Potential influences on suicide prevalence in comparisons of UK post-industrial cities

No abstract available

Malaria transmission in the vicinity of impounded water: evidence from the Koka Reservoir, Ethiopia

Malaria / Waterborne diseases / Disease vectors / Habitats / Disease control / Entomology / Epidemiology / Surveys / Dams / Reservoirs / Villages / Case studies / Africa / Ethiopia / Koka Reservoir / Rift Valley / Awash River Basin

Visualising and quantifying 'excess deaths' in Scotland compared with the rest of the UK and the rest of Western Europe

BACKGROUND: Scotland has higher mortality rates than the rest of Western Europe (rWE), with more cardiovascular disease and cancer among older adults; and alcohol-related and drug-related deaths, suicide and violence among younger adults. METHODS: We obtained sex, age-specific and year-specific all-cause mortality rates for Scotland and other populations, and explored differences in mortality both visually and numerically. RESULTS: Scotland's age-specific mortality was higher than the rest of the UK (rUK) since 1950, and has increased. Between the 1950s and 2000s, 'excess deaths' by age 80 per 100 000 population associated with living in Scotland grew from 4341 to 7203 compared with rUK, and from 4132 to 8828 compared with rWE. UK-wide mortality risk compared with rWE also increased, from 240 'excess deaths' in the 1950s to 2320 in the 2000s. Cohorts born in the 1940s and 1950s throughout the UK including Scotland had lower mortality risk than comparable rWE populations, especially for males. Mortality rates were higher in Scotland than rUK and rWE among younger adults from the 1990s onwards suggesting an age-period interaction. CONCLUSIONS: Worsening mortality among young adults in the past 30 years reversed a relative advantage evident for those born between 1950 and 1960. Compared with rWE, Scotland and rUK have followed similar trends but Scotland has started from a worse position and had worse working age-period effects in the 1990s and 2000s

Destination image in travel magazines: A textual and pictorial analysis of Hong Kong and Macau

Based on the analyses of texts and pictures in the top six outbound travel magazines in Mainland China, this article presents an evaluation of the destination images of Hong Kong and Macau as portrayed in 88 travel articles over a three-year period. The results showed that the projected destination images of Hong Kong and Macau were dominated by attributes related to culture, history, and art and leisure and recreation. Hong Kong was often described by image attributes such as places and attractions, shopping, cuisine and food, hotels, and the creative industries. For Macau, history and heritage, places and attractions, gambling, cuisine and food, and hotels were the most often reported. During the study period, Hong Kong and Macau witnessed several significant changes in the image attributes featured in both texts and pictures. These changes were partly influenced by news and events over the period. In this article, implications for destination marketing organizations and directions for future research were suggested

How can socioeconomic inequalities in hospital admissions be explained? A cohort study

Objectives To investigate which antecedent risk factors can explain the social patterning in hospital use. Design Prospective cohort study with up to 37 years of follow-up. Setting Representative community sample in the West of Scotland. Participants 7049 men and 8353 women aged 45–64 years were recruited into the study from the general population between 1972 and 1976 (78% of the eligible population). Primary and secondary outcome measures Hospital admissions and bed days by cause and by classification into emergency or non-emergency. Results All-cause hospital admission rate ratios (RRs) were not obviously socially patterned for women (RR 1.04, 95% CI 0.98 to 1.10) or men (RR 1.0, 95% CI 0.94 to 1.06) in social classes IV and V compared with social classes I and II. However, cardiovascular disease, coronary heart disease and stroke in women, and respiratory disease for men and women were socially patterned, although this attenuated markedly with the addition of baseline risk factors. Hospital bed days were generally socially patterned and the differences were largely explained by baseline risk factors. The overall RRs of mental health admissions in contrast were socially patterned for women (RR 1.77, 95% CI 1.38 to 2.27) and men (RR 1.51, 95% CI 1.11 to 2.06) in social classes IV and V compared with social classes I and II, but the pattern did not attenuate with the addition of baseline risk factors. Emergency hospital admissions were associated with lower social class, but there was an inverse relationship for non-emergency hospital admissions. Conclusions Overall admissions to hospital were only marginally socially patterned, and less than would be expected on the basis of the gradient in baseline risk. However, there was marked social patterning in admissions for mental health problems. Non-emergency hospital admissions were patterned inversely according to risk. Further work is required to explain and address this inequitable gradient in healthcare use. </p

