scholarly journals Characteristics and outcomes of 627 044 COVID-19 patients with and without obesity in the United States, Spain, and the United Kingdom

2020 ◽  
Author(s):  
Martina Recalde ◽  
Elena Roel ◽  
Andrea Pistillo ◽  
Anthony G Sena ◽  
Albert Prats-Uribe ◽  
...  
Keyword(s):  
Data Model ◽  
The United States ◽  
Common Data Model ◽  
Obese Patients ◽  
The United Kingdom ◽  
Respiratory Events ◽  
Obesity Status ◽  
The Us ◽  
Prevalence Of Obesity ◽  
The Uk

Background: COVID-19 may differentially impact people with obesity. We aimed to describe and compare the demographics, comorbidities, and outcomes of obese patients with COVID-19 to those of non-obese patients with COVID-19, or obese patients with seasonal influenza. Methods: We conducted a cohort study based on outpatient/inpatient care, and claims data from January to June 2020 from the US, Spain, and the UK. We used six databases standardized to the OMOP common data model. We defined two cohorts of patients diagnosed and/or hospitalized with COVID-19. We created corresponding cohorts for patients with influenza in 2017-2018. We followed patients from index date to 30 days or death. We report the frequency of socio-demographics, prior comorbidities, and 30-days outcomes (hospitalization, events, and death) by obesity status. Findings: We included 627 044 COVID-19 (US: 502 650, Spain: 122 058, UK: 2336) and 4 549 568 influenza (US: 4 431 801, Spain: 115 224, UK: 2543) patients. The prevalence of obesity was higher among hospitalized COVID-19 (range: 38% to 54%) than diagnosed COVID-19 (30% to 47%), or diagnosed/hospitalized influenza (15% to 48%) patients. Obese hospitalized COVID-19 patients were more often female and younger than non-obese COVID-19 patients or obese influenza patients. Obese COVID-19 patients were more likely to have prior comorbidities, present with cardiovascular and respiratory events during hospitalization, require intensive services, or die compared to non-obese COVID-19 patients. Obese COVID-19 patients were also more likely to require intensive services or die compared to obese influenza patients, despite presenting with fewer comorbidities. Interpretation: We show that obesity is more common among COVID-19 than influenza patients, and that obese patients present with more severe forms of COVID-19 with higher hospitalization, intensive services, and fatality than non-obese patients. These data are instrumental for guiding preventive strategies of COVID-19 infection and complications

scholarly journals Characteristics and outcomes of 627 044 COVID-19 patients living with and without obesity in the United States, Spain, and the United Kingdom

2021 ◽  
Author(s):  
Martina Recalde ◽  
Elena Roel ◽  
Andrea Pistillo ◽  
Anthony G. Sena ◽  
Albert Prats-Uribe ◽  
...  
Keyword(s):  
The United States ◽  
Common Data Model ◽  
Medical Conditions ◽  
The United Kingdom ◽  
Hospitalization Rates ◽  
Respiratory Events ◽  
Obesity Status ◽  
Wide Range ◽  
Prevalence Of Obesity ◽  
The Uk

Abstract Background A detailed characterization of patients with COVID-19 living with obesity has not yet been undertaken. We aimed to describe and compare the demographics, medical conditions, and outcomes of COVID-19 patients living with obesity (PLWO) to those of patients living without obesity. Methods We conducted a cohort study based on outpatient/inpatient care and claims data from January to June 2020 from Spain, the UK, and the US. We used six databases standardized to the OMOP common data model. We defined two non-mutually exclusive cohorts of patients diagnosed and/or hospitalized with COVID-19; patients were followed from index date to 30 days or death. We report the frequency of demographics, prior medical conditions, and 30-days outcomes (hospitalization, events, and death) by obesity status. Results We included 627 044 (Spain: 122 058, UK: 2336, and US: 502 650) diagnosed and 160 013 (Spain: 18 197, US: 141 816) hospitalized patients with COVID-19. The prevalence of obesity was higher among patients hospitalized (39.9%, 95%CI: 39.8−40.0) than among those diagnosed with COVID-19 (33.1%; 95%CI: 33.0−33.2). In both cohorts, PLWO were more often female. Hospitalized PLWO were younger than patients without obesity. Overall, COVID-19 PLWO were more likely to have prior medical conditions, present with cardiovascular and respiratory events during hospitalization, or require intensive services compared to COVID-19 patients without obesity. Conclusion We show that PLWO differ from patients without obesity in a wide range of medical conditions and present with more severe forms of COVID-19, with higher hospitalization rates and intensive services requirements. These findings can help guiding preventive strategies of COVID-19 infection and complications and generating hypotheses for causal inference studies.

