-FU injection in just over 50%. Bleb needling was exclusively performed in operating theatre by 56% of respondents and solely at the slit lamp in the clinic room by 12%. A further 30% used a combination of both theatre and outpatient clinic rooms. Anti-metabolites used were 5-FU (72%) and mitomycin C (22%) with 12% using either of the two substances. There is a significantly wide variety of current practices for antimetabolite administration and bleb needling within the UK and Ireland. This may be influenced by a glaucoma surgeon's specific experience and audit results as well as particular clinical set-up, availability of antimetabolite and clinic room space. © 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.

  4. What are the priorities for future success in critical care research in the UK? Report from a national stakeholder meeting.

    Science.gov (United States)

    Walsh, Tim; Brett, Stephen J

    2015-11-01

    Critical care in the United Kingdom is now well-established in terms of professional status, standards of clinical practice and training, and national audit through professional bodies and government representation. Research is fundamental to the further development and maturation of the specialty, to develop new therapies and technologies, more efficient and effective service organisation, and to improve patient and family experience and outcomes. Critical care research has expanded rapidly in the UK, and now has established organisations and infrastructure to share and develop ideas, through the UK Critical Care Research Forum and similar meetings. In September 2014, the Intensive Care Foundation and Critical Care Leadership Forum hosted a research colloquium to reflect, in part, on achievements, but more importantly plan for the future. With an invited list of participants the meeting explored firstly - the practical delivery of clinical research and secondly - the future financing landscape, from both academic funders' and commercial developers' perspectives. The following article summarises the important 'take home' messages from this meeting and suggests key issues for future strategy.

  5. [Internal quality control of the blood products in the Lomé National Blood Transfusion Centre].

    Science.gov (United States)

    Fétéké, L; Mawussi, K; Lakté, P; Kuéviakoe, I M; Haudrechy, D; Ségbéna, A Y

    2008-07-01

    Evaluate the conformity of blood red cells units prepared in the Lomé CNTS with European norms concerning volume, haemoglobin content and haematocrite. Measure the conservation of the haemostatic properties and the rate of haemostasis factors V and VIII in the fresh frozen plasma. Measure the rate of residual cells in the plasma. In the year 2006, from March 1st to April 15th, we analysed the quality of 135 units of whole blood, red blood cells (RBC) and plasma from blood donors in the Lomé National Blood Transfusion Centre. The quality control had concerned: the volume of whole blood units; the volume, the haemoglobin content and the haematocrite of red blood cells units; the volume, the prothrombin rate, the cephalin with activator time (TCA), the rate of haemostasis factors V and VIII and the number of residual cells (red cells, leucocytes and platelets) in the plasma. Among the 135 units of whole blood which were controlled, 50.57% were in conformity with the norms concerning the volume. The red blood cells units were in conformity with norms concerning their volume, their haemoglobin content and their haematocrite respectively in 21.48%, 80.75% and 20% of the cases. The volume of 75.56% of the plasma units controlled were conform with the norm. All of the plasma units were conform with the norm concerning the number of residual platelets while the number of residual red blood cells and leucocytes were conform respectively in 80.74% and 60%. The percentage of conformity concerning the prothrombin rate, the TCA, the coagulation factor V and the factor VIII were respectively 66.67; 97.78; 48.89 and 47.4 before freezing, and 54.81; 88.14; 64.44; 84.44 a month after freezing. To improve the quality of the new blood products of the Lomé CNTS, some correctives actions must be applied concerning the adequate volume of blood which must be collected from the donors, the position of the blood bags in during the centrifugation and the volume of plasma which must be

  6. 15th March 2011 - Singapore National Research Foundation Permanent Secretary(National Research and Development)T. M. Kian signing the guest book with Head of International Relations F. Pauss and visiting CMS control centre with Collaboration Spokesperson G. Tonelli.

    CERN Multimedia

    Maximilien Brice

    2011-01-01

    15th March 2011 - Singapore National Research Foundation Permanent Secretary(National Research and Development)T. M. Kian signing the guest book with Head of International Relations F. Pauss and visiting CMS control centre with Collaboration Spokesperson G. Tonelli.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-07-01

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

  9. The UK National Air Quality Strategy: the effects of the proposed changes on Local Air Quality Management

    Energy Technology Data Exchange (ETDEWEB)

    Beattie, C.I.; Ling, K.; Longhurst, J.W.S. [Univ. of the West of England, Faculty of Applied Sciences, Bristol (GB)] [and others

    1999-07-01

    The UK has implemented a system of Local Air Quality Management (LAQM) to tackle the many contemporary sources of air pollution, notably transport, industry and domestic fuel burning, in a holistic manner. The current legislation stems from the Environment Act 1995, which required a National Air Quality Strategy (NAQS) to be published outlining the Governments policies with respect to the assessment and management of air quality. The NAQS, originally published in March 1997, is on a rolling programme of reviews in order to reflect developments in European legislation, technological and scientific advances, improved air pollution modelling techniques and an increasingly better understanding of the economic and social issues involved. Following the first review (currently at consultation state), this paper will comment on how the proposed changes may affect the LAQM process. The proposed changes will also be summarised and discussed in the context of European Union air quality objectives and the economic analysis of NAQS.

  10. Factors affecting UK medical students' decision to train in urology: a national survey.

    Science.gov (United States)

    Jayakumar, Nithish; Ahmed, Kamran; Challacombe, Ben

    2016-10-01

    Our aim was to understand the specific factors which influence medical students' choice to train in urology, in order to attract the best and the brightest into the specialty during a challenging time for surgical training in the United Kingdom A cross-sectional web-based survey was generated to evaluate: 1) perceptions of urology; 2) attitudes about urology as a career; 3) exposure to urology at medical school; and 4) proficiency in common urological procedures. The survey was sent to all 33 medical schools in the UK and advertised to all medical students. The survey received 488 responses were received from 14 medical schools; 59.8% of respondents did not consider a career in urology. Factors affecting a career choice in urology included: 1) year of study; 2) male gender; 3) favorable perceptions of urology; 4) favorable attitudes about urology as a career; 5) more hours of urology teaching in preclinical years; 6) attendance at urology theatre sessions; 7) confidence in performing urological procedures; and 8) more attempts at male catheterization. The commonest reason for not considering urology was inadequate exposure to urology. Students in Year 3 were more likely to consider urology than final-year students, due to multifactorial reasons. Year of study is a novel factor affecting students' consideration of urology as a career. This paper clearly shows that early and sustained exposure to urology positively correlated with considering a career in urology. Urologists must be more active in promoting the specialty to medical students.

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

    Science.gov (United States)

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

    2012-01-01

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

  12. Assessing climate risks across different business sectors and industries: an investigation of methodological challenges at national scale for the UK

    Science.gov (United States)

    Surminski, Swenja; Di Mauro, Manuela; Baglee, J. Alastair R.; Connell, Richenda K.; Hankinson, Joel; Haworth, Anna R.; Ingirige, Bingunath; Proverbs, David

    2018-06-01

    Climate change poses severe risks for businesses, which companies as well as governments need to understand in order to take appropriate steps to manage those. This, however, represents a significant challenge as climate change risk assessment is itself a complex, dynamic and geographically diverse process. A wide range of factors including the nature of production processes and value chains, the location of business sites as well as relationships and interdependencies with customers and suppliers play a role in determining if and how companies are impacted by climate risks. This research explores the methodological challenges for a national-scale assessment of climate risks through the lens of the UK Climate Change Risk Assessment (UKCCRA) process and compares the approaches adopted in the first and second UKCCRA (2011, 2016), while also reflecting on international experiences elsewhere. A review of these issues is presented, drawing on a wide body of contemporary evidence from a range of sources including the research disciplines, grey literature and government policy. The study reveals the methodological challenges and highlights six broad themes, namely scale, evidence base, adaptation responses, scope, interdependencies and public policy. The paper concludes by identifying suitable lessons for future national climate risk assessments, which should guide the next phase of research in preparation for UKCCRA3 and those of national-level risk assessments elsewhere. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

  13. Annual report April 1974-March 1975 of the Gama Research Centre National Atomic Energy Agency

    International Nuclear Information System (INIS)

    1975-01-01

    Activities at the Gama Research Centre for the period of April 1974-March 1975, covering works at the Laboratory of Nuclear and Atomic Physics, at the Reactor Laboratory, at the Laboratory of Chemistry, and at the Laboratory of Process Technology, are described. The Center's personnel and financial accounts are also given. (RUW)

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

    Directory of Open Access Journals (Sweden)

    Colleen D Acosta

    2014-07-01

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

  15. Nitrous oxide from solid fuel combustion: contribution to national inventories in the UK, France and Germany

    International Nuclear Information System (INIS)

    Fynes, G.; Hughes, I.S.C.; Sage, P.W.

    1994-01-01

    Considerable uncertainties exist over the extent and timing of any potential climate change as a result of increases in the concentration of greenhouse gases in the atmosphere. These uncertainties result from inadequate knowledge and understanding of the natural mechanisms that control the chemistry, and hence lifetimes, of these gases in the atmosphere. An important aspect of the scientific investigation into potential climate change is the attempt to quantify the sources and sinks of the various greenhouse gases. This will enable the contribution of anthropogenic emissions to be placed in context with those from natural sources. The British Coal Corporation is co-ordinating a project funded by the EEC JOULE Programme to investigate the emissions of greenhouse gases from coal fired plant. This collaborative programme aims to establish the extent of greenhouse gas emissions, with particular emphasis on nitrous oxide (N 2 O) from a wide range of coal burning appliances. An important aspect of the programm is to identify potential greenhouse-related problems with emerging clean-coal technologies, as well as retrofit pollution abatement technology, attributable to modifications to the combustion process. For example, the environmental benefits of fluidised bed combustion in reducing emissions of acidic gases are well proven. However, the lower combustion temperatures in such systems have been shown to promote greater emissions of N 2 O. The information from the various emissions assessments will be combined with a survey of coal use in the UK and the rest of Europe to establish an inventory of greenhouse gas emissions. 5 refs., 3 tabs

  16. Gambling and negative life events in a nationally representative sample of UK men.

    Science.gov (United States)

    Roberts, Amanda; Sharman, Stephen; Coid, Jeremy; Murphy, Raegan; Bowden-Jones, Henrietta; Cowlishaw, Sean; Landon, Jason

    2017-12-01

    The links between gambling problems, trauma and life stressors are known to exist but understanding the extent of these relationships will allow for greater efficacy in early intervention and treatment. We investigated these relationships among men and sought to determine whether links were attenuated by alcohol and drug use problems. A cross-sectional UK representative general population survey was conducted in 2009 with 3025 men aged 18-64years. Measurements included self-reported gambling behaviours, as measured by the South Oaks Gambling Scale (SOGS) and traumatic or stressful life events. Covariates included alcohol and drug dependence and socio-demographics. Binary logistic regression models were used to examine associations. Problem gambling (SOGS 3-4) and probable pathological gambling (SOGS 5+) were associated with increased odds of trauma in childhood (e.g. violence in the home (Adjusted Odd Ratios (AOR) 3.0 (CI=1.8-5.0) and 2.6 (CI=1.7-4.1) respectively), and life stressors in adulthood (e.g. intimate partner violence (AORs 4.5 (CI=2.0-10.3) and 4.7 (CI=2.3-9.7) and homelessness (AORs 2.2 (CI=1.1-4.6) and 3.2 (CI=1.9-5.5)). Results were attenuated when adjusted for probable alcohol and drug dependence with the latter having largest effects. Among men in the United Kingdom, disordered gambling remains uniquely associated with trauma and life stressors in childhood and adulthood after adjusting for alcohol and drug dependence. The results support a need for disordered gambling treatment services to undertake routine screening for alcohol, drugs, IPV and traumatic life events and to tailor treatment that specifically targets the effects of stress for clients who present with such a cluster of issues. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  17. The experimental operation of a seismological data centre at Blacknest

    International Nuclear Information System (INIS)

    Grover, F.H.

    1978-10-01

    A short account is given of the development and operation of a unit within Blacknest which acts as a centre for handling data received from overseas seismological array stations and stations in the British Isles and also exchanges data with other centres. The work has been carried out as a long-term experiment to assess the capability of small networks of existing research and development stations to participate in the monitoring of a possible future Comprehensive Test Ban treaty (CTB) and to gain experience of the operational requirements for Data Centres. A preliminary assessment of a UK National Technical Means (NTM) for verifying a CTB is obtained inter alia. (author)

  18. Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service.

    Science.gov (United States)

    Aggarwal, Reena; Swanwick, Tim

    2015-01-01

    Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors) in the UK who provide the majority of front-line patient care and form an "operating core" of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing "leaders", to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a "heroic" individual leader to a more distributed model, where organizations are "leader-ful" and not just "well led" and leadership is centered on a shared vision owned by whole teams working on the frontline.

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kathryn E Fitzpatrick

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

  1. 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.

  2. Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service

    Science.gov (United States)

    Aggarwal, Reena; Swanwick, Tim

    2015-01-01

    Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors) in the UK who provide the majority of front-line patient care and form an “operating core” of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing “leaders”, to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a “heroic” individual leader to a more distributed model, where organizations are “leader-ful” and not just “well led” and leadership is centered on a shared vision owned by whole teams working on the frontline. PMID:29355184

  3. 'Strategy is a commodity, implementation is an art' - 2 years of implementation of the UK national LLW strategy

    International Nuclear Information System (INIS)

    Cassidy, Helen; Rossiter, David

    2013-01-01

    The Low Level Waste Repository (LLWR) is the primary facility for disposal of Low Level Waste (LLW) in the United Kingdom (UK), serving the UK nuclear industry and a diverse range of other sectors. Management of LLW in the UK historically was dominated by disposal to the LLWR. The value of the LLWR as a national asset was recognised by the 2007 UK Governmental Policy on management of solid LLW. At this time, analysis of the projected future demand for disposal at LLWR against facility capacity was undertaken identifying a credible risk that the capacity of LLWR would be insufficient to meet future demand if existing waste management practices were perpetuated. To mitigate this risk a National Strategy for the management of LLW in the UK was developed by the Nuclear Decommissioning Authority (NDA), partnered with LLW Repository Ltd. (the organisation established in 2008 to manage the LLWR on behalf of NDA). This strategy was published in 2010 and identified three mechanisms for protection of the capacity of LLWR - application of the Waste Hierarchy by waste producers; optimised use of existing assets for LLW management; and opening of new waste treatment and disposal routes to enable diversion of waste away from the LLWR. (authors)

  4. A New UK 2006 National Kidney Allocation Scheme for deceased heart-beating donor kidneys.

    Science.gov (United States)

    Johnson, Rachel J; Fuggle, Susan V; Mumford, Lisa; Bradley, J Andrew; Forsythe, John L R; Rudge, Chris J

    2010-02-27

    In 2004, it was agreed that a new allocation scheme for kidneys from deceased heart-beating donors was required in the United Kingdom to address observed inequities in access to transplant. The 2006 National Kidney Allocation Scheme (2006 NKAS) was developed to meet agreed objectives and preparatory work included a review of the criteria for human leukocyte antigen (HLA) matching and simulation evidence about the effectiveness of alternative schemes. ALGORITHM FOR 2006 NKAS: The 2006 NKAS gives absolute priority to all 000 HLA-A, -B, -DR-mismatched patients and well-matched pediatric patients (inequity of access will take a number of years to address fully.

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

    OpenAIRE

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

    2010-01-01

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

  6. WLB in the UK: Present situation and challenges for national and corporate initiatives, suggestions for Japan (Japanese)

    OpenAIRE

    YAJIMA Yoko

    2011-01-01

    In this paper, we develop a sense of the present situation and challenges of work-life balance (WLB) policies, corporate initiatives, and the workplace environment from the perspective of workers in the UK, and we carry out a comparison analysis with initiatives in Japan. Further, the analysis in this paper is a summary based on the results of a questionnaire survey of workers in Japan and the UK, a survey of the literature, and the results of local interview surveys in the UK. The UK resembl...

  7. Scientific data management, e.g. as related to accessing wind data centres

    Energy Technology Data Exchange (ETDEWEB)

    Kleese, Kerstin [CLRC, Daresbury Lab., Warrington (United Kingdom)

    2000-07-01

    Proposes that the prototype catalogue system developed by UK NERC for its 37 UK Data Centres for earth sciences should be expanded to include all UK wind data holdings, and services to enable required wind data to be generated. (UK)

  8. International Energy Agency's Heat Pump Centre (IEA-HPC) Annual National Team Working Group Meeting

    Science.gov (United States)

    Broders, M. A.

    1992-09-01

    The traveler, serving as Delegate from the United States Advanced Heat Pump National Team, participated in the activities of the fourth IEA-HPC National Team Working Group meeting. Highlights of this meeting included review and discussion of 1992 IEA-HPC activities and accomplishments, introduction of the Switzerland National Team, and development of the 1993 IEA-HPC work program. The traveler also gave a formal presentation about the Development and Activities of the IEA Advanced Heat Pump U.S. National Team.

  9. The risk of transfusion-transmitted viral infections at the Gabonese National Blood Transfusion Centre

    Science.gov (United States)

    Rerambiah, Leonard Kounegnigan; Rerambiah, Laurence Essola; Bengone, Calixte; Djoba Siawaya, Joel F.

    2014-01-01

    Background Blood transfusions carry the risk of transmitting blood-borne infections. In contrast to the situation in the developed world, there is a limited number of studies examining this problem in sub-Saharan Africa. In this study we aimed to calculate the risks of acquiring human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infection from units of blood issued by the Gabonese Blood Transfusion Centre between 2009 and 2011. Materials and methods All the donations were tested for infectious diseases and the seroconversion incidence rates of HIV, HBV and HCV were calculated. The residual risk of transfusion-associated transmission for each virus was calculated by multiplying the seroconversion rates by the window period expressed in fractions of a year. Results The risks of becoming infected with HIV, HCV, and HBV in subjects receiving units of blood from the Gabonese Blood Transfusion Centre were 64.7, 207.94 and 534.53 per million donations, respectively. Conclusions This study, which is the first to quantify the true risks of transfusion-transmitted infections in Gabon, reveals and confirms the need to reinforce preventative and screening strategies to improve transfusion safety in sub-Saharan Africa. PMID:24333085

  10. 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.

  11. National renewable energy policy and local opposition in the UK: the failed development of a biomass electricity plant

    International Nuclear Information System (INIS)

    Upreti, B.R.; Horst, Dan van der

    2004-01-01

    Biomass energy developments in the UK are supported by central government but face considerable opposition from the public. The purpose of this study is to explore the causes and consequences of public opposition to biomass energy development in North Wiltshire where Ambient Energy Ltd. proposed the development of a 5 MWe wood gasification plant near the town of Cricklade. The case study was conducted through in-depth interviews, content analysis, person to person questionnaire survey, focus group discussion and participatory appraisal methods. Though biomass energy plants in general have fewer environmental impacts than plants which use fossil fuel, there could still be local impacts which give rise to concerns and local opposition to the development. The opposition could be partially explained by the fact that the general public is relatively unfamiliar with biomass energy. Public acceptance or rejection was mainly based on the public trust or mistrust. The case study demonstrates two distinctly rigid characteristics among the key stakeholders of biomass energy development. These are the 'not-in-my-back-yard' attitude from the public and the 'there-is-no-alternative' attitude of the developers. These rigid stances were widely contributing to the failure of the project to gain planning permission. The environmental justification of biomass energy at the national level is not always sufficient to convince the local residents. Winning public support to promote biomass energy requires an alternative approach of planning and action through interactive communication, public participation and collective learning among all the stakeholders

  12. Analysis of enquiries to the National Pharmacy Association following major changes to controlled drug legislation in the UK.

    Science.gov (United States)

    Gallagher, Cathal T; Hickman, Adrienne C; Hannbeck, Leyla; Flynn, Robert W

    2012-02-01

    The National Pharmacy Association (NPA) provides an advice service to community pharmacists in the UK, and keeps a database of the enquiries it receives. The aim of this research was to analyse the database for the period of October 2007 to March 2008 to gain an insight into how well pharmacists coped with legislative changes directly affecting pharmacy by identifying which changes generated the most enquiries during these 6 months and ascertaining in which months these queries were at their highest levels. Anonymised telephone enquiries regarding controlled drugs (CDs) received by the NPA from pharmacists during a 6-month period were reviewed and categorised according to the legislative change or other CD issue to which they related. A Poisson model was applied to determine whether there was a significant difference in the total number of CD queries generated each month. Altogether 6082 queries regarding CDs were received, of which 57% related to legislative changes. The three legislative changes that took place during the 6-month period all generated a significant increase in numbers of queries around the time of the change. Queries regarding the new form of CD register comprised the largest single category. Community pharmacists seek information regarding legislative changes when such changes come into force to a greater degree than when the legislation is drafted, consulted upon or enacted. The high number of queries received by the NPA does reflect that there was a difficulty in applying the various legislative changes in practice. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

  13. Tinnitus and hyperacusis therapy in a UK National Health Service audiology department: Patients’ evaluations of the effectiveness of treatments

    Science.gov (United States)

    Aazh, Hashir; Moore, Brian C. J.; Lammaing, Karen; Cropley, Mark

    2016-01-01

    Abstract Objective: To assess patients’ judgements of the effectiveness of the tinnitus and hyperacusis therapies offered in a specialist UK National Health Service audiology department. Design: Cross-sectional service evaluation questionnaire survey. Patients were asked to rank the effectiveness of the treatment they received on a scale from 1 to 5 (1 = no effect, 5 = very effective). Study sample: The questionnaire was sent to all patients who received treatment between January and March 2014 (n = 200) and 92 questionnaires were returned. Results : The mean score was greatest for counselling (Mean = 4.7, SD = 0.6), followed by education (Mean = 4.5, SD = 0.8), cognitive behavioural therapy - CBT (Mean = 4.4, SD = 0.7), and hearing tests (Mean = 4.4, SD = 0.9). Only 6% of responders rated counselling as 3 or below. In contrast, bedside sound generators, hearing aids, and wideband noise generators were rated as 3 or below by 25%, 36%, and 47% of participants, respectively. Conclusion: The most effective components of the tinnitus and hyperacusis therapy interventions were judged by the patients to be counselling, education, and CBT. PMID:27195947

  14. UK nuclear data progress report for the period January - December 1981

    International Nuclear Information System (INIS)

    Lees, E.W.

    1982-06-01

    Summaries are given of work by AERE Harwell, AEEW Winfrith, National Physical Laboratory, NRPB, Birmingham Radiation Centre and the Universities of Birmingham and Edinburgh. A paper on fission product decay heat from 235 U and 239 Pu is included. (U.K.)

  15. An exploration of socio-economic and food characteristics of high trans fatty acid consumers in the Dutch and UK national surveys after voluntary product reformulation.

    Science.gov (United States)

    Rippin, H L; Hutchinson, J; Ocke, M; Jewell, J; Breda, J J; Cade, J E

    2017-01-01

    Trans fatty acids (TFA) increase the risk of mortality and chronic diseases. TFA intakes have fallen since reformulation, but may still be high in certain, vulnerable, groups. This paper investigates socio-economic and food consumption characteristics of high TFA consumers after voluntary reformulation in the Netherlands and UK. Post-reformulation data of adults aged 19-64 was analysed in two national surveys: the Dutch National Food Consumption Survey (DNFCS) collected 2007-2010 using 2*24hr recalls (N = 1933) and the UK National Diet and Nutrition Survey (NDNS) years 3&4 collected 2010/11 and 2011/12 using 4-day food diaries (N = 848). The socio-economic and food consumption characteristics of the top 10% and remaining 90% TFA consumers were compared. Means of continuous data were compared using t-tests and categorical data means using chi-squared tests. Multivariate logistic regression models indicated which socio-demographic variables were associated with high TFA consumption. In the Dutch analyses, women and those born outside the Netherlands were more likely to be top 10% TFA consumers than men and Dutch-born. In the UK unadjusted analyses there was no significant trend in socio-economic characteristics between high and lower TFA consumers, but there were regional differences in the multivariate logistic regression analyses. In the Netherlands, high TFA consumers were more likely to be consumers of cakes, buns & pastries; cream; and fried potato than the remaining 90%. Whereas in the UK, high TFA consumers were more likely to be consumers of lamb; cheese; and dairy desserts and lower crisps and savoury snack consumers. Some socio-demographic differences between high and lower TFA consumers were evident post-reformulation. High TFA consumers in the Dutch 2007-10 survey appeared more likely to obtain TFA from artificial sources than those in the UK survey. Further analyses using more up-to-date food composition databases may be needed.

  16. Perceptions of UK medical graduates' preparedness for practice: a multi-centre qualitative study reflecting the importance of learning on the job.

    Science.gov (United States)

    Illing, Jan C; Morrow, Gill M; Rothwell nee Kergon, Charlotte R; Burford, Bryan C; Baldauf, Beate K; Davies, Carol L; Peile, Ed B; Spencer, John A; Johnson, Neil; Allen, Maggie; Morrison, Jill

    2013-02-28

    There is evidence that graduates of different medical schools vary in their preparedness for their first post. In 2003 Goldacre et al. reported that over 40% of UK medical graduates did not feel prepared and found large differences between graduates of different schools. A follow-up survey showed that levels of preparedness had increased yet there was still wide variation. This study aimed to examine whether medical graduates from three diverse UK medical schools were prepared for practice. This was a qualitative study using a constructivist grounded theory approach. Prospective and cross-sectional data were collected from the three medical schools.A sample of 60 medical graduates (20 from each school) was targeted. They were interviewed three times: at the end of medical school (n = 65) and after four (n = 55) and 12 months (n = 46) as a Year 1 Foundation Programme doctor. Triangulated data were collected from clinicians via interviews across the three sites (n = 92). In addition three focus groups were conducted with senior clinicians who assess learning portfolios. The focus was on identifying areas of preparedness for practice and any areas of lack of preparedness. Although selected for being diverse, we did not find substantial differences between the schools. The same themes were identified at each site. Junior doctors felt prepared in terms of communication skills, clinical and practical skills and team working. They felt less prepared for areas of practice that are based on experiential learning in clinical practice: ward work, being on call, management of acute clinical situations, prescribing, clinical prioritisation and time management and dealing with paperwork. Our data highlighted the importance of students learning on the job, having a role in the team in supervised practice to enable them to learn about the duties and responsibilities of a new doctor in advance of starting work.

  17. 23rd May 2011 - University of Liverpool Pro-Vice-Chancellor and Public Orator K. Everest (UK) Mrs Everest in the ATLAS visitor centre with Collaboration Deputy Spokesperson D. Charlton, in LHCb surface building with Collaboration Spokesperson A. Golutvin, accompanied throughout by P. Wells and Liverpool University T. Bowcock and M. Klein.

    CERN Multimedia

    Maximilen Brice

    2011-01-01

    23rd May 2011 - University of Liverpool Pro-Vice-Chancellor and Public Orator K. Everest (UK) Mrs Everest in the ATLAS visitor centre with Collaboration Deputy Spokesperson D. Charlton, in LHCb surface building with Collaboration Spokesperson A. Golutvin, accompanied throughout by P. Wells and Liverpool University T. Bowcock and M. Klein.

  18. System of radiation monitoring of nuclear hazardous facilities in Institute of Atomic Energy of National Nuclear Centre

    International Nuclear Information System (INIS)

    Azarov, V.A.; Meshin, M.M.; Shuklin, G.S.

    1996-01-01

    Issues of radiation monitoring (RM) at reactor complex of Inst. of Atomic Energy (IAE) are discussed in report. The National Nuclear Centre's reactor base consists of 2 complexes situated in 2 different locations: Bajkal-1 and IGR. So far as IAE has common mythology for RM at all hazardous nuclear facilities the issues of RM for Baikal-1 and IGR Radiation monitoring system includes: - personal dosimetric control of personnel, maintaining the reactor systems and research laboratories; RM of industrial buildings; - RM of technical areas of technical area of the facility; sanitary system of dosimetry control (DC); etc. The description of stationary DC system of the complex based on 'System' facility are given. Baikal is surround by sanitary area with radius of 5 km and with its centre in the reactor location. Complexity of studying the radiation status on the territory of Baikal-1 and its surroundings is the result of nuclear testing conducted at the test site in the past, reactor operation with open exhaust of coolant into atmosphere while testing on Nuclear Rocket Engines program as well as global fall out of radionuclides

  19. The materials production and processing facility at the Spanish National Centre for fusion technologies (TechnoFusion)

    International Nuclear Information System (INIS)

    Munoz, A.; Monge, M.A.; Pareja, R.; Hernandez, M.T.; Jimenez-Rey, D.; Roman, R.; Gonzalez, M.; Garcia-Cortes, I.; Perlado, M.; Ibarra, A.

    2011-01-01

    In response to the urgent request from the EU Fusion Program, a new facility (TechnoFusion) for research and development of fusion materials has been planned with support from the Regional Government of Madrid and the Ministry of Science and Innovation of Spain. TechnoFusion, the National Centre for Fusion Technologies, aims screening different technologies relevant for ITER and DEMO environments while promoting the contribution of international companies and research groups into the Fusion Programme. For this purpose, the centre will be provided with a large number of unique facilities for the manufacture, testing (a triple-beam multi-ion irradiation, a plasma-wall interaction device, a remote handling for under ionizing radiation testing) and analysis of critical fusion materials. Particularly, the objectives, semi-industrial scale capabilities and present status of the TechnoFusion Materials Production and Processing (MPP) facility are presented. Previous studies revealed that the MPP facility will be a very promising infrastructure for the development of new materials and prototypes demanded by the fusion technology and therefore some of them will be here briefly summarized.

  20. The materials production and processing facility at the Spanish National Centre for fusion technologies (TechnoFusion)

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, A., E-mail: rpp@fis.uc3m.es [Departamento de Fisica, UC3M, Avda de la Universidad 30, 28911 Leganes, Madrid (Spain); Monge, M.A.; Pareja, R. [Departamento de Fisica, UC3M, Avda de la Universidad 30, 28911 Leganes, Madrid (Spain); Hernandez, M.T. [LNF-CIEMAT, Avda, Complutense, 22, 28040 Madrid (Spain); Jimenez-Rey, D. [CMAM, UAM, C/Faraday 3, 28049, Madrid (Spain); Roman, R.; Gonzalez, M.; Garcia-Cortes, I. [LNF-CIEMAT, Avda, Complutense, 22, 28040 Madrid (Spain); Perlado, M. [IFN, ETSII, UPM, C/Jose Gutierrez Abascal, 2, 28006 Madrid (Spain); Ibarra, A. [LNF-CIEMAT, Avda, Complutense, 22, 28040 Madrid (Spain)

    2011-10-15

    In response to the urgent request from the EU Fusion Program, a new facility (TechnoFusion) for research and development of fusion materials has been planned with support from the Regional Government of Madrid and the Ministry of Science and Innovation of Spain. TechnoFusion, the National Centre for Fusion Technologies, aims screening different technologies relevant for ITER and DEMO environments while promoting the contribution of international companies and research groups into the Fusion Programme. For this purpose, the centre will be provided with a large number of unique facilities for the manufacture, testing (a triple-beam multi-ion irradiation, a plasma-wall interaction device, a remote handling for under ionizing radiation testing) and analysis of critical fusion materials. Particularly, the objectives, semi-industrial scale capabilities and present status of the TechnoFusion Materials Production and Processing (MPP) facility are presented. Previous studies revealed that the MPP facility will be a very promising infrastructure for the development of new materials and prototypes demanded by the fusion technology and therefore some of them will be here briefly summarized.

  1. Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study

    Directory of Open Access Journals (Sweden)

    Heeley Emma L

    2011-01-01

    Full Text Available Abstract Background We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH in China where the disease is more common than in Western populations. Methods Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment study, a multi-centre, prospective, 62 hospital registry in China during 2006-07. Results Nearly all ICH patients (n = 1572 received an intravenous haemodiluting agent such as mannitol (96% or a neuroprotectant (72%, and there was high use of intravenous traditional Chinese medicine (TCM (42%. Neurosurgery was undertaken in 137 (9% patients; being overweight, having a low Glasgow Coma Scale (GCS score on admission, and Total Anterior Circulation Syndrome (TACS clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p Conclusions The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH.

  2. Acute thiopurine overdose: analysis of reports to a National Poison Centre 1995-2013.

    Directory of Open Access Journals (Sweden)

    Claudia Gregoriano

    Full Text Available Literature regarding acute human toxicity of thiopurines is limited to a handful of case reports. Our objectives were to describe all cases of overdose with thiopurines reported to the Swiss Toxicological Information Centre between 1995-2013. A retrospective analysis was performed to determine circumstances, magnitude, management and outcome of overdose with these substances. A total of 40 cases (14 paediatric were reported (azathioprine, n = 35; 6-mercaptopurine, n = 5. Of these, 25 were with suicidal intent, 12 were accidental and 3 were iatrogenic errors. The magnitude of overdose ranged from 1.5 to 43 (median 8 times the usual dose in adults. Twelve cases (30% had attributable symptoms. The majority of these were minor and included gastrointestinal complaints and liver function test and blood count abnormalities. Symptoms were experienced by patients who took at least 1.5-times their usual daily thiopurine dose. Overdoses over two or more consecutive days, even if of modest size, were less well tolerated. One case of azathioprine and allopurinol co-ingestion over consecutive days led to agranulocytosis. Decontamination measures were undertaken in 11 cases (10 activated charcoal, 1 gastric lavage and these developed fewer symptoms than untreated patients. This study shows that acute overdoses with thiopurines have a favourable outcome in the majority of cases and provides preliminary evidence that gastrointestinal decontamination with activated charcoal may reduce symptom development after overdose of these substances if patients present to medical services soon after ingestion.

  3. The Development of National Beef-Cattle Population in Relation to Beef-Cattle Population at the Centre and Non Centre Area, and the Policy of National Development Program

    Directory of Open Access Journals (Sweden)

    A Sodiq

    2006-09-01

    Full Text Available The objectives of this research were (1 to find out the development of beef-cattle population at national level, at the Centre Area of Population (CAP and Non Centre Area of Population (NCAP, (2 to assess the relation between population of national beef-cattle and beef-cattle population at CAP and NCAP, (3 to study the policy of beef-cattle development program in Indonesia. The target of this study addressed to the Directorate General of Livestock Services, Republic of Indonesia. A literature review and communication methods were applied in this study. Descriptive and regression analysis were used for data analysis.  The study revealed that: (1 During 1995-2005, beef-cattle population at national level, CAP and NCAP were unstable.  Due to financial crises (1997, the population at national and CAP tended to decrease, but the population at NCAP was relatively constant.  During 2003-2005, national population tended to increase (0.83% per year, and that figure was less than national target (1.05%,  (2 Population of national beef-cattle (Y was highly related (r2: 0,95; MSE: 108508 to the population of beef-cattle at NCAP (X;  Y = 4764492 + 0.896 X;  (3 An increase in beef-cattle population during 2000-2005 was due to an increase in calving and cattle importation. Slaughtering of cows should be controlled to increase calving. The evaluation results of beef self-sufficiency program revealed that there were failures in achieving main goals of the program. It is recommended that to improve the contribution of CAP to national needs, the development of cattle population should be focused in those areas.  The evaluation results of beef self-sufficiency program could be considered in the future policy in term of the development cattle population. Some causes of the policy failures: (1 the formulated policy was not equipped with detailed operation plans. The program formulation was limited to title and goal without elaborating the way to achieve the

  4. The United Nations University: The Concept, History, Structure, Financing, Objectives, Centres and Programmes. Guest Editorial.

