Introduction

2021 ◽  
pp. 1-6
Author(s):  
Terry Robinson ◽  
Jane Scullion
Keyword(s):  
Respiratory Diseases ◽  
Mortality And Morbidity ◽  
North West ◽  
The North ◽  
The United Kingdom ◽  
Common Causes ◽  
Drug Treatments ◽  
The Common ◽  
The Uk ◽  
Lung Health

Respiratory diseases are one of the most common forms of ill-health, affecting about 12.5 million in the United Kingdom (UK); approximately one in five people. Globally the UK is in the top 20 countries for lung cancer and COPD deaths, with prevalence being highest in the North-West and South-West of England. More women than men have a diagnosed lung disease, mainly due to higher pneumonia incidence; most other lung conditions are more common in men. This chapter begins with an overview of respiratory disease, and outlines some of the common causes that impact on lung health. The mortality and morbidity of various respiratory diseases is covered, and the costs of consultations and drug treatments are discussed.

scholarly journals FRI0649-HPR HYDROXYCHLOROQUINE PRESCRIBING AND OPHTHALMOLOGY SCREENING WITHIN RHEUMATOLOGY DEPARTMENTS IN THE NORTH-WEST OF THE UNITED KINGDOM: A PROSPECTIVE REGIONAL AUDIT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 928.2-929
Author(s):  
S. Juman ◽  
T. David ◽  
L. Gray ◽  
R. Hamad ◽  
S. Horton ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Service Level ◽  
High Risk Group ◽  
North West ◽  
The North ◽  
The United Kingdom ◽  
The Uk ◽  
Treatment Dosage ◽  
Sd Oct

Background:Hydroxychloroquine (HCQ) is widely used in the management of rheumatoid arthritis and connective tissue disease. The prevalence of retinopathy in patients taking long-term HCQ is approximately 7.5%, increasing to 20-50% after 20 years of therapy. Hydroxychloroquine prescribed at ≤5 mg/kg poses a toxicity risk of <1% up to five years and <2% up to ten years, but increases sharply to almost 20% after 20 years. Risk factors for retinopathy include doses >5mg/kg/day, concomitant tamoxifen or chloroquine use and renal impairment. The UK Royal College of Ophthalmologists (RCOphth) 2018 guidelines for HCQ screening recommend optimal treatment dosage and timing for both baseline and follow-up ophthalmology review for patients on HCQ, with the aim of preventing iatrogenic visual loss. This is similar to recommendations made by the American Academy of Ophthalmology (2016).Objectives:To determine adherence to the RCOphth guidelines for HCQ screening within the Rheumatology departments in the North-West of the UK.Methods:Data for patients established on HCQ and those initiated on HCQ therapy were collected over a 7 week period from 9 Rheumatology departments.Results:473 patients were included of which 56 (12%) were new starters and 417 (88%) were already established on HCQ. 79% of the patients were female, with median ages of 60.5 and 57 years for new and established patients respectively. The median (IQR) weight for new starters was 71 (27.9) kg and for established patients, 74 (24.7) kg.20% of new starters exceeded 5mg/kg daily HCQ dose. 16% were identified as high risk (9% had previously taken chloroquine, 5% had an eGFR <60ml/min/m2and 2% had retinal co-pathology). Of the high-risk group, 44% were taking <5mg/kg. In total, 36% of new starters were referred for a formal baseline Ophthalmology review.In the established patients, 74% were taking ≤5mg/kg/day HCQ dose and 16% were categorized as high risk (10% had an eGFR less than 60ml/min/m2, 3% had previous chloroquine or tamoxifen use and 2% had retinal co-pathology). In the high-risk group, 75% were not referred for spectral domain optical coherence tomography (SD-OCT). 41% of patients established on HCQ for <5 years, and 33% of patients on HCQ for >5 years were not referred for SD-OCT. Reasons for not referring included; awaiting 5 year review, previous screening already performed and optician review advised.Since the introduction of the RCOphth guidelines, 29% patients already established on HCQ had an alteration in the dosage of HCQ in accordance with the guidelines. In the high-risk group, 16% were not on the recommended HCQ dose.Conclusion:This audit demonstrates inconsistencies in adherence to the RCOphth guidelines for HCQ prescribing and ophthalmology screening within Rheumatology departments in the North-West of the UK for both new starters and established patients. Plans to improve this include wider dissemination of the guidelines to Rheumatology departments and strict service level agreements with ophthalmology teams to help optimize HCQ prescribing and screening for retinopathy.Acknowledgments:Drs. S Jones, E MacPhie, A Madan, L Coates & Prof L Teh. Co-1st author, T David.Disclosure of Interests:None declared

