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5.
Am J Public Health ; 111(10): 1885-1893, 2021 10.
Article in English | MEDLINE | ID: mdl-34554817

ABSTRACT

Objectives. To explore associations between police stops, self-harm, and attempted suicide among a large, representative sample of adolescents in the United Kingdom. Methods. Data were drawn from the 3 most recent sweeps of the UK Millennium Cohort Study (MCS), from 2012 to 2019. The MCS is an ongoing nationally representative contemporary birth cohort of children born in the United Kingdom between September 2000 and January 2002 (n = 10 345). Weights were used to account for sample design and multiple imputation for missing data. Results. Youths experiencing police stops by the age of 14 years (14.77%) reported significantly higher rates of self-harm (incidence rate ratio = 1.52; 95% confidence interval [CI] = 1.35, 1.69) at age 17 years and significantly higher odds of attempted suicide (odds ratio = 2.25; 95% CI = 1.84, 2.76) by age 17 years. These patterns were largely consistent across examined features of police stops and generally did not vary by sociodemographic factors. In addition, 17.73% to 40.18% of associations between police stops and outcomes were explained by mental distress. Conclusions. Police-initiated encounters are associated with youth self-harm and attempted suicide. Youths may benefit when school counselors or social workers provide mental health screenings and offer counseling care following these events. (Am J Public Health. 2021;111(10):1885-1893. https://doi.org/10.2105/AJPH.2021.306434).


Subject(s)
Juvenile Delinquency/statistics & numerical data , Police , Self-Injurious Behavior/epidemiology , Suicide, Attempted/statistics & numerical data , Adolescent , Cohort Studies , Fear/psychology , Female , Humans , Juvenile Delinquency/psychology , Male , Risk Factors , Self-Injurious Behavior/psychology , Suicide, Attempted/psychology , United Kingdom
6.
Br J Radiol ; 95(1129): 20210727, 2022 Jan 01.
Article in English | MEDLINE | ID: mdl-34591603

ABSTRACT

OBJECTIVE: Implementing a streamlined interventional radiology (IR) service in the UK has been a challenge. This study aims to review a set of changes introduced in IR at a tertiary centre, including a new referral process and the designation of IR clinical nurse specialists. METHODS: A new process of referring patients to IR using a single generic referral pathway was implemented, replacing an order dropdown-based system. A qualitative survey was designed and distributed as a single-use web link in order to assess the satisfaction and impact of this new process. Responses were based on Likert scale and pertained to perceived qualities of the new referral process. Data analysis was performed to identify specialty and grade-specific trends and possible differences amongst groups. RESULTS: Findings from 98 respondents revealed a strong overall satisfaction with the new referral method and support for its continuation. Subgroup analysis by specialty, concluded medical specialties rated the new referral system more favourably than surgical specialties across all aspects: time efficiency, ease of use, periprocedural support and overall user experience. The new system also increased departmental productivity with an increase in the number of patients treated by 11.2%. CONCLUSION: Micropolicy changes within individual IR departments such as the replacement of a request-based referral system to one which puts IR in control of vetting and patient flow is one of many changes that reinforce the transformational phase of this specialty. ADVANCES IN KNOWLEDGE: Micropolicy changes within IR departments are key in the progression and widespread recognition of the specialty.


Subject(s)
Radiology, Interventional/organization & administration , Referral and Consultation/organization & administration , Humans , Medical Staff, Hospital , Nurse Clinicians , Nursing Staff, Hospital , Patient Satisfaction , Tertiary Care Centers , United Kingdom
7.
Infect Dis Poverty ; 12(1): 5, 2023 Jan 30.
Article in English | MEDLINE | ID: mdl-36717939

