30 results on '"Saunders, J."'
Search Results
2. Interests and their conflicts.
- Author
-
Saunders, J.
- Subjects
- *
CONFLICT of interests , *DERMATOLOGY , *DRUG development , *MEDICAL research , *PHYSICIANS - Abstract
An editorial is presented on conflicts of interest in dermatology. Topics mentioned include the relationships of pharmaceutical industry and doctors that raises conflicts of interest, the development of drugs for several skin diseases, and the commercialisation and privatisation of clinical research. Also mentioned are the ways to prevent conflicts of interest among physicians and the development of professionalism to doctors in Great Britain.
- Published
- 2017
- Full Text
- View/download PDF
3. The National Singing Programme for primary schools in England: an initial baseline study.
- Author
-
Welch, G.F., Himonides, E., Papageorgi, I., Saunders, J., Rinta, T., Stewart, C., Preti, C., Lani, J., Vraka, M., and Hill, J.
- Subjects
PRIMARY school teaching ,PRIMARY education ,SINGING ,SELF-efficacy - Abstract
The 'Sing Up' National Singing Programme for primary schools in England was launched in November 2007 under the UK government's 'Music Manifesto'. 'Sing Up' is a four-year programme whose overall aim is to raise the status of singing and increase opportunities for children throughout the country to enjoy singing as part of their everyday lives, in and out of school. As part of the Programme's research evaluation, a key focus has been to build an initial picture of singing in primary schools across England. This information could then be used as a 'baseline' by which the programme's subsequent impact could be judged, including 'before' and 'after' measures of schools that receive particular 'Sing Up' input. This paper reports an overview of key outcomes of the first five months of baseline profiling (October 2007-February 2008), embracing analyses of the singing behaviours of 3472 children in 76 primary schools. These findings are complimented by additional analyses of children's views on singing in and out of school; and the self-efficacy of their class teachers (n=90), both as singers and as teachers of singing. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
4. What are local issues? The problem of the local review of research.
- Author
-
Wainwright, P. and Saunders, J.
- Subjects
- *
RESEARCH ethics , *ETHICS committees , *MEDICAL ethics committees , *CLINICAL trials , *CLINICAL medicine - Abstract
Local review of research by ethics committees in the UK has long been held to be an important right of the local research ethics committee and, even with the introduction of the European Clinical Trials Directive, the governance arrangements for research ethics committees continue to allow for local review of multicentre studies. There is no requirement for local review in either the European Union directive or in the guidelines on good clinical practice, and there is little evidence of it anywhere else in Europe. The idea that there can be "local", as opposed to "central" ethical issues in research is an interesting one, which raises important issues about the nature of research ethics and ethical review. The aim of this paper is to argue that there are no such things as local issues in research ethics, and suggest that those questions currently addressed as local issues properly belong within the research governance framework. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
- View/download PDF
5. JAPANESE MARKETING STRATEGIES IN THE UK: A COMPARATIVE STUDY.
- Author
-
Doyle, P., Saunders, J., and Wong, V.
- Subjects
MARKETING research ,MARKETING management ,SALES promotion ,INDUSTRIAL concentration ,MARKET share ,INDUSTRIES - Abstract
Abstract. Hypotheses about Japanese marketing are examined using a matched sample of British companies and their major Japanese competitors. Japanese subsidiaries in Britain are shown to be much more market-oriented, more single-minded in their pursuit of market share and more alert to strategic opportunities than their British counterparts. Organizationally, however, their subsidiaries are more like successful British companies than the Japanese stereotype. Differences in performance between the two groups appear due to marketing skills rather than national cultures. [ABSTRACT FROM AUTHOR]
- Published
- 1986
- Full Text
- View/download PDF
6. Permanent sacral nerve stimulation for treatment of idiopathic constipation (Br J Surg 2002; 89: 882–8).
- Author
-
Chan, C.L.H., Saunders, J., and Williams, N.S.
- Subjects
- *
SURGERY , *TREATMENT of fecal incontinence , *NEURAL stimulation - Abstract
Presents correspondence relating to surgery published in the November 2002 issue of the journal 'British Journal of Surgery.' Doubts over the effectiveness of sacral nerve stimulation in the treatment for faecal incontinence; Non-representation of largest possible clinical group of patients; Alternative suggestions regarding the treatment of Faecal incontinence.
- Published
- 2002
- Full Text
- View/download PDF
7. Factors associated with human papillomavirus, hepatitis A, hepatitis B and mpox vaccination uptake among gay, bisexual and other men who have sex with men in the UK- findings from the large community-based RiiSH-Mpox survey.
- Author
-
Baldry G, Phillips D, Wilkie R, Checchi M, Folkard K, Simmons R, Saunders J, Mandal S, Mercer CH, Mohammed H, and Ogaz D
- Subjects
- Humans, Male, Adult, United Kingdom epidemiology, Young Adult, Hepatitis A Vaccines administration & dosage, Middle Aged, Surveys and Questionnaires, Adolescent, Sexual Behavior statistics & numerical data, Patient Acceptance of Health Care statistics & numerical data, Bisexuality statistics & numerical data, Sexually Transmitted Diseases prevention & control, Human Papillomavirus Viruses, Homosexuality, Male statistics & numerical data, Vaccination statistics & numerical data, Hepatitis B prevention & control, Hepatitis A prevention & control, Hepatitis A epidemiology, Papillomavirus Vaccines administration & dosage, Papillomavirus Infections prevention & control, Sexual and Gender Minorities statistics & numerical data, Hepatitis B Vaccines administration & dosage
- Abstract
Background: Gay, bisexual, and other men who have sex with men (GBMSM) face a disproportionate burden of sexually transmitted infections and are eligible for targeted vaccinations for hepatitis A (HAV), hepatitis B (HBV), human papilloma virus (HPV) and mpox. This study examines the sociodemographic characteristics, sexual behaviours, and sexual healthcare service (SHS) use associated with vaccination uptake., Methods: We undertook analyses of RiiSH-Mpox - an online, community-based survey with GBMSM recruited via social media and dating apps. We calculated vaccination uptake (≥1 dose) among eligible GBMSM. Bivariate and multivariable logistic regression was performed to identify factors independently associated with vaccination uptake among eligible participants., Results: Reported uptake in eligible GBMSM was around two-thirds for each of the vaccinations considered: mpox 69% (95% confidence interval (CI): 66%-72%), HAV 68% (CI:65%-70%), HBV 72% (CI:69%-74%) and HPV 65% (CI:61%-68%). Vaccination course completion (receiving all recommended doses) ranged from 75% (HBV) to 89% (HAV) among eligible GBMSM. Individuals who represented missed opportunities for vaccination ranged from 22 to 30% of eligible SHS attendees. Younger participants, individuals identifying as bisexual, reporting lower educational qualifications, or being unemployed reported lower uptake across multiple GBMSM-selective vaccinations. Individuals who reported greater levels of sexual behaviour and recent SHS use were more likely to report vaccinations., Conclusion: Eligible participants reported high uptake of vaccinations; however, uptake was lower amongst young GBMSM and self-identifying bisexual men. Awareness of groups with lower vaccination uptake will help inform practice, delivery strategies and health promotion, to improve the reach and impact of vaccinations amongst GBMSM., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Published
