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Introduction: SARS‐CoV‐2 infection has had a significant impact on vulnerable individuals including transplant patients. Socioeconomic deprivation negatively affects outcomes of many health conditions. The aim of this study was to evaluate the effect of socioeconomic deprivation on the incidence and severity of SARS‐CoV‐2 infection among Welsh transplant patients. Methods: This study is a retrospective, cross‐sectional study on the transplant population of Wales. The Welsh Index of Multiple Deprivation (WIMD) was used to assess the influence of socioeconomic deprivation on outcomes of Welsh transplant patients who developed SARS‐CoV‐2 infection. Outcome measures were the incidence of SARS‐CoV‐2 infection, rates of hospital and ICU admission, development of acute kidney injury (AKI) and mortality. A logistic binomial regression analysis was used to correlate the various risk factors with the incidence of SARS‐CoV‐2 infection. Results: Two hundred and sixty‐six (25%) of regular follow up patients had SARS‐CoV‐2 infection; of these 55 (20.7%) were admitted, 15 (5.6%) to ICU, 37 (13.9%) developed AKI, and 23 (8.6%) died. In a regression analysis, patients of younger age were associated with more (p =.001) and those with SPK (simultaneous pancreas kidney) transplant less chance of infection (p =.038), whereas social deprivation was not associated with the chance of infection (p =.14). In regression analysis increased social deprivation was associated with higher chance of AKI post SARS‐CoV‐2 (p =.049). Conclusions: Socioeconomic deprivation did not affect the rates or severity of SARS‐CoV‐2 infection apart from the degree of AKI in Welsh Transplant patients. Adherence to the preventive measures for this high‐risk population must continue to remain a priority. [ABSTRACT FROM AUTHOR]

For those who are connected digitally, the digital health revolution is an enormous opportunity for patient empowerment. However, half the world's population are not online. Those who are least likely to be online are exactly those who experience the greatest burden of ill health. As information about health and illness is increasingly (and often exclusively) available in digital form, we face a new public health challenge – digital health inequality. Libraries are ideally placed to reach these population groups who may be hardest to reach. The IFLA (2017) Statement on Digital Literacy recognises that with libraries' mission to help all their users access and apply the information they need for personal and community development, digital inclusion is an important part of the practice of librarianship. Successful interventions to improve digital inclusion involve targeting connecting, and transforming lives. This article focuses on initiatives to combat digital exclusion in England and Wales. [ABSTRACT FROM AUTHOR]

Background: Breast cancer, historically a disease of more affluent women, has increased in incidence for women from areas of greater social deprivation, yet prognosis is worse for these women. This study identifies differences in presentation, treatment and prognostic factors between the socioeconomic groups.Methods: Patient data obtained from the prospectively maintained Welsh national Cancer Network Information System Cymru, for an 11-year period, were categorised according to Welsh Index of Multiple Deprivation quintiles. Quintiles were compared for differences in variables relating to patient characteristics, detection of cancer, tumour biology and treatment.Results: 1570 patients were included. Analysis showed that in the more socially deprived quintiles, there are proportionally fewer women being diagnosed through the NHS breast cancer screening programme and as a consequence greater numbers of women from poorer areas being diagnosed outwith the screening age parameters. Screen detection is strongly associated with better prognosis in terms of Nottingham Prognostic Index. Similarly, increasing levels of social deprivation are associated with higher incidence of oestrogen receptor negative and triple negative tumours, both features associated with a shorter disease free and overall survival. Other variables of tumour biology, rates and type of surgical and adjuvant treatment were similar across social deprivation quintiles.Conclusion: There is a trend of reduced early detection of breast cancer in South East Wales in those patients living in areas of higher social deprivation. Given that there is equity in access to treatment within NHS, which is free for patients at the point of care, further study is warranted to address this existing disparity. Population cancer surveillance will need to inform both public health and NHS service responses, to continue to achieve improvements. Health trends may yet alter depending on current and future shifts in governmental health policy. [ABSTRACT FROM AUTHOR]

As information about health and illness is increasingly (and often exclusively) available in digital form, we face a new public health challenge – digital health inequality. Those who are least likely to be online (including older people and people with disabilities) are exactly those who experience the greatest burden of ill health. Wales has particular challenges in digital inclusion, including social deprivation, an ageing population and poor broadband connectivity in remote rural areas. In response to these challenges, a review of digital inclusion and health in Wales was commissioned in 2018. The review was carried out by the author (Gann) using a mixed methods approach including literature review, stakeholder interviews and case studies. The review identified creative, community based approaches which are showing inspiring ways to build digital access and confidence so people can become active partners in their own health. [ABSTRACT FROM AUTHOR]

