Search

The possible cause of disease and mortality in corvids on an outdoor pig unit in the north of England between August 2007 and March 2008 was investigated. Nine carrion crows (Corvus corone corone) and nine rooks (Corvus frugilegus), comprising five live-caught birds with clinical signs of respiratory disease, one live-caught bird without respiratory disease, and 12 birds submitted dead were examined. Clinical signs, gross and histopathological examination, microbiology and toxicology indicated that Pasteurella multocida infection was the cause of disease. Molecular and serotyping analyses showed that P. multocida isolates (obtained from live-caught birds with clinical respiratory disease) were all capsular type F with a mix of somatic serotypes 3, 4 and 7. Immunohistochemistry increased the diagnostic sensitivity of the analysis and detected P. multocida within the pulmonary lesions of all affected live-caught birds and 10 of 12 birds found dead. These findings suggest that wild corvids in the UK can suffer from lung pathology associated with P. multocida and, as potential vectors of P. multocida, may pose a risk to domestic poultry. [ABSTRACT FROM AUTHOR]

The current paper describes the use of fibre reinforced polymer (FRP) composites as primary structural members. In particular FRP composite bridge decks are discussed and the Asset project, which comprised the development of a FRP composite bridge deck system, is described in detail. The analysis, design and testing undertaken within the project are also discussed in detail. The culmination of the project, the reconstruction of West Mill Bridge in Oxfordshire, is described and conclusions made on the particular advantages of using FRP composites for bridge decks. [ABSTRACT FROM AUTHOR]

The intensity of vesicular-arbuscular mycorrhizal infection was assessed in the major vegetation types of east-central England. All of the most important species of grassland, scrub and woodland were mycorrhizal and each individual of any species normally carried a heavy VA infection. Members of the Gramineae were particularly heavily infected, In limestone grassland, infection extended to members of the Cyperaceae and Juncaceae. Infection levels were high throughout the year, the highest levels occurring in the most nutrient-stressed situations. Mycorrhiza develops soon after germination, often while seedlings are still in the cotyledon stage. Since numbers of viable Glomus type spores are low, infection is thought to arise from root to root contact rather than from spores. The ecological implications of the widespread infection are discussed. [ABSTRACT FROM AUTHOR]

Background: The BNT162b2 mRNA vaccine has been shown to be effective at preventing serious COVID-19 events in clinical trials. There is less evidence on effectiveness in real-world settings, especially for older people. Here, we aimed to estimate vaccine effectiveness in the context of the rapid NHS mass-vaccination programme in England, exploiting age-based vaccination eligibility thresholds to minimise and correct for selection bias., Methods: We studied 170,226 individuals between the ages of 80 and 83 years from community settings outside care homes who received one dose of BNT162b2 mRNA between the 15 and 20 December 2020 and were scheduled a second dose 21 days later. We matched these vaccine recipients to slightly younger (aged 76-79 years) persons not yet eligible to receive the vaccine on gender, area of residence, area deprivation, health status, living arrangements, acute illness, and history of seasonal flu vaccination. We compared their rates of COVID-19 positivity and hospitalisation in the subsequent 45 days. We adjusted for the increasing concentration of COVID-19 positivity in the control population caused by the requirement to have no COVID-19 symptoms prior to vaccination., Results: Emergency hospital admissions were 51.0% (95% confidence interval 19.9 to 69.5%) lower and positive COVID-19 tests were 55.2% (40.8 to 66.8%) lower for vaccinated individuals compared to matched controls 21 to 27 days after first vaccination. Emergency admissions were 75.6% (52.8 to 87.6%) lower, and positive COVID-19 tests were 70.1% (55.1 to 80.1%) lower 35 to 41 days after first vaccination when 79% of participants had received a second dose within 26 days of their first dose., Conclusions: Receipt of the BNT162b2 mRNA vaccine is effective at reducing COVID-19 hospitalisations and infections. The nationwide vaccination of older adults in England with the BNT162b2 mRNA vaccine reduced the burden of COVID-19., (© 2021. The Author(s).)

This article provides an overview of the various forms of appeal which are available within the English legal system. It discusses why appeals are necessary, what form they take and some of the fundamental aspects of the legal structures and principles which are applied by the judges. The criminal and civil appeal systems are separately outlined and the discretionary nature of further appeals explained. The place of statutory appeals from regulatory bodies is briefly indicated.

