scholarly journals Estimate of deaths attributable to passive smoking among UK adults: database analysis

BMJ ◽  
2005 ◽  
Vol 330 (7495) ◽  
pp. 812 ◽  
Author(s):  
Konrad Jamrozik
Keyword(s):  
United Kingdom ◽  
General Population ◽  
Passive Smoking ◽  
Hospitality Industry ◽  
Sensitivity Analyses ◽  
Database Analysis ◽  
The United Kingdom ◽  
Working Day ◽  
The Uk ◽  
At Home

AbstractObjective To estimate deaths from passive smoking in employees of the hospitality industry as well as in the general workforce and general population of the United Kingdom.Design Calculation, using the formula for population attributable proportion, of deaths likely to have been caused by passive smoking at home and at work in the UK according to occupation. Sensitivity analyses to examine impact of varying assumptions regarding prevalence and risks of exposure.Setting National UK databases of causes of death, employment, structure of households, and prevalences of active and passive smoking.Main outcome measures Estimates of deaths due to passive smoking according to age group (< 65 or ≥ 65) and site of exposure (domestic or workplace).Results Across the United Kingdom as a whole, passive smoking at work is likely to be responsible for the deaths of more than two employed people per working day (617 deaths per year), including 54 deaths in the hospitality industry each year. Each year passive smoking at home might account for another 2700 deaths in persons aged 20-64 years and 8000 deaths among people aged ≥ 65.Conclusion Exposure at work might contribute up to one fifth of all deaths from passive smoking in the general population aged 20-64 years, and up to half of such deaths among employees of the hospitality industry. Adoption of smoke free policies in all workplaces and reductions in the general prevalence of active smoking would lead to substantial reductions in these avoidable deaths.

scholarly journals Outcomes Following SARS-CoV-2 Infection in Patients With Primary and Secondary Immunodeficiency in The United Kingdom

2021 ◽  
Author(s):  
Adrian M Shields ◽  
Ariharan Anantharachagan ◽  
Gururaj Arumugakani ◽  
Kenneth Baker ◽  
Sameer Bahal ◽  
...  
Keyword(s):  
United Kingdom ◽  
General Population ◽  
Lymphocyte Count ◽  
Demographic Data ◽  
Secondary Immunodeficiency ◽  
The United Kingdom ◽  
Risk Of Mortality ◽  
Younger Age ◽  
Targeted Treatments ◽  
The Uk

Abstract Purpose To define the burden of morbidity and mortality arising from COVID-19 in individuals with primary (PID) and secondary immunodeficiency (SID) in the United Kingdom. Methods In March 2020, the United Kingdom Primary Immunodeficiency Network (UKPIN) established a registry of cases to collate the outcomes of individuals with PID and SID following SARS-CoV-2 infection and treatment. Anonymised demographic data, pre-SARS-CoV-2 infection lymphocyte counts, co-morbidities, targeted treatments and outcomes were collected. Three groups were analysed in further detail: individuals with common variable immunodeficiency (CVID), individuals with any PID, including CVID, receiving immunoglobulin replacement therapy (IgRT) and individuals with secondary immunodeficiency. Results A total of 310 cases of SARS-CoV-2 infection in individuals with PID or SID have now been reported in the UK. The overall mortality within the cohort was 17.7% (n = 55/310). Individuals with CVID demonstrated an infection fatality rate (IFR) of 18.3% (n = 17/93), individuals with PID receiving IgRT had an IFR of 16.3% (n = 26/159) and individuals with SID, an IFR of 27.2% (n = 25/92). Individuals with PID and SID, had higher inpatient mortality and died at a younger age than the general population. Increasing age, low pre-SARS-CoV-2 infection lymphocyte count and the presence of common co-morbidities increased the risk of mortality in PID. Access to specific COVID-19 treatments in this cohort was limited: only 22.9% (n = 33/144) of patients admitted to hospital received dexamethasone, remdesivir, an anti-SARS-CoV-2 antibody-based therapeutic (e.g. REGN-COV2 or convalescent plasma) or tocilizumab as a monotherapy or in combination. Dexamethasone, remdesivir and anti-SARS-CoV-2 antibody-based therapeutics appeared efficacious in PID and SID. Conclusion Compared to the general population, individuals with PID or SID are at high risk of mortality following SARS-CoV-2 infection. Increasing age, low baseline lymphocyte count and the presence of co-morbidities are additional risk factors for poor outcome in this cohort.

scholarly journals The potential impact of increased treatment rates for alcohol dependence in the United Kingdom in 2004

