P20 Evaluating the impact of planning guidance on the food environment, health outcomes, and inequalities: a quasi-experimental analysis using longitudinal data for a local authority in the North East of England

Abstract Background The North of England, particularly the North East (NE), has worse health (e.g. 2 years lower life expectancy) and higher health inequalities compared to the rest of England. Sources of data We explore this over time drawing on publicly available data. Areas of agreement and controversy Whilst overall health is improving, within-regional health inequalities are getting worse and the gap between the NE and other regions (particularly the South of England) is worsening. The gap in life expectancy is widening with substantial variation between deprived and affluent areas within the NE. Those living in the NE are more likely to have a shorter lifespan and to spend a larger proportion of their shorter lives in poor health, as well as being more likely to die prematurely from preventable diseases. Growing points We highlight wide, and in some cases increasing, inequalities in health outcomes between the NE and the rest of England. This health disadvantage and the north-south health divide are recognized; despite this, the situation appears to be worsening over the time. Areas timely for developing research Research to understand and reduce health inequalities is needed particularly in the NE of England where reductions could have enhanced the impact.

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EVALUATION OF THE IMPACT OF ENVIRONMENTAL CONDITIONS ON THE STATUS OF THE BODY OF YOUNG PEOPLE OF 17-19 YEARS OF DIFFERENT ETHNIC GROUPS OF THE NORTH-EAST RUSSIA

Hygiene and Sanitation ◽

10.18821/0016-9900-2017-96-8-766-769 ◽

2019 ◽

Vol 96 (8) ◽

pp. 766-769 ◽

Cited By ~ 1

Author(s):

Inessa V. Averyanova ◽

S. I. Vdovenko ◽

A. L. Maksimov

Keyword(s):

Gas Exchange ◽

Climatic Conditions ◽

The Body ◽

External Respiration ◽

Adaptive Responses ◽

Northeast Russia ◽

North East ◽

The North ◽

Magadan Region ◽

The Impact

Natural and climatic conditions of the environment of Northeast Russia and particularly Magadan region are the very factor mostly influencing adaptive responses by individuals inhabiting the region. Compensatory and adaptive responses in indigenes and newcomers of the region can be assumed to have their specific features. In 2009 there was executed the examination of the cardiovascular and respiratory systems and gas exchange in 392 cases aged of 17-19 years, including Europeans (Caucasians) born in the North in the 1st-2nd generation and indigenes. The methodologically similar study was carried out in 2014 in 265 persons, referred to the same cohorts of North-born Caucasians and Indigenes from the Magadan region. The results of the study executed in 2009 testified to a small number of physiological parameters that were reliably different in Caucasians vs. Indigene subjects. In 2014 no difference was found between the two examined cohorts throughout the observed parameters. The revealed changes in gas exchange, external respiration and cardiovascular systems demonstrated by modern young Indigenes of Northeast Russia testified to the fall in the effectiveness of their breathing. All that makes them farther from the classic “polar metabolic type” and their morphofunctional status becomes closer to European male subjects of Northeast Russia. Thus, we can observe a clear tendency towards “convergence in programs” of the adaptive changes between populations of the North residents undergoing similar natural, environmental and social factors.

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

Finisterra ◽

10.18055/finis1791 ◽

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.

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Inequalities in awareness and availability of bereavement services in North-East England

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-002422 ◽

2020 ◽

pp. bmjspcare-2020-002422

Author(s):

Donna Wakefield ◽

Elizabeth Fleming ◽

Kate Howorth ◽

Kerry Waterfield ◽

Emily Kavanagh ◽

...

