scholarly journals Financial implications and maternal impact of national recommendations for thromboprophylaxis: a retrospective cross-sectional analysis

2011 ◽  
Vol 4 (2) ◽  
pp. 70-72 ◽  
Author(s):  
Cressida Bond ◽  
Kate O'Brien ◽  
Tim Draycott ◽  
Robert Fox
Keyword(s):  
Risk Score ◽  
Normal Weight ◽  
Cross Sectional ◽  
National Guidance ◽  
Postnatal Women ◽  
Current Guidance ◽  
The Uk ◽  
Sectional Analysis ◽  
Individual Scores ◽  
Financial Implication

Background Thromboembolism was a leading direct cause of maternal death in the UK in the last Saving Mothers’ Lives report. National guidance proposes that all women should be risk assessed in pregnancy and after delivery. Methods An audit was designed to assess the financial implication for our service. One hundred consecutive live and stillbirths were identified using the maternity database; 97 case records were obtained. Risk factors were identified and individual scores were calculated, together with the proportion that would have extended measures (low-molecular-weight heparin [LMWH], antiembolic stockings). Results The series appeared to be representative of the UK pregnant population in terms of age, parity, body mass index, smoking and caesarean rate. Antenatally, 2.1% had a Royal College of Obstetricians and Gynaecologists (RCOG) risk score of three or more and would have been advised to have LMWH throughout pregnancy and the puerperium. Postnatally, 40.1% had an RCOG score of two or more and would have required enoxaparin for one to six weeks. The annual cost of stockings, LMWH and sharps bins approximate to GB£44,847 for every one thousand deliveries, GB£2.6 million for each life saved. About 10% of normal-weight postnatal women who achieved a vaginal birth had a risk score prompting thromboprophylaxis for at least seven days. Conclusions These data suggest that the current guidance might represent overmedicalization of pregnancy and that the criteria for thromboprophylaxis should be refined further.

scholarly journals Is Environmental and Occupational Particulate Air Pollution Exposure Related to Type-2 Diabetes and Dementia? A Cross-Sectional Analysis of the UK Biobank

2020 ◽  
Vol 17 (24) ◽  
pp. 9581
Author(s):  
Eirini Dimakakou ◽  
Helinor J. Johnston ◽  
George Streftaris ◽  
John W. Cherrie
Keyword(s):  
Air Pollution ◽  
Occupational Exposure ◽  
Environmental Exposure ◽  
Uk Biobank ◽  
Job Exposure Matrix ◽  
Cross Sectional ◽  
Particulate Air Pollution ◽  
The Uk ◽  
Sectional Analysis

Human exposure to particulate air pollution (e.g., PM2.5) can lead to adverse health effects, with compelling evidence that it can increase morbidity and mortality from respiratory and cardiovascular disease. More recently, there has also been evidence that long-term environmental exposure to particulate air pollution is associated with type-2 diabetes mellitus (T2DM) and dementia. There are many occupations that may expose workers to airborne particles and that some exposures in the workplace are very similar to environmental particulate pollution. We conducted a cross-sectional analysis of the UK Biobank cohort to verify the association between environmental particulate air pollution (PM2.5) exposure and T2DM and dementia, and to investigate if occupational exposure to particulates that are similar to those found in environmental air pollution could increase the odds of developing these diseases. The UK Biobank dataset comprises of over 500,000 participants from all over the UK. Environmental exposure variables were used from the UK Biobank. To estimate occupational exposure both the UK Biobank’s data and information from a job exposure matrix, specifically developed for UK Biobank (Airborne Chemical Exposure–Job Exposure Matrix (ACE JEM)), were used. The outcome measures were participants with T2DM and dementia. In appropriately adjusted models, environmental exposure to PM2.5 was associated with an odds ratio (OR) of 1.02 (95% CI 1.00 to 1.03) per unit exposure for developing T2DM, while PM2.5 was associated with an odds ratio of 1.06 (95% CI 0.96 to 1.16) per unit exposure for developing dementia. These environmental results align with existing findings in the published literature. Five occupational exposures (dust, fumes, diesel, mineral, and biological dust in the most recent job estimated with the ACE JEM) were investigated and the risks for most exposures for T2DM and for all the exposures for dementia were not significantly increased in the adjusted models. This was confirmed in a subgroup of participants where a full occupational history was available allowed an estimate of workplace exposures. However, when not adjusting for gender, some of the associations become significant, which suggests that there might be a bias between the occupational assessments for men and women. The results of the present study do not provide clear evidence of an association between occupational exposure to particulate matter and T2DM or dementia.

scholarly journals Associations between active travel and diet: cross-sectional evidence on healthy, low-carbon behaviours from UK Biobank

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030741
Author(s):  
Michaela A Smith ◽  
Jan Rasmus Boehnke ◽  
Hilary Graham ◽  
Piran C L White ◽  
Stephanie L Prady
Keyword(s):  
Active Travel ◽  
Processed Meat ◽  
Low Carbon ◽  
Cross Sectional ◽  
Dietary Consumption ◽  
Underlying Causes ◽  
Behavioural Factors ◽  
The Uk ◽  
Sectional Analysis ◽  
Red And Processed Meat

ObjectivesTo examine whether there are associations between active travel and markers of a healthy, low-carbon (HLC) diet (increased consumption of fruit and vegetables (FV), reduced consumption of red and processed meat (RPM)).DesignCross-sectional analysis of a cohort study.SettingsPopulation cohort of over 500 000 people recruited from 22 centres across the UK. Participants aged between 40 and 69 years were recruited between 2006 and 2010.Participants412 299 adults with complete data on travel mode use, consumption of FV and RPM, and sociodemographic covariates were included in the analysis.Exposure measuresMutually exclusive mode or mode combinations of travel (car, public transport, walking, cycling) for non-work and commuting journeys.Outcome measuresConsumption of FV measured as portions per day and RPM measured as frequency per week.ResultsEngaging in all types of active travel was positively associated with higher FV consumption and negatively associated with more frequent RPM consumption. Cycling exclusively or in combination with walking was most strongly associated with increased dietary consumption of FV and reduced consumption of RPM for both non-work and commuting journeys. Overall, the strongest associations were between non-work cycling and FV consumption (males: adjusted OR=2.18, 95% CI 2.06 to 2.30; females: adjusted OR=2.50, 95% CI 2.31 to 2.71) and non-work cycling and RPM consumption (males: adjusted OR=0.57, 95% CI 0.54 to 0.60; females: adjusted OR=0.54, 95% CI 0.50 to 0.59). Associations were generally similar for both commuting and non-work travel, and were robust to adjustment with sociodemographic and behavioural factors.ConclusionsThere are strong associations between engaging in active travel, particularly cycling, and HLC dietary consumption, suggesting that these HLC behaviours are related. Further research is needed to better understand the drivers and dynamics between these behaviours within individuals, and whether they share common underlying causes.

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