scholarly journals Uptake of pneumococcal polysaccharide vaccine in at-risk populations in England and Wales 1999–2005

2007 ◽  
Vol 136 (3) ◽  
pp. 360-369 ◽  
Author(s):  
R. G. PEBODY ◽  
J. HIPPISLEY-COX ◽  
S. HARCOURT ◽  
M. PRINGLE ◽  
M. PAINTER ◽  
...  
Keyword(s):  
Chronic Renal Disease ◽  
Risk Groups ◽  
Invasive Disease ◽  
Chronic Respiratory Disease ◽  
Effective Strategies ◽  
Chronic Heart Disease ◽  
High Risk Populations ◽  
At Risk Populations ◽  
The Uk ◽  
Primary Care Practices

SUMMARYThe UK has had a pneumococcal polysaccharide vaccination (PPV) programme for groups at higher risk of invasive disease since 1992. This paper presents data from a sample of primary-care practices (Q-RESEARCH) of PPV uptake in patients according to their risk status. Of 2·9 million registered patients in 2005, 2·1% were vaccinated with PPV in the preceding 12 months and 6·5% in the preceding 5 years. Twenty-nine per cent of the registered population fell into one or more risk groups. The proportion of each risk group vaccinated in the previous 5 years ranged from 69% (cochlear implants), 53·4% (splenic dysfunction), 36·5% (chronic heart disease), 34·7% (diabetes), 22·9% (immunosuppressed), 28·7% (chronic renal disease), 15·9% (sickle cell disease) to 12·6% (chronic respiratory disease). Uptake was lower in areas where the non-white proportion of population was >10%. In conclusion, there remain large gaps in the uptake of PPV in several high-risk populations in the United Kingdom. Effective strategies need to be developed to address these deficiencies.

Ambulant erworbene Pneumonie: Komorbiditäten als Risikofaktoren erkennen

2020 ◽  
Vol 8 (1) ◽  
pp. 26-27
Author(s):  
Stefan Krüger
Keyword(s):  
Risk Group ◽  
Risk Groups ◽  
Chronic Respiratory Disease ◽  
Marrow Transplant ◽  
Community Acquired Pneumonia ◽  
Comorbid Condition ◽  
Odds Ratios ◽  
Chronic Heart Disease ◽  
Comparator Group ◽  
Increased Risk

Background: UK specific data on the risk of developing hospitalised CAP for patients with underlying comorbidities is lacking. This study compared the likelihood of hospitalised all-cause community acquired pneumonia (CAP) in patients with certain high-risk comorbidities and a comparator group with no known risk factors for pneumococcal disease. Methods: This retrospective cohort study interrogated data in the Hospital Episodes Statistics (HES) dataset between financial years 2012/13 and 2016/17. In total 3,078,623 patients in England (aged ≥18 years) were linked to their hospitalisation records. This included 2,950,910 individuals with defined risk groups and a comparator group of 127,713 people who had undergone tooth extraction with none of the risk group diagnoses. Risk groups studied were chronic respiratory disease (CRD), chronic heart disease (CHD), chronic liver disease (CLD), chronic kidney disease (CKD), diabetes (DM) and post bone marrow transplant (BMT). The patients were tracked forward from year 0 (2012/13) to Year 3 (2016/17) and all diagnoses of hospitalised CAP were recorded. A Logistic regression model compared odds of developing hospitalised CAP for patients in risk groups compared to healthy controls. The model was simultaneously adjusted for age, sex, strategic heath authority (SHA), index of multiple deprivation (IMD), ethnicity, and comorbidity. To account for differing comorbidity profiles between populations the Charlson Comorbidity Index (CCI) was applied. The model estimated odds ratios (OR) with 95% confidence intervals of developing hospitalised CAP for each specified clinical risk group.Results: Patients within all the risk groups studied were more likely to develop hospitalised CAP than patients in the comparator group. The odds ratios varied between underlying conditions ranging from 1.18 (95% CI 1.13, 1.23) for those with DM to 5.48 (95% CI 5.28, 5.70) for those with CRD. Conclusions: Individuals with any of 6 pre-defined underlying comorbidities are at significantly increased risk of developing hospitalised CAP compared to those with no underlying comorbid condition. Since the likelihood varies by risk group it should be possible to target patients with each of these underlying comorbidities with the most appropriate preventative measures, including immunisations.