ABSTRACT

BACKGROUND: Socioeconomic status (SES) inequity was recognized as a driver of some certain infectious diseases. However, few studies evaluated the association between SES and the burden of overall infections, and even fewer identified preventable mediators. This study aimed to assess the association between SES and overall infectious diseases burden, and the potential roles of factors including lifestyle, environmental pollution, chronic disease history. METHODS: We included 401,009 participants from the UK Biobank (UKB) and defined the infection status for each participant according to their diagnosis records. Latent class analysis (LCA) was used to define SES for each participant. We further defined healthy lifestyle score, environment pollution score (EPS) and four types of chronic comorbidities. We used multivariate logistic regression to test the associations between the four above covariates and infectious diseases. Then, we performed the mediation and interaction analysis to explain the relationships between SES and other variables on infectious diseases. Finally, we employed seven types of sensitivity analyses, including considering the Townsend deprivation index as an area level SES variable, repeating our main analysis for some individual or composite factors and in some subgroups, as well as in an external data from the US National Health and Nutrition Examination Survey, to verify the main results. RESULTS: In UKB, 60,771 (15.2%) participants were diagnosed with infectious diseases during follow-up. Lower SES [odds ratio (OR) = 1.5570] were associated with higher risk of overall infections. Lifestyle score mediated 2.9% of effects from SES, which ranged from 2.9 to 4.0% in different infection subtypes, while cardiovascular disease (CVD) mediated a proportion of 6.2% with a range from 2.1 to 6.8%. In addition, SES showed significant negative interaction with lifestyle score (OR = 0.8650) and a history of cancer (OR = 0.9096), while a significant synergy interaction was observed between SES and EPS (OR = 1.0024). In subgroup analysis, we found that males and African (AFR) with lower SES showed much higher infection risk. Results from sensitivity and validation analyses showed relative consistent with the main analysis. CONCLUSIONS: Low SES is shown to be an important risk factor for infectious disease, part of which may be mediated by poor lifestyle and chronic comorbidities. Efforts to enhance health education and improve the quality of living environment may help reduce burden of infectious disease, especially for people with low SES.


Subject(s)
Biological Specimen Banks , Communicable Diseases , Male , Humans , Nutrition Surveys , Social Class , Environmental Pollution , Life Style , United Kingdom/epidemiology , Socioeconomic Factors
8.
Br J Nurs ; 32(2): 88-89, 2023 Jan 26.
Article in English | MEDLINE | ID: mdl-36715525

ABSTRACT

John Tingle Lecturer in Law, Birmingham Law School, University of Birmingham, discusses several reports addressing patient safety, ethical and legal issues in healthcare digital technologies and artificial intelligence.


Subject(s)
Artificial Intelligence , Digital Technology , Humans , State Medicine , Patient Safety , Delivery of Health Care , United Kingdom
9.
Front Public Health ; 10: 1064677, 2022.
Article in English | MEDLINE | ID: mdl-36711346

ABSTRACT

Introduction: Public health mitigation policies aimed at slowing the spread of COVID-19 led to an increase in mental health problems (MHPs). This study examines the association between multiple pre-pandemic health behaviors and MHPs prior to, and during, the COVID-19 pandemic. Methods: We analyzed a representative population sample of 11,256 adults (aged 20-65 years) from Understanding Society-The UK Household Longitudinal Study. Baseline data from participants interviewed in 2017/2019 (wave 9) were linked to web surveys conducted during the COVID-19 pandemic. We used latent class analysis (LCA) to identify mutually exclusive health behavior (physical activity, alcohol consumption, eating habits and smoking tobacco) clusters by gender, and examined the sociodemographic correlates of each cluster. We assessed how pre-pandemic latent classes of health behaviors were associated with changes in MHPs during the pandemic using fixed effects regression models. Results: Three health behavior clusters were identified: positive (33%), moderate (24%), and high risk (43%), where similar behaviors clustered within individuals and sociodemographic circumstances. In particular, gender, age, migrant status and ethnicity were found to have strong associations with each cluster. Our results also demonstrated a clear association in MHPs with health behaviors both prior to, and during the pandemic. There were significant increases in MHPs between 2017/2019 and January 2021, with fluctuations coinciding with changes in public health mitigation policies. Assessments across the three clusters showed about 25.2%, 16.9%, and 0.7% increases in MHPs in the positive, moderate and high risk health behavior clusters, respectively. Discussion: This study shows that pre-pandemic health behaviors were significantly associated with mental health before and during the pandemic. Holistic policy interventions and promotions targeting multiple health behaviors may be an effective strategy to improve mental health in the pandemic recovery period.