Keyword(s):

Phase 1 ◽

Waiting Times ◽

Financial Strain ◽

Web Based ◽

North East ◽

The North ◽

Referral Criteria ◽

National Guidance ◽

The Uk ◽

The Impact

ObjectivesNational guidance recommends equality in access to bereavement services; despite this, awareness and availability appears inconsistent. The aim of this study was to explore availability and accessibility of bereavement services across the North-East of England and to highlight issues potentially applicable across the UK, at a time of unprecedented need due to the impact of COVID-19.MethodsPhase 1: an eight item, web-based survey was produced. A survey link was cascaded to all GP practices (General Practitioners) in the region. Phase 2: an email was sent to all services identified in phase 1, requesting details such as referral criteria and waiting times.ResultsAll 392 GP practices in the region were invited to participate. The response rate was 22% (85/392). Twenty-one per cent (18/85) of respondents reported that they do not refer patients, comments included ‘not aware of any services locally’. A total of 36 services were contacted with 72% responding with further information. Most bereavement specific support was reliant on charity-funded services including hospices, this sometimes required a pre-existing link with the hospice. Waiting times were up to 4 months.ConclusionsAlthough multiple different, usually charity-funded services were identified, awareness and accessibility were variable. This survey was conducted prior to the COVID-19 pandemic, where complex situations surrounding death is likely to impact on the usual grieving process and increase the need for bereavement support. Meanwhile, charities providing this support are under severe financial strain. There is an urgent need to bridge the gap between need and access to bereavement services.

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Reducing pressure ulcers across multiple care settings using a collaborative approach

BMJ Open Quality ◽

10.1136/bmjoq-2018-000409 ◽

2019 ◽

Vol 8 (3) ◽

pp. e000409 ◽

Cited By ~ 2

Author(s):

Julia Wood ◽

Bob Brown ◽

Annette Bartley ◽

Andreia Margarida Batista Custódio Cavaco ◽

Anthony Paul Roberts ◽

...

Keyword(s):

Pressure Ulcers ◽

Length Of Hospital Stay ◽

Community Services ◽

Care Community ◽

North East ◽

The North ◽

Healthcare Improvement ◽

The Uk ◽

Breakthrough Series Collaborative ◽

The Impact

In the UK, over 700 000 patients are affected by pressure ulcers each year, and 180 000 of those are newly acquired each year. The occurrence of pressure ulcers costs the National Health Service (NHS) more than 3.8 million every day. In 2004, pressure ulcers were estimated to cost the NHS £1.4–£2.4 billion per year, which was 4% of the total NHS expenditure.The impact on patients can be considerable, due to increased pain, length of hospital stay and decreased quality of life. However, it is acknowledged that a significant number of these are avoidable.In early 2015, it was identified that for the North East and North Cumbria region the incidence of pressure ulcers was higher than the national average. Because of this, a 2-year Pressure Ulcer Collaborative was implemented, involving secondary care, community services, care homes and the ambulance service, with the aim of reducing the percentage of pressure ulcers developed by patients within their care.The Breakthrough Series Collaborative Model from the Institute for Healthcare Improvement provided the framework for this Collaborative.In year 1, pressure ulcers were reduced by 36%, and in year 2 by 33%, demonstrating an estimated cost saving during the lifespan of the Collaborative of £513 000, and a reduction in the number of bed days between 220 and 352.

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The digital lottery: The impact of next generation broadband on rural small and micro businesses in the North East of Scotland

Journal of Rural Studies ◽

10.1016/j.jrurstud.2020.08.049 ◽

2020 ◽

Author(s):

Megan Palmer-Abbs ◽

Caitlin Cottrill ◽

John Farrington

Keyword(s):

Next Generation ◽

North East ◽

The North ◽

The Impact

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Effect of Food Environment Interventions on Anthropometric Outcomes in School-Aged Children and Adolescents in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Current Developments in Nutrition ◽

10.1093/cdn/nzaa098 ◽

2020 ◽

Vol 4 (7) ◽

Cited By ~ 1

Author(s):

Bianca Carducci ◽

Christina Oh ◽

Emily C Keats ◽

Daniel E Roth ◽

Zulfiqar A Bhutta

Keyword(s):

