scholarly journals Occurrence of Cryptosporidium Oocysts in Leisure Pools in the UK, 2017, and Modelling of Oocyst Contamination Events

Water ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 1503
Author(s):  
Rachel M. Chalmers ◽  
Lester P. Simmonds ◽  
Martin Wood ◽  
Megan Luxford ◽  
Rob Miller ◽  
...  

Cryptosporidium is a major cause of diarrhoea outbreaks linked to swimming pools, but little is known about the frequency of contamination. The primary aim was to investigate the occurrence and concentration, through sampling and modelling, of Cryptosporidium oocysts in leisure pools. Secondary aims were to compare detections with operational parameters, provide the evidence-base for guidance, and improve sampling capacity and interpretation for public health investigations. Up to 1000 L pool water was sampled during swim sessions once weekly for 10 weeks from 8th August 2017 at six volunteer pools. Oocysts were detected by microscopy in 12/59 (20%) pool water samples, at least once in each pool; 8/12 (66%) detections were in August when bather loads were highest. At three pools, 1 L filter backwash was sampled weekly and oocysts were detected in 2/29 (7%) samples, following detections in pool water. The probabilities of a bather contaminating the pool ranged from 1 in 1000 to over 1 in 10,000. Monte Carlo analysis showed that when high bather numbers caused contamination on over 70% of days, multiple events per day were more likely than single events. In these generally well-managed leisure pools, Cryptosporidium risk related to high bather loads. We conclude that public awareness campaigns for bather hygiene, and reminding pool operators of current guidance for managing faecal accidents, should be ahead of peak swim season.

2019 ◽  
Vol 26 (1) ◽  
pp. 79-95 ◽  
Author(s):  
Kevin Wong ◽  
Kris Christmann ◽  
Michelle Rogerson ◽  
Neil Monk

The underreporting of hate crime is recognised as problematic for jurisdictions across Europe and beyond. Within the UK, the landmark inquiry report into the murder of Stephen Lawrence 25 years ago has seen governments faithfully adhering to a policy of promoting the increased reporting of hate crime. An enduring legacy of the inquiry, third-party reporting centres (TPRCs) have been equally faithfully promoted as the primary vehicle for achieving such increases. While the nations of the United Kingdom have pioneered the development of TPRCs, their function and form have been adopted in other jurisdictions, including Victoria, Australia. Nevertheless, despite their reliance on TPRCs, policymakers have given limited attention to their efficacy. The evidence from a plethora of small scale studies has consistently found that TPRCs have been limited by public awareness, capability, capacity and poor oversight difficulties. Responding to these long-standing problems, the authors have developed the first ‘TPRC assessment tool’ which offers a diagnostic facility to improve effectiveness. This paper describes the development and piloting of this tool and highlights its potential to inform policy and practice both in the UK and internationally, providing an original contribution to the limited evidence base around third-party reporting.


2020 ◽  
Vol 3 (1) ◽  
pp. 01-05
Author(s):  
Peter Marks ◽  
Debi Prasad ◽  
Roger Williams

A strong evidence-based case is made for a reduction in the drink driving blood alcohol concentration (BAC), currently in the UK 80 mg to 50 mg per 100 ml which worldwide has been shown to decrease the number of drink driving including fatal accidents. An even lower BAC of 20 mg per 100 ml is recommended for the younger novice representing 7% of driving licence holders in the UK but involved in 20% of fatal and serious collisions. The danger of binge drinking and of combining alcohol with other drugs such as cannabis and marijuana is emphasised and the harmful influence of simple energy drinks when combined with alcohol. The review also emphasises the need for enhanced police enforcement and more public awareness campaigns which to date have indicated growing public support for reducing the drink driving limits.


2021 ◽  
pp. emermed-2021-211767
Author(s):  
James Price ◽  
Georgina Malakounides ◽  
Sarah Stibbards ◽  
Shruti Agrawal

IntroductionThe ingestion of small, strong, rare-earth magnets, also termed ‘ball magnets’, can rapidly result in life-threatening bowel injuries. The objective of this study was to report the incidence and management of ‘ball magnet’ ingestion in children across the UK and to discuss the potential implications for policy-makers and public awareness campaigns.MethodsIn this multi-centre survey of UK major trauma centres (MTCs), paediatric patients admitted to hospital following ‘ball magnet’ ingestion from 1 January 2020 to 31 December 2020 were included.ResultsResponses were received from 11 MTCs (52%) reporting a total of 53 children admitted with ‘ball magnet’ ingestion over the 1-year study period. Most patients (n=51) presented following unintentional ingestion. 36 (68%) patients presented asymptomatically following witnessed or reported ingestion. In symptomatic patients, abdominal pain and vomiting were the the most common symptoms. The median number of ‘ball magnets’ ingested was 5.0 (IQR 3.0–7.8), range 1 to 63. 27 (51%) patients underwent operative intervention; laparotomy being the the most common (n=24, 89%). There were no deaths reported during the study period.ConclusionThis multi-centre survey from the UK demonstrates the serious impact of ‘ball magnet’ ingestion in children. Clinicians, regulators and caregivers must work symbiotically in order to prevent, recognise and reduce life-threatening bowel injuries.