    Science.gov (United States)

    Reddy, J.

    2000-01-01

    The United Nations University (UNU) is an international academic organization which brings together leading international scholars to tackle world problems. This article describes for South African scholars, institutions, governments, and their agencies the importance of the work being undertaken by the UNU and encourages their participation. (EV)

  5. Nacionalismo no centro e na periferia do capitalismo Nationalism at the centre and periphery of Capitalism

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Bresser-Pereira

    2008-04-01

    Full Text Available Neste trabalho, inicialmente, argumento que o nacionalismo é uma das ideologias das sociedades modernas conjuntamente com o liberalismo, o socialismo, o eficientismo e o ambientalismo. Em seguida, na primeira seção, defino a nação como a forma de sociedade politicamente organizada que nasce com a revolução capitalista e leva à formação dos estados-nação, e o nacionalismo como a ideologia correspondente: seu objetivo é a autonomia e o desenvolvimento econômico nacional. Na segunda seção, distingo o nacionalismo dos países centrais daquele dos países periféricos; enquanto nos primeiros o nacionalismo é implícito, nos periféricos ou é explícito ou então deriva para o cosmopolitismo. Na terceira, argumento que, embora o imperialismo seja inevitável entre países fortes e fracos, ele mudará de características na medida em que essa relação de forças se modificar graças ao nacionalismo dos dominados. Ainda nessa seção, faço uma breve referência ao Brasil. Finalmente, volto às ideologias do capitalismo para mostrar que, ao contrário das demais, o nacionalismo é uma ideologia particularista - o que aumenta a resistência a ela e facilita a tarefa de dominação dos países centrais. Não obstante, o nacionalismo não morre porque é um princípio organizador da sociedade capitalista.In this work I show that nationalism, together with liberalism, socialism, efficientism and the environmentalism, is one of the ideologies of the modern societies. In the first section, I define nation as the form of society politically organized that is born with the Capitalist Revolution and leads to the formation of the nation-state, and nationalism as the corresponding ideology: its objective is the autonomy and the national economic development. In the second section, I distinguish the nationalism of the central countries from that one of the peripheral countries; while in the first the nationalism is implicit, in the peripherals is

  6. The GP Patient Survey for use in primary care in the National Health Service in the UK--development and psychometric characteristics.

    Science.gov (United States)

    Campbell, John; Smith, Patten; Nissen, Sonja; Bower, Peter; Elliott, Marc; Roland, Martin

    2009-08-22

    The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9) involved the development of a new survey instrument. We describe the process of that development, and the findings of an extensive pilot survey in UK primary healthcare. The survey was developed following recognised guidelines and involved expert and stakeholder advice, cognitive testing of early versions of the survey instrument, and piloting of the questionnaire in a cross sectional pilot survey of 1,500 randomly selected individuals from the UK electoral register with two reminders to non-respondents. The questionnaire comprises 66 items addressing a range of aspects of UK primary healthcare. A response rate of 590/1500 (39.3%) was obtained. Non response to individual items ranged from 0.8% to 15.3% (median 5.2%). Participants did not always follow internal branching instructions in the questionnaire although electronic controls allow for correction of this problem in analysis. There was marked skew in the distribution of responses to a number of items indicating an overall favourable impression of care. Principal components analysis of 23 items offering evaluation of various aspects of primary care identified three components (relating to doctor or nurse care, or addressing access to care) accounting for 68.3% of the variance in the sample. The GP Patient Survey has been carefully developed and pilot-tested. Survey findings, aggregated at practice level, will be used to inform the distribution of pound sterling 65 million ($107 million) of UK NHS resource in 2008/9 and this offers the opportunity for NHS service planners and providers to take account of users' experiences of health care in planning and delivering primary healthcare in the UK.

  7. The GP Patient Survey for use in primary care in the National Health Service in the UK – development and psychometric characteristics

    Directory of Open Access Journals (Sweden)

    Bower Peter

    2009-08-01

    Full Text Available Abstract Background The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9 involved the development of a new survey instrument. We describe the process of that development, and the findings of an extensive pilot survey in UK primary healthcare. Methods The survey was developed following recognised guidelines and involved expert and stakeholder advice, cognitive testing of early versions of the survey instrument, and piloting of the questionnaire in a cross sectional pilot survey of 1,500 randomly selected individuals from the UK electoral register with two reminders to non-respondents. Results The questionnaire comprises 66 items addressing a range of aspects of UK primary healthcare. A response rate of 590/1500 (39.3% was obtained. Non response to individual items ranged from 0.8% to 15.3% (median 5.2%. Participants did not always follow internal branching instructions in the questionnaire although electronic controls allow for correction of this problem in analysis. There was marked skew in the distribution of responses to a number of items indicating an overall favourable impression of care. Principal components analysis of 23 items offering evaluation of various aspects of primary care identified three components (relating to doctor or nurse care, or addressing access to care accounting for 68.3% of the variance in the sample. Conclusion The GP Patient Survey has been carefully developed and pilot-tested. Survey findings, aggregated at practice level, will be used to inform the distribution of £65 million ($107 million of UK NHS resource in 2008/9 and this offers the opportunity for NHS service planners and providers to take account of users' experiences of health care in planning and delivering primary healthcare in the UK.

  8. Argonne National Laboratory: An example of a US nuclear research centre

    International Nuclear Information System (INIS)

    Bhattacharyya, S.

    2001-01-01

    The nuclear era was ushered in 1942 with the demonstration of a sustained nuclear chain reaction in Chicago Pile 1 facility. The USA then set up five large national multi disciplinary laboratories for developing nuclear technology for civilian use and three national laboratories for military applications. Reactor development, including prototype construction, was the main focus of the Argonne National Laboratory. More than 100 power reactors operating in the USA have benefited from R and D in the national laboratories. However, currently the support for nuclear power has waned. With the end of the cold war there has also been a need to change the mission of laboratories involved in military applications. For all laboratories of the Department of Energy (DOE) the mission, which was clearly focused earlier on high risk, high payoff long term R and D has now become quite diffused with a number of near term programmes. Cost and mission considerations have resulted in shutting down of many large facilities as well as auxiliary facilities. Erosion of infrastructure has also resulted in reduced opportunities for research which means dwindling of interest in nuclear science and engineering among the younger generation. The current focus of nuclear R and D in the DOE laboratories is on plant life extension, deactivation and decommissioning, spent fuel management and waste management. Advanced aspects include space nuclear applications and nuclear fusion R and D. At the Argonne National Laboratory, major initiatives for the future would be in the areas of science, energy, environment and non-proliferation technologies. International collaboration would be useful mechanisms to achieve cost effective solutions for major developmental areas. These include reactor operation and safety, repositories for high level nuclear waste, reactor system decommissioning, large projects like a nuclear fusion reactor and advanced power reactors. The IAEA could have a positive role in these

  9. Ion Beam Facilities at the National Centre for Accelerator based Research using a 3 MV Pelletron Accelerator

    Science.gov (United States)

    Trivedi, T.; Patel, Shiv P.; Chandra, P.; Bajpai, P. K.

    A 3.0 MV (Pelletron 9 SDH 4, NEC, USA) low energy ion accelerator has been recently installed as the National Centre for Accelerator based Research (NCAR) at the Department of Pure & Applied Physics, Guru Ghasidas Vishwavidyalaya, Bilaspur, India. The facility is aimed to carried out interdisciplinary researches using ion beams with high current TORVIS (for H, He ions) and SNICS (for heavy ions) ion sources. The facility includes two dedicated beam lines, one for ion beam analysis (IBA) and other for ion implantation/ irradiation corresponding to switching magnet at +20 and -10 degree, respectively. Ions with 60 kV energy are injected into the accelerator tank where after stripping positively charged ions are accelerated up to 29 MeV for Au. The installed ion beam analysis techniques include RBS, PIXE, ERDA and channelling.

  10. The changing profile of surrogacy in the UK – implications for national and international policy and practice

    OpenAIRE

    Crawshaw, Marilyn; Blyth, Eric; van den Akker, Olga

    2012-01-01

    Since 2007, the numbers of UK Parental Orders granted following surrogacy have markedly increased. More recently, eligibility criteria have been extended to unmarried heterosexual couples and same-sex couples rather than only married couples. Numbers seeking fertility treatments, including through surrogates, outside their country of residence have also increased. This paper presents the limited data currently available – from UK General Register Offices, Child and Family Court Advisory and S...

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

    Science.gov (United States)

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

    2009-06-01

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

  12. The development of the UK National Institute of Health and Care Excellence evidence-based clinical guidelines on motor neurone disease.

    Science.gov (United States)

    Oliver, David; Radunovic, Aleksandar; Allen, Alexander; McDermott, Christopher

    2017-08-01

    The care of people with motor neuron disease/amyotrophic lateral sclerosis is often complex and involves a wide multidisciplinary team approach. The National Institute for Health and Care Excellence (NICE) in the UK has produced an evidence based guideline for the management of patients. This has made recommendations, based on clear evidence or consensus discussion. The evidence is often limited and areas for further research are suggested.

  13. Initiatives in national and international collaborations at Variable Energy Cyclotron Centre

    International Nuclear Information System (INIS)

    Viyogi, Yogendra Pathak; Chakrabarti, Alok

    2008-01-01

    Over the last two decades VECC scientists, under the leadership of their director Bikash Sinha, have pursued experimental physics studies under international collaboration programmes, which would not have been possible with the existing facilities at home. The collaboration extended from RIKEN (Japan) in the east to CERN (Switzerland) in the west. It spanned the energy scales from a few tens of MeV per nucleon to several hundred GeV per nucleon and the physics topics on one extreme being the structure of exotic nuclei and their decay modes and on other extreme being the phase transition of hadronic matter and the formation of quark gluon plasma. The dynamic leadership of Dr. Sinha not only helped to shed the initial inhibitions towards such activities, going beyond the national frontiers, but also gave a new dimension to the experimental physics research in the country. It helped to organize an Indian team of scientists from various national institutes and universities. It paved way for full scale funding of the projects and set the trend that enabled many other Indian groups to join several international collaborations in various fields. Here we reflect on the evolution of these national and international collaboration programmes and the physics, technological and sociological benefits resulting from these activities. (author)

  14. Screening for iron deficiency and iron deficiency anaemia in pregnancy: a structured review and gap analysis against UK national screening criteria.

    Science.gov (United States)

    Rukuni, Ruramayi; Knight, Marian; Murphy, Michael F; Roberts, David; Stanworth, Simon J

    2015-10-20

    Iron deficiency anaemia is a common problem in pregnancy despite national recommendations and guidelines for treatment. The aim of this study was to appraise the evidence against the UK National Screening Committee (UKNSC) criteria as to whether a national screening programme could reduce the prevalence of iron deficiency anaemia and/or iron deficiency in pregnancy and improve maternal and fetal outcomes. Search strategies were developed for the Cochrane library, Medline and Embase to identify evidence relevant to UK National Screening Committee (UKNSC) appraisal criteria which cover the natural history of iron deficiency and iron deficiency anaemia, the tests for screening, clinical management and evidence of cost effectiveness. Many studies evaluated haematological outcomes of anaemia, but few analysed clinical consequences. Haemoglobin and ferritin appeared the most suitable screening tests, although future options may follow recent advances in understanding iron homeostasis. The clinical consequences of iron deficiency without anaemia are unknown. Oral and intravenous iron are effective in improving haemoglobin and iron parameters. There have been no trials or economic evaluations of a national screening programme for iron deficiency anaemia in pregnancy. Iron deficiency in pregnancy remains an important problem although effective tests and treatment exist. A national screening programme could be of value for early detection and intervention. However, high quality studies are required to confirm whether this would reduce maternal and infant morbidity and be cost effective.

  15. What is the role of a specialist regional mesothelioma multidisciplinary team meeting? A service evaluation of one tertiary referral centre in the UK.

    Science.gov (United States)

    Bibby, Anna C; Williams, Katie; Smith, Sarah; Bhatt, Nidhi; Maskell, Nick A

    2016-09-08

    Multidisciplinary team meetings are standard care for cancer in the UK and Europe. Professional bodies recommend that mesothelioma cases should be discussed at specialist multidisciplinary team meetings. However, no evidence exists exploring the role of the specialist mesothelioma multidisciplinary team meeting. To evaluate the clinical activity of 1 specialist mesothelioma multidisciplinary team meeting and to determine how often a definitive diagnosis was made, whether the core requirements of the meeting were met and whether there was any associated benefit or detriment. A service evaluation using routinely collected data from 1 specialist mesothelioma multidisciplinary team meeting in a tertiary referral hospital in the South-West of England. All cases discussed between 1/1/2014 and 31/12/2015. The primary outcome measure was whether a definitive diagnosis was made. Secondary outcomes included whether treatment advice was offered, information on clinical trials provided or further investigations suggested. Additional benefits of the multidisciplinary team meeting and time taken from referral to outcome were also collected. A definitive diagnosis was reached in 171 of 210 cases discussed (81%). Mesothelioma was diagnosed in 153/210 (73%). Treatment advice was provided for 127 of 171 diagnostic cases (74%) and further investigations suggested for all 35 non-diagnostic cases. 86/210 cases (41%) were invited to participate in a trial, of whom 43/86 (50%) subsequently enrolled. Additional benefits included the avoidance of postmortem examination if the coroner was satisfied with the multidisciplinary team decision. The overall process from referral to outcome dispatch was specialist mesothelioma multidisciplinary team meeting was effective at making diagnoses and providing recommendations for further investigations or treatment. The core requirements of a specialist mesothelioma multidisciplinary team meeting were met. The process was timely, with most outcomes

  16. Addiction research centres and the nurturing of creativity. National institute on alcohol and drugs policies, Brazil.

    Science.gov (United States)

    Laranjeira, Ronaldo; Mitsuhiro, Sandro Sendin

    2012-04-01

    The National Institute of Public Policy for Alcohol and Other Drugs (INPAD) is based at the Federal University of São Paulo, Brazil, and was created to collect scientific evidence regarding epidemiology, develop new therapeutic approaches, study health economics and provide education to subsidize the proper measures to change the Brazilian scenario of alcohol and drug consumption. Policies directed towards the control of alcohol and drugs in Brazil are fragmented, poorly enforced and therefore ineffective. The unregulated market of alcohol in Brazil has contributed to the worsening health of the Brazilian population. Since 1994, INPAD has participated actively in academic debates and discussions about alcohol and drug policies and their effects on the political welfare of the country. Many scientific papers and books have been published on this subject, and the internet and other media have provided excellent opportunities for the dissemination of specialized information to the general population. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  17. Metric-based vs peer-reviewed evaluation of a research output: Lesson learnt from UK's national research assessment exercise.

    Directory of Open Access Journals (Sweden)

    Kushwanth Koya

    Full Text Available There is a general inquisition regarding the monetary value of a research output, as a substantial amount of funding in modern academia is essentially awarded to good research presented in the form of journal articles, conferences papers, performances, compositions, exhibitions, books and book chapters etc., which, eventually leads to another question if the value varies across different disciplines. Answers to these questions will not only assist academics and researchers, but will also help higher education institutions (HEIs make informed decisions in their administrative and research policies.To examine both the questions, we applied the United Kingdom's recently concluded national research assessment exercise known as the Research Excellence Framework (REF 2014 as a case study. All the data for this study is sourced from the openly available publications which arose from the digital repositories of REF's results and HEFCE's funding allocations.A world leading output earns between £7504 and £14,639 per year within the REF cycle, whereas an internationally excellent output earns between £1876 and £3659, varying according to their area of research. Secondly, an investigation into the impact rating of 25315 journal articles submitted in five areas of research by UK HEIs and their awarded funding revealed a linear relationship between the percentage of quartile-one journal publications and percentage of 4* outputs in Clinical Medicine, Physics and Psychology/Psychiatry/Neuroscience UoAs, and no relationship was found in the Classics and Anthropology/Development Studies UoAs, due to the fact that most publications in the latter two disciplines are not journal articles.The findings provide an indication of the monetary value of a research output, from the perspectives of government funding for research, and also what makes a good output, i.e. whether a relationship exists between good quality output and the source of its publication. The

  18. Metric-based vs peer-reviewed evaluation of a research output: Lesson learnt from UK's national research assessment exercise.

    Science.gov (United States)

    Koya, Kushwanth; Chowdhury, Gobinda

    2017-01-01

    There is a general inquisition regarding the monetary value of a research output, as a substantial amount of funding in modern academia is essentially awarded to good research presented in the form of journal articles, conferences papers, performances, compositions, exhibitions, books and book chapters etc., which, eventually leads to another question if the value varies across different disciplines. Answers to these questions will not only assist academics and researchers, but will also help higher education institutions (HEIs) make informed decisions in their administrative and research policies. To examine both the questions, we applied the United Kingdom's recently concluded national research assessment exercise known as the Research Excellence Framework (REF) 2014 as a case study. All the data for this study is sourced from the openly available publications which arose from the digital repositories of REF's results and HEFCE's funding allocations. A world leading output earns between £7504 and £14,639 per year within the REF cycle, whereas an internationally excellent output earns between £1876 and £3659, varying according to their area of research. Secondly, an investigation into the impact rating of 25315 journal articles submitted in five areas of research by UK HEIs and their awarded funding revealed a linear relationship between the percentage of quartile-one journal publications and percentage of 4* outputs in Clinical Medicine, Physics and Psychology/Psychiatry/Neuroscience UoAs, and no relationship was found in the Classics and Anthropology/Development Studies UoAs, due to the fact that most publications in the latter two disciplines are not journal articles. The findings provide an indication of the monetary value of a research output, from the perspectives of government funding for research, and also what makes a good output, i.e. whether a relationship exists between good quality output and the source of its publication. The findings may also

  19. The role of the national low level waste repository operator in delivering new solutions for the management of low level wastes in the UK - 16217

    International Nuclear Information System (INIS)

    Walkingshaw, Martin

    2009-01-01

    The UK National Low Level Waste Repository (LLWR) is located near to the village of Drigg in West Cumbria. It is the principal site for disposal of solid Low Level Radioactive Waste (LLW) in the United Kingdom. This paper describes the program of work currently being undertaken by the site's operators, (LLW Repository Ltd and its newly appointed Parent Body Organisation), to extend the life of the LLWR and reduce the overall cost of LLW management to the UK taxpayer. The current focus of this program is to prevent disposal capacity being taken up at LLWR by waste types which lend themselves to alternative treatment and/or disposition routes. The chosen approach enables consignors to segregate LLW at source into formats which allow further treatment for volume reduction or, (for wastes with lower levels of activity), consignment in the future to alternative disposal facilities. Segregated waste services are incorporated into LLW Disposal commercial agreements between the LLWR operator and waste consignors. (author)

  20. Meeting UK dietary recommendations is associated with higher estimated consumer food costs: an analysis using the National Diet and Nutrition Survey and consumer expenditure data, 2008-2012.

    Science.gov (United States)

    Jones, Nicholas Rv; Tong, Tammy Yn; Monsivais, Pablo

    2018-04-01

    To test whether diets achieving recommendations from the UK's Scientific Advisory Committee on Nutrition (SACN) were associated with higher monetary costs in a nationally representative sample of UK adults. A cross-sectional study linking 4 d diet diaries in the National Diet and Nutrition Survey (NDNS) to contemporaneous food price data from a market research firm. The monetary cost of diets was assessed in relation to whether or not they met eight food- and nutrient-based recommendations from SACN. Regression models adjusted for potential confounding factors. The primary outcome measure was individual dietary cost per day and per 2000 kcal (8368 kJ). UK. Adults (n 2045) sampled between 2008 and 2012 in the NDNS. On an isoenergetic basis, diets that met the recommendations for fruit and vegetables, oily fish, non-milk extrinsic sugars, fat, saturated fat and salt were estimated to be between 3 and 17 % more expensive. Diets meeting the recommendation for red and processed meats were 4 % less expensive, while meeting the recommendation for fibre was cost-neutral. Meeting multiple targets was also associated with higher costs; on average, diets meeting six or more SACN recommendations were estimated to be 29 % more costly than isoenergetic diets that met no recommendations. Food costs may be a population-level barrier limiting the adoption of dietary recommendations in the UK. Future research should focus on identifying systems- and individual-level strategies to enable consumers achieve dietary recommendations without increasing food costs. Such strategies may improve the uptake of healthy eating in the population.

  1. 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.

  2. Scenario design and basic analysis of the National Data Centre Preparedness Exercise 2013

    Science.gov (United States)

    Ross, Ole; Ceranna, Lars; Hartmann, Gernot; Gestermann, Nicolai; Bönneman, Christian

    2014-05-01

    The Comprehensive Nuclear-Test-Ban Treaty (CTBT) prohibits all kinds of nuclear explosions. For the detection of treaty violations the International Monitoring System (IMS) operates stations observing seismic, hydroacoustic, and infrasound signals as well as radioisotopes in the atmosphere. While the IMS data is collected, processed and technically analyzed in the International Data Center (IDC) of the CTBT-Organization, National Data Centers (NDC) provide interpretation and advice to their government concerning suspicious detections occurring in IMS data. NDC Preparedness Exercises (NPE) are regularly performed dealing with fictitious treaty violations to practice the combined analysis of CTBT verification technologies and for the mutual exchange of information between NDC and also with the IDC. The NPE2010 and NPE2012 trigger scenarios were based on selected seismic events from the Reviewed Event Bulletin (REB) serving as starting point for fictitious Radionuclide dispersion. The main task was the identification of the original REB event and the discrimination between earthquakes and explosions as source. The scenario design of NPE2013 differs from those of previous NPEs. The waveform event selection is not constrained to events in the REB. The exercise trigger is a combination of a tempo-spatial indication pointing to a certain waveform event and simulated radionuclide concentrations generated by forward Atmospheric Transport Modelling based on a fictitious release. For the waveform event the date (4 Sept. 2013) is given and the region is communicated in a map showing the fictitious state of "Frisia" at the Coast of the North Sea in Central Europe. The synthetic radionuclide detections start in Vienna (8 Sept, I-131) and Schauinsland (11 Sept, Xe-133) with rather low activity concentrations and are most prominent in Stockholm and Spitsbergen mid of September 2013. Smaller concentrations in Asia follow later on. The potential connection between the waveform and

  3. Histologic heterogeneity of triple negative breast cancer: A National Cancer Centre Database analysis.

    Science.gov (United States)

    Mills, Matthew N; Yang, George Q; Oliver, Daniel E; Liveringhouse, Casey L; Ahmed, Kamran A; Orman, Amber G; Laronga, Christine; Hoover, Susan J; Khakpour, Nazanin; Costa, Ricardo L B; Diaz, Roberto

    2018-06-02

    Triple negative breast cancer (TNBC) is an aggressive disease, but recent studies have identified heterogeneity in patient outcomes. However, the utility of histologic subtyping in TNBC has not yet been well-characterised. This study utilises data from the National Cancer Center Database (NCDB) to complete the largest series to date investigating the prognostic importance of histology within TNBC. A total of 729,920 patients (pts) with invasive ductal carcinoma (IDC), metaplastic breast carcinoma (MBC), medullary breast carcinoma (MedBC), adenoid cystic carcinoma (ACC), invasive lobular carcinoma (ILC) or apocrine breast carcinoma (ABC) treated between 2004 and 2012 were identified in the NCDB. Of these, 89,222 pts with TNBC that received surgery were analysed. Kaplan-Meier analysis, log-rank testing and multivariate Cox proportional hazards regression were utilised with overall survival (OS) as the primary outcome. MBC (74.1%), MedBC (60.6%), ACC (75.7%), ABC (50.1%) and ILC (1.8%) had significantly different proportions of triple negativity when compared to IDC (14.0%, p < 0.001). TNBC predicted an inferior OS in IDC (p < 0.001) and ILC (p < 0.001). Lumpectomy and radiation (RT) were more common in MedBC (51.7%) and ACC (51.5%) and less common in MBC (33.1%) and ILC (25.4%), when compared to IDC (42.5%, p < 0.001). TNBC patients with MBC (HR 1.39, p < 0.001), MedBC (HR 0.42, p < 0.001) and ACC (HR 0.32, p = 0.003) differed significantly in OS when compared to IDC. Our results indicate that histologic heterogeneity in TNBC significantly informs patient outcomes and thus, has the potential to aid in the development of optimum personalised treatments. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Organisational structure of liver transplantation in the UK.

    Science.gov (United States)

    Neuberger, James

    2015-07-01

    This review aims to outline the delivery of liver transplant services in the UK. Liver transplantation in the UK is based on seven designated transplant units serving a population of just over 60 million people. Nearly 900 liver transplants were done in 2013/2014. Potential deceased donors are identified and referred to centrally employed specialist nurses for obtaining family consent and for donor characterisation. Organs are retrieved by a National Organ Retrieval Service, based on seven abdominal and six cardiothoracic retrieval teams providing a 24/7 service which has shown to be capable of retrieving organs from up to ten donors a day. Donated organs are allocated first nationally to those who qualify for super-urgent listing. The next priority is for splitting livers, and if there is no suitable recipient or the liver is not suitable for splitting, then livers are offered first to the local centre; each centre has a designated donor zone, adjusted annually to ensure equity between the number of patients listed and the number of donors. The allocation scheme is being reviewed, and national schemes based on need, utility and benefit are being assessed. Outcomes are monitored by National Health Service Blood and Transplant (NHSBT), and if there is a possibility of adverse deviation, then further inquiries are made. Outcomes, both from listing and from transplantation, are published by the centre on the NHSBT website ( www.odt.nhs.uk ). NHSBT works closely with stakeholders primarily through the advisory groups with clinicians, patients, lay members and professional societies and aims to provide openness and transparency. The system for organ donation and delivery of liver transplant in the UK has developed and is now providing an effective and efficient service, but there remains room for improvement.

  5. The role of the national general medical journal: surveys of which journals UK clinicians read to inform their clinical practice.

    Science.gov (United States)

    Jones, Teresa H; Hanney, Stephen; Buxton, Martin J

    2008-12-01

    For biomedical research findings to contribute toward health gains they must reach clinicians. Academic journals have historically been considered important information sources. Birken and Parkin found seven journals to most consistently contain the best pediatric evidence and, of these seven, four were general medical journals. We surveyed clinicians in three UK medical specialties (psychiatry, surgery and pediatrics), asking which journals they read and which they considered important to inform their clinical practice. The readership of general medical journals, in comparison to specialty and sub-specialty journals, is widespread across the three UK medical specialties, although the importance of general medical journals varies widely. The BMJ is the most prominent general medical journal in terms of readership and importance but a dominant specialty or sub-specialty journal was usually more important for most groups. The Lancet is less widely read and less important, although more academics than non-academics consider it important. Overall, key general medical journals play an important role. Journal availability and cost, particularly in relation to membership for UK clinicians, and the position of academics and non-academics have to be considered in any analysis. Three of the four general medical journals containing the best pediatric evidence were found to be widely read by UK pediatricians and two UK-based general medical journals, the BMJ and The Lancet, were also considered important in our survey. Further investigation of the reasons for the importance of a journal and studies that would allow international comparisons would provide greater input to the discussion.

  6. 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.

  7. Experiences with the implementation of a national teaching qualification in university medical centres and veterinary medicine in the Netherlands.

    Science.gov (United States)

    Molenaar, Willemina M Ineke; Zanting, Anneke

    2015-02-01

    In 2008, a compulsory national basic teaching qualification was introduced for all university teachers in the Netherlands. At that time all eight University Medical Centres (UMCs) and the only Faculty of Veterinary Medicine had adopted or were setting up teacher development programmes. This study explores how these programmes relate to each other and to the basic teaching qualification. To gather information on teacher development programmes in the UMCs and the Veterinary Medicine Faculty an online survey was filled out by teacher development representatives from each of them. The programmes had main features in common (e.g. competency based and portfolio assessment), but differed somewhat in contents according to the local situation. Importantly, they had all been formally accepted as equivalent to the basic teaching qualification. We consider the freedom to tailor the qualifications to the medical context as well as to the local situation of the UMCs and the Veterinary Medicine Faculty one of the major success factors and the well-established collaboration between teacher development representatives of the UMCs and the Faculty of Veterinary Medicine as another. Challenges for the future include embedding the teacher development programmes in the institutional organizations and maintaining and further developing the programmes and the competencies of the qualified teachers, e.g. in a senior qualification.

  8. Innovation and the English National Health Service: a qualitative study of the independent sector treatment centre programme.

    Science.gov (United States)

    Turner, Simon; Allen, Pauline; Bartlett, Will; Pérotin, Virginie

    2011-08-01

    Over the past two decades, an international trend of exposing public health services to different forms of economic organisation has emerged. In the English National Health Service (NHS), care is currently provided through a quasi-market including 'diverse' providers from the private and third sector. The predominant scheme through which private sector companies have been awarded NHS contracts is the Independent Sector Treatment Centre (ISTC) programme. ISTCs were designed to produce innovative models of service delivery for elective care and stimulate innovation among incumbent NHS providers. This paper investigates these claims using qualitative data on the impact of an ISTC upon a local health economy (LHE) composed of NHS organisations in England. Using the case of elective orthopaedic surgery, we conducted semi-structured interviews with senior managers from incumbent NHS providers and an ISTC in 2009. We show that ISTCs exhibit a different relationship with frontline clinicians because they counteract the power of professional communities associated with the NHS. This has positive and negative consequences for innovation. ISTCs have introduced new routines unencumbered by the extant norms of professional communities, but they appear to represent weaker learning environments and do not reproduce cooperation across organisational boundaries to the same extent as incumbent NHS providers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. A Worksite Health Education Workshop as Empowerment Intervention for Health Promotion in the National Research Centre of Egypt

    Directory of Open Access Journals (Sweden)

    Nagat Mohamed Amer

    2016-09-01

    Full Text Available AIM: The study aimed to assess worksite health education workshops as a successful tool for health promotion of employees. MATERIAL AND METHODS: A one day workshop was held for individuals engaged in research activities in the National research Centre of Egypt at the worksite. Its main objective was to highlight the nature, causes, symptoms and management of job stress. Participants were asked to fill a personality assessment sheet, a self-reported questionnaire for job satisfaction. Other questionnaires for assessment of falsification of type and some socio-demographic data were filled by the attendants. A concise survey was introduced at the end of the workshop for feedback collection. RESULTS: Attendants of the workshop were 36 subjects mainly females (94.4%. Mean age was 40.5 years with 63.9% of participants at their postdoctoral studies stage. Participants were at midway in the scale of job satisfaction (3.3 and did not suffer from falsification (0.3. The feedback survey score (11.5 showed great acceptance for the intervention. Special interest in the topic of stress was reported by 35.1% of attendants who found it the best item in the workshop and the interactive manipulation came next as declared by 18.9% of the participants. CONCLUSION: Worksite health education workshops seem to be a successful practice for empowerment in the Egyptian workplace.

  10. Implementing the ESC/ERS pulmonary hypertension guidelines: real-life cases from a national referral centre

    Directory of Open Access Journals (Sweden)

    D. Montani

    2009-12-01

    Full Text Available Pulmonary hypertension (PH comprises a heterogeneous group of disorders characterised by increased pulmonary vascular resistance that results in progressive right ventricular failure. In order to translate current evidence into routine clinical practice, the European Society of Cardiology (ESC and the European Respiratory Society (ERS have recently jointly proposed evidence-based guidelines for the optimal management of different PH patient groups. This article describes a series of clinical cases of PH due to various aetiologies that were referred to a large national PH expert referral centre. In each case, the assessment and therapeutic approach undertaken is described in the context of the new ECS/ERS guidelines. The routine diagnostic work-up of suspected idiopathic pulmonary arterial hypertension (PAH and recommended treatments for patients with functional class II, III and IV disease is emphasised. Familial screening and management of heritable PAH is discussed. Appropriate investigation and therapeutic strategies for patients with chronic thromboembolic disease and PH that is associated with congenital heart disease, pulmonary veno-occlusive disease and systemic sclerosis are also highlighted.

  11. Clinical applicability and cost of a 46-gene panel for genomic analysis of solid tumours: Retrospective validation and prospective audit in the UK National Health Service.

    Directory of Open Access Journals (Sweden)

    Angela Hamblin

    2017-02-01

    Full Text Available Single gene tests to predict whether cancers respond to specific targeted therapies are performed increasingly often. Advances in sequencing technology, collectively referred to as next generation sequencing (NGS, mean the entire cancer genome or parts of it can now be sequenced at speed with increased depth and sensitivity. However, translation of NGS into routine cancer care has been slow. Healthcare stakeholders are unclear about the clinical utility of NGS and are concerned it could be an expensive addition to cancer diagnostics, rather than an affordable alternative to single gene testing.We validated a 46-gene hotspot cancer panel assay allowing multiple gene testing from small diagnostic biopsies. From 1 January 2013 to 31 December 2013, solid tumour samples (including non-small-cell lung carcinoma [NSCLC], colorectal carcinoma, and melanoma were sequenced in the context of the UK National Health Service from 351 consecutively submitted prospective cases for which treating clinicians thought the patient had potential to benefit from more extensive genetic analysis. Following histological assessment, tumour-rich regions of formalin-fixed paraffin-embedded (FFPE sections underwent macrodissection, DNA extraction, NGS, and analysis using a pipeline centred on Torrent Suite software. With a median turnaround time of seven working days, an integrated clinical report was produced indicating the variants detected, including those with potential diagnostic, prognostic, therapeutic, or clinical trial entry implications. Accompanying phenotypic data were collected, and a detailed cost analysis of the panel compared with single gene testing was undertaken to assess affordability for routine patient care. Panel sequencing was successful for 97% (342/351 of tumour samples in the prospective cohort and showed 100% concordance with known mutations (detected using cobas assays. At least one mutation was identified in 87% (296/342 of tumours. A locally

  12. Does it matter why immigrants came here? Original motives, the labour market, and national identity in the UK

    OpenAIRE

    Stuart Campbell

    2014-01-01

    The importance of the original motives for migration has often been asserted in the economics of migration literature, but direct measures of such motives have seldom been included in empirical models of immigrant outcomes. For the first time, I am able to directly identify work, student, family, and refugee immigrants in a large UK survey dataset. Using a sample of immigrants who have been in the country for at least five years, I show that original motives are strong predictors of employmen...

  13. SOME RECENT TECHNOLOGY DEVELOPMENTS FROM THE UK'S NATIONAL NUCLEAR LABORATORY TO ENABLE HAZARD CHARACTERISATION FOR NUCLEAR DECOMMISSIONING APPLICATIONS

    Energy Technology Data Exchange (ETDEWEB)

    Farfan, E.; Foley, T.