2021 ◽  
Author(s):  
Kevin D. Shield ◽  
Jürgen Rehm ◽  
Maximilien X. Rehm ◽  
Gerrit Gmel ◽  
Colin Drummond
Keyword(s):  
United Kingdom ◽  
Alcohol Consumption ◽  
Alcohol Dependence ◽  
Burden Of Disease ◽  
Pharmacological Treatment ◽  
Clinical Excellence ◽  
Sensitivity Analyses ◽  
Treatment Coverage ◽  
The United Kingdom ◽  
The Uk

Alcohol consumption has been linked to a considerable burden of disease in the United Kingdom (UK), with most of this burden due to heavy drinking and Alcohol Dependence (AD). However, AD is undertreated in the UK, with only 8% of those individuals with AD being treated in England and only 6% of those individuals with AD being treated in Scotland. Thus, the objective of this paper is to quantify the deaths that would have been avoided in the UK in 2004 if the treatment rate for AD had been increased. Methods Data on the prevalence of AD, alcohol consumption, and mortality were obtained from the Adult Psychiatric Morbidity Survey, the Global Information System on Alcohol and Health, and the 2004 Global Burden of Disease study respectively. Data on the effectiveness of pharmacological treatment and Motivational Interviewing/Cognitive Behavioural Therapy were obtained from Cochrane reviews and meta-analyses. Simulations were used to model the number of deaths under different treatment scenarios. Sensitivity analyses were performed to model the effects of Brief Interventions and to examine the effect of using AD prevalence data obtained from the National Institute for Health and Clinical Excellence. Results In the UK, 320 female and 1,385 male deaths would have been avoided if treatment coverage of pharmacological treatment had been increased to 20%. This decrease in the number of deaths represents 7.9% of all alcohol-attributable deaths (7.0% of all alcohol-attributable deaths for women and 8.1% of all alcohol-attributable deaths for men). If we used lower AD prevalence rates obtained from the National Institute for Health and Clinical Excellence, then treatment coverage of pharmacological treatment in hospitals for 20% of the population with AD would have resulted in the avoidance of 529 deaths in 2004 (99 deaths avoided for women and 430 deaths avoided for men). Conclusions Increasing AD treatment in the UK would have led to a large number of deaths being avoided in 2004. Increased AD treatment rates not only impact mortality but also impact upon the large burden of disability and morbidity attributable to AD, as well as the associated social and economic burdens.

scholarly journals The potential impact of increased treatment rates for alcohol dependence in the United Kingdom in 2004

2021 ◽  
Author(s):  
Kevin D. Shield ◽  
Jürgen Rehm ◽  
Maximilien X. Rehm ◽  
Gerrit Gmel ◽  
Colin Drummond
Keyword(s):  
United Kingdom ◽  
Alcohol Consumption ◽  
Alcohol Dependence ◽  
Burden Of Disease ◽  
Pharmacological Treatment ◽  
Clinical Excellence ◽  
Sensitivity Analyses ◽  
Treatment Coverage ◽  
The United Kingdom ◽  
The Uk

Alcohol consumption has been linked to a considerable burden of disease in the United Kingdom (UK), with most of this burden due to heavy drinking and Alcohol Dependence (AD). However, AD is undertreated in the UK, with only 8% of those individuals with AD being treated in England and only 6% of those individuals with AD being treated in Scotland. Thus, the objective of this paper is to quantify the deaths that would have been avoided in the UK in 2004 if the treatment rate for AD had been increased. Methods Data on the prevalence of AD, alcohol consumption, and mortality were obtained from the Adult Psychiatric Morbidity Survey, the Global Information System on Alcohol and Health, and the 2004 Global Burden of Disease study respectively. Data on the effectiveness of pharmacological treatment and Motivational Interviewing/Cognitive Behavioural Therapy were obtained from Cochrane reviews and meta-analyses. Simulations were used to model the number of deaths under different treatment scenarios. Sensitivity analyses were performed to model the effects of Brief Interventions and to examine the effect of using AD prevalence data obtained from the National Institute for Health and Clinical Excellence. Results In the UK, 320 female and 1,385 male deaths would have been avoided if treatment coverage of pharmacological treatment had been increased to 20%. This decrease in the number of deaths represents 7.9% of all alcohol-attributable deaths (7.0% of all alcohol-attributable deaths for women and 8.1% of all alcohol-attributable deaths for men). If we used lower AD prevalence rates obtained from the National Institute for Health and Clinical Excellence, then treatment coverage of pharmacological treatment in hospitals for 20% of the population with AD would have resulted in the avoidance of 529 deaths in 2004 (99 deaths avoided for women and 430 deaths avoided for men). Conclusions Increasing AD treatment in the UK would have led to a large number of deaths being avoided in 2004. Increased AD treatment rates not only impact mortality but also impact upon the large burden of disability and morbidity attributable to AD, as well as the associated social and economic burdens.

scholarly journals Households, bubbles and hugging grandparents: Caring and lockdown rules during COVID-19

