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Al Ozairi E, Alsaeed D, Al Roudhan D, Voase N, Pell JP, Ho FK, Abdulla M, Gray SR. Corrigendum: A comparison of physical activity, muscle strength, and sleep between people with type 2 diabetes in Kuwait and he UK: a cross sectional study. Front Endocrinol (Lausanne) 2023; 14:1278604. [PMID: 37876539 PMCID: PMC10593430 DOI: 10.3389/fendo.2023.1278604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/19/2023] [Indexed: 10/26/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fendo.2022.1067227.].
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Affiliation(s)
- Ebaa Al Ozairi
- Clinical Research Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Dalal Alsaeed
- Clinical Research Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Dherar Al Roudhan
- Clinical Research Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Nia Voase
- Clinical Research Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jill P. Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Frederick K. Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Mohammed Abdulla
- Clinical Research Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Stuart R. Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
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102
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Lui JNM, Williams C, Keng MJ, Hopewell JC, Sammons E, Chen F, Gray A, Bowman L, Landray SMJ, Mihaylova B. Impact of New Cardiovascular Events on Quality of Life and Hospital Costs in People With Cardiovascular Disease in the United Kingdom and United States. J Am Heart Assoc 2023; 12:e030766. [PMID: 37750555 PMCID: PMC7615160 DOI: 10.1161/jaha.123.030766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/24/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Despite optimized risk factor control, people with prior cardiovascular disease remain at high cardiovascular disease risk. We assess the immediate- and longer-term impacts of new vascular and nonvascular events on quality of life (QoL) and hospital costs among participants in the REVEAL (Randomized Evaluation of the Effects of Anacetrapib Through Lipid Modification) trial in secondary prevention. METHODS AND RESULTS Data on demographic and clinical characteristics, health-related quality of life (QoL: EuroQoL 5-Dimension-5-Level), adverse events, and hospital admissions during the 4-year follow-up of the 21 820 participants recruited in Europe and North America informed assessments of the impacts of new adverse events on QoL and hospital costs from the UK and US health systems' perspectives using generalized linear regression models. Reductions in QoL were estimated in the years of event occurrence for nonhemorrhagic stroke (-0.067 [United Kingdom], -0.069 [US]), heart failure admission (-0.072 [United Kingdom], -0.103 [US]), incident cancer (-0.064 [United Kingdom], -0.068 [US]), and noncoronary revascularization (-0.071 [United Kingdom], -0.061 [US]), as well as in subsequent years following these events. Myocardial infarction and coronary revascularization (CRV) procedures were not found to affect QoL. All adverse events were associated with additional hospital costs in the years of events and in subsequent years, with the highest additional costs in the years of noncoronary revascularization (£5830 [United Kingdom], $14 133 [US Medicare]), of myocardial infarction with urgent CRV procedure (£5614, $24722), and of urgent/nonurgent CRV procedure without myocardial infarction (£4674/£4651 and $15 251/$17 539). CONCLUSIONS Stroke, heart failure, and noncoronary revascularization procedures substantially reduce QoL, and all cardiovascular disease events increase hospital costs. These estimates are useful in informing cost-effectiveness of interventions to reduce cardiovascular disease risk in secondary prevention. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT01252953; https://www.Isrctn.com. Unique identifier: ISRCTN48678192; https://www.clinicaltrialsregister.eu. Unique identifier: 2010-023467-18.
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Affiliation(s)
- Juliana Nga Man Lui
- Health Economics Research Centre, Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Claire Williams
- Health Economics Research Centre, Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Mi Jun Keng
- Health Economics Research Centre, Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Jemma C. Hopewell
- Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Emily Sammons
- Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Fang Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Alastair Gray
- Health Economics Research Centre, Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Louise Bowman
- Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
- Medical Research Council Population Health Research Unit, Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Sir Martin J. Landray
- Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Borislava Mihaylova
- Health Economics and Policy Research Unit, Wolfson Institute of Population HealthQueen Mary University of LondonUnited Kingdom
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103
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Hyams C, Challen R, Hettle D, Amin-Chowdhury Z, Grimes C, Ruffino G, Conway R, Heath R, North P, Malin A, Maskell NA, Williams P, Williams OM, Ladhani SN, Danon L, Finn A. Serotype Distribution and Disease Severity in Adults Hospitalized with Streptococcus pneumoniae Infection, Bristol and Bath, UK, 2006‒2022. Emerg Infect Dis 2023; 29. [PMID: 37735739 PMCID: PMC10521591 DOI: 10.3201/eid2910.230519] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
Pneumococcal conjugate vaccinations should be evaluated and considered in formulating future public health policy recommendations. Ongoing surveillance after pneumococcal conjugate vaccination (PCV) deployment is essential to inform policy decisions and monitor serotype replacement. We report serotype and disease severity trends in 3,719 adults hospitalized for pneumococcal disease in Bristol and Bath, United Kingdom, during 2006–2022. Of those cases, 1,686 were invasive pneumococcal disease (IPD); 1,501 (89.0%) had a known serotype. IPD decreased during the early COVID-19 pandemic but during 2022 gradually returned to prepandemic levels. Disease severity changed throughout this period: CURB65 severity scores and inpatient deaths decreased and ICU admissions increased. PCV7 and PCV13 serotype IPD decreased from 2006–2009 to 2021–2022. However, residual PCV13 serotype IPD remained, representing 21.7% of 2021–2022 cases, indicating that major adult PCV serotype disease still occurs despite 17 years of pediatric PCV use. Percentages of serotype 3 and 8 IPD increased, and 19F and 19A reemerged. In 2020–2022, a total of 68.2% IPD cases were potentially covered by PCV20.
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Affiliation(s)
| | | | - David Hettle
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Zahin Amin-Chowdhury
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Charli Grimes
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Gabriella Ruffino
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Rauri Conway
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Robyn Heath
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Paul North
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Adam Malin
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Nick A. Maskell
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Philip Williams
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - O. Martin Williams
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Shamez N. Ladhani
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Leon Danon
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
| | - Adam Finn
- University of Bristol, Bristol, UK (C. Hyams, R. Challen, R. Heath, L. Danon, A. Finn)
- Southmead Hospital, Bristol (C. Hyams, C. Grimes, G. Ruffino, R. Conway, N.A. Maskell, A. Finn)
- Bristol Royal Infirmary, Bristol (D. Hettle, P. North, P. Williams, O.M. Williams)
- UK Health Security Agency, London, UK (Z. Amin-Chowdhury, S.N. Ladhani)
- The Royal United Hospital, Bath, UK (A. Malin)
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104
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Casemore RK, Wolffsohn JS, Dutta D. Dry eye clinical practice patterns of UK optometrists. Cont Lens Anterior Eye 2023; 46:101889. [PMID: 37455178 DOI: 10.1016/j.clae.2023.101889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/20/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE In light of the increased roles of optometrists working in primary care in the UK, this research study aimed to gain an insight into perceptions of dry eye disease (DED), knowledge and confidence in diagnosis and management, and satisfaction with currently available treatment options. METHODS Links to an online survey were distributed to optometrists across the UK via optometry websites newsletters, conferences, and local optical committee data bases, between October 2021 and July 2022. The anonymous questionnaire contained a variety of question types including multiple choice, likert-type scale, and free text questions. RESULTS The survey was completed by 131 optometrists, with a broad range of experience, who reported examining 33.3 ± 31.0 dry eye patients per month. Forty-eight percent of respondents were involved in the provision of an extended service. Fluorescein tear breakup time, corneal fluorescein staining, and anterior lid assessment were the most used clinical procedures, both for diagnosis and monitoring purposes. Sixty percent of respondents reported that they believed their patients were satisfied/managed with artificial tear alone, with the availability of a preservative free option being the top consideration, particularly with increasing severity. Of the 18.7% of respondents who held Independent prescriber status, 68% felt this had widened their ability to diagnose and treat DED. This was evidenced by an increase in steroid recommendation for moderate and severe disease. CONCLUSIONS Although dry eye disease was perceived to be an important condition, opinions varied widely regarding knowledge and confidence in diagnosis and management. Involvement in an extended service did not alter patient management. However, an increase in therapeutic management and the employment of a stepwise approach to management has been identified.
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Affiliation(s)
- Rachel K Casemore
- Optometry and Vision Science Research Group, Optometry School, Aston University, UK
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, Optometry School, Aston University, UK
| | - Debarun Dutta
- Optometry and Vision Science Research Group, Optometry School, Aston University, UK.
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105
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Richards-Jones L, Patel P, Jagpal PK, Lowrie R, Saunders K, Burwood S, Shrestha S, Paudyal V. Provision of drug and alcohol services amidst COVID-19 pandemic: a qualitative evaluation on the experiences of service providers. Int J Clin Pharm 2023; 45:1098-1106. [PMID: 36971897 PMCID: PMC10042098 DOI: 10.1007/s11096-023-01557-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/14/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND The impact of COVID-19 pandemic on the provision of drug and alcohol (D&A) services and associated outcomes have been under-researched. AIM This study aimed to understand the experiences of service providers in relation to how drug and alcohol (D&A) services were affected during COVID-19 pandemic, including the adaptations made and lessons learnt for the future. METHOD Focus groups and semi-structured interviews were conducted with participants from various D&A service organisations across the UK. Data were audio recorded, followed by transcription and thematic analysis. RESULTS A total of 46 participants representing various service providers were recruited between October and January 2022. The thematic analysis identified ten themes. COVID-19 required significant changes to how the treatment was provided and prioritised. Expansion of telehealth and digital services were described, which reduced service wait times and increased opportunities for peer network. However, they described missed opportunities for disease screening, and some users risked facing digital exclusion. Participants who provided opiate substitution therapy service spoke of improving service provider/user trust following the shift from daily supervised treatment consumption to weekly dispensing. At the same time, they feared fatal overdoses and non-adherence to treatment. CONCLUSION This study demonstrates the multifaceted impact of the COVID-19 pandemic on UK-based D&A service provisions. The long-term impact of reduced supervision on Substance Use Disorder treatment and outcomes and any effect of virtual communications on service efficiency, patient-provider relationships and treatment retention and successes are unknown, suggesting the need for further study to assess their utility.
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Affiliation(s)
- Levi Richards-Jones
- School of Pharmacy, College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Priya Patel
- School of Pharmacy, College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Parbir Kaur Jagpal
- School of Pharmacy, College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Richard Lowrie
- Pharmacy and Prescribing Support Unit, NHS Glasgow and Clyde, Glasgow, G76 7AT, UK
| | | | | | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Vibhu Paudyal
- School of Pharmacy, College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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106
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Rasmussen S, Cramer RJ, Nascimbene L, Robertson RA, Cacace S, Bowling J. A qualitative assessment and short-term mediation analysis of defeat, entrapment, and suicide. Suicide Life Threat Behav 2023; 53:880-892. [PMID: 37571915 DOI: 10.1111/sltb.12990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/27/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVES The Integrated Motivational-Volitional Model (IMV) of Suicide is growing in empirical support. The present study advances IMV research through two aims: (1) to qualitatively probe the subjective experiences of defeat, internal entrapment, and external entrapment, and (2) conducting a 3-month prospective mediation analysis using quantitative and qualitative metrics of defeat and entrapment. METHODS The study featured an online two-point survey separated by 3 months. Participants were 255 adults living in the United Kingdom. RESULTS Persons endorsing qualitative defeat and internal entrapment in their narratives also showed higher quantitative scores on corresponding IMV and suicide-related self-report scales. Internal entrapment mediated the effect of baseline defeat on 3-month suicidal ideation, whereas external entrapment mediated the association of baseline defeat on 3-month suicide attempt likelihood. Quantitative assessment of entrapment was more significantly associated with suicide attempts and ideation within mediation tests compared to corresponding qualitative variables. CONCLUSIONS IMV model principles are largely supported by findings. Mediation results support further consideration of entrapment and defeat within clinical practice and public health-focused suicide research. Understanding the complexity of entrapment narratives represents an important next step for conducting qualitative IMV-focused research with minoritized and high-risk suicide populations.
