scholarly journals The clinically extremely vulnerable to COVID: Identification and changes in health care while self-isolating (shielding) during the coronavirus pandemic

2021 ◽  
Author(s):  
Jessica Erin Butler ◽  
Mintu Nath ◽  
Dimitra Blana ◽  
William P Ball ◽  
Nicola Beech ◽  
...  
Keyword(s):  
General Population ◽  
Emergency Care ◽  
Ad Hoc ◽  
Clinical History ◽  
Healthcare Use ◽  
Primary Care Data ◽  
Economically Deprived ◽  
History Of ◽  
The Government ◽  
Scheduled Care

Background In March 2020, the government of Scotland identified people deemed clinically extremely vulnerable to COVID due to their pre-existing health conditions. These people were advised to strictly self-isolate (shield) at the start of the pandemic, except for necessary healthcare. We examined who was identified as clinically extremely vulnerable, how their healthcare changed during isolation, and whether this process exacerbated healthcare inequalities. Methods We linked those on the shielding register in NHS Grampian, a health authority in Scotland, to healthcare records from 2015-2020. We described the source of identification, demographics, and clinical history of the cohort. We measured changes in out-patient, in-patient, and emergency healthcare during isolation in the shielding population and compared to the general non-shielding population. Results The register included 16,092 people (3% of the population), clinically vulnerable primarily due to a respiratory disease, immunosuppression, or cancer. Among them, 42% were not identified by national healthcare record screening but added ad hoc, with these additions including more children and fewer economically-deprived. During isolation, all forms of healthcare use decreased (25%-46%), with larger decreases in scheduled care than in emergency care. However, people shielding had better maintained scheduled care compared to the non-shielding general population: out-patient visits decreased 35% vs 49%; in-patient visits decreased 46% vs 81%. Notably, there was substantial variation in whose scheduled care was maintained during isolation: younger people and those with cancer had significantly higher visit rates, but there was no difference between sexes or socioeconomic levels. Conclusions Healthcare changed dramatically for the clinically extremely vulnerable population during the pandemic. The increased reliance on emergency care while isolating indicates that continuity of care for existing conditions was not optimal. However, compared to the general population, there was success in maintaining scheduled care, particularly in young people and those with cancer. We suggest that integrating demographic and primary care data would improve identification of the clinically vulnerable and could aid prioritising their care.

The Radium Committee of the Royal Society and the fate of the substances purchased by it

2012 ◽  
Vol 66 (2) ◽  
pp. 169-194 ◽  
Author(s):  
Neil Todd
Keyword(s):  
World War I ◽  
Royal Society ◽  
Ad Hoc ◽  
Research Fund ◽  
World War ◽  
Ernest Rutherford ◽  
History Of ◽  
Government Laboratory ◽  
The Government ◽  
First Time

In this article, documents relating to the history of the Radium Committee of the Royal Society are collated for the first time. Founded in 1903, the committee had its status enhanced in 1904, when the Goldsmiths' Company donated £1000 for the establishment of a Radium Research Fund. Two years later the fund was used to purchase 500 kg of pitchblende residues from the Austrian government. The French chemist Armet de Lisle was contracted to perform the first stage of extraction, and the process of purification was performed at the Government Laboratory during 1907 by the Government Analyst, T. E. Thorpe, yielding an estimated 70 mg of radium chloride. In 1914 the unexpended balance of about £500 was awarded to Ernest Rutherford, but the bulk was not used until 1921, when Rutherford had moved to Cambridge. The fund was then used to purchase radium that had been on loan to him from Austria before World War I. After Rutherford's death in 1937 the Committee was wound up, and the Society's radium was controlled on a more ad hoc basis. After Thorpe's work in 1907, the radium was lent out successively to several leading scientists until its existence was last recorded in 1953.

