scholarly journals Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study

2021 ◽  
pp. 100180
Author(s):  
Katherine Woolf ◽  
I Chris McManus ◽  
Christopher A Martin ◽  
Laura B Nellums ◽  
Anna L Guyatt ◽  
...  
Keyword(s):  
Cohort Study ◽  
United Kingdom ◽  
Ethnic Differences ◽  
Healthcare Workers ◽  
Vaccine Hesitancy ◽  
The Uk

scholarly journals Access to personal protective equipment in healthcare workers during the COVID-19 pandemic in the United Kingdom: results from a nationwide cohort study (UK-REACH)

2021 ◽  
Author(s):  
Christopher A Martin ◽  
Daniel Pan ◽  
Joshua Nazareth ◽  
Avinash Aujayeb ◽  
Luke Bryant ◽  
...  
Keyword(s):  
Cohort Study ◽  
United Kingdom ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Secondary Analysis ◽  
Protective Equipment ◽  
Primary Analysis ◽  
Questionnaire Response ◽  
The United Kingdom ◽  
The Uk

Abstract Objectives: To determine the prevalence and predictors of self-reported access to appropriate personal protective equipment (aPPE) for healthcare workers (HCWs) in the United Kingdom (UK) during the first UK national COVID-19 lockdown (March 2020) and at the time of questionnaire response (December 2020 - February 2021). Design: Two cross sectional analyses using data from a questionnaire-based cohort study. Setting: Nationwide questionnaire from 4th December 2020 to 28th February 2021. Participants: A representative sample of HCWs or ancillary workers in a UK healthcare setting aged 16 or over, registered with one of seven main UK healthcare regulatory bodies. Main outcome measure: Binary measure of self-reported aPPE (access all of the time vs access most of the time or less frequently) at two timepoints: the first national lockdown in the UK (primary analysis) and at the time of questionnaire response (secondary analysis). Results: 10,508 HCWs were included in the primary analysis, and 12,252 in the secondary analysis. 3702 (35.2%) of HCWs reported aPPE at all times in the primary analysis; 6806 (83.9%) reported aPPE at all times in the secondary analysis. After adjustment (for age, sex, ethnicity, migration status, occupation, aerosol generating procedure exposure, work sector, work region, working hours, night shift frequency and trust in employing organisation), older HCWs (per decade increase in age: aOR 1.2, 95% CI 1.16 - 1.26, p<0.001) and those working in Intensive Care Units (1.61, 1.38 - 1.89, p<0.001) were more likely to report aPPE at all times. Those from Asian ethnic groups compared to White (0.77, 0.67 - 0.89, p<0.001), those in allied health professional (AHPs) and dental roles (vs those in medical roles; AHPs: 0.77, 0.68 - 0.87, p<0.001; dental: 0.63, 0.49 - 0.81, p<0.001), and those who saw a higher number of COVID-19 patients compared to those who saw none (≥21 patients 0.74, 0.61 - 0.90, p=0.003) were less likely to report aPPE at all times in the primary analysis. aPPE at all times was also not uniform across UK regions (reported access being better in South West and North East England than London). Those who trusted their employing organisation to deal with concerns about unsafe clinical practice, compared to those who did not, were twice as likely to report aPPE at all times (2.18, 1.97 - 2.40, p<0.001). With the exception of occupation, these factors were also significantly associated with aPPE at all times in the secondary analysis. Conclusions: We found that only a third of HCWs in the UK reported aPPE at all times during the period of the first lockdown and that aPPE had improved later in the pandemic. We also identified key sociodemographic and occupational determinants of aPPE during the first UK lockdown, the majority of which have persisted since lockdown was eased. These findings have important public health implications for HCWs, particularly as cases of infection and long-COVID continue to rise in the UK.