    2010-02-11

    Under its programme of self investment Internal Research and Development (IR&D), the UK's National Nuclear Laboratory (NNL) is addressing the requirement for development in technology to enable hazard characterisation for nuclear decommissioning applications. Three such examples are described here: (1) RadBall developed by the NNL (patent pending) is a deployable baseball-sized radiation mapping device which can, from a single location, locate and quantify radiation hazards. RadBall offers a means to collect information regarding the magnitude and distribution of radiation in a given cell, glovebox or room to support the development of a safe, cost effective decontamination strategy. RadBall requires no electrical supplies and is relatively small, making it easy to be deployed and used to map radiation hazards in hard to reach areas. Recent work conducted in partnership with the Savannah River National Laboratory (SRNL) is presented. (2) HiRAD (patent pending) has been developed by the NNL in partnership with Tracerco Ltd (UK). HiRAD is a real-time, remotely deployed, radiation detection device designed to operate in elevated levels of radiation (i.e. thousands and tens of thousands of Gray) as seen in parts of the nuclear industry. Like the RadBall technology, the HiRAD system does not require any electrical components, the small dimensions and flexibility of the device allow it to be positioned in difficult to access areas (such as pipe work). HiRAD can be deployed as a single detector, a chain, or as an array giving the ability to monitor large process areas. Results during the development and deployment of the technology are presented. (3) Wireless Sensor Network is a NNL supported development project led by the University of Manchester (UK) in partnership with Oxford University (UK). The project is concerned with the development of wireless sensor network technology to enable the underwater deployment and communication of miniaturised probes allowing pond

  14. Teachers of the Alexander Technique in the UK and the people who take their lessons: A national cross-sectional survey.

    Science.gov (United States)

    Eldred, J; Hopton, A; Donnison, E; Woodman, J; MacPherson, H

    2015-06-01

    Given the rising profile of the Alexander Technique in the UK, there is a need for a comprehensive description of its teachers and of those who currently take lessons. In a national survey of Alexander teachers, we set out to address this information gap. A cross-sectional survey of 871 UK members of three main Alexander Technique teachers' professional associations was conducted. A questionnaire requested information about their professional background, teaching practice and methods, and about the people who attend lessons and their reasons for seeking help. With an overall response rate of 61%, 534 teachers responded; 74% were female with median age of 58 years, 60% had a higher education qualification, and 95% were self-employed, many with additional non-Alexander paid employment. The majority (87%) offered lessons on their own premises or in a privately rented room, and 19% provided home visits; both individual and group lessons were provided. People who took lessons were predominantly female (66%) with a median age of 48 years, and 91% paid for their lessons privately. Nearly two-thirds (62%) began lessons for reasons related to musculoskeletal conditions, including back symptoms, posture, neck pain, and shoulder pain. Other reasons were general (18%, including well-being), performance-related (10%, including voice-, music-, and sport-related), psychological (5%) and neurological (3%). We estimate that Alexander teachers in the UK provide approximately 400,000 lessons per year. This study provides an overview of Alexander Technique teaching in the UK today and data that may be useful when planning future research. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. UK National Data Guardian for Health and Care’s Review of Data Security: Trust, better security and opt-outs

    Directory of Open Access Journals (Sweden)

    Tom Chan

    2016-12-01

    Full Text Available Sharing health and social care data is essential to the delivery of high quality health care as well as disease surveillance, public health, and for conducting research. However, these societal benefits may be constrained by privacy and data protection principles. Hence, societies are striving to find a balance between the two competing public interests. Whilst the spread of IT advancements in recent decades has increased the demand for an increased privacy and data protection in many ways health is a special case. UK, are adopting guidelines, codes of conduct and regulatory instruments aimed to implement privacy principles into practical settings and enhance public trust. Accordingly, in 2015, the UK National Data Guardian (NDG requested to conduct a further review of data protection, referred to as Caldicott 3.  The scope of this review is to strengthen data security standards and confidentiality. It also proposes a consent system based on an “opt-out” model rather than on “opt-in. Across Europe as well as internationally the privacy-health data sharing balance is not fixed.  In Europe enactment of the new EU Data Protection Regulation in 2016 constitute a major breakthrough, which is likely to have a profound effect on European countries and beyond.  In Australia and across North America different ways are being sought to balance out these twin requirements of a modern society - to preserve privacy alongside affording high quality health care for an ageing population.   Whilst in the UK privacy legal framework remains complex and fragmented into different layers of legislation, which may negatively impact on both the rights to privacy and health the UK is at the forefront in the uptake of international and EU privacy and data protection principles. And, if the privacy regime were reorganised in a more comprehensive manner, it could be used as a sound implementation model for other countries.

  16. A national survey exploring UK trainees' perceptions, core training experience, and decisions to pursue advanced training in breast radiology.

    Science.gov (United States)

    Lowes, S; Bydder, M; Sinnatamby, R

    2017-11-01

    To investigate UK radiology trainees' perceptions of breast radiology and the factors that influenced their decision whether or not to choose breast radiology as an area of special interest. An online survey was compiled and distributed to all UK specialty trainees in clinical radiology via the Royal College of Radiologists Junior Radiologists' Forum (JRF) regional representatives. There were 275 respondents, representing 22% of all UK radiology trainees. Responses were received from all regions. A significant factor identified in influencing whether or not trainees decide to pursue advanced training in breast radiology is the timing and quality of their initial core training experience. Specific positive aspects of breast radiology that were repeatedly identified included the high level of patient contact and frequent use of interventional procedures. Recurring negative aspects of breast radiology included isolation from general radiology and finding the subject matter boring. Breast radiology faces a significant workforce shortfall that is predicted to worsen in the coming years. There has never been a greater need to recruit specialty trainees into this field, and action is urgently needed to help ensure the sustainability of breast services and drive further improvements to patient care. The findings from this survey should be regarded as a challenge to all breast radiologists to engage with trainees from an early stage in their training and to enthuse them with the many positive aspects of a career in breast radiology. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  17. Synthetic biology in the UK - An outline of plans and progress.

    Science.gov (United States)

    Clarke, L J; Kitney, R I

    2016-12-01

    Synthetic biology is capable of delivering new solutions to key challenges spanning the bioeconomy, both nationally and internationally. Recognising this significant potential and the associated need to facilitate its translation and commercialisation the UK government commissioned the production of a national Synthetic Biology Roadmap in 2011, and subsequently provided crucial support to assist its implementation. Critical infrastructural investments have been made, and important strides made towards the development of an effectively connected community of practitioners and interest groups. A number of Synthetic Biology Research Centres, DNA Synthesis Foundries, a Centre for Doctoral Training, and an Innovation Knowledge Centre have been established, creating a nationally distributed and integrated network of complementary facilities and expertise. The UK Synthetic Biology Leadership Council published a UK Synthetic Biology Strategic Plan in 2016, increasing focus on the processes of translation and commercialisation. Over 50 start-ups, SMEs and larger companies are actively engaged in synthetic biology in the UK, and inward investments are starting to flow. Together these initiatives provide an important foundation for stimulating innovation, actively contributing to international research and development partnerships, and helping deliver useful benefits from synthetic biology in response to local and global needs and challenges.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  19. 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.

  20. External validation of the Intensive Care National Audit & Research Centre (ICNARC) risk prediction model in critical care units in Scotland.

    Science.gov (United States)

    Harrison, David A; Lone, Nazir I; Haddow, Catriona; MacGillivray, Moranne; Khan, Angela; Cook, Brian; Rowan, Kathryn M

    2014-01-01

    Risk prediction models are used in critical care for risk stratification, summarising and communicating risk, supporting clinical decision-making and benchmarking performance. However, they require validation before they can be used with confidence, ideally using independently collected data from a different source to that used to develop the model. The aim of this study was to validate the Intensive Care National Audit & Research Centre (ICNARC) model using independently collected data from critical care units in Scotland. Data were extracted from the Scottish Intensive Care Society Audit Group (SICSAG) database for the years 2007 to 2009. Recoding and mapping of variables was performed, as required, to apply the ICNARC model (2009 recalibration) to the SICSAG data using standard computer algorithms. The performance of the ICNARC model was assessed for discrimination, calibration and overall fit and compared with that of the Acute Physiology And Chronic Health Evaluation (APACHE) II model. There were 29,626 admissions to 24 adult, general critical care units in Scotland between 1 January 2007 and 31 December 2009. After exclusions, 23,269 admissions were included in the analysis. The ICNARC model outperformed APACHE II on measures of discrimination (c index 0.848 versus 0.806), calibration (Hosmer-Lemeshow chi-squared statistic 18.8 versus 214) and overall fit (Brier's score 0.140 versus 0.157; Shapiro's R 0.652 versus 0.621). Model performance was consistent across the three years studied. The ICNARC model performed well when validated in an external population to that in which it was developed, using independently collected data.

  1. A single-centre cohort study of National Early Warning Score (NEWS) and near patient testing in acute medical admissions.

    Science.gov (United States)

    Abbott, Tom E F; Torrance, Hew D T; Cron, Nicholas; Vaid, Nidhi; Emmanuel, Julian

    2016-11-01

    The utility of an early warning score may be improved when used with near patient testing. However, this has not yet been investigated for National Early Warning Score (NEWS). We hypothesised that the combination of NEWS and blood gas variables (lactate, glucose or base-excess) was more strongly associated with clinical outcome compared to NEWS alone. This was a prospective cohort study of adult medical admissions to a single-centre over 20days. Blood gas results and physiological observations were recorded at admission. NEWS was calculated retrospectively and combined with the biomarkers in multivariable logistic regression models. The primary outcome was a composite of mortality or critical care escalation within 2days of hospital admission. The secondary outcome was hospital length of stay. After accounting for missing data, 15 patients out of 322 (4.7%) died or were escalated to the critical care unit. The median length of stay was 4 (IQR 7) days. When combined with lactate or base excess, NEWS was associated with the primary outcome (OR 1.18, p=0.01 and OR 1.13, p=0.03). However, NEWS alone was more strongly associated with the primary outcome measure (OR 1.46, pglucose was not associated with the primary outcome. Neither NEWS nor any combination of NEWS and a biomarker were associated with hospital length of stay. Admission NEWS is more strongly associated with death or critical care unit admission within 2days of hospital admission, compared to combinations of NEWS and blood-gas derived biomarkers. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  2. Are ENT surgeons in the UK at risk of stress, psychological morbidities and burnout? A national questionnaire survey.

    Science.gov (United States)

    Vijendren, Ananth; Yung, Matthew; Shiralkar, Uttam

    2018-02-01

    Work-related stress, psychological disorders and burnout are common occupational disorders affecting UK doctors. To date, there are no studies looking at these psychosocial morbidities amongst ENT surgeons worldwide. The General Health Questionnaire-12 (GHQ-12) and abbreviated Maslach Burnout Inventory (aMBI) were incorporated into a questionnaire on occupational diseases amongst ENT surgeons and distributed to the entire membership of ENT-UK. The survey study also acquired demographic data on grade of respondent, years of experience in ENT and subspecialty interest. We received 108 (8.1% response rate) appropriately filled GHQ-12 and 121 (9.0% response rate) aMBI questionnaires. 61 respondents (56.5%) on the GHQ-12 were at high risk of developing stress and psychological morbidity and 35 (28.9%) had high enough aMBI scores to suggested burnout. When comparing scores of both GHQ-12 and aMBI with grade of respondent, years of experience in ENT and subspecialty, statistical difference was only found on the risk of stress and psychiatric disorders amongst paediatric ENT surgeons (7 high risk vs 0 low risk, p = 0.02), however the number of these respondents was small (7 in total). Both questionnaires had been validated for use within our population. We found high incidence rates of stress and psychological morbidity (56.5%) and a burnout prevalence rate of 28.9% amongst our responding cohort of UK Oto-rhino-laryngologists. No meaningful differences were found between stress, psychological morbidity and burnout with grade of ENT surgeon, years of experience in ENT and subspecialty within ENT. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  3. Should money follow the patient: Financial implication for being the National Centre for the Treatment and Management of Pelvic and Acetabular Fractures in Ireland.

    LENUS (Irish Health Repository)

    Kelly, M E

    2013-03-13

    BACKGROUND: Pelvic and acetabular fractures are complex injuries requiring specialist treatment. Our institution is the National Centre for Treatment and Management of these injuries. AIM: To audit all referrals to our institution over a 6-month period and calculate the cost incurred by being the national referral centre. METHODS: Retrospective review of database, and subsequent allocation of Casemix points to assess total cost of treatment for each patient referred to our institution. RESULTS: 103 patients referred with pelvic or acetabular fracture for operative management. The furthest referral distance was 181miles. Over-all, the length of stay was 15.4 days. The average inclusive cost for a referral to our unit for operative management was €16,302. CONCLUSION: Pelvic and acetabular fractures are complex injuries that require specialist referral unit management. However for these units to remain sustainable money needs to "follow the patient".

  4. Problems encountered in embodying the principles of ICRP-26 and the revised IAEA safety standards into UK national legislation

    International Nuclear Information System (INIS)

    Beaver, P.F.

    1979-01-01

    This paper describes the United Kingdom procedures and format for safety legislation and goes on to show how the necessary legislation for radiological protection will fit into the general framework. The United Kingdom, as a member of the European Community and EURATOM, is bound to implement the Euratom Directive on radiological protection within the next few years. The latest draft of the Directive takes account of the recommendations of ICRP-26 and further, a recent draft of the revised IAEA Basic Safety Standards is a composite of both the Directive and ICRP-26. Thus, the effect of embodying the principles of the Directive is to embody the principles of ICRP-26 and the Basic Safety Standards. Some of the problems which have been met are described and in particular there is discussion of the problems arising from the incorporation of the three ICRP-26 facets of dose control, namely justification, optimization and limitation, into a legislative package. The UK system of evolving safety legislation now requires considerable participation by all the parties affected (or by their representatives). This paper indicates that the involvement of persons affected, coupled with a legislative package which consists of a hierarchy of (a) regulations; (b) codes of practice; and (c) guidance notes, will result in the fundamental principles of ICRP-26 being incorporated into UK legislation in a totally acceptable way. (author)

  5. The Structural Integrity Centre

    International Nuclear Information System (INIS)

    Tomkins, B.

    1987-01-01

    The paper concerns the development and work of the Structural Integrity Centre (SIC) at Risley Nuclear Laboratories, United Kingdom. The centre was set up to provide authoritative advice to plant designers and operators on the integrity and life assessment of structures and components across the reactor projects in the United Kingdom. A description is given of the structure and role of the SIC, as well as the Structural Integrity Assessment work. The assessment methods are described for thermally loaded structures and welded structures. Finally, defect significance assessment and environmental effects are outlined. (U.K.)

  6. Evaluation of directional vacuum-assisted breast biopsy: Report for the National Breast Cancer Centre final report, CHERE Project Report No 21

    OpenAIRE

    Marion Haas; Lorraine Ivancic

    2003-01-01

    This project was commissioned by the National Breast Cancer Centre (NBCC). The objectives of the project, as set out in the call for expressions of interest, were to determine: 1. The costs associated with the introduction and use of directional vacuum-assisted breast biopsy(DVA breast biopsy) in Australia; and 2. Whether directional vacuum-assisted breast biopsy used for diagnostic purposes is cost-effectivein Australia when compared to core biopsy. The motivation for commissioning the proje...

  7. The Text of the Agency's Agreement with the United Nations Educational, Scientific and Cultural Organization Concerning the Joint Operation of the International Centre for Theoretical Physics at Trieste

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1969-10-20

    The text of the agreement between the Agency and the United Nations Educational, Scientific and Cultural Organization (UNESCO) concerning the joint operation of the International Centre for Theoretical Physics at Trieste, which was signed by the Director General of the Agency on 3 July and by the Director General of UNESCO on 15 July 1969, is reproduced in this document for the information of all Members of the Agency. The agreement will enter into force on 1 January 1970.

  8. The Text of the Agency's Agreement with the United Nations Educational, Scientific and Cultural Organization Concerning the Joint Operation of the International Centre for Theoretical Physics at Trieste

    International Nuclear Information System (INIS)

    1969-01-01

    The text of the agreement between the Agency and the United Nations Educational, Scientific and Cultural Organization (UNESCO) concerning the joint operation of the International Centre for Theoretical Physics at Trieste, which was signed by the Director General of the Agency on 3 July and by the Director General of UNESCO on 15 July 1969, is reproduced in this document for the information of all Members of the Agency. The agreement will enter into force on 1 January 1970.

  9. An ozone budget for the UK: using measurements from the national ozone monitoring network; measured and modelled meteorological data, and a 'big-leaf' resistance analogy model of dry deposition

    International Nuclear Information System (INIS)

    Coyle, M.; Smith, R.; Fowler, D.

    2003-01-01

    A method of calculating a mass budget for O 3 in the UK boundary layer is presented which shows that the spatial scale of the UK is small relative to the footprint of the atmosphere influenced by UK emissions. - Data from the UK national air-quality monitoring network are used to calculate an annual mass budget for ozone (O 3 ) production and loss in the UK boundary layer during 1996. Monthly losses by dry deposition are quantified from 1 kmx1 km scale maps of O 3 concentration and O 3 deposition velocities based on a 'big-leaf' resistance analogy. The quantity of O 3 deposition varies from ∼50 Gg-O 3 month -1 in the winter to over 200 Gg-O 3 month -1 in the summer when vegetation is actively absorbing O 3 . The net O 3 production or loss in the UK boundary layer is found by selecting days when the UK is receiving 'clean' Atlantic air from the SW to NW. In these conditions, the difference in O 3 concentration observed at Mace Head and a rural site on the east coast of the UK indicates the net O 3 production or loss within the UK boundary layer. A simple box model is then used to convert the concentration difference into a mass. The final budget shows that for most of the year the UK is a net sink for O 3 (-25 to -800 Gg-O 3 month -1 ) with production only exceeding losses in the photochemically active summer months (+45 Gg-O 3 month -1 )

  10. An ozone budget for the UK: using measurements from the national ozone monitoring network; measured and modelled meteorological data, and a 'big-leaf' resistance analogy model of dry deposition

    Energy Technology Data Exchange (ETDEWEB)

    Coyle, M.; Smith, R.; Fowler, D

    2003-05-01

    A method of calculating a mass budget for O{sub 3} in the UK boundary layer is presented which shows that the spatial scale of the UK is small relative to the footprint of the atmosphere influenced by UK emissions. - Data from the UK national air-quality monitoring network are used to calculate an annual mass budget for ozone (O{sub 3}) production and loss in the UK boundary layer during 1996. Monthly losses by dry deposition are quantified from 1 kmx1 km scale maps of O{sub 3} concentration and O{sub 3} deposition velocities based on a 'big-leaf' resistance analogy. The quantity of O{sub 3} deposition varies from {approx}50 Gg-O{sub 3} month{sup -1} in the winter to over 200 Gg-O{sub 3} month{sup -1} in the summer when vegetation is actively absorbing O{sub 3}. The net O{sub 3} production or loss in the UK boundary layer is found by selecting days when the UK is receiving 'clean' Atlantic air from the SW to NW. In these conditions, the difference in O{sub 3} concentration observed at Mace Head and a rural site on the east coast of the UK indicates the net O{sub 3} production or loss within the UK boundary layer. A simple box model is then used to convert the concentration difference into a mass. The final budget shows that for most of the year the UK is a net sink for O{sub 3} (-25 to -800 Gg-O{sub 3} month{sup -1}) with production only exceeding losses in the photochemically active summer months (+45 Gg-O{sub 3} month{sup -1})

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

    Science.gov (United States)

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

    2009-01-01

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

  12. UK doctors and equal opportunities in the NHS: national questionnaire surveys of views on gender, ethnicity and disability.

    Science.gov (United States)

    Lambert, Trevor; Surman, Geraldine; Goldacre, Michael

    2014-10-01

    To seek doctors' views about the NHS as an employer, our surveys about doctors' career intentions and progression, undertaken between 1999 and 2013, also asked whether the NHS was, in their view, a good 'equal opportunities' employer for women doctors, doctors from ethnic minority groups and doctors with disabilities. Surveys undertaken in the UK by mail and Internet. UK medical graduates in selected graduation years between 1993 and 2012. Respondents were asked to rate their level of agreement with three statements starting 'The NHS is a good equal opportunities employer for…' and ending 'women doctors', 'doctors from ethnic minorities' and 'doctors with disabilities'. Of first-year doctors surveyed in 2013, 3.6% (78/2158) disagreed that the NHS is a good equal opportunities employer for women doctors (1.7% of the men and 4.7% of the women); 2.2% (44/1968) disagreed for doctors from ethnic minorities (0.9% of white doctors and 5.8% of non-white doctors) and 12.6% (175/1387) disagreed for doctors with disabilities. Favourable perceptions of the NHS in these respects improved substantially between 1999 and 2013; among first-year doctors of 2000-2003, combined, the corresponding percentages of disagreement were 23.5% for women doctors, 23.1% for doctors from ethnic minorities and 50.6% for doctors with disabilities. Positive views about the NHS as an equal opportunities employer have increased in recent years, but the remaining gap in perception of this between women and men, and between ethnic minority and white doctors, is a concern. © The Royal Society of Medicine.

  13. Factors influencing junior doctors' choices of future specialty: trends over time and demographics based on results from UK national surveys.

    Science.gov (United States)

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

    2015-10-01

    To study trends in factors influencing junior doctors' choice of future specialty. Respondents were asked whether each of 15 factors had a great deal of influence on their career choice, a little influence or no influence on it. Percentages are reported of those who specified that a factor had a great deal of influence on their career choice. UK. A total of 15,765 UK-trained doctors who graduated between 1999 and 2012. Questions about career choices and factors which may have influenced those choices, in particular comparing doctors who qualified in 2008-2012 with those who qualified in 1999-2002. Enthusiasm for and commitment to the specialty was a greater influence on career choice in the 2008-2012 qualifiers (81%) than those of 1999-2002 (64%), as was consideration of their domestic circumstances (43% compared with 20%). Prospects for promotion were less important to recent cohorts (16%) than older cohorts (21%), as were financial prospects (respectively, 10% and 14%). Domestic circumstances and working hours were considered more important, and financial prospects less important, by women than men. Inclination before medical school was rated as important by 41% of doctors who were over 30 years old, compared with 13% of doctors who were under 21, at the time of starting medical school. The increasing importance of both domestic circumstances and enthusiasm for their specialty choice in recent cohorts suggest that today's young doctors prize both work-life balance and personal fulfilment at work more highly than did their predecessors. The differences in motivations of older and younger generations of doctors, men and women, and doctors who start medical school relatively late are worthy of note. © The Royal Society of Medicine.

  14. Poisonous plants in New Zealand: a review of those that are most commonly enquired about to the National Poisons Centre.

    Science.gov (United States)

    Slaughter, Robin J; Beasley, D Michael G; Lambie, Bruce S; Wilkins, Gerard T; Schep, Leo J

    2012-12-14

    New Zealand has a number of plants, both native and introduced, contact with which can lead to poisoning. The New Zealand National Poisons Centre (NZNPC) frequently receives enquiries regarding exposures to poisonous plants. Poisonous plants can cause harm following inadvertent ingestion, via skin contact, eye exposures or inhalation of sawdust or smoked plant matter. The purpose of this article is to determine the 15 most common poisonous plant enquiries to the NZNPC and provide a review of current literature, discussing the symptoms that might arise upon exposure to these poisonous plants and the recommended medical management of such poisonings. Call data from the NZNPC telephone collection databases regarding human plant exposures between 2003 and 2010 were analysed retrospectively. The most common plants causing human poisoning were selected as the basis for this review. An extensive literature review was also performed by systematically searching OVID MEDLINE, ISI Web of Science, Scopus and Google Scholar. Further information was obtained from book chapters, relevant news reports and web material. For the years 2003-2010 inclusive, a total of 256,969 enquiries were received by the NZNPC. Of these enquiries, 11,049 involved exposures to plants and fungi. The most common poisonous plant enquiries, in decreasing order of frequency, were: black nightshade (Solanum nigrum), arum lily (Zantedeschia aethiopica), kowhai (Sophora spp.), euphorbia (Euphorbia spp.), peace lily (Spathiphyllum spp.), agapanthus (Agapanthus spp.), stinking iris (Iris foetidissima), rhubarb (Rheum rhabarbarum), taro (Colocasia esculentum), oleander (Nerium oleander), daffodil (Narcissus spp.), hemlock (Conium maculatum), karaka (Corynocarpus laevigatus), foxglove (Digitalis purpurea) and ongaonga/New Zealand tree nettle (Urtica ferox). The combined total of enquiries for these 15 species was 2754 calls (representing approximately 25% of all enquiries regarding plant exposures). The signs

  15. A national survey of UK health libraries investigating the cost of interlibrary loan services and assessing the accessibility to key orthopaedic journals.

    Science.gov (United States)

    Tahim, Arpan; Stokes, Oliver; Vedi, Vikas

    2012-06-01

     NHS Library Services are utilised by NHS staff and junior trainees to locate scientific papers that provide them with the evidence base required for modern medical practice. The cost of accessing articles can be considerable particularly for junior trainees.  This survey looks at variations in cost of journal article loans and investigates access to particular orthopaedic journals across the country.  A national survey of UK Health Libraries was performed. Access to and costs of journals and interlibrary loan services were assessed. Availability of five wide-reaching orthopaedic journals was investigated.  Seven hundred and ten libraries were identified. One hundred and ten libraries completed the questionnaire (16.7%). Of these, 96.2% reported free access to scientific journals for users. 99.1% of libraries used interlibrary loan services with 38.2% passing costs on to the user at an average of £2.99 per article. 72.7% of libraries supported orthopaedic services. Journal of Bone and Joint Surgery (British) had greatest onsite availability.  The study demonstrates fluctuations in cost of access to interlibrary loan services and variation in access to important orthopaedic journals. It provides a reflection of current policy of charging for the acquisition of medical evidence by libraries in the UK. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  16. Management of poisoning with ethylene glycol and methanol in the UK: a prospective study conducted by the National Poisons Information Service (NPIS).

    Science.gov (United States)

    Thanacoody, Ruben H K; Gilfillan, Claire; Bradberry, Sally M; Davies, Jeremy; Jackson, Gill; Vale, Allister J; Thompson, John P; Eddleston, Michael; Thomas, Simon H L

    2016-01-01

    Poisoning with methanol and ethylene glycol can cause serious morbidity and mortality. Specific treatment involves the use of antidotes (fomepizole or ethanol) with or without extracorporeal elimination techniques. A prospective audit of patients with methanol or ethylene glycol poisoning reported by telephone to the National Poisons Information Service (NPIS) in the UK was conducted during the 2010 calendar year and repeated during the 2012 calendar year. The study was conducted to determine the frequency of clinically significant systemic toxicity and requirement for antidote use and to compare outcomes and rates of adverse reaction and other problems in use between ethanol and fomepizole. The NPIS received 1315 enquiries involving methanol or ethylene glycol, relating to 1070 individual exposures over the 2-year period. Of the 548 enquiries originating from hospitals, 329 involved systemic exposures (enteral or parenteral as opposed to topical exposure), of which 216 (66%) received an antidote (204 for ethylene glycol and 12 for methanol), and 90 (27%) extracorporeal treatment (86 for ethylene glycol and 4 for methanol). Comparing ethanol with fomepizole, adverse reactions (16/131 vs. 2/125, p methanol results in hospitalisation at least 2-3 times per week on average in the UK. No difference in outcome was detected between ethanol and fomepizole-treated patients, but ethanol was associated with more frequent adverse reactions.

  17. Cyber resilience: a review of critical national infrastructure and cyber security protection measures applied in the UK and USA.

    Science.gov (United States)

    Harrop, Wayne; Matteson, Ashley

    This paper presents cyber resilience as key strand of national security. It establishes the importance of critical national infrastructure protection and the growing vicarious nature of remote, well-planned, and well executed cyber attacks on critical infrastructures. Examples of well-known historical cyber attacks are presented, and the emergence of 'internet of things' as a cyber vulnerability issue yet to be tackled is explored. The paper identifies key steps being undertaken by those responsible for detecting, deterring, and disrupting cyber attacks on critical national infrastructure in the United Kingdom and the USA.

  18. Pushing the Child Centred Approach in Myanmar: The Role of Cross National Policy Networks and the Effects in the Classroom

    Science.gov (United States)

    Lall, Marie

    2011-01-01

    In Myanmar schools, rote learning is the norm. International aid and education organisations based in the country have been trying to promote the child centred approach (CCA) as a much more progressive form of teaching and learning. The CCA is being rolled out principally through monastic school networks aided by international and national…

  19. Associations between Restrained Eating and the Size and Frequency of Overall Intake, Meal, Snack and Drink Occasions in the UK Adult National Diet and Nutrition Survey

    Science.gov (United States)

    Olea López, Ana Lorena; Johnson, Laura

    2016-01-01

    Obesity is a global public health priority. Restrained eating is related to obesity and total energy intake but associations with the eating patterns are unclear. We examined the associations of restrained eating with the size and frequency of intake occasions among 1213 British adult (19–64 y) participants in a cross-sectional analysis of the UK National Diet and Nutrition Survey 2000. The Dutch Eating Behaviour Questionnaire assessed restrained eating. Overall intake occasions were all energy consumed in a 60 min period. A food-based classification separated intake occasions into meals, snacks, or drinks from seven-day weighed food diaries. Average daily frequency and size (kcal) of overall intake, meal, snack and drink occasions were calculated and associations with restrained eating were modelled using multiple linear regression including under-reporting of energy intake, age, gender, BMI, emotional eating, external eating and physical activity as covariates. Restrained eating was very weakly positively correlated with overall intake (r = 0.08, psnack or drink frequency (r = 0.02 and -0.02 respectively). Adjusted regressions showed a one-point change in restrained eating was associated with 0.07 (95% CI 0.03, 0.11) more meal occasions/day and 0.13 (95% CI 0.01, 0.25) extra overall intake occasions/day. Overall intake occasion size was weakly negatively correlated with restrained eating regardless of type (r = -0.16 to -0.20, all psnacks or overall intake occasions. Among a national sample of UK adults, greater restrained eating was associated with smaller and slightly more frequent eating, suggesting that restrained eaters restrict their energy intake by reducing meal/drink size rather than skipping snacks. PMID:27227409

  20. Associations between Restrained Eating and the Size and Frequency of Overall Intake, Meal, Snack and Drink Occasions in the UK Adult National Diet and Nutrition Survey.

    Science.gov (United States)

    Olea López, Ana Lorena; Johnson, Laura

    2016-01-01

    Obesity is a global public health priority. Restrained eating is related to obesity and total energy intake but associations with the eating patterns are unclear. We examined the associations of restrained eating with the size and frequency of intake occasions among 1213 British adult (19-64 y) participants in a cross-sectional analysis of the UK National Diet and Nutrition Survey 2000. The Dutch Eating Behaviour Questionnaire assessed restrained eating. Overall intake occasions were all energy consumed in a 60 min period. A food-based classification separated intake occasions into meals, snacks, or drinks from seven-day weighed food diaries. Average daily frequency and size (kcal) of overall intake, meal, snack and drink occasions were calculated and associations with restrained eating were modelled using multiple linear regression including under-reporting of energy intake, age, gender, BMI, emotional eating, external eating and physical activity as covariates. Restrained eating was very weakly positively correlated with overall intake (r = 0.08, pmeal frequency (r = 0.10, pfrequency (r = 0.02 and -0.02 respectively). Adjusted regressions showed a one-point change in restrained eating was associated with 0.07 (95% CI 0.03, 0.11) more meal occasions/day and 0.13 (95% CI 0.01, 0.25) extra overall intake occasions/day. Overall intake occasion size was weakly negatively correlated with restrained eating regardless of type (r = -0.16 to -0.20, all pmeals (-15 kcal 95% CI -5.9, -24.2) and drinks (-4 kcal 95%CI -0.1, -8), but not snacks or overall intake occasions. Among a national sample of UK adults, greater restrained eating was associated with smaller and slightly more frequent eating, suggesting that restrained eaters restrict their energy intake by reducing meal/drink size rather than skipping snacks.

  1. Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

    OpenAIRE

    Clark, Catharine H; Aird, Edwin GA; Bolton, Steve; Miles, Elizabeth A; Nisbet, Andrew; Snaith, Julia AD; Thomas, Russell AS; Venables, Karen; Thwaites, David I

    2015-01-01

    Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK...

  2. A model for facilitating translational research and development in China: Call for establishing a Hong Kong Branch of the Chinese National Engineering Research Centre for Biomaterials

    Directory of Open Access Journals (Sweden)

    Liming Bian

    2014-10-01

    Full Text Available With significant improvements in living standards in China and the aging population that accompanies these improvements, the market demand for high-quality orthopaedic biomaterials for clinical applications is tremendous and growing rapidly. There are major efforts to promote cooperation between different scientific institutes with complementary strengths for the further development of the biomaterial industry in China to achieve the technological level of developed countries. An excellent example is that the Ministry of Science and Technology of the People's Republic of China (MOST; Beijing, China established the Chinese National Engineering Research Centres (CNERCs, which serve as a major initiative in driving basic and applied technological research and development (R&D in mainland China. To create a win-win situation with Hong Kong, the MOST and the Hong Kong Innovation and Technology Commission are jointly establishing the Hong Kong Branch of the CNERCs. Through an amicable arrangement, the Chinese University of Hong Kong (CUHK; Shatin, Hong Kong and the Chinese National Engineering Research Centre for Biomaterials (i.e., Main Centre in Chengdu, People's Republic of China have decided to apply to establish the Hong Kong Branch of the CNERC for Biomaterials at the CUHK. The effort in establishing the Hong Kong Branch of Biomaterials seeks to promote further collaboration with the Main Centre with the goals of promoting synergy and a win-win cooperation between mainland China and Hong Kong in scientific research, talent cultivation, clinically driven novel biomaterials product design, and preclinical and clinical testing. It will thus become a model for the successful collaboration between the Hong Kong research institutions and the mainland CNERCs in the area of biomaterials. Such initiatives will facilitate close collaboration in translational medicine associated with biomaterial development and application.

  3. Characterisation of UK diets according to degree of food processing and associations with socio-demographics and obesity: cross-sectional analysis of UK National Diet and Nutrition Survey (2008-12).

    Science.gov (United States)

    Adams, Jean; White, Martin

    2015-12-18

    Food processing alters food from its natural state for safety, convenience, taste or palatability. Previous research suggests that industrially processed foods, and diets high in these products, tend to be less healthful. However, most previous work is based on household, rather than individual-level, data. Little has been reported on the relationship between processed food consumption and markers of health; or on socio-demographic correlates of processed food consumption. Our objective was to describe: the nutritional content of foods classified according to degree of processing; the nutritional content of diets with different relative intakes of processed foods; the socio-demographic characteristics of individuals with different relative intakes of processed foods; and the association between intake of processed foods and body weight. Secondary analysis of data from the UK National Diet and Nutrition Survey (2008-12), a large national cross-sectional study of diet. Dietary information was collected using four-day, unweighed, food-diaries. Foods were classified as: unprocessed or minimally processed (MPF; foods with no processing or mostly physical processes applied to single whole foods), processed ingredients (PI; extracted and purified components of single whole foods), or ultra-processed food products (UPF; products produced from industrial combining of MPF and PI). Two thousand one hundred seventy four adults were included. MPF and diets high in these foods, had the most healthful nutritional profile. UPF did not necessarily have the least healthful nutritional profile, but diets high in these foods did. Women, and older adults consumed more energy from MPF, and less from UPF. Those living in lower occupation social class households consumed less energy from MPF, but no more from UPF. Only higher intake of PI was consistently, inversely, associated with body weight. This is the first study to explore correlates of processed food consumption, using individual

  4. 9 August 2011 - United Nations High Commissioner for Human Rights N. Pillay signing the guest book with Head of International Relations F. Pauss; in the ATLAS visitor centre with Collaboration Former Spokesperson P. Jenni.

