Obstructive jaundice: a clinical review for the UK armed forces

2017 ◽  
Vol 103 (1) ◽  
pp. 44-48
Author(s):  
S K Roy ◽  
A Lambert
Keyword(s):  
Obstructive Jaundice ◽  
Clinical Review ◽  
Disease Process ◽  
Armed Forces ◽  
Medical Personnel ◽  
Underlying Disease ◽  
The United Kingdom ◽  
Short And Long Term ◽  
The Uk

AbstractObstructive jaundice is a clinical condition that indicates the possibility of a significant underlying disease process. This clinical review considers the pathophysiology, investigation and management of patients with obstructive jaundice and considers the particular challenges that medical personnel may face when deployed away from the United Kingdom (UK). It aims to give guidance with regard to the short- and long-term investigation and management of such patients.

scholarly journals Radiation oncology teaching provision and practice prior to and during the first wave of the COVID-19 pandemic in medical schools in the United Kingdom and the Republic of Ireland: a cross-sectional survey

2021 ◽  
Author(s):  
Gerard M Walls ◽  
Orla A Houlihan ◽  
Ciaran Mooney ◽  
Rebecca Prince ◽  
Katie Spencer ◽  
...  
Keyword(s):  
United Kingdom ◽  
Radiation Oncology ◽  
Medical Schools ◽  
Team Members ◽  
Republic Of Ireland ◽  
The United Kingdom ◽  
Short And Long Term ◽  
The Uk ◽  
The Impact

Objectives: Radiotherapy is a key cancer treatment modality but is poorly understood by doctors. We sought to evaluate radiation oncology (RO) teaching in medical schools within the United Kingdom (UK) and Republic of Ireland (RoI), as well as any impacts on RO teaching delivery from the coronavirus disease 2019 (COVID-19) pandemic. Methods: A bespoke online survey instrument was developed, piloted and distributed to oncology teaching leads at all UK and RoI medical schools. Questions were designed to capture information on the structure, format, content and faculty for RO teaching, as well as both the actual and the predicted short- and long-term impacts of COVID-19. Results: Responses were received from 29/41 (71%) UK and 5/6 (83%) RoI medical schools. Pre-clinical and clinical oncology teaching was delivered over a median of 2 weeks (IQR 1–6), although only 9 (27%) of 34 responding medical schools had a standalone RO module. RO teaching was most commonly delivered in clinics or wards (n = 26 and 25 respectively). Few medical schools provided teaching on the biological basis for radiotherapy (n = 11) or the RO career pathway (n = 8), and few provide teaching delivered by non-medical RO multidisciplinary team members. There was evidence of short- and long-term disruption to RO teaching from COVID-19. Conclusions: RO teaching in the UK and RoI is limited with minimal coverage of relevant theoretical principles and little exposure to radiotherapy departments and their non-medical team members. The COVID-19 pandemic risks exacerbating trainee doctors’ already constrained exposure to radiotherapy. Advances in knowledge: This study provides the first analysis of radiotherapy-related teaching in the UK and RoI, and the first to explore the impact of the COVID-19 pandemic on radiationoncology teaching.

Slow-acting antirheumatic drugs

1993 ◽  
Vol 31 (5) ◽  
pp. 17-20
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Process ◽  
Underlying Disease ◽  
Disease Outcome ◽  
Serological Markers ◽  
Antirheumatic Drugs ◽  
Slow Progression ◽  
The Uk ◽  
Underlying Disease Process

Rheumatoid arthritis (RA) is common and debilitating. It affects approximately 1% of adults in the UK, with a prevalence which increases with age; over the age of 60 years roughly 2% of men and 5% of women are affected.1 Early in the disease most patients will receive analgesics and NSAIDs, which relieve symptoms but do not affect the underlying disease process.2 Slow-acting antirheumatic drugs (SAARDs) – gold, penicillamine, hydroxychloroquine/chloroquine or sulphasalazine – have conventionally been used later.3 These drugs act slowly, improve symptoms and suppress clinical and serological markers of RA activity. Moreover they appear to slow progression of the disease, although whether they modify disease outcome in the long term is not clear. Many rheumatologists now advocate their earlier use in some patients. We review the place of SAARDs, including methotrexate and immunosuppressants, in the treatment of RA.