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Affiliation(s)
- Susan Rasmussen
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Robert J Cramer
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Laura Nascimbene
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Ryan A Robertson
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Sam Cacace
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Jessamyn Bowling
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
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107
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Ojo-Aromokudu O, Suffel A, Bell S, Mounier-Jack S. Views and experiences of primary care among Black communities in the United Kingdom: a qualitative systematic review. Ethn Health 2023; 28:1006-1025. [PMID: 37160684 DOI: 10.1080/13557858.2023.2208313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND In the United Kingdom, people with non-white ethnicities are more likely to report being in worse health conditions and have poorer experiences of healthcare services than white counterparts. The voices of those of Black ethnicities are often merged in literature among other non-white ethnicities. This literature review aims to analyse studies that investigate Black participant experiences of primary care in the UK. METHODS We conducted a systematic literature review searching Medline, Web of Science, EMBASE, SCOPUS, Social Policy and Practice, CINAHL plus, Psych INFO and Global Health with specific search terms for appropriate studies. No publish date limit was applied. RESULTS 40 papers (39 articles and 1 thesis) were deemed eligible for inclusion in the review. A number of major themes emerged. Patient expectations of healthcare and the health seeking behaviour impacted their interactions with health systems in the UK. Both language and finances emerged as barriers through which some Black participants interacted with primary care services. (Mis)trust of clinicians and the health system was a common theme that often negatively impacted views of UK primary care services. The social context of the primary care service and instances of a cultural disconnect also impacted views of primary care services. Some papers detail patients recognising differential treatment based on ethnicity. The review included the voices of primary care professionals where descriptions of Black patients were overwhelmingly negative. CONCLUSION Views and experiences of Black groups may be radically different to other ethnic minorities and thus, should be teased out of broader umbrella terms like Black and Asian Minority Ethnic (BAME) and Black Minority Ethnic (BME). To address ethnicity-based health inequalities, culturally sensitive interventions that engage with the impacted community including co-designed interventions should be considered while acknowledging the implications of being racialised as Black in the UK.
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Affiliation(s)
- Oyinkansola Ojo-Aromokudu
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Anne Suffel
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Sadie Bell
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sandra Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
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108
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Peake L, Inns T, Jarvis C, King G, Rabie H, Henderson J, Wensley A, Jarratt R, Roberts C, Williams C, Orife O, Browning L, Neilson M, McCarthy C, Millar P, Love N, Elwin K, Robinson G, Mannes T, Young N, Chalmers R, Elson R, Vivancos R. Preliminary investigation of a significant national Cryptosporidium exceedance in the United Kingdom, August 2023 and ongoing. Euro Surveill 2023; 28:2300538. [PMID: 37883039 PMCID: PMC10604540 DOI: 10.2807/1560-7917.es.2023.28.43.2300538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 10/25/2023] [Indexed: 10/27/2023] Open
Abstract
Routine laboratory surveillance has identified an unprecedented and ongoing exceedance of Cryptosporidium spp. across the United Kingdom, notably driven by C. hominis transmission, since 14 August 2023. Information from 477 reported cases in England and Wales, followed up with a standardised exposure questionnaire as of 25 September 2023, identified foreign travel in 250 (54%) of 463 respondents and swimming in 234 (66%) of 353 cases. A significant, common exposure has not yet been identified in first analyses.
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Affiliation(s)
- Lewis Peake
- United Kingdom Health Security Agency, London, the United Kingdom
| | - Thomas Inns
- United Kingdom Health Security Agency, London, the United Kingdom
| | | | - Grace King
- United Kingdom Health Security Agency, London, the United Kingdom
| | - Hussein Rabie
- United Kingdom Health Security Agency, London, the United Kingdom
| | - Joan Henderson
- United Kingdom Health Security Agency, London, the United Kingdom
| | - Adrian Wensley
- United Kingdom Health Security Agency, London, the United Kingdom
| | - Reece Jarratt
- United Kingdom Health Security Agency, London, the United Kingdom
| | | | | | | | | | | | | | - Paul Millar
- Health and Safety Committee (HSC) Public Health Agency, Belfast, Northern Ireland, the United Kingdom
| | - Nicola Love
- United Kingdom Health Security Agency, London, the United Kingdom
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Gastrointestinal Infections, Liverpool, the United Kingdom
| | - Kristin Elwin
- Cryptosporidium Reference Unit, Public Health Wales, Swansea, the United Kingdom
| | - Guy Robinson
- Cryptosporidium Reference Unit, Public Health Wales, Swansea, the United Kingdom
| | - Trish Mannes
- United Kingdom Health Security Agency, London, the United Kingdom
| | - Nick Young
- United Kingdom Health Security Agency, London, the United Kingdom
| | - Rachel Chalmers
- Cryptosporidium Reference Unit, Public Health Wales, Swansea, the United Kingdom
| | - Richard Elson
- United Kingdom Health Security Agency, London, the United Kingdom
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Gastrointestinal Infections, Liverpool, the United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, the United Kingdom
| | - Roberto Vivancos
- United Kingdom Health Security Agency, London, the United Kingdom
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Gastrointestinal Infections, Liverpool, the United Kingdom
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, the United Kingdom
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Harrison RE, Hamada A, Haswell N, Groves A, Vihta KD, Cella K, Garner S, Walker AS, Seale AC. Cycle Threshold Values as Indication of Increasing SARS-CoV-2 New Variants, England, 2020-2022. Emerg Infect Dis 2023; 29:2024-2031. [PMID: 37678158 PMCID: PMC10521603 DOI: 10.3201/eid2910.230030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
Early detection of increased infections or new variants of SARS-CoV-2 is critical for public health response. To determine whether cycle threshold (Ct) data from PCR tests for SARS-CoV-2 could serve as an early indicator of epidemic growth, we analyzed daily mean Ct values in England, UK, by gene target and used iterative sequential regression to detect break points in mean Ct values (and positive test counts). To monitor the epidemic in England, we continued those analyses in real time. During September 2020-January 2022, a total of 7,611,153 positive SARS-CoV-2 PCR test results with Ct data were reported. Spike (S) gene target (S+/S-)-specific mean Ct values decreased 6-29 days before positive test counts increased, and S-gene Ct values provided early indication of increasing new variants (Delta and Omicron). Our approach was beneficial in the context of the first waves of the COVID-19 pandemic and can be used to support future infectious disease monitoring.
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110
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Plahe G, Hall JL, Johnson D, Gilbert L, Birtles RJ. Borrelia bavariensis in Questing Ixodes ricinus Ticks, United Kingdom. Emerg Infect Dis 2023; 29:2173-2175. [PMID: 37735806 PMCID: PMC10521598 DOI: 10.3201/eid2910.230907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
We detected Borrelia bavariensis in Ixodes ricinus ticks collected near 2 towns in the United Kingdom. Human B. bavariensis infections have not been reported previously in the country, underscoring the value of tick surveillance to warn of emerging human disease. B. bavariensis should be considered in patients with suspected neuroborreliosis.
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Lowther-Payne HJ, Ushakova A, Beckwith A, Liberty C, Edge R, Lobban F. Understanding inequalities in access to adult mental health services in the UK: a systematic mapping review. BMC Health Serv Res 2023; 23:1042. [PMID: 37773154 PMCID: PMC10542667 DOI: 10.1186/s12913-023-10030-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/14/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Population groups experience differential access to timely and high-quality mental healthcare. Despite efforts of recent UK policies to improve the accessibility of mental health services, there remains a lack of comprehensive understanding of inequalities in access to services needed to do this. This systematic mapping review aimed to address this gap by identifying which population groups continue to be poorly served by access to adult mental health services in the UK, how access has been measured, and what research methods have been applied. METHODS Seven electronic databases were searched from January 2014 up to May 2022. Primary research studies of any design were included if they examined access to adult NHS mental health services in the UK by population groups at risk of experiencing inequalities. Study characteristics, measures of access, inequalities studied, and key findings were extracted. A best-fit framework approach was used, applying Levesque's Conceptual Framework for Healthcare Access to synthesise measures of access, and applying a template derived from Cochrane Progress-Plus and NHS Long Term Plan equality characteristics to synthesise key findings associated with inequalities. RESULTS Of 1,929 publications retrieved, 152 studies of various types were included. The most frequently considered dimensions of inequality were gender, age, and ethnicity, whilst social capital, religion, and sexual orientation were least frequently considered. Most studies researched access by measuring "healthcare utilisation", followed by studies that measured "healthcare seeking". Key barriers to access were associated with individuals' "ability to seek" (e.g. stigma and discrimination) and "ability to reach" (e.g. availability of services). Almost half of the studies used routinely collected patient data, and only 16% of studies reported patient and public involvement. CONCLUSIONS Little appears to have changed in the nature and extent of inequalities, suggesting that mental health services have not become more accessible. Actions to reduce inequalities should address barriers to population groups' abilities to seek and reach services such as stigma-reducing interventions, and re-designing services and pathways. Significant benefits exist in using routinely collected patient data, but its limitations should not be ignored. More theoretically informed research, using a holistic measurement of access, is needed in this area. REVIEW REGISTRATION https://doi.org/10.17605/OSF.IO/RQ5U7 .
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Affiliation(s)
- Hayley J Lowther-Payne
- Lancaster Medical School, Faculty of Health and Medicine, Health Innovation Campus, Lancaster University, Sir John Fisher Drive, Lancaster, Lancashire, LA1 4AT, UK.
| | - Anastasia Ushakova
- Lancaster Medical School, Faculty of Health and Medicine, Health Innovation Campus, Lancaster University, Sir John Fisher Drive, Lancaster, Lancashire, LA1 4AT, UK
| | - Adelaide Beckwith
- Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Bamber Bridge, Preston, Lancashire, PR5 6AW, UK
| | - Catherine Liberty
- Division of Health Research, Faculty of Health and Medicine, Health Innovation Campus, Lancaster University, Sir John Fisher Drive, Lancaster, LA1 4AT, Lancashire, UK
| | - Rhiannon Edge
- Lancaster Medical School, Faculty of Health and Medicine, Health Innovation Campus, Lancaster University, Sir John Fisher Drive, Lancaster, Lancashire, LA1 4AT, UK
| | - Fiona Lobban
- Division of Health Research, Faculty of Health and Medicine, Health Innovation Campus, Lancaster University, Sir John Fisher Drive, Lancaster, LA1 4AT, Lancashire, UK
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112
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Beecher R. Children, Sexual Abuse and the Emotions of the Community Health Practitioner in England and Wales, 1970-2000. J Hist Med Allied Sci 2023; 78:365-380. [PMID: 37158733 PMCID: PMC10518052 DOI: 10.1093/jhmas/jrad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
A survivor of child sexual abuse felt that doctors missed opportunities to notice her distress when, at fourteen, she had an unexplained illness that lasted for a year. The cause, she wrote, was "explained by Doctors as psychological, but nobody questioned further. WHY??? … If adults don't listen[,] then we have no one to turn to." For decades, community health practitioners have been identified as an important group in protecting children from maltreatment, but survivor testimony and agency statistics demonstrate that they rarely receive verbal disclosures or recognize the physical or behavioural warning signs of sexual abuse. The accounts we have of the 1980s tell of swiftly heightening professional awareness, followed by a visceral backlash in the latter part of the decade that discouraged practitioners from acting on their concerns. This article uses trade and professional journals, training materials, textbooks, and new oral histories to consider why community-based doctors and nurses have struggled to notice and respond to the sexually abused child. It will argue that the conceptual model of child sexual abuse that community health practitioners encountered in the workplace encouraged a mechanical and procedural response to suspicions of abuse. In a highly gendered and contested workplace, practitioners' feelings about how survivors, non-abusing family members, and perpetrators should be understood were rarely debated in training or in practice. The emotional cost to the practitioners of engagement with sexual abuse, and their need for spaces of reflexivity and structures of support, were ignored.
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Lombardo C, Guo L, Solomon S, Crepaz-Keay D, McDaid S, Thorpe L, Martin S, John A, Morton A, Davidson G, Kousoulis AA, Van Bortel T. Inequalities and mental health during the Coronavirus pandemic in the UK: a mixed-methods exploration. BMC Public Health 2023; 23:1830. [PMID: 37730605 PMCID: PMC10510114 DOI: 10.1186/s12889-023-16523-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND The World Health Organisation declared the novel Coronavirus disease (COVID-19) a global pandemic on 11th March 2020. Since then, the world has been firmly in its grip. At the time of writing, there were more than 767,972,961 million confirmed cases and over 6,950,655 million deaths. While the main policy focus has been on controlling the virus and ensuring vaccine roll-out and uptake, the population mental health impacts of the pandemic are expected to be long-term, with certain population groups affected more than others. METHODS The overall objectives of our 'Coronavirus: Mental Health and the Pandemic' study were to explore UK adults' experiences of the Coronavirus pandemic and to gain insights into the mental health impacts, population-level changes over time, current and future mental health needs, and how these can best be addressed. The wider mixed-methods study consisted of repeated cross-sectional surveys and embedded qualitative sub-studies including in-depth interviews and focus group discussions with the wider UK adult population. For this particular inequalities and mental health sub-study, we used mixed methods data from our cross-sectional surveys and we carried out three Focus Group Discussions with a maximum variation sample from across the UK adult population. The discussions covered the broader topic of 'Inequalities and mental health during the Coronavirus pandemic in the UK' and took place online between April and August 2020. Focus Groups transcripts were analysed using thematic analysis in NVIVO. Cross-sectional survey data were analysed using STATA for descriptive statistics. RESULTS Three broad main themes emerged, each supporting a number of sub-themes: (1) Impacts of the pandemic; (2) Moving forward: needs and recommendations; (3) Coping mechanisms and resilience. Findings showed that participants described their experiences of the pandemic in relation to its impact on themselves and on different groups of people. Their experiences illustrated how the pandemic and subsequent measures had exacerbated existing inequalities and created new ones, and triggered various emotional responses. Participants also described their coping strategies and what worked and did not work for them, as well as support needs and recommendations for moving forward through, and out of, the pandemic; all of which are valuable learnings to be considered in policy making for improving mental health and for ensuring future preparedness. CONCLUSIONS The pandemic is taking a long-term toll on the nations' mental health which will continue to have impacts for years to come. It is therefore crucial to learn the vital lessons learned from this pandemic. Specific as well as whole-government policies need to respond to this, address inequalities and the different needs across the life-course and across society, and take a holistic approach to mental health improvement across the UK.