Optimisation of Vitamin D Status for Enhanced Immuno-protection Against Covid-19

Abstract Background Vitamin D deficiency (serum 25(OH)D\u3c50nmol/l) is common in Ireland, particularly amongst older adults, hospital inpatients and nursing home residents. Vitamin D deficiency is associated with increased risk of acute viral respiratory infection and community acquired pneumonia, with several molecular mechanisms proposed to explain this association. Vitamin D supplementation has also been shown to reduce the risk of respiratory infection. Vitamin D and Covid-19 Correction of vitamin D deficiency is thought to suppress CD26, a putative adhesion molecule for Covid-19 host cell invasion. Vitamin D may also attenuate interferon gamma (IFNγ) and interleukin-6 (IL-6) inflammatory responses, both potent predictors of poorer outcome in critically-ill ventilated patients including those with Covid-19. Vitamin D Requirements Irish adults require 25-30μg/d of vitamin D3, an intake not achievable by diet alone, to reliably maintain serum 25(OH)D levels \u3e50nmol/l. Supplementation with doses up to 100μg/d has been shown to be safe for adults, and many agencies and expert groups now advocate supplementation in older adults, albeit at lower levels than this. Conclusions and Recommendations Vitamin D deficiency is common and may contribute to increased risk of respiratory infection including Covid-19. We recommend that all older adults, hospital inpatients, nursing home residents and other vulnerable groups (e.g. those with diabetes mellitus or compromised immune function, those with darker skin, vegetarians and vegans, those who are overweight or obese, smokers and healthcare workers) be urgently supplemented with 20-50μg/d of vitamin D to enhance their resistance to Covid-19, and that this advice be quickly extended to the general adult population

Use of record-linkage to handle non-response and improve alcohol consumption estimates in health survey data: a study protocol

&lt;p&gt;Introduction: Reliable estimates of health-related behaviours, such as levels of alcohol consumption in the population, are required to formulate and evaluate policies. National surveys provide such data; validity depends on generalisability, but this is threatened by declining response levels. Attempts to address bias arising from non-response are typically limited to survey weights based on sociodemographic characteristics, which do not capture differential health and related behaviours within categories. This project aims to explore and address non-response bias in health surveys with a focus on alcohol consumption.&lt;/p&gt; &lt;p&gt;Methods and analysis: The Scottish Health Surveys (SHeS) aim to provide estimates representative of the Scottish population living in private households. Survey data of consenting participants (92% of the achieved sample) have been record-linked to routine hospital admission (Scottish Morbidity Records (SMR)) and mortality (from National Records of Scotland (NRS)) data for surveys conducted in 1995, 1998, 2003, 2008, 2009 and 2010 (total adult sample size around 40 000), with maximum follow-up of 16 years. Also available are census information and SMR/NRS data for the general population. Comparisons of alcohol-related mortality and hospital admission rates in the linked SHeS-SMR/NRS with those in the general population will be made. Survey data will be augmented by quantification of differences to refine alcohol consumption estimates through the application of multiple imputation or inverse probability weighting. The resulting corrected estimates of population alcohol consumption will enable superior policy evaluation. An advanced weighting procedure will be developed for wider use.&lt;/p&gt; &lt;p&gt;Ethics and dissemination: Ethics approval for SHeS has been given by the National Health Service (NHS) Multi-Centre Research Ethics Committee and use of linked data has been approved by the Privacy Advisory Committee to the Board of NHS National Services Scotland and Registrar General. Funding has been granted by the MRC. The outputs will include four or five public health and statistical methodological international journal and conference papers.&lt;/p&gt

Centrifuge permeameter for unsaturated soils system

The present invention includes an apparatus, method and centrifuge permeameter system that includes a hydraulic permeameter adapted for use in a centrifuge; and an automated data acquisition system, wherein the centrifuge permeameter non-destructively determines one or more soil characteristics from a sample of granular material such as soil, rock, and concrete when centrifuged.Board of Regents, University of Texas Syste

Challenges in evaluating Welfare to Work policy interventions: Would an RCT design have been the answer to all our problems?

&lt;p&gt;Background: UK policy direction for recipients of unemployment and sickness benefits is to support these people into employment by increasing 'into work' interventions. Although the main aim of associated interventions is to increase levels of employment, improved health is stated as a benefit, and a driver of these interventions. This is therefore a potentially important policy intervention with respect to health and health inequalities, and needs to be validated through rigorous impact evaluation.&lt;/p&gt; &lt;p&gt;We attempted to evaluate the Pathways Advisory Service intervention which aims to provide employment support for Incapacity Benefit recipients, but encountered a number of challenges and barriers to evaluation. This paper explores the issues that arose in designing a suitable evaluation of the Pathways Advisory Service.&lt;/p&gt; &lt;p&gt;Discussion: The main issues that arose were that characteristics of the intervention lead to difficulties in defining a suitable comparison group; and governance restrictions such as uncertainty regarding ethical consent processes and data sharing between agencies for research. Some of these challenges threatened fundamentally to limit the validity of any experimental or quasi-experimental evaluation we could design - restricting recruitment, data collection and identification of an appropriate comparison group. Although a cluster randomised controlled trial design was ethically justified to evaluate the Pathways Advisory Service, this was not possible because the intervention was already being widely implemented. However, this would not have solved other barriers to evaluation. There is no obvious method to perform a controlled evaluation for interventions where only a small proportion of those eligible are exposed. Improved communication between policymakers and researchers, clarification of data sharing protocols and improved guidelines for ethics committees are tangible ways which may reduce the current obstacles to this and other similar evaluations of policy interventions which tackle key determinants of health.&lt;/p&gt; &lt;p&gt;Summary: The evaluation of social interventions is hampered by more than their suitability to randomisation. Data sharing, participant identification and recruitment problems are common to randomised and non-randomised evaluation designs. These issues require further attention if we are to learn from current social policy.&lt;/p&gt