- 2024
- Full Text
- View/download PDF
8. Use of a meningococcal group B vaccine (4CMenB) in populations at high risk of gonorrhoea in the UK.
- Author
-
Ladhani SN, White PJ, Campbell H, Mandal S, Borrow R, Andrews N, Bhopal S, Saunders J, Mohammed H, Drisdale-Gordon L, Callan E, Sinka K, Folkard K, Fifer H, and Ramsay ME
- Subjects
- Humans, United Kingdom epidemiology, Male, Neisseria gonorrhoeae immunology, Female, Adult, Neisseria meningitidis, Serogroup B immunology, Gonorrhea epidemiology, Gonorrhea prevention & control, Meningococcal Vaccines administration & dosage, Meningococcal Vaccines immunology, Meningococcal Infections prevention & control, Meningococcal Infections epidemiology
- Abstract
The meningococcal group B vaccine, 4CMenB, is a broad-spectrum, recombinant protein vaccine that is licensed for protection against meningococcal group B disease in children and adults. Over the past decade, several observational studies supported by laboratory studies have reported protection by 4CMenB against gonorrhoea, a sexually transmitted infection caused by Neisseria gonorrhoeae. Gonorrhoea is a major global public health problem, with rising numbers of diagnoses and increasing resistance to multiple antibiotics. In England, more than 82 000 cases of gonorrhoea were diagnosed in 2022, with nearly half of the cases diagnosed among gay, bisexual, and other men who have sex with men. There are currently no licensed vaccines against gonorrhoea but 4CMenB is estimated to provide 33-47% protection against gonorrhoea. On Nov 10, 2023, the UK Joint Scientific Committee on Vaccination and Immunisation agreed that a targeted programme should be initiated using 4CMenB to prevent gonorrhoea among individuals at higher risk of infection attending sexual health services in the UK. This decision was made after reviewing evidence from retrospective and prospective observational studies, laboratory and clinical data, national surveillance reports, and health economic analyses. In this Review, we summarise the epidemiology of invasive meningococcal disease and gonorrhoea in England, the evidence supporting the use of 4CMenB for protection against gonorrhoea, and the data needed to inform long-term programme planning and extension to the wider population., Competing Interests: Declaration of interests PJW has received payment from Pfizer for teaching of mathematical modelling of infectious disease transmission and vaccination. RB performs contract serology on behalf of UKHSA for GlaxoSmithKline, Pfizer, and Sanofi but receives no personal remuneration. SNL performs contract research for St George's University of London for vaccine manufacturers but receives no personal remuneration. All other authors declare no competing interests., (Crown Copyright © 2024 Published by Elsevier Ltd. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
9. Mpox Diagnosis, Behavioral Risk Modification, and Vaccination Uptake among Gay, Bisexual, and Other Men Who Have Sex with Men, United Kingdom, 2022.
- Author
-
Ogaz D, Enayat Q, Brown JRG, Phillips D, Wilkie R, Jayes D, Reid D, Hughes G, Mercer CH, Saunders J, and Mohammed H
- Subjects
- Humans, Male, United Kingdom epidemiology, Adult, Middle Aged, Young Adult, Sexual and Gender Minorities statistics & numerical data, Adolescent, Disease Outbreaks prevention & control, Risk Reduction Behavior, Surveys and Questionnaires, Bisexuality, Homosexuality, Male statistics & numerical data, Vaccination statistics & numerical data
- Abstract
During the 2022 multicountry mpox outbreak, the United Kingdom identified cases beginning in May. UK cases increased in June, peaked in July, then rapidly declined after September 2022. Public health responses included community-supported messaging and targeted mpox vaccination among eligible gay, bisexual, and other men who have sex with men (GBMSM). Using data from an online survey of GBMSM during November-December 2022, we examined self-reported mpox diagnoses, behavioral risk modification, and mpox vaccination offer and uptake. Among 1,333 participants, only 35 (2.6%) ever tested mpox-positive, but 707 (53%) reported behavior modification to avoid mpox. Among vaccine-eligible GBMSM, uptake was 69% (95% CI 65%-72%; 601/875) and was 92% (95% CI 89%-94%; 601/655) among those offered vaccine. GBMSM self-identifying as bisexual, reporting lower educational qualifications, or identifying as unemployed were less likely to be vaccinated. Equitable offer and provision of mpox vaccine are needed to minimize the risk for future outbreaks and mpox-related health inequalities.
- Published
- 2024
- Full Text
- View/download PDF
10. Sexual behaviour, STI and HIV testing and testing need among gay, bisexual and other men who have sex with men recruited for online surveys pre/post-COVID-19 restrictions in the UK.