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Affiliation(s)
- Chiara Lombardo
- Cambridge Public Health Interdisciplinary Research Centre, Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 113, Cambridge, CB2 0SR, UK
- Mental Health Foundation, Studio 2, 197 Long Lane, London, SE1 4PD, UK
| | - Lijia Guo
- Cambridge Public Health Interdisciplinary Research Centre, Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 113, Cambridge, CB2 0SR, UK
| | - Susan Solomon
- Mental Health Foundation, Studio 2, 197 Long Lane, London, SE1 4PD, UK
| | - David Crepaz-Keay
- Mental Health Foundation, Studio 2, 197 Long Lane, London, SE1 4PD, UK
| | - Shari McDaid
- Mental Health Foundation, Studio 2, 197 Long Lane, London, SE1 4PD, UK
| | - Lucy Thorpe
- Mental Health Foundation, Studio 2, 197 Long Lane, London, SE1 4PD, UK
| | - Steven Martin
- Leicester School of Allied Health Sciences, Faculty of Health and Life Sciences, De Montfort University, Gateway House, Leicester, LE1 9BH, UK
| | - Ann John
- Health Data Research UK, Swansea University Medical School, Singleton Park, Swansea, SA2 8PP, UK
| | - Alec Morton
- Department of Management Science, Strathclyde Business School, University of Strathclyde, 199 Cathedral Street, Glasgow, G4 0QU, UK
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, BT7 1NN, UK
| | | | - Tine Van Bortel
- Cambridge Public Health Interdisciplinary Research Centre, Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 113, Cambridge, CB2 0SR, UK.
- Leicester School of Allied Health Sciences, Faculty of Health and Life Sciences, De Montfort University, Gateway House, Leicester, LE1 9BH, UK.
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Elamin A, Ansah JP. Projecting the burden of dental caries and periodontal diseases among the adult population in the United Kingdom using a multi-state population model. Front Public Health 2023; 11:1190197. [PMID: 37744497 PMCID: PMC10513470 DOI: 10.3389/fpubh.2023.1190197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Objectives With the aging United Kingdom population, oral diseases are expected to increase. Exploring credible projections is fundamental to understanding the likely impact of emerging population-level interventions on oral disease burden. This study aims at providing a credible, evidence-based projection of the adult population in the United Kingdom with dental caries and periodontal diseases. Methods We developed a multi-state population model using system dynamics that disaggregates the adult population in the United Kingdom into different oral health states. The caries population was divided into three states: no caries, treated caries, and untreated caries. The periodontal disease population was disaggregated into no periodontal disease, pocketing between 4 and < 6 mm, 6 and < 9 mm, and 9 mm or more. Data from the 2009 dental health survey in the United Kingdom was used to estimate age and gender-specific prevalence rates as input to the multi-state population model. Results Of the population 16 years and older, the number with carious teeth is projected to decrease from 15.742 million in the year 2020 to 15.504 million by the year 2050, representing a decrease of 1.5%. For individuals with carious teeth, the older adult population is estimated to constitute 62.06% by 2050 and is projected to increase 89.4% from 5.079 million in 2020 to 9.623 million by 2050. The adult population with periodontal pocketing is estimated to increase from 25.751 million in 2020 to 27.980 million by 2050, while those with periodontal loss of attachment are projected to increase from 18.667 million in 2020 to 20.898 million by 2050. The burden of carious teeth and periodontal diseases is anticipated to shift from the adult population (16-59 years) to the older adult population. The older adult population with carious teeth is estimated to rise from 32.26% in 2020 to 62.06% by 2050, while that for periodontal disease is expected to increase from 42.44% in 2020 to 54.57% by 2050. Conclusion This model provides evidence-based plausible future demand for oral health conditions, allowing policymakers to plan for oral health capacity to address growing needs. Because of the significant delay involved in educating and training oral health personnel, such projections offer policymakers the opportunity to be proactive in planning for future capacity needs instead of being reactive.
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Affiliation(s)
- Amal Elamin
- School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, London, United Kingdom
| | - John P. Ansah
- Center for Community Health Integration, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
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Ryan R, Eisen S, Patel D, Longley N. Perspectives on the current diphtheria outbreak among asylum seekers in the UK. J Travel Med 2023; 30:taad095. [PMID: 37486727 DOI: 10.1093/jtm/taad095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/09/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
An outbreak of diphtheria has been reported among asylum seekers to the UK, with a 7-fold increase in annual cases in 2022. The UK response involves a mass screening, vaccination and prophylaxis programme for all individuals who have been through an asylum seeker reception centre.
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Affiliation(s)
- Rebecca Ryan
- University College London Hospitals, London NW1 2BU, UK
| | - Sarah Eisen
- Hospital for Tropical Diseases, University College London Hospitals, London NW1 2BU, UK
- London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Dipti Patel
- National Travel Health Network and Centre, University College London Hospitals, London NW1 2BU, UK
| | - Nicky Longley
- Hospital for Tropical Diseases, University College London Hospitals, London NW1 2BU, UK
- London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
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116
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Attar-Zadeh D, Capstick T, Leese D, Arnetorp S, Rapsomaniki E, Da Costa KP, Maslova E, Xu Y, Gibson D, Quint JK. Healthcare costs associated with short-acting β 2-agonists in asthma: observational UK SABINA study. BJGP Open 2023; 7:BJGPO.2023.0015. [PMID: 36759020 PMCID: PMC10646192 DOI: 10.3399/bjgpo.2023.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Poor asthma control is associated with high short-acting β2-agonist (SABA) use. AIM To assess asthma-related healthcare resource utilisation (HCRU) and medication costs associated with high versus low SABA prescriptions in the UK. DESIGN & SETTING Analysis of SABINA I (SABA use IN Asthma I), a retrospective longitudinal study using UK electronic health records (Clinical Practice Research Datalink GOLD 2008-2019 and Hospital Episode Statistics database). METHOD Eligible patients were ≥12 years old with SABA prescriptions in the past year. SABA prescriptions (number of canisters per year) were defined as high (≥3) or low (1-2). Association of SABA prescriptions with HCRU was assessed by negative binominal model adjusted for covariates. The UK unit costs from the NHS were applied to estimate total healthcare costs (2020). Medication costs were based on the annual average number of canisters per year per patient. RESULTS Overall, 186 061 patients with SABA prescriptions were included, of whom 51% were prescribed high SABA. Total annual average costs (HCRU and medication) were 52% higher in the high SABA group versus the low SABA group (£2 256 091 per 1000 patients/year versus £1 480 640 per 1000 patients/year). Medication costs accounted for the majority of asthma-related costs. Across both groups, most HCRU costs were for non-exacerbation-related primary care or hospital outpatient visits. The annual average HCRU cost difference for high SABA versus low SABA was the greatest for hospitalisations (+230%; £15 521 per 1000 patients/year versus £4697 per 1000 patients/year) and exacerbation-related primary care visits (+162%; £18 770 per 1000 patients/year versus £7160 per 1000 patients/year). Asthma-related HCRU extrapolated to the broader UK asthma population was £108.5 million per year higher with high SABA versus low SABA. CONCLUSION High SABA versus low SABA prescriptions are associated with higher asthma-related HCRU costs.
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Affiliation(s)
| | - Toby Capstick
- Medicines Management and Pharmacy Services, Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - Deborah Leese
- Sheffield Medicines Optimisation Team, NHS Sheffield Clinical Commissioning Group, Sheffield, UK
| | - Sofie Arnetorp
- Biopharmaceuticals Business Unit, Global Market Access Pricing, Vaccine & Immune Therapy, AstraZeneca, Gothenburg, Sweden
| | - Eleni Rapsomaniki
- Real World Science, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK
| | | | - Ekaterina Maslova
- BioPharmaceutical Medical, Medical Affairs Respiratory and Immunology, AstraZeneca, Cambridge, UK
| | - Yang Xu
- BioPharmaceutical Medical, Medical Affairs Respiratory and Immunology, AstraZeneca, Cambridge, UK
| | - Danny Gibson
- Global Market Access and Pricing, Health Economics and Payer Evidence, AstraZeneca, Cambridge, UK
| | - Jennifer K Quint
- National Heart Lung Institute, Imperial College London, London, UK
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Romanelli RJ, Cabling M, Marciniak-Nuqui Z, Marjanovic S, Morris S, Dufresne E, Yerushalmi E. The Societal and Indirect Economic Burden of Seasonal Influenza in the United Kingdom. Rand Health Q 2023; 10:2. [PMID: 37720072 PMCID: PMC10501821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Seasonal influenza is a significant public-health issue. In the UK, the influenza season is associated with an increased demand for and pressure on the NHS. The direct health and economic impacts of seasonal influenza have received much attention. However, less attention has been given to its broader societal burden, including its indirect economic impact. We first conducted a rapid evidence assessment of the literature to understand the societal burden of seasonal influenza in the UK. Secondly, we conducted analyses of publicly available, aggregated data from NHS England and NHS Digital to better understand the impact of seasonal influenza on the provision of NHS services both before and after the COVID-19 pandemic. We also conducted a geographically representative survey of 1,000 working-age adults across the UK, who reported having influenza or caring for a dependent with influenza during at least one of the past four influenza seasons to understand impacts related to absenteeism and presenteeism in the workplace, lost wages and out-of-pocket costs. Fourthly, we conducted interviews with 20 key stakeholders within the NHS from primary care and secondary care across the four UK nations. Lastly, we used an epidemiologic-economic framework to estimate the number of influenza cases and then applied a macro-economic computable general equilibrium model to estimate the indirect economic costs associated with lost economic productivity among working-age adults who become ill with influenza.
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Craddock N, Gentili C, Phoenix A, White P, Diedrichs PC, Barlow FK. Investigating the role of perceived ingroup and outgroup colourism on body image and wellbeing among Black, Asian, and other racialised/ethnic minority groups living in the UK. Body Image 2023; 46:246-255. [PMID: 37356207 DOI: 10.1016/j.bodyim.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/15/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023]
Abstract
Colourism is a form of prejudice and discrimination based on skin shade, disadvantaging people of colour with darker skin. This study investigates the relationship between perceived colourism, body image, and psychological wellbeing, considering perceived colourism from the ingroup (people of the same racialised group) and the outgroup (white people). A total of 516 Black, Asian, and other racialised/ethnic minority adults living in the UK (56.8 % women) completed an online survey. Using structural equation modelling, we tested a theoretically informed model: ingroup and outgroup colourism were predictors, body image and psychological distress were outcomes, and skin shade satisfaction and surveillance were hypothesised mediators. The model provided a good fit to the data. Ingroup colourism was related to lower skin shade satisfaction and higher skin shade surveillance, which in turn related to worse body image and greater psychological distress. Outgroup colourism was related to higher skin shade surveillance, which in turn was associated with worse body image. Outgroup colourism was directly associated with greater psychological distress. Results showed perceived colourism was associated with worse body image and psychological distress among people of colour in the UK. Therefore, colourism should be considered in the development of societal-, community-, and individual-level body image interventions.