Measurement of Structural Change in the Pakistan Economy: A Review of the National Income Estimates 1949/50 to 1963/64

1966 ◽  
Vol 6 (2) ◽  
pp. 163-208
Author(s):  
Taufiq M. Khan ◽  
Asbjorn Bergan
Keyword(s):  
Capita Income ◽  
Ad Hoc ◽  
National Income ◽  
Per Capita Income ◽  
British India ◽  
History Of ◽  
Per Capita ◽  
The Government ◽  
Net National Product ◽  
The Masses

A number of national income estimates are available for pre-Partition India. Many of these estimates, especially those pertaining to the last quarter of the 19th and the early 20th centuries, had their origin in political controversy. The estimators were mainly concerned with proving or refuting the idea that the per capita income was very low and that the government had failed to improve the economic conditions of the masses[6]. The earlier estimates were based on scanty data but as time passed, the basic statistics as well as the methods of income estima¬tion improved. The studies of national income of British India, undertaken by Dr. V.K.R.V. Rao, were exhaustive and comprehensive and still serve as a useful reference for all those who are interested in the history of national income estimation in India [14]. Because of the general lack of economic data in India, Dr. Rao conducted a number of ad hoc enquiries in different parts of India to fill in the existing gaps in data. The various estimates of per capita income in India before Partition are shown in Appendix Table A-I. These estimates are at current prices. Because of differences in concepts and methodology, these estimates are not entirely comparable and are to be regarded as rough approximations of per capita net national product at factor cost.

Making It Count

2020 ◽  
Author(s):  
Arunabh Ghosh
Keyword(s):  
Cold War ◽  
Statistical Data ◽  
New Technology ◽  
Political Leaders ◽  
Republic Of China ◽  
Great Leap Forward ◽  
History Of ◽  
History Of Statistics ◽  
The Government ◽  
The Great Leap Forward

In 1949, at the end of a long period of wars, one of the biggest challenges facing leaders of the new People's Republic of China was how much they did not know. The government of one of the world's largest nations was committed to fundamentally reengineering its society and economy via socialist planning while having almost no reliable statistical data about their own country. This book is the history of efforts to resolve this “crisis in counting.” The book explores the choices made by political leaders, statisticians, academics, statistical workers, and even literary figures in attempts to know the nation through numbers. It shows that early reliance on Soviet-inspired methods of exhaustive enumeration became increasingly untenable in China by the mid-1950s. Unprecedented and unexpected exchanges with Indian statisticians followed, as the Chinese sought to learn about the then-exciting new technology of random sampling. These developments were overtaken by the tumult of the Great Leap Forward (1958–1961), when probabilistic and exhaustive methods were rejected and statistics was refashioned into an ethnographic enterprise. By acknowledging Soviet and Indian influences, the book not only revises existing models of Cold War science but also globalizes wider developments in the history of statistics and data. Anchored in debates about statistics and its relationship to state building, the book offers fresh perspectives on China's transition to socialism.

Component resolved diagnostics in peanut sensitized children with and without a history of clinical reaction

2020 ◽  
Vol 41 (5) ◽  
pp. 336-340
Author(s):  
Yasmin Hamzavi Abedi ◽  
Cristina P. Sison ◽  
Punita Ponda
Keyword(s):  
Retrospective Chart Review ◽  
Clinical History ◽  
Specific Ige ◽  
Exact Test ◽  
Ara H 1 ◽  
Sige Level ◽  
History Of ◽  
Laboratory Procedures ◽  
Ige Mediated ◽  
The Relationship

Background: Serum Peanut-specific-IgE (PN-sIgE) and peanut-component-resolved-diagnostics (CRD) are often ordered simultaneously in the evaluation for peanut allergy. Results often guide the plans for peanut oral challenge. However, the clinical utility of CRD at different total PN-sIgE levels is unclear. A commonly used predefined CRD Ara h2 cutoff value in the literature predicting probability of peanut challenge outcomes is 0.35kUA/L. Objective: To examine the utility of CRD in patients with and without a history of clinical reactivity to peanut (PN). Methods: This was a retrospective chart review of 196 children with PN-sIgE and CRD testing, of which, 98 patients had a clinical history of an IgE-mediated reaction when exposed to PN and 98 did not. The Fisher's exact test was used to assess the relationship between CRD and PN-sIgE at different cutoff levels, McNemar test and Gwet’s approach (AC1 statistic) were used to examine agreement between CRD and PN-sIgE, and logistic regression was used to assess differences in the findings between patients with and without reaction history. Results: Ara h 1, 2, 3, or 9 (ARAH) levels ≤0.35 kUA/L were significantly associated with PN-sIgE levels <2 kUA/L rather than ≥2 kUA/L (p < 0.0001). When the ARAH threshold was increased to 1 kUA/L and 2 kUA/L, these thresholds were still significantly associated with PN-sIgE levels of <2, <5, and <14 kUA/L. These findings were not significantly different in patients with and without a history of clinical reactivity. Conclusion: ARAH values correlated with PN-sIgE. Regardless of clinical history, ARAH levels are unlikely to be below 0.35, 1, or 2 kUA/L if the PN-sIgE level is >2 kUA/L. Thus, if possible, practitioners should consider PN-sIgE rather than automatically ordering CRD with PN-sIgE every time. Laboratory procedures that allow automatically and reflexively adding CRD when the PN-sIgE level is ≤5 kUA/L can be helpful. However, further studies are needed in subjects with challenge-proven PN allergy.