scholarly journals Language Legislation and Policy in the uk and Ireland: Different Aspects of Territoriality in a ‘Celtic’ Context

2016 ◽  
Vol 23 (4) ◽  
pp. 454-484 ◽  
Author(s):  
Robert Dunbar
Keyword(s):  
United Kingdom ◽  
Language Policy ◽  
Indigenous Languages ◽  
Scottish Gaelic ◽  
The United Kingdom ◽  
Language Legislation ◽  
The Uk

In spite of the long-term dominance in Britain and Ireland of English, other indigenous languages continue to be spoken, and in relatively recent years several of those languages have benefited not only from a more coherent and supportive language policy but also from significant language legislation. One of the interesting features of these other indigenous languages is that, although strongly associated with rural ‘heartlands’ in the particular jurisdictions with which they are associated, they are also spoken in other parts of those jurisdictions, and, indeed, in other parts of the United Kingdom and Ireland. In this article, the ways in which the concept of territoriality has impacted upon legislation and on broader policy for two of these languages, Irish and Scottish Gaelic, will be considered.

Leishmaniasis and its relevance to UK Armed Forces

2014 ◽  
Vol 100 (3) ◽  
pp. 238-243
Author(s):  
HC Preedy ◽  
MS Bailey
Keyword(s):  
Armed Forces ◽  
Medical Personnel ◽  
Patient Characteristics ◽  
Military Operations ◽  
Tropical Regions ◽  
Evidence Based Treatment ◽  
Phlebotomine Sandflies ◽  
Clinical Syndromes ◽  
The Relationship

AbstractLeishmaniasis is an infectious disease caused by Leishmania protozoa, transmitted by the bite of phlebotomine sandflies. It causes a spectrum of clinical syndromes, of which the most common are cutaneous and visceral leishmaniasis. Clinical presentation is highly variable and is dependent on multiple factors, such as Leishmania species and patient characteristics (including immune competence). The relationship between these variables is poorly understood, and there is no single, evidence-based treatment for the disease. Currently management focuses on identification of the species, but this requires specialist tests which are often unavailable, particularly on military operations. Leishmaniasis is of particular relevance to military medical personnel as it is endemic in many tropical and sub-tropical regions of the world, including Belize, Iraq and Afghanistan where UK Armed Forces may be deployed. It can present a potentially serious threat to military personnel deployed in endemic areas due to the possibility of long-term sequelae of infection.

scholarly journals Economic Consequences of Implementing the Engagement Partner: Signature Requirement in the UK

2017 ◽  
Vol 10 (9) ◽  
pp. 141 ◽  
Author(s):  
Min Liu
Keyword(s):  
Information Asymmetry ◽  
Control Sample ◽  
Economic Consequences ◽  
Forecast Errors ◽  
Omitted Variables ◽  
Ceteris Paribus ◽  
Forecast Dispersion ◽  
Short And Long Term ◽  
The Uk

This paper examines whether and the extent to which requiring the audit engagement partner (EP) signature influences on information asymmetry, analysts’ forecast errors, and forecast dispersion. I predict and find that, ceteris paribus, there is a significant decline in information asymmetry, analysts’ forecast errors and forecast dispersion from the pre- to post-EP signature period in the UK over both of short-term (i.e., 2008-2010) and long-term (i.e., 2004-2014). These findings hold when using a control sample approach, indicating that my results are not likely due to the effect of concurrent events and correlated omitted variables. These findings suggest that implementing the EP signature requirement benefits analysts forecasts over a short- and long-term.