Background: The issue of missed appointments in primary care is important for patients and staff. Little is known about how missed appointments, and the people who miss them, are managed in primary care, or about effective strategies for managing missed appointments., Aims: To understand the perceptions of primary care staff as to why patients miss appointments, to determine how these perceptions influence their management, and to explore the merit of different management strategies., Design of Study: A postal questionnaire survey and focus group interviews., Setting: General practices in Yorkshire., Results: Missed appointments were regarded as an important problem. Patient factors rather than practice factors were perceived as most important in causing missed appointments. Intervention strategies appeared to be driven by perceptions of why patients miss appointments. Negative attitudes, embodied in terms such as "offenders" to refer to those who missed appointments were prevalent, and favoured intervention strategies included punishing the patient in some way. Receptionists believed that general practitioners should address the issue of the missed appointment with the patient. General practitioners felt guarded about addressing missed appointments with their patients in case it affected the doctor-patient relationship., Conclusion: People who miss appointments were viewed negatively by primary care staff, and most of the reasons for missed appointments were focused on patients. These beliefs underpinned intervention strategies aimed mainly at punishment. Since there is no evidence base concerning interventions that are effective in reducing missed appointments, these negative attitudes may not be beneficial to staff or their patients.

In 1993, a case-control study by the Health and Safety Executive (HSE) assessed the risk of leukaemia and non-Hodgkin's lymphoma (LNHL) among children of fathers employed at the Sellafield nuclear installation in relation to paternal preconceptional irradiation (PPI). It concluded that the statistical association between risk of LNHL and PPI was confined to children born in the village of Seascale, where the dose-response was extremely high and very significant. In contrast, in 2002, a Cumbrian birth cohort study, investigating largely the same cases, concluded that this statistical association was not significantly different among children born inside and outside Seascale and estimated the dose-response inside Seascale to be much lower. This review makes a detailed comparison of the two studies, considering their design, data and analyses. The differences between their findings are due to: (i) differences in the distribution of offspring-years which are differential with respect to dose category and Seascale birth status, (ii) a non-Seascale high-dose case included in the Cumbrian but not the HSE study, (iii) differences between analyses using categorical and continuous PPI dose and (iv) the presence of Seascale controls with PPI over 200 mSv in the Cumbrian but not the HSE study.

Background: The concern that maternal exposure to electromagnetic fields (EMF) might be related to childhood cancer risks, particularly leukemia risks., Methods: Maternal occupational data already collected as part of the Oxford Survey of Childhood Cancers have been reviewed. Information on occupations held before, during, and after the pregnancy was sought for 15,041 children dying of cancer in Great Britain in the period 1953-1981, and for an equal number of matched controls. Each period of working was classified under one of five headings: (1) sewing machinist; (2) textile industry workers (other than sewing machinists) with likely exposures to EMF; (3) other machinists and other jobs with likely "higher" EMF exposure; (4) other jobs with likely exposure to some EMF, and (5) jobs with little potential for EMF exposure., Results: Relative to risks in the children of mothers who held occupations with little potential for EMF exposure during pregnancy (a category that included housewives), risks of all childhood cancers were close to unity both for the children of sewing machinists (22 case and 31 control mothers, RR 0.72, 95% CI 0.42 to 1.25) and for the children of other machinists with likely "higher" EMF exposures (44 case and 47 control mothers, RR 0.93, 95% CI 0.61 to 1.41). Corresponding risks for all childhood leukemias and for all childhood brain cancers were similarly unexceptional. Simultaneous adjustment for social class, maternal age at birth of child, and sibship position had little effect., Conclusions: The study findings did not indicate that maternal occupational exposure to EMF during pregnancy is a risk factor for childhood leukemias, childhood brain cancers, or the generality of all childhood cancers.

A method to increase audiology referral after meningitis or meningococcal disease was audited in 89 children. A standardised proforma increased referrals from 78% to 96% over a two year period. However, only 73% of children had a hearing test. The major reason for hearing not being tested changed from non-referral to non-attendance.