Stepping up detection, response, preparedness and readiness measures for “COVID-19”- A Pandemic

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1042-1047
Author(s):  
Khushbu Balsara ◽  
Deepankar Shukla
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Clinical History ◽  
Frontline Workers ◽  
Diagnostic Assays ◽  
Care Workers ◽  
Short Period ◽  
History Of ◽  
Detection Response ◽  
Care Worker

In a very short period of time, “COVID-19” has seized the consciousness globally by making remarkable changes in our day to day living and has superintended as a public health emergency globally. It has high radar of transmission, affecting an individual at work to frontline workers. The measures and planning for a response plays a key role from drawing up an emergency committee and this follows an equation which broadly deals with epidemiological to clinical history of the patient, management steps from isolation, screening, diagnostic assays for identification and treatment. The application of an organized plan with secure structure aids in better performance, increases efficacy of management and saves time. Also saves time for a health care worker to g through routine levels of channels of administration if already a familiar way of operation is known for such situations. Thus, planning and developing a ‘blueprint of approach’ towards management of patient while facing such situation is a must. This review provides an insight to the measures for detection, response and preparedness of the hospital and health care workers should largely be inclusive of; also highlights the measures to be taken at every step after coming in contact with a positive case of “COVID-19”.

INFLUENCE OF THE TAX SYSTEM ON POLITICAL LIFE IN THE ADMINISTRATION OF THE KOKAND KHANATE

2019 ◽  
Vol 19 (2) ◽  
pp. 21-27
Author(s):  
Ilyoskhon Burhanov ◽  
Keyword(s):  
Political Life ◽  
Tax System ◽  
History Of ◽  
The Government

The article begins with writing about the scientists who conducted a study on the history of the Kokand Khanate. The article writes the taxation of the Kokand Khan and raising taxes, people protest against the government of Kokand, as a result it had a significant impact on political life

The Mortality Rate of COVID-19 in Iraq Compare with Iran and Turkey, its Association with the Bacillus Calmette-Guerin (BCG) vaccine and the Iraqi Preparedness Plan Prior to Pandemics. (Preprint)

2020 ◽  
Author(s):  
Rawand Essa
Keyword(s):  
Middle East ◽  
Mortality Rate ◽  
Daily Basis ◽  
Bcg Vaccine ◽  
Critical Position ◽  
Preparedness Plan ◽  
Contagious Diseases ◽  
History Of ◽  
The Government

