Personal exposure to static and time-varying magnetic fields during MRI procedures in clinical practice in the UK

Background: MRI has developed into one of the most important medical diagnostic imaging modalities, but it exposes staff to static magnetic fields (SMF) when present in the vicinity of the MR system, and to radiofrequency and switched gradient electromagnetic fields if they are present during image acquisition. We measured exposure to SMF and motion-induced time-varying magnetic fields (TVMF) in MRI staff in clinical practice in the UK to enable extensive assessment of personal exposure levels and variability, which enables comparison to other countries. Methods: 8 MRI facilities across National Health Service sites in England, Wales and Scotland were included, and staff randomly selected during the days when measurements were performed were invited to wear a personal MRI-compatible dosimeter and keep a diary to record all procedures and tasks performed during the measured shift. Results: 98 participants, primarily radiographers (71%) but also other healthcare staff, anaesthetists and other medical staff were included, resulting in 149 measurements. Average geometric mean peak SMF and TVMF exposures were 448 mT (range 20–2891) and 1083 mT/s (9–12 355 mT/s), and were highest for radiographers (GM=559 mT and GM=734 mT/s). Time-weighted exposures to SMF and TVMF (GM=16 mT (range 5–64) and GM=14 mT/s (range 9–105)) and exposed-time-weighted exposures to SMF and TVMF (GM=27 mT (range 11–89) and GM=17 mT/s (range 9–124)) were overall relative low—primarily because staff were not in the MRI suite for most of their shifts—and did not differ significantly between occupations. Conclusions: These results are comparable to the few data available from the UK but they differ from recent data collected in the Netherlands, indicating that UK staff are exposed for shorter periods but to higher levels. These data indicate that exposure to SMF and TVMF from MRI scanners cannot be extrapolated across countries

Association between cigarette smoking status and voting intentions: Cross sectional surveys in England 2015-2020

Background and aims: Cigarette smoking takes place within a cultural and social context. Political views and practices are an important part of that context. To gain a better understanding of smoking, it may be helpful to understand its association with voting patterns as an expression of the political views and practices of the population who smoke. This study aimed to assess the association between cigarette smoking and voting intentions and to examine how far any association can be explained by sociodemographic factors and alcohol use. Methods: Pooled monthly representative repeat cross-sectional household surveys of adults (16+) in England (N = 55,482) between 2015 and 2020 were used to assess the association between cigarette smoking status and voting intentions, and whether this was accounted for by age, occupational grade, gender, region and alcohol use. Voting intention was measured by asking ‘How would you vote if there were a General Election tomorrow?’ Respondents chose from a list of the major English political parties or indicated their intention not to vote. Results: In adjusted multinomial regression, compared with intending to vote Conservative (majority party of government during the period), being undecided (aOR1.22 [1.13-1.33] <0.001), intending to vote Labour (aOR1.27 [1.16-1.36] <0.001), to vote “Other” (aOR1.54 [1.37-1.72] <0.001), or not to vote (aOR1.93 [1.77-2.11] <0.001) was associated with higher odds of current relative to never smoking rates. Intending to vote for the Liberal Democrats was associated with a significant lower odds of current smoking prevalence (aOR0.80 [0.70-0.91] <0.001) compared with intending to vote Conservative. Conclusions: Controlling for a range of other factors, current as compared with never-smokers appear more likely to intend not to vote, to be undecided, to vote for Labour or a non-mainstream party, and less likely to vote for the Liberal Democrats, compared with the Conservative party

Effect of heuristics on serendipity in path-based storytelling with linked data

Path-based storytelling with Linked Data on the Web provides users the ability to discover concepts in an entertaining and educational way. Given a query context, many state-of-the-art pathfinding approaches aim at telling a story that coincides with the user's expectations by investigating paths over Linked Data on the Web. By taking into account serendipity in storytelling, we aim at improving and tailoring existing approaches towards better fitting user expectations so that users are able to discover interesting knowledge without feeling unsure or even lost in the story facts. To this end, we propose to optimize the link estimation between - and the selection of facts in a story by increasing the consistency and relevancy of links between facts through additional domain delineation and refinement steps. In order to address multiple aspects of serendipity, we propose and investigate combinations of weights and heuristics in paths forming the essential building blocks for each story. Our experimental findings with stories based on DBpedia indicate the improvements when applying the optimized algorithm

Testing the impact of local alcohol licencing policies on reported crime rates in England.