- Author
-
Brown JR, Reid D, Howarth AR, Mohammed H, Saunders J, Pulford CV, Ogaz D, Hughes G, and Mercer CH
- Subjects
- Male, Humans, Homosexuality, Male, Sexual Behavior, Surveys and Questionnaires, HIV Testing, United Kingdom epidemiology, Sexual and Gender Minorities, HIV Infections diagnosis, HIV Infections epidemiology, HIV Infections prevention & control, COVID-19 diagnosis, COVID-19 epidemiology, COVID-19 prevention & control, Sexually Transmitted Diseases diagnosis, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control, Pre-Exposure Prophylaxis
- Abstract
Objectives: We examined sexual behaviour, sexually transmitted infection (STI) and HIV testing and testing need, and identified associated factors, among gay, bisexual and other men who have sex with men (GBMSM) in the UK after COVID-19 restrictions ended, and compared these with 'pre-pandemic' estimates., Methods: We analysed survey data from GBMSM (N=1039) recruited via social media and Grindr in November-December 2021. We then compared Grindr-recruited 2021 participants (N=437) with those from an equivalent survey fielded in March-May 2017 (N=1902). Questions on sexual behaviour and service use had lookback periods of 3-4 months in both surveys. Unmet testing need was defined as reporting any new male and/or multiple condomless anal sex (CAS) partners without recent STI/HIV testing. Participants were UK residents, GBMSM, aged ≥16 years who reported sex with men in the last year. Multivariable logistic regression identified associated sociodemographic and health-related factors with unmet STI/HIV testing need in 2021, and then for 2017/2021 comparative analyses, adjusting for demographic differences., Results: In 2021, unmet STI and HIV testing need were greater among older GBMSM (aged ≥45 years vs 16-29 years; adjusted OR (aOR): 1.45 and aOR: 1.77, respectively), and lower for pre-exposure prophylaxis (PrEP) users (vs non-PrEP users; aOR: 0.32 and aOR: 0.23, respectively). Less unmet STI testing need was observed among HIV-positive participants (vs HIV-negative/unknown; aOR: 0.63), and trans and non-binary participants (vs cisgender male; aOR: 0.34). Between 2017 (reference) and 2021, reported sexual risk behaviours increased: ≥1 recent new male sex partner (72.1%-81.1%, aOR: 1.71) and ≥2 recent CAS partners (30.2%-48.5%, aOR: 2.22). Reporting recent STI testing was greater in 2021 (37.5%-42.6%, aOR: 1.34) but not recent HIV testing, and there was no significant change over time in unmet STI (39.2% vs 43.7%) and HIV (32.9% vs 39.0%) testing need., Discussion: Comparable community surveys suggest that UK resident GBMSM may have engaged in more sexual risk behaviours in late 2021 than pre-pandemic. While there was no evidence of reduced STI/HIV service access during this time, there remained considerable unmet STI/HIV testing need., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)
- Published
- 2023
- Full Text
- View/download PDF
11. Barriers and facilitators to HIV Pre-Exposure Prophylaxis (PrEP) in Specialist Sexual Health Services in the United Kingdom: A systematic review using the PrEP Care Continuum.
- Author
-
Coukan F, Murray KK, Papageorgiou V, Lound A, Saunders J, Atchison C, and Ward H
- Subjects
- Male, Humans, Female, Homosexuality, Male, United Kingdom, HIV Infections drug therapy, HIV Infections prevention & control, Sexual and Gender Minorities, Pre-Exposure Prophylaxis
- Abstract
Objectives: HIV pre-exposure prophylaxis (PrEP) delivery in the UK is inequitable; over 95% of PrEP users were men who have sex with men (MSM) despite making up less than 50% of new HIV diagnoses. We conducted a systematic review to identify modifiable barriers and facilitators to PrEP delivery in the UK among underserved populations., Methods: We searched bibliographic/conference databases using the terms HIV, PrEP, barriers, facilitators, underserved populations, and UK. Modifiable factors were mapped along the PrEP Care Continuum (PCC) to identify targets for interventions., Results: In total, 44 studies were eligible: 29 quantitative, 12 qualitative and three mixed-methods studies. Over half (n = 24 [54.5%]) exclusively recruited MSM, whereas 11 were in mixed populations (all included MSM as a sub-population) and the other nine were in other underserved populations (gender and ethnicity minorities, women, and people who inject drugs). Of the 15 modifiable factors identified, two-thirds were at the PrEP contemplation and PrEParation steps of the PCC. The most reported barriers were lack of PrEP awareness (n = 16), knowledge (n = 19), willingness (n = 16), and access to a PrEP provider (n = 16), whereas the more reported facilitators were prior HIV testing (n = 8), agency and self-care (n = 8). All but three identified factors were at the patient rather than provider or structural level., Conclusions: This review highlights that the bulk of the scientific literature focuses on MSM and on patient-level factors. Future research needs to ensure underserved populations are included and prioritized (e.g. ethnicity and gender minorities, people who inject drugs) and provider and structural factors are investigated., (© 2023 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.)
- Published
- 2023
- Full Text
- View/download PDF
12. Difficulty accessing condoms because of the COVID-19 pandemic reported by gay, bisexual and other men who have sex with men in the UK: findings from a large, cross-sectional, online survey.
- Author
-
Brown JR, Reid D, Howarth AR, Mohammed H, Saunders J, Pulford CV, Ogaz D, Hughes G, and Mercer CH
- Subjects
- Infant, Newborn, Male, Humans, Homosexuality, Male, Cross-Sectional Studies, Pandemics prevention & control, Condoms, Sexual Behavior, United Kingdom epidemiology, Sexual and Gender Minorities, HIV Infections epidemiology, COVID-19 epidemiology, COVID-19 prevention & control
- Abstract
Background: COVID-19 restrictions severely reduced face-to-face sexual health services, an important access point for condoms. We examine whether gay, bisexual and other men who have sex with men (GBMSM) in the UK had difficulty accessing condoms during the first year of the pandemic, and if so, which groups were most affected., Methods: Questions about difficulty accessing condoms were asked as part of a short, online cross-sectional survey of GBMSM undertaken November/December 2021, recruited via social media and Grindr. Eligible participants were UK-resident GBMSM (cis/trans/gender-diverse person assigned male at birth [AMAB]), aged ≥16 years who were sexually active (reported sex with men in the last year). Multivariable logistic regression was used to examine if and how reporting this outcome varied by key sociodemographic, health and behavioural factors independent of the potential confounding effect of numbers of new male sex partners., Results: Of all participants ( N = 1039), 7.4% ( n = 77) reported difficulty accessing condoms due to the pandemic. This was higher among younger GBMSM (aged 16-29 years vs. ≥45; 12.8% vs. 4.9%; aOR: 2.78); trans/gender-diverse AMAB participants (vs. cis gender males; 24.4% vs. 6.6%; aOR = 4.86); bisexually-identifying participants (vs. gay-identifying; 11.1% vs. 6.5%; aOR = 1.78); and those without degree level education (vs. having a degree; 9.8% vs. 5.6%; aOR = 2.01)., Conclusions: A minority of sexually active GBMSM reported difficulty accessing condoms because of the pandemic, however, this was more common amongst those who already experience a disproportionate burden of poor sexual health. Interventions are needed to address these inequalities in accessing this important primary STI/HIV prevention measure.