Transmission dynamics and mechanisms of endemicity of scrapie in the UK sheep population

2008 ◽  
Vol 137 (6) ◽  
pp. 762-774 ◽  
Author(s):  
J. E. TRUSCOTT ◽  
N. M. FERGUSON
Keyword(s):  
Structural Diversity ◽  
Epidemiological Data ◽  
Transmissible Spongiform Encephalopathies ◽  
Spongiform Encephalopathies ◽  
Sheep Population ◽  
Mean Values ◽  
The United Kingdom ◽  
The Family ◽  
The Uk

SUMMARYScrapie is a fatal neurological disease of sheep which is endemic in the United Kingdom. It is one of the family of transmissible spongiform encephalopathies (TSEs) that includes BSE. In this paper, we developed a micro-simulation model for scrapie in the UK sheep population, incorporating the genetic and structural diversity of the population and infectious contact between flocks through trading. The simulation was fitted to epidemiological data from a range of sources. We found a detection/reporting probability of 16% (95% CI 12–17) for animals dying of scrapie. Prevalence of infected animals in the population was about 0·15%. Infected individuals were found in 9% of flocks overall, rising to 60% in Shetland and 75% in Swaledale flocks. Mean values of R0 for flocks varied with breed from 2·43 (Shetland) to 0·21 (Suffolk). We also examined the possible long-term persistence of scrapie in the UK flock in the absence of any intervention.

scholarly journals Content analysis for <i>Agricultural Records</i> of the United Kingdom, AD 200 to 1977: a study of frequency in human records concerning climate phenomenon

2011 ◽  
Vol 7 (4) ◽  
pp. 2555-2577
Author(s):  
D. H. Holt
Keyword(s):  
Content Analysis ◽  
Ice Age ◽  
Climate Data ◽  
The United Kingdom ◽  
Weather Phenomenon ◽  
Continuous Record ◽  
Frequency Occurrence ◽  
The Uk ◽  
Climate Events

Abstract. A content analysis has been completed on a text from the UK that has gathered agricultural and climate data from the years AD 220 to 1977 from 100s of sources. The content analysis coded all references to climate and agriculture to ascertain which climate events were recorded and which were not. This study addressed the question: is there bias in human records of climate? This evaluated the continuous record (AD 1654–1977), discontinous record (AD 220–1653), the whole record (AD 220–1977), the Little Climate Optimum (AD 850–1250) and the Little Ice Age (AD 1450–1880). This study shows that there is no significant variation in any of these periods in frequency occurrence of "good" or "bad" climate suggesting humans are not recording long-term changes in climate, but they are recording weather phenomenon as it occurs.

scholarly journals Forecasting of COVID-19 Reproduction Number by ARIMA Methodology and Quantile Estimation based on Best Fit Distribution by L- moments for Top-10 Affected Countries

2021 ◽  
Author(s):  
Muhammad Waqas ◽  
Songhua Xu ◽  
Linyun Zhou
Keyword(s):  
Reproduction Number ◽  
Quantile Estimation ◽  
The Usa ◽  
L Moments ◽  
Short And Long Term ◽  
Long Term Forecasting ◽  
Novel Coronavirus ◽  
The Uk ◽  
Health Experts

Abstract We utilized the average weekly estimated reproduction number data of COVID-19 from March (2020–2021). By applying ARIMA and L-moments methodology, short-and-long-term forecasting of R0 is made for Govt. officials and public health experts to take before-time policy measures to control the spread of novel coronavirus. This study helps medical staff to measure the expected demand of COVID-19 vaccine doses. We applied various ARIMA models on each country’s data and the best selected based on RMSE, AIC, and BIC for point and interval forecasting. Application L-Moments techniques selected GLO, GEV, and GNO distributions and quantile estimation with return period calculations. The forecasting shows that maximum countries mean R0 > 1, which is still a serious threat and can lead to heath disaster. The forecasting provided an alarming situation in the coming months for India, France, Turkey, and Spain; health experts should take strict measures because the cases rise due to the high R0 forecast. The USA, Russia, and the UK mean R0 will not suddenly increase; these countries consistent in COVID-19 R0 control. We find that even the significant population differences prevail among selected countries, the R0 is still high in maximum countries, so its a dire need to take strict control actions to minimize the R0 for public safety.

