Suicides among construction occupations in the UK

Studies on mental health are increasingly complementing those on safety and physical health within the construction research community, with suicide numbers being an indicative measure of mental health. In the UK, deaths by suicide are approximately 470 per year, which dwarfs fatal accident numbers. The aim of this paper is to review the evidence base about suicide and construction workers. The methods consisted of two approaches: combining secondary data from UK statistical databases to create a suicide rate per 100,000 for construction occupations; and a systematic literature review to help explain the suicide rates observed. Trend analysis of suicide rates, from 2015 to 2021 shows construction occupations to be approximately three times that of the combined non-construction occupations, and steadily rising, whereas non-construction rates have remained relatively steady. Unskilled workers have the highest rate, around seven times managers and professional occupations. Potential reasons for this, found in the literature, included managers/professionals’ greater propensity to shift beliefs about suicide stigmas, and skilled workers being more likely to report substance abuse; - rather than hide it, thereby increasing opportunities to discuss and resolve such issues to reduce suicide risk. However, the socio-economic risk associated with unskilled workers means being poor is certainly not good for their mental health. The analysis presented in this paper informs industry policy and practice by uncovering a previously unknown upward trend in suicide rates among UK construction workers, along with a focused list of evidence-based factors to inform further research on why this phenomenon is occurring.</p

Regional Transportation and Land Use Decision Making in Metropolitan Regions: Findings from Four Case Studies

Throughout the United States, metropolitan regions face increasingly complex issues related to transportation and land use. The diffuse nature of decision making creates a need to better coordinate land use and transportation to address issues such as: congestion, infrastructure costs, and greenhouse gas emissions. Key players in this decision making are regional metropolitan planning organizations (MPOs) with transportation planning authority, regional planning responsibilities, and in some cases regional land use planning authority. The goal of this study was to describe and assess efforts by regional agencies to coordinate land use and transportation. Policies and processes in four key topic areas were examined: 1) Governance: formal and informal decision making approaches; 2) Coordination: strategies used to coordinate land use and transportation; 3) Growth Centers: policies to encourage development in higher density centers; and 4) Transportation Improvement Program (TIP): policies to incorporate smart growth criteria in TIP funding decisions

Suicides among Construction Occupations in the UK

Studies on mental health are increasingly complementing those on safety and physical health within the construction research community, with suicide numbers being an indicative measure of mental health. In the UK, deaths by suicide are approximately 470 per year, which dwarfs fatal accident numbers. The aim of this paper is to review the evidence base about suicide and construction workers. The methods consisted of two approaches: combining secondary data from UK statistical databases to create a suicide rate per 100,000 for construction occupations; and a systematic literature review to help explain the suicide rates observed. Trend analysis of suicide rates, from 2015 to 2021 shows construction occupations to be approximately three times that of the combined non-construction occupations, and steadily rising, whereas non-construction rates have remained relatively steady. Unskilled workers have the highest rate, around seven times managers and professional occupations. Potential reasons for this, found in the literature, included managers/professionals’ greater propensity to shift beliefs about suicide stigmas, and skilled workers being more likely to report substance abuse; - rather than hide it, thereby increasing opportunities to discuss and resolve such issues to reduce suicide risk. However, the socio-economic risk associated with unskilled workers means being poor is certainly not good for their mental health. The analysis presented in this paper informs industry policy and practice by uncovering a previously unknown upward trend in suicide rates among UK construction workers, along with a focused list of evidence-based factors to inform further research on why this phenomenon is occurring

Metropolitan smart growth centers: An assessment of incentive policies in four regions

JTLU vol. 6, no. 2, pp 21-32 (2013)Across the United States, metropolitan areas face challenges related to transportation and land use. An emerging policy in many regions is to promote development around higher-density, mixed-use (smart-growth) centers that create locally accessible nodes; many of these nodes are also linked to transit stops. Some metropolitan planning organizations (MPOs) have developed regional plans and incentive programs to encourage local governments to develop these centers. Incentives include grants as well as funding criteria in transportation improvement programs (TIP) that favor projects supporting centers. This paper assesses these policies as they have been applied in: (1) Puget Sound, Washington; (2) Portland, Oregon; (3) Denver, Colorado; and (4) San Diego, California. For the four regions we reviewed documents, conducted 40 interviews with key individuals, administered an online survey of 450 experts (response rate = 44 percent), and held a two-day forum involving 40 participants. We found that incentive policies by themselves were having a limited impact because they are new and offer small amounts of funding relative to local government needs and market forces. However, when incentives are combined with plans, policies, and transit investment, they provide a significant foundation for promoting growth around centers. There are a number of ways these policies can be improved, and many policies are transferable to other metropolitan regions