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Affiliation(s)
- Nadia Craddock
- Centre for Appearance Research, University of the West of England, UK.
| | - Caterina Gentili
- Centre for Appearance Research, University of the West of England, UK
| | - Aisha Phoenix
- School of Education, Communication & Society, King's College London, UK
| | - Paul White
- Department of Statistics, University of the West of England, UK
| | | | - Fiona K Barlow
- School of Psychology, The University of Queensland, Australia
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Jewitt S, Smallman-Raynor M, McClaughlin E, Clark M, Dunham S, Elliott S, Munro A, Parnell T, Tarlinton R. Exploring the responses of smallscale poultry keepers to avian influenza regulations and guidance in the United Kingdom, with recommendations for improved biosecurity messaging. Heliyon 2023; 9:e19211. [PMID: 37662753 PMCID: PMC10470266 DOI: 10.1016/j.heliyon.2023.e19211] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023] Open
Abstract
Understanding how smallscale ('backyard') poultry keepers interpret and respond to governmental directives designed to reduce the transmission of highly pathogenic avian influenza (HPAI) is of paramount importance in preparing for future HPAI outbreaks. Qualitative insights from open questions in an online survey conducted during the 2021-22 HPAI season (1,559 responses) shed light on smallscale poultry keepers' understanding of, and responses to, governmental directives to control HPAI exposure and onwards transmission. A follow-up participatory workshop (21 participants) explored the HPAI-related information sources used by smallscale poultry keepers, their trust in these sources, perceptions of HPAI-related risk, and interpretation of, opinions on and adherence to government regulations and communications regarding biosecurity and housing measures. This paper draws on a multi-scale behaviour change model to explore barriers to compliance with HPAI-related regulations. Insights from behaviour settings theory reveal how poultry-keeping settings and routines might be 'disrupted' and 're-configured' to improve long-term biosecurity and reduce the risk of HPAI exposure. The findings highlight the need for HPAI-related guidance that is tailored to smallscale poultry keepers. This guidance should include clear action points and simple, practical, affordable and sustainable suggestions for improving compliance with biosecurity measures.
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Affiliation(s)
- Sarah Jewitt
- School of Geography, University of Nottingham, UK
| | | | | | - Michael Clark
- One Virology, The Wolfson Centre for Global Virus Research, School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Stephen Dunham
- One Virology, The Wolfson Centre for Global Virus Research, School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Sol Elliott
- One Virology, The Wolfson Centre for Global Virus Research, School of Veterinary Medicine and Science, University of Nottingham, UK
| | | | | | - Rachael Tarlinton
- One Virology, The Wolfson Centre for Global Virus Research, School of Veterinary Medicine and Science, University of Nottingham, UK
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Dowling T, Steele S. Is sexual misconduct training sufficient in the UK's medical schools: Results of a cross-sectional survey and opportunities for improvement. JRSM Open 2023; 14:20542704231198732. [PMID: 37719087 PMCID: PMC10501073 DOI: 10.1177/20542704231198732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Objective Sexual misconduct adversely affects the mental and physical health of millions of people each year and has been declared a global pandemic. Incidence in both educational and clinical settings remains high. In the last 5 years, the NHS spent over £4 million settling sexual misconduct-related claims. Effective prevention requires training across all stages of career, beginning in clinical school. Here, we explore training in the UK's medical schools to identify provision and areas for improvement. Design Freedom of Information Act 2000 requests for data on training delivery and curricula content. Setting 34 public UK universities offering medical education. Participants not applicable. Main Outcome Measures Provision and delivery of training, mode of delivery, theme, and continuation of training. Results All 34 universities responded. Twenty-two identified offering training. Seventeen made it compulsory. A review of curricula identified, however, only 18 did more just than mentioned sexual misconduct. Nine offered training more than once. Twelve did not offer training, of which three identified no plans to offer such training in the future. The most common delivery modes for training were workshops and lectures. The training was most often within the sexual health curriculum, disconnecting it from professionalism. Conclusions There is no standardisation of sexual harassment training across the UK's public medical schools. Many future doctors will not have received relevant education when they assume posts in the NHS. Considering the magnitude of this issue and its critical connection to professionalism and collegiality, universities and professional bodies urgently should address this deficiency.
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Affiliation(s)
- Tia Dowling
- Population Health Sciences Partnership, University of Cambridge, Cambridge, UK
- St Edmund's College, Cambridge, UK
| | - Sarah Steele
- St Edmund's College, Cambridge, UK
- ThinkLab, University of Cambridge, Cambridge, UK
- Intellectual Forum, Jesus College, Cambridge, UK
- Department of Social and Political Sciences, Bocconi University, Milan, Italy
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Loopstra R, Lambie-Mumford H. Food banks: Understanding their role in the food insecure population in the UK. Proc Nutr Soc 2023; 82:253-263. [PMID: 36999354 DOI: 10.1017/s0029665123002720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
The present paper reviews the growing body of literature on food insecurity and food bank use in the UK. It provides an overview of food insecurity in this context, followed by a description of the emergence of food banks, highlighting how any role that food banks play in the food insecure population is limited. Data on food insecurity and food bank use suggest many people experiencing food insecurity do not receive help from food banks. To better understand the factors influencing the relationship between food insecurity and food bank use, a conceptual framework is outlined, suggesting the relationship is far from straightforward and contingent on many factors. The nature and availability of food banks and other local support services and individual-level factors influence the likelihood of food banks being used in the context of food insecurity. Then, the extent to which food banks can impact food insecurity is also dependent on the quantity and quality of food distributed, as well as other support services offered from food banks. Closing reflections highlight rising living costs and food banks reporting that they do not have capacity to cope with increasing demand, underscoring the need for policy interventions. Reliance on food banks to respond to food insecurity may ultimately impede formulation of effective policy interventions to reduce food insecurity, giving the illusion of widespread available support, whilst food insecurity persists among those receiving help from food banks and those who experience food insecurity but do not use food banks.
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Affiliation(s)
- Rachel Loopstra
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
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122
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Anderson A, Hobson‐West P. Animal research, ethical boundary-work, and the geographies of veterinary expertise. Trans Inst Br Geogr 2023; 48:491-505. [PMID: 38505469 PMCID: PMC10946936 DOI: 10.1111/tran.12594] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/21/2022] [Accepted: 11/18/2022] [Indexed: 03/21/2024]
Abstract
The veterinary profession has been relatively understudied in social science, though recent work has highlighted the geographic dimensions of veterinary expertise. This paper draws on in-depth qualitative interviews with Named Veterinary Surgeons (NVSs) working in UK animal research to demonstrate how and why they distinguish between ethical aspects of veterinary work in the spaces of the laboratory and general clinical practice. The paper mobilises the sociological concept of ethical boundary-work to help understand how animal research - often assumed to represent a contentious ethical space - is constructed positively as a space for veterinary work. Findings suggest first, that NVSs differentiate between laboratory veterinary-work and clinical work based on the scale at which veterinary expertise functions in the provision of healthcare to animals. Second, NVSs highlight a geography of veterinary authority in which veterinary expertise is felt to be more successfully applied in the laboratory compared with the clinic, where professional expertise competes with other sources of information and clients' finances and behaviours. Third, NVSs articulate a geography of consistency in which veterinary care in the laboratory is claimed to be more consistent between animals, as opposed to in the clinic, where animal experience may be influenced by individual owner characteristics. Overall, we show how through engaging in this kind of ethical boundary-work NVSs are not only presenting a form of scientific practice as 'ethical', they are also constructing a professional topology of veterinary practice and expertise. Finally, the paper argues for greater attentiveness to veterinary geographies beyond the more routine spaces of veterinary practice.
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Affiliation(s)
- Alistair Anderson
- School of Sociology and Social PolicyUniversity of NottinghamNottinghamUK
| | - Pru Hobson‐West
- School of Sociology and Social PolicyUniversity of NottinghamNottinghamUK
- School of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
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Wilkinson T, Beaver S, Macartney M, McArthur E, Yadav V, Lied‐Lied A. Burden of respiratory syncytial virus in adults in the United Kingdom: A systematic literature review and gap analysis. Influenza Other Respir Viruses 2023; 17:e13188. [PMID: 37744994 PMCID: PMC10511839 DOI: 10.1111/irv.13188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/31/2023] [Accepted: 08/09/2023] [Indexed: 09/26/2023] Open
Abstract
Despite the growing recognition of a potentially significant respiratory syncytial virus (RSV) disease burden in adults, relevant evidence in the United Kingdom (UK) is limited. This systematic literature review (SLR) aimed to identify the disease burden of RSV in UK adults, including certain high-risk subgroups and existing evidence gaps. Published studies (2011 onwards) reporting epidemiological, economic and clinical burden outcomes in UK adults (≥15 years) with RSV were identified from indexed databases, including MEDLINE, Embase and the Cochrane library. High-risk groups included elderly (≥65 years), immunocompromised, co-morbid and co-infected patients. Outcomes included RSV incidence/prevalence, mortality, clinical presentation and direct/indirect resource use/costs. Twenty-eight publications on 28 unique studies were identified, mostly in general/respiratory indicator (n = 17), elderly (n = 10) and immunocompromised (n = 6) cohorts. Main outcomes reported in the general/respiratory indicator cohort were RSV infection incidence (seasonal/annual: 0.09-17.9%/6.6-15.1%), mortality (8,482 deaths/season) and direct resource use (including mean general practitioner [GP] episodes/season: 487,247). Seasonal/annual incidence was 14.6-26.5%/0.7-16% in high-risk cohorts. Attributed to RSV in the elderly were 7,915 deaths/season and 175,070 mean GP episodes/season. Only two studies reported on co-morbid cohorts. Clinical burden outcomes were only reported in general and immunocompromised patients, and no evidence was found in any cohort on indirect economic burden or RSV complications. Evidence captured suggests that RSV may have a substantial burden in UK adults. However, available data were limited and highly heterogenous, with further studies needed to characterise the burden of RSV in adults and to validate our findings.
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Affiliation(s)
- Tom Wilkinson
- Clinical and Experimental SciencesUniversity of Southampton Faculty of MedicineSouthamptonUK
- National Institute for Health and Care Research Southampton Biomedical Research CentreSouthamptonUK
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Özen-Dursun B, Panagioti M, Alharbi R, Giles S, Husain N. A qualitative study on lived experience of self-harm in South Asians in the UK: From reasons to recovery. Clin Psychol Psychother 2023; 30:1179-1189. [PMID: 37337356 DOI: 10.1002/cpp.2875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/17/2023] [Accepted: 05/22/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Self-harm rates and clinical presentations differ by ethnicity. South Asian women are at risk of self-harm. Previous research suggested investigating individuals' experiences with self-harm with qualitative studies in developing self-harm prevention strategies. This research aims to explore self-harm experiences among South Asians in the United Kingdom. DESIGN Qualitative study. METHODS Participants were recruited via third-sector organizations and online platforms. Semi-structured interviews were conducted with 11 South Asian individuals with a history of self-harm living in the United Kingdom. The data were analysed based on a reflective thematic analysis approach. RESULTS Results revealed four main themes: (1) reasons for self-harm; (2) recovery journey; (3) culture and mental health; and (4) the transition to suicidal thoughts and behaviours. Reasons for self-harm included negative life circumstances, social life difficulties, challenges faced during COVID-19 and mental health problems. Participants described their recovery journey by acknowledging the role of professional help, self-care, psychoeducation and personal growth, improving social relationships, and faith and spirituality. Cultural factors included generational differences and stigma. Culturally adapted psychological interventions were perceived as promising. The reported transition from self-harm to suicidal behaviours was linked to experiencing major stressful life events and the use of severe methods of self-harm. CONCLUSIONS The findings suggest that socio-cultural factors impact mental health and recovery processes among South Asians. Mental health services should consider improving culturally sensitive clinical practices in responding to self-harm among South Asian communities.
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Affiliation(s)
- Büşra Özen-Dursun
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Maria Panagioti
- Division of Population Health, Health Services Research and Primary Care, National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, National Institute for Health and Care Research School for Primary Care Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Reem Alharbi
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Sally Giles
- Division of Population Health, Health Services Research and Primary Care, National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Nusrat Husain
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Mersey Care NHS Foundation Trust, Prescot, UK
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Connelly L, Anijeet D, Tole D, Alexander CL. Acanthamoeba keratitis: Molecular typing of Acanthamoeba species directly from ocular tissue. Curr Res Parasitol Vector Borne Dis 2023; 4:100141. [PMID: 37680763 PMCID: PMC10480524 DOI: 10.1016/j.crpvbd.2023.100141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
This report explores the molecular profiling of Acanthamoeba spp. from individuals in the UK suffering from a debilitating, sight-threatening disease of the cornea known as Acanthamoeba keratitis (AK). Seventy ocular samples from individuals undergoing investigations for AK were sent to the Scottish Microbiology Reference Laboratories (SMiRL), Glasgow during 2017-2019, and subjected to DNA extraction followed by in-depth molecular typing using a nested PCR/bi-directional sequencing approach. Of the 70 samples tested, 40 were PCR-positive. Of these, 32 were successfully sequenced and assigned to two of 23 existing genotypes termed T1 to T23. Molecular profiling of the 32 samples highlighted two genotypes, namely T3 (n = 3) and T4 (n = 29). For those 29 samples identified as the T4 genotype, a sub-genotype (T4A-T4H) was recorded: T4A (n = 18); T4B (n = 5); T4C (n = 1); T4E (n = 4); and T4F (n = 1). This study highlights that the T4 genotype and T4A subtype are the predominant molecular variants to cause ocular disease in the UK. Gaining in-depth information on the molecular profiling of Acanthamoeba spp. is essential to increase our understanding of the source(s) of infection, transmission pathways, and potential associations with clinical outcomes for this rare, yet potentially debilitating ocular disease.
