Reflex and reflective testing practice in Clinical Biochemistry in the United Kingdom – a national survey

2019 ◽  
Vol 57 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Gareth C McKeeman ◽  
Sally L Hall ◽  
Danielle B Freedman
Keyword(s):  
United Kingdom ◽  
Clinical Biochemistry ◽  
Diagnostic Laboratory ◽  
Staff Members ◽  
The United Kingdom ◽  
Clinical Scenarios ◽  
National Guidance ◽  
Testing Practice ◽  
Survey Results ◽  
The Uk

Background/aims The addition of further tests to patient samples, whether by reflex (automated) methods or reflectively after result review, remains an important function of the diagnostic laboratory. This can assist clinicians with interpretation of results and aid further management. We aimed to investigate how this is performed within Clinical Biochemistry laboratories across the United Kingdom (UK). Methods A questionnaire, consisting of 16 clinical scenarios, was circulated to Clinical Biochemistry laboratories across the UK via the Association for Clinical Biochemistry and Laboratory Medicine (ACB) office. The survey sought to examine opinion on what tests are considered reflex and reflective, which staff members are involved in addition of further tests, whether clinicians are contacted and how abnormal results are handled. Results Responses were received from 74 laboratories, and data were compiled for each scenario surveyed. The majority of laboratories are adding calcium and magnesium, reflectively, to confirm hyperkalaemia or hypocalcaemia, and a number of additional endocrine tests are also commonly performed in particular scenarios. However, there are variations in what is regarded as reflex and reflective testing, in how this testing is conducted within the laboratory and in the level of communication with the requesting clinician. Discussion We present the consensus views of the survey participants for a number of commonly used additional tests within Clinical Biochemistry and a discussion on current reflex and reflective testing practice based on the survey results and evidence, where it exists. There is a need for harmonization and national guidance in this area.

Survey of the Use of Diffusion-Weighted Imaging for Cholesteatoma in the United Kingdom

ORL ◽  
2021 ◽  
pp. 1-7
Author(s):  
Sunil Dutt Sharma ◽  
Ahmad Hariri ◽  
Ravi Kumar Lingam ◽  
Arvind Singh
Keyword(s):  
United Kingdom ◽  
British Society ◽  
Petrous Apex ◽  
The United Kingdom ◽  
Diffusion Weighted ◽  
Clinical Scenarios ◽  
Head And Neck Imaging ◽  
The Mean ◽  
The Uk

<b><i>Background:</i></b> Non-echoplanar diffusion-weighted MRI (DWMRI) has a role in the surgical planning for cholesteatoma. <b><i>Aims/Objectives:</i></b> The aim of the study was to assess the use of DWMRI in the management of cholesteatoma across the UK, and measure clinicians’ confidence in the use of DWMRI. <b><i>Materials and Methods:</i></b> Telephone survey in 139 Otolaryngology Departments in the United Kingdom between March 2017 and July 2017, and asking radiology delegates at the British Society of Head and Neck Imaging 2017 meeting. <b><i>Results:</i></b> The response rate was 101 out of 139 Trusts (73%). Of those respondents who did have DWMRI available, 68/88 respondents (77%) use it for cholesteatoma. The mean confidence (±standard deviation) of the respondents with DWMRI in identifying cholesteatoma presence was 7.3 ± 2.1, in identifying volume of cholesteatoma was 6.8 ± 1.8, and in identifying subsites of cholesteatoma was 4.6 ± 2.1. <b><i>Conclusions and Significance:</i></b> DWMRI has a well-defined role in the follow-up of patients after cholesteatoma surgery, and those primary cases of cholesteatoma where the diagnosis is in question. The use of DWMRI for cholesteatoma is variable across the UK, but there are certain clinical scenarios where there is not enough awareness regarding the benefits of imaging (such as petrous apex cases of cholesteatoma).

scholarly journals SARS-CoV-2 neutralising antibodies in Dogs and Cats in the United Kingdom

2021 ◽  
Author(s):  
Shirley Smith ◽  
Enyia Anderson ◽  
Cintia Cansado Utrilla ◽  
Tessa Prince ◽  
Sean Farrell ◽  
...  
Keyword(s):  
United Kingdom ◽  
Large Scale ◽  
Companion Animals ◽  
Human Infection ◽  
Neutralising Antibodies ◽  
Diagnostic Laboratory ◽  
The United Kingdom ◽  
The Uk ◽  
Human Infections ◽  
Second Wave

Companion animals are susceptible to SARS-CoV-2 infection and sporadic cases of pet infections have occurred in the United Kingdom. Here we present the first large-scale serological survey of SARS-CoV-2 neutralising antibodies in dogs and cats in the UK. Results are reported for 688 sera (454 canine, 234 feline) collected by a large veterinary diagnostic laboratory for routine haematology during three time periods; pre-COVID-19 (January 2020), during the first wave of UK human infections (April-May 2020) and during the second wave of UK human infections (September 2020-February 2021). Both pre-COVID-19 sera and those from the first wave tested negative. However, in sera collected during the second wave, 1.4% (n=4) of dogs and 2.2% (n=2) cats tested positive for neutralising antibodies. The low numbers of animals testing positive suggests pet animals are unlikely to be a major reservoir for human infection in the UK. However, continued surveillance of in-contact susceptible animals should be performed as part of ongoing population health surveillance initiatives.