scholarly journals Burden of selected infectious diseases covered by UK childhood vaccinations: systematic literature review

2020 ◽  
Vol 15 (17) ◽  
pp. 1679-1688
Author(s):  
James Clark-Wright ◽  
Pollyanna Hudson ◽  
Conor McCloskey ◽  
Stuart Carroll
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Hepatitis B ◽  
Literature Review ◽  
Disease Burden ◽  
Risk Groups ◽  
Invasive Disease ◽  
Cost Burden ◽  
The Uk ◽  
In Pregnancy

Aim: An overview of recent epidemiology and disease burden, independent of patient age, of diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis and Hemophilus influenzae invasive disease in the UK. Materials & methods: A systematic review was undertaken. Outcomes included incidence, prevalence, risk factors and cost burden. Results: 39 publications were included. Hepatitis B prevalence is high among certain risk groups. A small pertussis risk remains in pregnancy and for infants, which led to the introduction of maternal vaccination. H. influenzae invasive disease cases are limited to rare serotypes. Polio, tetanus and diphtheria are well controlled. Conclusion: The evaluated diseases are currently well controlled, thanks to a comprehensive vaccination program, with a generally low clinical and cost burden.

scholarly journals ‘The body says it’: the difficulty of measuring and communicating sensations of breathlessness

2021 ◽  
pp. medhum-2019-011816
Author(s):  
Alice Malpass ◽  
Coreen Mcguire ◽  
Jane Macnaughton
Keyword(s):  
Clinical Research ◽  
Interdisciplinary Collaboration ◽  
Chronic Respiratory Disease ◽  
The Body ◽  
Clinical Expertise ◽  
Cultural Assumptions ◽  
Sensory Qualities ◽  
Bodily Sensations ◽  
Object Of Study ◽  
The Uk

Breathlessness is a sensation affecting those living with chronic respiratory disease, obesity, heart disease and anxiety disorders. The Multidimensional Dyspnoea Profile is a respiratory questionnaire which attempts to measure the incommunicable different sensory qualities (and emotional responses) of breathlessness. Drawing on sensorial anthropology we take as our object of study the process of turning sensations into symptoms. We consider how shared cultural templates of ‘what counts as a symptom’ evolve, mediate and feed into the process of bodily sensations becoming a symptom. Our contribution to the field of sensorial anthropology, as an interdisciplinary collaboration between history, anthropology and the medical humanities, is to provide a critique of how biomedicine and cultures of clinical research have measured the multidimensional sensorial aspects of breathlessness. Using cognitive interviews of respiratory questionnaires with participants from the Breathe Easy groups in the UK, we give examples of how the wording used to describe sensations is often at odds with the language those living with breathlessness understand or use. They struggle to comprehend and map their bodily experience of sensations associated with breathlessness to the words on the respiratory questionnaire. We reflect on the alignment between cognitive interviewing as a method and anthropology as a disciplinary approach. We argue biomedicine brings with it a set of cultural assumptions about what it means to measure (and know) the sensorial breathless body in the context of the respiratory clinic (clinical research). We suggest the mismatch between the descriptions (and confusion) of those responding to the respiratory questionnaire items and those selecting the vocabularies in designing it may be symptomatic of a type of historical testimonial epistemic injustice, founded on the prioritisation of clinical expertise over expertise by experience.

scholarly journals Dynamic transmission modelling to address infant pneumococcal conjugate vaccine schedule modifications in the UK

2018 ◽  
Vol 146 (14) ◽  
pp. 1797-1806 ◽  
Author(s):  
M. Wasserman ◽  
A. Lucas ◽  
D. Jones ◽  
M. Wilson ◽  
B. Hilton ◽  
...  
Keyword(s):  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Disease Burden ◽  
Invasive Disease ◽  
Transmission Model ◽  
Routine Immunisation ◽  
Scenario Analyses ◽  
Vaccine Schedule ◽  
Vaccine Type ◽  
The Uk