scholarly journals Building partnerships

2017 ◽  
Vol 1 (1) ◽  
pp. 1-8
Author(s):  
Richard Byrne
Keyword(s):  
Water Quality ◽  
Landscape Conservation ◽  
Sustainable Change ◽  
North West ◽  
The North ◽  
Quality Issue ◽  
The United Kingdom ◽  
Peat Deposits ◽  
The Uk ◽  
Water Quality Issue

Water is generally plentiful in the United Kingdom; however, there is an emerging water quality issue driven by agricultural intensification. Poor land management over generations has contributed to the degradation of upland peat deposits leading to discolouration of potable water and the loss of valuable habitats. Employing agri-environmental schemes operated by the UK Government and private Capital One water company in the North West of England is achieving water quality gains as well as landscape, conservation and habitat benefit at the same time as supporting tenant farm incomes. We describe the pressures on the uplands and how innovative partnerships are achieving sustainable change.

Geographical Perspectives on United States Investment in the United Kingdom

1976 ◽  
Vol 8 (6) ◽  
pp. 685-705 ◽  
Author(s):  
P Dicken ◽  
P E Lloyd
Keyword(s):  
Direct Investment ◽  
Motor Vehicles ◽  
Total Output ◽  
North West ◽  
Manufacturing Operations ◽  
The North ◽  
The United Kingdom ◽  
Considerable Impact ◽  
The Uk ◽  
High Degree

American direct investment in Britain has a long history, dating back to 1851. In the past twenty years, however, the magnitude of US investment in Britain has dramatically increased. Events such as the closure of the Imperial Typewriter Co. at Hull and the threatened withdrawal of Chrysler from its UK manufacturing operations have served to focus attention on the activities of US based multinationals in Britain. Direct investment by US companies has a very considerable impact on the UK economy. American owned enterprises employ one in every fourteen workers in private enterprise manufacturing and account for more than 10% of total output. There is a high degree of sectoral concentration in this ownership pattern with the main emphasis in vehicles, electrical engineering, mechanical engineering, and the food, drink, and tobacco industries. Spatially there is a particular tendency toward concentration in the South East. In terms of net gains over time, however, Scotland has fared particularly well in attracting US companies. Within the North West of England there is also a tendency toward sectoral and spatial concentration. The motor vehicles industry on Merseyside represents the most prominent cluster and, in a region chronically prone to serious unemployment, there is potentially a degree of vulnerability which might give legitimate cause for concern.

scholarly journals On tho proportions of the prevailing winds, the mean temperature, and depth of rain in the climate of London, computed through a cycle of Eighteen Years, or periods of the Moon’s declination

1843 ◽  
Vol 4 ◽  
pp. 300-300
Keyword(s):  
The Moon ◽  
Fair Weather ◽  
North West ◽  
West Wind ◽  
North East ◽  
East Wind ◽  
The North ◽  
The Common ◽  
The Mean ◽  
Solar Influence