2020 ◽  
Vol 28 (3) ◽  
pp. 329-339
Author(s):  
Jackie Gulland
Keyword(s):  
United Kingdom ◽  
Human Life ◽  
Living Conditions ◽  
Feminist Scholarship ◽  
Social Distancing ◽  
The United Kingdom ◽  
The Uk ◽  
At Home

AbstractEfforts to combat the COVID-19 crisis brought mountains of legislation and guidance to coerce or encourage people to stay at home and reduce the spread of the virus. During peak lockdown in the United Kingdom (UK) regulations defined when people could or could not leave their homes. Meanwhile guidance on social distancing advised people to stay within ‘households’. This paper explores the legislation under lockdowns in the UK from March to October 2020 and the implications for women’s gendered caring roles. The regulations and guidance assumed that households were separate units and ignored the interdependencies which exist between households and between individuals and wider society. The continuing focus in the lockdown regulations has been on households as autonomous, safe, adequate and secure. This overlooks the interdependency of human life, gendered aspects of caring and the inequalities of housing and living conditions, highlighted by feminist scholarship.

scholarly journals 1481. Incidence of Pertussis in Older Adults in England and the United Kingdom: A Large, Retrospective Database Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S742-S742
Author(s):  
Emmanuel Aris ◽  
Esse Ifebi Akpo ◽  
Amit Bhavsar ◽  
Lauriane Harrington ◽  
Evie Merinopoulou ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
United Kingdom ◽  
Secondary Care ◽  
Clinical Practice Research Datalink ◽  
Database Analysis ◽  
The United Kingdom ◽  
Retrospective Database Analysis ◽  
The Uk ◽  
Retrospective Database

Abstract Background Pertussis affects people of all ages and can lead to severe complications in adults, including hospitalization. Pertussis immunity, whether vaccine-induced or from natural infection, wanes over time. Therefore, despite extensive pediatric vaccination against pertussis, adults remain susceptible to the disease. Here we present the reported incidence of pertussis in people ≥ 50 years old (≥ 50yo) in England and the United Kingdom (UK). Methods We performed an observational, retrospective database analysis using the UK Clinical Practice Research Datalink GOLD and Aurum primary care databases, and Hospital Episode Statistics database when available for English subjects (HES-Eng), 2009-2018. Occurrence of pertussis was identified by diagnostic codes recorded in primary care only for the UK subset, and primary care and/or secondary care for HES-Eng. Results In the ≥ 50yo UK population, a total of 47.1 million (m) person-years of follow-up (PYFU) including 28.5m PYFU for HES-Eng, were included. In the UK, the pertussis Incidence Rate (IR) across all years was 5.44 per 100,000 PYFU. Yearly IRs ranged from 0.79 – 11.40 per 100,000 PYFU and reflected the cyclic epidemiology of pertussis. A peak of IR was observed in 2012, known to be an outbreak year, and observed IRs were higher in 2013-2018 (4.75 – 9.73 per 100,000 PYFU) than 2009-2011 (0.79 – 1.48 per 100,000 PYFU). In the HES-Eng population, overall IR was 5.76 per 100,000 PYFU. IRs were highest in the younger age groups (HES-Eng: 8.88 in 50-54 yo; 1.42 in ≥ 85 yo) (see table 1 and 2). Table 1 Table 2 Conclusion The observed reported IR of pertussis was similar in the UK and HES-Eng populations, noting the inclusion of secondary care diagnoses in the latter. The dynamics of IRs across years are consistent with estimated IRs from Public Health England data. Considering the burden of pertussis established elsewhere in older adults, and their non-negligible contribution to the whole population incidence, strategies for the prevention of pertussis should include this age group. Disclosures Emmanuel Aris, PhD, the GSK group of companies (Employee, Shareholder) Esse Ifebi Akpo, n/a, the GSK group of companies (Employee, Shareholder) Amit Bhavsar, MBBS, MHA, the GSK group of companies (Employee) Lauriane Harrington, n/a, the GSK group of companies (Employee) Evie Merinopoulou, MSc, Evidera Ltd (Employee)the GSK group of companies (Consultant) Nicola Sawalhi-Leckenby, MSc, Evidera Ltd (Employee)the GSK group of companies (Consultant) Elisa Turriani, PhD, the GSK group of companies (Employee) Kinga Meszaros, MBA, the GSK group of companies (Employee, Shareholder) Dimitra Lambrelli, PhD, MPharm, Evidera Ltd (Employee)the GSK group of companies (Consultant) Piyali Mukherjee, MBBS, MPH, the GSK group of companies (Employee, Shareholder)

TBE in United Kingdom

2020 ◽  
Keyword(s):  
United Kingdom ◽  
Clinical Disease ◽  
England And Wales ◽  
Probable Case ◽  
The United Kingdom ◽  
South West ◽  
Louping Ill ◽  
The Uk ◽  
North And South ◽  
South West England