BACKGROUND: Excessive alcohol use contributes to public nuisance, antisocial behaviour, and domestic, interpersonal and sexual violence. We test whether licencing policies aimed at restricting its spatial and/or temporal availability, including cumulative impact zones, are associated with reductions in alcohol-related crime. METHODS: Reported crimes at English lower tier local authority (LTLA) level were used to calculate the rates of reported crimes including alcohol-attributable rates of sexual offences and violence against a person, and public order offences. Financial fraud was included as a control crime not directly associated with alcohol abuse. Each area was classified as to its cumulative licensing policy intensity for 2009-2015 and categorised as 'passive', low, medium or high. Crime rates adjusted for area deprivation, outlet density, alcohol-related hospital admissions and population size at baseline were analysed using hierarchical (log-rate) growth modelling. RESULTS: 284 of 326 LTLAs could be linked and had complete data. From 2009 to 2013 alcohol-related violent and sexual crimes and public order offences rates declined faster in areas with more 'intense' policies (about 1.2, 0.10 and 1.7 per 1000 people compared with 0.6, 0.01 and 1.0 per 1000 people in 'passive' areas, respectively). Post-2013, the recorded rates increased again. No trends were observed for financial fraud. CONCLUSIONS: Local areas in England with more intense alcohol licensing policies had a stronger decline in rates of violent crimes, sexual crimes and public order offences in the period up to 2013 of the order of 4-6% greater compared with areas where these policies were not in place, but not thereafter

Assessing the contribution of alcohol-specific causes to socio-economic inequalities in mortality in England and Wales 2001-16

Background and Aims When measuring inequalities in health, public health and addiction research has tended to focus on differences in average life‐span between socio‐economic groups. This does not account for the extent to which age of death varies between individuals within socio‐economic groups or whether this variation differs between groups. This study assesses (1) socio‐economic inequalities in both average life‐span and variation in age at death, (2) the extent to which these inequalities can be attributed to alcohol‐specific causes (i.e. those attributable only to alcohol) and (3) how this contribution has changed over time. Design Cause‐deleted life table analysis of national mortality records. Setting England and Wales, 2001–16. Cases All‐cause and alcohol‐specific deaths for all adults aged 18+, stratified by sex, age and quintiles of the index of multiple deprivation (IMD). Measurements Life expectancy at age 18 yearss and standard deviation in age at death within IMD quintiles and the contribution of alcohol to overall differences in both measures between the highest and lowest IMD quintiles by comparing observed and cause‐deleted inequality ‘gaps’. Findings In 2016, alcohol‐specific causes reduced life expectancy for men and women by 0.26 and 0.14 years, respectively, and increased the standard deviation in age at death. These causes also increased the inequality gap in life expectancy by 0.33 years for men and 0.17 years for women, and variation in age at death by 0.14 years and 0.13 years, respectively. For both measures, the contribution of alcohol to mortality inequalities rose after 2001 and subsequently fell back. For women, alcohol accounted for 3.6% of inequality in age at death and 6.0% of life‐span uncertainty, suggesting that using only the former may underestimate alcohol‐induced inequalities. There was no comparable difference for men. Conclusions Deaths from alcohol‐specific causes increase inequalities in both life expectancy and variation in age of death between socio‐economic groups. Using both measures can provide a fuller picture of overall inequalities in health

Personalised digital interventions for reducing hazardous and harmful alcohol consumption in community-dwelling populations

This is the protocol for a review and there is no abstract. The objectives are as follows: The main objective is to assess the effectiveness and cost effectiveness of digital interventions for reducing hazardous and harmful alcohol consumption and/or alcohol-related problems in community-dwelling populations. We envisage two comparator groups: (1) no intervention (or minimal input) controls; and (2) another active intervention for delivering preventive advice or counselling to reduce hazardous or harmful alcohol consumption. Specifically, we will address two questions: (1) Are digital interventions superior to no intervention (or minimal input) controls? This question is important for individuals accessing interventions through their own motivation or interest. These individuals will be unlikely to experience active practitioner input and it is important to understand whether digital interventions are better than general material they might seek out on the internet or via mobile phone-based apps etc. (2) Are digital interventions at least equally effective as face-to-face brief alcohol interventions? Practitioner delivered brief interventions are generally accepted to be the best alternative in secondary preventive care in health, workplace, educational or community settings. However, time constraints can impede face-to-face delivery of such interventions and it is important to know whether digitally provided input can yield comparable effects to interventions delivered by trained practitioners. We will also identify the most effective component behaviour change techniques of such interventions and their mechanisms of action. Secondary objectives are as follows: 1.To assess whether outcomes differ between trials where the digital intervention targets participants attending health, social care, education or other community-based settings and those where it is offered remotely via the internet or mobile phone platforms; 2.To develop a taxonomy of interventions according to their mode of delivery (e.g. functionality features) and assess their impact on outcomes; 3.To identify theories or models that have been used in the development and/or evaluation of the intervention – this will inform intervention development work