In this paper the author investigates the periodical variations of the winds, rain and temperature, corresponding to the conditions of the moon’s declination, in a manner similar to that he has already followed in the case of the barometrical variations, on a period of years extending from 1815 to 1832 inclusive. In each case he gives tables of the average quantities for each week, at the middle of which the moon is in the equator, or else has either attained its maximum north or south declination. He thus finds that a north-east wind is most promoted by the constant solar influence which causes it, when the moon is about the equator, going from north to south; that a south-east wind, in like manner, prevails most when the moon is proceeding to acquire a southern declination ; that winds from the south and west blow more when the moon is in her mean degrees of declination, going either way, than with a full north or south declination ; and that a north-west wind, the common summer and fair weather wind of the climate, affects, in like manner, the mean declination, in either direction, in preference to the north or south, and most when the moon is coming north. He finds the average annual depth of rain, falling in the neighbourhood of London, is 25’17 inches.

scholarly journals Psychiatry in Ireland

2009 ◽  
Vol 6 (2) ◽  
pp. 36-38 ◽  
Author(s):  
Zahid Latif
Keyword(s):  
Northern Ireland ◽  
European Economic Community ◽  
Total Population ◽  
Economic Community ◽  
Republic Of Ireland ◽  
North West ◽  
North East ◽  
The North ◽  
The United Kingdom ◽  
The Republic

Ireland is the third largest island in Europe and the twentieth largest island in the world, with an area of 86 576 km2; it has a total population of slightly under 6 million. It lies to the north-west of continental Europe and to the west of Great Britain. The Republic of Ireland covers five-sixths of the island; Northern Ireland, which is part of the United Kingdom, is in the north-east. Twenty-six of the 32 counties are in the Republic of Ireland, which has a population of 4.2 million, and its capital is Dublin. The other six counties are in Northern Ireland, which has a population of 1.75 million, and its capital is Belfast. In 1973 both parts of Ireland joined the European Economic Community. This article looks at psychiatry in the Republic of Ireland.

scholarly journals Clinical Profile and Outcome of Neonates Admitted to Neonatal Intensive Care Unit of NGMC

2017 ◽  
Vol 15 (1) ◽  
pp. 20-22
Author(s):  
Roma KM ◽  
Manita Pyakurel ◽  
Veena Gupta ◽  
Piush Kanodia
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Study Data ◽  
Clinical Profile ◽  
Mortality And Morbidity ◽  
Medical Practitioners ◽  
Common Causes ◽  
Causes Of Mortality ◽  
The Common

Background: Neonatal period is a period from birth to under 28 days of life. The common causes of mortality and morbidity in our region are preventable, among which neonatal sepsis is the commonest one. Most of the deaths occur within 7 days of life. Objectives: To study the clinical profile, pattern of diseases, causes of morbidity and mortality amongst newborns. Materials and methods: A hospital based descriptive study was done among total 967 newborns including both inborn and out born admitted in NICU, NGMC from January 2016 to December 2016. Age, sex, gestational age, diagnosis at admission, outcome of admitted th newborns were the main variables under study. Data was entered in Excel and analyzed using SPSS 20th version. Data were presented through pie, bar graph and table with frequency and percentage. Results: Male were predominant in the study (65%). One third of the admitted newborns were preterms. Half of the admitted newborns were admitted on their first day of life. Neonatal sepsis was the most common cause of admission. Deaths occured in 7.4%of total babies. Seventy-six percent got improved after treatment. Only 2.8% were referred to higher center. Conclusions: Most of the neonates got admitted in first day of life with commonest cause being neonatal sepsis. Recovery rate was satisfactory. To reduce the mortality and morbidity of neonates, we need to increase awareness level in general population and proper aseptic practices in medical practitioners.

scholarly journals Morphology of <i>Emiliania huxleyi</i> coccoliths on the North West European shelf – is there an influence of carbonate chemistry?