    CERN Multimedia

    Maximilien Brice

    2011-01-01

    9 August 2011 - United Nations High Commissioner for Human Rights N. Pillay signing the guest book with Head of International Relations F. Pauss; in the ATLAS visitor centre with Collaboration Former Spokesperson P. Jenni.

  5. A comparison of UK primary care data with other national data sources for monitoring the prevalence of smoking during pregnancy.

    Science.gov (United States)

    Dhalwani, Nafeesa N; Tata, Laila J; Coleman, Tim; Fiaschi, Linda; Szatkowski, Lisa

    2015-09-01

    We aimed to assess the potential usefulness of primary care data in the UK for estimating smoking prevalence in pregnancy by comparing the primary care data estimates with those obtained from other data sources. In The Health Improvement Network (THIN) primary care database, we identified pregnant smokers using smoking information recorded during pregnancy. Where this information was missing, we used smoking information recorded prior to pregnancy. We compared annual smoking prevalence from 2000 to 2012 in THIN with measures from the Infant Feeding Survey (IFS), Smoking At Time of Delivery (SATOD), Child Health Systems Programme (CHSP) and Scottish Morbidity Record (SMR). Smoking estimates from THIN data converged with estimates from other sources after 2004, though still do not agree completely. For example, in 2012 smoking prevalence at booking was 11.6% in THIN using data recorded only during pregnancy, compared with 19.6% in SMR data. However, the use of smoking data recorded up to 27 months before conception increased the THIN prevalence to 20.3%, improving the comparability. Under-recording of smoking status during pregnancy results in unreliable prevalence estimates from primary care data and needs improvement. However, in the absence of gestational smoking data, the inclusion of pre-conception smoking records may increase the utility of primary care data. One strategy to improve gestational smoking status recording in primary care could be the inclusion of pregnancy in the Quality and Outcome's Framework as a condition for which smoking status and smoking cessation advice must be recorded electronically in patient records. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health.

  6. Centre for Education, Training, & Research in Renewable Energy and Energy Efficiency (CETREE) of Malaysia: Educating the Nation

    Science.gov (United States)

    Ibrahim, Kamarulazizi; Hilme, Khairur Rahim Ahmad

    2007-10-01

    Centre for Education, Training, and Research in Renewable Energy and Energy Efficiency (CETREE), was established in the year 2000, in Universiti Sains Malaysia (USM). CETREE is a not-for-profit organization that was part of the Malaysian Government's continuous effort in promoting sustainable development. The centre's main task is to tackle issues and problems that are slowing the potential growth of RE & EE utilizations in Malaysia. CETREE and the Government of Malaysia, with funding and supports from Danish International Development Assistance (DANIDA) and USM, has been working together closely in applying trans-disciplinary educational methods and approaches for the teaching of RE & EE that are compatible with Malaysian. Through association with various entities such as Energy Centre of Malaysia (PTM), Energy Commission of Malaysia (ST), Malaysia Electricity Supply Industry Trust Account (MESITA); CETREE was able to successfully promote sustainable development through education and training. Significant accomplishments made by CETREE include introducing RE and EE as part of Malaysian secondary schools and universities education; conducting energy related courses for professionals; and generating awareness via campaign in the mass media and CETREE's mobile-exhibition-unit road-tour.

  7. Being prepared to verify the CTBT-Atmospheric Transport modeling and radionuclide analysis at the Austrian National Data Centre during the NDC Preparedness Exercise 2009

    Science.gov (United States)

    Wotawa, Gerhard; Schraick, Irene

    2010-05-01

    An explosion in the Kara-Zhyra mine in Eastern Kazakhstan on 28 November 2009 around 07:20 UTC was recorded by both the CTBTO seismic and infrasound networks. This event triggered a world-wide preparedness exercise among the CTBTO National Data Centres. Within an hour after the event was selected by the German NDC, a computer program developed by NDC Austria based on weather forecasts from the European Centre for Medium-Range Weather Forecasts (ECMWF) and from the U.S. National Centers for Environmental Prediction (NCEP) was started to analyse what Radionuclide Stations of the CTBTO International Monitoring System (IMS) would be potentially affected by the release from a nuclear explosion at this place in the course of the following 3-10 days. These calculations were daily updated to consider the observed state of the atmosphere instead of the predicted one. Based on these calculations, automated and reviewed radionuclide reports from the potentially affected stations as produced by the CTBTO International Data Centre (IDC) were looked at. An additional analysis of interesting spectra was provided by the Seibersdorf Laboratories. Based on all the results coming in, no evidence whatsoever was found that the explosion in Kazakhstan was nuclear. This is in accordance with ground truth information saying that the event was caused by the detonation of more than 53 Tons of explosives as part of mining operations. A number of conclusions can be drawn from this exercise. First, the international, bilateral as well as national mechanisms and procedures in place for such an event worked smoothly. Second, the products and services from the CTBTO IDC proved to be very useful to assist the member states in their verification efforts. Last but not least, issues with the availability of data from IMS radionuclide stations do remain.

  8. Delivering Service Quality in Alcohol Treatment: A Qualitative Comparison of Public and Private Treatment Centres by Service Users and Service Providers

    Science.gov (United States)

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2012-01-01

    In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…

  9. Archives of the Dance (22): Pioneer Women – early British modern dancers (the National Resource Centre for Dance, University of Surrey).

    OpenAIRE

    Carter, Alexandra

    2010-01-01

    Pioneer Women was an AHRC-funded project based on archives held at the National Resource Centre for Dance, University of Surrey. Two of the largest collections, those on Madge Atkinson and Natural Movement, and Ruby Ginner’s Revived (later Classical) Greek Dance, are categorized and interrogated for not only what they reveal of the work of these two dance artists, but also for how they resonate with dominant cultural trends in the arts. The research privileges a much under-explored or theoriz...

  10. Coordinated protection of the population in emergencies in Switzerland: The National Emergency Operations Centre (NAZ) and the Emergency Organisation Radioactivity (EOR)

    International Nuclear Information System (INIS)

    Brunner, H.H.

    1992-01-01

    As consequence of the nuclear weapons tests Switzerland has since 30 years expert commissions, concepts, monitoring networks, monitoring and emergency teams for the protection of the population following radiological accidents of all types inside or outside the country. Thus Chernobyl hit a prepared country - except information. The Radiological Emergency Organisation (EOR) and its National Emergency Operations Centre (NAZ) have up-to-date legal bases, concepts and operational means. Besides radiological events, NAZ deals also with chemical accidents, satellite, satellite crashes and dam breaks. Unique is the coordinated use of the combined means of civil authorities, civil defense and army in all strategic cases. (author)

  11. Relationship between mean daily energy intake and frequency of consumption of out-of-home meals in the UK National Diet and Nutrition Survey.

    Science.gov (United States)

    Goffe, Louis; Rushton, Stephen; White, Martin; Adamson, Ashley; Adams, Jean

    2017-09-22

    Out-of-home meals have been characterised as delivering excessively large portions that can lead to high energy intake. Regular consumption is linked to weight gain and diet related diseases. Consumption of out-of-home meals is associated with socio-demographic and anthropometric factors, but the relationship between habitual consumption of such meals and mean daily energy intake has not been studied in both adults and children in the UK. We analysed adult and child data from waves 1-4 of the UK National Diet and Nutrition Survey using generalized linear modelling. We investigated whether individuals who report a higher habitual consumption of meals out in a restaurant or café, or takeaway meals at home had a higher mean daily energy intake, as estimated by a four-day food diary, whilst adjusting for key socio-demographic and anthropometric variables. Adults who ate meals out at least weekly had a higher mean daily energy intake consuming 75-104 kcal more per day than those who ate these meals rarely. The equivalent figures for takeaway meals at home were 63-87 kcal. There was no association between energy intake and frequency of consumption of meals out in children. Children who ate takeaway meals at home at least weekly consumed 55-168 kcal more per day than those who ate these meals rarely. Additionally, in children, there was an interaction with socio-economic position, where greater frequency of consumption of takeaway meals was associated with higher mean daily energy intake in those from less affluent households than those from more affluent households. Higher habitual consumption of out-of-home meals is associated with greater mean daily energy intake in the UK. More frequent takeaway meal consumption in adults and children is associated with greater daily energy intake and this effect is greater in children from less affluent households. Interventions seeking to reduce energy content through reformulation or reduction of portion sizes in restaurants

  12. A cross-national comparison of violence among young men in China and the UK: psychiatric and cultural explanations.

    Science.gov (United States)

    Coid, Jeremy; Hu, Junmei; Kallis, Constantinos; Ping, Yuan; Zhang, Juying; Hu, Yueying; Bui, Laura; Ullrich, Simone; Bebbington, Paul

    2017-10-01

    Public health psychiatry has a key role in violence prevention. Cross-national comparisons of violence and associated psychiatric morbidity can indicate targets for preventive interventions. Data on young adult men in households, 18-34 years, were drawn from the Second Men's Modern Lifestyles survey in Great Britain (n = 2046) and from a corresponding survey in Chengdu, China (n = 4132), using a translated questionnaire. Binary logistic regression models were carried out to estimate the cross-national differences for different types of violence and to identify explanatory variables. Chinese men were less likely to report violence in the past 5 years (AOR 0.59, 95% CI 0.48-0.72, P violence were lower among Chinese men except intimate partner violence (AOR 2.43, 95% CI 1.65-3.59, P violence persisting into adulthood, confidence in fighting ability, perception that violence is acceptable behaviour, and experience of violent victimization. More British men screened positive for antisocial personality disorder and substance misuse. Attitudes which condone violence and a serious problem of alcohol-related, male-on-male violence are key targets for preventive interventions among British men. The higher prevalence of life course-persistent antisocial behaviour among British men is of concern and requires further investigation. Higher prevalence of intimate partner violence among Chinese men reflects patriarchal approaches to conflict resolution and confirms an important public health problem in China which requires further cross-national investigation.

  13. Longer sleep is associated with lower BMI and favorable metabolic profiles in UK adults: Findings from the National Diet and Nutrition Survey.

    Directory of Open Access Journals (Sweden)

    Gregory D M Potter

    Full Text Available Ever more evidence associates short sleep with increased risk of metabolic diseases such as obesity, which may be related to a predisposition to non-homeostatic eating. Few studies have concurrently determined associations between sleep duration and objective measures of metabolic health as well as sleep duration and diet, however. We therefore analyzed associations between sleep duration, diet and metabolic health markers in UK adults, assessing associations between sleep duration and 1 adiposity, 2 selected metabolic health markers and 3 diet, using National Diet and Nutrition Survey data. Adults (n = 1,615, age 19-65 years, 57.1% female completed questions about sleep duration and 3 to 4 days of food diaries. Blood pressure and waist circumference were recorded. Fasting blood lipids, glucose, glycated haemoglobin (HbA1c, thyroid hormones, and high-sensitivity C-reactive protein (CRP were measured in a subset of participants. We used regression analyses to explore associations between sleep duration and outcomes. After adjustment for age, ethnicity, sex, smoking, and socioeconomic status, sleep duration was negatively associated with body mass index (-0.46 kg/m2 per hour, 95% CI -0.69 to -0.24 kg/m2, p < 0.001 and waist circumference (-0.9 cm per hour, 95% CI -1.5 to -0.3cm, p = 0.004, and positively associated with high-density lipoprotein cholesterol (0.03 mmol/L per hour, 95% CI 0.00 to 0.05, p = 0.03. Sleep duration tended to be positively associated with free thyroxine levels and negatively associated with HbA1c and CRP (p = 0.09 to 0.10. Contrary to our hypothesis, sleep duration was not associated with any dietary measures (p ≥ 0.14. Together, our findings show that short-sleeping UK adults are more likely to have obesity, a disease with many comorbidities.

  14. Increasing frequency of severe clinical toxicity after use of 2,4-dinitrophenol in the UK: a report from the National Poisons Information Service.

    Science.gov (United States)

    Kamour, Ashraf; George, Nathan; Gwynnette, David; Cooper, Gillian; Lupton, David; Eddleston, Michael; Thompson, John Paul; Vale, John Allister; Thanacoody, Harry Krishna Ruben; Hill, Simon; Thomas, Simon Hugh Lynton

    2015-05-01

    2,4-Dinitrophenol (DNP) increases energy consumption by uncoupling oxidative phosphorylation. Although not licensed as a medicine, it is sometimes used by 'body sculptors' and for weight loss as a 'fat burning' agent. This research was performed to characterise patterns of presentation, clinical features and outcomes of patients reported to the National Poisons Information Service (NPIS) in the UK after exposure to DNP. NPIS telephone enquiry records and user sessions for TOXBASE, the NPIS online information database, related to DNP, were reviewed from 1 January 2007 to 31 December 2013. Of the 30 separate systemic exposures to DNP reported by telephone to NPIS during the study period (27 males, 3 females, with a median age of 23.5 years), there were 3 during 2007-2011 (inclusive), 5 during 2012 and 22 during 2013. TOXBASE user sessions also increased sharply from 6 in 2011 to 35 in 2012 and 331 in 2013. The modes of exposure reported in telephone enquiries were chronic (n=2), acute (n=12) and subacute (n=16). Commonly reported clinical features were fever (47%), tachycardia (43%), sweating (37%), nausea or vomiting (27%), skin discolouration or rash (23%), breathing difficulties (23%), abdominal pain (23%), agitation (13%) and headache (13%). There were five (17%, 95% CI 6.9% to 34%) fatalities, four involving acute overdose. The study indicates a substantial recent increase in clinical presentations with toxicity caused by exposure to DNP in the UK with an associated high mortality. Further steps are needed to warn potential users of the severe and sometimes fatal toxicity that may occur after exposure to this compound. 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.

  15. Do surgeon interviewers have human factor-related issues during the long day UK National Trauma and Orthopaedic specialty recruitment process?

    Science.gov (United States)

    Scrimgeour, D S G; Higgins, J; Bucknall, V; Arnett, R; Featherstone, C R; Cleland, J; Lee, A J; Brennan, P A

    2018-03-05

    The role that human factors (HF) play in contributing to medical error is increasingly being recognised by healthcare professionals. Surprisingly, much less is known about the possible effects of HF including boredom, fatigue and organisational influences, on performance outside of the clinical environment such as examining or assessing candidates in other high stakes situations. The authors used a validated 38 response questionnaire based around the HF analysis and classification system (HFACS) to assess factors including stress and pressure, care and support and working within the rules for surgeon interviewers at the UK national trainee selection process in Trauma and Orthopaedic surgery. 121 completed questionnaires were analysed (86% response rate). No statistically significant differences were found between interviewer experience, grade or role at the interview and the mean scores obtained for all four factor items. Overall interviewers had a positive experience during national selection with mean factor scores ranging from 3.80 to 3.98 (out of a maximum satisfaction score of 5). Careful planning by organisations and recognising the importance of the human element are essential to ensure assessors are looked after properly during high stakes assessment processes. Our data suggests that a positive experience for examiners is likely to benefit candidate performance and contribute to a fair and reliable recruitment process. The relationship between examiner experience and candidate performance merits further investigation. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  16. 7. meeting of the Atomic and Molecular Data Centre Network, Oak Ridge National Laboratory, Oak Ridge, TN, 9-11 November 1987

    International Nuclear Information System (INIS)

    Smith, J.J.

    1988-02-01

    This is a brief summary report of the Seventh Atomic and Molecular Data Centre Network Meeting convened by the IAEA at the Oak Ridge National Laboratory, Oak Ridge, Tennessee, 9-11 November 1987. The goal of the Centre is to provide coordination of the international management of atomic and molecular data pertinent to controlled fusion research and technology. The meeting was attended by twelve representatives of centres from six member states. The meeting resulted in five conclusions: (i) the establishment of a single international atomic and molecular collision data base was stressed to be the short-term priority for the data centre network; (ii) the Specialists' Meeting on ''Atomic and Molecular Data for Plasma Edge Studies'' was reviewed, and the proposal for the formation of a coordinated research programme on the production and evaluation of atomic and molecular data for plasma edge studies as a means of generating the needed data for fusion research was endorsed; (iii) it was recommended that the recent report entitled ''Recommended Data on Atomic Collision Processes Involving Iron Ions'' be published as a special supplement to the Nuclear Fusion journal, 1987. This unit was asked to investigate the possibility to provide data covering recombination processes for iron ions which were not included in the recommended data base; (iv) the participants felt that a meeting covering the Atomic and Molecular and fusion data base was timely and important for maximizing the efficient usage of the Atomic and Molecular collision data base. The convening of a Specialists' Meeting on carbon and oxygen ion collision data was also discussed. Finally, (v) it was proposed that the Atomic and Molecular Data Unit should fully address all discrepancies within the recommended data base. Nine status and progress reports are summarized in the Appendices to the present summary report. Refs, 1 fig., tabs

  17. Lack of a standardised UK care pathway resulting in national variations in management and outcomes of paediatric small area scalds.

    Science.gov (United States)

    Trevatt, Alexander E J; Kirkham, Emily N; Allix, Bradley; Greenwood, Rosemary; Coy, Karen; Hollén, Linda I; Young, Amber E R

    2016-09-01

    There is a paucity of evidence guiding management of small area partial thickness paediatric scalds. This has prevented the development of national management guidelines for these injuries. This research aimed to investigate whether a lack of evidence for national guidelines has resulted in variations in both management and outcomes of paediatric small area scalds across England and Wales (E&W). A national survey of initial management of paediatric scalds ≤5% Total Body Surface Area (%TBSA) was sent to 14 burns services in E&W. Skin graft rates of anonymised burns services over seven years were collected from the international Burns Injury Database (iBID). Average skin grafting rates across services were compared. Length of stay and proportion of patients receiving general anaesthesia for dressing application at each service were also compared. All 14 burns services responded to the survey. Only 50% of services had a protocol in place for the management of small area burns. All protocols varied in how partial thickness paediatrics scalds ≤5% TBSA should be managed. There was no consensus as to which scalds should be treated using biosynthetic dressings. Data from iBID for 11,917 patients showed that the average reported skin grafting rate across all burns services was 2.3% (95% CI 2.1, 2.6) but varied from 0.3% to 7.1% (P<0.001). Service provider remained associated with likelihood of skin grafting when variations in the %TBSA case mix seen by each service were controlled for (χ(2)=87.3, P<0.001). The use of general anaesthetics across services varied between 0.6 and 35.5% (P<0.001). The median length of stay across services varied from 1 to 3 days (P<0.001). A lack of evidence guiding management of small-area paediatric scalds has resulted in variation in management of these injuries across E&W. There is also significant variation in outcomes for these injuries. Further research is indicated to determine if care pathways and outcomes are linked. An evidence

  18. Presentation of the CEA's crisis national organization: coordination centre in case of crisis, crisis technical teams, intervention means, and so on

    International Nuclear Information System (INIS)

    Pectorin, X.

    2010-01-01

    After having briefly recalled the existence of a legal framework for crisis management organisation, this report briefly describes how the CEA plans the crisis management. This management is based on the definition of critical scenarios, on the building up of a crisis management team, and on the elaboration of crisis management operational documents. It evokes the alert organisation and the triggering of crisis management. Then, it describes the CEA's national crisis organisation with its main crisis management structures, the role and the operation of the Crisis Coordination Centre (CCC, the decision body), the role and operation of the Central Crisis Technical Teams (ETC-C, Equipes Techniques de Crise Centrales), the role of field interveners (various rescue, protection, health care and technical teams) and of other additional intervention actors. It evokes the objectives of the various exercises which are organised every year at the internal, national or international level

  19. [The design and development of a quality system for the diagnosis of exotic animal diseases at the National Centre for Animal and Plant Health in Cuba].

    Science.gov (United States)

    de Oca, N Montes; Villoch, A; Pérez Ruano, M

    2004-12-01

    A quality system for the diagnosis of exotic animal diseases was developed at the national centre for animal and plant health (CENSA), responsible for coordinating the clinical, epizootiological and laboratory diagnosis of causal agents of exotic animal diseases in Cuba. A model was designed on the basis of standard ISO 9001:2000 of the International Organization for Standardization (ISO), standard ISO/IEC 17025:1999 of ISO and the International Electrotechnical Commission, recommendations of the World Organisation for Animal Health (OIE) and other regulatory documents from international and national organisations that deal specifically with the treatment of emerging diseases. Twenty-nine standardised operating procedures were developed, plus 13 registers and a checklist to facilitate the evaluation of the system. The effectiveness of the quality system was confirmed in the differential diagnosis of classical swine fever at an animal virology laboratory in Cuba.

  20. BASHH 2016 UK national audit and survey of HIV testing, risk assessment and follow-up: case note audit.

    Science.gov (United States)

    Bhaduri, Sumit; Curtis, Hilary; McClean, Hugo; Sullivan, Ann K

    2018-01-01

    This national audit demonstrated discrepancies between actual practice and that indicated by clinic policies following enquiry about alcohol, recreational drugs and chemsex use. Clinics were more likely to enquire about risk behaviour if this was clinic policy or routine practice. Previous testing was the most common reason for refusing HIV testing, although 33% of men who have sex with men had a prior test of more than three months ago. Of the group declining due to recent exposure in the window period, 21/119 cases had an exposure within the four weeks prior to presentation, but had a previous risk not covered by previous testing. Recommendations include provision of risk assessments for alcohol, recreational drug use and chemsex, documenting reasons for HIV test refusal, provision of HIV point-of-care testing, follow-up for cases at higher risk of HIV and advice about community testing or self-sampling/testing.

  1. 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.)

  2. 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

  3. The Aube centre

    International Nuclear Information System (INIS)

    1996-07-01

    This educational booklet is devoted to a general presentation of the Aube radioactive wastes storage centre. After a short presentation of the Andra, the French national agency for the management of radioactive wastes, it gives some general information about radioactive wastes (origin, classification), containers (quality assurance and different types), wastes transportation (planning, safety), and about the Aube centre itself: description, treatment and conditioning of drums (compacting and injection), storage facilities, geological situation of the site, and environmental controls. (J.S.)

  4. News and Views: Very short GRBs may be Hawking radiation source; CubeSat for the UK: UKube1 seeks payloads; Galactic centre? It's just up there… There could be a lot of Earths out there

    Science.gov (United States)

    2010-12-01

    A particular group of gamma-ray bursts, those of very short duration, have characteristics that suggest they may be the signature of an evaporating primordial black hole - the Hawking radiation proposed by Stephen Hawking in 1974. The UK Space Agency is seeking small innovative payloads for the pilot UK CubeSat, UKube1. Planet-hunters have examined the distribution of exoplanets around stars like the Sun in our galaxy, and concluded that they can expect to find planets the size of Earth around a quarter of them - 46 billion or thereabouts.

  5. Modelling relationships between lichen bioindicators, air quality and climate on a national scale: Results from the UK OPAL air survey

    International Nuclear Information System (INIS)

    Seed, Lindsay; Wolseley, Pat; Gosling, Laura; Davies, Linda; Power, Sally A.

    2013-01-01

    Air pollution has many negative effects on the natural environment, from changes in plant growth patterns to loss of ecosystem function. This study uses citizen science to investigate national-scale patterns in the distribution and abundance of selected lichen species on tree trunks and branches, and to relate these to air pollution and climate. Volunteers collected data for nine lichen indicators on 19,334 deciduous trees. Submitted data provided information on species-level patterns, and were used to derive composite lichen indices. Multiple linear regression and ANCOVA were used to model the relationships between lichen response variables on Quercus spp. and pollution, climate and location. The study demonstrated significant relationships between patterns in indicator lichens and levels of N- and S-containing pollutants on trunks and twigs. The derived lichen indices show great potential as a tool to provide information on local, site-specific levels of air quality. -- Highlights: •Data on presence and abundance of selected lichens were collected by members of the public. •Indicator species and indices were modelled against air pollution and climate data. •Lichens and indices show significant relationships with nitrogenous air pollution. •Lichen indices are useful tools for providing information on local air quality. -- Data on selected lichen taxa collected by members of the public in England is used to show the relationship of indicator taxa and pollution indices to air pollution and climate data

  6. A designated centre for people with disabilities operated by National Association of Housing for Visually Impaired Limited, Co. Dublin

    LENUS (Irish Health Repository)

    Bennett, Annemarie E

    2014-08-06

    Adults with an intellectual disability have poorer diets than the general adult population. The Able 2 Cook 4 Health cookery course aims to improve the diets of adults with mild to moderate intellectual disability. This study aims to evaluate the course by obtaining the views of course participants and the views of managers hosting the course. Thirty course participants took part in focus groups. Five managers hosting the course participated in a semi-structured interview. Positive features of the course included the group cooking, social interaction and course instructors. Collaboration between centres hosting the course and participants\\' home environment is needed to help transfer the skills learned to all home settings. The Able 2 Cook 4 Health cookery course provided participants with an important social outlet to learn essential occupational skills. These findings could particularly influence the diets of adults with an intellectual disability moving into independent living.

  7. Social Gradients and Physical Activity Trends in an Obesogenic Dietary Pattern: Cross-Sectional Analysis of the UK National Diet and Nutrition Survey 2008-2014.

    Science.gov (United States)

    Johnson, Laura; Toumpakari, Zoi; Papadaki, Angeliki

    2018-03-22

    An energy-dense, high-fat, low-fibre dietary pattern has been prospectively associated with the development of obesity in childhood but is population-specific, which limits translating the pattern into interventions. We explored the generalisability and correlates of this obesogenic dietary pattern in the UK National Diet and Nutrition Survey (NDNS) for the first time. Data came from participants ( n = 4636 children and n = 4738 adults) with 4-day food diaries in NDNS 2008-2014. Reduced rank regression was applied to 51 food groups to explain variation in energy density, fibre and fat intake. Consistency of the pattern in population subgroups (according to sex, age, occupation and income) was compared with the whole sample pattern using coefficients of congruence (COC). Pattern correlates (sociodemographic, survey year, physical activity and eating related behaviours) were explored using multiple linear regression. Food group loadings were similar to the previously identified obesogenic dietary pattern and were generalisable across all sub-groups (COC: 0.93-0.99). An obesogenic diet was associated with eating takeaways, being omnivorous, a manual household occupation and lower household income in both adults and children ( p pattern could be used to monitor the effectiveness of obesity prevention policies or develop personalised interventions.

  8. Bariatric Surgery in Obese Women of Reproductive Age Improves Conditions That Underlie Fertility and Pregnancy Outcomes: Retrospective Cohort Study of UK National Bariatric Surgery Registry (NBSR).

    Science.gov (United States)

    Edison, Eric; Whyte, Martin; van Vlymen, Jeremy; Jones, Simon; Gatenby, Piers; de Lusignan, Simon; Shawe, Jill

    2016-12-01

    The aims of this study are the following: to describe the female population of reproductive age having bariatric surgery in the UK, to assess the age and ethnicity of women accessing surgery, and to assess the effect of bariatric surgery on factors that underlie fertility and pregnancy outcomes. Demographic details, comorbidities, and operative type of women aged 18-45 years were extracted from the National Bariatric Surgery Registry (NBSR). A comparison was made with non-operative cases (aged 18-45 and BMI ≥40 kg/m 2 ) from the Health Survey for England (HSE, 2007-2013). Analyses were performed using "R" software. Data were extracted on 15,222 women from NBSR and 1073 from HSE. Women aged 18-45 comprised 53 % of operations. Non-Caucasians were under-represented in NBSR compared to HSE (10 vs 16 % respectively, p years (Wilcoxon test p year postoperatively from 48.2 ± 8.3 to 37.4 ± 7.5 kg/m 2 (t test, p fertility and pregnancy outcomes. A prospective study is required to verify these effects.

  9. Metrics for Success in the Preservation of Scientific Data at the STFC Centre for Environmental Data Archival (CEDA).

    Science.gov (United States)

    Lawrence, B.; Pepler, S.

    2009-04-01

    CEDA (http://www.ceda.ac.uk) hosts three main data centres: the British Atmospheric Data Centre (http://badc.nerc.ac.uk), the NERC Earth Observation Data Centre (http://neodc.nerc.ac.uk), and the Intergovernmental Panel for Climate Change Dedicated Data Centre (http://ipcc-data.org) as well as components of many national and international projects. CEDA recieves both core funding (from the UK Natural Environment Research Council) and per project funding (from a variety of sources). However, all funders require metrics assessing success. In the case of preservation it is hard to measure success - usage alone is not enough, since next year someone may use currently unused data if it is well preserved, and so it is the act of preservation which in this case marks success. Even where data is accessed, it is not necessarily used. Hence at CEDA we have three key focii in our approach to metrics: measuring direct website access, benchmarking procedures against best practice, and hopefully soon, recording data citation. In this presentation we cover how we are addressing each of these three areas.

  10. Surgeon length of service and risk-adjusted outcomes: linked observational analysis of the UK National Adult Cardiac Surgery Audit Registry and General Medical Council Register.

    Science.gov (United States)

    Hickey, Graeme L; Grant, Stuart W; Freemantle, Nick; Cunningham, David; Munsch, Christopher M; Livesey, Steven A; Roxburgh, James; Buchan, Iain; Bridgewater, Ben

    2014-09-01

    To explore the relationship between in-hospital mortality following adult cardiac surgery and the time since primary clinical qualification for the responsible consultant cardiac surgeon (a proxy for experience). Retrospective analysis of prospectively collected national registry data over a 10-year period using mixed-effects multiple logistic regression modelling. Surgeon experience was defined as the time between the date of surgery and award of primary clinical qualification. UK National Health Service hospitals performing cardiac surgery between January 2003 and December 2012. All patients undergoing coronary artery bypass grafts and/or valve surgery under the care of a consultant cardiac surgeon. All-cause in-hospital mortality. A total of 292,973 operations performed by 273 consultant surgeons (with lengths of service from 11.2 to 42.0 years) were included. Crude mortality increased approximately linearly until 33 years service, before decreasing. After adjusting for case-mix and year of surgery, there remained a statistically significant (p=0.002) association between length of service and in-hospital mortality (odds ratio 1.013; 95% CI 1.005-1.021 for each year of 'experience'). Consultant cardiac surgeons take on increasingly complex surgery as they gain experience. With this progression, the incidence of adverse outcomes is expected to increase, as is demonstrated in this study. After adjusting for case-mix using the EuroSCORE, we observed an increased risk of mortality in patients operated on by longer serving surgeons. This finding may reflect under-adjustment for risk, unmeasured confounding or a real association. Further research into outcomes over the time course of surgeon's careers is required. © The Royal Society of Medicine.

  11. Model-based analysis of costs and outcomes of non-invasive prenatal testing for Down's syndrome using cell free fetal DNA in the UK National Health Service.

    Directory of Open Access Journals (Sweden)

    Stephen Morris

    Full Text Available Non-invasive prenatal testing (NIPT for Down's syndrome (DS using cell free fetal DNA in maternal blood has the potential to dramatically alter the way prenatal screening and diagnosis is delivered. Before NIPT can be implemented into routine practice, information is required on its costs and benefits. We investigated the costs and outcomes of NIPT for DS as contingent testing and as first-line testing compared with the current DS screening programme in the UK National Health Service.We used a pre-existing model to evaluate the costs and outcomes associated with NIPT compared with the current DS screening programme. The analysis was based on a hypothetical screening population of 10,000 pregnant women. Model inputs were taken from published sources. The main outcome measures were number of DS cases detected, number of procedure-related miscarriages and total cost.At a screening risk cut-off of 1∶150 NIPT as contingent testing detects slightly fewer DS cases, has fewer procedure-related miscarriages, and costs the same as current DS screening (around UK£280,000 at a cost of £500 per NIPT. As first-line testing NIPT detects more DS cases, has fewer procedure-related miscarriages, and is more expensive than current screening at a cost of £50 per NIPT. When NIPT uptake increases, NIPT detects more DS cases with a small increase in procedure-related miscarriages and costs.NIPT is currently available in the private sector in the UK at a price of £400-£900. If the NHS cost was at the lower end of this range then at a screening risk cut-off of 1∶150 NIPT as contingent testing would be cost neutral or cost saving compared with current DS screening. As first-line testing NIPT is likely to produce more favourable outcomes but at greater cost. Further research is needed to evaluate NIPT under real world conditions.

  12. Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) Investigation of Perioperative Anaphylaxis.

    Science.gov (United States)

    Egner, W; Cook, T M; Garcez, T; Marinho, S; Kemp, H; Lucas, D N; Floss, K; Farooque, S; Torevell, H; Thomas, M; Ferguson, K; Nasser, S; Karanam, S; Kong, K-L; McGuire, N; Bellamy, M; Warner, A; Hitchman, J; Farmer, L; Harper, N J N

    2018-05-19

    The Royal College of Anaesthetists 6th National Audit Project examined Grade 3-5 perioperative anaphylaxis for one year in the UK. To describe the causes and investigation of anaphylaxis in the NAP6 cohort, in relation to published guidance and previous baseline survey results. We used a secure registry to gather details of Grade 3-5 perioperative anaphylaxis. Anonymous reports were aggregated for analysis and reviewed in detail. Panel consensus diagnosis, reaction grade, review of investigations and clinic assessment are reported and compared to the prior NAP6 baseline clinic survey. 266 cases met inclusion criteria between November 2015 and 2016, detailing reactions and investigations. 192/266 (72%) had anaphylaxis with a trigger identified, of which 140/192(75%) met NAP6 criteria for IgE-mediated allergic anaphylaxis, 13% lacking evidence of positive IgE tests were labelled "non-allergic anaphylaxis". 3% were non-IgE mediated anaphylaxis. Adherence to guidance was similar to the baseline survey for waiting time for clinic assessment. However, lack of testing for chlorhexidine and latex, non-harmonised testing practices and poor coverage of all possible culprits was confirmed. Challenge testing may be under-used and many have unacceptably delayed assessments, even in urgent cases. Communication or information provision for patients was insufficient, especially for avoidance advice and communication of test results. Insufficient detail regarding skin test methods was available to draw conclusions regarding techniques. Current clinical assessment in the UK is effective but harmonisation of approach to testing, access to services and MHRA reporting is needed. Expert anaesthetist involvement should increase to optimise diagnostic yield and advice for future anaesthesia. Dynamic tryptase evaluation improves detection of tryptase release where peak tryptase is <14mcg/L and should be adopted. Standardised clinic reports containing appropriate details of tests

  13. Bico 2: second national intercomparison campaign of WBC centres working in Italy; Bico 2: la seconda campagna MIDIA di interconfronto dei WBC operanti in Italia

    Energy Technology Data Exchange (ETDEWEB)

    Castellani, C.M.; Battisti, P.; Tarroni, G. [ENEA, Centro Ricerche `Ezio Clementel`, Bologna (Italy). Dip. Ambiente

    1998-12-31

    During the period November 1994 - May 1995 the coordinating group of WBC centres working in Italy organised the 2. national intercalibration and intercomparison campaign. A BOMAB phantom was used filled with four radionuclides gel solution with gamma energy emissions ranging between 100 keV and 2 MeV. 17 out of 21 Italian WBC centres took part in the campaign. Through the intercalibration, organised according to internationally accepted methodologies, each WBC centre could check its own calibration procedures. many intermediate data, collected for the methodologies and measurement procedures intercomparison, permitted analyses and comparison of uncertainly causes in a WBC measurement of the internal contamination. A proposal of MDA definition and assessment procedure resulted from the intercomparison campaign. [Italiano] Il Coordinamento dei Centri WBC operanti in Italia ha organizzato la seconda campagna di intercalibrazione ed interconfronto nazionale basata sulle misure di un fantoccio BOMAB riempito con una soluzione radioattiva gelificata contenente 4 radionuclidi con emissioni gamma nell`intervallo energetico compreso fra 100 keV e 2 MeV. Alla campagna, che si e` svolta fra novembre 1994 e maggio 1995, hanno partecipato 17 dei 21 Centri WBC censiti in Italia. L`intercalibrazione e` stata organizzata secondo criteri ormai consolidati in campo internazionale ed ha permesso ad ognuno dei partecipanti di verificare le proprie procedure di calibrazione. Per l`interconfronto delle procedure e dei metodi di misura impiegati e` stata raccolta una serie di dati intermedi che hanno consentito di analizzare e confrontare le fonti di incertezza insite nella misura di contaminazione interna nell`uomo tramite WBC. Cio` ha infine reso possibile una proposta di definizione e di procedura di determinazione del valore della minima attivita` rivelabile (MDA) in accordo con le piu` recenti tendenze in campo internazionale.