- Published
- 2023
- Full Text
- View/download PDF
13. Detection of 10 cases of ceftriaxone-resistant Neisseria gonorrhoeae in the United Kingdom, December 2021 to June 2022.
- Author
-
Day M, Pitt R, Mody N, Saunders J, Rai R, Nori A, Church H, Mensforth S, Corkin H, Jones J, Naicker P, Khan WM, Thomson Glover R, Mortimer K, Hylton C, Moss E, Pasvol TJ, Richardson A, Sun S, Woodford N, Mohammed H, Sinka K, and Fifer H
- Subjects
- Humans, Ceftriaxone pharmacology, Ceftriaxone therapeutic use, Microbial Sensitivity Tests, United Kingdom epidemiology, Neisseria gonorrhoeae genetics, Gonorrhea diagnosis, Gonorrhea drug therapy, Gonorrhea epidemiology
- Abstract
Between December 2021 and June 2022, 10 cases of ceftriaxone-resistant Neisseria gonorrhoeae (ST8123; n = 8) were detected in the United Kingdom, compared with nine cases during the previous 6 years. Most of these cases were associated with travel from the Asia-Pacific region; all were heterosexual people, with most in their 20s. Although all cases were successfully treated, not all partners of cases could be traced, and there is a risk of further transmission of ceftriaxone-resistant gonococcal infection within the UK.
- Published
- 2022
- Full Text
- View/download PDF
14. 'Stay at home …': exploring the impact of the COVID-19 public health response on sexual behaviour and health service use among men who have sex with men: findings from a large online survey in the UK.
- Author
-
Howarth AR, Saunders J, Reid D, Kelly I, Wayal S, Weatherburn P, Hughes G, and Mercer CH
- Subjects
- Communicable Disease Control, Cross-Sectional Studies, Homosexuality, Male, Humans, Infant, Newborn, Male, Pandemics prevention & control, Patient Acceptance of Health Care, Public Health, Sexual Behavior, United Kingdom epidemiology, COVID-19 epidemiology, COVID-19 prevention & control, HIV Infections diagnosis, HIV Infections epidemiology, HIV Infections prevention & control, Sexual and Gender Minorities, Sexually Transmitted Diseases diagnosis, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control
- Abstract
Objectives: The first UK national lockdown began on 23 March 2020, in response to the COVID-19 pandemic, and led to reduced STI/HIV service provision in the UK. We investigated sexual behaviour, use and need for sexual healthcare during the pandemic., Methods: Participants (N=2018), including men (cis/transgender), transwomen and gender-diverse people reporting sex with another man (cis/transgender) or non-binary person assigned male at birth, completed an online cross-sectional survey (23 June 2020-14 July 2020), in response to adverts on social media and dating apps.Sexual behaviour, service use and unmet need for STI testing (any new male and/or multiple condomless anal sex (CAS) partners without STI testing) in the 3 months since lockdown began were examined and compared using multivariable analyses with an equivalent 3-month period in a 2017 survey (N=1918), conducted by the same research team., Results: Since lockdown began, 36.7% of participants reported one or more new partners, 17.3% reported CAS with multiple partners, 29.7% HIV testing (among 1815 of unknown/negative status), 24.9% STI testing and 15.4% using pre-exposure prophylaxis (PrEP).Since lockdown began, 25.3% of participants had unmet need for STI testing. This was more likely among Asian versus white participants (adjusted OR (aOR)=1.76, (1.14 to 2.72), p=0.01); for participants living in Scotland (aOR=2.02, (1.40 to 2.91), p<0.001) or Northern Ireland (aOR=1.93, (1.02-3.63), p=0.04) versus England; and for those living with HIV (aOR=1.83, (1.32 to 2.53), p<0.001).Compared to 2017, the equivalent 2020 subsample were less likely to report new male partners (46.8% vs 71.1%, p<0.001), multiple CAS partners (20.3% vs 30.8%, p<0.001) and have unmet need for STI testing (32.8% vs 42.5%, p<0.001) in the past 3 months., Conclusions: We found potential for ongoing STI/HIV transmission among men who have sex with men during the initial UK lockdown, despite reduced sexual activity, and inequalities in service access. These findings will support public health planning to mitigate health risks during and after the COVID-19 response., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)
- Published
- 2022
- Full Text
- View/download PDF
15. Patterns and mechanisms of major trauma injuries during and after the UK Covid-19 Nationwide lockdown: analysis from a UK Major Trauma Centre.
- Author
-
Adiamah A, Lewis-Lloyd C, Seehra JK, Rashid A, Dickson E, Moody N, Blackburn L, Reilly JJ, Saunders J, and Brooks A
- Subjects
- Aged, Communicable Disease Control, Female, Humans, Male, Pandemics, Prospective Studies, United Kingdom epidemiology, COVID-19 epidemiology, Trauma Centers
- Abstract
Purpose: To compare patterns and mechanisms of injuries during and after the UK Nationwide lockdown during the COVID-19 pandemic., Methods: This prospective cohort study included all major trauma admissions during the 10-week period of the nationwide lockdown (09/03/2020-18/05/2020), compared with admissions in the 10-weeks following the full lifting of lockdown restrictions (04/07/20-12/09/2020). Differences in the volume, spectrum and mechanism of injuries presenting during and post-lockdown were compared using Fisher's exact and Chi-squared tests as appropriate. The associated risk of 30-day mortality was examined using univariable and multivariable logistic regression., Results: A total of 692 major trauma admissions were included in this analysis. Of these, 237 patients were admitted during the lockdown and 455 patients were admitted post-lockdown. This represented a twofold increase in trauma admission between the two periods. Characteristically, both cohorts had a higher proportion of male patients (73.84% male during lockdown and 72.5% male post-lockdown). There was a noted shift in age groups between both cohorts with an overall more elderly population during lockdown (p = 0.0292), There was a significant difference in mechanisms of injury between the two cohorts. The 3-commonest mechanisms during the lockdown period were: Road traffic accidents (RTA)-31.22%, Falls of less than 2 m-26.58%, and falls greater than 2 m causing 22.78% of major trauma admissions. However, in the post-lockdown period RTAs represented 46.15% of all trauma admissions with falls greater than 2 m causing 17.80% and falls less than 2 m causing 15.16% of major trauma injuries. With falls in the elderly associated with an increased risk of mortality. In terms of absolute numbers, there was a twofold increase in major trauma injuries due to stabbings and shootings, rising from 25 admitted patients during the lockdown to 53 admitted patients post-lockdown., Conclusions: The lifting of lockdown restrictions resulted in a twofold increase in major trauma admissions that was also associated with significant changes in both the demographic and patterns of injuries with RTA's contributing almost half of all injury presentations., Trial Registration: This study was classed as a service evaluation and registered with the local audit department, registration number: 20-177C., (© 2022. The Author(s).)