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Affiliation(s)
- Lisa Connelly
- Scottish Microbiology Reference Laboratories, Glasgow (SMiRL), Glasgow, UK
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126
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Tam W, Alajlani M, Abd-Alrazaq A. An Exploration of Wearable Device Features Used in UK Hospital Parkinson Disease Care: Scoping Review. J Med Internet Res 2023; 25:e42950. [PMID: 37594791 PMCID: PMC10474516 DOI: 10.2196/42950] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 03/13/2023] [Accepted: 04/14/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND The prevalence of Parkinson disease (PD) is becoming an increasing concern owing to the aging population in the United Kingdom. Wearable devices have the potential to improve the clinical care of patients with PD while reducing health care costs. Consequently, exploring the features of these wearable devices is important to identify the limitations and further areas of investigation of how wearable devices are currently used in clinical care in the United Kingdom. OBJECTIVE In this scoping review, we aimed to explore the features of wearable devices used for PD in hospitals in the United Kingdom. METHODS A scoping review of the current research was undertaken and reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The literature search was undertaken on June 6, 2022, and publications were obtained from MEDLINE or PubMed, Embase, and the Cochrane Library. Eligible publications were initially screened by their titles and abstracts. Publications that passed the initial screening underwent a full review. The study characteristics were extracted from the final publications, and the evidence was synthesized using a narrative approach. Any queries were reviewed by the first and second authors. RESULTS Of the 4543 publications identified, 39 (0.86%) publications underwent a full review, and 20 (0.44%) publications were included in the scoping review. Most studies (11/20, 55%) were conducted at the Newcastle upon Tyne Hospitals NHS Foundation Trust, with sample sizes ranging from 10 to 418. Most study participants were male individuals with a mean age ranging from 57.7 to 78.0 years. The AX3 was the most popular device brand used, and it was commercially manufactured by Axivity. Common wearable device types included body-worn sensors, inertial measurement units, and smartwatches that used accelerometers and gyroscopes to measure the clinical features of PD. Most wearable device primary measures involved the measured gait, bradykinesia, and dyskinesia. The most common wearable device placements were the lumbar region, head, and wrist. Furthermore, 65% (13/20) of the studies used artificial intelligence or machine learning to support PD data analysis. CONCLUSIONS This study demonstrated that wearable devices could help provide a more detailed analysis of PD symptoms during the assessment phase and personalize treatment. Using machine learning, wearable devices could differentiate PD from other neurodegenerative diseases. The identified evidence gaps include the lack of analysis of wearable device cybersecurity and data management. The lack of cost-effectiveness analysis and large-scale participation in studies resulted in uncertainty regarding the feasibility of the widespread use of wearable devices. The uncertainty around the identified research gaps was further exacerbated by the lack of medical regulation of wearable devices for PD, particularly in the United Kingdom where regulations were changing due to the political landscape.
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Affiliation(s)
- William Tam
- Insitute of Digital Healthcare, Warwick Manufacturing Group, University of Warwick, Coventry, United Kingdom
| | - Mohannad Alajlani
- Insitute of Digital Healthcare, Warwick Manufacturing Group, University of Warwick, Coventry, United Kingdom
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Gillespie D, Wootton M, Ray R, Calder PC, Mandy Lau TM, Owen-Jones E, Lowe R, Davies L, Richards J, Hood K, Castro-Herrera V, Davies J, Francis NA, Hobbs FDR, Lown M, Moore M, Shepherd V, Butler CC. Gut microbiology of UK care home residents: a cross-sectional analysis from a randomised controlled trial. Clin Microbiol Infect 2023:S1198-743X(23)00362-2. [PMID: 37595801 DOI: 10.1016/j.cmi.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE To describe the prevalence of potentially clinically relevant gut pathogens and associations with the carriage of resistant organisms in UK care home residents. METHODS Stool samples were collected pre-randomisation from care home residents participating in a randomised placebo-controlled trial. Cultivable clinically relevant bacteria were analysed. Antimicrobial susceptibility testing was performed by agar dilution (amoxicillin, co-amoxiclav, gentamicin, trimethoprim, nitrofurantoin, and ciprofloxacin). We also aimed to detect resistance to third-generation cephalosporins, carbapenems, and vancomycin. RESULTS Stool samples were available for 159/310 residents participating in the trial (51%) from 23 care homes between 2016 and 2018. In total, 402 bacterial isolates were cultured from 158 stool samples and 29 different species were cultured. The five most common species were Escherichia coli (155/158, 98%), Pseudomonas aeruginosa (40/158, 25%), Enterococcus faecalis (35/158, 22%), Enterococcus faecium (30/158, 19%), and Proteus mirabilis (25/158, 16%). Enterobacterales isolates were cultured from 157 samples (99%), and resistance to at least one of the tested antimicrobials was found in 119 of these (76%). There were high levels of variation in outcomes by care home. DISCUSSION We demonstrated that care home residents harbour significant levels of antimicrobial-resistant organisms in their stool. This work emphasises the importance of both enhanced infection control practices and antimicrobial stewardship programmes to support the appropriate use of antimicrobials in this setting.
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Affiliation(s)
- David Gillespie
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom; Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom.
| | - Mandy Wootton
- Specialist Antimicrobial Chemotherapy Unit, Public Health Wales Microbiology Cardiff, Cardiff, United Kingdom
| | - Ruby Ray
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Philip C Calder
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Tin Man Mandy Lau
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Eleri Owen-Jones
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Rachel Lowe
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Leanne Davies
- Specialist Antimicrobial Chemotherapy Unit, Public Health Wales Microbiology Cardiff, Cardiff, United Kingdom
| | - Jennifer Richards
- Specialist Antimicrobial Chemotherapy Unit, Public Health Wales Microbiology Cardiff, Cardiff, United Kingdom
| | - Kerenza Hood
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Vivian Castro-Herrera
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Jane Davies
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Nick A Francis
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - F D Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Mark Lown
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Michael Moore
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Victoria Shepherd
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Christopher C Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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128
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Jentoft EE. Technology and older adults in British loneliness policy and political discourse. Front Digit Health 2023; 5:1168413. [PMID: 37664873 PMCID: PMC10469321 DOI: 10.3389/fdgth.2023.1168413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction This article provides an analysis of recent loneliness policy and political discourses from the United Kingdom pertaining to older adults. Although government asserts that several groups in society are "at risk" of loneliness, older adults remain the most frequent targets of policy interventions. Technology is positioned as playing a role in the causation and alleviation of loneliness. Little research has examined loneliness in political discourses. Methods With a focus on how loneliness intersects with themes of technology and aging, this article presents an analysis of discourses guided by Bacchi's What is the Problem Represented to Be (WPR) framework. It endeavors to answer the following questions: What is the problem of loneliness among older adults represented to be, and what is the role of technology in this context - problem or solution? Results In the discourses, assertions are made that issues of loneliness, societal change and digital exclusion are intertwined. Lonely older adults are problematized as hard to find and thus connect with interventions, warranting surveillance measures like loneliness heatmaps. Technological interventions to assist older adults in maintaining independence and connections to social networks are often proposed as solutions. The findings indicate dominant discourses position older adults primarily as subjects in need of care and as non-users of technology. Technology is positioned as a cost-effective tool to fill gaps in an overburdened and under-funded social care system that compounds issues of loneliness. Discussion The author argues the neoliberal and stigmatizing undertones within the corpus may undermine efforts to combat loneliness. Further, austerity is silent in the dominant problematizations of loneliness, foreclosing upon alternatives that problematize loneliness as resulting from neoliberal policies that continue to dismantle public infrastructure and social care.
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Affiliation(s)
- Elian Eve Jentoft
- Faculty of Social Sciences, Oslo Metropolitan University, Oslo, Norway
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Barrett A, Debackere N, Ribeiro A, Keapoletswe K, Zingel R, Coles B. Dosing Patterns of Dulaglutide and Semaglutide in Patients with Type 2 Diabetes in the United Kingdom and Germany: A Retrospective Cohort Study. Adv Ther 2023; 40:3446-3464. [PMID: 37286889 PMCID: PMC10246869 DOI: 10.1007/s12325-023-02540-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/28/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION As new glucagon-like peptide 1 receptor agonist (GLP-1 RA) formulations are available, the aim of this study was to understand dulaglutide and subcutaneous (s.c.) semaglutide dosing patterns in people with type 2 diabetes mellitus (T2DM) in the UK and Germany as well as oral semaglutide in the UK. METHODS Adults with evidence of T2DM and a prescription of dulaglutide or semaglutide between August 2020 and December 2021 were identified using the IQVIA Longitudinal Prescription Data (LRx). Patients were divided into cohort 1 (incident users) and cohort 2 (prevalent users) based on previous exposure to GLP-1 RAs and were followed up to 12 months post-index. RESULTS During the patient selection window in Germany and the UK, 368,320 and 123,548 patients respectively received at least one prescription of a study GLP-1 RA. Among dulaglutide users in Germany at 12 months post-index, the 1.5-mg dosage formulation was the most common for both cohort 1 (65.6%) and 2 (71.2%). Among s.c. semaglutide users at 12 months post-index, 39.2% and 58.4% of cohort 1 received 0.5 mg and 1.0 mg, respectively. In the UK, at 12 months post-index, the most common dulaglutide dosage formulation was 1.5 mg (71.7% cohort 1 and 80.9% cohort 2). Among s.c. semaglutide users at 12 months post-index, 0.5- and 1.0-mg formulations were the most common for both cohort 1 (38.9% and 56.0%, respectively) and cohort 2 (29.5% and 67.1%, respectively). Prescribing of the more recently introduced 3.0- and 4.5-mg formulations for dulaglutide and oral semaglutide was also reported in the study. CONCLUSION Dosing patterns of GLP-1 RAs, although similar between the UK and Germany, were heterogeneous over time. Given that the higher dulaglutide doses and oral semaglutide were recently introduced to the market, additional real-world evidence studies which include clinical outcomes is required.
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Affiliation(s)
- Annabel Barrett
- Eli Lilly and Company, 8 Arlington Square West, Downshire Way, Bracknell, RG12 1PU, UK.
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Shapiro K, Cross SJ, Morton TH, Inaba H, Holland A, Fasipe FR, Adderson EE. Healthcare-Associated Infections Caused by Mycolicibacterium neoaurum. Emerg Infect Dis 2023; 29. [PMID: 37486155 PMCID: PMC10370869 DOI: 10.3201/eid2908.230007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Mycolicibacterium neoaurum is a rapidly growing mycobacterium and an emerging cause of human infections. M. neoaurum infections are uncommon but likely underreported, and our understanding of the disease spectrum and optimum management is incomplete. We summarize demographic and clinical characteristics of a case of catheter-related M. neoaurum bacteremia in a child with leukemia and those of 36 previously reported episodes of M. neoaurum infection. Most infections occurred in young to middle-aged adults with serious underlying medical conditions and commonly involved medical devices. Overall, infections were not associated with severe illness or death. In contrast to other mycobacteria species, M. neoaurum was generally susceptible to multiple antimicrobial drugs and responded promptly to treatment, and infections were associated with good outcomes after relatively short therapy duration and device removal. Delays in identification and susceptibility testing were common. We recommend using combination antimicrobial drug therapy and removal of infected devices to eradicate infection.
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Thiers C, Wehner L. Britain's COVID-19 battle: The role of political leaders in shaping the responses to the pandemic. Br J Polit Int Relat 2023; 25:517-534. [PMID: 38602936 PMCID: PMC10028684 DOI: 10.1177/13691481231159021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
This article introduces an analytical framework to trace and compare leaders' different types of behaviours to the health crisis posed by COVID-19, following the analytical benefits of Leadership Trait Analysis. It examines Boris Johnson's and Nicola Sturgeon's diverging initial responses to the pandemic's onset. We employ the Leadership Trait Analysis to shed light on three main differences in their respective leadership styles: risk-proneness versus risk-aversion; flexibility versus rigidity and rule advocacy versus rule ambivalence. Crises are one of the more fruitful situations in which to study leaders as their personal characteristics become central to the decision-making process. Thus, we employ an agent-centred and political psychology approach to analyse leaders' behaviour and make sense of their divergent management styles. The results show that the differences between these leaders' approaches to handling this global health crisis can be partly explained by their level of openness to information and their task versus relationship focus.