  14. Estimation of content of anti-TB drugs supplied at centres of the Revised National TB Control Programme in Tamil Nadu, India.

    Science.gov (United States)

    Ramachandran, Geetha; Chandrasekaran, Vedachalam; Hemanth Kumar, Agibothu Kupparam; Dewan, Puneet; Swaminathan, Soumya; Thomas, Aleyamma

    2013-09-01

    To determine the content of certain antituberculosis (TB) drugs supplied at TB treatment centres of the Revised National TB Control Programme (RNTCP) in the state of Tamil Nadu, India. Eight districts across the state were selected, and the following drugs were collected from five settings (District TB centre, TB unit, designated microscopy centres, DOT providers) in each district: rifampicin (150 and 450 mg), isoniazid (300 mg), pyrazinamide (500 and 750 mg), ethambutol (400 and 600 mg), ethionamide (250 mg), levofloxacin (500 mg) and cycloserine (250 mg). A maximum of 10 tablets/capsules were collected from each setting. The drugs were coded prior to analysis. All drugs were assayed by validated spectrophotometric methods. The acceptable limits for drug content were taken as 90-110% of the stated content. More than 90% of tablets of rifampicin 450 mg, isoniazid 300 mg, pyrazinamide 500 and 750 mg, ethambutol 400 and 600 mg and ethionamide 250 mg were within acceptable limits. Eighty per cent of rifampicin 150 mg, 21% of cycloserine 250 mg and 87% of levofloxacin 500 mg were within acceptable limits. The mean cycloserine content was below the acceptable limit in all districts, the mean drug content being 200 mg (range: 108-245 mg). This systematic study showed that the stated drug content of cycloserine was not reached in all districts. Deterioration of cycloserine could be minimised by storing the drug in refrigerators. The geographical location of the districts had no influence on the drug content. © 2013 John Wiley & Sons Ltd.

  15. The UK radiotherapy dosimetry audit network

    International Nuclear Information System (INIS)

    Thwaites, D.I.

    2002-01-01

    Full text: Radiotherapy dosimetry intercomparison in the UK has been carried out in limited studies since the 1960s. However the first national dosimetry intercomparison involving all radiotherapy centres was conducted in the late 1980s. This was based on visits to each centre, using ionisation chamber dosimetry. It audited megavoltage photon beam calibration and other single field parameters. It also measured doses in a three-field 'treatment' in a trapezoidal phantom constructed from epoxy-resin water-equivalent material and compared these to locally planned doses. This included off-axis points, oblique incidence, inhomogeneities, etc. The study found mean measured beam calibration doses close to stated values (ratio 1.003), with a standard deviation (sd) of the distribution of 1.5% and 97% of doses within the pro-set 3% tolerance. For the planned multi-field irradiations, mean dose ratios (measured/stated) were 1.01 (sd 3%, 90% of results within 5%). A number of discrepancies were identified, leading to improved practice. A follow up study (mid-1990s) for electron beam audit also repeated the megavoltage photon calibration audit. For photons, an improvement was noted (mean ratio 1.003, sd 1.0%, 100% within 3%), whilst for electron beams, the mean ratio of measured/stated dose was 0.994 (sd 1.8%, 94% within 3%, 99% within 5%). In parallel with - and growing out of - this, a national audit network began to develop in 1991/2. It utilised similar methodology to the intercomparison and a network approach to allow parallel developments of the scope of the system. The network has eight regional groups, each with up to 10 radiotherapy centres, serving average populations of 7-8 million. Each group organises audits of its own centres and has developed at its own pace. Most have piloted methodology, phantoms, etc. for new audits which can then be used by other groups. All 65 UK centres are included. The network is co-ordinated by an IPEM Steering Committee (current chair

  16. UK Environmental Prediction - integration and evaluation at the convective scale

    Science.gov (United States)

    Fallmann, Joachim; Lewis, Huw; Castillo, Juan Manuel; Pearson, David; Harris, Chris; Saulter, Andy; Bricheno, Lucy; Blyth, Eleanor

    2016-04-01

    Traditionally, the simulation of regional ocean, wave and atmosphere components of the Earth System have been considered separately, with some information on other components provided by means of boundary or forcing conditions. More recently, the potential value of a more integrated approach, as required for global climate and Earth System prediction, for regional short-term applications has begun to gain increasing research effort. In the UK, this activity is motivated by an understanding that accurate prediction and warning of the impacts of severe weather requires an integrated approach to forecasting. The substantial impacts on individuals, businesses and infrastructure of such events indicate a pressing need to understand better the value that might be delivered through more integrated environmental prediction. To address this need, the Met Office, NERC Centre for Ecology & Hydrology and NERC National Oceanography Centre have begun to develop the foundations of a coupled high resolution probabilistic forecast system for the UK at km-scale. This links together existing model components of the atmosphere, coastal ocean, land surface and hydrology. Our initial focus has been on a 2-year Prototype project to demonstrate the UK coupled prediction concept in research mode. This presentation will provide an update on UK environmental prediction activities. We will present the results from the initial implementation of an atmosphere-land-ocean coupled system, including a new eddy-permitting resolution ocean component, and discuss progress and initial results from further development to integrate wave interactions in this relatively high resolution system. We will discuss future directions and opportunities for collaboration in environmental prediction, and the challenges to realise the potential of integrated regional coupled forecasting for improving predictions and applications.

  17. Enhancing national Daily Landslide Hazard Assessments through inter-agency collaboration; lessons learned from storm Desmond (UK)/Synne (Norway), Dec 2015.

    Science.gov (United States)

    Boje, Søren; Devoli, Graziella; Sund, Monica; Freeborough, Katy; Dijkstra, Tom; Reeves, Helen; Banks, Vanessa

    2016-04-01

    The Norwegian Water Resources and Energy Directorate (NVE) and the British Geological Survey (BGS) compile daily landslide hazard assessments (DLHA) in their respective countries. NVE DLHA has been operational since 2013 and provides national daily assessments based on quantitative thresholds related to daily hydro-meteorological forecasts coupled with qualitative expert analysis of these forecasts. The BGS DLHA has been operational since 2012 and this is predominantly based on expert evaluation of antecedent hydro-meteorological conditions and triggering rainfall across Great Britain (GB). In both cases, the hydro-meteorological evaluation is coupled with observations derived from proprietary datasets on landslide events and landslide potential in order to specify, and limit, the spatial extent of the potentially impacted area. However, the DLHA are strongly driven by hydro-meteorological forecasts. In December 2015, a large extra-tropical cyclone developed over the Atlantic and delivered record-breaking precipitation over parts of the UK and Norway. The meteorological services started naming these events to enhance public uptake and awareness and the storms were named as Desmond (the 4th large storm in 2015/16 in the UK) and Synne (the 5th storm in 2015 in Norway). Desmond arrived in earnest on the 5th of December and brought intense precipitation and strong winds over a 48-hour period. In Cumbria (NW-England) record precipitation was measured (341.4 mm in 24-hour at Honister Pass which is more than twice the monthly average), with 48-hour accumulations exceeding 400 mm. Synne arrived shortly after in Norway and was also characterised by excessive rainfall of 140 mm in 24-hour, 236 mm in 48-hour and 299 mm in 72-hour at Maudal, SW-Norway. Both organisations managed to issue appropriate advance warnings, operating individually. In Norway, warnings were issued some 2 days in advance with a yellow level communicated on Friday 4th and an orange warning the 5th and 6

  18. “Financial alchemy” or a zero sum game? Real estate finance, securitisation and the UK property market

    OpenAIRE

    Lizieri, Colin; Ward, Charles

    2001-01-01

    Following the US model, the UK has seen considerable innovation in the funding, finance and procurement of real estate in the last decade. In the growing CMBS market asset backed securitisations have included $2.25billion secured on the Broadgate office development and issues secured on Canary Wharf and the Trafford Centre regional mall. Major occupiers (retailer Sainsbury’s, retail bank Abbey National) have engaged in innovative sale & leaseback and outsourcing schemes. Strong claims are mad...

  19. The Radiotherapy Dosimetry Audit System In the UK

    International Nuclear Information System (INIS)

    Thwaites, D.I.

    1999-01-01

    Two national radiotherapy dosimetry intercomparisons have been earned out in the UK, involving all radiotherapy institutes. The first was concerned with megavoltage photon beams and looked at beam calibration and simple three-field planned distributions in a geometric phantom. The intercomparisons were carried out by an independent intercomparison physicist visiting each department in turn and making measurements with ion chambers, following a fixed protocol. The beam calibration intercomparison was earned out on every 60 C o beam and every MV x-ray beam, whilst the planned comparisons were carried out on one beam only. The plans included effects of wedges, oblique incidence and inhomogeneities. The study was unfunded and took a significant time (1988-1991) to cover the 65 or so centres. It was followed up by a national electron dosimetry intercomparison which was fended (Department of Health) and which ran from 1994-1996. This audited three electron beam energies in each centre (depth dose, beam energy, dose calibration) and also included a follow-up of the original photon beam intercomparison. In general these studies showed good consistency of dosimetry across the UK centres, with mean (measured/locally stated) doses being close to unity and standard deviations of the distributions of values being approx. 1.5 and 1% for photons, 1.8% for electrons for beam calibration and 2.5-3.5% for the planned multi-beam situations. 97-100% of measurements were within the pre-set 3% tolerance for beam calibration and around 90% of the measurements within a pre-set 5% tolerance for planned situations. The studies did highlight some areas where increased on Q A could provide benefits. In particular the photon intercomparison discovered one 60 C o unit mis calibration which led to national recommendations for the implementation of Quality Systems in radiotherapy departments

  20. Consistency of histopathological reporting of breast lesions detected by screening: findings of the U.K. National External Quality Assessment (EQA) Scheme. U. K. National Coordinating Group for Breast Screening Pathology.

    Science.gov (United States)

    Sloane, J P; Ellman, R; Anderson, T J; Brown, C L; Coyne, J; Dallimore, N S; Davies, J D; Eakins, D; Ellis, I O; Elston, C W

    1994-01-01

    The aim of the scheme was to determine consistency of histopathological reporting in the United Kingdom National Breast Screening Programme. This external quality assessment scheme involved 51 sets of 12 slides which were circulated to 186-251 pathologists at intervals of 6 months for 3 years. Participants recorded their diagnoses on standard reporting forms, which were submitted to the U.K. National Cancer Screening Evaluation Unit for analysis. A high level of consistency was achieved in diagnosing major categories of breast disease including invasive carcinoma and the important borderline lesions, radial scar and ductal carcinoma in situ (DCIS), the latter exceeding a national target set prior to the onset of the scheme. Atypical hyperplasia (AH) was reported with much less consistency although, where it was the majority opinion, over 86% of diagnoses were of benign disorders and only 14% were of DCIS. Inconsistency was encountered in subtyping and measuring DCIS, the former apparently due to current uncertainties about classification and the latter to poor circumscription, variation in size in different sections and merging with zones of AH. Reporting prognostic features of invasive carcinomas was variable. Measurement of size was achieved with adequate consistency except in a small number of very poorly circumscribed tumours. Grading and subtyping were inconsistent although the latter was not specifically tested and will be the subject of future study. Members of the National Coordinating Group achieved greater uniformity than the remainder of the participants in all diagnostic categories, but both groups experienced similar types of problem. Our findings suggest that participation in the scheme improves diagnostic consistency. In conclusion, consistency in diagnosing invasive carcinoma and radial scar is excellent, and good in DCIS, but improvements are desirable in diagnosing atypical hyperplasia, classifying DCIS and reporting certain prognostic features of

  1. Breakfast consumption and nutrient intakes in 4-18-year-olds : UK National Diet and Nutrition Survey Rolling Programme (2008-2012)

    NARCIS (Netherlands)

    Coulthard, Janine D.; Palla, Luigi; Pot, Gerda K.

    2017-01-01

    Although breakfast consumption is widely considered to be an important component of a healthy lifestyle, few UK studies have examined differences in nutrient intakes between breakfast consumers and breakfast skippers among children and adolescents. We investigated associations between breakfast

  2. The relationship between sleep duration and fruit/vegetable intakes in UK adults: a cross-sectional study from the National Diet and Nutrition Survey

    Science.gov (United States)

    Cade, Janet E; Burley, Victoria J; Hardie, Laura J

    2018-01-01

    Objectives There is increasing evidence to suggest an association between sleep and diet. The aim of the present study was to examine the association between sleep duration and fruit/vegetable (FV) intakes and their associated biomarkers in UK adults. Design Cross-sectional. Setting Data from The National Diet and Nutrition Survey. Participants 1612 adults aged 19–65 years were included, pregnant/breastfeeding women were excluded from the analyses. Outcome measures Sleep duration was assessed by self-report, and diet was assessed by 4-day food diaries, disaggregation of foods containing FV into their components was conducted to determine total FV intakes. Sleep duration was divided into: short (8 hours/day) sleep periods. Multiple regression adjusting for confounders was used for analyses where sleep duration was the exposure and FV intakes and their associated biomarkers were the outcomes. Restricted cubic spline models were developed to explore potential non-linear associations. Results In adjusted models, long sleepers (LS) consumed on average 28 (95% CI −50 to −6, p=0.01) g/day less of total FV compared to reference sleepers (RS), whereas short sleepers (SS) consumed 24 g/day less (95% CI −42 to –6, p=0.006) and had lower levels of FV biomarkers (total carotenoids, β-carotene and lycopene) compared to RS. Restricted cubic spline models showed that the association between sleep duration and FV intakes was non-linear (pimportant implications for lifestyle and behavioural change policy. PMID:29703857

  3. Getting the right balance? A mixed logit analysis of the relationship between UK training doctors' characteristics and their specialties using the 2013 National Training Survey.

    Science.gov (United States)

    Rodriguez Santana, Idaira; Chalkley, Martin

    2017-08-11

    To analyse how training doctors' demographic and socioeconomic characteristics vary according to the specialty that they are training for. Descriptive statistics and mixed logistic regression analysis of cross-sectional survey data to quantify evidence of systematic relationships between doctors' characteristics and their specialty. Doctors in training in the United Kingdom in 2013. 27 530 doctors in training but not in their foundation year who responded to the National Training Survey 2013. Mixed logit regression estimates and the corresponding odds ratios (calculated separately for all doctors in training and a subsample comprising those educated in the UK), relating gender, age, ethnicity, place of studies, socioeconomic background and parental education to the probability of training for a particular specialty. Being female and being white British increase the chances of being in general practice with respect to any other specialty, while coming from a better-off socioeconomic background and having parents with tertiary education have the opposite effect. Mixed results are found for age and place of studies. For example, the difference between men and women is greatest for surgical specialties for which a man is 12.121 times more likely to be training to a surgical specialty (relative to general practice) than a woman (p-valuevalue<0.01). There are systematic and substantial differences between specialties in respect of training doctors' gender, ethnicity, age and socioeconomic background. The persistent underrepresentation in some specialties of women, minority ethnic groups and of those coming from disadvantaged backgrounds will impact on the representativeness of the profession into the future. Further research is needed to understand how the processes of selection and the self-selection of applicants into specialties gives rise to these observed differences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

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

    Directory of Open Access Journals (Sweden)

    Janet Richardson

    2012-04-01

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

  5. Assessing "chaotic eating" using self-report and the UK Adult National Diet and Nutrition Survey: No association between BMI and variability in meal or snack timings.

    Science.gov (United States)

    Zimmerman, Annie R; Johnson, Laura; Brunstrom, Jeffrey M

    2018-03-24

    Although regular meal timings are recommended for weight loss, no study has characterised irregularity in the timing of eating occasions or investigated associations with body-mass index (BMI). Here, we characterise "chaotic eating" as the tendency to eat at variable times of day. In two studies, we used a novel measure to explore the relationship between BMI and chaotic eating. In Study 1 (N = 98) we measured BMI and used a self-report measure to assess the usual range of times that meals and snacks are consumed over a seven-day period, as well as meal and snack frequency. A separate meal and snack 'chaotic eating index' was derived from the number of possible thirty-minute snack- or meal-slots, divided by the frequency of these eating events. After adjusting for age, gender, and dietary habits (Three-Factor Eating Questionnaire) we found no relationship between BMI and chaotic eating of meals (β = -0.07, p = 0.73) or snacks (β = -0.10, p = 0.75). In Study 2, we calculated the same chaotic eating index (meals and snacks) using data from the UK National Diet and Nutrition Survey of adults 2000-2001 (seven-day diet diaries; N = 1175). Again, we found little evidence that BMI is associated with chaotic eating of meals (β = 0.16, p = 0.27) or snacks (β = 0.15, p = 0.12). Together, these results suggest that irregular eating timings do not promote weight gain and they challenge guidelines that recommend regularity in meal timings for weight loss. Copyright © 2018. Published by Elsevier Inc.

  6. Effects of residents' tourism development expectation and tourism impacts perception on their attitude towards tourism in natural tourist destination: A Comparative study between China's Jiuzhaigou and the UK's New Forest National Parks

    OpenAIRE

    Cheng, S.; Zhang, J.; Xu, Feifei; Liang, Y.

    2010-01-01

    Local residents' perception of tourism impacts in tourist destinations has been found to affect their attitude towards tourism; however, there have been relatively few studies on the influence of residents' tourism development expectation on their attitude towards tourism. With the utilization of SPSS16.0 software, this paper, taking China's Jiuzhaigou and the UK's New Forest National Parks as case study areas, makes a comparative study on the influence of local residents' tourism development...

  7. Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials.

    Science.gov (United States)

    Clark, Catharine H; Aird, Edwin G A; Bolton, Steve; Miles, Elizabeth A; Nisbet, Andrew; Snaith, Julia A D; Thomas, Russell A S; Venables, Karen; Thwaites, David I

    2015-01-01

    Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK over the past 30 years, including the involvement of the UK in international audits. A summary of audit results is given, with an overview of methodologies employed and lessons learnt. Recent and forthcoming more complex audits are considered, with a focus on future needs including the arrival of proton therapy in the UK and other advanced techniques such as four-dimensional radiotherapy delivery and verification, stereotactic radiotherapy and MR linear accelerators. The work of the main quality assurance and auditing bodies is discussed, including how they are working together to streamline audit and to ensure that all radiotherapy centres are involved. Undertaking regular external audit motivates centres to modernize and develop techniques and provides assurance, not only that radiotherapy is planned and delivered accurately but also that the patient dose delivered is as prescribed.

  8. Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

    Science.gov (United States)

    Aird, Edwin GA; Bolton, Steve; Miles, Elizabeth A; Nisbet, Andrew; Snaith, Julia AD; Thomas, Russell AS; Venables, Karen; Thwaites, David I

    2015-01-01

    Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK over the past 30 years, including the involvement of the UK in international audits. A summary of audit results is given, with an overview of methodologies employed and lessons learnt. Recent and forthcoming more complex audits are considered, with a focus on future needs including the arrival of proton therapy in the UK and other advanced techniques such as four-dimensional radiotherapy delivery and verification, stereotactic radiotherapy and MR linear accelerators. The work of the main quality assurance and auditing bodies is discussed, including how they are working together to streamline audit and to ensure that all radiotherapy centres are involved. Undertaking regular external audit motivates centres to modernize and develop techniques and provides assurance, not only that radiotherapy is planned and delivered accurately but also that the patient dose delivered is as prescribed. PMID:26329469

  9. Radiotherapy physics research in the UK: challenges and proposed solutions

    Science.gov (United States)

    Mackay, R I; Burnet, N G; Green, S; Illidge, T M; Staffurth, J N

    2012-01-01

    In 2011, the Clinical and Translational Radiotherapy Research Working Group (CTRad) of the National Cancer Research Institute brought together UK radiotherapy physics leaders for a think tank meeting. Following a format that CTRad had previously and successfully used with clinical oncologists, 23 departments were asked to complete a pre-meeting evaluation of their radiotherapy physics research infrastructure and the strengths, weaknesses, opportunities and threats within their own centre. These departments were brought together with the CTRad Executive Group and research funders to discuss the current state of radiotherapy physics research, perceived barriers and possible solutions. In this Commentary, we summarise the submitted materials, presentations and discussions from the meeting and propose an action plan. It is clear that there are challenges in both funding and staffing of radiotherapy physics research. Programme and project funding streams sometimes struggle to cater for physics-led work, and increased representation on research funding bodies would be valuable. Career paths for academic radiotherapy physicists need to be examined and an academic training route identified within Modernising Scientific Careers; the introduction of formal job plans may allow greater protection of research time, and should be considered. Improved access to research facilities, including research linear accelerators, would enhance research activity and pass on developments to patients more quickly; research infrastructure could be benchmarked against centres in the UK and abroad. UK National Health Service departments wishing to undertake radiotherapy research, with its attendant added value for patients, need to develop a strategy with their partner higher education institution, and collaboration between departments may provide enhanced opportunities for funded research. PMID:22972972

  10. Radiotherapy physics research in the UK: challenges and proposed solutions.

    Science.gov (United States)

    Mackay, R I; Burnet, N G; Green, S; Illidge, T M; Staffurth, J N

    2012-10-01

    In 2011, the Clinical and Translational Radiotherapy Research Working Group (CTRad) of the National Cancer Research Institute brought together UK radiotherapy physics leaders for a think tank meeting. Following a format that CTRad had previously and successfully used with clinical oncologists, 23 departments were asked to complete a pre-meeting evaluation of their radiotherapy physics research infrastructure and the strengths, weaknesses, opportunities and threats within their own centre. These departments were brought together with the CTRad Executive Group and research funders to discuss the current state of radiotherapy physics research, perceived barriers and possible solutions. In this Commentary, we summarise the submitted materials, presentations and discussions from the meeting and propose an action plan. It is clear that there are challenges in both funding and staffing of radiotherapy physics research. Programme and project funding streams sometimes struggle to cater for physics-led work, and increased representation on research funding bodies would be valuable. Career paths for academic radiotherapy physicists need to be examined and an academic training route identified within Modernising Scientific Careers; the introduction of formal job plans may allow greater protection of research time, and should be considered. Improved access to research facilities, including research linear accelerators, would enhance research activity and pass on developments to patients more quickly; research infrastructure could be benchmarked against centres in the UK and abroad. UK National Health Service departments wishing to undertake radiotherapy research, with its attendant added value for patients, need to develop a strategy with their partner higher education institution, and collaboration between departments may provide enhanced opportunities for funded research.

  11. Radioecological studies at the National Accelerator Centre based on the determination of 129I by accelerator mass spectrometry (AMS)

    International Nuclear Information System (INIS)

    Lopez-Gutierrez, J. M.; Gomez-Guzman, J. M.; Chamizo, E.; Santos, F. J.; Garcia-Leon, M.; Garcia-Tenorio, R.

    2013-01-01

    Since 2006 a compact system of mass spectrometry with Accelerator (AMS) is installed at the National Center of Accelerators, Seville. After an initial set-up and study have been opening many lines of research in fields such as archeology, geology, paleontology, oceanography, oceanography, internal dosimetry and characterization of radioactive waste, among others. In particular, based on the measurement of 1 29I have made contributions to the field of radioecology and radiation protection. In this work they are summarized and presented some of these investigations. (Author)

  12. Centre-level variation in outcomes and treatment for otitis media with effusion and hearing loss and the association of hearing loss with developmental outcomes at ages 5 and 7 years in children with non-syndromic unilateral cleft lip and palate: The Cleft Care UK study. Part 2.

    Science.gov (United States)

    Hall, A; Wills, A K; Mahmoud, O; Sell, D; Waylen, A; Grewal, S; Sandy, J R; Ness, A R

    2017-06-01

    To explore centre-level variation in otitis media with effusion (OME), hearing loss and treatments in children in Cleft Care UK (CCUK) and to examine the association between OME, hearing loss and developmental outcomes at 5 and 7 years. Two hundred and sixty-eight 5-year-old British children with non-syndromic unilateral cleft lip and palate (UCLP) recruited to CCUK. Children had air and bone conduction audiometry at age 5. Information on grommet and hearing aid treatment was obtained from parental questionnaire and medical notes. Hearing loss at age 5 was defined as >20 dB in the better ear and history of OME and hearing loss was determined from past treatment. Children with sensorineural hearing loss were excluded. Associations were examined with speech, behaviour and self-confidence at age 5 and educational attainment at age 7. Centre variation was examined using hierarchical models and associations between hearing variables and developmental outcomes were examined using logistic regression. There was centre-level variation in early grommet placement (variance partition coefficient (VPC) 18%, P=.001) and fitting of hearing aids (VPC 8%, P=.03). A history of OME and hearing loss was associated with poor intelligibility of speech (adjusted odds ratio=2.87, 95% CI 1.42-5.77) and aspects of educational attainment. Hearing loss is an important determinant of poor speech and treatment variation across centres suggest management of OME and hearing loss could be improved. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. 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

  14. Institutional Support : Centre for Research and Technology ...

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

    year-old science and technology research centre at Maseno University in western Kenya. The Centre focuses on science and technology research to influence both national policies and development practices at the community level. Currently ...

  15. Inter-observer variation in delineation of the heart and left anterior descending coronary artery in radiotherapy for breast cancer: a multi-centre study from Denmark and the UK

    DEFF Research Database (Denmark)

    Lorenzen, Ebbe L; Taylor, Carolyn W; Maraldo, Maja

    2013-01-01

    BACKGROUND AND PURPOSE: To determine the extent of inter-observer variation in delineation of the heart and left anterior descending coronary artery (LADCA) and its impact on estimated doses. METHODS AND MATERIALS: Nine observers from five centres delineated the heart and LADCA on fifteen patient...... guidelines were used. In contrast, for the LADCA there was substantial variation in the estimated dose, which was not reduced with guidelines....

  16. Lessons learned from the operation of a LILW National disposal centre: The Cabril and the Spanish case - 16029

    International Nuclear Information System (INIS)

    Navarro, Mariano; Gomez, Fernando; Garcia, Emilio

    2009-01-01

    Spain occupies a relatively important position in experience in the field of LILW management. The management of LILW in Spain may be defined as an integrated system encompassing the entire spectrum; from production controls, removal and transport, to disposal. In this system, a clear definition of the responsibilities of each of the people involved plays a fundamental role. ENRESA, the organization in charge of radioactive waste management in Spain, has been operating the El Cabril LILW disposal facility since 1992, this installation being a key component in the national LILW management programme. Over the years ENRESA has acquired significant operating experience from a multi-disciplinary point of view, including technical, economic and social aspects. To date, since the design phase of the facility and over more than fifteen years, ENRESA has adopted a series of decisions and has undertaken programmes and activities that have allowed the installation to evolve into the reality that it now is. The aim of this paper is to present the lessons learned from a strategic point of view and in relation to the most relevant and significant aspects that have facilitated the normal operation of the facility, and the development of specific solutions to the challenges posed by the performance of activities, and the emerging needs of the Spanish programme. (authors)

  17. `Green heat` in a UK city

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1997-06-01

    This brief article describes the Sheffield `green heat` scheme which utilises heat from a local waste incinerator to operate an independent district heating scheme within Sheffield city centre. Standby and peak overload heat generation capacity is provided by four boiler plants ensuring integrity of supply. The benefits of the scheme and future developments are outlined. (UK)

  18. Rental Values in UK Shopping Malls

    NARCIS (Netherlands)

    Yuo, Tony Shun-Te; Lizieri, Colin; McCann, Phillip; Crosby, Neil

    This paper employs a unique dataset to analyse the retail rental levels of 1108 retail tenants in 148 UK regional shopping malls. The dataset integrates information regarding the characteristics of the shopping centre, the individual retailer, the brand, the individual unit occupied, the tenancy

  19. Audit of sweat testing: a first report from Italian Cystic Fibrosis Centres.

    Science.gov (United States)

    Cirilli, Natalia; Padoan, Rita; Raia, Valeria

    2008-09-01

    Cystic Fibrosis diagnosis is confirmed using sweat test. The aim of our study was to evaluate current techniques and methodologies in use at Italian CF Care Centres. A series of questions related to the performance of the sweat test was collected by all CF Care Centres in Italy. Answers were compared with UK and NCCLS guidelines. 39/41 Centres replied to the questionnaire. A good adherence to guidelines was registered for storing samples before analysis in 90.9%, while performing CF diagnosis by at least two sweat tests, and chloride analysis were reported respectively in 100% and 75.7% of Centres. Some inconsistencies were registered for minimum acceptable sweat quantity and time to collect sweat inadequate in respectively 42.5% and 24.2% of Centres, while performing quality control procedures and referring to an external quality assessment scheme were found inadequate in respectively 54.6% and 100%. 57.6% didn't provide any appropriate analytical ranges and only 15.1% of Centres offered proper information to patients/parents. A report form, including sweat quantity, reference ranges and interpretation, was adequate only for 9.4 up to 41.4% of CF Centres. Our study showed areas of inconsistencies in sweat testing current practices in Italy and highlights the need for evidence based national guidelines to improve practice and management strategies.

  20. The Role of National Adult Education Centre in Curriculum Development in Somalia in Selected Government Primary Adult Schools of Mogadisho. African Studies in Curriculum Development and Evaluation, No. 109.

    Science.gov (United States)

    Bahar, Ismail F. S.

    A study of curriculum development in Somalia focused on the role of the National Adult Education Centre (NAEC) and involvement of teachers and inspectors. The sample consisted of 80 Mogadisho primary adult school teachers. Information sources were related literature, teacher questionnaires, and unstructured interviews with school inspectors,…

  1. The Agency's Agreement with the United Nations Educational, Scientific and Cultural Organization concerning the Joint Operation of the International Centre for Theoretical Physics at Trieste. Extension of the Agreement

    International Nuclear Information System (INIS)

    1983-02-01

    By an exchange of letters between the Directors General of the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the Agency, the duration of the agreement between the two organizations concerning the joint operation of the International Centre for Theoretical Physics at Trieste has been extended until 31 December 1986.

  2. The Agency's Agreement with the United Nations Educational, Scientific and Cultural Organization concerning the Joint Operation of the International Centre for Theoretical Physics at Trieste. Extension of the Agreement

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1983-02-15

    By an exchange of letters between the Directors General of the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the Agency, the duration of the agreement between the two organizations concerning the joint operation of the International Centre for Theoretical Physics at Trieste has been extended until 31 December 1986.

  3. 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.)

  4. The ideal Atomic Centre

    International Nuclear Information System (INIS)

    Mas, R.

    1965-01-01

    The author presents considerations which should prove to be of interest to all those who have to design, to construct and to operate a nuclear research centre. A large number of the ideas presented can also be applied to non-nuclear scientific research centres. In his report the author reviews: various problems with which the constructor is faced: ground-plan, infrastructure, buildings and the large units of scientific equipment in the centre, and those problems facing the director: maintenance, production, supplies, security. The author stresses the relationship which ought to exist between the research workers and the management. With this aim in view he proposes the creation of National School for Administration in Research which would train administrative executives for public or private organisations; they would be specialised in the fields of fundamental or applied research. (author) [fr

  5. Introduction of a National Minimum Wage Reduced Depressive Symptoms in Low-Wage Workers: A Quasi-Natural Experiment in the UK

    NARCIS (Netherlands)

    A. Reeves (Aaron); M. McKee (Martin); J.P. Mackenbach (Johan); M. Whitehead (Margaret); D. Stuckler (David)

    2017-01-01

    textabstractDoes increasing incomes improve health? In 1999, the UK government implemented minimum wage legislation, increasing hourly wages to at least £3.60. This policy experiment created intervention and control groups that can be used to assess the effects of increasing wages on health.

  6. One-Stop Clinic Utilization in Plastic Surgery: Our Local Experience and the Results of a UK-Wide National Survey

    Science.gov (United States)

    Gorman, Mark; Coelho, James; Gujral, Sameer; McKay, Alastair

    2015-01-01

    Introduction. “See and treat” one-stop clinics (OSCs) are an advocated NHS initiative to modernise care, reducing cancer treatment waiting times. Little studied in plastic surgery, the existing evidence suggests that though they improve care, they are rarely implemented. We present our experience setting up a plastic surgery OSC for minor skin surgery and survey their use across the UK. Methods. The OSC was evaluated by 18-week wait target compliance, measures of departmental capacity, and patient satisfaction. Data was obtained from 32 of the 47 UK plastic surgery departments to investigate the prevalence of OSCs for minor skin cancer surgery. Results. The OSC improved 18-week waiting times, from a noncompliant mean of 80% to a compliant 95% average. Department capacity increased 15%. 95% of patients were highly satisfied with and preferred the OSC to a conventional service. Only 25% of UK plastic surgery units run OSCs, offering varying reasons for not doing so, 42% having not considered their use. Conclusions. OSCs are underutilised within UK plastic surgery, where a significant proportion of units have not even considered their benefit. This is despite associated improvements in waiting times, department capacity, and levels of high patient satisfaction. We offer our considerations and local experience instituting an OSC service. PMID:26236502

  7. The cataract national data set electronic multi-centre audit of 55,567 operations: case-mix adjusted surgeon's outcomes for posterior capsule rupture.

    Science.gov (United States)

    Sparrow, J M; Taylor, H; Qureshi, K; Smith, R; Johnston, R L

    2011-08-01

    To develop a methodology for case-mix adjustment of surgical outcomes for individual cataract surgeons using electronically collected multi-centre data conforming to the cataract national data set (CND). Routinely collected anonymised data were remotely extracted from electronic patient record (EPR) systems in 12 participating NHS Trusts undertaking cataract surgery. Following data checks and cleaning, analyses were carried out to risk adjust outcomes for posterior capsule rupture rates for individual surgeons, with stratification by surgical grade. A total of 406 surgeons from 12 NHS Trusts submitted data on 55,567 cataract operations between November 2001 and July 2006 (86% from January 2004). In all, 283 surgeons contributed data on >25 cases, providing 54,319 operations suitable for detailed analysis. Case-mix adjusted results of individual surgeons are presented as funnel plots for all surgeons together, and separately for three different grades of surgeon. Plots include 95 and 99.8% confidence limits around the case-mix adjusted outcomes for detection of surgical outliers. Routinely collected electronic data conforming to the CND provides sufficient detail for case-mix adjustment of cataract surgical outcomes. The validation of these risk indicators should be carried out using fresh data to confirm the validity of the risk model. Once validated this model should provide an equitable approach for peer-to-peer comparisons in the context of revalidation.

  8. Causes of death in hospitalised HIV-infected patients at a National Referral Centre in Singapore: a retrospective review from 2008 to 2010.