- Published
- 2022
- Full Text
- View/download PDF
16. Optimising partner notification outcomes for bacterial sexually transmitted infections: a deliberative process and consensus, United Kingdom, 2019.
- Author
-
Wayal S, Estcourt CS, Mercer CH, Saunders J, Low N, McKinnon T, Symonds M, and Cassell JA
- Subjects
- Consensus, Contact Tracing, Humans, SARS-CoV-2, Sexual Partners, United Kingdom epidemiology, COVID-19, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control
- Abstract
Partner notification (PN) is an essential element of sexually transmitted infection (STI) control. It enables identification, treatment and advice for sexual contacts who may benefit from additional preventive interventions such as HIV pre- and post-exposure prophylaxis. PN is most effective in reducing STI transmission when it reaches individuals who are most likely to have an STI and to engage in sexual behaviour that facilitates STI transmission, including having multiple and/or new sex partners. Outcomes of PN practice need to be measurable in order to inform standards. They need to address all five stages in the cascade of care: elicitation of partners, establishing contactable partners, notification, testing and treatment. In the United Kingdom, established outcome measures cover only the first three stages and do not take into account the type of sexual partnership. We report an evidence-based process to develop new PN outcomes and inform standards of care. We undertook a systematic literature review, evaluation of published information on types of sexual partnership and a modified Delphi process to reach consensus. We propose six new PN outcome measures at five stages of the cascade, including stratification by sex partnership type. Our framework for PN outcome measurement has potential to contribute in other domains, including Covid-19 contact tracing.
- Published
- 2022
- Full Text
- View/download PDF
17. The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK.
- Author
-
Adiamah A, Thompson A, Lewis-Lloyd C, Dickson E, Blackburn L, Moody N, Gida S, La Valle A, Reilly JJ, Saunders J, and Brooks A
- Subjects
- Accidental Falls statistics & numerical data, Accidents, Traffic statistics & numerical data, Female, Humans, Male, Middle Aged, SARS-CoV-2, Trauma Severity Indices, United Kingdom epidemiology, COVID-19 epidemiology, COVID-19 prevention & control, Emergency Service, Hospital statistics & numerical data, Infection Control methods, Infection Control organization & administration, Surgical Procedures, Operative statistics & numerical data, Wounds and Injuries classification, Wounds and Injuries epidemiology, Wounds and Injuries etiology, Wounds and Injuries surgery
- Abstract
Background: The global pandemic caused by SARS-CoV-2 has impacted population health and care delivery worldwide. As information emerges regarding the impact of "lockdown measures" and changes to clinical practice worldwide; there is no comparative information emerging from the United Kingdom with regard to major trauma., Methods: This observational study from a UK Major Trauma Centre matched a cohort of patients admitted during a 10-week period of the SARS-CoV-2-pandemic (09/03/2020-18/05/2020) to a historical cohort of patients admitted during a similar time period in 2019 (11/03/2019-20/05/2019). Differences in demographics, Clinical Frailty Scale, SARS-CoV-2 status, mechanism of injury and injury severity were compared using Fisher's exact and Chi-squared tests. Univariable and multivariable logistic regression analyses examined the associated factors that predicted 30-days mortality., Results: A total of 642 patients were included, with 405 in the 2019 and 237 in the 2020 cohorts, respectively. 4/237(1.69%) of patients in the 2020 cohort tested positive for SARS-CoV-2. There was a 41.5% decrease in the number of trauma admissions in 2020. This cohort was older (median 46 vs 40 years), had more comorbidities and were frail (p < 0.0015). There was a significant difference in mechanism of injury with a decrease in vehicle related trauma, but an increase in falls. There was a twofold increased risk of mortality in the 2020 cohort which in adjusted multivariable models, was explained by injury severity and frailty. A positive SARS-CoV-2 status was not significantly associated with increased mortality when adjusted for other variables., Conclusion: Patients admitted during the COVID-19 pandemic were older, frailer, more co-morbid and had an associated increased risk of mortality.
- Published
- 2021
- Full Text
- View/download PDF
18. How does the sexual, physical and mental health of young adults not in education, employment or training (NEET) compare to workers and students?
- Author
-
Tanton C, McDonagh L, Cabecinha M, Clifton S, Geary R, Rait G, Saunders J, Cassell J, Bonell C, Mitchell KR, and Mercer CH
- Subjects
- Adolescent, Educational Status, Female, Humans, Male, Sexual Behavior, Students, United Kingdom epidemiology, Young Adult, Employment, Mental Health
- Abstract
Background: Syndemic theory highlights the potential for health problems to interact synergistically, compounding impact. Young adults not in education, employment or training (NEET) are more likely to experience disadvantage and poorer general health outcomes. However, there is little research on their sexual health, or the extent to which this clusters with mental and physical health outcomes., Methods: Analysis of data from 16 to 24 year olds (1729 men, 2140 women) interviewed 2010-12 for Britain's third National Survey of Sexual Attitudes and Lifestyles. Natsal-3 is a national probability sample survey using computer-assisted personal interviewing with computer-assisted self-interviewing. Participants were classified as workers, students or NEET. We used multivariable logistic regression to examine associations between being NEET (relative to worker or student) and risk behaviours and outcomes in physical, sexual and mental health domains. We then examined how risk behaviours and poor health outcomes cluster within and across domains., Results: 15% men and 20% women were NEET; 36% men and 32% women were workers; and 49% men and 48% women were students. Young people who were NEET were more likely to report smoking and drug use (men) than other young people. There were few differences in sexual health, although NEETs were more likely to report condomless sex, and NEET women, unplanned pregnancy (past year). Risk behaviours clustered more within and across domains for NEET men. Among NEET women, poor health outcomes clustered across mental, physical and sexual health domains., Conclusions: Harmful health behaviours (men) and poor health outcomes (women) clustered more in those who are NEET. This points to a possible syndemic effect of NEET status on general ill health, especially for women. Our paper is novel in highlighting that elevated risk pertains to sexual as well as mental and physical health.