Adolescent Police Stops, Self-Harm, and Attempted Suicide: Findings From the UK Millennium Cohort Study, 2012‒2019

2021 ◽  
pp. e1-e9
Author(s):  
Dylan B. Jackson ◽  
Alexander Testa ◽  
Rebecca L. Fix ◽  
Tamar Mendelson
Keyword(s):  
Cohort Study ◽  
United Kingdom ◽  
School Counselors ◽  
Attempted Suicide ◽  
Sociodemographic Factors ◽  
Millennium Cohort Study ◽  
The United Kingdom ◽  
Self Harm ◽  
Uk Millennium Cohort Study ◽  
The Uk

Objectives. To explore associations between police stops, self-harm, and attempted suicide among a large, representative sample of adolescents in the United Kingdom. Methods. Data were drawn from the 3 most recent sweeps of the UK Millennium Cohort Study (MCS), from 2012 to 2019. The MCS is an ongoing nationally representative contemporary birth cohort of children born in the United Kingdom between September 2000 and January 2002 (n = 10 345). Weights were used to account for sample design and multiple imputation for missing data. Results. Youths experiencing police stops by the age of 14 years (14.77%) reported significantly higher rates of self-harm (incidence rate ratio = 1.52; 95% confidence interval [CI] = 1.35, 1.69) at age 17 years and significantly higher odds of attempted suicide (odds ratio = 2.25; 95% CI = 1.84, 2.76) by age 17 years. These patterns were largely consistent across examined features of police stops and generally did not vary by sociodemographic factors. In addition, 17.73% to 40.18% of associations between police stops and outcomes were explained by mental distress. Conclusions. Police-initiated encounters are associated with youth self-harm and attempted suicide. Youths may benefit when school counselors or social workers provide mental health screenings and offer counseling care following these events. (Am J Public Health. Published online ahead of print September 23, 2021: e1–e9. https://doi.org/10.2105/AJPH.2021.306434 )

scholarly journals Predictors of SARS-CoV-2 infection in a multi-ethnic cohort of United Kingdom healthcare workers: a prospective nationwide cohort study (UK-REACH)

2021 ◽  
Author(s):  
Christopher A Martin ◽  
Daniel Pan ◽  
Carl Melbourne ◽  
Lucy Teece ◽  
Avinash Aujayeb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
United Kingdom ◽  
Ethnic Minority ◽  
Healthcare Workers ◽  
Occupational Risk ◽  
Hospital Inpatient ◽  
Occupational Risk Factors ◽  
Occupational Factors ◽  
Factors Associated

Introduction Healthcare workers (HCWs), particularly those from ethnic minority groups, have been shown to be at disproportionately higher risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) compared to the general population. However, there is insufficient evidence on how demographic and occupational factors influence infection risk among ethnic minority HCWs. Methods We analysed data from the United Kingdom Research study into Ethnicity And COVID-19 Outcomes in Healthcare workers (UK-REACH) cohort study. We used logistic regression to examine associations of demographic, household and occupational predictor variables with SARS-CoV-2 infection (defined by PCR, serology or suspected COVID-19) in a diverse group of HCWs. Results 2,496 of the 10,772 HCWs (23.2%) who worked during the first UK national lockdown in March 2020 reported previous SARS-CoV-2 infection. In an adjusted model, demographic and household factors associated with increased odds of infection included younger age, living with other key workers and higher religiosity. Important occupational risk factors associated with increased odds of infection included attending to a higher number of COVID-19 positive patients (aOR 2.49, 95%CI 2.03—3.05 for ≥21 patients per week vs none), working in a nursing or midwifery role (1.35, 1.15—1.58, compared to doctors), reporting a lack of access to personal protective equipment (1.27, 1.15 — 1.41) and working in an ambulance (1.95, 1.52—2.50) or hospital inpatient setting (1.54, 1.37 — 1.74). Those who worked in Intensive Care Units were less likely to have been infected (0.76, 0.63—0.90) than those who did not. Black HCWs were more likely to have been infected than their White colleagues, an effect which attenuated after adjustment for other known predictors. Conclusions We identified key sociodemographic and occupational risk factors associated with SARS-CoV-2 infection amongst UK HCWs, and have determined factors that might contribute to a disproportionate odds of infection in HCWs from Black ethnic groups. These findings demonstrate the importance of social and occupational factors in driving ethnic disparities in COVID-19 outcomes, and should inform policies, including targeted vaccination strategies and risk assessments aimed at protecting HCWs in future waves of the COVID-19 pandemic. Trial registration: ISRCTN 11811602

scholarly journals Recruiting individuals into the HTLV cohort study in the United Kingdom: clinical findings and challenges in the first six years, 2003 to 2009

2011 ◽  
Vol 16 (46) ◽  
Author(s):  
L J Brant ◽  
C Cawley ◽  
K L Davison ◽  
G P Taylor ◽  
collective the HTLV National Register Steering Group
Keyword(s):  
Cohort Study ◽  
United Kingdom ◽  
Blood Donation ◽  
Spastic Paraparesis ◽  
Clinical Findings ◽  
T Lymphotropic Virus ◽  
The United Kingdom ◽  
Multicentre Cohort Study ◽  
The Uk