Reweighting national survey data for small area behaviour estimates : modelling alcohol consumption in local authorities in England

Background There are likely to be differences in alcohol consumption levels and patterns across local areas within a country, yet survey data is often collected at the national or sub-national/regional level and is not representative for small geographic areas. Methods This paper presents a method for reweighting national survey data—the Health Survey for England—by combining survey and routine data to produce simulated locally representative survey data and provide statistics of alcohol consumption for each Local Authority in England. Results We find a 2-fold difference in estimated mean alcohol consumption between the lightest and heaviest drinking Local Authorities, a 4.5-fold difference in abstention rates, and a 3.5-fold difference in harmful drinking. The method compares well to direct estimates from the data at regional level. Conclusions The results have important policy implications in itself, but the reweighted data can also be used to model local policy effects. This method can also be used for other public health small area estimation where locally representative data are not available

Has the increased participation in the national campaign ‘Dry January’ been associated with cutting down alcohol consumption in England?

Aims Dry January is a national multimedia campaign in the UK that encourages people to abstain from drinking alcohol during the month of January. The population-level campaign makes extensive use of email and social media to support participants and has reported a substantial increase in participation since 2015. This study aimed to assess whether the increase in participation in Dry January between 2015 and 2018 was associated with reduced alcohol consumption in England. Design Repeat cross-sectional design. Setting England, March 2014 to January 2018. Participants A total of 37,142 respondents to the Alcohol Toolkit Study, a monthly in-home survey of alcohol consumption among representative cross-sectional samples of people aged 16+ years in England. Measures Outcomes included i) percentage of adults reporting drinking monthly or less frequently in the last 6 months and ii) mean weekly alcohol consumption among drinkers derived from the Alcohol Use Disorders Identification Test questions on typical frequency and quantity in the last 6 months. Analyses For each outcome, regression models were fitted for month: January (2015 and 2018) vs March-December (2014 and 2017) and for year: 2014/15 vs 2017/18. Interaction terms were included in the models to examine whether the difference between January and the preceding months on each outcome measure depended upon the year (2014/15 vs 2017/18). For non-significant interactions, Bayes factors were calculated to assess the relative strength of evidence for large effects (OR = 1.80 on monthly drinking and β=-1.0 on mean consumption) compared with the null. Results Differences between January and other months were similar in 2014/15 and 2017/18 for adults reporting drinking monthly or less frequently and the mean consumption among drinkers (OR = 0.91, 95 %CI 0.79–1.05, BF = 0.05; β = 0.55, 95 %CI=-0.14 to 1.25, BF = 0.13 respectively). Conclusions The increase in participation in Dry January between 2015 and 2018 was not associated with large corresponding changes in people drinking monthly or less frequently over the last 6 months, or in mean weekly consumption among drinkers

Study protocol for First Dental Steps Intervention: feasibility study of a health visitor led infant oral health improvement programme.

BACKGROUND: Dental caries in childhood is a burden on the daily lives of children and their families, and associated with poor oral health in adulthood. In England, dental caries is the most common reason for young children to be admitted to hospital. It is believed that most tooth extractions (due to decay) for children aged 10 years and under, could be avoided with improved prevention and early management. National public health policy recommendations in England include specific oral health initiatives to tackle tooth decay. One of these initiatives is delivered as part of the Healthy Child Programme and includes providing workforce training in oral health, integrating oral health advice into home visits, and the timely provision of fluoride toothpaste. This protocol seeks to assess the delivery of the First Dental Steps intervention and uncertainties related to the acceptability, recruitment, and retention of participants. METHODS: This study seeks to explore the feasibility and acceptability of the First Dental Steps intervention and research methods. First Dental Steps intervention will be delivered in local authority areas in South West England and includes oral health training for health visitors (or community nursery nurses) working with 0-5-year-olds and their families. Further, for vulnerable families, integrating oral health advice and the provision of an oral health pack (including a free flow cup, an age appropriate toothbrush, and 1450 ppm fluoride toothpaste) during a mandated check by a health visitor. In this study five local authority areas will receive the intervention. Interviews with parents receiving the intervention and health visitors delivering the intervention will be undertaken, along with a range of additional interviews with stakeholders from both intervention and comparison sites (four additional local authority areas). DISCUSSION: This protocol was written after the start of the COVID-19 pandemic, as a result, some of the original methods were adjusted specifically to account for disruptions caused by the pandemic. Results of this study will primarily provide evidence on the acceptability and feasibility of both the First Dental Steps intervention and the research methods from the perspective of both families and stakeholders