- Published
- 2021
- Full Text
- View/download PDF
19. Physical Activity, Sport and Physical Education in Northern Ireland School Children: A Cross-Sectional Study.
- Author
-
Connolly S, Carlin A, Johnston A, Woods C, Powell C, Belton S, O'Brien W, Saunders J, Duff C, Farmer O, and Murphy M
- Subjects
- Child, Cross-Sectional Studies, Female, Humans, Male, Northern Ireland, Schools, United Kingdom, Exercise, Physical Education and Training
- Abstract
Internationally, insufficient physical activity (PA) is a major health concern. Children in Northern Ireland (NI) are recorded as having the lowest levels of PA in the United Kingdom (UK). To date, validated and representative data on the PA levels of NI school children are limited. The aim of this study was to provide surveillance data on self-reported PA, sport and physical education (PE) participation of school children in NI. Differences between genders and factors associated with PA were also examined. A representative sample of primary ( n = 446) and post-primary ( n = 1508) children was surveyed in school using validated self-report measures. Findings suggest that PA levels are low, with a minority of children (13%) meeting the PA guidelines (primary pupils 20%, post-primary pupils 11%). NI school children have lower levels of PA, PE and sports participation than UK and European peers. A trend of age-related decline across all the domains of PA was apparent. The data presented highlighted that females are less likely to achieve PA guidelines, children from lower socio-economic background participate in school and community sport less often, and that enjoyment and social support are important variables in PA adherence. Policy solutions that would support implementation e.g., mandatory minimum PE time, whole school approaches to PA promotion and targeted investment in schools, particularly in areas of deprivation and for females, are suggested.
- Published
- 2020
- Full Text
- View/download PDF
20. ICON Trauma (Impact of COVID-19 on Major Trauma workload) Study.
- Author
-
Adiamah A, Moody N, Blackburn L, Dickson E, Thompson A, Reilly JJ, Saunders J, and Brooks A
- Subjects
- Facilities and Services Utilization, Humans, Pandemics, SARS-CoV-2, United Kingdom epidemiology, Wounds and Injuries surgery, COVID-19 epidemiology, Trauma Centers statistics & numerical data, Workload statistics & numerical data
- Published
- 2020
- Full Text
- View/download PDF
21. 2019 UK National Guideline for consultations requiring sexual history taking : Clinical Effectiveness Group British Association for Sexual Health and HIV.
- Author
-
Brook G, Church H, Evans C, Jenkinson N, McClean H, Mohammed H, Munro H, Nambia K, Saunders J, Walton L, and Sullivan A
- Subjects
- Adult, Female, Humans, Male, Sexual Health, Sexual and Gender Minorities psychology, Substance-Related Disorders complications, Treatment Outcome, United Kingdom, Guidelines as Topic, HIV Infections diagnosis, Medical History Taking standards, Referral and Consultation standards, Sexual Behavior, Sexual and Gender Minorities statistics & numerical data, Sexually Transmitted Diseases diagnosis
- Abstract
This guideline is an update of a previous version published in 2013. In this new version, we have reflected changes in the way sexual health services are now provided by assuming an integrated Sexual Health/Sexual and Reproductive Healthcare service. There are new recommendations for online testing, female genital mutilation (FGM), chemsex and considerations for transgender (and non-binary) individuals. Previous versions rather assumed a cis-gender clientele and so we have taken a more mechanistic approach to sex and risk without assuming gender identification. We have updated our gender terminology in line with the British Association for Sexual Health and HIV 'sexual health standards for trans, including non-binary, people' although have retained the terminology of 'men' and 'women' in a few cases where it related to other guidelines, e.g. human papillomavirus vaccination and FGM.
- Published
- 2020
- Full Text
- View/download PDF
22. 2018 UK national guideline for the management of infection with Neisseria gonorrhoeae .
- Author
-
Fifer H, Saunders J, Soni S, Sadiq ST, and FitzGerald M
- Subjects
- Disease Management, Humans, Specimen Handling, United Kingdom, Gonorrhea diagnosis, Gonorrhea drug therapy, Neisseria gonorrhoeae isolation & purification, Practice Guidelines as Topic
- Published
- 2020
- Full Text
- View/download PDF
23. Assessment of steroid use as a key performance indicator in inflammatory bowel disease-analysis of data from 2385 UK patients.
