906 A national cohort of children born after assisted conception in the UK (1992–2009): methodology and birthweight analysis

IntroductionAttracting graduates was recommended as a means of diversifying the UK medical student population. Graduates now make up nearly a quarter of the total medical student population. Research to date has focused on comparing the sociodemographic characteristics of applicants to and/or students on traditional and graduate entry programmes (GEMs), yet GEMs account for only 40% of the graduate medical student population. Thus, we aimed to compare the sociodemographic characteristic and outcomes of graduates and non-graduate applicants across a range of programmes.MethodsThis was an observational study of 117 214 applicants to medicine who took the UK Clinical Aptitude Test (UKCAT) from 2006 to 2014 and who applied to medical school through Universities and Colleges Admissions Service (UCAS). We included applicant demographics, UKCAT total score and offers in our analysis. Applicants were assigned as graduates or non-graduates on the basis of their highest qualification. Multiple logistic regression was used to predict the odds of receiving an offer, after adjusting for confounders.ResultsIrrespective of graduate or non-graduate status, most applicants were from the highest socioeconomic groups and were from a white ethnic background. Receiving an offer was related to gender and ethnicity in both graduates and non-graduates. After adjusting for UKCAT score, the OR of an offer for graduates versus non-graduates was approximately 0.5 (OR=0.48, 95% CI 0.46 to 0.49).DiscussionOur findings indicate that the aim of diversifying the medical student population on socioeconomic grounds by attracting graduates has been only marginally successful. Graduate applicants from widening access backgrounds are less likely than others to be offered a place at medical school. Different approaches must be considered if medicine is to attract and select more socially diverse applicants.

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Intracranial haemorrhage in children with inherited bleeding disorders in the UK 2003-2015: A national cohort study

Haemophilia ◽

10.1111/hae.13461 ◽

2018 ◽

Vol 24 (4) ◽

pp. 641-647 ◽

Cited By ~ 9

Author(s):

E. A. Chalmers ◽

J. Alamelu ◽

P. W. Collins ◽

M. Mathias ◽

J. Payne ◽

...

Keyword(s):

Cohort Study ◽

Intracranial Haemorrhage ◽

Bleeding Disorders ◽

National Cohort ◽

The Uk

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Regulation of assisted conception in the UK

Textbook of Clinical Embryology ◽

10.1017/cbo9781139192736.024 ◽

2013 ◽

pp. 210-218

Author(s):

James Lawford Davies ◽

Alan R. Thornhill

Keyword(s):

Assisted Conception ◽

The Uk

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Evaluating the impact of cycle helmet use on severe traumatic brain injury and death in a national cohort of over 11000 pedal cyclists: a retrospective study from the NHS England Trauma Audit and Research Network dataset

BMJ Open ◽

10.1136/bmjopen-2018-027845 ◽

2019 ◽

Vol 9 (9) ◽

pp. e027845 ◽

Cited By ~ 1

Author(s):

Nick Dodds ◽

Rowena Johnson ◽

Benjamin Walton ◽

Omar Bouamra ◽

David Yates ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Research Network ◽

Lower Limb Injury ◽

Helmet Use ◽

Mortality And Morbidity ◽

National Cohort ◽

The Uk ◽

The Impact

ObjectivesIn the last 10 years there has been a significant increase in cycle traffic in the UK, with an associated increase in the overall number of cycling injuries. Despite this, and the significant media, political and public health debate into this issue, there remains an absence of studies from the UK assessing the impact of helmet use on rates of serious injury presenting to the National Health Service (NHS) in cyclists.SettingThe NHS England Trauma Audit and Research Network (TARN) Database was interrogated to identify all adult (≥16 years) patients presenting to hospital with cycling-related major injuries, during a period from 14 March 2012 to 30 September 2017 (the last date for which a validated dataset was available).Participants11 192 patients met inclusion criteria. Data on the use of cycling helmets were available in 6621 patients.Outcome measuresTARN injury descriptors were used to compare patterns of injury, care and mortality in helmeted versus non-helmeted cohorts.ResultsData on cycle helmet use were available for 6621 of the 11 192 cycle-related injuries entered onto the TARN Database in the 66 months of this study (93 excluded as not pedal cyclists). There was a significantly higher crude 30-day mortality in un-helmeted cyclists 5.6% (4.8%–6.6%) versus helmeted cyclists 1.8% (1.4%–2.2%) (p<0.001). Cycle helmet use was also associated with a reduction in severe traumatic brain injury (TBI) 19.1% (780, 18.0%–20.4%) versus 47.6% (1211, 45.6%–49.5%) (p<0.001), intensive care unit requirement 19.6% (797, 18.4%–20.8%) versus 27.1% (691, 25.4%–28.9%) (p<0.001) and neurosurgical intervention 2.5% (103, 2.1%–3.1%) versus 8.5% (217, 7.5%–9.7%) (p<0.001). There was a statistically significant increase in chest, spinal, upper and lower limb injury in the helmeted group in comparison to the un-helmeted group (all p<0.001), though in a subsequent analysis of these anatomical injury patterns, those cyclists wearing helmets were still found to have lower rates of TBI. In reviewing TARN injury codes for specific TBI and facial injuries, there was a highly significant decrease in rates of impact injury between cyclists wearing helmets and those not.ConclusionsThis study suggests that there is a significant correlation between use of cycle helmets and reduction in adjusted mortality and morbidity associated with TBI and facial injury.