Subject(s)
COVID-19 , Humans , Adult , COVID-19/epidemiology , Pandemics , Longitudinal Studies , Mental Health , Health Behavior , Public Policy , United Kingdom/epidemiology
10.
Front Public Health ; 10: 1060694, 2022.
Article in English | MEDLINE | ID: mdl-36711414

ABSTRACT

Background: Minority ethnic groups are at increased risk of COVID-19 related mortality or morbidity yet continue to have a disproportionally lower uptake of the vaccine. The importance of adherence to prevention and control measures to keep vulnerable populations and their families safe therefore remains crucial. This research sought to examine the knowledge, perceived risk, and attitudes toward COVID-19 among an ethnically diverse community. Methods: A cross-sectional self-administered questionnaire was implemented to survey ethnic minority participants purposefully recruited from Luton, an ethnically diverse town in the southeast of England. The questionnaire was structured to assess participants knowledge, perceived risk, attitudes toward protective measures as well as the sources of information about COVID-19. The questionnaire was administered online via Qualtrics with the link shared through social media platforms such as Facebook, Twitter, and WhatsApp. Questionnaires were also printed into brochures and disseminated via community researchers and community links to individuals alongside religious, community and outreach organisations. Data were analysed using appropriate statistical techniques, with the significance threshold for all analyses assumed at p = 0.05. Findings: 1,058 participants (634; 60% females) with a median age of 38 (IQR, 22) completed the survey. National TV and social networks were the most frequently accessed sources of COVID-19 related information; however, healthcare professionals, whilst not widely accessed, were viewed as the most trusted. Knowledge of transmission routes and perceived susceptibility were significant predictors of attitudes toward health-protective practises. Conclusion/recommendation: Improving the local information provision, including using tailored communication strategies that draw on trusted sources, including healthcare professionals, could facilitate understanding of risk and promote adherence to health-protective actions.


Subject(s)
COVID-19 , Female , Humans , Male , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Ethnic and Racial Minorities , Ethnicity , Minority Groups , Health Knowledge, Attitudes, Practice , United Kingdom
11.
12.
BMJ Open Gastroenterol ; 10(1)2023 Jan.
Article in English | MEDLINE | ID: mdl-36717154

ABSTRACT

OBJECTIVE: Mathematical models have gained traction when estimating cases of foodborne illness. Model structures vary due to differences in data availability. This begs the question as to whether differences in foodborne illness rates internationally are real or due to differences in modelling approaches.Difficulties in comparing illness rates have come into focus with COVID-19 infection rates being contrasted between countries. Furthermore, with post-EU Exit trade talks ongoing, being able to understand and compare foodborne illness rates internationally is a vital part of risk assessments related to trade in food commodities. DESIGN: We compared foodborne illness estimates for the United Kingdom (UK) with those from Australia, Canada and the USA. We then undertook sensitivity analysis, by recreating the mathematical models used in each country, to understand the impact of some of the key differences in approach and to enable more like-for-like comparisons. RESULTS: Published estimates of overall foodborne illness rates in the UK were lower than the other countries. However, when UK estimates were adjusted to a more like-for-like approach to the other countries, differences were smaller and often had overlapping credible intervals. When comparing rates by specific pathogens, there were fewer differences between countries. The few large differences found, such as virus rates in Canada, could at least partly be traced to methodological differences. CONCLUSION: Foodborne illness estimation models are country specific, making international comparisons problematic. Some of the disparities in estimated rates between countries can be shown to be attributed to differences in methodology rather than real differences in risk.


Subject(s)
COVID-19 , Foodborne Diseases , Humans , COVID-19/epidemiology , Foodborne Diseases/epidemiology , Canada/epidemiology , Australia/epidemiology , United Kingdom/epidemiology
13.
Br J Hosp Med (Lond) ; 84(1): 1-9, 2023 Jan 02.
Article in English | MEDLINE | ID: mdl-36708341

ABSTRACT

BACKGROUND/AIMS: Since the COVID-19 pandemic began, training and education have been significantly disrupted, causing an incalculable effect on trainees. However, the consultant workforce is crucial to the success of training recovery. The motivation of the consultant workforce to assist in training recovery, in a context of significant workload and increasing pressures on resources, is currently unknown. METHODS: This survey gathered the consultant workforce's views on assisting training recovery at one site of a large NHS foundation trust. RESULTS: There was reduced motivation to engage in training and education when compared to pre-pandemic levels, widespread indicators of burnout, and changes in attitude towards reducing their working hours and early retirement. CONCLUSIONS: These findings demonstrate a worrying trend that is likely to be replicated nationwide, which highlights the need to support consultants to avoid further disruption to training recovery.