Until 2019, TBE was considered only to be an imported disease to the United Kingdom. In that year, evidence became available that the TBEV is likely circulating in the country1,2 and a first “probable case” of TBE originating in the UK was reported.3 In addition to TBEV, louping ill virus (LIV), a member of the TBEV-serocomplex, is also endemic in parts of the UK. Reports of clinical disease caused by LIV in livestock are mainly from Scotland, parts of North and South West England and Wales.4

Risk Transferin Public Private Partnership/Private Finance Initiative Procurement Documents:The Differencebetween The United Kingdom and Malaysia

2016 ◽  
Vol 4 (4) ◽  
pp. 30
Author(s):  
Nooriha Abdullah ◽  
Darinka Asenova ◽  
Stephen J. Bailey
Keyword(s):  
United Kingdom ◽  
Public Procurement ◽  
Research Question ◽  
Public Private Partnership ◽  
Private Finance Initiative ◽  
Private Partnership ◽  
Risk Transfer ◽  
Private Finance ◽  
The United Kingdom ◽  
The Uk

The aim of this paper is to analyse the risk transfer issue in Public Private Partnership/Private Finance Initiative (PPP/PFI) procurement documents in the United Kingdom (UK) and Malaysia. It utilises qualitative research methods using documentation and interviews for data collection. The UK documents (guidelines and contracts) identify the risks related to this form of public procurement of services and makeexplicittheappropriateallocation of those risks between the public and the private sector PPP/PFI partners and so the types of risks each party should bear. However, in Malaysia, such allocation of risks was not mentioned in PPP/PFI guidelines. Hence, a question arises regarding whether risk transfer exists in Malaysian PPP/PFI projects, whether in contracts or by other means. This research question is the rationale for the comparative analysis ofdocumentsand practicesrelatingtorisk transfer in the PPP/PFI procurements in both countries. The results clarify risk-related issues that arise in implementing PPP/PFI procurement in Malaysia, in particular how risk is conceptualised, recognised and allocated (whether explicitly or implicitly), whether or not that allocation is intended to achieve optimum risk transfer, and so the implications forachievement ofvalue for moneyor other such objectivesinPPP/PFI.

HIV and other STIs in the United Kingdom: further increases

2003 ◽  
Vol 7 (48) ◽  
Author(s):  
◽  
Keyword(s):  
United Kingdom ◽  
Disease Surveillance ◽  
Communicable Disease ◽  
People Living With Hiv ◽  
Health Protection Agency ◽  
Protection Agency ◽  
England And Wales ◽  
The United Kingdom ◽  
The Uk ◽  
Living With Hiv

The Health Protection Agency Communicable Disease Surveillance Centre for England and Wales and others have reported that the number of people living with HIV in the UK has increased

Research Applications

1989 ◽  
Vol 21 (6-7) ◽  
pp. 709-715
Author(s):  
M. J. Rouse
Keyword(s):  
United Kingdom ◽  
Water Utilities ◽  
Practical Application ◽  
Research Results ◽  
Contract Research ◽  
The United Kingdom ◽  
New Knowledge ◽  
The Uk

This paper covers the approach taken by WRc to the practical application of research results. WRc works on an annual programme of research paid for collectively by the UK water utilities totalling ₤15m. In addition contract research is carried out for government largely on environmental matters and for utilities and others on a confidential basis. The approach to the implementation described here deals with the application of results across the whole of the United Kingdom where there are a large number of users of the results but with varying degrees of interest in any particular topic. The requirement is to inform all of the outcome of the work and then to provide the facility of rapid implementation for those who have an immediate requirement to apply the new knowledge and technology.

Volunteering in hospice and palliative care in the United Kingdom

2018 ◽  
Author(s):  
Ros Scott
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Care Services ◽  
The United Kingdom ◽  
Strategic Direction ◽  
Palliative Care Services ◽  
History Of ◽  
The Uk ◽  
Hospice And Palliative Care ◽  
Changing Role

This chapter explores the history of volunteers in the founding and development of United Kingdom (UK) hospice services. It considers the changing role and influences of volunteering on services at different stages of development. Evidence suggests that voluntary sector hospice and palliative care services are dependent on volunteers for the range and quality of services delivered. Within such services, volunteer trustees carry significant responsibility for the strategic direction of the organiszation. Others are engaged in diverse roles ranging from the direct support of patient and families to public education and fundraising. The scope of these different roles is explored before considering the range of management models and approaches to training. This chapter also considers the direct and indirect impact on volunteering of changing palliative care, societal, political, and legislative contexts. It concludes by exploring how and why the sector is changing in the UK and considering the growing autonomy of volunteers within the sector.

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