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Clinical outcomes and programming strategies of implantable cardioverter-defibrillator devices in paediatric hypertrophic cardiomyopathy: a UK National Cohort Study

EP Europace ◽

10.1093/europace/euaa307 ◽

2020 ◽

Author(s):

Gabrielle Norrish ◽

Henry Chubb ◽

Ella Field ◽

Karen McLeod ◽

Maria Ilina ◽

...

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Implantable Cardioverter Defibrillator ◽

Incidence Rate ◽

Clinical Outcomes ◽

Cardioverter Defibrillator ◽

National Cohort ◽

Icd Shock ◽

The Uk ◽

Device Complications

Abstract Aims Sudden cardiac death (SCD) is the most common mode of death in paediatric hypertrophic cardiomyopathy (HCM). This study describes the implant and programming strategies with clinical outcomes following implantable cardioverter-defibrillator (ICD) insertion in a well-characterized national paediatric HCM cohort. Methods and results Data from 90 patients undergoing ICD insertion at a median age 13 (±3.5) for primary (n = 67, 74%) or secondary prevention (n = 23, 26%) were collected from a retrospective, longitudinal multi-centre cohort of children (<16 years) with HCM from the UK. Seventy-six (84%) had an endovascular system [14 (18%) dual coil], 3 (3%) epicardial, and 11 (12%) subcutaneous system. Defibrillation threshold (DFT) testing was performed at implant in 68 (76%). Inadequate DFT in four led to implant adjustment in three patients. Over a median follow-up of 54 months (interquartile range 28–111), 25 (28%) patients had 53 appropriate therapies [ICD shock n = 45, anti-tachycardia pacing (ATP) n = 8], incidence rate 4.7 per 100 patient years (95% CI 2.9–7.6). Eight inappropriate therapies occurred in 7 (8%) patients (ICD shock n = 4, ATP n = 4), incidence rate 1.1/100 patient years (95% CI 0.4–2.5). Three patients (3%) died following arrhythmic events, despite a functioning device. Other device complications were seen in 28 patients (31%), including lead-related complications (n = 15) and infection (n = 10). No clinical, device, or programming characteristics predicted time to inappropriate therapy or lead complication. Conclusion In a large national cohort of paediatric HCM patients with an ICD, device and programming strategies varied widely. No particular strategy was associated with inappropriate therapies, missed/delayed therapies, or lead complications.

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Peritoneal Dialysis–Associated Peritonitis Rates and Outcomes in a National Cohort are not Improving in the Post-Millennium (2000 – 2007)

Peritoneal Dialysis International ◽

10.3747/pdi.2010.00185 ◽

2011 ◽

Vol 31 (6) ◽

pp. 639-650 ◽

Cited By ~ 74

Author(s):

Michaela C. Brown ◽

Keith Simpson ◽

Jan J. Kerssens ◽

Robert A. Registry

Keyword(s):

Peritoneal Dialysis ◽

Present Report ◽

Cure Rate ◽

National Guidelines ◽

Free Survival ◽

Audit Data ◽

National Cohort ◽

The Uk ◽

Technique Failure ◽

Culture Negative

BackgroundPeritoneal dialysis (PD)–related peritonitis remains the leading cause of technique failure and a significant cause of morbidity among PD patients. Rates in the literature vary, reflecting differences in study design and in populations. The objective of the present study was to determine peritonitis incidence and outcomes in Scotland and to compare them with national guidelines.MethodsAll 10 adult renal units in Scotland prospectively collect data relating to peritonitis for all PD patients in Scotland. Complete audit data between 1 January 2000 and 31 December 2007 were analyzed for the study.ResultsThe 1918 peritonitis episodes in 38 106 PD treatment months yielded a national rate of 1 episode every 19.9 months. The UK Renal Association standard was met every year, but is not consistently improving. The median peritonitis-free survival was 526 days (95% confidence interval: 463 to 589 days). The spectrum of causative organisms reflected those in previous reports, with a culture- negative rate of 19.4%. Nationally, the cure rate was 74.6%, the refractory rate was 22.6%, and the death rate was 2.8%. Outcome varied by organism. Recurrences represented 9.3% of episodes, and technique failure occurred in 14.9%. The peritonitis rate was higher for continuous ambulatory PD patients than for automated PD patients (1 episode every 17.6 months vs 1 episode every 22.3 months, p < 0.001, relative risk: 1.27). There were significant differences between renal units.ConclusionsThis large national PD cohort met targets for peritonitis rates every year during the 8 years covered by the present report, but showed no consistent trend for improvement. Peritonitis remains the main cause of technique failure in Scotland. Peritonitis rates varied widely between the units, which suggests that we should look to the units and countries with lower peritonitis rates to see if we can adopt successful elements of their practice before resigning ourselves to our ongoing peritonitis burden.

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