Antitrust Regulation of IT Giants` Activities: Main Trends of Foreign and Russian Legislation

2021 ◽  
Author(s):  
D.V. Shram ◽  
Keyword(s):  
House Of Representatives ◽  
Network Effects ◽  
The United States ◽  
The European Union ◽  
The United Kingdom ◽  
The Us ◽  
The Usa ◽  
Economic Concentration ◽  
The Uk ◽  
Antitrust Regulation

The article is devoted to the antimonopoly regulation of IT giants` activities. The author presents an overview of the main trends in foreign and Russian legislation in this area. The problems the antimonopoly regulation of digital markets faces are the following: the complexity of determining the criteria for the dominant position of economic entities in the digital economy and the criteria for assessing the economic concentration in the commodity digital markets; the identification and suppression of cartels; the relationship between competition law and intellectual property rights in the digital age. Some aspects of these problems are considered through the prism of the main trends in the antimonopoly policy in the United States, the European Union, the United Kingdom and Russia. The investigation findings of the USA House of Representatives Antitrust Subcommittee against Apple, Google, Amazon and Facebook are presented. The author justifies the need to separate them, which requires the adoption of appropriate amendments to the antimonopoly legislation. The article analyzes the draft law of the European Commission on the regulation of digital markets – Digital Markets Act, reveals the criteria for classifying IT companies as «gatekeepers», and notes the specific approaches to antimonopoly regulation in the UK and the US. The article describes the concepts «digital platform» and «network effects», presented in the «fifth antimonopoly package of amendments», developed in 2018 by the Federal Antimonopoly Service of the Russian Federation, and gives an overview of the comments of the Ministry of Economic Development regarding these concepts wording in the text of the draft law, which formed the basis for the negative conclusion of the regulator. It is concluded that in the context of the digital markets’ globalization, there is a need for the international legal nature antitrust norms formation, since regional legislation obviously cannot cope with the monopolistic activities of IT giants.

Overview of Ghana’s Export and Import, FDI inflow and outflow: Is there any connection between its trading partners and foreign investing countries?

2020 ◽  
Vol 3 (2) ◽  
pp. 1-14
Author(s):  
Evans Yeboah ◽  
Yu Jing ◽  
Anning Lucy
Keyword(s):  
Trade Deficit ◽  
The United States ◽  
Outward Fdi ◽  
Trade Surplus ◽  
The United Kingdom ◽  
The Us ◽  
Trading Partners ◽  
Balance Of Trade ◽  
Major Factors ◽  
The Uk

Foreign direct investment inflows and outflows, export and import are seen as some of the major factors for transforming a country’s economic growth and development. This paper provides and evaluates literature review on importation and exportation alongside inward and outward FDI in Ghana. By considering some selected countries such as China, India, the United States of America, and the United Kingdom in determining whether there is some sort of connection between Ghana’s trading partners and investing countries in its economy by the use of the quantitative method. The results show that Ghana’s export values have improved rapidly over the past years with a continuous decrease in its imports. The outcome further proves that, at the initial level, export from Ghana to China, India, the US, and the UK were of lower values and with much effort by the Ghana government to control the balance of trade deficit from these major trading partners is in the process of achieving the goal, as the country has been experiencing balance of trade surplus from China and India except in the situation the US, and the UK. It was also revealed that China, India, the US, and the UK are not only major trading partners but also among the top investing nations in Ghana. It is suggested that Ghana should increase its outward FDI and also encourages its multinational companies to embark on cross-border investment.

Framing China's rise in the United States, Australia and the United Kingdom

2021 ◽  
Author(s):  
David M McCourt
Keyword(s):  
United States ◽  
United Kingdom ◽  
The United States ◽  
Diplomatic Relations ◽  
China’S Rise ◽  
Secondary Sources ◽  
The United Kingdom ◽  
The Us ◽  
China's Rise ◽  
The Uk

Abstract Optimism about China's rise has in recent years given way to deep concern in the United States, Australia and the United Kingdom. Drawing on an original set of interviews with China experts from each country, and an array of primary and secondary sources, I show that shifting framings of China's rise reflect the dynamics of the US, Australian and UK national security fields. The article highlights three features specifically: first, the US field features a belief that China's rise can be arrested or prevented, absent in Australia and the UK. I root this dynamic in the system of professional appointments and the intense US ‘marketplace of ideas’, which gives rise to intense framing contestation and occasional sharp frame change. I then identify the key positions produced by each field, from which key actors have shaped the differing interpretations of China and its meaning. The election of Donald Trump, a strong China-critic, to the US presidency empowered key individuals across government who shifted the predominant framing of China from potential challenger to current threat. The smaller and more centralized fields in Australia and Britain feature fewer and less intense China-sceptical voices; responses have thereby remained largely pragmatic, despite worsening diplomatic relations in each case.

