79 research outputs found
Prevalence of skin problems and leg ulceration in a sample of young injecting drug users
No full textBackground: Drug users suffer harm from the injecting process, and clinical services are reporting increasing numbers presenting with skin-related problems such as abscesses and leg ulcers. Skin breakdown can lead to long-term health problems and increased service costs and is often the first indication of serious systemic ill health. The extent of skin problems in injecting drug users has not previously been quantified empirically, and there is a dearth of robust topical literature. Where skin problems have been reported, this is often without clear definition and generic terms such as ‘soft tissue infection' are used which lack specificity. The aim of this study was to identify the range and extent of skin problems including leg ulceration in a sample of injecting drug users. Definitions of skin problems were developed and applied to descriptions from drug users to improve rigour. Methods: Data were collected in needle exchanges and methadone clinics across Glasgow, Scotland, from both current and former drug injectors using face-to-face interviews. Results: Two hundred participants were recruited, of which 74% (n = 148) were males and 26% (n = 52) were females. The age range was 21-44 years (mean 35 years). Just under two thirds (64%, n = 127) were currently injecting or had injected within the last 6 months, and 36% (n = 73) had previously injected and had not injected for more than 6 months. Sixty per cent (n = 120) of the sample had experienced a skin problem, and the majority reported more than one problem. Most common were abscesses, lumps, track marks and leg ulcers. Fifteen per cent (n = 30) of all participants reported having had a leg ulcer. Conclusions: This is an original empirical study which demonstrated unique findings of a high prevalence of skin disease (60%) and surprisingly high rates of leg ulceration (15%). Skin disease in injecting drug users is clearly widespread. Leg ulceration in particular is a chronic recurring condition that is costly to treat and has long-term implications for drug users and services caring for current or former injectors long after illicit drug use has ceased
Artificial Turf: Contested Terrains for Precautionary Public Health with Particular Reference to Europe?
No full textMillions of adults, children and teenagers use artificial sports pitches and playgrounds globally. Pitches are artificial grass and bases may be made up of crumb rubber from recycled tires or new rubber and sand. Player injury on pitches was a major concern. Now, debates about health focus on possible exposure and uptake of chemicals within pitch and base materials. Research has looked at potential risks to users from hazardous substances such as metals, volatile organic compounds, polycyclic aromatic hydrocarbons including benzo (a) (e) pyrenes and phthalates: some are carcinogens and others may be endocrine disruptors and have developmental reproductive effects. Small environmental monitoring and modelling studies, often with significant data gaps about exposure, range of substances monitored, occupational exposures, types of surfaces monitored and study length across seasons, indicated little risk to sports people and children but some risk to installation workers. A few, again often small, studies indicated potentially harmful human effects relating to skin, respiration and cancers. Only one widely cited biomonitoring study has been done and no rigorous cancer epidemiological studies exist. Unravelling exposures and uptake over decades may prove complex. European regulators have strengthened controls over crumb rubber chemicals, set different standards for toys and crumb rubber pitches. Bigger US studies now underway attempting to fill some of the data gaps will report between 2017 and 2019. Public health professionals in the meantime may draw on established principles to support greater caution in setting crumb rubber exposure limits and controls
Chief coroner's guidance on covid-19 deaths: workers outside the NHS are also vulnerable to risk
No full textFirst paragraph: The BMJ rightly questioned the decision that coroners need not investigate NHS England personal protective equipment (PPE) failures in staff deaths from covid-19. This rings alarm bells for workers beyond the NHS who may have been exposed to SARS-CoV-2 without appropriate PPE. The medical press will hopefully speak up for these often very vulnerable workers.Output Type: Lette
Towards integration of environmental and health impact assessments for wild capture fishing and farmed fish with particular reference to public health and occupational health dimensions