2014 ◽  
Vol 11 (3) ◽  
pp. 4531-4561 ◽  
Author(s):  
J. R. Young ◽  
A. J. Poulton ◽  
T. Tyrrell
Keyword(s):  
Environmental Samples ◽  
Significant Variation ◽  
Emiliania Huxleyi ◽  
Morphometric Study ◽  
Saturation State ◽  
North West ◽  
The North ◽  
Microscope Images ◽  
Calcite Saturation ◽  
The Uk

Abstract. Within the context of the UK Ocean Acidification project, Emiliania huxleyi (type A) coccolith morphology was examined from samples collected during cruise D366. In particular, a morphometric study of coccolith size and degree of calcification was made on scanning electron microscope images of samples from shipboard CO2 perturbation experiments and from a set of environmental samples with significant variation in calcite saturation state (Ωcalcite). One bioassay in particular (E4 from the southern North Sea) yielded unambiguous results – in this bioassay exponential growth from a low level occurred with no artificial stimulation and coccosphere numbers increased ten-fold during the experiment. The samples with elevated CO2 saw significantly reduced coccolithophore growth. However, coccolithophore morphology was not significantly affected by the changing CO2 conditions even under the highest levels of perturbation (1000 μatm). Environmental samples similarly showed no correlation of coccolithophore morphology with calcite saturation state. Some variation in coccolith size and degree of calcification does occur but this seems to be predominantly due to genotypic differentiation between populations on the shelf and in the open ocean.

scholarly journals 'Greenfields' and 'Brownfields': automotive industrial development in the UK and in Portugal

Finisterra ◽  
2012 ◽  
Vol 31 (62) ◽  
Author(s):  
Andrew Pike ◽  
Mário Vale
Keyword(s):  
Industrial Policy ◽  
Automobile Industry ◽  
Industrial Development ◽  
Development Strategies ◽  
North West ◽  
Demonstration Effect ◽  
North East ◽  
The North ◽  
The Uk ◽  
The Impact

The industrial policy in the UK and in Portugal, as in most EU countries, seeks to attract new investment capacity, to create jobs and to promote the impact of the so-called "demonstration efect" of "greenfield" development strategies pursued in the new plants of inward investors on existing or "brownfield" plants. This industrial policy focus is particularly evident in the automobile industry.This paper compares the industrial policy oriented towards the automobile industry in the UK and in Portugal. Two recent "greenfield" investments are analised: Nissan in the North-East region (UK) and Ford/VW in the Setúbal Peninsula (Portugal), as well as three "brownfield" plants: Ford Halewood and GM Vauxhall Ellesmere Port in the North-West region (UK) and Renault in Setúbal (Portugal). The first part starts with a discussion of industrial policy in the automobile sector, the role of "greenfield" development strategies and the "demonstration effect" on "brownfield" plants. Then, the limits of new inward investment are pointed out, basically their problems and restrictions. Afterwards, the structural barriers to the "demonstration effect" within "brownfield" plants are outlined and some possabilities for alternative "brownfield" development strategies are presented.

scholarly journals Development of the Web Users Self-Efficacy Scale (WUSE)

10.28945/3027 ◽  
2006 ◽  
Author(s):  
Peter Eachus ◽  
Simon Cassidy
Keyword(s):  
Self Efficacy ◽  
Reliability And Validity ◽  
Iterative Approach ◽  
Student Body ◽  
Web Based ◽  
North West ◽  
The North ◽  
The United Kingdom ◽  
Set Up ◽  
The Web

The aim of this research was to develop a scale that could evaluate an individuals confidence in using the Internet. Web-based resources are becoming increasingly important within higher education and it is therefore vital that students and staff feel confident and competent in the access, provision, and utilisation of these resources. The scale developed here represents an extension of previous research (Cassidy & Eachus, 2002) that developed a measure of self-efficacy in the context of computer use. An iterative approach was used in the development of the Web User SelfEfficacy scale (WUSE) and the participants were recruited from the student body of a large University in the North West of the United Kingdom, and globally via a web site set up for this purpose. Initial findings suggest that the scale has acceptable standards of reliability and validity though work is continuing to refine the scale and improve the psychometric properties of the tool.

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