Epidemiology of Immune Thrombocytopenic Purpura in the United Kingdom, Germany, and the Netherlands.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5554-5554 ◽  
Author(s):  
Jessie A. Satia
Keyword(s):  
United Kingdom ◽  
The Netherlands ◽  
General Practitioners ◽  
Immune Thrombocytopenic Purpura ◽  
Incidence Rates ◽  
Data Availability ◽  
Prevalence Rates ◽  
Thrombocytopenic Purpura ◽  
The Uk ◽  
Over Time

Abstract Background: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder that is associated with serious clinical and health-related quality of life consequences. However, the true burden of ITP is not known because there is limited published data on its incidence and prevalence. Aims: To describe the incidence and prevalence of ITP over time among adults in selected European countries (United Kingdom, Germany, and the Netherlands) and to ascertain whether ITP incidence and prevalence differ by age or sex. Methods: ITP incidence and prevalence rates were calculated from three healthcare databases: the General Practitioners Research Database (UK), the IMS Disease Analyzer (UK and Germany), and the PHARMO Database (the Netherlands). These databases contain longitudinal patient medical record information from selected general practitioners and specialists, using samples designed to be representative of the countries of interest. Patient information is acquired through electronic linkages to providers’ practices in the GPRD and IMS Disease Analyzer, and through the Dutch National Medical Registry in PHARMO. The study periods were 1990–2000 (GPRD), 1994–2003 (IMS Disease Analyzer), and 1991–2003 (PHARMO); analyses were restricted to persons 19 years and older. ITP diagnoses were identified using the ICD-9-CM 287.3 and ICD-I0-CM D69.3 codes. Incidence rates as calculated include only first-time diagnoses whereas prevalence rates include all new and existing cases during a given year. Results: As shown in the table, average ITP incidence and prevalence rates during the study periods (10 years or more) were generally similar in the UK, Germany, and the Netherlands; for example, average incidence rates ranged from 0.6–3.0 per 100,000 persons/year. Although the differences were relatively minor, in general, incidence and prevalence appeared to be highest in Germany and lowest in the Netherlands. From all databases and years of study, persons 60 years and older had the highest age/sex-specific incidence and prevalence. Incidence and prevalence rates were also generally higher (7–36%) among women than men. ITP Incidence and Prevalence Among Adults in the UK, Germany, and the Netherlands Country Rates per 100,000 ** UK Incidence Prevalence ** Lowest and highest incidence and prevalence rates not necessarily for the same year; *** N/A = Not applicable GPRD: 1990–2000 Average 3.0 N/A*** Lowest 2.1 2.1 Highest 4.3 8.1 Most recent year of data availability 2.2 3.2 IMS Disease Analyzer: 1994–2003 Average 0.6 N/A*** Lowest 0.1 0.1 Highest 2.0 3.2 Most recent year of data availability (2003) 2.0 3.2 Germany IMS Disease Analyzer: 1994–2003 Average 2.7 N/A*** Lowest 1.7 2.8 Highest 5.1 7.3 Most recent year of data availability (2003) 2.0 3.5 The Netherlands PHARMO Database: 1992–2003 Average 1.9 Lowest 1.6 N/A*** Highest 2.1 1.9 Most recent year of data availability (2003) 2.1 2.4 2.4 Summary/Conclusions: During all study years, the incidence and prevalence of ITP in the UK, Germany, and the Netherlands was less than 10 per 100,000 persons/year and was relatively stable over time. ITP was more frequent among women and persons over 60 years of age. While studies derived from databases of medical records have potential limitations, such as disease misclassification, selection bias, or omissions/recording errors, our findings are consistent with other published investigations showing that ITP incidence and prevalence is fairly low in European countries.

scholarly journals Resource and waste quantification scenarios for wind turbine decommissioning in the United Kingdom

2020 ◽  
Author(s):  
Kiran Tota-Maharaj ◽  
Alexander McMahon
Keyword(s):  
United Kingdom ◽  
Waste Management ◽  
Wind Turbine ◽  
End Of Life ◽  
Wind Turbines ◽  
Rapid Rise ◽  
The United Kingdom ◽  
Management Procedures ◽  
The Uk ◽  
Over Time