- Author
-
Selinger CP, Parkes GC, Bassi A, Limdi JK, Ludlow H, Patel P, Smith M, Saluke S, Ndlovu Z, George B, Saunders J, Adamson M, Fraser A, Robinson J, Donovan F, Parisi I, Tidbury J, Gray L, Pollok R, Scott G, and Raine T
- Subjects
- Adrenal Cortex Hormones therapeutic use, Adult, Aged, Aged, 80 and over, Anti-Inflammatory Agents classification, Anti-Inflammatory Agents therapeutic use, Cohort Studies, Female, Humans, Inflammatory Bowel Diseases diagnosis, Male, Middle Aged, Prognosis, Quality Assurance, Health Care, Tumor Necrosis Factor-alpha antagonists & inhibitors, Tumor Necrosis Factor-alpha immunology, United Kingdom epidemiology, Young Adult, Inflammatory Bowel Diseases drug therapy, Inflammatory Bowel Diseases epidemiology, Practice Patterns, Physicians' standards, Practice Patterns, Physicians' statistics & numerical data, Quality Indicators, Health Care, Steroids therapeutic use
- Abstract
Background: Patients with IBD are at risk of excess corticosteroids., Aims: To assess steroid excess in a large IBD cohort and test associations with quality improvement and prescribing., Methods: Steroid exposure was recorded for outpatients attending 19 centres and associated factors analysed. Measures taken to avoid excess were assessed., Results: Of 2385 patients, 28% received steroids in the preceding 12 months. 14.8% had steroid excess or dependency. Steroid use was significantly lower at 'intervention centres' which participated in a quality improvement programme (exposure: 23.8% vs 31.0%, P < .001; excess 11.5% vs 17.1%, P < .001). At intervention centres, steroid use fell from 2015 to 2017 (steroid exposure 30.0%-23.8%, P = .003; steroid excess 13.8%-11.5%, P = .17). Steroid excess was judged avoidable in 50.7%. Factors independently associated with reduced steroid excess in Crohn's disease included maintenance with anti-TNF agents (OR 0.61 [95% CI 0.24-0.95]), treatment in a centre with a multi-disciplinary team (OR 0.54 [95% CI 0.20-0.86]) and treatment at an intervention centre (OR 0.72 [95% CI 0.46-0.97]). Treatment with 5-ASA in CD was associated with higher rates of steroid excess (OR 1.72 [95% CI 1.24-2.09]). In ulcerative colitis (UC), thiopurine monotherapy was associated with steroid excess (OR 1.97 [95% CI 1.19-3.01]) and treatment at an intervention centre with less steroid excess (OR 0.72 [95% CI 0.45-0.95])., Conclusions: This study validates steroid assessment as a meaningful quality measure and provides a benchmark for this performance indicator in a large cohort. A programme of quality improvement was associated with lower steroid use., (© 2019 John Wiley & Sons Ltd.)
- Published
- 2019
- Full Text
- View/download PDF
24. Detection in the United Kingdom of the Neisseria gonorrhoeae FC428 clone, with ceftriaxone resistance and intermediate resistance to azithromycin, October to December 2018.
- Author
-
Eyre DW, Town K, Street T, Barker L, Sanderson N, Cole MJ, Mohammed H, Pitt R, Gobin M, Irish C, Gardiner D, Sedgwick J, Beck C, Saunders J, Turbitt D, Cook C, Phin N, Nathan B, Horner P, and Fifer H
- Subjects
- Adult, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Azithromycin administration & dosage, Ceftriaxone administration & dosage, Ertapenem administration & dosage, Female, Gonorrhea diagnosis, Humans, Microbial Sensitivity Tests, Neisseria gonorrhoeae isolation & purification, Polymorphism, Single Nucleotide, Treatment Outcome, United Kingdom, Whole Genome Sequencing, Anti-Bacterial Agents pharmacology, Azithromycin therapeutic use, Ceftriaxone therapeutic use, Drug Resistance, Bacterial genetics, Ertapenem therapeutic use, Gonorrhea drug therapy, Neisseria gonorrhoeae drug effects, Neisseria gonorrhoeae genetics
- Abstract
We describe detection in the United Kingdom (UK) of the drug-resistant Neisseria gonorrhoeae FC428 clone, with ceftriaxone resistance and intermediate azithromycin resistance. Two female patients developed infection following contact with UK-resident men from the same sexual network linked to travel to Ibiza, Spain. One case failed treatment with ceftriaxone, and azithromycin and gentamicin, before successful treatment with ertapenem. Both isolates had indistinguishable whole-genome sequences. Urgent action is essential to contain this drug-resistant strain.
- Published
- 2019
- Full Text
- View/download PDF
25. Seventy years old and counting… but is the NHS meeting everyone's needs?
- Author
-
Saunders J
- Subjects
- Humans, Life Expectancy, United Kingdom, Public Health Practice, State Medicine
- Published
- 2018
- Full Text
- View/download PDF
26. Neighbourhood typologies and associations with body mass index and obesity: A cross-sectional study.
- Author
-
Hobbs M, Griffiths C, Green MA, Jordan H, Saunders J, and McKenna J
- Subjects
- Cross-Sectional Studies, Exercise, Fast Foods statistics & numerical data, Female, Food Supply, Humans, Male, Middle Aged, Parks, Recreational statistics & numerical data, United Kingdom, Body Mass Index, Environment, Obesity epidemiology, Residence Characteristics statistics & numerical data
- Abstract
Little research has investigated associations between a combined measure of the food and physical activity (PA) environment, BMI (body-mass-index) and obesity. Cross-sectional data (n=22,889, age 18-86years) from the Yorkshire Health Study were used [2010-2013]. BMI was calculated using self-reported height and weight; obesity=BMI≥30. Neighbourhood was defined as a 2km radial buffer. Food outlets and PA facilities were sourced from Ordnance Survey Points of Interest (PoI) and categorised into 'fast-food', 'large supermarkets', 'convenience and other food retail outlets' and 'physical activity facilities'. Parks were sourced from Open Street Map. Latent class analysis was conducted on these five environmental variables and availability was defined by quartiles of exposure. Linear and logistic regressions were then conducted for BMI and obesity respectively for different neighbourhood types. Models adjusted for age, gender, ethnicity, area-level deprivation, and rural/urban classification. A five-class solution demonstrated best fit and was interpretable. Neighbourhood typologies were defined as; 'low availability', 'moderate availability', 'moderate PA, limited food', 'saturated' and 'moderate PA, ample food'. Compared to low availability, one typology demonstrated lower BMI (saturated, b=-0.50, [95% CI=-0.76, -0.23]), while three showed higher BMI (moderate availability, b=0.49 [0.27, 0.72]; moderate PA, limited food, b=0.30 [0.01, 0.59]; moderate PA, ample food, b=0.32 [0.08, 0.57]). Furthermore, compared to the low availability, saturated neighbourhoods showed lower odds of obesity (OR=0.86 [0.75, 0.99]) while moderate availability showed greater odds of obesity (OR=1.18 [1.05, 1.32]). This study supports population-level approaches to tackling obesity however neighbourhoods contained features that were health-promoting and -constraining., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