Human T-lymphotropic virus (HTLV) infection is rare in the United Kingdom (UK) and few studies are available worldwide. Following introduction of blood donation testing in 2002, a cohort of individuals could be identified and prospectively recruited to describe progression and onset of disease. Here we describe baseline characteristics of participants, and evaluate recruitment into the UK HTLV National Register over the first six years, from July 2003 to June 2009. A multicentre cohort study recruited participants from the UK blood services (recipients and donors) and specialist HTLV clinics. Almost half of the 148 participants recruited were blood donors, nine were blood transfusion recipients, 40 contacts and 29 clinic attendees (nine asymptomatic and 20 symptomatic). Most participants were HTLV-1 positive (n=115); 11 had HTLV-2 and 22 were HTLV-negative. Baseline self-completion questionnaires were received for 83%. The most commonly reported condition was a past operation/serious illness (69%). Twenty-six participants reported four or more possible signs/symptoms of HTLV-1-associated myelopathy/tropical spastic paraparesis. Recruitment into a study of a rare, long-term infection is challenging. This cohort will enable descriptions of HTLV-associated disease progression amongst people recruited from varying sources; it is the first prospective study of its kind in Europe.

scholarly journals Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Jamie Murphy ◽  
Frédérique Vallières ◽  
Richard P. Bentall ◽  
Mark Shevlin ◽  
Orla McBride ◽  
...  
Keyword(s):  
United Kingdom ◽  
Psychological Characteristics ◽  
Vaccine Hesitancy ◽  
Geographical Proximity ◽  
Psychological Constructs ◽  
The United Kingdom ◽  
Broad Array ◽  
Health Related ◽  
Nationally Representative ◽  
The Uk

AbstractIdentifying and understanding COVID-19 vaccine hesitancy within distinct populations may aid future public health messaging. Using nationally representative data from the general adult populations of Ireland (N = 1041) and the United Kingdom (UK; N = 2025), we found that vaccine hesitancy/resistance was evident for 35% and 31% of these populations respectively. Vaccine hesitant/resistant respondents in Ireland and the UK differed on a number of sociodemographic and health-related variables but were similar across a broad array of psychological constructs. In both populations, those resistant to a COVID-19 vaccine were less likely to obtain information about the pandemic from traditional and authoritative sources and had similar levels of mistrust in these sources compared to vaccine accepting respondents. Given the geographical proximity and socio-economic similarity of the populations studied, it is not possible to generalize findings to other populations, however, the methodology employed here may be useful to those wishing to understand COVID-19 vaccine hesitancy elsewhere.

scholarly journals Can a data driven obesity classification system identify those at risk of severe COVID-19 in the UK Biobank cohort study?

2021 ◽  
Author(s):  
Stephen Clark ◽  
Michelle Morris ◽  
Nik Lomax ◽  
Mark Birkin
Keyword(s):  
Cohort Study ◽  
United Kingdom ◽  
Classification System ◽  
Holistic Approach ◽  
Data Driven ◽  
Uk Biobank ◽  
The United Kingdom ◽  
The Individual ◽  
The Uk

AbstractCOVID-19 is a disease that has been shown to have outcomes that vary by certain socio-demographic and socio-economic groups. It is increasingly important that an understanding of these outcomes should be derived not from the consideration of one aspect, but by a more multi-faceted understanding of the individual. In this study use is made of a recent obesity driven classification of participants in the United Kingdom Biobank (UKB) to identify trends in COVID-19 outcomes. This classification is informed by a recently created obesity systems map, and the COVID-19 outcomes are: undertaking a test, a positive test, hospitalisation and mortality. It is demonstrated that the classification is able to identify meaningful differentials in these outcomes. This more holistic approach is recommended for identification and prioritisation of COVID-19 risk and possible long-COVID determination.

scholarly journals Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: an observational cohort study.