AbstractWind power produces more electricity than any other form of renewable energy in the United Kingdom (UK) and plays a key role in decarbonisation of the grid. Although wind energy is seen as a sustainable alternative to fossil fuels, there are still several environmental impacts associated with all stages of the lifecycle of a wind farm. This study determined the material composition for wind turbines for various sizes and designs and the prevalence of such turbines over time, to accurately quantify waste generation following wind turbine decommissioning in the UK. The end of life stage is becoming increasingly important as a rapid rise in installation rates suggests an equally rapid rise in decommissioning rates can be expected as wind turbines reach the end of their 20–25-year operational lifetime. Waste data analytics were applied in this study for the UK in 5-year intervals, stemming from 2000 to 2039. Current practices for end of life waste management procedures have been analysed to create baseline scenarios. These scenarios have been used to explore potential waste management mitigation options for various materials and components such as reuse, remanufacture, recycling, and heat recovery from incineration. Six scenarios were then developed based on these waste management options, which have demonstrated the significant environmental benefits of such practices through quantification of waste reduction and greenhouse gas (GHG) emissions savings. For the 2015–2019 time period, over 35 kilotonnes of waste are expected to be generated annually. Overall waste is expected to increase over time to more than 1200 kilotonnes annually by 2039. Concrete is expected to account for the majority of waste associated with wind turbine decommissioning initially due to foundations for onshore turbines accounting for approximately 80% of their total weight. By 2035–2039, steel waste is expected to account for almost 50% of overall waste due to the emergence of offshore turbines, the foundations of which are predominantly made of steel.

scholarly journals A unique measles B3 cluster in the United Kingdom and the Netherlands linked to air travel and transit at a large international airport, February to April 2014

2016 ◽  
Vol 21 (13) ◽  
Author(s):  
Laura Nic Lochlainn ◽  
Sema Mandal ◽  
Rita de Sousa ◽  
Karthik Paranthaman ◽  
Rob van Binnendijk ◽  
...  
Keyword(s):  
Public Health ◽  
United Kingdom ◽  
The Netherlands ◽  
Virus Strain ◽  
Measles Virus ◽  
The Philippines ◽  
The United Kingdom ◽  
Public Health Officials ◽  
The Uk ◽  
In Transit

This report describes a joint measles outbreak investigation between public health officials in the United Kingdom (UK) and the Netherlands following detection of a measles cluster with a unique measles virus strain. From 1 February to 30 April 2014, 33 measles cases with a unique measles virus strain of genotype B3 were detected in the UK and the Netherlands, of which nine secondary cases were epidemiologically linked to an infectious measles case travelling from the Philippines. Through a combination of epidemiological investigation and sequence analysis, we found that measles transmission occurred in flight, airport and household settings. The secondary measles cases included airport workers, passengers in transit at the same airport or travelling on the same flight as the infectious case and also household contacts. This investigation highlighted the particular importance of measles genotyping in identifying transmission networks and the need to improve vaccination, public health follow-up and management of travellers and airport staff exposed to measles.

Anorexia Nervosa

1995 ◽  
Vol 166 (4) ◽  
pp. 462-471 ◽  
Author(s):  
Eric Fombonne
Keyword(s):  
Anorexia Nervosa ◽  
Time Trends ◽  
Epidemiological Studies ◽  
Incidence Rates ◽  
Prevalence Rates ◽  
Upward Trend ◽  
Cross Sectional ◽  
Prevalence Estimates ◽  
Secular Increase ◽  
Over Time