No full textThe paper offers a review and commentary, with particular reference to the production of fish from wild capture fisheries and aquaculture, on neglected aspects of health impact assessments which are viewed by a range of international and national health bodies and development agencies as valuable and necessary project tools. Assessments sometimes include environmental health impact assessments but rarely include specific occupational health and safety impact assessments especially integrated into a wider public health assessment. This is in contrast to the extensive application of environmental impact assessments to fishing and the comparatively large body of research now generated on the public health effects of eating fish. The value of expanding and applying the broader assessments would be considerable because in 2004 the United Nations Food and Agriculture Organization reports there were 41,408,000 people in the total ‘fishing’ sector including 11,289,000 in aquaculture. The paper explores some of the complex interactions that occur with regard to fishing activities and proposes the wider adoption of health impact assessment tools in these neglected sectors through an integrated public health impact assessment tool
Scoping a public health impact assessment of aquaculture with particular reference to tilapia in the UK
No full textBackground. The paper explores shaping public health impact assessment tools for tilapia, a novel emergent aquaculture sector in the UK. This Research Council’s UK Rural Economy and Land Use project embraces technical, public health, and marketing perspectives scoping tools to assess possible impacts of the activity. Globally, aquaculture produced over 65 million tonnes of food in 2008 and will grow significantly requiring apposite global public health impact assessment tools.<p></p>
Methods. Quantitative and qualitative methods incorporated data from a tridisciplinary literature. Holistic tools scoped tilapia farming impact assessments. Laboratory-based tilapia production generated data on impacts in UK and Thailand along with 11 UK focus groups involving 90 consumers, 30 interviews and site visits, 9 visits to UK tilapia growers and 2 in The Netherlands.<p></p>
Results. The feasibility, challenges, strengths, and weaknesses of creating a tilapia Public Health Impact Assessment are analysed. Occupational and environmental health benefits and risks attached to tilapia production were identified.<p></p>
Conclusions. Scoping public health impacts of tilapia production is possible at different levels and forms for producers, retailers, consumers, civil society and governmental bodies that may contribute to complex and interrelated public health assessments of aquaculture projects. Our assessment framework constitutes an innovatory perspective in the field
The influences of crustal extension, salt tectonics and gravity-driven deformation on the structural evolution of the Halten Terrace, offshore mid-Norway: new sights from 3D seismic data and fault analysis
No full textNormal fault zones play a fundamental role in the development of sedimentary basins and in the migration and trapping of hydrocarbons. The idealised geometry of an isolated post-sedimentary normal fault (Barnett, 1987, Walsh & Watterson, 1989) existing conceptual models that describe the process of fault growth and linkage in brittle systems (Childs et al, 1995; Cartwright et al, 1996; Childs et al, 1995, 1996b; Huggins et al, 1995), where fault planes composed of many overstepping segments are linked by areas of complex deformation called relay ramps, are generally accepted. Relay zones can trap significant volumes of hydrocarbon or act as leakage points, thus understanding the style of fault linkage, which strongly influences the location of hydrocarbon tops and reservoir compartmentalisation, is vital for any petroleum system.EThOS - Electronic Theses Online ServiceGBUnited Kingdo
Multi-factorial influences on sex ratio: a spatio-temporal investigation of endocrine disruptor pollution and neighborhood stress
No full textBackground: It is suggested the declining male birth proportion in some industrialized countries is linked to ubiquitous endocrine disruptor exposure. Stress and advanced parental age are determinants which frequently present positive findings. Multi-factorial influences on population sex ratio are rarely explored or tested in research. Objectives: To test the hypothesis that dual factors of pollution and population stress affects sex proportion at birth through geographical analysis of Central Scotland. Methods: The study incorporates the use of Geographical Information Systems (GIS) tools to overlay modeled point source endocrine disruptor air emissions with "small-area" data on multiple deprivation (a proxy measurement of stress) and birth sex. Historical review of regional sex ratio trends presents additional data on sex ratio in Scotland to consider. Results: There was no overall concentration in Central Scotland of low sex ratio neighborhoods with areas where endocrine disruptor air pollution and deprivation or economic stress were high. Historical regional trends in Scotland (from 1973), however, do show significantly lower sex ratio values for populations where industrial air pollution is highest (i.e. Eastern Central Scotland). Conclusions: Use of small area data sets and pollution inventories is a potential new method of inquiry for reproductive environmental and health protection monitoring and has produced interesting finding
Education programmes preparing independent prescribers in Scotland: An evaluation