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Affiliation(s)
| | - Leslie Wehner
- Department of Politics, Languages and International Studies, University of Bath, Bath, UK
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Birmpili P, Cromwell DA, Li Q, Johal AS, Atkins E, Waton S, Pherwani AD, Williams R, Richards T, Nandhra S. The Impact of Pre-Operative Anaemia on One Year Amputation Free Survival and Re-Admissions in Patients Undergoing Vascular Surgery for Peripheral Arterial Disease: a National Vascular Registry Study. Eur J Vasc Endovasc Surg 2023; 66:204-212. [PMID: 37169135 DOI: 10.1016/j.ejvs.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 02/27/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Anaemia is common among patients undergoing surgery, but its association with post-operative outcomes in patients with peripheral arterial disease (PAD) is unclear. The aim of this observational population based study was to examine the association between pre-operative anaemia and one year outcomes after surgical revascularisation for PAD. METHODS This study used data from the National Vascular Registry, linked with an administrative database (Hospital Episode Statistics), to identify patients who underwent open surgical lower limb revascularisation for PAD in English NHS hospitals between January 2016 and December 2019. The primary outcome was one year amputation free survival. Secondary outcomes were one year re-admission rate, 30 day re-intervention rate, 30 day ipsilateral major amputation rate and 30 day death. Flexible parametric survival analysis and generalised linear regression were performed to assess the effect of anaemia on one year outcomes. RESULTS The analysis included 13 641 patients, 57.9% of whom had no anaemia, 23.8% mild, and 18.3% moderate or severe anaemia. At one year follow up, 80.6% of patients were alive and amputation free. The risk of one year amputation or death was elevated in patients with mild anaemia (adjusted HR 1.3; 95% CI 1.15 - 1.41) and moderate or severe anaemia (aHR 1.5; 1.33 - 1.67). Patients with moderate or severe anaemia experienced more re-admissions over one year (adjusted IRR 1.31; 1.26 - 1.37) and had higher odds of 30 day re-interventions (aOR 1.22; 1.04 - 1.45), 30 day ipsilateral major amputation (aOR 1.53; 1.17 - 2.01), and 30 day death (aOR 1.39; 1.03 - 1.88) compared with patients with no anaemia. CONCLUSION Pre-operative anaemia is associated with lower one year amputation free survival and higher one year re-admission rates following surgical revascularisation in patients with PAD. Research is required to evaluate whether interventions to correct anaemia improve outcomes after lower limb revascularisation.
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Affiliation(s)
- Panagiota Birmpili
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK; Hull York Medical School, Hull, UK
| | - David A Cromwell
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Qiuju Li
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Amundeep S Johal
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK
| | - Eleanor Atkins
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK; Hull York Medical School, Hull, UK
| | - Sam Waton
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK
| | - Arun D Pherwani
- Staffordshire & South Cheshire Vascular Network, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Robin Williams
- Department of Interventional Radiology, Freeman Hospital, Newcastle-upon-Tyne Hospitals, Newcastle upon Tyne, UK
| | - Toby Richards
- Department of Vascular Surgery, University of Western Australia, Perth, Australia
| | - Sandip Nandhra
- Northern Vascular Centre, Freeman Hospital, Newcastle-upon-Tyne Hospitals, Newcastle upon Tyne, UK; Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
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Jones NK, Coelho J, Logan JMJ, Broughton K, Hopkins KL, Pichon B, Potterill I, Wan Y, Reid AWN, Gouliouris T. Soft Tissue Infection of Immunocompetent Man with Cat-Derived Globicatella Species. Emerg Infect Dis 2023; 29:1684-1687. [PMID: 37486350 PMCID: PMC10370850 DOI: 10.3201/eid2908.221770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
We report a novel Globicatella species causing extensive soft tissue infection in a man bitten by a stray domestic cat in the United Kingdom. We identified this bacterium by 16S rRNA gene sequencing, whole-genome sequencing, and biochemical profiling and determined antimicrobial drug susceptibility.
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Awe AO, David-Olawade AC, Ayodele-Awe I, Feng H, Odetayo A, Afolalu TD, Ladan H, Olawade DB. Predictors and influencing factors of emotional intelligence among nurses in the North East England, United Kingdom. J Educ Health Promot 2023; 12:236. [PMID: 37727434 PMCID: PMC10506741 DOI: 10.4103/jehp.jehp_1656_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 01/13/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Recognising that high levels of emotional intelligence (EI) are required for involvement in the nursing practice, this study was conducted to assess the traits of emotional intelligence, perception of emotional intelligence and factors associated with emotional intelligence among nursing teams in Northeast England. MATERIALS AND METHODS For this descriptive cross-sectional study, a concurrent mixed method was employed (qualitative and quantitative method) using a convenience sampling technique. Data were obtained from one hundred and ten (110) staff nurses practicing with the National Health Service via a validated semi-structured questionnaire and in-depth interview. Data collected through questionnaires (online- Google form link) were retrieved via Ms excel spreadsheet and then imported to Statistics Package for Social Sciences (SPSS) version 25 for analyses. Interviews recorded were transcribed word for word as Nvivo software (version 12) was utilised for thematic analysis and rapid analysis was also adopted to validate the responses. RESULTS Majority (77%) of the respondents were females, and about half (46%) have work experience between one to five years. The mean emotional intelligence trait score for each domain was self-awareness (20.20), self-regulation (38.15), self-motivation (20.54), empathy (18.78), and social skills (29.60), as 82% of the nurses had high emotional intelligence trait. There was a statistically significant relationship between empathy, and race of the respondents (P = 0.040). Also, from the qualitative data; cultural differences, personality traits, self-care, family support, and organisational structure are key predictors of emotional intelligence traits among nurses. CONCLUSION Enhancing emotional intelligence traits among nursing teams is significant, as it may serve as an intervention strategy to manage changes and still increase level of morale and productivity among nurses. Hence, creating a more supportive environment, encouragement from team leads or supervisors, and training on stress management strategies can help to reduce burnout, anxiety and stress in nurses.
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Affiliation(s)
- Ayodele O. Awe
- Department of Mechanical and Construction Engineering, Northumbria University, Newcastle, United Kingdom
| | | | - Iyanuoluwa Ayodele-Awe
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle, United Kingdom
| | - Haibo Feng
- Department of Mechanical and Construction Engineering, Northumbria University, Newcastle, United Kingdom
| | | | - Temitope D. Afolalu
- Oncology and Haematology Department, The Queen Elizabeth Hospital, NHS Trust, King's Lynn, United Kingdom
| | - Henrietha Ladan
- Critical and Surgical Care Unit, Medway Maritime Hospital, NHS Trust, Gillingham, Kent, United Kingdom
| | - David B. Olawade
- Department of Allied and Public Health, School of Health, Sport and Bioscience, University of East London, London, United Kingdom
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Wilson JJ, Trott M, Tully MA, Lindsay RK, Fossey M, Godier-McBard L, Butler LT, Torrance A, Smith L. Mental Health and Recreational Angling in UK Adult Males: A Cross-Sectional Study. Epidemiologia (Basel) 2023; 4:298-308. [PMID: 37489501 PMCID: PMC10366712 DOI: 10.3390/epidemiologia4030030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
Exposure to aquatic environments (i.e., blue spaces) can lead to improved mental health and well-being. One meaningful way to spend time in blue spaces is through recreational angling, although limited scientific literature exists on this topic. The present study aims to examine the relationship between recreational angling and mental health and well-being in a sample of UK adult male anglers. A cross-sectional online survey asked questions about demographic characteristics, participation in recreational angling, physical activity levels, diagnosis of psychiatric disorders, and mental health and well-being. Relationships between angling status (i.e., how often and how long participants angled for) and mental health variables were determined using regression models adjusted for age. In total, 1752 participants completed the survey. The regression models found that those who took part in angling more regularly had reduced odds of having depression (p < 0.001), schizophrenia (p = 0.001), suicidal thoughts (p < 0.001), and deliberately self-harming (p = 0.012), in addition to having a higher mental well-being and lower symptoms of depression and anxiety compared to those taking part in angling less frequently. In general, the findings suggest that encouraging frequent participation in recreational angling could be a dual method strategy for promoting relaxation and positive mental health, as well as encouraging increased levels of physical activity in those with mental health issues.
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Affiliation(s)
- Jason J Wilson
- Sport and Exercise Sciences Research Institute, School of Sport, Ulster University, Newtownabbey BT37 0QB, UK
| | - Mike Trott
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BA, UK
- Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry BT48 7JL, UK
| | - Rosie K Lindsay
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Matt Fossey
- Veterans and Families Institute for Military Social Research, Anglia Ruskin University, Chelmsford CMI 1SQ, UK
- The Centre for Mental Health, London W1G 0AN, UK
| | - Lauren Godier-McBard
- Veterans and Families Institute for Military Social Research, Anglia Ruskin University, Chelmsford CMI 1SQ, UK
| | - Laurie T Butler
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | | | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
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Johnson DA, Hogan M, Marriot R, Heaney LM, Bailey SJ, Clifford T, James LJ. A comparison of advertised versus actual cannabidiol (CBD) content of oils, aqueous tinctures, e-liquids and drinks purchased in the UK. J Cannabis Res 2023; 5:28. [PMID: 37438849 DOI: 10.1186/s42238-023-00183-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/30/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Cannabidiol (CBD)-containing products are sold widely in consumer stores, but concerns have been raised regarding their quality, with notable discrepancies between advertised and actual CBD content. Information is limited regarding how different types of CBD products may differ in their deviation from advertised CBD concentrations. Therefore, CBD concentrations were quantified and compared in aqueous tinctures, oils, e-liquids and drinks. METHODS Products (13 aqueous tinctures, 29 oils, 10 e-liquids and 11 drinks) were purchased online in the UK. CBD concentrations were quantified in aqueous tinctures, oils and e-liquids via high performance liquid chromatography (HPLC), and in drinks via gas chromatograhy-mass spectrometry (GC-MS). RESULTS Measured concentrations fell -25.7 ± 17.3, -6.1 ± 7.8, -6.9 ± 4.6 and - 0.03 ± 0.06 mg/mL below advertised concentrations for aqueous tinctures, oils, e-liquids and drinks, respectively (medians ± interquartile ranges; p < .05). Oils deviated relatively less (-19.0 ± 14.5%) from advertised concentrations than e-liquids (-29.2 ± 10.2%), aqueous tinctures (-51.4 ± 41.4%) and drinks (-65.6 ± 36.5%; p < .01), whilst e-liquids deviated less than aqueous tinctures and drinks (p < .05), and deviation was not different between aqueous tinctures and drinks (p = .19). Only 5/63 (8%) products had measured concentrations within 10% of advertised concentrations. DISCUSSION Similarly to previous studies, few products had measured CBD concentrations within 10% of advertised concentrations, with most falling below advertised concentrations. All individual product types deviated from advertised concentrations, with oils deviating least. These findings may be indicative of poor manufacturing standards, or that CBD undergoes degradation in consumer products. This reinforces concerns over quality of CBD-containing consumer products and may highlight the need for improved regulation of such products.
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Affiliation(s)
- Drusus A Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Megan Hogan
- Bridge Farm Group, Spalding, Lincolnshire, UK
| | - Ray Marriot
- Bridge Farm Group, Spalding, Lincolnshire, UK
| | - Liam M Heaney
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Tom Clifford
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Lewis J James
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.
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Chong AC, Diwakar L, Kaplan CM, Fox AT, Abrams EM, Greenhawt M, Oppenheimer JJ, Shaker MS. Provision of Food Allergy Care in the United Kingdom and United States: Current Issues and Future Directions. J Allergy Clin Immunol Pract 2023; 11:2054-2066. [PMID: 36990429 DOI: 10.1016/j.jaip.2023.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023]
Abstract
Food allergy (FA) is a growing issue worldwide. The United Kingdom and United States are high-income, industrialized countries with reported increases in FA prevalence over the past few decades. This review compares delivery of FA care in the United Kingdom and United States and each country's response to the heightened demand and disparities for FA services. In the United Kingdom, allergy specialists are scarce and general practitioners (GPs) provide most allergy care. Whereas the United States has more allergists per capita than the United Kingdom, there is still a shortage of allergy services owing to the greater reliance on specialist care for FA in America and wide geographic variation in access to allergist services. Currently, generalists in these countries lack the specialty training and equipment to diagnose and manage FA optimally. Moving forward, the United Kingdom aims to enhance training for GPs so they may provide better quality frontline allergy care. In addition, the United Kingdom is implementing a new tier of semi-specialized GPs and increasing cross-center collaboration through clinical networks. The United Kingdom and United States aim to increase the number of FA specialists, which is critical at a time of rapidly expanding management options for allergic and immunologic diseases requiring clinical expertise and shared decision-making to select appropriate therapies. While these countries aim to grow their supply of quality FA services actively, further efforts to build clinical networks and perhaps recruit international medical graduates and expand telehealth services are necessary to reduce disparities in access to care. For the United Kingdom in particular, increasing quality services will require additional support from the leadership of the centralized National Health Service, which remains challenging.