scholarly journals A Comparative Survey Of Capital Investment Decision Practices In The United States And The United Kingdom

2011 ◽  
Vol 1 (11) ◽  
Author(s):  
Thomas Klammer ◽  
Neil Wilner ◽  
Jan Smolarski
Keyword(s):  
United States ◽  
Risk Management ◽  
United Kingdom ◽  
The United States ◽  
Capital Expenditures ◽  
The United Kingdom ◽  
Management Techniques ◽  
Comparative Survey ◽  
The Uk

Capital expenditures can be crucial to firms long-term success, especially in a complex global environment. As companies increasingly compete in the global market place, it is important to study project evaluation processes from an international perspective. Capital investments involve substantial monetary commitments and risks that affect long-term firm profitability and influence capital allocation decisions in the future. Survey research in the area of capital expenditure analysis has been extensively done in both the United States [US] and the United Kingdom [UK]. This research is the first comparative survey of practices in both countries that we are aware of. A direct comparison of the use of project evaluation, management science, and risk management techniques in the two countries is made. The survey instrument used is an adaptation of the Klammer [1970] instrument that has been used repeatedly in surveys of American firms. This is the first time that it has been applied to British firms. The use of a common instrument allows for more meaningful comparisons. The samples consisted of 127 American and 59 British firms with sales of at least $100 million and capital expenditures of at least $10 million. Preliminary results indicate a continued extensive use of discounted cash flow techniques by US firms. Techniques such as payback or urgency continue to be used, but to a lesser degree than discounting. Firms in the UK also make extensive use of discounting but do so to a lesser degree than their American counterparts. Payback is widely used in the UK. Risk management techniques are widely used in both countries, with sensitivity analysis being the most popular technique in both countries. Extensive use of technical and administrative procedures, such as detailed budgets, standardized forms and post-audits, are evidenced in both countries. The paper offers reasons that have to do with organizational structure and form, as well as market differences, to explain our results.

scholarly journals Heterogeneous Mental Health Development During the COVID-19 Pandemic in the United Kingdom

2021 ◽  
Author(s):  
Lea Ellwardt ◽  
Patrick Praeg
Keyword(s):  
United Kingdom ◽  
Psychological Distress ◽  
Latent Class ◽  
Mitigation Measures ◽  
Social Lives ◽  
The United Kingdom ◽  
Policy Measures ◽  
Nationally Representative ◽  
The Uk

Aim. The COVID-19 pandemic and the mitigation measures by governments have upended the economic and social lives of many, leading to widespread psychological distress. However, how distress developed during the pandemic and who was most affected is poorly understood. We explore heterogeneity in trajectories of psychological distress during the first six months of the pandemic in the United Kingdom and relate this heterogeneity to socio-demographic and health factors. Subjects and Methods. We analyze six waves of longitudinal, nationally representative survey data from the UK Household Longitudinal Study (N = 15,218), covering the first lockdown in 2020. First, latent class mixture modelling (LCCM) is used to identify trajectories of psychological distress. Second, associations of the trajectories with covariates are tested with multinomial logistic regressions. Results. We find four different trajectories of distress: continuously low, continuously moderate, temporarily elevated, and continuously elevated distress. One-fifth of the population experienced severely elevated risks of distress. Long-term exposure was highest among younger people, women, those who lost income, and those with previous health conditions or COVID-19 symptoms. Conclusion. Given the threat of persistent stress on health, policy measures should be sensitized to the unintended yet far-reaching consequences of non-pharmaceutical interventions.

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