No full textBackground: Nurse prescribing (NP) is part of the modernisation of the health care workforce and contributes to patient care by improving access to quality services and medication, through utilisation of advanced professional skills. Nurses and midwives need to complete additional education in order to prescribe. This paper explores pedagogical issues relevant to professional training programmes. Objectives: To assess if programmes of education for nurse prescribing in Scotland were fit for purpose, from both the student and educator perspective with recommendations for future educational delivery. Design: Data were collected using several methods: a questionnaire to all course members on prescribing programmes followed by focus-groups; and interviews with programme providers. Results: Nurses and midwives training as prescribers work in a wide range of healthcare settings, in different geographic environments. They tended to be experienced, educated to degree level and most are over forty years of age. Most undertook the course to develop professionally and to improve patient care. Existing provision of education for prescribing is deemed appropriate and fit for purpose. The NP programme greatly enhances pharmacological knowledge building on existing clinical experience. The nature of these programmes works well and should be retained. However, whilst the educational programmes were centrally funded, less than half of students were provided with any allocated study time from their employers preventing nurses from maximising the gain from the educational preparation for prescribing. Conclusions: Nurse and midwife generic preparation for independent nurse prescribing in Scotland greatly increases professional expertise and is appropriate and fit for purpose. As other countries beyond Scotland and the UK seek to further progress nursing roles, learning from this controlled and structured development of prescribing underpinned by evidence could be of significant benefit
MARGINAL ABATEMENT COST CURVES FOR UK AGRICULTURAL GREENHOUSE GAS EMISSIONS
No full textThis paper addresses the challenge of developing a ‘bottom-up’ marginal abatement cost curve (MACC) for greenhouse gas emissions from UK agriculture. A MACC illustrates the costs of specific crop, soil, and livestock abatement measures against a ‘‘business as usual’’ scenario. The results indicate that in 2022 under a specific policy scenario, around 5.38 MtCO2 equivalent (e) could be abated at negative or zero cost. A further 17% of agricultural GHG emissions (7.85 MtCO2e) could be abated at a lower unit cost than the UK Government’s 2022 shadow price of carbon (£34 (tCO2e)-1). The paper discusses a range of methodological hurdles that complicate cost-effectiveness appraisal of abatement in agriculture relative to other sectors.Climate change, Marginal abatement costs, Agriculture, Environmental Economics and Policy, Resource /Energy Economics and Policy, Q52, Q 54, Q58,
Risk factors for leg ulceration in people who inject drugs: A cross‐sectional study
No full textAlison Coull - ORCID: 0000-0002-3166-0699
https://orcid.org/0000-0002-3166-0699Item not available in this repository.Aims and Objectives
The aim of this study was to assess, for the first time in a hard‐to‐reach population, the risk factors for leg ulceration among PWID, with the objective of making improvements to prevention and care.Background
An estimated 4.8 million people globally inject drugs with potential for injecting‐related harm. Skin and vein damage associated with drug injecting is increasing. Leg ulceration is a chronic condition which in the UK has a prevalence of 15% among people who have injected drugs (PWID) compared with 1% in the general population. Glasgow has the highest rate of problematic drug use in Scotland with approximately 13,900 individuals, about 50% of whom are thought to inject. However, the reasons for high prevalence of leg ulceration among PWID are unknown. To support improvements in prevention and care, the dearth of evidence around risk factors for leg ulceration in PWID needs to be addressed.Design
A cross‐sectional survey of 200 current and former injectors recruited from drug services in Glasgow, Scotland, to measure skin problems, leg ulceration and injecting habits is reported following STROBE guidelines. Logistic regression modelling examined whether demographics and injecting habits predicted leg ulceration.Results
The likelihood of leg ulceration was increased for those who injected in the groin and the leg. Additionally, injecting in the groin and leg were associated with having a DVT.Conclusion
The primary risk factors for leg ulceration in PWID are injecting in the groin and the legs and these are clinically linked to deep vein thrombosis. Injecting into the femoral vein is increasingly common practice for PWID and healthcare practitioners should advise injectors of the increased risk of leg ulceration and DVT and discourage injecting into these areas.AFC was supported by a Smith and Nephew Foundation Doctoral Studentship Awardhttps://doi.org/10.1111/jocn.1571630pubpub11-1
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