BackgroundThis paper examines the evidence that rates of anorexia nervosa have increased over time.MethodEpidemiological studies that have provided time trends in incidence rates in specific countries or psychiatric registers and prevalence surveys were reviewed to assess whether or not prevalence estimates are higher in the most recent studies.ResultsEstimated trends in incidence rates showed an increase but no study ruled out plausible alternative explanations. Studies showing no upward trend were as numerous and were generally based on larger samples. Analysis of 29 cross-sectional surveys conducted over the last 25 years indicated that the median prevalence rate was 1.3 per 1000 females. There was no indication that more recent surveys yielded higher prevalence rates.ConclusionAnorexia nervosa remains a rare disorder and there is no evidence of a secular increase in its incidence.

scholarly journals Not an age of depression after all? Incidence rates may be stable over time

2000 ◽  
Vol 30 (3) ◽  
pp. 489-490 ◽  
Author(s):  
E. S. PAYKEL
Keyword(s):  
Temporal Stability ◽  
Incidence Rates ◽  
Cohort Effects ◽  
Prevalence Rates ◽  
Important Paper ◽  
Period Effects ◽  
Over 40 Years ◽  
Over Time ◽  
Time Point

In an important paper in this issue Murphy et al. (pp. 503–512) report on incidence rates for depression over 40 years in the Stirling County Study. Incidence rates remained stable, contrary to most evidence that is principally based on prevalence or retrospective lifetime prevalence. Incidence rates were only a little higher in women than in men.Incidence rates are assuming increasing importance in psychiatry as they do in other areas of epidemiology. Prevalence rates are complex, depending not only on incidence of new cases of the disorder, but its persistence, and in a recurrent disorder, recurrence. Incidence rates are unbiased by these factors, a particularly valuable attribute when considering risk factors. In depression, development and widespread use of antidepressants, newer patterns of care, and in the opposite direction, increased urbanization with its accompanying social pressures, could have produced considerable changes in outcome in the last 40 years. Changes in enumerated prevalences alone could reflect changed length of episodes and rates of recurrence, so giving a misleading picture as to what has happened to the disorder.The Stirling County Study is one of the classics of epidemiology. Its originator, Alexander Leighton, is an author of the present paper with his wife, Jane Murphy, who has directed the study since the mid-1970s. Representative community samples were studied cross-sectionally in 1952, 1969 and 1992, and the previously studied samples restudied on follow-up at the later points. The design enables a separation of period effects, involving all subjects at one time point, from cohort effects. In this study similar temporal stability of prevalence has been found (Murphy et al. 2000b) to that now reported for incidence.

scholarly journals The United Kingdom 2009 Swine Flu Outbreak As Recorded in Real Time by General Practitioners

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Hershel Jick ◽  
Dean S. MacLaughlin ◽  
Pascal Egger ◽  
Peter Wiggins
Keyword(s):  
General Practice ◽  
United Kingdom ◽  
Real Time ◽  
General Practitioners ◽  
Swine Flu ◽  
Practice Research ◽  
Research Database ◽  
Planning Stage ◽  
The United Kingdom ◽  
The Uk

Background. Initially the course of the 2009 swine flu pandemic was uncertain and impossible to predict with any confidence. An effective prospective data resource exists in the United Kingdom (UK) that could have been utilized to describe the scope and extent of the swine flu outbreak as it unfolded. We describe the 2009 swine flu outbreak in the UK as recorded daily by general practitioners and the potential use of this database for real-time tracking of flu outbreaks. Methods. Using the General Practice Research Database, a real-time general practice, electronic database, we estimated influenza incidence from July 1998 to September 2009 according to age, region, and calendar time. Results. From 1998 to2008, influenza outbreaks regularly occurred yearly from October to March, but did not typically occur from April to September until the swine flu outbreak began in April 2009. The weekly incidence rose gradually, peaking at the end of July, and the outbreak had largely dissipated by early September. Conclusions. The UK swine flu outbreak, recorded in real time by a large group of general practitioners, was mild and limited in time. Simultaneous online access seemed feasible and could have provided additional clinical-based evidence at an early planning stage of the outbreak.