Do Views on Sex Offending Vary by Nationality? A Comparative Analysis of Community Sentiment Toward Sex Offense Legislation in the United States and United Kingdom

2020 ◽  
pp. 0306624X2096416
Author(s):  
Devin Cowan ◽  
Kristen M. Zgoba ◽  
Rob T. Guerette ◽  
Jill S. Levenson
Keyword(s):  
United States ◽  
United Kingdom ◽  
Sex Offenders ◽  
Sex Offender ◽  
International Comparisons ◽  
The United States ◽  
The United Kingdom ◽  
The Us ◽  
The Uk ◽  
Sex Offense

Much attention has been paid to the examination of community sentiment regarding convicted sex offenders and the policy that governs these offenders’ behavior. This literature, however, has largely been absent of international comparisons of sex offender community sentiment. The current study seeks to fill this gap by drawing from the results of surveys ( n = 333) conducted in both the United States (US) and the United Kingdom (UK). Results indicate that sex offender policy is generally supported in both the US and the UK. Contrary to our expectations, we found that participants from the UK were less tolerant of sex offenders residing in their neighborhoods than participants from the US. Additionally, there is support for the notion that sex offender policy holds a symbolic value for both study locations. Theoretical and practical implications of these findings are discussed.

Mental Health Services in Transition: the United States and the United Kingdom

1992 ◽  
Vol 161 (5) ◽  
pp. 589-593 ◽  
Author(s):  
James Raftery
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Health Services ◽  
Health Services ◽  
Community Care ◽  
The United States ◽  
The Past ◽  
The United Kingdom ◽  
The Us ◽  
The Uk

Mental health services are of interest not only because of the large burden they impose, but also because they have been subject to more change than virtually any other type of health service over the past four decades. Although both the US and UK have taken to ‘deinstitutionalisation’ with enthusiasm, the US has so far proceeded somewhat further down that road than the UK. While both countries face similar problems, the NHS and Community Care Act 1990 may now lead to considerable further changes in the UK.

scholarly journals There Is Life After the UK Clozapine Central Non-Rechallenge Database

2021 ◽  
Author(s):  
Ebenezer Oloyede ◽  
Cecilia Casetta ◽  
Olubanke Dzahini ◽  
Aviv Segev ◽  
Fiona Gaughran ◽  
...  
Keyword(s):  
United Kingdom ◽  
Clinical Outcomes ◽  
Hematological Parameters ◽  
The United States ◽  
The United Kingdom ◽  
Number Of Patients ◽  
The Us ◽  
The Uk ◽  
To Receive ◽  
Health Trust

Abstract Background and Aims In the United Kingdom, patients on clozapine whose hematological parameters fall below certain thresholds are placed on the Central Non-Rechallenge Database (CNRD), meaning that they cannot be prescribed clozapine again except under exceptional circumstances. This practice was discontinued in the United States in 2015 by expanding the hematological monitoring guidelines, allowing more patients to receive clozapine. Our objective was to investigate the implications this policy change would have on clozapine utilization in the United Kingdom. Methods This was an observational, retrospective analysis of patients registered on the CNRD in a large mental health trust. The first objective was to compare the number of patients placed on the CNRD under the United Kingdom and the US Food and Drug Administration (FDA) criteria. The second objective was to explore the hematological and clinical outcomes of CNRD patients. The third objective was to investigate the hematological outcomes of patients rechallenged on clozapine after nonrechallengeable status. Results One hundred and fifteen patients were placed on CNRD from 2002 to 2019, of whom 7 (6%) met the equivalent criteria for clozapine discontinuation under the FDA guidelines. Clinical outcomes, as measured by the Clinical Global Impression-Severity scale, were worse 3 months after clozapine cessation than on clozapine (t = −7.4862; P < .001). Sixty-two (54%) patients placed on CNRD were rechallenged. Fifty-nine of those (95%) were successfully rechallenged; 3 patients were placed back on CNRD, only one of which would have had to stop clozapine again under FDA criteria. Conclusion Implementation of the updated FDA’s monitoring criteria in the United Kingdom would significantly reduce clozapine discontinuation due to hematological reasons. The evidence suggests an urgent need for revising the UK clozapine monitoring guidelines to improve outcomes in treatment-resistant schizophrenia.