Author(s):  
Keri Thomas

This chapter provides an introduction to advance care planning (ACP) and an introductory overview of the book. It affirms the importance of ACP, the strong evidence base and experience in practice. It cites the current and evolving models of ACP in the UK, linked with the Mental Capacity Act, and the use of advance statements (AS), refusals of treatment (ADRT) and nominated spokesperson (LPOA). There is encouragement that most can initiate such discussions and suggested ways to do this. It describes the evolving ACP model balancing both medical (transactional) and personal (transformational) aspects of it, with a description of the different conversations and suggested five steps in ACP to raise public awareness. There is a reflection of the deeper significance of ACP including hope and expectations, concluding with a call for ACP to become a mainstream part of care for all people nearing the end of life.


2018 ◽  
Vol 10 (1) ◽  
pp. 16-33 ◽  
Author(s):  
Shakirudeen Odunuga ◽  
Samuel Udofia ◽  
Opeyemi Esther Osho ◽  
Olubunmi Adegun

Introduction:Human activities exert great pressures on the environment which in turn cause environmental stresses of various intensities depending on the factors involved and the sensitivity of the receiving environment.Objective:This study examines the effects of anthropogenic activities along the sub-urban lagoon fragile coastal ecosystem using DPSIR framework.Results:The results show that the study area has undergone a tremendous change between 1964 and 2015 with the built up area increasing to about 1,080 ha (17.87%) in 2015 from 224 ha (1.32%) in 1964 at an average growth rate of 16.78ha per annum. The nature of the degradation includes an increasing fragility of the ecosystem through the emergence and expansion of wetlands, flooding and erosion as well as a reduction in the benefits from the ecosystem services. Population growth, between 2006 and 2015 for Ikorodu LGA, estimated at 8.84% per annum serves as the most important driving force in reducing the quality of the environment. This is in addition to Pressures emanating from anthropogenic activities. The state of the environment shows continuous resource exploitation (fishing and sand mining) with the impacts of the pressures coming from water pollution, bank erosion, biodiversity loss and flooding. Although there has been a strong policy formulation response from the government, weak implementation is a major challenge.Recommendation:The study recommends public awareness campaigns and the implementation of existing policies to ensure a sustainable sub-urban lagoon coastal environment..


2020 ◽  
Vol 25 (12) ◽  
pp. 610-614
Author(s):  
Garry Cooper-Stanton

There are various opportunities and challenges in the delivery of care to those diagnosed with chronic oedema/lymphoedema. Service provision is not consistent within the UK, and non-specialist nurses and other health professionals may be called on to fill the gaps in this area. The latest best practice guidance on chronic oedema is directed at community services that care for people within their own homes in primary care. This guide was developed in order to increase awareness, knowledge and access to an evidence base. Those involved in its creation cross specialist fields (lymphoedema and tissue viability), resulting in the document covering a number of areas, including an explanation of chronic oedema, its assessment and management and the association between chronic oedema and wet legs. The document complements existing frameworks on the condition and its management and also increases the available tools within chronic oedema management in the community. The present article provides an overview of the guidance document and discusses its salient features.


2020 ◽  
pp. bmjspcare-2020-002304
Author(s):  
Judith Rietjens ◽  
Ida Korfage ◽  
Mark Taubert

ObjectivesThere is increased global focus on advance care planning (ACP) with attention from policymakers, more education programmes, laws and public awareness campaigns.MethodsWe provide a summary of the evidence about what ACP is, and how it should be conducted. We also address its barriers and facilitators and discuss current and future models of ACP, including a wider look at how to best integrate those who have diminished decisional capacity.ResultsDifferent models are analysed, including new work in Wales (future care planning which includes best interest decision-making for those without decisional capacity), Asia and in people with dementia.ConclusionsACP practices are evolving. While ACP is a joint responsibility of patients, relatives and healthcare professionals, more clarity on how to apply best ACP practices to include people with diminished capacity will further improve patient-centred care.


