scholarly journals Reducing the health risks of severe winter weather among older people in the United Kingdom: an evidence-based intervention

2009 ◽  
Vol 30 (2) ◽  
pp. 275-297 ◽  
Author(s):  
CLAIRE GASCOIGNE ◽  
KEVIN MORGAN ◽  
HARRIET GROSS ◽  
JAMES GOODWIN
Keyword(s):  
United Kingdom ◽  
Older People ◽  
Health Risks ◽  
Early Warning ◽  
Early Warning System ◽  
Warning System ◽  
Severe Winter ◽  
Winter Weather ◽  
The United Kingdom ◽  
The Uk

ABSTRACTExcess winter morbidity and mortality among older people remain significant public health issues in those European countries which experience relatively mild winter temperatures, particularly the United Kingdom (UK), Ireland, Portugal and Spain. In the UK, episodes of severe winter weather, when ambient temperatures fall below 5° C, are associated with peaks in general practitioner consultations, hospital admissions, and cardiovascular deaths among those aged over 65. While research indicates that such health risks could be substantially reduced by the adoption of appropriate behavioural strategies, accessible and credible advice on how older people can reduce risk during ‘cold snaps’ is lacking. This paper describes a programme of research that aimed: (a) to translate the relevant scientific literature into practical advice for older people in order to reduce health risk during episodes of severe winter weather; and (b) to integrate this advice with a severe winter weather ‘Early Warning System’ developed by the UK Met Office. An advice booklet was generated through a sequential process of systematic review, consensus development, and focus group discussions with older people. In a subsequent field trial, a combination of the Met Office ‘Early Warning System’ and the advice booklet produced behavioural change among older people consistent with risk reduction. The results also show that long-held convictions about ‘healthy environments’ and anxieties about fuel costs are barriers to risk reduction.

scholarly journals The Difficulty in Engaging the Engaged: Administrative Adaptation to the Early Warning System within the UK Houses of Parliament

2021 ◽  
Vol 17 (3) ◽  
Author(s):  
Nandor Revesz
Keyword(s):  
Early Warning ◽  
Early Warning System ◽  
Warning System ◽  
Primary User ◽  
House Of Commons ◽  
Structured Interviews ◽  
Behavioural Adaptation ◽  
House Of Lords ◽  
Lower Chamber ◽  
The Uk

This article applies a mixed-methods approach through semi-structured interviews and document analysis to provide a comprehensive account of administrative and behavioural adaptation within the UK Houses of Parliament (HoP) to the EU’s subsidiarity monitoring mechanism, the Early Warning System (EWS). The article also tests theoretical assumptions regarding the adaptation and use of the EWS on this basis, confirming that Eurosceptic MPs bolster the use of the EWS and finding that the HoP are an outlier among bicameral legislatures, as the lower chamber was the primary user of the EWS. Overall, results demonstrate that both the House of Commons and the House of Lords treated the EWS as an optional bolt-on when adapting to the mechanism. Furthermore, the EWS did not encourage the HoP to increase engagement with UK devolved legislatures, but the mechanism contributed to the mainstreaming of EU scrutiny in the case of the Welsh and Scottish legislatures.

scholarly journals Development, implementation and evaluation of an evidence-based paediatric early warning system improvement programme: the PUMA mixed methods study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Davina Allen ◽  
Amy Lloyd ◽  
Dawn Edwards ◽  
Kerenza Hood ◽  
Chao Huang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Early Warning ◽  
Early Warning System ◽  
Paediatric Intensive Care Unit ◽  
Warning System ◽  
Early Warning Systems ◽  
Paediatric Intensive Care ◽  
The United Kingdom ◽  
Alternative Outcome

Abstract Background Paediatric mortality rates in the United Kingdom are amongst the highest in Europe. Clinically missed deterioration is a contributory factor. Evidence to support any single intervention to address this problem is limited, but a cumulative body of research highlights the need for a systems approach. Methods An evidence-based, theoretically informed, paediatric early warning system improvement programme (PUMA Programme) was developed and implemented in two general hospitals (no onsite Paediatric Intensive Care Unit) and two tertiary hospitals (with onsite Paediatric Intensive Care Unit) in the United Kingdom. Designed to harness local expertise to implement contextually appropriate improvement initiatives, the PUMA Programme includes a propositional model of a paediatric early warning system, system assessment tools, guidance to support improvement initiatives and structured facilitation and support. Each hospital was evaluated using interrupted time series and qualitative case studies. The primary quantitative outcome was a composite metric (adverse events), representing the number of children monthly that experienced one of the following: mortality, cardiac arrest, respiratory arrest, unplanned admission to Paediatric Intensive Care Unit, or unplanned admission to Higher Dependency Unit. System changes were assessed qualitatively through observations of clinical practice and interviews with staff and parents. A qualitative evaluation of implementation processes was undertaken. Results All sites assessed their paediatric early warning systems and identified areas for improvement. All made contextually appropriate system changes, despite implementation challenges. There was a decline in the adverse event rate trend in three sites; in one site where system wide changes were organisationally supported, the decline was significant (ß = -0.09 (95% CI: − 0.15, − 0.05); p = < 0.001). Changes in trends coincided with implementation of site-specific changes. Conclusions System level change to improve paediatric early warning systems can bring about positive impacts on clinical outcomes, but in paediatric practice, where the patient population is smaller and clinical outcomes event rates are low, alternative outcome measures are required to support research and quality improvement beyond large specialist centres, and methodological work on rare events is indicated. With investment in the development of alternative outcome measures and methodologies, programmes like PUMA could improve mortality and morbidity in paediatrics and other patient populations.