The mortality patterns of United Kingdom tin miners were examined in relation to calendar period and duration of underground work with particular attention to lung cancer and exposure to radon. Subjects were all men who had worked for at least one year between 1941 and 1984 at one of two United Kingdom tin mines and for whom a complete work history could be constructed from mine records. Standardised mortality ratios (SMRs) were calculated using national (England and Wales) rates. The pattern of SMRs in relation to potential explanatory variables was analysed using Poisson regression methods. Mortalities from lung cancer and silicosis (including silicotuberculosis) were significantly raised and showed a significant relation with duration of underground work (mortality from stomach cancer was raised in both underground and surface workers, but not significantly). Excess mortality from silica related disease declined steeply from 35% among workers first exposed before 1920 to 1% among those first exposed after 1950. Thirteen surface workers with known exposure to arsenic had high rates of lung and stomach cancer. The SMR for lung cancer showed a consistent pattern in relation to duration of underground exposure, rising from 83 (observed/expected = 8/9.6) for surface workers (without exposure to arsenic) to 447 (15/3.4) for workers with more than 30 years underground exposure. Examination of the SMR for lung cancer by total underground exposure, age, and time since last exposure gave rise to a model for the expression of risk which depends only on total exposure and time since exposure. The fitted model implies that the effect of exposure to radon in a given year has no effect on risk for 10 years, then rapidly rises to a maximum from which the excess risk then declines, halving every 4.3 years. There were no direct measurements of historic radon levels. A conservative estimate based on measurements taken since 1969 by the National Radiological Protection Board and the Mines and Quarries Inspectorate is that the annual dose to an underground worker was about 10 working level months (WLM). Given this assumption, the risk/exposure slope implied by the present data, and the model fitted to it, was somewhat lower than that given in the fourth Committee on the Biological Effects of Ionisation Radiation (BEIR IV) report (about 40% lower for lifetime exposures). The present data also imply different risks depending on the age at exposure, with relatively higher lifetime risks for exposure at older ages, and relatively lower risks for exposures at younger ages. In conclusion, there was a clear relation between exposure to radon and death from lung cancer. The relative risk of lung cancer due to exposure to radon was not constant in cessation of exposure. The lifetime excess risk of lung cancer implied by these data for 40 years exposure at the current statutory limit of four WLM a year starting at age 20, was about 8% (79 excess deaths per 1000 exposed), assuming average smoking habits among the exposed workers. Control of dust concentrations in the mines has substantially reduced--and may have eliminated--direct mortality from silica related disease.

A national study of British asbestos workers is briefly described and the mortality experience of 31 150 male asbestos workers in England and Wales who had been medically examined at least once as part of that survey is presented. The survey population is divided into workers with occupational exposure to asbestos before the inception of the 1969 Asbestos Regulations and those who worked with asbestos only after 1969. Of the 1128 who had died, 897 had worked before 1969; 34 of the death certificates received for these men mentioned mesothelioma and for another nine asbestosis was reported in the absence of mesothelioma or lung cancer. A statistically significant excess of lung cancer (SMR 136) was found. For the post-1969 workers, one case of asbestosis and one case of mesothelioma were reported, but further investigation of these cases showed probable occupational exposure to asbestos many years before 1969. The time from first exposure for this section of the population is too short to exclude an excess of asbestos related disease. The most noticeable excess of asbestos related disease was seen among the insulation workers who had more than twice (SMR 256) the expected number of deaths from lung cancer, and for whom almost 10% of all death certificates mentioned mesothelioma. No excess of any alimentary tract cancer was found and the population showed a significant deficit of large bowel cancer mortality (SMR 54).

The mortality of 622 men who worked for at least one year in the production, polymerization, and processing of styrene at a chemical site in the United Kingdom during the period 1945-1974 was surveyed up to the end of 1978; 3 072 male manual workers at the same site but unexposed to styrene were also studied. A statistically significant excess of lymphoma deaths was found in the exposed population, and two of the three deaths observed occurred in men less than 40 years of age. The small number of deaths and the lack of any evidence for an association with duration or level of exposure to styrene are reasons for interpreting this result cautiously. However, the otherwise normal pattern of mortality in the exposed population and the absence of any excess of lymphomas in the reference group lend some support to suggestions that exposure to styrene may be associated with lymphomas in man. An analysis of cancer registrations for the exposed population revealed no further cases of lymphoma but identified one case of lymphatic leukemia. An excess of laryngeal cancer registrations was found. As this effect has not been previously postulated and because of the small number of registrations, too much weight should not be attached to this one observation.