AbstractThe 13-valent pneumococcal conjugate vaccine (PCV) has been part of routine immunisation in a 2 + 1 schedule (two primary infant doses and one booster during the second year of life) in the UK since 2010. Recently, the UK's Joint Committee on Vaccination and Immunisation recommended changing to a 1 + 1 schedule while conceding that this will increase disease burden; however, uncertainty remains on how much pneumococcal burden – including invasive pneumococcal disease (IPD) and non-invasive disease – will increase. We built a dynamic transmission model to investigate this question. The model predicted that a 1 + 1 schedule would incur 8777–27 807 additional cases of disease and 241–743 more deaths over 5 years. Serotype 19A caused 55–71% of incremental IPD cases. Scenario analyses showed that booster dose adherence, effectiveness against carriage and waning in a 1 + 1 schedule had the most influence on resurgence of disease. Based on the model assumptions, switching to a 1 + 1 schedule will substantially increase disease burden. The results likely are conservative since they are based on relatively low vaccine-type pneumococcal transmission, a paradigm that has been called into question by data demonstrating an increase of IPD due to several vaccine serotypes during the last surveillance year available.

scholarly journals Musculoskeletal Tuberculosis in Bradford – A 6-Year Review

2007 ◽  
Vol 89 (4) ◽  
pp. 405-409 ◽  
Author(s):  
JC Talbot ◽  
Q Bismil ◽  
D Saralaya ◽  
DAG Newton ◽  
RM Frizzel ◽  
...  
Keyword(s):  
At Risk ◽  
World Wide ◽  
Surgical Intervention ◽  
Indian Subcontinent ◽  
Anatomical Site ◽  
At Risk Populations ◽  
Recorded Data ◽  
The Uk ◽  
Ethnic Distribution ◽  
Radiological Intervention

INTRODUCTION Tuberculosis (TB) remains the most common cause of death from infectious disease world-wide. In the UK, the incidence of TB has risen by 25% over the last 10 years; extrapulmonary diagnosis remains challenging and can be delayed. This study evaluates the epidemiology of musculoskeletal tuberculosis in a large multi-ethnic UK city. PATIENTS AND METHODS A review of prospectively recorded data of incidence, anatomical site, ethnic distribution, treatment and drug resistance of musculoskeletal tuberculosis over a 6-year period was performed. RESULTS From January 1999 to December 2004, there were 729 TB notifications; 61 cases (8.4%) had musculoskeletal involvement. Of the patients, 74% were immigrants from the Indian subcontinent; nearly 50% had spinal involvement; 24 patients underwent surgical intervention; 29 were subjected to either diagnostic or therapeutic radiological intervention; and resolution of symptoms was achieved in 59 out of 61 cases. CONCLUSIONS This study highlights the high proportion of musculoskeletal TB in immigrant patients in an area with a relatively large at-risk population, but will also serve to alert physicians, in areas with smaller at-risk populations, of the possibility of musculoskeletal TB.

scholarly journals Elbow joint disease in dogs attending primary-care practices in the UK

2017 ◽  
pp. 492-493
Author(s):  
Rebecca Hodge ◽  
Richard Meeson ◽  
David Brodbelt ◽  
David Church ◽  
Dan O’Neill
Keyword(s):  
Primary Care ◽  
Elbow Joint ◽  
Joint Disease ◽  
Care Practices ◽  
The Uk ◽  
Primary Care Practices

scholarly journals Predictors of cognitive, behavioural and academic difficulties in NF1

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S243-S243
Author(s):  
Kavitha Chinnappa Ramamurthy ◽  
Marie-Maude Geoffray ◽  
Louise Robinson ◽  
Lauren Manderson ◽  
Julieta O'Flaherty ◽  
...  
Keyword(s):  
Remedial Education ◽  
Clinical Sample ◽  
Risk Groups ◽  
Neurological Complications ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Academic Difficulties ◽  
The North ◽  
Cognitive Behavioural ◽  
The Uk