    Science.gov (United States)

    Wong, Chen Seong; Lo, Francis A; Cavailler, Philippe; Ng, Oon Tek; Lee, Cheng Chuan; Leo, Yee Sin; Chua, Arlene C

    2012-12-01

    Highly active antiretroviral therapy (HAART) has improved outcomes for individuals infected with human immunodeficiency virus (HIV). This study describes the causes of death in hospitalised HIV-positive patients from 2008 to 2010 in Tan Tock Seng Hospital, the national referral centre for HIV management in Singapore. Data were retrospectively collected from HIV-positive patients who died in Tan Tock Seng Hospital from January 2008 to December 2010. Sixty-seven deaths occurred in the study period. A majority of patients died of non-acquired immune deficiency syndrome (AIDS)-defining illnesses (54.7%). The median CD4 count was 39.5 (range, 20.0 to 97.0), and 7 patients had HIV viral loads of <200 copies/mL. There were 27 deaths due to opportunistic infections, 27 due to non AIDS-defining infections, 4 due to non AIDS-associated malignancies. This study also describes 3 deaths due to cardiovascular events, and 1 due to hepatic failure. Patients who had virologic suppression were more likely to die from non AIDS-defining causes. Causes of death in HIV-positive patients have changed in the HAART era. More research is required to further understand and address barriers to testing and treatment to further improve outcomes in HIV/AIDS.

  9. Morphological, Phenological And Agronomical Characterisation Of Variability Among Common Bean (Phaseolus Vulgaris L. Local Populations From The National Centre For Plant Genetic Resources: Polish Genebank

    Directory of Open Access Journals (Sweden)

    Boros Lech

    2014-12-01

    Full Text Available The main purpose of this work was to analyse the morphological, phenological and agronomical variability among common bean local populations from The National Centre for Plant Genetic Resources, Polish Genebank, in order to know the relation among them, and to identify potentially useful accessions for future production and breeding. A considerable genotypic variation for number of seeds per plant, number of pods per plant and weight of seeds per plant were found. Studied bean accessions differed significantly in terms of thousand seeds weight (TSW as well as severity of bacterial halo blight and anthracnose, the major bean diseases. The lowest genotypic diversity was found for the percentage of protein in the seeds, the length of the vegetation period and lodging. The cluster analysis allowed identification of five groups of bean accessions. Genotypes from the first cluster (POLPOD 98-77, KOS 002 and Raba cv. and from the second cluster (WUKR 06-573a, KRA 4, WUKR 06-0534 together with Prosna cv. are of the highest usefulness for breeding purposes. There was no grouping of local populations depending on region of origin.

  10. Identifying critical success factors for designing selection processes into postgraduate specialty training: the case of UK general practice.

    Science.gov (United States)

    Plint, Simon; Patterson, Fiona

    2010-06-01

    The UK national recruitment process into general practice training has been developed over several years, with incremental introduction of stages which have been piloted and validated. Previously independent processes, which encouraged multiple applications and produced inconsistent outcomes, have been replaced by a robust national process which has high reliability and predictive validity, and is perceived to be fair by candidates and allocates applicants equitably across the country. Best selection practice involves a job analysis which identifies required competencies, then designs reliable assessment methods to measure them, and over the long term ensures that the process has predictive validity against future performance. The general practitioner recruitment process introduced machine markable short listing assessments for the first time in the UK postgraduate recruitment context, and also adopted selection centre workplace simulations. The key success factors have been identified as corporate commitment to the goal of a national process, with gradual convergence maintaining locus of control rather than the imposition of change without perceived legitimate authority.

  11. Investigating the job satisfaction of healthcare providers at primary healthcare centres in Lebanon: A national cross-sectional study.

    Science.gov (United States)

    Alameddine, Mohamad; Baroud, Maysa; Kharroubi, Samer; Hamadeh, Randa; Ammar, Walid; Shoaib, Hikma; Khodr, Hiba

    2017-11-01

    Low job satisfaction is linked to higher staff turnover and intensified shortages in healthcare providers (HCP). This study investigates the level of, and factors associated with, HCP job satisfaction in the national primary healthcare (PHC) network in Lebanon. The study adopts a cross-sectional design to survey HCP at 99 PHC centres distributed across the country between October 2013 and May 2014. The study questionnaire consisted of four sections: socio-demographics/professional background, employment characteristics, level of job satisfaction (Measure of Job Satisfaction scale) and level of professional burnout (Maslach Burnout Inventory-HSS scale). A total of 1,000 providers completed the questionnaire (75.8% response rate). Bivariate and multivariate regression analyses were used to identify factors significantly associated with job satisfaction. Findings of the study highlight an overall mean job satisfaction score of 3.59 (SD 0.54) indicating that HCP are partially satisfied. Upon further examination, HCP were least satisfied with pay, training and job prospects. Gender, age, career plans, salary, exposure to violence, and level of burnout were significantly associated with the overall level of job satisfaction which was also associated with increased likelihood to quit. Overall, the study highlights how compensation, development and protection of PHC HCP can influence their job satisfaction. Recommendations include the necessity of developing a nationally representative committee, led by the Ministry of Public Health, to examine the policies and remuneration scales within the PHC sector and suggest mechanisms to bridge the pay differential with other sectors. The effective engagement of key stakeholders with the development, organisation and evaluation of professional development programmes offered to HCP in the PHC sector remains crucial. Concerned stakeholders should assess and formulate initiatives and programmes that enrich the physical, psychological

  12. Communications strategy for the Chernobyl Centre

    International Nuclear Information System (INIS)

    Kurilchik, Mykola; Green, Len

    2000-01-01

    This Communications Strategy was developed for the International Chernobyl Centre (ICC) as part of a joint UK/Ukraine project, sponsored by the Department of Trade and Industry and NNC Limited. The Plan was developed during four weeks of workshop discussions in the UK between staff from the centre and experienced PR Professionals from NNC Limited. The requirements for a sustained communications activity at the ICC go much further than simply enhancing or promoting the Centre's scientific and technical activities. Raising sufficient awareness of the Centre among potential funding agents and commercial partners is critical to its future development as a major centre for international co-operation and research. It is only through establishing and developing effective communications that the Centre will become well enough known and understood both within the Ukraine, and internationally, to secure its long term future. However, as the workshop programme unfolded, it also became clear that communications was in itself a legitimate and necessary function of the Centre, and part of the foundations of its existence. The Centre has a fundamental role as an 'information exchange', collecting and communicating information from within the Ukraine to the rest of the world, and interpreting world interest and attitudes to the Ukraine Government and nuclear industry. As such compliments the efforts of individual power plant and corporate PR functions within the Ukraine nuclear energy sector

  13. Les sources de l’histoire du patrimoine cultuel dans la seconde moitié du XXe siècle au Centre national des archives de l’Église de France

    Directory of Open Access Journals (Sweden)

    Bernard Barbiche

    2012-03-01

    Full Text Available Fondé en 1973, installé à Issy-les-Moulineaux, le Centre national des archives de l'Église de France, service de la Conférence des évêques de France, est l'équivalent des Archives nationales pour l'État. Ses fonds datent majoritairement de la seconde moitié du XXe siècle, à quelques exceptions près. Dépôt central des archives de la Conférence épiscopale, le CNAEF reçoit ses archives et celles des comités qui en dépendent, mais aussi des dons divers (archives de mouvements ou de personnalités.Les documents touchant à l'histoire de l'art se trouvent plus particulièrement dans la section CO, répartis essentiellement dans les fonds du Comité national des constructions d'églises, le Comité national d'art sacré et le Centre national de pastorale liturgique. Ces fonds ne sont pas classés mais des répertoires sommaires sont consultables sur place, sachant que les délais de communication des documents varient entre 50 et 70 ans.The Centre national des archives de l’Eglise de France, the national archive centre for the French church, was founded in 1973 and is located today in the Paris suburb of Issy-les-Moulineaux. For the Catholic church in France, it is the equivalent of the national archives. With a few earlier exceptions, most of its holdings date from the second half of the 20th century. It is the central repository for the papers of the Episcopal Conference, and manages the papers of this institution and of the various committees attached to it. It also receives archives and papers by way of gifts from other organisations or personalities. The documents relating to art history are to be found mainly in the CO section, in particular in the papers of the Comité national des constructions d’églises (church building, the Comité national d’art sacré (sacred art and the Centre national de pastorale liturgique (pastoral liturgy. These holdings are not well ordered and certain documents cannot be divulged for 50 or

  14. Fuel cycle centres

    International Nuclear Information System (INIS)

    Hagen, M.

    1977-01-01

    The concept of co-locating and integrating fuel cycle facilities at one site is discussed. This concept offers considerable advantages, especially in minimizing the amount of radioactive material to be transported on public roads. Safeguards and physical protection as relating to such an integrated system of facilities are analysed in detail, also industrial and commercial questions. An overall risk-benefit evaluation turns out to be in favour of fuel cycle centres. These centres seem to be specifically attractive with regard to the back end of the fuel cycle, including on-site disposal of radioactive wastes. The respective German approach is presented as an example. Special emphasis is given to the site selection procedures in this case. Time scale and cost for the implementation of this concept are important factors to be looked at. Since participation of governmental institutions in these centres seems to be indispensable their respective roles as compared to industry must be clearly defined. The idea of adjusting fuel cycle centres to regional rather than national use might be an attractive option, depending on the specific parameters in the region, though results of existing multinational ventures are inconclusive in this respect. Major difficulties might be expected e.g. because of different national safety regulations and standards as well as commercial conditions among partner countries. Public acceptance in the host country seems to be another stumbling block for the realization of this type of multinational facilities

  15. Multiple-camera tracking: UK government requirements

    Science.gov (United States)

    Hosmer, Paul

    2007-10-01

    The Imagery Library for Intelligent Detection Systems (i-LIDS) is the UK government's new standard for Video Based Detection Systems (VBDS). The standard was launched in November 2006 and evaluations against it began in July 2007. With the first four i-LIDS scenarios completed, the Home Office Scientific development Branch (HOSDB) are looking toward the future of intelligent vision in the security surveillance market by adding a fifth scenario to the standard. The fifth i-LIDS scenario will concentrate on the development, testing and evaluation of systems for the tracking of people across multiple cameras. HOSDB and the Centre for the Protection of National Infrastructure (CPNI) identified a requirement to track targets across a network of CCTV cameras using both live and post event imagery. The Detection and Vision Systems group at HOSDB were asked to determine the current state of the market and develop an in-depth Operational Requirement (OR) based on government end user requirements. Using this OR the i-LIDS team will develop a full i-LIDS scenario to aid the machine vision community in its development of multi-camera tracking systems. By defining a requirement for multi-camera tracking and building this into the i-LIDS standard the UK government will provide a widely available tool that developers can use to help them turn theory and conceptual demonstrators into front line application. This paper will briefly describe the i-LIDS project and then detail the work conducted in building the new tracking aspect of the standard.

  16. 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...

  17. What do we know about medical tourism? A review of the literature with discussion of its implications for the UK National Health Service as an example of a public health care system.

    Science.gov (United States)

    Hanefeld, Johanna; Smith, Richard; Horsfall, Daniel; Lunt, Neil

    2014-01-01

    Medical tourism is a growing phenomenon. This review of the literature maps current knowledge and discusses findings with reference to the UK National Health Service (NHS). Databases were systematically searched between September 2011 and March 2012 and 100 papers were selected for review. The literature shows specific types of tourism depending on treatment, eg, dentistry, cosmetic, or fertility. Patient motivation is complex and while further research is needed, factors beyond cost, including availability and distance, are clearly important. The provision of medical tourism varies. Volume of patient travel, economic cost and benefit were established for 13 countries. It highlights contributions not only to recipient countries' economies but also to a possible growth in health systems' inequities. Evidence suggests that UK patients travel abroad to receive treatment, complications arise and are treated by the NHS, indicating costs from medical travel for originating health systems. It demonstrates the importance of quality standards and holds lessons as the UK and other EU countries implement the EU Directive on cross-border care. Lifting the private-patient-cap for NHS hospitals increases potential for growth in inbound medical tourism; yet no research exists on this. Research is required on volume, cost, patient motivation, industry, and on long-term health outcomes in medical tourists. © 2014 International Society of Travel Medicine.

  18. The comparative effectiveness and efficiency of cognitive behaviour therapy and generic counselling in the treatment of depression: evidence from the 2nd UK National Audit of psychological therapies.

    Science.gov (United States)

    Pybis, Jo; Saxon, David; Hill, Andy; Barkham, Michael

    2017-06-09

    Cognitive Behaviour Therapy (CBT) is the front-line psychological intervention for step 3 within UK psychological therapy services. Counselling is recommended only when other interventions have failed and its effectiveness has been questioned. A secondary data analysis was conducted of data collected from 33,243 patients across 103 Improving Access to Psychological Therapies (IAPT) services as part of the second round of the National Audit of Psychological Therapies (NAPT). Initial analysis considered levels of pre-post therapy effect sizes (ESs) and reliable improvement (RI) and reliable and clinically significant improvement (RCSI). Multilevel modelling was used to model predictors of outcome, namely patient pre-post change on PHQ-9 scores at last therapy session. Counselling received more referrals from patients experiencing moderate to severe depression than CBT. For patients scoring above the clinical cut-off on the PHQ-9 at intake, the pre-post ES (95% CI) for CBT was 1.59 (1.58, 1.62) with 46.6% making RCSI criteria and for counselling the pre-post ES was 1.55 (1.52, 1.59) with 44.3% of patients meeting RCSI criteria. Multilevel modelling revealed a significant site effect of 1.8%, while therapy type was not a predictor of outcome. A significant interaction was found between the number of sessions attended and therapy type, with patients attending fewer sessions on average for counselling [M = 7.5 (5.54) sessions and a median (IQR) of 6 (3-10)] than CBT [M = 8.9 (6.34) sessions and a median (IQR) of 7 (4-12)]. Only where patients had 18 or 20 sessions was CBT significantly more effective than counselling, with recovery rates (95% CIs) of 62.2% (57.1, 66.9) and 62.4% (56.5, 68.0) respectively, compared with 44.4% (32.7, 56.6) and 42.6% (30.0, 55.9) for counselling. Counselling was significantly more effective at two sessions with a recovery rate of 34.9% (31.9, 37.9) compared with 22.2% (20.5, 24.0) for CBT. Outcomes for counselling and CBT in the

  19. Theorizing Surveillance in the UK Crime Control Field

    Directory of Open Access Journals (Sweden)

    Michael McCahill

    2015-09-01

    Full Text Available Drawing upon the work of Pierre Bourdieu and Loic Wacquant, this paper argues that the demise of the Keynesian Welfare State (KWS and the rise of neo-liberal economic policies in the UK has placed new surveillance technologies at the centre of a reconfigured “crime control field” (Garland, 2001 designed to control the problem populations created by neo-liberal economic policies (Wacquant, 2009a. The paper also suggests that field theory could be usefully deployed in future research to explore how wider global trends or social forces, such as neo-liberalism or bio-power, are refracted through the crime control field in different national jurisdictions. We conclude by showing how this approach provides a bridge between society-wide analysis and micro-sociology by exploring how the operation of new surveillance technologies is mediated by the “habitus” of surveillance agents working in the crime control field and contested by surveillance subjects.

  20. Current radiography and tomography applications at Necsa and an envisaged upgrade towards a proposed South African national centre for radiography and tomography (SANCRAT)

    International Nuclear Information System (INIS)

    Radebe, M.J.; De Beer, F.C.

    2008-01-01

    An upgrade of the current Radiography and Tomography Research facilities is envisaged to enhance the group's support for Necsa's mission to undertake and support nuclear research and utilize penetrating radiation for the benefit of mankind. It is envisage that the SANCRAT will host neutron-, X-ray- and gamma ray penetrating radiation imaging infrastructures that can be utilized by researchers from industry as well as post graduate students from higher educational institutions. Modelling for the upgrade to a multifunctional neutron radiography and tomography facility has been underway. Upgrade plans and implementation has also begun for a 250 kV X-ray radiography set-up, that will exist independent from the neutron facility. Future expansion entails catering for a micro-focus X-ray -, and gamma ray radiography and tomography facilities. The current facilities available consist of one infrastructure facility based on two sources of penetrating radiation, i.e. SAFARI-1 research nuclear reactor as thermal neutron source and a 100 kV X-ray generator. This facility, which hosts the only operational neutron tomography R and D facility in the Southern Hemisphere and in Africa, are being extensively utilized by post graduate students and industry. The facility sees application in a wide range of scientific and engineering disciplines, amongst which is nuclear, geosciences, palaeontology, civil, mechanical, chemical, etc. This paper focus on case studies engaged at the current radiography and tomography facilities over the past 2 years as well as describing the envisaged upgrade initiatives to a fully equipped national centre. (authors)

  1. Current radiography and tomography applications at Necsa and an envisaged upgrade towards a proposed South African national centre for radiography and tomography (SANCRAT)

    Energy Technology Data Exchange (ETDEWEB)

    Radebe, M.J.; De Beer, F.C. [Necsa - South African Nuclear Energy Corporation Limited, P. O.Box 582, Pretoria, 0001 (South Africa)

    2008-07-01

    An upgrade of the current Radiography and Tomography Research facilities is envisaged to enhance the group's support for Necsa's mission to undertake and support nuclear research and utilize penetrating radiation for the benefit of mankind. It is envisage that the SANCRAT will host neutron-, X-ray- and gamma ray penetrating radiation imaging infrastructures that can be utilized by researchers from industry as well as post graduate students from higher educational institutions. Modelling for the upgrade to a multifunctional neutron radiography and tomography facility has been underway. Upgrade plans and implementation has also begun for a 250 kV X-ray radiography set-up, that will exist independent from the neutron facility. Future expansion entails catering for a micro-focus X-ray -, and gamma ray radiography and tomography facilities. The current facilities available consist of one infrastructure facility based on two sources of penetrating radiation, i.e. SAFARI-1 research nuclear reactor as thermal neutron source and a 100 kV X-ray generator. This facility, which hosts the only operational neutron tomography R and D facility in the Southern Hemisphere and in Africa, are being extensively utilized by post graduate students and industry. The facility sees application in a wide range of scientific and engineering disciplines, amongst which is nuclear, geosciences, palaeontology, civil, mechanical, chemical, etc. This paper focus on case studies engaged at the current radiography and tomography facilities over the past 2 years as well as describing the envisaged upgrade initiatives to a fully equipped national centre. (authors)

  2. The effect of nitisinone on homogentisic acid and tyrosine: a two-year survey of patients attending the National Alkaptonuria Centre, Liverpool.

    Science.gov (United States)

    Milan, Anna M; Hughes, Andrew T; Davison, Andrew S; Devine, Jean; Usher, Jeannette; Curtis, Sarah; Khedr, Milad; Gallagher, James A; Ranganath, Lakshminarayan R

    2017-05-01

    Background Alkaptonuria is a rare, debilitating autosomal recessive disorder affecting tyrosine metabolism. Deficiency of homogentisate 1,2-dioxygenase leads to increased homogentisic acid which is deposited as ochronotic pigment. Clinical sequelae include severe early onset osteoarthritis, increased renal and prostate stone formation and cardiac complications. Treatment has been largely based on analgaesia and arthroplasty. The National Alkaptonuria Centre in Liverpool has been using 2 mg nitisinone (NTBC) off-license for all patients in the United Kingdom with alkaptonuria and monitoring the tyrosine metabolite profiles. Methods Patients with confirmed alkaptonuria are commenced on 2 mg dose (alternative days) of NTBC for three months with daily dose thereafter. Metabolite measurement by LC-MS/MS is performed at baseline, day 4, three-months, six-months and one-year post-commencing NTBC. Thereafter, monitoring and clinical assessments are performed annually. Results Urine homogentisic acid concentration decreased from a mean baseline 20,557 µmol/24 h (95th percentile confidence interval 18,446-22,669 µmol/24 h) by on average 95.4% by six months, 94.8% at one year and 94.1% at two year monitoring. A concurrent reduction in serum homogentisic acid concentration of 83.2% compared to baseline was also measured. Serum tyrosine increased from normal adult reference interval to a mean ± SD of 594 ± 184 µmol /L at year-two monitoring with an increased urinary excretion from 103 ± 81 µmol /24 h at baseline to 1071 ± 726 µmol /24 h two years from therapy. Conclusions The data presented represent the first longitudinal survey of NTBC use in an NHS service setting and demonstrate the sustained effect of NTBC on the tyrosine metabolite profile.

  3. The Role of the Sellafield Ltd Centres of Expertise in Engaging with the Science, Environment and Technology Supply Chain and University Sector to Support Site Operations and Decommissioning in the UK Nuclear Industry - 13018

    Energy Technology Data Exchange (ETDEWEB)

    Butcher, Ed [Uranium and Reactive Metals Centre of Expertise Lead, Technical Directorate, Sellafield Ltd, Sellafield, Seascale, Cumbria CA20 1PG (United Kingdom); Connor, Donna [Technical Capability Manager, Technical Directorate, Sellafield Ltd, Sellafield, Seascale, Cumbria CA20 1PG (United Kingdom); Keighley, Debbie [Head of Profession, Technical Directorate, Sellafield Ltd, Sellafield, Seascale, Cumbria CA20 1PG (United Kingdom)

    2013-07-01

    The development and maintenance of the broad range of the highly technical skills required for safe and successful management of nuclear sites is of vital importance during routine operations, decommissioning and waste treatment activities.. In order to maintain a core team of technical experts, across all of the disciplines required for these tasks, the approach which has been taken by the Sellafield Ltd has been the formation of twenty five Centres of Expertise (CoE), each covering key aspects of the technical skills required for nuclear site operations. Links with the Specialist University Departments: The CoE leads are also responsible for establishing formal links with university departments with specialist skills and facilities relevant to their CoE areas. The objective of these links is to allow these very specialist capabilities within the university sector to be more effectively utilized by the nuclear industry, which benefits both sectors. In addition to the utilization of specialist skills, the university links are providing an important introduction to the nuclear industry for students and researchers. This is designed to develop the pipeline of potential staff, who will be required in the future by both the academic and industrial sectors. (authors)

  4. The Role of the Sellafield Ltd Centres of Expertise in Engaging with the Science, Environment and Technology Supply Chain and University Sector to Support Site Operations and Decommissioning in the UK Nuclear Industry - 13018

    International Nuclear Information System (INIS)

    Butcher, Ed; Connor, Donna; Keighley, Debbie

    2013-01-01

    The development and maintenance of the broad range of the highly technical skills required for safe and successful management of nuclear sites is of vital importance during routine operations, decommissioning and waste treatment activities.. In order to maintain a core team of technical experts, across all of the disciplines required for these tasks, the approach which has been taken by the Sellafield Ltd has been the formation of twenty five Centres of Expertise (CoE), each covering key aspects of the technical skills required for nuclear site operations. Links with the Specialist University Departments: The CoE leads are also responsible for establishing formal links with university departments with specialist skills and facilities relevant to their CoE areas. The objective of these links is to allow these very specialist capabilities within the university sector to be more effectively utilized by the nuclear industry, which benefits both sectors. In addition to the utilization of specialist skills, the university links are providing an important introduction to the nuclear industry for students and researchers. This is designed to develop the pipeline of potential staff, who will be required in the future by both the academic and industrial sectors. (authors)

  5. The Neutron Personal Dosimetry Service of the Centre for Radiation, Chemical and Environmental Hazards, PHE-UK; Servicio de Dosimetría Personal Neutrónica del Centro para Emergencias Radiológicas, Químicas y Medioambientales, PHE-UK

    Energy Technology Data Exchange (ETDEWEB)

    Campo Blanco, X.

    2015-07-01

    The Centre for Radiation, Chemical and Environmental Hazards (CRCEH), that belongs to Public Health England (PHE), hosts the official Neutron Personal Dosimetry Service of the United Kingdom. They use etched-track detectors, made of a material called PADC (poly-allyl diglycol carbonate), to determinate de neutron personal dose. A two weeks visit has been made to this center, in order to learn about the facilities, the methods employed and the legislative framework of the Neutron Personal Dosimetry Service. In this work the main results of this visits are shown, which are interesting for the future development of an official neutron personal dosimetry service in Spain.

  6. Nuclear cardiology in the UK: activity and practice 1997

    International Nuclear Information System (INIS)

    Prvulovich, Elizabeth; Metcalfe, Malcolm J.

    2002-01-01

    A questionnaire was sent to 251 nuclear medicine centres asking for details of nuclear medicine activity, and nuclear cardiology activity and practice in 1997. One hundred and seventy-one (68%) centres replied. Nuclear medicine activity was estimated at 11.8 studies/1,000 population/year, and 9.5% of these studies were within cardiology (1.12 studies/1,000/year). Myocardial perfusion imaging (MPI) studies accounted for 77% and radionuclide ventriculography (RNV) for 22% of all nuclear cardiology. On a national basis this represents activity levels of 0.86 and 0.25 studies/1,000/year for MPI and RNV, respectively. Of the 171 responding centres, 102 (60%) performed MPI studies and 81 (79%) of these reported that activity was increasing. However, MPI activity was unevenly distributed between hospitals. Two centres accounted for 13% of total MPI; others had far lower activity rates, and 51/102 (50%) centres performed less than 200 MPI studies/year. Comparison with previous surveys showed that nuclear medicine activity had almost doubled since 1990 (it was 6.0 studies/1,000 population in 1990, 9.3 studies/1,000 in 1994 and 11.8 studies/1,000 in 1997). Over the same period, nuclear cardiology activity had also risen, the greatest increase being seen for the last 3 years (it was 0.7 studies/1,000 population in 1990, 0.82 studies/1,000 in 1994 and 1.12 studies/1,000 in 1997). Despite these encouraging figures, MPI activity for 1997 remained well below that recommended by the British Cardiac Society in 1994 (2.6 studies/1,000/year) as adequate to serve the needs of patients with cardiac disease in the UK; it was also below the European average activity for the same year (2.2 studies/1,000/year). The anticipated increased workload for nuclear cardiology is encouraging despite the wide and varied practice of nuclear cardiology around the UK. The nuclear medicine community now needs to address the issues that will prevent it keeping up with demand, such as restricted camera

  7. 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

  8. The Aube centre; Le Centre de l`Aube

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    This educational booklet is devoted to a general presentation of the Aube radioactive wastes storage centre. After a short presentation of the Andra, the French national agency for the management of radioactive wastes, it gives some general information about radioactive wastes (origin, classification), containers (quality assurance and different types), wastes transportation (planning, safety), and about the Aube centre itself: description, treatment and conditioning of drums (compacting and injection), storage facilities, geological situation of the site, and environmental controls. (J.S.)

  9. Alcohol education and training in pre-registration nursing: a national survey to determine curriculum content in the United Kingdom (UK).

    Science.gov (United States)

    Holloway, Aisha S; Webster, Brian J

    2013-09-01

    Alcohol-related harm impacts significantly on the health of the population. Nurses are often among the first health professionals that many patients with alcohol-related problems come into contact with and have been identified as playing a key role but may be ill-prepared to respond. Future nurses need to have the skills, knowledge and clinical confidence to respond to patients suffering from alcohol-related harm. A pre-registration curriculum that ensures a nursing workforce fit for practice in responding to alcohol-related harm is necessary. To determine the level of alcohol education and training content in the pre-registration curriculum for nursing in the United Kingdom (UK). To establish whether there are variations in the pre-registration curriculum content across the UK. A descriptive study. All 68 UK Higher Education Institutions offering a total of 111 pre-registration courses for nurses were invited to participate in the study. Twenty nine completed questionnaires were returned, a response rate of 26%. The largest number of identified responders were from England (n=15), with 3 from Scotland and 1 each from Wales and Northern Ireland. Nine Universities chose not to identify themselves. An online semi-structured questionnaire survey was used to collect the study data. Teaching of alcohol and alcohol related harm was mainly delivered during the second year of a pre-registration nursing programme provided mainly to adult and mental health students. Overall, the majority of alcohol related content that is provided within the responding pre-registration nursing courses relates to biophysiology, aetiology, and pharmacological and non-pharmacological interventions. This study highlights the need for a greater and more relevant focus of alcohol education to pre-registration nursing students of all fields of practice incorporating an integrated approach across all years of study. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Evaluation of the status of canine hydrotherapy in the UK.

    Science.gov (United States)

    Waining, M; Young, I S; Williams, S B

    2011-04-16

    To establish the current status of canine hydrotherapy in the UK and to ascertain information regarding the current use of hydrotherapy, a questionnaire was sent to 152 hydrotherapy centres throughout the UK, from which 89 responded. Hydrotherapy was found to be a rapidly growing business. Stand-alone centres were in existence; however, many centres were connected to other businesses, including boarding kennels and general practice veterinary surgeries. The dogs using the facility were mainly pedigree breeds, particularly labrador retrievers (30 per cent), and the most commonly encountered conditions were rupture of the cranial cruciate ligament (25 per cent), hip dysplasia (24 per cent) and osteoarthritis (18 per cent). The proportion of qualified versus unqualified staff varied between centres, highlighting a need for improved regulation of this aspect of the industry. However, all the dogs treated by the hydrotherapy centres surveyed were direct veterinary referrals, suggesting a good degree of professionalism in the field and a high regard for the benefits of hydrotherapy.

  11. Interventions that improve maternity care for immigrant women in the UK: protocol for a narrative synthesis systematic review.

    Science.gov (United States)

    Higginbottom, Gina Marie Awoko; Evans, Catrin; Morgan, Myfanwy; Bharj, Kuldip Kaur; Eldridge, Jeanette; Hussain, Basharat

    2017-07-12

    A quarter of all births in the UK are to mothers born outside the UK. There is also evidence that immigrant women have higher maternal and infant death rates and of inequalities in the provision and uptake of maternity services/birth centres. The topic is of great significance to the National Health Service because of directives that address inequalities and the changing patterns of migration to the UK. Our main question for the systematic review is 'what interventions exist that are specifically focused on improving maternity care for immigrant women in the UK?' The primary objective of this synthesis is to generate new interpretations of research evidence. Second, the synthesis will provide substantive base to guide developments and implementation of maternity services/birth centres which are acceptable and effective for immigrant women in the UK. We are using a narrative synthesis (NS) approach to identify, assess scientific quality and rigour, and synthesise empirical data focused on access and interventions that enhance quality of maternity care/birth centres for the UK immigrant women. The inclusion criteria include: publication date 1990 to present, English language, empirical research and findings are focused on women who live in the UK, participants of the study are immigrant women, is related to maternity care/birth centres access or interventions or experiences of maternity.In order to ensure the robustness of the NS, the methodological quality of key evidence will be appraised using the Center for Evidence-Based Management tools and review confidence with CERQual (Confidence in the Evidence from Reviews of Qualitative Research). Two reviewers will independently screen studies and extract relevant evidence. We will synthesise evidence studying relationships between included studies using a range of tools. Dissemination plan includes: an e-workshop for policymakers, collaborative practitioner workshops, YouTube video and APP, scientific papers and

  12. Research from therapeutic radiographers: An audit of research capacity within the UK

    International Nuclear Information System (INIS)

    Probst, H.; Harris, R.; McNair, H.A.; Baker, A.; Miles, E.A.; Beardmore, C.

    2015-01-01

    Research from Allied Health Professionals (AHPs) is anecdotally known to lag behind that of other professions. The developing research landscape within other therapies and internationally led us to question how UK practice in therapeutic radiography was developing. The aim of the survey was to audit research capacity across therapy radiography in the UK. Method: An electronic survey was sent to Radiotherapy Service Managers (RSM) and research leads in each of the radiotherapy centres in the UK. An adapted version of the ‘Auditing Research Capacity’ tool (ARC © tool) was used as the basis of the questionnaire. Results: A total of 45 RSM responded to the survey (67% response rate) and 30 Research radiographers (RR) (45% response rate). A total of 51 RR were in post equating to 40.3 whole time equivalents and averaging 1 RR per centre. Variation was evident in the commitment to the development of a research culture identified by practices such as linking research to the business planning cycle, inclusion of research in recruitment and advertising materials, or having a nominated therapeutic radiographer lead on research for the department. Over a third of responding centres did not have a research strategy and training for RRs was limited; specifically in areas such as writing funding bids, writing for publication and the research and governance process. Conclusion: A number of short and long-term strategies are proposed that should enhance a positive research culture and improve research capacity for therapeutic radiography led research. These include utilisation of the existing infrastructure provided by the National Institute for Health Research, a lead or co-ordinator for research activity with a remit to motivate others. Development of links and networks, and the development of a research strategy linked to wider Trust research priorities. The research strategy should include mentoring or developing appropriate research skills for those engaged in research

  13. Text of the agreement between the International Atomic Energy Agency and the United Nations Educational, Scientific and Cultural Organization concerning the joint operation of the International Centre for Theoretical Physics at Trieste

    International Nuclear Information System (INIS)

    1996-02-01

    The text of the Agreement between the International Atomic Energy Agency and the United Nations Educational, Scientific and Cultural Organization concerning the Joint Operation of the International Centre for Theoretical Physics at Trieste is reproduced in this document for the information of all Members. The Agreement was approved by the Agency's Board of Governors on 25 February 1993 and by the UNESCO General Conference on 16 November 1993

  14. Text of the agreement between the International Atomic Energy Agency, the United Nations Educational, Scientific and Cultural Organization and the Government of the Republic of Italy concerning the International Centre for Theoretical Physics at Trieste

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-02-01

    The text of the Agreement between the International Atomic Energy Agency, the United Nations Educational, Scientific and Cultural Organization and the Government of the Republic of Italy concerning the International Centre for Theoretical Physics at Trieste is reproduced in this document for the information of all Members. The Agreement was approved by the Agency`s Board of Governors on 25 February 1993, by the UNESCO General Conference on 16 November 1993, and ratified by the Italian Parliament on 2 January 1995.

  15. Text of the agreement between the International Atomic Energy Agency, the United Nations Educational, Scientific and Cultural Organization and the Government of the Republic of Italy concerning the International Centre for Theoretical Physics at Trieste

    International Nuclear Information System (INIS)

    1996-02-01

    The text of the Agreement between the International Atomic Energy Agency, the United Nations Educational, Scientific and Cultural Organization and the Government of the Republic of Italy concerning the International Centre for Theoretical Physics at Trieste is reproduced in this document for the information of all Members. The Agreement was approved by the Agency's Board of Governors on 25 February 1993, by the UNESCO General Conference on 16 November 1993, and ratified by the Italian Parliament on 2 January 1995

  16. Factors determining UK album success

    OpenAIRE

    Elliott, Caroline; Simmons, Robert

    2011-01-01

    This article uses a recently compiled dataset on the UK album sales to determine which factors contribute to best-selling album sales success. We control for factors including length of time since release, nationality of artist, artist type and album type, testing the increasing returns to information hypothesis. Information on general public online review scores for the albums in the dataset allows for a strong test of the accuracy of online reviews in predicting music sales, as online revie...