Subject(s)
COVID-19 , Consultants , Humans , Pandemics , Workforce , United Kingdom
14.
Br J Hosp Med (Lond) ; 84(1): 1-7, 2023 Jan 02.
Article in English | MEDLINE | ID: mdl-36708340

ABSTRACT

Clubfoot is one of the most common congenital anomalies, affecting every 1 of 1000 live births in the UK. Historically, clubfeet have been managed with a variety of conservative and operative techniques. Over the last two decades, the Ponseti serial casting method has become the gold standard of treatment. In July 2021, the British Society of Children's Orthopaedic Surgery (Gelfer et al, 2022) published a consensus statement that outlines the optimal management for clubfoot. This article provides an overview of clubfoot and a summary of the latest management guidelines.


Subject(s)
Clubfoot , Orthopedic Procedures , Child , Humans , Infant , Clubfoot/surgery , Treatment Outcome , Casts, Surgical , Orthopedic Procedures/methods , United Kingdom
15.
Br Dent J ; 234(2): 78, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36707562

Subject(s)
Dentists , Humans , United Kingdom
17.
BMC Public Health ; 23(1): 178, 2023 Jan 27.
Article in English | MEDLINE | ID: mdl-36703163

ABSTRACT

Indicative evidence suggests that minoritised ethnic groups have higher risk of developing multiple long-term conditions (MLTCs), and do so earlier than the majority white population. While there is evidence on ethnic inequalities in single health conditions and comorbidities, no review has attempted to look across these from a MLTCs perspective. As such, we currently have an incomplete understanding of the extent of ethnic inequalities in the prevalence of MLTCs. Further, concerns have been raised about variations in the way ethnicity is operationalised and how this impedes our understanding of health inequalities. In this systematic review we aimed to 1) describe the literature that provides evidence of ethnicity and prevalence of MLTCs amongst people living in the UK, 2) summarise the prevalence estimates of MLTCs across ethnic groups and 3) to assess the ways in which ethnicity is conceptualised and operationalised. We focus on the state of the evidence prior to, and during the very early stages of the pandemic. We registered the protocol on PROSPERO (CRD42020218061). Between October and December 2020, we searched ASSIA, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed, ScienceDirect, Scopus, Web of Science, OpenGrey, and reference lists of key studies/reviews. The main outcome was prevalence estimates for MLTCs for at least one minoritised ethnic group, compared to the majority white population. We included studies conducted in the UK reporting on ethnicity and prevalence of MLTCs. To summarise the prevalence estimates of MLTCs across ethnic groups we included only studies of MLTCs that provided estimates adjusted at least for age. Two reviewers screened and extracted data from a random sample of studies (10%). Data were synthesised using narrative synthesis. Of the 7949 studies identified, 84 met criteria for inclusion. Of these, seven contributed to the evidence of ethnic inequalities in MLTCs. Five of the seven studies point to higher prevalence of MLTCs in at least one minoritised ethnic group compared to their white counterparts. Because the number/types of health conditions varied between studies and some ethnic populations were aggregated or omitted, the findings may not accurately reflect the true level of ethnic inequality. Future research should consider key explanatory factors, including those at the macrolevel (e.g. racism, discrimination), as they may play a role in the development and severity of MLTCs in different ethnic groups. Research is also needed to ascertain the extent to which the COVID19 pandemic has exacerbated these inequalities.


Subject(s)
COVID-19 , Humans , United Kingdom/epidemiology , Ethnicity , Narration , Research Design
18.
Br J Gen Pract ; 73(727): 74-75, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36702590
19.
BMJ ; 380: 191, 2023 01 26.
Article in English | MEDLINE | ID: mdl-36702482
20.
BMJ ; 380: 193, 2023 01 26.
Article in English | MEDLINE | ID: mdl-36702487
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