AimsThe aim of this study is to systematically investigate the demographic and disease predictors of cognitive and behavioural phenotype in the largest cohort of children with NF1 published to date. Based on previously published research, we examine the potential role of demographic predictors such as age, sex, SES, parental NF1 status as well as the neurological complications such as epilepsy and brain tumours in NF1 associated cognitive/ behavioural impairments.MethodIn this cross-sectional study design, participant data were drawn from two large databases which included (i) A clinical database of all patients with NF1 seen in a clinical psychological service from 2010 to 2019 and (ii) A research dataset from two previously published studies (2,8). The complex National NF1 service based within Manchester regional genetic services is set up for individuals with complex NF1 (https://www.mangen.co.uk/healthcare-professionals/clinical-genomic-services/nf1/) in the North of the UK. Children were referred to the psychological services by NF1 clinicians if psychological assessment was warranted based on parental reports. In order to reduce clinic referral bias, the clinical sample was supplemented by including participants that were seen solely for the purposes of research studies within our centre.ResultRelative to population norms, 90% of the NF1 sample demonstrated significantly lower scores in at least one cognitive or behavioral domain. Family history of NF1 and lower SES were independently associated with poorer cognitive, behavioral and academic outcomes. Neurological problems such as epilepsy and hydrocephalus were associated with lower IQ and academic skills.ConclusionCognitive and behavioural phenotypes commonly emerge via a complex interplay between genes and environmental factors, and this is true also of a monogenic condition such as NF1. Early interventions and remedial education may be targeted to risk groups such those with familial NF1, families with lower SES and those with associated neurological comorbidities.

Clinical features and diagnosis of acute rheumatic fever

ESC CardioMed ◽  
2018 ◽  
pp. 1138-1140
Author(s):  
Antoinette Cilliers
Keyword(s):  
High Risk ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Heart Association ◽  
Risk Groups ◽  
Group A ◽  
High Risk Populations ◽  
Minor Criteria

The diagnosis of acute rheumatic fever cannot be made using a single test. The diagnosis requires the recognition of a complex of clinical signs divided into major and minor manifestations as well as laboratory investigations aided by application of the Jones criteria, originally devised in 1944. The clinical manifestations are secondary to the effects of antibodies produced against the group A Streptococcus organism which cross-react against cardiac, skin, synovial, and neurological tissue associated with signs of inflammation. Several adjustments to the Jones criteria have been published over the last 70 years. The latest 2015 American Heart Association modification includes echocardiography/Doppler studies to diagnose subclinical carditis and also incorporates risk stratification whereby at-risk populations are divided into low- and moderate-to-high-risk groups. The presence of a single episode of a fever of at least 38°C and a slight elevation of the erythrocyte sedimentation rate to at least 30 mm/hour are classified as minor criteria in moderate- and high-risk populations. A monoarthritis or polyarthralgia are included as major criteria in the same risk group.

scholarly journals Protocol for a Mixed-Method Investigation of the Impact of the COVID-19 Pandemic and Gambling Practices, Experiences and Marketing in the UK: The “Betting and Gaming COVID-19 Impact Study”

2020 ◽  
Vol 17 (22) ◽  
pp. 8449
Author(s):  
Kate Hunt ◽  
Nathan Critchlow ◽  
Ashley Brown ◽  
Christopher Bunn ◽  
Fiona Dobbie ◽  
...  
Keyword(s):  
Young Adults ◽  
Mixed Method ◽  
Qualitative Interviews ◽  
Risk Groups ◽  
Third Wave ◽  
Policy Makers ◽  
Treatment Providers ◽  
Sports Events ◽  
The Uk ◽  
The Impact

The COVID-19 pandemic led to unprecedented restrictions on people’s movements and interactions, as well as the cancellation of major sports events and social activities, directly altering the gambling landscape. There is urgent need to provide regulators, policy makers and treatment providers with evidence on the patterns and context of gambling during COVID-19 and its aftermath. This protocol describes a study addressing the following three questions: (1) How has COVID-19 changed gambling practices and the risk factors for, and experience of, gambling harms? (2) What is the effect of COVID-19 on gambling marketing? (3) How has COVID-19 changed high risk groups’ gambling experiences and practices? This mixed-method study focuses on two groups, namely young adults and sports bettors. In workpackage-1, we will extend an existing longitudinal survey of gambling in young adults (aged 16–24 years) (first wave conducted June–August 2019), adding COVID-19-related questions to the second wave (July–August 2020) and extending to a third wave in 2021; and undertake a survey of sports bettors in the UK (baseline n = 4000, ~July–August 2020), with follow-ups in ~October–November 2020 and ~February-March 2021. In workpackage-2, we will examine changes in expenditure on paid-for gambling advertising from January 2019 to July 2021 and undertake a mixed-method content analysis of a random sample of paid-for gambling advertising (n ~ 200) and social media marketing (n ~ 100) during the initial COVID-19 “lockdown”. Workpackage-3 will involve qualitative interviews with a purposive sample of (a) young adults (aged 18–24 years) and (b) sports bettors.

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