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Affiliation(s)
- Albert C Chong
- Keck School of Medicine, University of Southern California, Los Angeles, Calif
| | - Lavanya Diwakar
- Department of Immunology, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom; Department of Health Economics, University of Birmingham, Birmingham, United Kingdom
| | - Cameron M Kaplan
- Gehr Center for Health Systems Science and Innovation, Keck School of Medicine, University of Southern California, Los Angeles, Los Angeles, Calif
| | - Adam T Fox
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Elissa M Abrams
- Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Manitoba, Canada; Division of Allergy and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthew Greenhawt
- Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colo
| | - John J Oppenheimer
- Department of Internal Medicine, Pulmonary and Allergy, UMDJ Rutgers University School of Medicine, Newark, NJ
| | - Marcus S Shaker
- Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, NH; Department of Pediatrics, Dartmouth Geisel School of Medicine, Hanover, NH; Department of Medicine, Dartmouth Geisel School of Medicine, Hanover, NH.
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Williamson LE, Sleeman KE, Evans CJ. Exploring access to community care and emergency department use among people with dementia: A qualitative interview study with people with dementia, and current and bereaved caregivers. Int J Geriatr Psychiatry 2023; 38:e5966. [PMID: 37485729 DOI: 10.1002/gps.5966] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 06/27/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES Emergency department (ED) attendance is common among people with dementia and associated with poor health outcomes. Literature suggests a link between access to community care and the ED, but we know little about the mechanisms behind this link. This study aimed to explore experiences of accessing community and emergency care among people affected by dementia. METHODS Informed by critical realism, semi-structured online and telephone interviews were conducted with people with dementia and family caregivers, with and without experience of using the ED. Participants were recruited from across the United Kingdom using purposive sampling with maximum variation. A mostly experiential reflexive thematic analysis approach was used, applying the candidacy model of access to deepen interpretation. RESULTS Two dyad and 33 individual interviews were conducted with 10 people with dementia, 11 current caregivers and 16 bereaved caregivers (men = 11, 70-89 years = 18, white ethnicity = 32). Three themes are reported: (1) Navigating a 'push system', (2) ED as the 'last resort', and (3) Taking dementia 'seriously'. Themes describe a discrepancy between the configuration of services and the needs of people affected by dementia, who resort to the ED in the absence of accessible alternatives. Underlying this discrepancy is a lack of systemic prioritisation of dementia and wider societal stigma. CONCLUSION Although a last resort, ED attendance is frequently the path of least resistance for people with dementia who encounter multiple barriers for timely, responsive access to community health and social care. Greater systemic prioritisation of dementia as a life-limiting condition may help to reduce reliance on the ED through essential development of post-diagnostic care, from diagnosis to the end of life.
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Affiliation(s)
- Lesley E Williamson
- King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
| | - Katherine E Sleeman
- King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
| | - Catherine J Evans
- King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
- Sussex Community NHS Foundation Trust, Brighton General Hospital, Brighton, UK
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de Silva D, Roberts R, Nayar V, Rutt G, Gregory S, Khan A. Tackling differential attainment in specialist GP training in England and Scotland. Educ Prim Care 2023; 34:199-203. [PMID: 37643423 DOI: 10.1080/14739879.2023.2243453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/29/2023] [Indexed: 08/31/2023]
Abstract
In this article NHS England and NHS Education for Scotland describe practical ways we are tackling differences in the attainment of people training as general practitioners (GPs).Trainees from minority ethnic groups and international medical graduates are less likely than others to qualify as GPs. It is difficult to change systemic inequalities, but over the past five years we have made practical changes to GP speciality training. Educators recognise there is an issue and are trying to tackle it.For example, people who had not successfully qualified had an opportunity to return to GP training. When we provided individualised targeted support, the proportion who completed training significantly increased (76%).This was a catalyst for reviewing unconscious bias in GP training. We implemented a national programme to tackle differential attainment and system-level bias. Educators now work with all GP trainees to identify their individual needs. Supervisors are trained to recognise bias and provide targeted support. There is mental health support and regular reviews to see whether trainees are ready to sit exams. Trainee representatives are championing the learner voice in national committees. Exams are being altered to reduce unconscious bias. We are monitoring attainment over time.The key message is that differential attainment should not be in the 'too hard basket'. The narrative is changing from 'can't do' to 'must do', supported by appropriate leadership, promotion and resourcing. There is much more to do, but we are making changes, evaluating and applying our learning. We have moved from talking to taking action.
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Affiliation(s)
- Debra de Silva
- Department of primary care, The Evidence Centre, London, UK
| | | | - Vijay Nayar
- Department of primary care, NHS England, London, UK
| | - Graham Rutt
- Department of primary care, NHS England, London, UK
| | | | - Amjad Khan
- Department of primary care, NHS Education for Scotland, Edinburgh, UK
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Shiba K, Cowden RG, Gonzalez N, Ransome Y, Nakagomi A, Chen Y, Lee MT, VanderWeele TJ, Fancourt D. Associations of online religious participation during COVID-19 lockdown with subsequent health and well-being among UK adults. Psychol Med 2023; 53:3887-3896. [PMID: 35189993 PMCID: PMC10317791 DOI: 10.1017/s0033291722000551] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND In-person religious service attendance has been linked to favorable health and well-being outcomes. However, little research has examined whether online religious participation improves these outcomes, especially when in-person attendance is suspended. METHODS Using longitudinal data of 8951 UK adults, this study prospectively examined the association between frequency of online religious participation during the stringent lockdown in the UK (23 March -13 May 2020) and 21 indicators of psychological well-being, social well-being, pro-social/altruistic behaviors, psychological distress, and health behaviors. All analyses adjusted for baseline socio-demographic characteristics, pre-pandemic in-person religious service attendance, and prior values of the outcome variables whenever data were available. Bonferroni correction was used to correct for multiple testing. RESULTS Individuals with online religious participation of ≥1/week (v. those with no participation at all) during the lockdown had a lower prevalence of thoughts of self-harm in week 20 (odds ratio 0.24; 95% CI 0.09-0.62). Online religious participation of <1/week (v. no participation) was associated with higher life satisfaction (standardized β = 0.25; 0.11-0.39) and happiness (standardized β = 0.25; 0.08-0.42). However, there was little evidence for the associations between online religious participation and all other outcomes (e.g. depressive symptoms and anxiety). CONCLUSIONS There was evidence that online religious participation during the lockdown was associated with some subsequent health and well-being outcomes. Future studies should examine mechanisms underlying the inconsistent results for online v. in-person religious service attendance and also use data from non-pandemic situations.
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Affiliation(s)
- Koichiro Shiba
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | - Richard G. Cowden
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | | | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Atsushi Nakagomi
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Ying Chen
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | - Matthew T. Lee
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | - Tyler J. VanderWeele
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
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Aldeyab MA, Lattyak WJ. Challenges in Forecasting Antimicrobial Resistance. Emerg Infect Dis 2023; 29:1496. [PMID: 37347998 PMCID: PMC10310378 DOI: 10.3201/eid2907.230489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
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Davies PJB, Russell CD, Morgan AR, Taori SK, Lindsay D, Ure R, Brown D, Smith A. Increase of Severe Pulmonary Infections in Adults Caused by M1 UK Streptococcus pyogenes, Central Scotland, UK. Emerg Infect Dis 2023; 29. [PMID: 37343545 PMCID: PMC10370863 DOI: 10.3201/eid2908.230569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
We characterized the epidemiology, host-pathogen characteristics, and outcomes of severe adult pulmonary Streptococcus pyogenes infections that coincided with a high community caseload in central Scotland, UK. The pulmonary infections had high illness and death rates and were associated with socioeconomic deprivation, influenza A co-infection, and the M1UK lineage of S. pyogenes.
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Sparks L. Marketing Responses to the Taxation of Soft Drinks Comment on "Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019". Int J Health Policy Manag 2023; 12:7612. [PMID: 37579371 PMCID: PMC10461891 DOI: 10.34172/ijhpm.2023.7612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 05/30/2023] [Indexed: 08/16/2023] Open
Abstract
The paper by Forde et al provides a useful qualitative consideration of marketing responses to the implementation of the 2018 Soft Drinks Industry Levy (SDIL) in the United Kingdom. This commentary discusses that paper and its conclusions and seeks to place them in a broader context for marketing, fiscal measures and health and public policy. It suggests that modern conceptualisations of marketing and wider considerations of market and non-market strategies could provide a valuable lens to understand the ways in which companies and sectors respond to the threats they perceive and the constantly changing sectoral opportunities. It is important that fiscal measures introduced have the desired effects, and that not only positive behaviours (whether of companies or consumers) are incentivised, but that adverse behaviours are actively disincentivised.
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Affiliation(s)
- Leigh Sparks
- Stirling Management School, University of Stirling, Stirling, UK
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Anto A, Asif RO, Basu A, Kanapathipillai D, Salam H, Selim R, Zaman J, Eisingerich AB. Exploring the Impact of Social Media on Anxiety Among University Students in the United Kingdom: Qualitative Study. JMIR Form Res 2023; 7:e43037. [PMID: 37327030 DOI: 10.2196/43037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND The rapid surge in social media platforms has significant implications for users' mental health, particularly anxiety. In the case of social media, the impact on mental well-being has been highlighted by multiple stakeholders as a cause for concern. However, there has been limited research into how the association between social media and anxiety arises, specifically among university students-the generation that has seen the introduction and evolution of social media, and currently lives through the medium. Extant systematic literature reviews within this area of research have not yet focused on university students or anxiety, rather predominantly investigating adolescents or generalized mental health symptoms and disorders. Furthermore, there is little to no qualitative data exploring the association between social media and anxiety among university students. OBJECTIVE The purpose of this study is to conduct a systematic literature review of the existing literature and a qualitative study that aims to develop foundational knowledge around the association of social media and anxiety among university students and enhance extant knowledge and theory. METHODS A total of 29 semistructured interviews were conducted, comprising 19 male students (65.5%) and 10 female students (34.5%) with a mean age of 21.5 years. All students were undergraduates from 6 universities across the United Kingdom, with most students studying in London (89.7%). Participants were enrolled through a homogenous purposive sampling technique via social media channels, word of mouth, and university faculties. Recruitment was suspended at the point of data saturation. Participants were eligible for the study if they were university students in the United Kingdom and users of social media. RESULTS Thematic analysis resulted in 8 second-order themes: 3 mediating factors that decrease anxiety levels and 5 factors that increase anxiety levels. Social media decreased anxiety through positive experiences, social connectivity, and escapism. Social media increased anxiety through stress, comparison, fear of missing out, negative experiences, and procrastination. CONCLUSIONS This qualitative study sheds critical light on how university students perceive how social media affects their anxiety levels. Students revealed that social media did impact their anxiety levels and considered it an important factor in their mental health. Thus, it is essential to educate stakeholders, including students, university counselors, and health care professionals, about the potential impact of social media on students' anxiety levels. Since anxiety is a multifactorial condition, pinpointing the main stressors in a person's life, such as social media use, may help manage these patients more effectively. The current research highlights that there are also many benefits to social media, and uncovering these may help in producing more holistic management plans for anxiety, reflective of the students' social media usage.
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Affiliation(s)
- Ailin Anto
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Rafey Omar Asif
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Arunima Basu
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | - Haadi Salam
- Faculty of Life Sciences and Medicine, Kings College London, London, United Kingdom
| | - Rania Selim
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Jahed Zaman
- Faculty of Medicine, Imperial College London, London, United Kingdom
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145
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Osunronbi T, Adeboye W, Faluyi D, Sofela J, Abankwa E, Abraha S, Adamu-Biu F, Ahmad Z, Akhionbare I, Chimba C, Corriero AC, Fofanah IJ, Ibeanusi I, Ibrahim U, Inyang D, Jones R, Kolawole A, Madume R, Mandangu C, Mberu V, Nelson-Rowe E, O'Riordan M, Shoker S, Sofela A. Predictors of self-reported research productivity amongst medical students in the United Kingdom: a national cross-sectional survey. BMC Med Educ 2023; 23:412. [PMID: 37280642 DOI: 10.1186/s12909-023-04412-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 05/30/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND The number of academic clinicians in the UK is declining and there are demographic inequalities in the clinical-academic workforce. Increased research productivity by medical students is believed to reduce future attrition in the clinical-academic workforce. Thus, this study investigated the association between student demographics and research productivity amongst UK medical students. METHODS This is a national multicentre cross-sectional study of UK medical students in the 2020/21 academic year. We appointed one student representative per medical school, and they disseminated a 42-item online questionnaire over nine weeks, through departmental emails and social media advertisements. The outcome measures were: (i) publications (yes/no) (ii) number of publications (iii) number of first-authored publications (iv) abstract presentation (yes/no). We utilised multiple logistic and zero-inflated Poisson regression analyses to test for associations between the outcome measures and predictor variables at a 5% significance level. RESULTS There are 41 medical schools in the UK. We received 1573 responses from 36 UK medical schools. We failed to recruit student representatives from three newly formed medical schools, whilst two medical schools prohibited us from sending the survey to their students. Women had lower odds of having a publication (OR: 0.53, 95% CI: 0.33-0.85) and on average had fewer first-author publications than men (IRR: 0.57, 95% CI: 0.37-0.89). Compared to white students, mixed-ethnicity students had greater odds of having a publication (OR: 3.06, 95% CI: 1.67-5.59), an abstract presentation (OR: 2.12, 95% CI: 1.37-3.26), and on average had a greater number of publications (IRR: 1.87, 95% CI: 1.02-3.43). On average, students who attended independent UK secondary schools had a higher rate of first-author publications compared to those that attended state secondary schools (IRR: 1.97, 95% CI: 1.23-3.15). CONCLUSION Our data suggest that there are gender, ethnic and socioeconomic inequalities in research productivity among UK medical students. To tackle this, and potentially improve diversity in clinical academia, we recommend that medical schools should facilitate targeted high quality research mentorship, funding and training, especially for under-represented-in-medicine students.