Summary: We used routine hospital data to investigate whether socially deprived patients had an increased risk of dying following hip fracture compared with affluent patients. We found that the most deprived patients had a significantly increased risk of dying at 30, 90 and 365 days compared with the most affluent patients. Introduction: To identify whether social deprivation has any effect on mortality risk after emergency admission with hip fracture and to determine whether any increased mortality observed among deprived groups was associated with patient and hospital-related factors. Methods: We used routine, linked hospital inpatient and mortality data for emergency admissions with a hip fracture in both England and Wales between 2004 and 2011. Mortality rates at 30, 90 and 365 days were reported. Logistic regression was used to identify any significant increases in mortality with higher levels of social deprivation and the influence of other risk factors on any increased mortality among the most deprived group. Results: Mortality rates at 30, 90 and 365 days were 9.3, 17.4 and 29.0 % in England and 8.3, 16.1 and 27.9 % in Wales. Social deprivation was significantly associated with increased mortality in the most deprived quintile compared with the least deprived quintile at 30, 90 and 365 days in England (OR = 1.187, 1.185 and 1.154, respectively) and at 90 and 365 days in Wales (1.135 and 1.203). There was a little interaction between deprivation and other risk factors influencing 30- and 365-day mortality except for patient age, pre-fracture residence and hospital size. Conclusions: We demonstrated a positive association between social deprivation and increased mortality at 30 days post-admission for hip fracture in both England and Wales that was still evident at 90 and 365 days. We found little influence of other factors on social inequalities in mortality risk at 30 and 365 days post-admission. [ABSTRACT FROM AUTHOR]

Introduction: Low socio-economic status is thought to be associated with increased burn risk, however the significance and generalisability across different populations and cultures has been questioned. Methods: A nine-year retrospective study of burn presentations to a large teaching hospital (2005-2014) was performed to investigate the association between socio-economic status and burns. Demographic and injury data was collected via the trust 'Information portal'. The Welsh Index of Multiple: Deprivation 2011 was used to score for socio-economic status. Chi-squared test and Odds Ratios were calculated and statistical significance defined as p<0.05 throughout. Results: 6441 burns were identified, with 755 (11.7%) admitted. Overall incidence rates were the highest published in the UK (0.35/1000/year) with sub group analysis showing the highest rates in under fives and males. Significant relationships between both age and burn mechanism and gender and burn mechanism (p=0.0005) were identified. Scald (67.1%) was the most common mechanism with the upper limb (48%) most commonly burned. Chi square analysis demonstrated a significant relationship between socio-economic deprivation, age and burn incidence (p≤0.0005), with a disproportionately high number of burns in patients under the age of 16 in the most deprived quintile (OR 1.23; 95% CI 1.06-1.44). Conclusion: This study specifically highlights patients under the age of 16 living in poorer socio-economic areas as the most at risk of suffering burns receiving hospital attention. This study demonstrates burns as a significant public health issue, and the results should aid in designing specific burn prevention strategies to target high-risk groups. [ABSTRACT FROM AUTHOR]

Abstract: Being able to analyse the relationships between people and nature has always been of key interest to ecosystems conservation, planning decisions and in a number of disciplines of natural and social sciences. In this framework, it is of paramount importance to evaluate possible correlations between factors such as ecosystem services, human health, and social deprivation. The present study aims at exploring relationships between ecosystem services, human health, and social deprivation for the region of Wales in the United Kingdom. Wales is of special interest because as a region it offers many ‘green’ ecosystems which have already been found to have a positive influence on humans' well-being as well as on socio-economic status. First, a recreational layer showing the size and location of all potential recreational areas in each Welsh local authority was created. Subsequently, correlation/regression analysis and weighted raster analysis were performed which allowed determining quantitatively the degree of correlation between the observed socio-economic factors and recreational areas. The findings of this exploratory study suggested that the relative size of potential recreational area varies widely within the local authorities comprising Wales. Not all the socio-economic factors which were examined herein found to be correlated with recreational areas. Some variables, such as income and employment deprivation showed high correlations with poor recreation options. Very poor correlation was also reported between recreation options and variables such as life expectancy and long-term illness. Our results, in agreement to previous studies conducted elsewhere, suggested that human health is determined by a complex interplay of more than one of the observed determinants, including for example biology and genetics or living and working conditions. As to our knowledge there are no prior research studies on the topic for our study region, this work provides a key contribution concerning the determination of a “social” value of ecosystems in the context of human health and other socio-economic factors. However, as these are only initial results, further work is required to verify those. [Copyright &y& Elsevier]

Summary Objective. To investigate differences in risk of categories and causes of death before 1 year of age between rural and urban areas. Methods. Population-based ecological study using Poisson regression analysis of data from all enumeration districts in Wales. Data included alt 243 223 registrable births to women resident in Wales, 809 therapeutic and spontaneous abortions, 1302 stillbirths and 1418 infant deaths occurring between 1993 and 1999. Main results. The relative risk of mortality in rural areas compared with urban areas for all deaths before 1 year of age was 0.89 (95% confidence interval 0.82, 0.98, P=0.02). The risk of mortality in rural areas was significantly Lower than in urban areas for all categories of deaths occurring after 7 days of life. The relative risk of death due to infection was significantly Lower in rural areas compared with urban areas (P=0.04), with similar results for deaths due to sudden infant death syndrome (P=0.03). After adjusting for social deprivation, there were no significant differences in the risk of death between rural and urban areas. Conclusions. While there were significant differences in crude risk between rural and urban enumeration districts for some causes and age groups before 1 year, after adjusting for social deprivation, these differences were not significant. The lack of significant interaction between rurality and deprivation indicated that the relationship between social deprivation and death before 1 year of age was not significantly different in rural areas compared with urban areas. Collaborative public health programmes to tackle deprivation are necessary in both rural and urban areas. [ABSTRACT FROM AUTHOR]