Eye ◽  
2021 ◽  
Author(s):  
Sana Hamid ◽  
Parul Desai ◽  
Pirro Hysi ◽  
Jennifer M. Burr ◽  
Anthony P. Khawaja

AbstractEffective population screening for glaucoma would enable earlier diagnosis and prevention of irreversible vision loss. The UK National Screening Committee (NSC) recently published a review that examined the viability, effectiveness and appropriateness of a population-based screening programme for primary open-angle glaucoma (POAG). In our article, we summarise the results of the review and discuss some future directions that may enable effective population screening for glaucoma in the future. Two key questions were addressed by the UK NSC review; is there a valid, accurate screening test for POAG, and does evidence exist that screening reduces morbidity from POAG compared with standard care. Six new studies were identified since the previous 2015 review. The review concluded that screening for glaucoma in adults is not recommended because there is no clear evidence for a sufficiently accurate screening test or for better outcomes with screening compared to current care. The next UK NSC review is due to be conducted in 2023. One challenge for POAG screening is that the relatively low disease prevalence results in too many false-positive referrals, even with an accurate test. In the future, targeted screening of a population subset with a higher prevalence of glaucoma may be effective. Recent developments in POAG polygenic risk prediction and deep learning image analysis offer potential avenues to identifying glaucoma-enriched sub-populations. Until such time, opportunistic case finding through General Ophthalmic Services remains the primary route for identification of glaucoma in the UK and greater public awareness of the service would be of benefit.


Mindfulness ◽  
2021 ◽  
Author(s):  
Kate Williams ◽  
Samantha Hartley ◽  
Peter Taylor

Abstract Objectives Mindfulness-based cognitive therapy (MBCT) is a well-evidenced relapse-prevention intervention for depression with a growing evidence-base for use in other clinical populations. The UK initiatives have outlined plans for increasing access to MBCT in clinical settings, although evidence suggests that access remains limited. Given the increased popularity and access to MBCT, there may be deviations from the evidence-base and potential risks of harm. We aimed to understand what clinicians believe should be best clinical practice regarding access to, delivery of, and adaptations to MBCT. Methods We employed a two-stage Delphi methodology. First, to develop statements around best practices, we consulted five mindfulness-based experts and reviewed the literature. Second, a total of 59 statements were taken forward into three survey rating rounds. Results Twenty-nine clinicians completed round one, with 25 subsequently completing both rounds two and three. Forty-four statements reached consensus; 15 statements did not. Clinicians agreed with statements regarding sufficient preparation for accessing MBCT, adherence to the evidence-base and good practice guidelines, consideration of risks, sufficient access to training, support, and resources within services, and carefully considered adaptations. The consensus was not reached on statements which reflected a lack of evidence-base for specific clinical populations or the complex decision-making processes involved in delivering and making adaptations to MBCT. Conclusions Our findings highlight the delicate balance of maintaining a client-centred and transparent approach whilst adhering to the evidence-base in clinical decisions around access to, delivery of, and adaptations in MBCT and have important wide-reaching implications.


Author(s):  
Thea Palsgaard Møller ◽  
Hejdi Gamst Jensen ◽  
Søren Viereck ◽  
Freddy Lippert ◽  
Doris Østergaaard

Abstract Background Medical dispatching is a highly complex procedure and has an impact upon patient outcome. It includes call-taking and triage, prioritization of resources and the provision of guidance and instructions to callers. Whilst emergency medical dispatchers play a key role in the process, their perception of the process is rarely reported. We explored medical dispatchers’ perception of the interaction with the caller during emergency calls. Secondly, we aimed to develop a model for emergency call handling based on these findings. Methods To provide an in-depth understanding of the dispatching process, an explorative qualitative interview study was designed. A grounded theory design and thematic analysis were applied. Results A total of 5 paramedics and 6 registered nurses were interviewed. The emerging themes derived from dispatchers’ perception of the emergency call process were related to both the callers and the medical dispatchers themselves, from which four and three themes were identified, respectively. Dispatchers reported that for callers, the motive for calling, the situation, the perception and presentation of the problem was influencing factors. For the dispatchers the expertise, teamwork and organization influenced the process. Based on the medical dispatchers´ perception, a model of the workflow and interaction between the caller and the dispatcher was developed based on themes related to the caller and the dispatcher. Conclusions According to medical dispatchers, the callers seem to lack knowledge about best utilization of the emergency number and the medical dispatching process, which can be improved by public awareness campaigns and incorporating information into first aid courses. For medical dispatchers the most potent modifiable factors were based upon the continuous professional development of the medical dispatchers and the system that supports them. The model of call handling underlines the complexity of medical dispatching that embraces the context of the call beyond clinical presentation of the problem.


Sign in / Sign up

Export Citation Format

Share Document