scholarly journals Coronavirus legislative responses in the UK: regression to panic and disdain of constitutionalism

2021 ◽  
Vol 72 (S1) ◽  
pp. 1-36
Author(s):  
Rebecca Moosavian ◽  
Clive Walker ◽  
Andrew Blick
Keyword(s):  
Public Health ◽  
United Kingdom ◽  
Health Risks ◽  
Individual Rights ◽  
Health Control ◽  
Public Health Risks ◽  
The United Kingdom ◽  
Wide Range ◽  
The Uk ◽  
Selection Of

The United Kingdom has considerable prowess in handling emergencies, not just in counterterrorism but also in a wide range of other real or imagined disasters, including public health risks. Core legislation has been installed, including the all-encompassing Civil Contingencies Act (CCA) 2004 and the more specialist Public Health (Control of Disease) Act (PHA) 1984. Despite these finely honed models, the UK state regressed to panic mode when faced with the COVID-19 pandemic. Rather than turning to the laws already in place, Parliament fast-tracked the Coronavirus Act 2020, with scant debate of its shabbily drafted contents. In addition, the UK Government has relied heavily, with minimal scrutiny, on regulations under the PHA 1984. The article analyses the competing legal codes and how they have been deployed to deal with COVID-19. It then draws out the strengths and weaknesses of the choices in terms of the key themes of: the choice of sectoral versus general emergency legislation; levels of oversight and accountability; effectiveness; and the protection of individual rights. Following this survey, it will be suggested that the selection of legal instruments and the design of their contents has been ill-judged. In short, the emergency code which is the most suitably engineered for the purpose, the CCA 2004, has been the least used for reasons which should not be tolerated.

scholarly journals Early warning systems in the UK: variation in content and implementation strategy has implications for a NHS early warning system

2011 ◽  
Vol 11 (5) ◽  
pp. 424-427 ◽  
Author(s):  
Caroline Patterson ◽  
Fiona Maclean ◽  
Cameron Bell ◽  
Elora Mukherjee ◽  
Leoni Bryan ◽  
...  
Keyword(s):  
Early Warning ◽  
Early Warning System ◽  
Implementation Strategy ◽  
Warning System ◽  
Early Warning Systems ◽  
Warning Systems ◽  
The Uk

scholarly journals The Response of Smokers to Health Warnings on Packs in the United Kingdom and Norway Following the Introduction of Standardized Packaging

2021 ◽  
Author(s):  
Crawford Moodie ◽  
Catherine Best ◽  
Ingeborg Lund ◽  
Janne Scheffels ◽  
Nathan Critchlow ◽  
...  
Keyword(s):  
United Kingdom ◽  
Health Risks ◽  
Health Warnings ◽  
Online Surveys ◽  
Tobacco Products ◽  
Cognitive Reactions ◽  
The United Kingdom ◽  
Pictorial Warnings ◽  
The Uk ◽  
The Impact

Abstract Introduction Standardized packaging was phased in between May 2016 and May 2017 in the United Kingdom and July 2017 and July 2018 in Norway. In both countries, the health warnings on packs prior to standardized packaging being implemented were from the former Tobacco Products Directive library of warnings (text warnings covering 43% of the pack front and pictorial warnings covering 53% of the pack reverse). The warnings on packs, postimplementation, were from the current Tobacco Products Directive library of warnings (novel pictorial warnings covering 65% of the pack front and reverse) for the United Kingdom but unchanged in Norway. Aims and Methods Longitudinal online surveys were conducted prior to standardized packaging (United Kingdom: April–May 2016; Norway: May–June 2017) and postimplementation (United Kingdom: September–November 2017 and May–July 2019; Norway: August–September 2018). We explored smokers’ response to the on-pack warnings (salience, cognitive reactions, and behavioral reactions). Results In the United Kingdom, noticing warnings on packs, reading or looking closely at them, thinking about them, thinking about the health risks, avoidant behaviors, forgoing cigarettes, and being more likely to quit due to the warnings significantly increased from waves 1 to 2, and then decreased from waves 2 to 3, but remained higher than at wave 1. In Norway, noticing warnings, reading or looking closely at them, thinking about them, thinking about the health risks, and being more likely to quit due to the warnings significantly decreased from waves 1 to 2; avoidant behaviors and forgoing cigarettes remained unchanged. Conclusions The inclusion of large novel pictorial warnings on standardized packs increases warning salience and effectiveness. Implications Two longitudinal online surveys in the United Kingdom and Norway explored the impact of standardized packaging on warning salience and effectiveness. That warning salience and effectiveness only increased in the UK postimplementation, where standardized packaging was implemented alongside new larger pictorial warnings on the pack front and reverse, and not in Norway, where standardized packaging was introduced but older smaller text warnings (pack front) and pictorial warnings (pack reverse) were retained, highlights the importance of removing full branding and introducing stronger warnings simultaneously.

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