2021 ◽  
Author(s):  
Naomi F Walker ◽  
Rachel Louise Byrne ◽  
Ashleigh Howard ◽  
Elissavet Nikolaou ◽  
Madlen Farrar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Healthcare Workers ◽  
Asymptomatic Infection ◽  
Observational Cohort Study ◽  
Symptom Profiles ◽  
Symptom Screening ◽  
Observational Cohort ◽  
Uk National Health Service ◽  
The Uk ◽  
Frontline Healthcare Workers

Background The SARS-CoV-2 pandemic has caused an unprecedented strain on healthcare systems worldwide, including the UK National Health Service (NHS). During the first wave of SARS-CoV-2 transmission in UK, SARS-CoV-2 NHS diagnostic test availability was limited to self-isolating symptomatic staff. The burden of symptomatic and asymptomatic infection in healthcare workers (HCW) attending work was unknown. Methods We conducted an observational cohort study of SARS-CoV-2 infection in HCW working in an acute NHS Trust during the first wave of the COVID-19 pandemic, using serial self-collected saliva and nasopharyngeal (NP) samples. We also collected self-assessed symptom profiles and isolation behaviours. We retrospectively compared SARS-CoV-2 detection by RT-PCR from saliva (weekly) and NP swabs (twice weekly) from 85 individuals in this cohort and evaluated the association with symptoms. Findings Over a 12-week period from 30th March 2020, 40% (n=34/85, CI95% 31.3-51.8%) HCWs had evidence of SARS-CoV-2 infection by surveillance NP swab and/or saliva RT-qPCR. Agreement between paired saliva and NP swabs was poor (28.6%, CI95% 13.2-48.7%) with both methods detecting symptomatic and asymptomatic infections. Symptoms were reported by 47.1% (n=40) and self-isolation by 25.9% participants (n=22). Only 41.2% (n=14/34) participants with SARS-CoV-2 infection reported any symptoms within 14 days of the infection. Interpretation HCWs are a potential source of SARS-CoV-2 transmission in hospitals and symptom screening will identify the minority of infections in HCW. Saliva is an easily accessible fluid sample for screening for SARS-CoV-2 infection and in addition to NP swab, facilitated ascertainment of symptomatic and asymptomatic cases in this setting. Combined saliva and NP testing would improve detection of SARS-CoV-2 for surveillance. Better understanding of transmissibility from asymptomatic staff using transmission-based infection precautions, is required to inform policy.

scholarly journals Pre-pandemic mental and physical health as predictors of COVID-19 vaccine hesitancy: evidence from a UK-wide cohort study

2021 ◽  
Author(s):  
George David Batty ◽  
Ian Deary ◽  
Drew Altschul
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Physical Health ◽  
General Health Questionnaire ◽  
Vaccine Hesitancy ◽  
Symptom Scale ◽  
Individual Level ◽  
Successful Testing ◽  
The Uk ◽  
Mental And Physical Health

Importance: Although several predictors of COVID-19 vaccine hesitancy have been identified, the role of physical health has not been well-examined, and the association with mental health is unknown. Objective: To examine the association of pre-pandemic mental health, physical health, and shielding with vaccine hesitancy after the announcement of the successful testing of the Oxford University/AstraZeneca vaccine. Design, Setting, and Participants: We used individual-level data from a pandemic-focused investigation (COVID Survey), a prospective cohort study nested within the UK Understanding Society (Main Survey) project. In the week immediately following the announcement of successful testing of the first efficacious inoculation (November/December 2020), data on vaccine intentionality were collected in 12,035 individuals aged 16-95 years. Pre-pandemic, study members had responded to enquiries about diagnoses of mental and physical health, completed the 12-item General Health Questionnaire for symptoms of psychological distress (anxiety and depression), and indicated whether they or someone in their household was shielding. Main outcome measures: Self-reported intention to take up a vaccination for COVID-19. To summarise our results, we computed odds ratios with accompanying 95% confidence intervals for indices of health and shielding adjusted for selected covariates. Results: In an analytical sample of 11,955 people (6741 women), 15.4% indicated that they were vaccine hesitant. Relative to their disease-free counterparts, shielding was associated with a 24% lower risk of being hesitant (odds ratio; 95% confidence interval: 0.76; 0.59, 0.96), after adjustment for a range of covariates which included age, education, and ethnicity. Corresponding results for cardiometabolic disease were 22% (0.78; 0.64, 0.95), and for respiratory disease were 26% (0.74; 0.59, 0.93). Having a pre-pandemic diagnosis of anxiety or depression, or a high score on the distress symptom scale, were all unrelated to the willingness to take up a vaccine. Conclusions and relevance: People who have been prioritised for COVID-19 vaccination owing to a physical condition are more likely to take it up. These effects were not apparent for indices of mental health.

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