Size and Electoral Participation in Local Elections

10.1068/c0228 ◽  
2002 ◽  
Vol 20 (6) ◽  
pp. 853-869 ◽  
Author(s):  
Annie Gaardsted Frandsen
Keyword(s):  
United Kingdom ◽  
The Netherlands ◽  
Electoral System ◽  
European Countries ◽  
Local Elections ◽  
Local Election ◽  
The United Kingdom ◽  
Motivation To Participate ◽  
The Relationship ◽  
Over Time

This paper reviews local election turnout for the period since the 1970s in five European countries: Denmark, the Netherlands, Norway, Switzerland, and the United Kingdom. It explores especially the relationship between size of municipality and turnout in local elections. The author seeks to explore this issue in the light of Dahl and Tufte's 1973 classic study Size and Democracy (Stanford University Press) which claimed that citizens' motivation to participate is greater in small governmental units than in large ones. This study confirms the Dahl and Tufte hypothesis, in that turnout is consistently higher over time in small municipalities in all the countries reviewed, although the strength of the relationship varies between the different countries. The paper also shows that other factors, such as the type of electoral system used or whether voting is compulsory or not, also have an effect on turnout.

Trends in Incidence and Survival of Multiple Myeloma in the Netherlands in the Last Two Decades. Results From a National Population Based Study

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5071-5071 ◽  
Author(s):  
Silvia GR Verelst ◽  
Hedwig M Blommestein ◽  
Henrike E Karim-Kos ◽  
Peter C Huijgens ◽  
Pieter Sonneveld
Keyword(s):  
The Netherlands ◽  
Board Of Directors ◽  
Research Funding ◽  
Age Groups ◽  
Relative Survival ◽  
Population Based ◽  
Incidence Rates ◽  
Newly Diagnosed ◽  
Advisory Committees ◽  
Over Time

Abstract Abstract 5071 Background: Multiple myeloma (MM) is de second most common haematological malignancy in adults worldwide. MM is common in the elderly. While the general life expectancy is increasing an ever increasing number of patients has to be expected. In the last decade treatment strategies are changed continuously because of the introduction of novel agents and allogeneic and autologous stem cell transplantation. In randomized controlled trials, overall survival in patients up to 65 years is improving convincing. In contrast with results in older patients. We studied data of patients treated outside clinical trials derived from the population based registry in the Netherlands to recognize trends in incidence en survival during 1989–2009. Patients and methods: We included all patients with newly diagnosed MM in the period 1989 – 2009 who were recorded in the Netherlands Cancer Registry (n =16.822 ). Follow-up was until January, 2010. We calculated the yearly age-standardised incidence rates for males and females and age-specific incidence rates in 10 year age groups for both sexes separately and combined. Changes in incidence were evaluated by calculating the estimated annual percentage change (EAPC). We then calculated relative survival, which may be interpreted as disease-specific survival within a cancer patient population. Traditional cohort-based, relative survival analysis was applied for patients diagnosed during 1989–2009. Since follow-up was available until 2010, 5 year relative survival for patients diagnosed in 2004–2009 was estimated using period-based relative survival analysis. Results: The number of newly diagnosed MM cases rose between 1989 and 2009 from 631 to 968 cases respectively. Significantly more males were diagnosed than females over time (p=0.01). Furthermore the proportion of male patients increased slightly over these time periods. However, the overall age standardised incidence rate for males and females remained stable over time but was higher among males than females. The median age at diagnosis was 71 years (p10-P90 range 53–84) and stable over time (p=0.07). Incidence was highest in the 70–79 age group for both sexes. However, because of the aging population the age-specific incidence rates (ASIR) were highest for patients aged 80+ years for both sexes. Within specific age groups significant changes were seen. In the population 50–59 years, the ASIR increased from 5.0 per 100,000 in 1989 to 6.9 in 2009 (EAPC 1989–2009 = + 0.7%; 95% CI: 0.0 –1.3). A decrease was seen in females aged 80+ years from 25.1 per 100,000 in 1989 to 22.4 in 2009 (EAPC 1989–2009 = −1,0; 95% CI: −1.8; −0.2). In the overall patient population the 1-year relative survival increased only slightly from 72% to 77% between 1989 and 2009. 5-year relative survival increased from 28% to 37%. Small improvements in survival were observed for all age groups in the past two decades except for patients aged 80+ years. Relative survival decreased with increasing age. In contrast, in the group aged 40–64 years improvements are already detectable from 1994 on. In 2004–2009 the highest 5-year relative survival, 62%, was seen in patients 40–49 year of age. However the strongest improvement over time was observed among the group 50–59 years. Conclusion: Although the average annual age-adjusted incidence rate remained stable from 1989–2009, the number of newly diagnosed MM patients increased because of the aging population. Relative survival increased slowly but continuously in time for patients until 80 years of age with strongest increase seen in patients up to 64 years of age. Improvement for these younger patients is most likely caused by the introduction of novel agents based regiments as well as by the introduction of high dose chemotherapy followed by stem cell transplantation. Our findings in trends of incidence and survival of MM are similar to those reported in other western populations. Disclosures: Sonneveld: Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen-Cilag: Membership on an entity's Board of Directors or advisory committees, Research Funding; Onyx: Membership on an entity's Board of Directors or advisory committees, Research Funding; Millennium: Membership on an entity's Board of Directors or advisory committees.