Health Outcomes ◽

Food Environment ◽

Cochrane Library ◽

Free Text ◽

Environmental Interventions ◽

Middle Income ◽

Middle Income Countries ◽

School Aged Children ◽

The Impact ◽

Low And Middle Income

ABSTRACT Food environments may promote access to unhealthy foods, contributing to noncommunicable diseases in low- and middle- income countries (LMICs). This review assessed published evidence on the effects of food environment interventions on anthropometric (BMI and weight status) outcomes in school-aged children (5–9 y) and adolescents (10–19 y) (SACA) in LMICs. We summarized randomized controlled trials (RCTs) and quasi-experimental studies (QES) published since 2000 to August 2019 in the peer-reviewed and gray literature that assessed the effects of food-related behavioral and environmental interventions on diet-related health outcomes in SACA in LMICs. Electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Library) were searched using appropriate keywords, Medical Subject Headings, and free text terms. Eleven RCTs and 6 QES met the inclusion criteria, testing multicomponent behavioral and environmental interventions in schools. Analysis of 6 RCTs (n = 17,054) suggested an overall effect on change in BMI [mean difference (MD): −0.11, 95% CI: −0.19 , −0.03], whereas there was no observed effect in 5 studies using endline BMI (n = 17,371) (MD: 0.05, 95% CI: −0.32, 0.21). There was no significant pooled effect among the 3 QES (n = 5,023) that reported differences in change in BMI or endline (MD: −0.37, 95% CI: −0.95, 0.22). There is limited evidence to support the modification of diet-related health outcomes through school-based food environment interventions in SACA in LMICs. Further studies are needed to understand the impact of school and community-based food environment interventions on nutritional status in this population.

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An interrupted time-series analysis of the impact of emergency department reconfiguration on regional emergency department trolley numbers in Ireland from 2005 to 2015

BMJ Open ◽

10.1136/bmjopen-2019-029261 ◽

2019 ◽

Vol 9 (9) ◽

pp. e029261 ◽

Cited By ~ 2

Author(s):

Brenda Lynch ◽

John Browne ◽

Claire Mary Buckley ◽

Orla Healy ◽

Paul Corcoran ◽

...

Keyword(s):

Emergency Department ◽

Time Series ◽

Time Series Analysis ◽

Interrupted Time Series Analysis ◽

Series Analysis ◽

North East ◽

The North ◽

Number Of Patients ◽

Geographical Regions ◽

The Impact

ObjectivesTo understand the impact of emergency department (ED) reconfiguration on the number of patients waiting for hospital beds on trolleys in the remaining EDs in four geographical regions in Ireland using time-series analysis.SettingEDs in four Irish regions; the West, North-East, South and Mid-West from 2005 to 2015.ParticipantsAll patients counted as waiting on trolleys in an ED for a hospital bed in the study hospitals from 2005 to 2015.InterventionThe system intervention was the reconfiguration of ED services, as determined by the Department of Health and Health Service Executive. The timing of these interventions varied depending on the hospital and region in question.ResultsThree of the four regions studied experienced a significant change in ED trolley numbers in the 12-month post-ED reconfiguration. The trend ratio before and after the intervention for these regions was as follows: North-East incidence rate ratio (IRR) 2.85 (95% CI 2.04 to 3.99, p<0.001), South IRR 0.68 (95% CI 0.51 to 0.89, p=0.006) and the Mid-West IRR 0.03 (95% 1.03 to 2.03, p=0.03). Two of these regions, the South and the Mid-West, displayed a convergence between the observed and expected trolley numbers in the 12-month post-reconfiguration. The North-East showed a much steeper increase, one that extended beyond the 12-month period post-ED reconfiguration.ConclusionsFindings suggest that the impacts of ED reconfiguration on regional level ED trolley trends were either non-significant or caused a short-term shock which converged on the pre-reconfiguration trend over the following 12 months. However, the North-East is identified as an exception due to increased pressures in one regional hospital, which caused a change in trend beyond the 12-month post reconfiguration.

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