  17. International research centre launched

    International Nuclear Information System (INIS)

    1965-01-01

    ), and (secretary) Prof. A. Sanielevici (IAEA). Prof. Salam is Director of the research centre, and Prof. Budini Deputy Director. Establishment of the Centre was first proposed in 1960, and after plans had been worked out, the IAEA Board of Governors approved the programme in June 1963. The Italian Government has lent its support and co-operation ; it is providing a building for the needs of the Centre, and staff housing, and is supplying staff services and $28,000 a year for fellowships as well as an annual contribution of $250,000 for five years. The IAEA Budget for 1965 includes a similar amount of $278,000 for the Centre. The Centre plans to work in close collaboration with the European Organisation for Nuclear Research (CERN); the United Nations Educational, Cultural and Scientific Organisation is also a party to the Centre and is making contributions

  18. The pattern of substance use disorder in the United Arab Emirates in 2015: results of a National Rehabilitation Centre cohort study.

    Science.gov (United States)

    Alblooshi, Hiba; Hulse, Gary K; El Kashef, Ahmed; Al Hashmi, Hanan; Shawky, Mansour; Al Ghaferi, Hamad; Al Safar, Habiba; Tay, Guan K

    2016-05-13

    Substance use disorder (SUD) is a global problem with no boundaries, which also afflicts individuals from countries of the Arabian Peninsula. Data from this region is limited. In an effort to develop targeted prevention and intervention initiatives in the United Arab Emirates (UAE), it was necessary to identify the nature of substance use by describing the characteristics of those using different substances. Consequently, this study in the UAE was conceived to describe the pattern of SUD in a first-ever cohort that was systematically recruited from the country's National Rehabilitation Centre (NRC) in Abu Dhabi. Two hundred and fifty male patients were recruited from the NRC. Information on substance use was collected using a questionnaire that was completed at an interview with patients who consented to participate. The questionnaire was based on information that the study was designed to capture. It was reviewed by members of institutional ethics committees and approved prior to use. Two hundred and fifty male subjects from the Emirates Family Registry (EFR) were used as a comparison group. In the cohort studied, SUD correlated with smoking and marital status. Poly-substance users formed the majority of the cohort (84.4 %) with various combinations of substances identified across different age groups. Opioid and alcohol were the most common substances used. The use of pharmaceutical opioids, primarily Tramadol (67.2 % of opioid users), was higher among the youngest age group studied (<30 years old), while older opioid users (≥30 years old) commonly used illicit opioids (Heroin). The use of prescribed medication for non-medical use also included Pregabalin (mean of 8.3 capsules ± 0.5 per day), Procyclidin (6.1 tablets + 0.6 per day) and Carisoprodol (4.2 tablets ± 0.4 per day) and was again highest in the age group below 30 years. This 2015 study highlights the importance of examining the pattern of poly-substance use in a population in order

  19. Impact of 68Ga-DOTA-Peptide PET/CT on the Management of Gastrointestinal Neuroendocrine Tumour (GI-NET): Malaysian National Referral Centre Experience.

    Science.gov (United States)

    Tan, Teik Hin; Boey, Ching Yeen; Lee, Boon Nang

    2018-04-01

    The National Cancer Institute is the only referral centre in Malaysia that provides 68 Ga-DOTA-peptide imaging. The purpose of this study is to determine the impact of 68 Ga-DOTA-peptide PET/CT on the management of gastrointestinal neuroendocrine tumours (GI-NET). A cross-sectional study was performed to review the impact of 68 Ga-DOTA-peptide ( 68 Ga-DOTATATE or 68 Ga-DOTATOC) PET/CT on patients with biopsy-proven GI-NET between January 2011 and December 2015. Suspected NET was excluded. Demographic data, tumoral characteristics, change of disease stage, pre-PET intended management and post-PET management were evaluated. Over a 5-year period, 82 studies of 68 Ga-DOTA-peptide PET/CT were performed on 44 GI-NET patients. The most common primary site was the rectum (50.0%) followed by the small bowel, stomach and colon. Using WHO 2010 grading, 40.9% of patients had low-grade (G1) tumour, 22.7% intermediate (G2) and 4.5% high (G3). Of ten patients scheduled for pre-operative staging, 68 Ga-DOTA-peptide PET/CT only led to therapeutic change in three patients. Furthermore, false-negative results of 68 Ga-DOTA-peptide PET/CT were reported in one patient after surgical confirmation. However, therapeutic changes were seen in 20/36 patients (55.6%) scheduled for post-surgical restaging or assessment of somatostatin analogue (SSA) eligibility. When 68 Ga-DOTA-peptide PET/CT was used for monitoring disease progress during systemic treatment (sandostatin, chemotherapy, everolimus and PRRT) in metastatic disease, impact on management modification was seen in 19/36 patients (52.8%), of which 84.2% had inter-modality change (switch to everolimus, chemotherapy or PRRT) and 15.8% had intra-modality change (increased SSA dosage). 68 Ga-DOTA-peptide PET/CT has a significant impact on management decisions in GI-NET patients as it can provide additional information on occult metastasis/equivocal lesions and supply the clinician an opportunity to select patients for targeted therapy.

  20. The impact of distance and duration of travel on participation rates and participants' satisfaction: results from a pilot study at one study centre in Pretest 2 of the German National Cohort.

    Science.gov (United States)

    Schweitzer, Aparna; Akmatov, Manas K; Kindler, Florentina; Kemmling, Yvonne; Kreienbrock, Lothar; Krause, Gérard; Pessler, Frank

    2015-08-21

    In this pilot study within the Pretest 2 phase of the German National Cohort, we aimed to (1) test the hypothesis that distance and duration of travel to a study centre may affect participation rates and participants' satisfaction and (2) to obtain data that would help to select recruitment areas around the study centre Hannover with the greatest projected participation rate for the main study. Mixed urban/suburban environment in Northern Germany with approximately 600,000 inhabitants. 4 recruitment areas with divergent estimated mean distances (range, 7-40 km) and duration of travel to the study centre Hannover were selected. 1050 men and women (ratio, 1:1), aged 20-69 years, were randomly selected from the population registries of the 4 recruitment areas and invited by mail to participate in the Pretest 2 study programme at the study centre Hannover, covering a variety of questionnaire-based and physical assessments. 166 individuals participated (16%). All 166 participants completed a travel questionnaire containing 5 items relating to travel duration and satisfaction, amounting to a participation rate of 100% in the questionnaire-based part of the study. Participation rates in the Pretest 2 programme at the study centre Hannover by area ranged from 11% (area farthest from the study centre, estimated median distance 38 km) to 18% (nearest area, 2 km). The odds of non-participation were highest in the area farthest from the study centre (adjusted OR 2.06; p=0.01; CI 1.28 to 3.32). Nonetheless, 97% of participants were satisfied with travel duration. Increasing distance was associated with a lower participation rate. However, acceptance of duration of travel was high, irrespective of distance or duration. Thus, recruiting in farther away locations may select individuals with a greater frustration tolerance for travel to the study centre, perhaps due to a greater interest in participating in health-oriented studies and thus different health-related behaviour

  1. National Nuclear Research Institute Annual Report 2013

    International Nuclear Information System (INIS)

    2014-01-01

    The report highlights the activities of the National Nuclear Research Institute (NNRI) of the Ghana Atomic Energy Commission for the year 2013, grouped under the following headings: Centres under the institute namely Nuclear Reactors Research Centre (NRRC); Accelerator Research Centre (ARC); Engineering Services Centre (ESC); National Radioactive Waste Management Centre (NRWMC); Nuclear Chemistry and Environmental Research Centre (NCERC); Nuclear Applications Centre (NAC) and National Data Centre (NDC). (A. B.)

  2. Impacts of erosion and restoration on POC flux and pollutant mobilisation in the peatlands of the Peak District National Park, UK

    Science.gov (United States)

    Shuttleworth, E. L.; Evans, M. G.; Rothwell, J. J.; Hutchinson, S. M.

    2012-04-01

    Peatlands represent major carbon stores. However, much of the UK's blanket peat is significantly degraded and actively eroding which significantly impacts carbon storage through the physical export of particulate organic carbon (POC). The stability of peatlands is therefore important for the preservation this carbon store and the restoration of the eroded peat of the Peak District, southern Pennines, UK has been a major conservation concern for several decades. The near-surface layer of these blanket peats is severely contaminated with high concentrations of atmospherically deposited lead - a legacy of Britain's Industrial Revolution. Recently there has been growing interest in the mobilisation of this heavy metal which has been shown to be associated with POC. However, little is known about the source and quality of sediment still entering the fluvial system in revegetated catchments. Understanding the physical process dynamics relating to revegetation and sediment flux is required in order to assess the efficacy of peatland restoration operations in reducing POC and lead release. Three sites have been studied in the Bleaklow area of the Peak District; each representing different surface conditions: (i) actively eroding, (ii) recently revegetated and, (iii) intact. The contaminated nature of the near surface peat distinguishes POC mobilised from the peat surface from that eroded from gully walls. This has allowed a fingerprinting approach to be adopted as a means of characterising and identifying the sources of sediment entering the fluvial system. A survey of surface lead concentrations at each site was conducted and other catchment sources were identified and their relative contribution to the suspended load assessed. POC fluxes are greatly reduced following restoration to levels comparable to intact sites. Lead flux is also significantly reduced but surface condition makes little difference to the quality of the sediment, i.e. the concentration of lead

  3. Assessing the impact of national level interventions on workplace respiratory disease in the UK: part 2--regulatory activity by the Health and Safety Executive.

    Science.gov (United States)

    Stocks, S J; McNamee, R; Turner, S; Carder, M; Agius, R M

    2013-07-01

    To investigate whether interventions implemented by the UK Health and Safety Executive addressing exposure to isocyanate-based spray paints in motor vehicle repair (MVR), flour dust in craft bakeries, rosin-based solder flux fume (RBSFF) in the electronics industry, metalworking fluids and wood dust coincided with a decline in incidence of work-related short latency respiratory disease (SLRD) or asthma in the target groups. Changes in the incidence of SLRD reported to a UK-based surveillance scheme were compared using a longitudinal, negative binomial regression model with β distributed random effects. An interrupted time series design was used and comparisons according to inclusion or exclusion in the target group were made by including a statistical interactions expressed as a ratio of incidence rate ratios (RIRRs) in the model. The incidence of SLRD attributed to flour dust significantly increased relative to all other agents (RIRR: 1.10; 95% CI 1.06 to 1.16) whereas SLRD attributed to RBSFF significantly declined relative to all other agents (0.94; 0.90 to 0.99). No significant changes in the incidence of SLRD attributed to wood dust (1.03; 0.91 to 1.16) or spray paints (1.03; 0.95 to 1.11) relative to all other agents were observed. A higher proportion of reports originated from the industries targeted by the intervention for RBSFF (65/107; 61%) than spray painting (27/93; 27%) or wood dust (16/42; 38%). These data support a beneficial effect of interventions to reduce exposure to RBSFF but an increase in SLRD attributed to flour dust may indicate increased exposure or increased awareness of the problem.

  4. Demographics and macroeconomic effects in aesthetic surgery in the UK.

    Science.gov (United States)

    Duncan, C O; Ho-Asjoe, M; Hittinger, R; Nishikawa, H; Waterhouse, N; Coghlan, B; Jones, B

    2004-09-01

    Media interest in aesthetic surgery is substantial and suggestions of demographic changes such as reductions in age or an increase in the number of male patients are common. In spite of this, there is no peer reviewed literature reporting demographics of a contemporary large patient cohort or of the effect of macroeconomic indicators on aesthetic surgery in the UK. In this study, computer records 13006 patients presenting between 1998 and the first quarter of 2003 at a significant aesthetic surgery centre were analysed for procedures undergone, patient age and sex. Male to female ratios for each procedure were calculated and a comparison was made between unit activity and macroeconomic indicators. The results showed that there has been no significant demographic change in the procedures studied with patient age and male to female ratio remaining constant throughout the period studied for each procedure. Comparison with macroeconomic indicators suggested increasing demand for aesthetic surgery in spite of a global recession. In conclusion, media reports of large scale demographic shifts in aesthetic surgery patients are exaggerated. The stability of unit activity in spite of falling national economic indicators suggested that some units in the UK might be relatively immune to economic vagaries. The implications for training are discussed.

  5. 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.

  6. Nuclear physics in the UK

    International Nuclear Information System (INIS)

    1994-12-01

    Nuclear physics is the study of the heavy but tiny nucleus that lies at the centre of all atoms and makes up 99.9 per cent by weight of everything we see. There are many applications of nuclear physics including direct contributions to medicine and industry, such as the use of radioactive isotopes as diagnostic tracers, or of beams of nuclei for tailoring the properties of semiconductors. More indirectly, ideas and concepts of nuclear physics have influence in many corners of modern science and technology. Physicists in the UK have a long tradition in nuclear physics, and have developed a world-wide reputation for the excellence of their work. This booklet explains more about this rich field of study, its applications, its role in training, and its future directions. (author)

  7. Introduction of a National Minimum Wage Reduced Depressive Symptoms in Low-Wage Workers: A Quasi-Natural Experiment in the UK.

    Science.gov (United States)

    Reeves, Aaron; McKee, Martin; Mackenbach, Johan; Whitehead, Margaret; Stuckler, David

    2017-05-01

    Does increasing incomes improve health? In 1999, the UK government implemented minimum wage legislation, increasing hourly wages to at least £3.60. This policy experiment created intervention and control groups that can be used to assess the effects of increasing wages on health. Longitudinal data were taken from the British Household Panel Survey. We compared the health effects of higher wages on recipients of the minimum wage with otherwise similar persons who were likely unaffected because (1) their wages were between 100 and 110% of the eligibility threshold or (2) their firms did not increase wages to meet the threshold. We assessed the probability of mental ill health using the 12-item General Health Questionnaire. We also assessed changes in smoking, blood pressure, as well as hearing ability (control condition). The intervention group, whose wages rose above the minimum wage, experienced lower probability of mental ill health compared with both control group 1 and control group 2. This improvement represents 0.37 of a standard deviation, comparable with the effect of antidepressants (0.39 of a standard deviation) on depressive symptoms. The intervention group experienced no change in blood pressure, hearing ability, or smoking. Increasing wages significantly improves mental health by reducing financial strain in low-wage workers. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

  8. The relationship between general practice characteristics and quality of care: a national survey of quality indicators used in the UK Quality and Outcomes Framework, 2004–5

    Directory of Open Access Journals (Sweden)

    Armstrong David

    2006-11-01

    Full Text Available Abstract Background The descriptive information now available for primary care in the UK is unique in international terms. Under the 'Quality and Outcomes Framework' (QOF, data for 147 performance indicators are available for each general practice. We aimed to determine the relationship between the quality of primary care, as judged by the total QOF score, social deprivation and practice characteristics. Methods We obtained QOF data for each practice in England and linked these with census derived data (deprivation indices and proportion of patients born in a developing country. Characteristics of practices were also obtained. QOF and census data were available for 8480 practices. Results The median QOF score was 999.7 out of a possible maximum of 1050 points. Three characteristics were independently associated with higher QOF scores: training practices, group practices and practices in less socially deprived areas. In a regression model, these three factors explained 14.6% of the variation in QOF score. Higher list sizes per GP, turnover of registered patients, chronic disease prevalence, proportions of elderly patients or patients born in a developing country did not contribute to lower QOF scores in the final model. Conclusion Socially deprived areas experience a lower quality of primary care, as judged by QOF scores. Social deprivation itself is an independent predictor of lower quality. Training and group practices are independent predictors of higher quality but these types of practices are less well represented in socially deprived areas.

  9. Current UK dental sedation practice and the 'National Institute for Health and Care Excellence' (NICE) guideline 112: sedation in children and young people.

    Science.gov (United States)

    Coulthard, P; Craig, D; Holden, C; Robb, N D; Sury, M; Chopra, S; Holroyd, I

    2015-04-24

    Describe current dental sedation practice for under 19-year-olds in the UK and compare it with the recommendations of NICE guidance 112. Members of the Society for the Advancement of Anaesthesia in Dentistry and members of the Dental Sedation Teachers Group were invited to participate in an online survey. Two hundred and sixty-six dentists and doctors completed the survey. Eighty-two percent were operator and sedationist (operator-sedationist). Ninety-five percent provided written information and 94% obtained written consent. Eighty-four percent kept a written or electronic sedation record. Eighty-six percent complied with life support training expectations. Eighty-six percent had immediate access to resuscitation equipment. Sixty-seven percent of sedationists reported that treatment could not be completed under sedation for sedation was unsuccessful, 61% said they would schedule general anaesthesia and 54.5% would schedule advanced sedation care. Forty-nine percent believed that a dentist was an appropriate person to provide advanced sedation for 12-18 years. Only 24% thought a dentist should provide advanced sedation for childrensedation was thought to be primary care by 33% and secondary care by 68%. We found good agreement between the current practice of sedation and the recommendations of the NICE guidance 112.

  10. 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)

  11. Discussion on 'Centres of excellence' in Africa

    International Nuclear Information System (INIS)

    Riad, S.

    1999-01-01

    In Africa, Centres of Excellence should be oriented to build up scientific and technological capacity in the four topics of international Monitoring System related technologies, namely, seismic monitoring, hydro acoustic monitoring, infrasound monitoring and radionuclides monitoring. Training programs on these topics should be a major objective. A network of such centres should be established in a number of African countries. Centres should be equipped with means and materials for on-line course dispatch to interested training centres or research institutions. African centres should develop strong relationship among themselves through information and data exchange and sharing, harmonization of training programs. National data centres may be established as a component of the African Centre of Excellence. States Signatories may authorize the establishment of a specific fund to support the activities of the African center

  12. 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.

  13. Are Retail Outlets Complying with National Legislation to Protect Children from Exposure to Tobacco Displays at Point of Sale? Results from the First Compliance Study in the UK.

    Directory of Open Access Journals (Sweden)

    Douglas Eadie

    Full Text Available From April 6th 2015, all small shops in the UK were required to cover up tobacco products at point of sale (POS to protect children from exposure. As part of a larger 5-year study to measure the impact of the legislation in Scotland, an audit was conducted to assess level and nature of compliance with the ban immediately following its introduction.A discreet observational audit was conducted 7-14 days post implementation which took measures of physical changes made to cover products, server/assistant practices, tobacco signage and advertising, and communication of price information. The audit was conducted in all small retail outlets (n = 83 selling tobacco in four communities in Scotland selected to represent different levels of urbanisation and social deprivation. Data were analysed descriptively.Compliance with the legislation was high, with 98% of shops removing tobacco from permanent display and non-compliance was restricted almost entirely to minor contraventions. The refurbishment of shops with new or adapted tobacco storage units resulted in the removal of nearly all commercial brand messages and images from POS, dropping from 51% to 4%. The majority of shops stored their tobacco in public-facing storage units (81%. Most shops also displayed at least one generic tobacco message (88%.Compliance with Scottish prohibitions on display of tobacco products in small retail outlets was high immediately after the legislation implementation date. However, although tobacco branding is no longer visible in retail outlets, tobacco storage units with generic tobacco messages are still prominent. This points towards a need to monitor how the space vacated by tobacco products is utilised and to better understand how the continuing presence of tobacco storage units influences people's awareness and understanding of tobacco and smoking. Countries with existing POS bans and who are considering such bans should pay particular attention to regulations

  14. Identifying current training provision and future training needs in allergy available for UK general practice trainees: national cross-sectional survey of General Practitioner Specialist Training programme directors.

    Science.gov (United States)

    Ellis, Jayne; Rafi, Imran; Smith, Helen; Sheikh, Aziz

    2013-03-01

    There are ongoing concerns about the quality of care provision for allergy in primary care. To identify current training provision in allergy to GP trainees and to understand how this could be enhanced. A cross-sectional survey of GP Speciality Training (GPST) programme directors was undertaken. Programme directors of the 174 GPST schemes were sent an online questionnaire which was informed by the content of the Royal College of General Practitioners curriculum. Quantitative data were descriptively analysed and a thematic analysis was undertaken of free text responses. We obtained responses from 146 directors representing 106 training programmes. Responses indicated that two-thirds (62%, 95% CI 53.1 to 71.5) of programmes were providing at least some allergy training, with the remaining third stating that they either provided no training or were unsure. Overall, one-third (33%, 95% CI 22.7 to 42.2) of programme directors believed that all the relevant allergy-related curriculum requirements were being met. Where provided, this training was believed to be best for organ-specific allergic disorders but was thought to be poorer for systemic allergic disorders, particularly food allergy where 67% (95% CI 57.5 to 76.5) of respondents indicated that training was poor. There was considerable interest in increasing the allergy training provided, preferably through eLearning modules and problem-based learning materials supported by those with relevant specialist knowledge. This UK-wide survey has identified important gaps in the training of GP trainees in relation to allergy care. Addressing these gaps, particularly in the management of systemic allergic disorders, should help to improve delivery of primary care-based allergy care.

  15. Are Retail Outlets Complying with National Legislation to Protect Children from Exposure to Tobacco Displays at Point of Sale? Results from the First Compliance Study in the UK.

    Science.gov (United States)

    Eadie, Douglas; Stead, Martine; MacKintosh, Anne Marie; Murray, Susan; Best, Catherine; Pearce, Jamie; Tisch, Catherine; van der Sluijs, Winfried; Amos, Amanda; MacGregor, Andy; Haw, Sally

    2016-01-01

    From April 6th 2015, all small shops in the UK were required to cover up tobacco products at point of sale (POS) to protect children from exposure. As part of a larger 5-year study to measure the impact of the legislation in Scotland, an audit was conducted to assess level and nature of compliance with the ban immediately following its introduction. A discreet observational audit was conducted 7-14 days post implementation which took measures of physical changes made to cover products, server/assistant practices, tobacco signage and advertising, and communication of price information. The audit was conducted in all small retail outlets (n = 83) selling tobacco in four communities in Scotland selected to represent different levels of urbanisation and social deprivation. Data were analysed descriptively. Compliance with the legislation was high, with 98% of shops removing tobacco from permanent display and non-compliance was restricted almost entirely to minor contraventions. The refurbishment of shops with new or adapted tobacco storage units resulted in the removal of nearly all commercial brand messages and images from POS, dropping from 51% to 4%. The majority of shops stored their tobacco in public-facing storage units (81%). Most shops also displayed at least one generic tobacco message (88%). Compliance with Scottish prohibitions on display of tobacco products in small retail outlets was high immediately after the legislation implementation date. However, although tobacco branding is no longer visible in retail outlets, tobacco storage units with generic tobacco messages are still prominent. This points towards a need to monitor how the space vacated by tobacco products is utilised and to better understand how the continuing presence of tobacco storage units influences people's awareness and understanding of tobacco and smoking. Countries with existing POS bans and who are considering such bans should pay particular attention to regulations regarding the use

  16. Patient factors influencing the prescribing of lipid lowering drugs for primary prevention of cardiovascular disease in UK general practice: a national retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Jianhua Wu

    Full Text Available Guidelines indicate eligibility for lipid lowering drugs, but it is not known to what extent GPs' follow guidelines in routine clinical practice or whether additional clinical factors systematically influence their prescribing decisions.A retrospective cohort analysis was undertaken using electronic primary care records from 421 UK general practices. At baseline (May 2008 patients were aged 30 to 74 years, free from cardiovascular disease and not taking lipid lowering drugs. The outcome was prescription of a lipid lowering drug within the next two years. The proportions of eligible and ineligible patients prescribed lipid lowering drugs were reported and multivariable logistic regression models were used to investigate associations between age, sex, cardiovascular risk factors and prescribing.Of 365,718 patients with complete data, 13.8% (50,558 were prescribed lipid lowering drugs: 28.5% (21,101/74,137 of those eligible and 10.1% (29,457/291,581 of those ineligible. Only 41.7% (21,101/50,558 of those prescribed lipid lowering drugs were eligible. In multivariable analysis prescribing was most strongly associated with increasing age (OR for age ≥ 65 years 4.21; 95% CI 4.05-4.39; diabetes (OR 4.49; 95% CI 4.35-4.64; total cholesterol level ≥ 7 mmol/L (OR 2.20; 95% CI 2.12-2.29; and ≥ 4 blood pressure measurements in the past year (OR 4.24; 95% CI 4.06-4.42. The predictors were similar in eligible and ineligible patients.Most lipid lowering drugs for primary prevention are prescribed to ineligible patients. There is underuse of lipid lowering drugs in eligible patients.

  17. 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)

  18. Imperial College Reactor Centre annual report. 1984

    International Nuclear Information System (INIS)

    1985-01-01

    The following new equipment is noted; for atomic absorption spectrometry to supplement the neutron activation analysis, and an additional nuclear data analysis system to improve the quality and speed of the service to users of the Centre's facilities. Users include undergraduates from the University of London, outside bodies such as the British Musueum, as well as departments of Colleges of the University of London. The reactor lost only three days through failures or faults. Two replacement fuel elements were put into the reactor during the year. The report contains brief accounts of 34 research programmes at the Centre. (U.K.)

  19. Pickering education centre aids nuclear acceptance

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Activities at the new education centre at Pickering are described. The opening of the Nuclear Communications Centre, in 1978, resulting from a search for an effective means of maintaining public acceptance of Ontario Hydro's extensive nuclear power programme. Activities include participation in the interactive computer games, guided tours of educational exhibits including a model of Pickering A generating station, and displays depicting the Candu fuel cycle, outdoor exhibits of renewable energy sources, and tours of the plant. Outside activities include lectures to schools and citizen, business, or professional groups. (U.K.)

  20. 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.

  1. Multislice computed tomographic coronary angiography: experience in a UK centre

    International Nuclear Information System (INIS)

    Morgan-Hughes, G.J.; Marshall, A.J.; Roobottom, C.A.

    2003-01-01

    AIM: To evaluate the technique of coronary angiography with retrospectively electrocardiogram (ECG)-gated four-slice helical computed tomography (CT). MATERIALS AND METHODS: Within 1 month of undergoing routine day-case diagnostic coronary angiography, 30 consecutive patients also underwent retrospectively ECG-gated multislice CT coronary angiography. This enabled direct comparison of seven segments of proximal and mid-coronary artery for each patient by two blinded assessors. Each segment of coronary artery from the multislice CT image was evaluated initially for 'assessability' and those segments deemed assessable were subsequently investigated for the presence or absence of a significantly (n=70%) stenotic lesion. RESULTS: Overall 68% of proximal and mid-coronary artery segments were assessable. The sensitivity and specificity of four-slice CT coronary angiography in assessable segments for detecting the presence or absence (n=70%) of stenoses were 72 and 86%, respectively. These results correspond to a positive predictive value of 53% and a 93% negative predictive value. If the 32% of non-assessable segments are added into the calculation then the sensitivity and specificity fall to 49 and 66%, respectively. CONCLUSION: Although multislice CT coronary angiography is a promising technique, the overall assessability and diagnostic accuracy of four-slice CT acquisition is not sufficient to justify routine clinical use. Further, evaluation should investigate the benefit of the reduction in temporal and spatial resolution offered by 16 and 32 slice acquisition

  2. Presentation of the CEA's crisis national organization: coordination centre in case of crisis, crisis technical teams, intervention means, and so on; Presentation de l'organisation nationale de crise du CEA: centre de coordination en cas de crise, equipes techniques de crise, moyens d'intervention...

    Energy Technology Data Exchange (ETDEWEB)

    Pectorin, X. [CEA Fontenay-aux-Roses, MR/DCS/DIR, 92 (France)

    2010-07-01

    After having briefly recalled the existence of a legal framework for crisis management organisation, this report briefly describes how the CEA plans the crisis management. This management is based on the definition of critical scenarios, on the building up of a crisis management team, and on the elaboration of crisis management operational documents. It evokes the alert organisation and the triggering of crisis management. Then, it describes the CEA's national crisis organisation with its main crisis management structures, the role and the operation of the Crisis Coordination Centre (CCC, the decision body), the role and operation of the Central Crisis Technical Teams (ETC-C, Equipes Techniques de Crise Centrales), the role of field interveners (various rescue, protection, health care and technical teams) and of other additional intervention actors. It evokes the objectives of the various exercises which are organised every year at the internal, national or international level

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

    Science.gov (United States)

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

    2016-08-09

    To describe the impact of omalizumab on asthma management in patients treated as part of normal clinical practice in the UK National Health Service (NHS). A non-interventional, mixed methodology study, combining retrospective and prospective data collection for 12 months pre-omalizumab and post-omalizumab initiation, respectively. Data were collected in 22 UK NHS centres, including specialist centres and district general hospitals in the UK. 258 adult patients (aged ≥16 years; 65% women) with severe persistent allergic asthma treated with omalizumab were recruited, of whom 218 (84.5%) completed the study. The primary outcome measure was change in mean daily dose of oral corticosteroids (OCS) between the 12-month pre-omalizumab and post-omalizumab initiation periods. A priori secondary outcome measures included response to treatment, changes in OCS dosing, asthma exacerbations, lung function, employment/education, patient-reported outcomes and hospital resource utilisation. The response rate to omalizumab at 16 weeks was 82.4%. Comparing pre-omalizumab and post-omalizumab periods, the mean (95% CIs) daily dose of OCS decreased by 1.61 (-2.41 to -0.80) mg/patient/day (pomalizumab period. The mean number of A&E visits, inpatient hospitalisations, outpatient visits (excluding for omalizumab) and number of bed days/patient decreased significantly (pomalizumab period. These data support the beneficial effects of omalizumab on asthma-related outcomes, quality of life and resource utilisation in unselected patients treated in 'real-world' clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Does current provision of undergraduate education prepare UK medical students in ENT? A systematic literature review.

    Science.gov (United States)

    Ferguson, Gary R; Bacila, Irina A; Swamy, Meenakshi

    2016-04-15

    To systematically identify and analyse all published literature relating to the provision of undergraduate education for preparedness in ear, nose and throat (ENT) surgery, as perceived by medical students and clinicians in the UK. Systematic literature review. 5 major databases were searched: MEDLINE, EMBASE, ERIC, Cochrane and Web of Science. The literature search was conducted from February to April 2015. Primary research or studies that report on the provision of undergraduate education for preparedness in ENT, from the perspective of medical students and clinicians in the UK. The timescale of searches was limited from 1999 onwards (ie, the past 15 years). The literature search was conducted by 2 independent reviewers. Search terms used involved the combination and variation of 5 key concepts, namely: medical student, clinician, ENT, undergraduate medical education and UK. A data extraction form was designed for and used in this study, based on guidelines provided by the UK National Health Service (NHS) Centre for Reviews and Dissemination. Textual narrative synthesis was used for data analysis. A total of 7 studies were included in the final review. 4 main themes were identified: confidence in managing patients, teaching delivery, student assessment and duration of rotations. A consistent finding in this review was that the majority of final year medical students and junior doctors did not feel adequately prepared to practise ENT. Important factors influencing preparedness in ENT included the duration of clinical rotations, the opportunity for hands-on learning and formal assessment. The findings of this review suggest the need for further development of the ENT undergraduate curricula across the UK. However, there is insufficient evidence from which to draw strong conclusions; this in itself is beneficial as it highlights a gap in the existing literature and supports the need for primary research. Published by the BMJ Publishing Group Limited. For

  5. Predicting fitness to practise events in international medical graduates who registered as UK doctors via the Professional and Linguistic Assessments Board (PLAB) system: a national cohort study.

    Science.gov (United States)

    Tiffin, Paul A; Paton, Lewis W; Mwandigha, Lazaro M; McLachlan, John C; Illing, Jan

    2017-03-20

    International medical graduates working in the UK are more likely to be censured in relation to fitness to practise compared to home graduates. Performance on the General Medical Council's (GMC's) Professional and Linguistic Assessments Board (PLAB) tests and English fluency have previously been shown to predict later educational performance in this group of doctors. It is unknown whether the PLAB system is also a valid predictor of unprofessional behaviour and malpractice. The findings would have implications for regulatory policy. This was an observational study linking data relating to fitness to practise events (referral or censure), PLAB performance, demographic variables and English language competence, as evaluated via the International English Language Test System (IELTS). Data from 27,330 international medical graduates registered with the GMC were analysed, including 210 doctors who had been sanctioned in relation to at least one fitness to practise issue. The main outcome was risk of eventual censure (including a warning). The significant univariable educational predictors of eventual censure (versus no censures or referrals) were lower PLAB part 1 (hazard ratio [HR], 0.99; 95% confidence interval, 0.98 to 1.00) and part 2 scores (HR, 0.94; 0.91 to 0.97) at first sitting, multiple attempts at both parts of the PLAB, lower IELTS reading (HR, 0.79; 0.65 to 0.94) and listening scores (HR, 0.76; 0.62 to 0.93) and higher IELTS speaking scores (HR, 1.28; 1.04 to 1.57). Multiple resits at either part of the PLAB and higher IELTS speaking score (HR, 1.49; 1.20 to 1.84) were also independent predictors of censure. We estimated that the proposed limit of four attempts at both parts of the PLAB would reduce the risk in this entire group by only approximately two censures per 5 years in this group of doctors. Making the PLAB, or any replacement assessment, more stringent and raising the required standards of English reading and listening may result in fewer fitness

  6. Association of volunteering with mental well-being: a lifecourse analysis of a national population-based longitudinal study in the UK.

    Science.gov (United States)

    Tabassum, Faiza; Mohan, John; Smith, Peter

    2016-08-08

    The association of volunteering with well-being has been found in previous research, but mostly among older people. The aim of this study was to examine the association of volunteering with mental well-being among the British population across the life course. British Household Panel Survey, a population-based longitudinal study. UK. 66 343 observations (person-years). Mental well-being was measured by using the General Health Questionnaire (GHQ-12 or GHQ); high values denote high mental disorder. Four groups of volunteering participation were created: frequent (once a week), infrequent (once a month/several times a year), rare (once or less a year) and never. Multilevel linear models were used to analyse variations in mental well-being over the life course by levels of volunteering. When not considering age, those who engaged in volunteering regularly appeared to experience higher levels of mental well-being than those who never volunteered. To explore the association of volunteering with the GHQ across the life course, interaction terms were fitted between age and volunteering. The interactions were significant, demonstrating that these associations vary by age. The association between volunteering and well-being did not emerge during early adulthood to mid-adulthood, instead becoming apparent above the age of 40 years and continuing up to old age. Moreover, in early adulthood, the absence of engagement in voluntary activity was not related to mental well-being, but GHQ scores for this group increased sharply with age, levelling off after the age of 40 and then increasing again above the age of 70 years. The study also indicates variation in GHQ scores (65%) within individuals across time, suggesting evidence of lifecourse effects. We conclude that volunteering may be more meaningful for mental well-being at some points of time in the life course. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

  7. A cost utility analysis of simeprevir used with peginterferon + ribavirin in the management of genotype 1 hepatitis C virus infection, from the perspective of the UK National Health Service.