scholarly journals O40 Trends in incidence of GCA in the UK

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Lauren A Barnett ◽  
Toby Helliwell ◽  
Kelvin Jordan ◽  
James Prior
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Sensitivity Analysis ◽  
Incidence Rate ◽  
Incidence Rates ◽  
Annual Incidence ◽  
Clinical Practice Research Datalink ◽  
Number Of Patients ◽  
The Uk ◽  
Over Time

Abstract Background Giant cell arteritis (GCA) is the most common form of medium and large vessel vasculitis. Diagnosis remains difficult since there are a multitude of symptoms experienced by patients with GCA and if not promptly identified or treated, patients with GCA are at risk of irreversible visual loss. Therefore, a clear understanding of recent trends in incidence is important for clinicians, researchers and policy-holders to better understand and address future healthcare resource needs. Our objective was to estimate the annual UK incidence of GCA and assess whether this is changing over time. Methods We used the Clinical Practice Research Datalink (CPRD), a database of routinely recorded primary care records from across the UK. CPRD is representative of the UK population and contains patient information from approximately 15% of the UK population. For each year from 1992-2017, the number of patients with a first Read coded record of GCA in that year, and aged 40 years or older at the time of diagnosis, was determined. The annual denominator population included the registered practice population without a prior record of GCA, aged 40 years or older. Annual incidence per 10,000 person-years (P-Y) at risk was derived overall and stratified by age, gender and region of the UK. Trends over time were modelled using Joinpoint regression. To be confident of the primary care diagnosis of GCA, a sensitivity analysis was undertaken which included a prescription of corticosteroids alongside the GCA Read code. Results There was a decrease in annual incidence of GCA in the UK between 1992 and 2017. Incidence was highest in 1994 (2.29/10,000 P-Y; 95% CI: 1.96, 2.67). This decreased to 1.51/10,000 P-Y in 2006, after which the incidence rates stabilised. Incidence rates for women were higher than men, irrespective of year. Incidence peaked between 70 and 89 years of age, with females aged 70-79 having the highest overall incidence rate of 5.20/10,000 P-Y (95% CI: 5.00, 5.40). The region of the UK with the highest incidence rate of GCA from 2015-2017 was Yorkshire & the Humber with 2.63/10,000 P-Y. The regions with the lowest incidence of 1.13/10,000 P-Y were the North East and West Midlands. Sensitivity analysis gave similar patterns. Conclusion The incidence of GCA in the UK has decreased slightly in recent years, which may reflect developments in more definitive early GCA diagnosis through fast-track clinics and improvements in imaging. However, further research into the presenting features of GCA in primary care is required. A set of early clinical features and comorbidities that are positively associated and predictive of a subsequent diagnosis of GCA would improve diagnosis and avert significant complications associated with delayed treatment. Disclosures L.A. Barnett None. T. Helliwell None. K. Jordan None. J. Prior None.

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