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Affiliation(s)
- Temidayo Osunronbi
- Melanin Medics Research Network, Luton, UK
- Department of Health Sciences, University of York, York, UK
| | | | | | | | | | | | | | - Zain Ahmad
- Melanin Medics Research Network, Luton, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Agbolahan Sofela
- Faculty of Health, University of Plymouth, Plymouth, UK.
- Southwest Neurosurgery Centre, University Hospitals Plymouth NHS Trust, Plymouth, PL6 8DH, UK.
- School of Medicine, University of Exeter Medical School, Exeter, EX1 2HZ, UK.
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146
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Moore R, Edmondson L, Gregory M, Griffiths K, Freeman E. Barriers and facilitators to physical activity and further digital exercise intervention among inactive British adolescents in secondary schools: a qualitative study with physical education teachers. Front Public Health 2023; 11:1193669. [PMID: 37346099 PMCID: PMC10280726 DOI: 10.3389/fpubh.2023.1193669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/16/2023] [Indexed: 06/23/2023] Open
Abstract
Background Previous studies indicated that physical education programs in schools were unsuccessful to ameliorate physical activity (PA) behaviors among adolescents. This study investigated PE teachers' perceptions of barriers and facilitators to PA and further digital exercise interventions among inactive British adolescents in secondary schools based on the Capability, Opportunity, Motivation, and Behavior (COM-B) model, the Behavior Change Wheel (BCW), and Theoretical Domains Framework (TDF). Method A qualitative study was conducted among 156 PE teachers in England. deductive thematic analysis approach was applied to analyze data. Results A comprehensive perception of PE teachers revealed 21 barriers to PA among inactive adolescents in secondary schools. The study findings show that barriers exist across all categories of the COM-B model in physical opportunity (7), reflective motivation (5), social opportunity (4), psychological capability (4) and physical capability (1). The majority of these barriers were reported in previous studies as being barriers to PA from the perspective of children and adolescents. This shows that the findings are consistent with the views of children and adolescents that participated in these studies. Particular salient barriers for inactive adolescents were reported and greater insight into their experiences was highlighted. The study reported the main sources of behavior, intervention functions, policy functions, and behavior change tools that can be used for future behavior change interventions to support inactive adolescents. Conclusion The study recommends using its findings to design interventions for inactive adolescents to achieve recommended levels of physical activity (PA). The study's comprehensive approach and evidence-based solutions provide extensive reference points for future intervention design, informing policy and contributing to enhancing support for inactive adolescents. Further development of digital exercise interventions, including conversational artificial intelligence (AI), is suggested to engage adolescents at scale and provide personalized support to overcome multiple barriers to PA.
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Affiliation(s)
- Richard Moore
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Lee Edmondson
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Maxine Gregory
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Kerry Griffiths
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Elizabeth Freeman
- Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield, United Kingdom
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147
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Ali OME, Gkekas E, Ali AMS, Tang TYT, Ahmed S, Chowdhury I, Waqar S, Hamed A, Al-Ghazal S, Ahmed S. Informing the UK Muslim Community on Organ Donation: Evaluating the Effect of a National Public Health Programme by Health Professionals and Faith Leaders. J Relig Health 2023; 62:1716-1730. [PMID: 36207562 PMCID: PMC9542453 DOI: 10.1007/s10943-022-01680-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/23/2022] [Indexed: 05/15/2023]
Abstract
There is a significant shortage of transplantable organs in the UK particularly from Black, Asian and Minority Ethnic (BAME) groups, of which Muslims make a large proportion. The British Islamic Medical Association (BIMA) held a nationwide series of community gatherings with the aim of describing the beliefs and attitudes to organ donation amongst British Muslims and evaluate the efficacy of a national public health programme on views and uncertainties regarding religious permissibility and willingness to register. Eight public forums were held across the UK between June 2019 and March 2020 by the British Islamic Medical Association (BIMA). A panel of experts consisting of health professionals and Imams discussed with audiences the procedures, experiences and Islamic ethico-legal rulings on organ donation. Attendees completed a self-administered questionnaire which captured demographic data along with opinions before and after the session regarding religious permissibility and willingness to register given permissibility. A total of 554 respondents across seven UK cities were included with a M:F ratio 1:1.1. Only 45 (8%) respondents were registered as organ donors. Amongst those not registered multiple justifications were detailed, foremost of which was religious uncertainty (73%). Pre-intervention results indicated 50% of respondents were unsure of the permissibility of organ donation in Islam. Of those initially unsure or against permissibility or willingness to register, 72% changed their opinion towards deeming it permissible and 60% towards a willingness to register indicating a significant change in opinion (p < 0.001). The effectiveness of our interventions suggests further education incorporating faith leaders alongside local healthcare professionals to address religious and cultural concerns can reduce uncertainty whilst improving organ donation rates among the Muslim community.
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Affiliation(s)
- Omar M E Ali
- Newcastle University Medical School, Newcastle upon Tyne, NE2 4HH, UK.
| | | | - Ahmad M S Ali
- Department of Neurosurgery, The Walton Centre for Neurology and Neurosurgery, Liverpool, L9 7LJ, UK
| | | | - Sameer Ahmed
- Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Queen Victoria Rd, Newcastle upon Tyne, NE1 4LP, UK
| | - Imadul Chowdhury
- Brighton and Sussex Medical School, University of Sussex Brighton, East Sussex, BN1 9PX, UK
| | - Salman Waqar
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Rd, Oxford, OX2 6GG, UK
| | - Amer Hamed
- Stepping Hill Hospital, Stockport NHS Foundation Trust, Poplar Grove, Hazel Grove, Stockport, SK2 7JE, UK
| | - Sharif Al-Ghazal
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Saeed Ahmed
- Renal Unit, South Tyneside and Sunderland NHS Foundation Trust, Kayl Rd, Sunderland, SR4 7TP, UK
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148
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Tyson GB, Jones S, Logan N, McDonald M, Marshall L, Murcia PR, Willett BJ, Weir W, Hosie MJ. SARS-CoV-2 Seroprevalence and Cross-Variant Antibody Neutralization in Cats, United Kingdom. Emerg Infect Dis 2023; 29:1223-1227. [PMID: 37141617 PMCID: PMC10202862 DOI: 10.3201/eid2906.221755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Anthropogenic transmission of SARS-CoV-2 to pet cats highlights the importance of monitoring felids for exposure to circulating variants. We tested cats in the United Kingdom for SARS-CoV-2 antibodies; seroprevalence peaked during September 2021-February 2022. The variant-specific response in cats trailed circulating variants in humans, indicating multiple human-to-cat transmissions over a prolonged period.
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149
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Johnston-Webber C, Mah J, Prionas A, Streit S, Wharton G, Forsythe J, Mossialos E, Papalois V. Solid Organ Donation and Transplantation in the United Kingdom: Good Governance is Key to Success. Transpl Int 2023; 36:11012. [PMID: 37305339 PMCID: PMC10249499 DOI: 10.3389/ti.2023.11012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/14/2023] [Indexed: 06/13/2023]
Abstract
The United Kingdom (UK) supports a highly successful organ donation and transplantation program. While the UK originally had one of the lowest organ donation rates in Europe, sustained reforms have resulted in steady improvement. Of note, the UK nearly doubled its rate of deceased donations between 2008 and 2018. In this report, we present a case study of the UK organ donation and transplantation program as an example of a complete system with sound and inclusive governing structures that are strongly integrated with critical programs focused on training and research. This study was based on an initial targeted review of the literature led by a UK expert that included guidelines, national reports, and academic papers. Feedback solicited from other European experts was incorporated into our findings via an iterative process. Overall, the study highlights the stepwise evolution of the UK program that ultimately became successful largely due to ongoing collaborative efforts carried out at all levels. Centralized coordination of all aspects of the program remains a key driver of improved rates of organ donation and transplantation. The designation and empowerment of expert clinical leadership have helped to maintain focus and promote ongoing quality improvement.
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Affiliation(s)
- Charlotte Johnston-Webber
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Jasmine Mah
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Apostolos Prionas
- Department of Surgery, Imperial College, London, United Kingdom
- Department of General Surgery, Whipps Cross Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Simon Streit
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - George Wharton
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - John Forsythe
- Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Institute of Global Health Innovation, Imperial College, London, United Kingdom
| | - Vassilios Papalois
- Department of Surgery, Imperial College, London, United Kingdom
- Renal and Transplant Unit, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
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150
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Martín-Ambrosio Francés M, Seth M, Sharman M, Pollard D, Ortiz AL, Miller R, Natsiopoulos T, Walker D, Jones B, Hardwick J, Glanemann B, Garcia AS, Bacon J, Selgas AG. Causes of thrombocytopenia in dogs in the United Kingdom: A retrospective study of 762 cases. Vet Med Sci 2023. [PMID: 37218364 DOI: 10.1002/vms3.1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Thrombocytopenia is a common laboratory abnormality in dogs, and numerous diseases have been associated with its development. Estimates for the sensitivity and specificity of the degree of reduction of platelet concentration for the diagnosis of primary immune-mediated thrombocytopenia (pITP) have not been reported. OBJECTIVES To report the prevalence of different causes of thrombocytopenia in dogs in the United Kingdom and to investigate the utility of platelet concentration to differentiate causes of thrombocytopenia. METHODS Medical records of 762 dogs with thrombocytopenia presented to seven referral hospitals from January 2017 to December 2018 were retrospectively reviewed. Cases were assigned into the following categories: pITP, infectious diseases, neoplasia, inflammatory/other immune-mediated disorders and miscellaneous causes. The prevalence of the different categories was estimated, and platelet concentrations were compared. Receiver-operating characteristic (ROC) curves were used to investigate the utility of platelet concentration to differentiate between causes of thrombocytopenia. RESULTS The most common disease category associated with thrombocytopenia was neoplasia (27.3%), followed by miscellaneous causes (26.9%), pITP (18.8%), inflammatory/immune-mediated disorders (14.4%) and infectious diseases (12.6%). Dogs with pITP had significantly lower platelet concentrations (median 8 × 109 /L, range: 0-70 × 109 /L) than dogs in the other four categories. Platelet concentration was useful for distinguishing pITP from other causes of thrombocytopenia (area under ROC curve = 0.89, 95% confidence interval 0.87, 0.92), with a platelet concentration ≤12 × 109 /L being 60% sensitive and 90% specific. CONCLUSIONS Severe thrombocytopenia was highly specific for a diagnosis of pITP, which was more prevalent in this UK population of thrombocytopenic dogs compared with previous epidemiological studies. Conversely, the proportion of dogs with infectious diseases was lower than in previous reports from other locations.
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Affiliation(s)
| | | | - Mellora Sharman
- Animal Health Trust, Newmarket, Suffolk, UK
- The VetCT Teleconsulting Hospital, Cambridge, UK
| | | | - Ana Liza Ortiz
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
| | - Rachel Miller
- Dick White Referrals, Six Mile Bottom, Cambridgeshire, UK
- VetOracle Telemedicine CVS Referrals, Diss, Norfolk, UK
| | | | - David Walker
- Anderson Moores Veterinary Specialists, Winchester, Hampshire, UK
| | - Bryn Jones
- Anderson Moores Veterinary Specialists, Winchester, Hampshire, UK
| | - Joshua Hardwick
- Langford Vets, University of Bristol, Langford, UK
- Cave Veterinary Specialists, West Buckland, Wellington, UK
| | - Barbara Glanemann
- Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Andrés Salas Garcia
- Pride Veterinary Centre, Derby, UK
- Davies Veterinary Specialists, Higham Gobion, Hitchin, UK
| | - Jessica Bacon
- Wear Referrals Veterinary Hospital, Stockton-on-Tees, UK
| | - Aida Gómez Selgas
- Animal Health Trust, Newmarket, Suffolk, UK
- The VetCT Teleconsulting Hospital, Cambridge, UK
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