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.

scholarly journals A Free-Market Environmentalist Transition toward Renewable Energy: The Cases of Germany, Denmark, and the United Kingdom

Energies ◽  
2021 ◽  
Vol 14 (15) ◽  
pp. 4659
Author(s):  
William Hongsong Wang ◽  
Vicente Moreno-Casas ◽  
Jesús Huerta de Soto
Keyword(s):  
United Kingdom ◽  
Renewable Energy ◽  
Private Property ◽  
Free Market ◽  
State Intervention ◽  
Tax Rate ◽  
Reform Agenda ◽  
The United Kingdom ◽  
Market Environmentalism ◽  
The Uk

Renewable energy (RE) is one of the most popular public policy orientations worldwide. Compared to some other countries and continents, Europe has gained an early awareness of energy and environmental problems in general. At the theoretical level, free-market environmentalism indicates that based on the principle of private property rights, with fewer state interventionist and regulation policies, entrepreneurs, as the driving force of the market economy, can provide better services to meet the necessity of offering RE to protect the environment more effectively. Previous studies have revealed that Germany, Denmark, and the United Kingdom have made some progress in using the market to develop RE. However, this research did not analyze the three countries’ RE conditions from the perspective of free-market environmentalism. Based on our review of the principles of free-market environmentalism, this paper originally provides an empirical study of how Germany, Denmark, and the United Kingdom have partly conducted free-market-oriented policies to successfully achieve their policy goal of RE since the 1990s on a practical level. In particular, compared with Germany and Denmark, the UK has maintained a relatively low energy tax rate and opted for more pro-market measures since the Hayekian-Thatcherism free-market reform of 1979. The paper also discovers that Fredrich A. Hayek’s theories have strongly impacted its energy liberalization reform agenda since then. Low taxes on the energy industry and electricity have alleviated the burden on the electricity enterprises and consumers in the UK. Moreover, the empirical results above show that the energy enterprises play essential roles in providing better and more affordable RE for household and industrial users in the three sampled countries. Based on the above results, the paper also warns that state intervention policies such as taxation, state subsidies, and industrial access restrictions can impede these three countries’ RE targets. Additionally, our research provides reform agendas and policy suggestions to policymakers on the importance of implementing free-market environmentalism to provide more efficient RE in the post-COVID-19 era.

scholarly journals Organizational Support Experiences of Care Home and Home Care Staff in Sweden, Italy, Germany and the United Kingdom during the COVID-19 Pandemic

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 767
Author(s):  
Connie Lethin ◽  
Andrea Kenkmann ◽  
Carlos Chiatti ◽  
Jonas Christensen ◽  
Tamara Backhouse ◽  
...  
Keyword(s):  
United Kingdom ◽  
Organizational Support ◽  
Care Home ◽  
External Support ◽  
Care Staff ◽  
Care Organization ◽  
Online Questionnaire ◽  
The United Kingdom ◽  
The Uk ◽  
Staff Experiences

The COVID-19 pandemic has affected care workers all over the globe, as older and more vulnerable people face a high risk of developing severe symptoms and dying from the virus infection. The aim of this study was to compare staff experiences of stress and anxiety as well as internal and external organizational support in Sweden, Italy, Germany, and the United Kingdom (UK) in order to determine how care staff were affected by the pandemic. A 29-item online questionnaire was used to collect data from care staff respondents: management (n = 136), nurses (n = 132), nursing assistants (n = 195), and other healthcare staff working in these organizations (n = 132). Stress and anxiety levels were highest in the UK and Germany, with Swedish staff showing the least stress. Internal and external support only partially explain the outcomes. Striking discrepancies between different staff groups’ assessment of organizational support as well as a lack of staff voice in the UK and Germany could be key factors in understanding staff’s stress levels during the pandemic. Structural, political, cultural, and economic factors play a significant role, not only factors within the care organization or in the immediate context.

Poverty and Sources of Income Support Among Older People With Disabilities and Out of Work: Comparison of Canada and the United Kingdom

2021 ◽  
pp. 1-21
Author(s):  
WEN-HAO CHEN ◽  
LEE BENTLEY ◽  
MARGARET WHITEHEAD ◽  
ASHLEY MCALLISTER ◽  
BENJAMIN BARR
Keyword(s):  
United Kingdom ◽  
Income Support ◽  
Disabled People ◽  
Liberal Democratic ◽  
The United Kingdom ◽  
Poverty Risk ◽  
Public Transfers ◽  
Low Educated ◽  
The Uk ◽  
Government Transfers

Abstract The debate about extending working lives in response to population ageing often overlooks the lack of employment opportunity for older adults with disabilities. Without work, their living standards depend heavily on government transfers. This study contributes to the literature on health inequalities by analysing the sources of income and poverty outcomes for people aged 50 to 64 in two liberal democratic countries yet with contrasting disability benefit contexts – Canada and the United Kingdom. This choice of countries offers the opportunity to assess whether the design of benefit systems has led the most disadvantaged groups to fare differently between countries. Overall, disabled older persons without work faced a markedly higher risk of poverty in Canada than in the UK. Public transfers played a much greater role in the UK, accounting for two-thirds of household income among low-educated groups, compared with one-third in Canada. The average benefit amount received was similar in both countries, but the coverage of disabled people was much lower in Canada than in the UK, leading to a high poverty risk among disabled people out of work. Our findings highlight the importance of income support systems in preventing the widening of the poverty-disability gap at older ages.

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