scholarly journals Time trends and treatment pathways in the prescribing of individual oral anticoagulants in patients with non-valvular atrial fibrillation: an observational study of more than three million patients from Europe and the United States

2021 ◽  
Author(s):  
Pareen Vora ◽  
Henry Morgan Stewart ◽  
Beth Russell ◽  
Alex Asiimwe ◽  
Gunnar Brobert
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Time Trends ◽  
Oral Anticoagulants ◽  
The United States ◽  
Common Data Model ◽  
Long Term Treatment ◽  
The Us ◽  
The Uk

Background: Data directly comparing trends in the use of different oral anticoagulants (OACs) among patients with atrial fibrillation (AF) from different countries are limited. We addressed this using a large-scale network cohort study in the United States (US), Belgium, France, Germany and United Kingdom (UK). Methods: We used nine databases (claims or electronic health records) that had been converted into the Observational Medical Outcomes Partnership Common Data Model with analysis performed using open-source analytical tools. We identified adults with AF and a first OAC prescription, either vitamin K antagonist (VKA) or direct oral anticoagulant (DOAC) from 2010–2017. We described time-trends in use, continuation and switching. Results: In 2010, 87.5%–99.8% of patients started on a VKA. By 2017, the majority started on a DOAC: 87.0% (US), 88.3% (Belgium), 93.1% (France), 88.4% (Germany), 86.1%–86.7% (UK). In the UK, DOACs became the most common starting OAC in 2015, 2–3 years later than elsewhere. Apixaban was the most common starting OAC by 2017: 50.2%–57.8% (US), 31.4% (Belgium), 45.9% (France), 39.5% (Germany), 49.8%– 50.5% (UK), followed by rivaroxaban; 24.8%–32.5% (US), 25.7% (Belgium), 38.4% (France), 24.9% (Germany), 30.2%– 31.2% (UK). Long-term treatment was less common in the US than in Europe, especially the UK. A minority of patients switched from their index OAC, both in the short- and long-term. Conclusions: From 2010–2017, VKA use had significantly declined and DOAC use had significantly increased in the US and Europe; apixaban was the most prescribed OAC in 2017 followed by rivaroxaban.

Legal Regulation of Harassment on the Ground of Age: Lessons from America?

2007 ◽  
Vol 9 (1) ◽  
pp. 57-65
Author(s):  
Sam Middlemiss
Keyword(s):  
United States ◽  
United Kingdom ◽  
The United States ◽  
Legal Regulation ◽  
Valuable Insight ◽  
Legal Rules ◽  
The United Kingdom ◽  
The Us ◽  
The Uk ◽  
Insight Into

While numerous articles have now been written on the age regulations 1 they tend to concentrate on the broad detail of the Regulations and their likely impact in the United Kingdom, whereas this article, while also involving analysis of the legal rules, concentrates on one aspect of the Regulations namely, age harassment. It will also involve consideration of the equivalent law in the United States because they have a much more mature set of legal rules dealing with this type of activity. The difficulty of making such a comparison is that the legal rules in the two jurisdictions are very different and the UK version is much more favourable than its US counterpart. Nevertheless, it is this writer’s view that identifying the various problems that have arisen in the US with implementing their age legislation in respect of age harassment over almost forty years 2 will prove instructive and valuable to those persons required to comply with the new law in the UK and offer valuable insight into the legal treatment of this issue.

Norms, institutions and freedom of speech in the US, the UK and Australia

2019 ◽  
pp. 1-19
Author(s):  
Katharine Gelber
Keyword(s):  
National Security ◽  
Policy Change ◽  
Free Speech ◽  
Freedom Of Speech ◽  
The United States ◽  
Rule Based ◽  
The United Kingdom ◽  
The Us ◽  
Level Institution ◽  
The Uk

Abstract While it has become accepted that norms can act in institution-like ways, a highly valued norm that has not been examined is free speech. Can free speech be conceptualised as acting in institution-like ways? If it can, what does this illuminate about processes of policy change? I analyse policy change between 2001 and 2011 in the United States, the United Kingdom and Australia, a period during which significant new limits were introduced on free speech in relation to national security. In addition to showing how free speech acted in institution-like ways, the analysis suggests three implications: norms can both act in institution-like ways and be subject to change in interaction with other institutions; a broad, cultural level institution can mask policy change at the narrow, rule-based level even where the latter contradicts the former; and complexity and variation in speech regulation can be understood as consequences of the to-be-expected variability in the institutionalisation of a norm.

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