BACKGROUND In the span of COVID-19, the mortality rate has been different from one country to another. As a country in the Middle East Iraq has a critical position, lies between Iran and Turkey while both countries coronavirus cases increase on daily basis, while Iranian mortality rate record is high similar to Turkey. After Wuhan city of China, Lombard of Italy, Qum city in Iran has the highest number of COVID-19 as a first country in the Middle East. OBJECTIVE aim of this study is to show the effect of BCG vaccine during pandemic diseases, especially nowadays at the time of COVID-19. One of the crucial observations is the government preparedness and strategic planning prior pandemics, in which the BCG vaccine is an attenuated live vaccine for control of tuberculosis (TB). BCG vaccine has a non-specific immune effect that is used against pathogens like bacteria and viruses, through the promotion of pro-inflammatory cytokines' secretion. METHODS An epidemiological study has been performed, and it shows that some countries are more prone to contagious diseases like COVID-19, regardless of the main cultural, religious, societal similarities among the three mentioned countries. The information data has been collected from WHO reports and worldometer in 18 February 2020 to 10 May 2020. Regarding the efficacy of the BCG vaccine, relevant data has been retrieved from Google scholar, Pub-med and BCG world-atlas. RESULTS COVID-19 mortality rates are at peak in Iran and Turkey while the mortality rate is very low in Iraq, while the patients that died in Iraq all had history of other long-term diseases as heart disease, blood pressure, cancer etc. CONCLUSIONS From the experiences of the three countries in the life span of COVID-19, the historical plan of BCG vaccine in Iraq in cooperation with WHO since the last decades it shows that COVID-19 mortality rate is lower than other countries due to the early vaccination of the Iraqis, otherwise Iraq is more fragile than Iran and Turkey due to the poor conditions of Iraq in terms of economics, politics, war and other aspects.

Truth to Power

2019 ◽  
Keyword(s):  
Cold War ◽  
Historical Context ◽  
Policy Issue ◽  
International Terrorism ◽  
Intelligence Community ◽  
Post Cold War ◽  
History Of ◽  
The Government ◽  
Intelligence Support ◽  
The Cold War

This first-ever history of the US National Intelligence Council (NIC) is told through the reflections of its eight chairs in the period from the end of the Cold War until 2017. Coeditors Robert Hutchings and Gregory Treverton add a substantial introduction placing the NIC in its historical context going all the way back to the Board of National Estimates in the 1940s, as well as a concluding chapter that highlights key themes and judgments. The historic mission of this remarkable but little-understood organization is strategic intelligence assessment in service of senior American foreign policymakers. It has been at the center of every critical foreign policy issue during the period covered by this volume: helping shape America’s post–Cold War strategies, confronting sectarian conflicts around the world, meeting the new challenge of international terrorism, and now assessing the radical restructuring of the global order. Each chapter places its particular period of the NIC’s history in context (the global situation, the administration, the intelligence community) and assesses the most important issues with which the NIC grappled during the period, acknowledging failures as well as claiming successes. With the creation of the director of national intelligence in 2005, the NIC’s mission mushroomed to include direct intelligence support to the main policymaking committees in the government. The mission shift took the NIC directly into the thick of the action but may have come at the expense of weakening its historic role of providing over-the horizon strategic analysis.

Poetics of the Pillory

2019 ◽  
Author(s):  
Thomas Keymer
Keyword(s):  
English Literature ◽  
Extended Period ◽  
Government Control ◽  
History And Criticism ◽  
Romantic Period ◽  
Restoration Measure ◽  
History Of ◽  
The Government ◽  
Argument Proceeds ◽  
Prior Restraint

On the lapse of the Licensing Act in 1695, Thomas Macaulay wrote in his History of England, ‘English literature was emancipated, and emancipated for ever, from the control of the government’. It’s certainly true that the system of prior restraint enshrined in this Restoration measure was now at an end, at least for print. Yet the same cannot be said of government control, which came to operate instead by means of post-publication retribution, not pre-publication licensing, notably for the common-law offence of seditious libel. For many of the authors affected, from Defoe to Cobbett, this new regime was a greater constraint on expression than the old, not least for its alarming unpredictability, and for the spectacular punishment—the pillory—that was sometimes entailed. Yet we may also see the constraint as an energizing force. Throughout the eighteenth century and into the Romantic period, writers developed and refined ingenious techniques for communicating dissident or otherwise contentious meanings while rendering the meanings deniable. As a work of both history and criticism, this book traces the rise and fall of seditious libel prosecution, and with it the theatre of the pillory, while arguing that the period’s characteristic forms of literary complexity—ambiguity, ellipsis, indirection, irony—may be traced to the persistence of censorship in the post-licensing world. The argument proceeds through case studies of major poets and prose writers including Dryden, Defoe, Pope, Fielding, Johnson, and Southey, and also calls attention to numerous little-known satires and libels across the extended period.

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