    Science.gov (United States)

    Westerhout, Kirsten; Treur, Maarten; Mehnert, Angelika; Pascoe, Katie; Ladha, Imran; Belsey, Jonathan

    2015-01-01

    Triple therapy using a protease inhibitor (PI) with peginterferon and ribavirin (PR) is increasingly used in patients with chronic hepatitis C virus (HCV) infection. The most recently introduced PI, simeprevir (SMV), offers high levels of viral eradication combined with a reduced overall duration of therapy. The objective of this study was to compare the cost-effectiveness of SMV + PR vs PR alone or in combination with telaprevir (TVR) or boceprevir (BOC) in patients infected with genotype 1 HCV Method: A cost-utility model was constructed, incorporating two phases, capturing the efficacy of therapy in an initial treatment phase, followed by a long-term post-treatment Markov phase, capturing lifetime outcomes according to whether a sustained viral response (SVR) had been achieved on treatment. Dosage regimens were based on the EMA approved label for each treatment. SVR estimates and adverse event rates were derived from a mixed treatment comparison. Baseline characteristics were drawn from an analysis of a UK HCV data-set and clinician opinion. Health state transition probabilities, utilities, and health state costs were drawn from previously published economic analyses. The model considered direct health costs only, and the perspective was that of the UK National Health Service. The model yielded an ICER for SMV + PR vs PR alone of £9725/QALY for treatment-naïve and £7819/QALY for treatment-experienced. Benefit was driven by increased likelihood of achieving SVR, with consequent long-term utility gains. SMV + PR dominated TVR + PR and BOC + PR in both patient groups. This principally reflected the QALY benefit of an increased likelihood of SVR with SMV, combined with lower overall drug costs, due to reduced mean treatment duration. Compared to other currently licensed treatment options, SMV + PR represents a cost effective treatment option for patients with chronic genotype 1 HCV infection.

  8. Association between home food preparation skills and behaviour, and consumption of ultra-processed foods: Cross-sectional analysis of the UK National Diet and nutrition survey (2008-2009).

    Science.gov (United States)

    Lam, Matthew Chak Leung; Adams, Jean

    2017-05-23

    'Ultra-processed foods' (UPF) have been industrially processed and tend to be higher in saturated fat, sodium and sugar than other foods. There is some evidence that consumption of UPF is associated with overweight, obesity and related diseases. In developed countries more than half of dietary energy is attributed to UPF. One reason for reliance on UPF may be poor home food preparation skills or infrequent use of these. This relationship has been previously proposed but not tested. We examined the relationship between home food preparation skills and behaviour and consumption of UPF. We used data from adults in the UK National Diet & Nutrition Survey 2008-09. Home food preparation skills and behaviours of adults (n = 509) were assessed using questions on confidence using eight cooking techniques, confidence cooking 10 foods, ability to prepare a cake or biscuits without help, and whether or not participants prepared a main meal five or more days per week. Individuals' UPF consumption was determined from four-day estimated diet diaries. Associations were adjusted for age, gender, occupational social class and household composition. In fully adjusted models, individuals who were confident with all 10 foods (adjusted beta (95% CI) = -3.76 (-6.02 to -1.50)), able to bake cakes or biscuits without help (-3.87 (-6.62 to -1.12)), and cooked a main meal at least five days a week (-2.84 (-5.43 to -0.24)) consumed a lower percentage of dietary energy from UPF. In UK adults better home food preparation skills and more frequent use of these skills tended to be cross-sectionally associated with lower UPF consumption. Greater encouragement of these skills may help reduce reliance on UPF.

  9. The Paramountcy of EU Law Over National Law The Extent to which Lyon’s Statements Reflect on the Relationship between EU and Domestic Law within the UK and Candidate States such as Albania

    Directory of Open Access Journals (Sweden)

    Erbi Ago

    2015-03-01

    Full Text Available As we live in a world that is becoming ever more globalized, it is unavoidable to consider the effect supranational entities and globalization itself have on the national sovereignty of the state. The EU is probably the most well-known example of a supranational entity and as such it cannot help but bring about a number of sides regarding its power over its members. There are many that would claim the EU has undermined national sovereignty, especially when it comes to the legal sphere. The issue at hand has been addressed by scholars such as Dr. Anne Lyon and this paper is a direct analysis of her statement regarding paramountcy. In summation, Lyon has stated that EU law has undermined national law. This has happened due to a number of reasons, one of which is the passing of a parliamentary Act intending to prioritize EU law. At this point, shall they need to provide otherwise, it is quite an argument to claim whether they could give effect to national law instead. Therefore, it has become necessary to consider the extent to which these statements reflect the relationship between EU law and ‘domestic’ laws within the UK and try and apply to the legal future of candidate states, such as Albania. This paper analyzes the two parts of Lyon’s argument, namely the paramountcy and parliamentary aspects of the issue, while also aiming to provide a framework on which future candidate states such as Albania can work on in order to achieve a more efficient assimilation into the EU legal system together with the forewarnings necessary shall they wish the opposite.

  10. Imperial College Reactor Centre annual report. 1983

    International Nuclear Information System (INIS)

    1984-01-01

    It is reported that the reactor operated reliably during the year with less than half a day of operating time lost by faults or failures. Brief accounts of the 34 research projects at the Centre are given, and a list of teaching experiments or visits is included. These include undergraduate and post-graduate teaching. Commercial requests for irradiations and neutron activation analysis are reported as increasing. (U.K.)

  11. A Blueprint for Success: A Model for Developing Engineering Education in the UK

    Directory of Open Access Journals (Sweden)

    Melanie Rose Nova King

    2014-03-01

    Full Text Available This paper details the emergence and development of the ‘Centre for Engineering and Design Education’ (CEDE at Loughborough University, UK, and provides a blueprint for success. With ample evidence that such a Centre can prove to be a highly effective support mechanism for discipline-specific academics and can develop and maintain valuable national and international networks and collaborations along with considerable esteem for the host university. The CEDE is unique in the UK and has achieved considerable success and recognition within the local engineering education community and beyond for the past 16 years. Here we discuss the historical background of the Centre’s development, the context in which it operates, and its effective management and operation strategy. The success it has enjoyed is described through examples, with much evidence of the generation of a significant amount of external funding; the development of high quality learning spaces; learning technology systems, open source software and improvements in curriculum design; a strong record of research and publication on the pedagogy of engineering; strong links with industry and employers; and a wealth of connections and know-how built up over the years. This paper provides the institutions with a model blueprint for success in developing engineering education.

  12. UK ignores treaty obligations

    International Nuclear Information System (INIS)

    Roche, P.

    1995-01-01

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

  13. BTC the UK focus for nuclear fission R and D in the post NDA era

    International Nuclear Information System (INIS)

    Rice, T.G.; Carpenter, J.C.; Williamson, R.

    2005-01-01

    The BNFL Technology Centre at Sellafield, UK, will provide the focal point for nuclear fission R and D in the UK for the 21th Century. The facility provides a range of non-active, trace active, plutonium active and high active facilities enabling NSTS to support the Nuclear Decommissioning Authority's remit to manage the UK's nuclear legacy and other requirements The facilities also provide an environment for academic research and foster the development of University Research Alliances. (Author)

  14. Product Lifecycle Management Centre of Technology

    CSIR Research Space (South Africa)

    Barnard, Rentia

    2017-10-01

    Full Text Available - Rentia Barnard.pdf.txt Content-Type text/plain; charset=UTF-8 1 Interactive activities Contents Product Lifecycle Management Centre of Technology Rentia Barnard National Industrialisation Support Initiative (NISI) 3 Initiative (NISI...

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

    Directory of Open Access Journals (Sweden)

    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

  16. 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.)

  17. 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.

  18. Pregnancy outcome in patients with sickle cell disease in the UK--a national cohort study comparing sickle cell anaemia (HbSS) with HbSC disease.

    Science.gov (United States)

    Oteng-Ntim, Eugene; Ayensah, Benjamin; Knight, Marian; Howard, Jo

    2015-04-01

    We describe the findings from a national study of maternal and fetal outcomes of pregnancy in women with sickle cell disease (SCD). Data were collected via the United Kingdom Obstetric Surveillance System between 1 February 2010 and 31 January 2011 from 109 women, of whom 51 (46·8%) had HbSS and 44 (40·4%) had HbSC. Data included antenatal, maternal and fetal outcomes. Comparisons were made between women with HbSS and HbSC. Incidence of complications were acute pain (57%), blood transfusion (26%), urinary tract infection (UTI; 12%) and critical care unit admission (23%) and these were all more common in women with HbSS than HbSC. There was no difference in the incidence of acute chest syndrome, hypertension and venous thromboembolism between HbSS and HbSC. Women with HbSS were more likely to deliver at pregnancy. © 2014 John Wiley & Sons Ltd.

  19. 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…

  20. 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...

  1. Out-of-pocket expenditure and catastrophic health spending on maternal care in public and private health centres in India: a comparative study of pre and post national health mission period.

    Science.gov (United States)

    Mohanty, Sanjay K; Kastor, Anshul

    2017-09-18

    The National Health Mission (NHM), one of the largest publicly funded maternal health programs worldwide was initiated in 2005 to reduce maternal, neo-natal and infant mortality and out-of-pocket expenditure (OOPE) on maternal care in India. Though evidence suggests improvement in maternal and child health, little is known on the change in OOPE and catastrophic health spending (CHS) since the launch of NHM. The aim of this paper is to provide a comprehensive estimate of OOPE and CHS on maternal care by public and private health providers in pre and post NHM periods. The unit data from the 60th and 71st rounds of National Sample Survey (NSS) is used in the analyses. Descriptive statistics is used to understand the differentials in OOPE and CHS. The CHS is estimated based on capacity to pay, derived from household consumption expenditure, the subsistence expenditure (based on state specific poverty line) and household OOPE on maternal care. Data of both rounds are pooled to understand the impact of NHM on OOPE and CHS. The log-linear regression model and the logit regression models adjusted for state fixed effect, clustering and socio-economic and demographic correlates are used in the analyses. Women availing themselves of ante natal, natal and post natal care (all three maternal care services) from public health centres have increased from 11% in 2004 to 31% by 2014 while that from private health centres had increased from 12% to 20% during the same period. The mean OOPE on all three maternal care services from public health centres was US$60 in pre-NHM and US$86 in post-NHM periods while that from private health center was US$170 and US$300 during the same period. Controlling for socioeconomic and demographic correlates, the OOPE on delivery care from public health center had not shown any significant increase in post NHM period. The OOPE on delivery care in private health center had increased by 5.6 times compared to that from public health centers in pre NHM

  2. Eating at Food Outlets and “On the Go” Is Associated with Less Healthy Food Choices in Adults: Cross-Sectional Data from the UK National Diet and Nutrition Survey Rolling Programme (2008–2014)

    Science.gov (United States)

    Ziauddeen, Nida; Penney, Tarra L.; Nicholson, Sonja; Page, Polly

    2017-01-01

    Eating location has been linked with variations in diet quality including the consumption of low-nutrient energy-dense food, which is a recognised risk factor for obesity. Cross-sectional data from 4736 adults aged 19 years and over from Years 1–6 of the UK National Diet and Nutrition Survey (NDNS) Rolling Programme (RP) (2008–2014) were used to explore food consumption patterns by eating location. Eating location was categorized as home, work, leisure places, food outlets and “on the go”. Foods were classified into two groups: core (included in the principal food groups and considered important/acceptable within a healthy diet) and non-core (all other foods). Out of 97,748 eating occasions reported, the most common was home (67–90% of eating occasions). Leisure places, food outlets and “on the go” combined contributed more energy from non-core (30%) than from core food (18%). Analyses of modulating factors revealed that sex, income, frequency of eating out and frequency of drinking were significant factors affecting consumption patterns (p diet quality vary by location. Public health interventions should focus on availability and access to healthy foods, promotion of healthy food choices and behaviours across multiple locations, environments and contexts for food consumption. PMID:29207469

  3. Eating at Food Outlets and “On the Go” Is Associated with Less Healthy Food Choices in Adults: Cross-Sectional Data from the UK National Diet and Nutrition Survey Rolling Programme (2008–2014

    Directory of Open Access Journals (Sweden)

    Nida Ziauddeen

    2017-12-01

    Full Text Available Eating location has been linked with variations in diet quality including the consumption of low-nutrient energy-dense food, which is a recognised risk factor for obesity. Cross-sectional data from 4736 adults aged 19 years and over from Years 1–6 of the UK National Diet and Nutrition Survey (NDNS Rolling Programme (RP (2008–2014 were used to explore food consumption patterns by eating location. Eating location was categorized as home, work, leisure places, food outlets and “on the go”. Foods were classified into two groups: core (included in the principal food groups and considered important/acceptable within a healthy diet and non-core (all other foods. Out of 97,748 eating occasions reported, the most common was home (67–90% of eating occasions. Leisure places, food outlets and “on the go” combined contributed more energy from non-core (30% than from core food (18%. Analyses of modulating factors revealed that sex, income, frequency of eating out and frequency of drinking were significant factors affecting consumption patterns (p < 0.01. Our study provides evidence that eating patterns, behaviours and resulting diet quality vary by location. Public health interventions should focus on availability and access to healthy foods, promotion of healthy food choices and behaviours across multiple locations, environments and contexts for food consumption.

  4. Eating at Food Outlets and "On the Go" Is Associated with Less Healthy Food Choices in Adults: Cross-Sectional Data from the UK National Diet and Nutrition Survey Rolling Programme (2008-2014).

    Science.gov (United States)

    Ziauddeen, Nida; Almiron-Roig, Eva; Penney, Tarra L; Nicholson, Sonja; Kirk, Sara F L; Page, Polly

    2017-12-02

    Eating location has been linked with variations in diet quality including the consumption of low-nutrient energy-dense food, which is a recognised risk factor for obesity. Cross-sectional data from 4736 adults aged 19 years and over from Years 1-6 of the UK National Diet and Nutrition Survey (NDNS) Rolling Programme (RP) (2008-2014) were used to explore food consumption patterns by eating location. Eating location was categorized as home, work, leisure places, food outlets and "on the go". Foods were classified into two groups: core (included in the principal food groups and considered important/acceptable within a healthy diet) and non-core (all other foods). Out of 97,748 eating occasions reported, the most common was home (67-90% of eating occasions). Leisure places, food outlets and "on the go" combined contributed more energy from non-core (30%) than from core food (18%). Analyses of modulating factors revealed that sex, income, frequency of eating out and frequency of drinking were significant factors affecting consumption patterns ( p eating patterns, behaviours and resulting diet quality vary by location. Public health interventions should focus on availability and access to healthy foods, promotion of healthy food choices and behaviours across multiple locations, environments and contexts for food consumption.

  5. Funding Decommissioning - UK Experience

    International Nuclear Information System (INIS)

    MacKerron, Gordon

    2006-01-01

    % of all BE free cash flow to go to the Fund; - Government would pay for all Stage 1/2/3 decommissioning expenses that BE could not meet. BE is still a private company in a formal sense but the UK Office of National Statistics classifies it as a public sector company, because it regards control (not ownership) as in State hands. Government is now setting up the Nuclear Decommissioning Authority (NDA) to manage all public sector liabilities. Intention was to have a 'segregated account' to help give assurance that funding would be long-term and reliable. First draft Annual Plan does not mention segregation or any funding commitment beyond the first year (2005/6). The BNFL NLIP will presumably go to the Treasury. NLIP will presumably go to the Treasury. In conclusion, it is clean that the decommissioning funding system has been short term and has relied mainly on Government. Some consumer contributions have been made, but now that nuclear power competes in a private market place and is relatively expensive, there is no guarantee that consumers/polluters will pay for a significant proportion of decommissioning costs

  6. Research Data Management at the University of Warwick: recent steps towards a joined-up approach at a UK university

    Directory of Open Access Journals (Sweden)

    Jenny Delasalle

    2013-10-01

    Full Text Available This paper charts the steps taken and possible ways forward for the University of Warwick in its approach to research data management, providing a typical example of a UK research university’s approach in two strands: requirements and support. The UK government approach and funding landscape in relation to research data management provided drivers for the University of Warwick to set requirements and provide support, and examples of good practice at other institutions, support from a central national body (the UK Digital Curation Centre and learning from other universities’ experiences all proved valuable to the University of Warwick. Through interviews with researchers at Warwick, various issues and challenges are revealed: perhaps the biggest immediate challenges for Warwick going forward are overcoming scepticism amongst researchers, overcoming costs, and understanding the implications of involving third party companies in research data management. Building technical infrastructure could sit alongside and beyond those immediate steps and beyond the challenges that face one University are those that affect academia as a whole. Researchers and university administrators need to work together to address the broader challenges, such as the accessibility of data for future use and the reward for researchers who practice data management in exemplary ways, and indeed it may be that a wider, national or international but disciplinary technical infrastructure affects what an individual university needs to achieve. As we take these steps, universities and institutions are all learning from each other.

  7. Frequency and socio-demographic correlates of eating meals out and take-away meals at home: cross-sectional analysis of the UK national diet and nutrition survey, waves 1-4 (2008-12).

    Science.gov (United States)

    Adams, Jean; Goffe, Louis; Brown, Tamara; Lake, Amelia A; Summerbell, Carolyn; White, Martin; Wrieden, Wendy; Adamson, Ashley J

    2015-04-16

    Food prepared out-of-home tends to be less healthful than food prepared at home, with a positive association between frequency of consumption and both fat intake and body fatness. There is little current data on who eats out-of-home food. We explored frequency and socio-demographic correlates of eating meals out and take-away meals at home, using data from a large, UK, population representative study. Data were from waves 1-4 of the UK National Diet and Nutrition Survey (2008-12). Socio-demographic variables of interest were gender, age group, and socio-economic position. Self-reported frequency of consuming meals out and take-away meals at home was categorised as: less than once per week and once per week or more. Analyses were performed separately for adults (aged 18 years or older) and children. Data from 2001 adults and 1963 children were included. More than one quarter (27.1%) of adults and one fifth (19.0%) of children ate meals out once per week or more. One fifth of adults (21.1%) and children (21.0%) ate take-away meals at home once per week or more. There were no gender differences in consumption of meals out, but more boys than girls ate take-away meals at home at least weekly. The proportion of participants eating both meals out and take-away meals at home at least weekly peaked in young adults aged 19-29 years. Adults living in more affluent households were more likely to eat meals out at least once per week, but children living in less affluent households were more likely to eat take-away meals at home at least once per week. There was no relationship between socio-economic position and consumption of take-away meals at home in adults. One-fifth to one-quarter of individuals eat meals prepared out-of-home weekly. Interventions seeking to improve dietary intake by reducing consumption of out-of-home food may be more effective if tailored to and targeted at adults aged less than 30 years. It may also be important to develop interventions to help

  8. The UK nephrostomy audit. Can a voluntary registry produce robust performance data?

    International Nuclear Information System (INIS)

    Chalmers, N.; Jones, K.; Drinkwater, K.; Uberoi, R.; Tawn, J.

    2008-01-01

    Aim: To investigate the effectiveness of the Royal College of Radiologists Audit Sub-Committee's national prospective registry of percutaneous nephrostomy, which enables participants to audit their practice and compare performance with predetermined standards. Methods: Following a limited retrospective audit, which permitted setting of achievable targets, a dataset was developed and all UK NHS acute hospitals were invited to participate in web-based prospective data collection. Results: Eighty-five out of 285 (29.8%) hospitals contributed 3262 cases over a 29 month period. A satisfactory level of performance was achieved with an overall technical success rate of 98% and a complication rate of 6.3%. Significant risk factors for complications included rigors, anaemia, and impaired renal function. Low frequency operators were shown to have a lower technical success rate and a higher complication rate than high frequency operators; however, target thresholds were exceeded in all groups. Sepsis was identified as a risk factor in the majority of serious complications and all deaths. Some anomalous results were found due to unusual interpretation of the data entry form in two centres, but no evidence of under-performance was identified at any centre. Conclusions: Some weaknesses of the registry are discussed. In view of the low response rate, the possibility of significant bias cannot be excluded. In addition, there is no objective verification of the data; therefore, the results have limited credibility. However, individual centres that accurately completed a representative sample of cases can have confidence that their performance achieves an acceptable standard

  9. The ideal Atomic Centre; Le Centre Atomique ideal

    Energy Technology Data Exchange (ETDEWEB)

    Mas, R [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1965-07-01

    The author presents considerations which should prove to be of interest to all those who have to design, to construct and to operate a nuclear research centre. A large number of the ideas presented can also be applied to non-nuclear scientific research centres. In his report the author reviews: various problems with which the constructor is faced: ground-plan, infrastructure, buildings and the large units of scientific equipment in the centre, and those problems facing the director: maintenance, production, supplies, security. The author stresses the relationship which ought to exist between the research workers and the management. With this aim in view he proposes the creation of National School for Administration in Research which would train administrative executives for public or private organisations; they would be specialised in the fields of fundamental or applied research. (author) [French] L'auteur propose une base de reflexions a tous ceux qui doivent concevoir, realiser et faire vivre un Centre d'Etudes Nucleaires. Un grand nombre des idees exprimees peut d'ailleurs s'appliquer a un Centre d'Etudes Scientifiques non nucleaires. Dans son ouvrage, l'auteur passe en revue les differents problemes qui se posent au constructeur: plan, masse, infrastructure, batiments et grands appareils du Centre, et ceux qu'a a resoudre le directeur: entretien, fabrication, approvisionnements, securite. L'auteur insiste sur l'aspect des rapports qui doivent exister entre les chercheurs et ceux qui les administrent. Il propose a cette fin la creation d'une Ecole Nationale d'Administration de la Recherche qui formerait des cadres administratifs pour les organismes publics ou prives, specialises dans la Recherche fondamentale ou appliquee. (auteur)

  10. Human-centred Governance

    DEFF Research Database (Denmark)

    Bason, Christian

    2017-01-01

    Design approaches are now being applied all over the world as a powerful approach to innovating public policies and services. Christian Bason, author of Leading public design: Discovering human-centred governance, argues that by bringing design methods into play, public managers can lead change...... with citizens at the centre, and discover a new model for steering public organisations: human-centred governance....

  11. The Search for Centre

    Science.gov (United States)

    Nunes, April

    2006-01-01

    This paper acknowledges the importance of a dancer's centre but likewise highlights the problematic nature of the communication of this concept from dance teacher to student. After a brief introduction of orthodox approaches in finding centre, this paper suggests a method of locating centre through the ancient somatic technique.

  12. A survey of the practice and management of radiotherapy linear accelerator quality control in the UK.

    Science.gov (United States)

    Palmer, A; Kearton, J; Hayman, O

    2012-11-01

    The objective of this study was to determine current radiotherapy linear accelerator quality control (QC) practice in the UK, as a comparative benchmark and indicator of development needs, and to raise awareness of QC as a key performance indicator. All UK radiotherapy centres were invited to complete an online questionnaire regarding their local QC processes, and submit their QC schedules. The range of QC tests, frequency of measurements and acceptable tolerances in use across the UK were analysed, and consensus and range statistics determined. 72% of the UK's 62 radiotherapy centres completed the questionnaire and 40% provided their QC schedules. 60 separate QC tests were identified from the returned schedules. There was a large variation in the total time devoted to QC between centres: interquartile range from 13 to 26 h per linear accelerator per month. There has been a move from weekly to monthly testing of output calibration in the last decade, with reliance on daily constancy testing equipment. 33% of centres thought their schedules were in need of an update and only 30% used risk-assessment approaches to determine local QC schedule content. Less than 30% of centres regularly complete all planned QC tests each month, although 96% achieve over 80% of tests. A comprehensive "snapshot" of linear accelerator QC testing practice in the UK has been collated, which demonstrates reasonable agreement between centres in their stated QC test frequencies. However, intelligent design of QC schedules and management is necessary to ensure efficiency and appropriateness.

  13. Annual report of the National Reference Centres established on the basis of regional public health authorities of the Slovak Republic and the Office of Public Health of the Slovak Republic. Year 2012

    International Nuclear Information System (INIS)

    2013-02-01

    A brief account of activities carried out by the National Reference Centres (NRC) established on the basis of regional public health authorities of the Slovak Republic and the Office of Public Health of the Slovak Republic. (UVZ SR) in 2012 is presented. These activities are reported under the headings: (1) NRC for flu; (2) NRC for arbovirus and hemorrhagic fever; (3) NRC for poliomyelitis; (4) NRC for meningococci; (5) NRC to monitor the resistance of microorganisms to antibiotics; (6) NRC for morbilli, rubella and parotitis; (7) NRC for salmonellosis; (8) NRC for evaluation of late effects of chemicals by methods of genetic toxicology; (9) NRC for hydrobiology; (10) NRC for ecotoxicology; (11) NRC for non-ionizing radiation; (12) NRC for hydrothermal microclimate; (13) NRC tests for exposure of xenobiotics; (14) NRC for environmental microbiology; (15) NRC for Legionella in the environment; (16) NRC on pesticide residues; (17) NRC for impact assessment of ambient air pollution and an enclosed non-productive nature of the health of the population; (18) NRC for toxoplasmosis; (19) NRC Assessment of personal exposure and health risk; (20) NRC for pertussis and parapertussis; (21) NRC for pneumococcal disease; (22) NRC for syphilis; (23) NRC for hygienic drinking water problems; (24) NRC for listeriosis; (25) The National Information Centre for bacteriological (biological) and toxin weapons; (26) NRC for intestinal parasites; (27) NRC for diphtheria; (28) NRC for coagulase-positive staphylococci and their toxins; (29) NRC for Vibrionaceae; (30) NRC for environmental mycology; (31) NRC for noise and vibration; (32) NRC for articles of daily use and packaging materials; (33) NRC for thermotolerant amoebae; (34) NRC issues for coal mines; (35) NRC to work physiology and ergonomics; (36) NRC for health issues fibrous dusts; (37) NRC for haemophilus infection; (38) NRC for cosmetic products.

  14. Patient-reported outcomes at hospital discharge from Heart Centres, a national cross-sectional survey with a register-based follow-up

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Svanholm, Jette; Lauberg, Astrid

    2014-01-01

    Introduction: Patient reported health status, which includes symptom burden, functional status and quality of life, is an important measure of health. Differences in health status between diagnostic groups within cardiology have only been sparsely investigated. These outcomes may predict morbidity...... in national registers. The following instruments are used: SF-12, Hospital Anxiety and Depression Scale, EQ-5D, Brief Illness Perception Questionnaire (B-IPQ), HeartQoL and Edmonton Symptom Assessment Scale. The following variables are collected from national registers: action diagnosis, procedures......, comorbidity, length of hospital stay, type of hospitalisation, visits to general practitioners and other agents in primary healthcare, dispensed prescription medication, vital status and cause of death. Labour market affiliation, sick leave, early retirement pension, educational degree and income...

  15. 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

  16. Economic feasibility study to Raise the operational capacity of the Electron Beam Accelerator at the National Centre for Radiation Research and Technology, atomic Energy Authority, Egypt

    International Nuclear Information System (INIS)

    El-Kolaly, M.; Hammad, A.; El-Gameel, E.A.

    2011-01-01

    The study aims to investigate the economic feasibility to raise the operational capacity of the accelerator at the National Center for Radiation Research and Technology, Atomic Energy Authority, Egypt, through proposal of additional processing of power cables as it have 4 thousand operating hours per year of total 6 thousand hours per year. The study involved three sections; the first section included the technical aspects and marketing, the second section was concerned with financial analysis, and the third section included the national return of the project. In the first part, the electronic and technical requirements of the accelerator were studied to raise the capacity of the accelerator and to identify the time trend of demand for services in marketing. The second section included the financial feasibility of the project which was carried out through two parts; the first part deal with the analysis of costs of the project including identifying of investment, spending, labor costs, operating expenses, the annual installment of the annual depreciation expense with the total annual costs and operating costs per hour and ton. The second part was carried out to evaluated business profitability of the project, preparation of the annual cash flow, calculation of the internal rate of return, payback period of capital, and the analysis of sensitivity of the project in terms of its ability to achieve profitable business in the event of increasing costs and decreasing revenue. The third section was carried out to raise the operational capacity of the accelerator at the Egyptian Atomic Energy Authority to generate added value for national income, and to study the social rate of return for the project and examine the project's ability to provide new employment opportunities. The study showed the possibility and the importance of the project implemented at the level of private investment and national security.

  17. Nation

    DEFF Research Database (Denmark)

    Østergaard, Uffe

    2014-01-01

    Nation er et gammelt begreb, som kommer af det latinske ord for fødsel, natio. Nationalisme bygger på forestillingen om, at mennesker har én og kun én national identitet og har ret til deres egen nationalstat. Ordet og forestillingen er kun godt 200 år gammel, og i 1900-tallet har ideologien bredt...

  18. What is the role of the centre for educational scholarship?

    Science.gov (United States)

    Evans, Phillip

    2009-01-01

    The role of the Centre for Educational Scholarship is to promote scholarship, in terms of teacher education, teacher accreditation, and teacher collaboration. The strategy adopted by the University of Glasgow, Scotland, UK, is outlined, and a way of estimating effectiveness is suggested.

  19. 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...

  20. CMS Centre at CERN

    CERN Multimedia

    2007-01-01

    A new "CMS Centre" is being established on the CERN Meyrin site by the CMS collaboration. It will be a focal point for communications, where physicists will work together on data quality monitoring, detector calibration, offline analysis of physics events, and CMS computing operations. Construction of the CMS Centre begins in the historic Proton Synchrotron (PS) control room. The historic Proton Synchrotron (PS) control room, Opened by Niels Bohr in 1960, will be reused by CMS to built its control centre. TThe LHC@FNAL Centre, in operation at Fermilab in the US, will work very closely with the CMS Centre, as well as the CERN Control Centre. (Photo Fermilab)The historic Proton Synchrotron (PS) control room is about to start a new life. Opened by Niels Bohr in 1960, the room will be reused by CMS to built its control centre. When finished, it will resemble the CERN Contro...

  1. The role of the sexual assault centre.

    LENUS (Irish Health Repository)

    Eogan, Maeve

    2013-02-01

    Sexual Assault Centres provide multidisciplinary care for men and women who have experienced sexual crime. These centres enable provision of medical, forensic, psychological support and follow-up care, even if patients chose not to report the incident to the police service. Sexual Support Centres need to provide a ring-fenced, forensically clean environment. They need to be appropriately staffed and available 24 hours a day, 7 days a week to allow prompt provision of medical and supportive care and collection of forensic evidence. Sexual Assault Centres work best within the context of a core agreed model of care, which includes defined multi-agency guidelines and care pathways, close links with forensic science and police services, and designated and sustainable funding arrangements. Additionally, Sexual Assault Centres also participate in patient, staff and community education and risk reduction. Furthermore, they contribute to the development, evaluation and implementation of national strategies on domestic, sexual and gender-based violence.

  2. 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.

  3. Impact of the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention on adherence to national obesity clinical practice guidelines in a primary care centre.

    Science.gov (United States)

    Barnes, Emily R; Theeke, Laurie A; Mallow, Jennifer

    2015-04-01

    Obesity is significantly underdiagnosed and undertreated in primary care settings. The purpose of this clinical practice change project was to increase provider adherence to national clinical practice guidelines for the diagnosis and treatment of obesity in adults. Based upon the National Institutes of Health guidelines for the diagnosis and treatment of obesity, a clinical change project was implemented. Guided by the theory of planned behaviour, the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention includes education sessions, additional provider resources for patient education, a provider reminder system and provider feedback. Primary care providers did not significantly increase on documentation of diagnosis and planned management of obesity for patients with body mass index (BMI) greater than or equal to 30. Medical assistants increased recording of height, weight and BMI in the patient record by 13%, which was significant. Documentation of accurate BMI should lead to diagnosis of appropriate weight category and subsequent care planning. Future studies will examine barriers to adherence to clinical practice guidelines for obesity. Interventions are needed that include inter-professional team members and may be more successful if delivered separately from routine primary care visits. © 2015 John Wiley & Sons, Ltd.

  4. Logistics centres development in Latvia

    Directory of Open Access Journals (Sweden)

    I. Kabashkin

    2007-12-01

    Full Text Available In the situation where a large increase in trade and freight transport volumes in the Baltic Sea region (BSR is expected and in which the BSR is facing a major economic restructuring, eff orts to achieve more integrated and sustainable transport and communication links within the BSR are needed. One of these eff orts is the development of logistics centres (LCs and their networking, which will continue to have an impact on improving communication links, spatial planning practices and approaches, logistics chain development and the promotion of sustainable transport modes. These factors will refl ect on logistics processes both in major gateway cities and in remote BSR areas. The importance of logistics systems as a whole is not seen clearly enough. Logistics actors see that logistics operations are not appreciated as much as other fi elds of activity. In addition, logistics centres and the importance of logistics activities to the business life of areas and the employment rate should be brought up better. In the paper main goal and tasks of national approach to LCs development are discussed. Strategic focus of new activities in this area is on the integration of various networks within and between logistics centres in order to improve and develop the quality of logistics networks as well as to spatially widen the networking activities. The key objectives are to integrate the links between logistics centres, ports and other logistics operators in a functional and sustainable way, to promote spatial integration by creating sustainable and integrated approaches to spatial planning of logistics centres and transport infrastructure, to improve ICT-based networking and communication practices of the fi elds of transport and logistics and to increase the competence of logistics centres and associated actors by organising educational and training events. The current activities include, for example, the creation of measures for transport networking and

  5. Are current UK National Institute for Health and Clinical Excellence (NICE) obesity risk guidelines useful? Cross-sectional associations with cardiovascular disease risk factors in a large, representative English population.

    Science.gov (United States)

    Tabassum, Faiza; Batty, G David

    2013-01-01

    The National Institute for Health and Clinical Excellence (NICE) has recently released obesity guidelines for health risk. For the first time in the UK, we estimate the utility of these guidelines by relating them to the established cardiovascular disease (CVD) risk factors. Health Survey for England (HSE) 2006, a population-based cross-sectional study in England was used with a sample size of 7225 men and women aged ≥35 years (age range: 35-97 years). The following CVD risk factor outcomes were used: hypertension, diabetes, total and high density lipoprotein cholesterol, glycated haemoglobin, fibrinogen, C-reactive protein and Framingham risk score. Four NICE categories of obesity were created based on body mass index (BMI) and waist circumference (WC): no risk (up to normal BMI and low/high WC); increased risk (normal BMI & very high WC, or obese & low WC); high risk (overweight & very high WC, or obese & high WC); and very high risk (obese I & very high WC or obese II/III with any levels of WC. Men and women in the very high risk category had the highest odds ratios (OR) of having unfavourable CVD risk factors compared to those in the no risk category. For example, the OR of having hypertension for those in the very high risk category of the NICE obesity groupings was 2.57 (95% confidence interval 2.06 to 3.21) in men, and 2.15 (1.75 to 2.64) in women. Moreover, a dose-response association between the adiposity groups and most of the CVD risk factors was observed except total cholesterol in men and low HDL in women. Similar results were apparent when the Framingham risk score was the outcome of interest. In conclusion, the current NICE definitions of obesity show utility for a range of CVD risk factors and CVD risk in both men and women.

  6. 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).

  7. Diabetes services in the UK

    DEFF Research Database (Denmark)

    Jefferson, I. G.; Swift, P. G F; Skinner, T. C.

    2003-01-01

    Aims: To determine the current level of diabetes services and to compare the results with previous national surveys. Methods: A questionnaire was mailed to all paediatricians in the UK identified as providing care for children with diabetes aged under 16 years. Information was sought on staffing...... consultants who did not contribute to the survey. Of 244 consultants, 78% expressed a special interest in diabetes and 91% saw children in a designated diabetic clinic. In 93% of the clinics there was a specialist nurse (44% were not trained to care for children; 47% had nurse:patient ratio > 1:100), 65......% a paediatric dietitian, and in 25% some form of specialist psychology or counselling available. Glycated haemoglobin was measured routinely at clinics in 88%, retinopathy screening was performed in 87%, and microalbuminuria measured in 66%. Only 34% consultants used a computer database. There were significant...

  8. Economic burden of advanced melanoma in France, Germany and the UK: a retrospective observational study (Melanoma Burden-of-Illness Study).

    Science.gov (United States)<