The Politics of Environmental Dispute Resolution

Also PCMA Working Paper #17.http://deepblue.lib.umich.edu/bitstream/2027.42/51148/1/380.pd

Clinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic Medicine

Despite rapid technical progress and demonstrable effectiveness for some types of diagnosis and therapy, much remains to be learned about clinical genome and exome sequencing (CGES) and its role within the practice of medicine. The Clinical Sequencing Exploratory Research (CSER) consortium includes 18 extramural research projects, one National Human Genome Research Institute (NHGRI) intramural project, and a coordinating center funded by the NHGRI and National Cancer Institute. The consortium is exploring analytic and clinical validity and utility, as well as the ethical, legal, and social implications of sequencing via multidisciplinary approaches; it has thus far recruited 5,577 participants across a spectrum of symptomatic and healthy children and adults by utilizing both germline and cancer sequencing. The CSER consortium is analyzing data and creating publically available procedures and tools related to participant preferences and consent, variant classification, disclosure and management of primary and secondary findings, health outcomes, and integration with electronic health records. Future research directions will refine measures of clinical utility of CGES in both germline and somatic testing, evaluate the use of CGES for screening in healthy individuals, explore the penetrance of pathogenic variants through extensive phenotyping, reduce discordances in public databases of genes and variants, examine social and ethnic disparities in the provision of genomics services, explore regulatory issues, and estimate the value and downstream costs of sequencing. The CSER consortium has established a shared community of research sites by using diverse approaches to pursue the evidence-based development of best practices in genomic medicine

Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission

Abstract Admission procalcitonin measurements and microbiology results were available for 1040 hospitalized adults with coronavirus disease 2019 (from 48 902 included in the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterisation Protocol UK study). Although procalcitonin was higher in bacterial coinfection, this was neither clinically significant (median [IQR], 0.33 [0.11–1.70] ng/mL vs 0.24 [0.10–0.90] ng/mL) nor diagnostically useful (area under the receiver operating characteristic curve, 0.56 [95% confidence interval, .51–.60]).</jats:p

Implementation of corticosteroids in treating COVID-19 in the ISARIC WHO Clinical Characterisation Protocol UK:prospective observational cohort study

BACKGROUND: Dexamethasone was the first intervention proven to reduce mortality in patients with COVID-19 being treated in hospital. We aimed to evaluate the adoption of corticosteroids in the treatment of COVID-19 in the UK after the RECOVERY trial publication on June 16, 2020, and to identify discrepancies in care. METHODS: We did an audit of clinical implementation of corticosteroids in a prospective, observational, cohort study in 237 UK acute care hospitals between March 16, 2020, and April 14, 2021, restricted to patients aged 18 years or older with proven or high likelihood of COVID-19, who received supplementary oxygen. The primary outcome was administration of dexamethasone, prednisolone, hydrocortisone, or methylprednisolone. This study is registered with ISRCTN, ISRCTN66726260. FINDINGS: Between June 17, 2020, and April 14, 2021, 47 795 (75·2%) of 63 525 of patients on supplementary oxygen received corticosteroids, higher among patients requiring critical care than in those who received ward care (11 185 [86·6%] of 12 909 vs 36 415 [72·4%] of 50 278). Patients 50 years or older were significantly less likely to receive corticosteroids than those younger than 50 years (adjusted odds ratio 0·79 [95% CI 0·70–0·89], p=0·0001, for 70–79 years; 0·52 [0·46–0·58], p80 years), independent of patient demographics and illness severity. 84 (54·2%) of 155 pregnant women received corticosteroids. Rates of corticosteroid administration increased from 27·5% in the week before June 16, 2020, to 75–80% in January, 2021. INTERPRETATION: Implementation of corticosteroids into clinical practice in the UK for patients with COVID-19 has been successful, but not universal. Patients older than 70 years, independent of illness severity, chronic neurological disease, and dementia, were less likely to receive corticosteroids than those who were younger, as were pregnant women. This could reflect appropriate clinical decision making, but the possibility of inequitable access to life-saving care should be considered. FUNDING: UK National Institute for Health Research and UK Medical Research Council