27. Food and beverage cues in UK and Irish children-television programming.
- Author
-
Scully P, Reid O, Macken A, Healy M, Saunders J, Leddin D, Cullen W, Dunne C, and O'Gorman CS
- Subjects
- Adolescent, Adult, Beverages, Child, Female, Humans, Ireland, Male, Pediatric Obesity prevention & control, United Kingdom, Young Adult, Advertising trends, Cues, Feeding Behavior, Food Industry, Pediatric Obesity epidemiology, Television
- Abstract
Objectives: Increased time in which children spend watching television is a well-described contributor to paediatric obesity. This study investigated the frequency and type of food and beverage placement in children-specific television broadcasts and compared data from UK (UK) and Irish television stations., Design: Content analysis, totalling 82.5 h, reflecting 5 weekdays of children-specific television broadcasting on UK and Irish television channels was performed. To allow comparison between UK and Irish food and beverage cues, only broadcasts between 06.00 and 11.30 were analysed. Data were coded separately by two analysts and transferred to SPSS for analyses. Food and beverage cues were coded based on type of product, product placement, product use, motivation, outcome and characters involved., Results: A total of 1155 food and beverage cues were recorded. Sweet snacks were the most frequent food cue (13.3%), followed by sweets/candy (11.4%). Tea/coffee was the most frequent beverage cue (13.5%), followed by sugar-sweetened beverages (13.0%). The outcome of the cue was positive in 32.6%, negative in 19.8%, and neutral in 47.5% of cases. The most common motivating factor associated with each cue was celebratory/social (25.2%), followed by hunger/thirst (25.0%). Comparison of UK and Irish placements showed both to portray high levels of unhealthy food cues. However, placements for sugar-sweetened beverages were relatively low on both channels., Conclusions: This study provides further evidence of the prominence of unhealthy foods in children's programming. These data may provide guidance for healthcare professionals, regulators and programme makers in planning for a healthier portrayal of food and beverage in children's television., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
- Published
- 2014
- Full Text
- View/download PDF
28. A qualitative study of primary care clinicians' views of treating childhood obesity.
- Author
-
Walker O, Strong M, Atchinson R, Saunders J, and Abbott J
- Subjects
- Child, Continuity of Patient Care standards, Counseling, Humans, Interviews as Topic, Nurse-Patient Relations, Obesity diet therapy, Obesity prevention & control, Outcome and Process Assessment, Health Care, Physician-Patient Relations, Professional-Family Relations, Referral and Consultation, Social Class, United Kingdom, Attitude of Health Personnel, Nurse Practitioners psychology, Obesity therapy, Physicians, Family psychology, Primary Health Care standards
- Abstract
Background: The prevalence of childhood obesity is rising and the UK Government have stated a commitment to addressing obesity in general. One method has been to include indicators relating to obesity within the GP pay-for-performance Quality and Outcomes Framework (QOF) contract. This study aimed to explore general practitioners' and practice nurses' views in relation to their role in treating childhood obesity., Methods: We interviewed eighteen practitioners (twelve GPs and six nurses) who worked in general practices contracting with Rotherham Primary Care Trust. Interviews were face to face and semi structured. The transcribed data were analysed using framework analysis., Results: GPs and practice nurses felt that their role was to raise the issue of a child's weight, but that ultimately obesity was a social and family problem. Time constraint, lack of training and lack of resources were identified as important barriers to addressing childhood obesity. There was concern that the clinician-patient relationship could be adversely affected by discussing what was often seen as a sensitive topic. GPs and practice nurses felt ill-equipped to tackle childhood obesity given the lack of evidence for effective interventions, and were sceptical that providing diet and exercise advice would have any impact upon a child's weight., Conclusion: GPs and practice nurses felt that their role in obesity management was centred upon raising the issue of a child's weight, and providing basic diet and exercise advice. Clinicians may find it difficult to make a significant impact on childhood obesity while the evidence base for effective management remains poor. Until the lack of effective interventions is addressed, implementing additional targets (for example through the QOF) may not be effective.
- Published
- 2007
- Full Text
- View/download PDF
29. Providing end-of-life care for people with learning disabilities.
- Author
-
Medley S, Saunders J, and McEnhill L
- Subjects
- Choice Behavior, Disabled Persons legislation & jurisprudence, Humans, Mental Competency legislation & jurisprudence, Mental Competency psychology, Models, Nursing, Models, Organizational, Patient Advocacy, Patient Care Planning organization & administration, Patient Participation legislation & jurisprudence, Patient Participation methods, Patient Participation psychology, Patient-Centered Care organization & administration, Philosophy, Nursing, Practice Guidelines as Topic, Total Quality Management, United Kingdom, Disabled Persons psychology, Learning Disabilities nursing, Learning Disabilities psychology, Terminal Care organization & administration, Terminal Care psychology
- Abstract
The end-of-life care model Preferred Place of Care and the philosophy known as person-centred planning both aim to make patient choices and views central to any service delivery. This article compares the two strategies.
- Published
- 2006
30. Accelerated development of alcoholic cirrhosis in patients with HLA-B8.
- Author
-
Saunders JB, Wodak AD, Haines A, Powell-Jackson PR, Portmann B, Davis M, and Williams R
- Subjects
- Adult, Aged, Female, HLA Antigens immunology, Hepatitis, Alcoholic immunology, Humans, Liver pathology, Liver Cirrhosis, Alcoholic immunology, Liver Cirrhosis, Alcoholic pathology, Male, Middle Aged, Necrosis, Risk, United Kingdom, White People, HLA Antigens genetics, Liver Cirrhosis, Alcoholic genetics
- Abstract
To test whether the increased prevalence of HLA-B8 reported in patients with alcoholic cirrhosis is due to the antigen being a genetic marker of susceptibility to liver damage from alcohol, patients who had cirrhosis of comparable clinical and histological severity were investigated for HLA-B8 status and cumulative alcohol intake. Both male and female cirrhotics with HLA-B8 had been drinking greater than 40 g alcohol/day for a shorter period of time (16.6 +/- 1.4 men, and 9.4 +/- 2.0 years, women) than their counterparts without this antigen (23.7 +/- 1.7, p less than 0.005, and 15.8 +/- 2.0 years, p less than 0.05, respectively), but the mean daily alcohol intake was similar whether patients had HLA-B8 or not. These results suggest that genetic determinants linked to HLA-B8 enhance the rate of development of liver damage in those who drink potentially hepatotoxic amounts of alcohol.
- Published
- 1982
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.