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  • 1
    In: Nature, Springer Science and Business Media LLC, Vol. 617, No. 7962 ( 2023-05-25), p. 764-768
    Abstract: Critical illness in COVID-19 is an extreme and clinically homogeneous disease phenotype that we have previously shown 1 to be highly efficient for discovery of genetic associations 2 . Despite the advanced stage of illness at presentation, we have shown that host genetics in patients who are critically ill with COVID-19 can identify immunomodulatory therapies with strong beneficial effects in this group 3 . Here we analyse 24,202 cases of COVID-19 with critical illness comprising a combination of microarray genotype and whole-genome sequencing data from cases of critical illness in the international GenOMICC (11,440 cases) study, combined with other studies recruiting hospitalized patients with a strong focus on severe and critical disease: ISARIC4C (676 cases) and the SCOURGE consortium (5,934 cases). To put these results in the context of existing work, we conduct a meta-analysis of the new GenOMICC genome-wide association study (GWAS) results with previously published data. We find 49 genome-wide significant associations, of which 16 have not been reported previously. To investigate the therapeutic implications of these findings, we infer the structural consequences of protein-coding variants, and combine our GWAS results with gene expression data using a monocyte transcriptome-wide association study (TWAS) model, as well as gene and protein expression using Mendelian randomization. We identify potentially druggable targets in multiple systems, including inflammatory signalling ( JAK1 ), monocyte–macrophage activation and endothelial permeability ( PDE4A ), immunometabolism ( SLC2A5 and AK5 ), and host factors required for viral entry and replication ( TMPRSS2 and RAB2A ).
    Type of Medium: Online Resource
    ISSN: 0028-0836 , 1476-4687
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    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 120714-3
    detail.hit.zdb_id: 1413423-8
    SSG: 11
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  • 2
    In: Nature, Springer Science and Business Media LLC, Vol. 619, No. 7971 ( 2023-07-27), p. E61-E61
    Type of Medium: Online Resource
    ISSN: 0028-0836 , 1476-4687
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    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 120714-3
    detail.hit.zdb_id: 1413423-8
    SSG: 11
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  • 3
    In: Nature, Springer Science and Business Media LLC, Vol. 621, No. 7977 ( 2023-09-07), p. E7-E26
    Type of Medium: Online Resource
    ISSN: 0028-0836 , 1476-4687
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    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 120714-3
    detail.hit.zdb_id: 1413423-8
    SSG: 11
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  • 4
    Online Resource
    Online Resource
    Public Library of Science (PLoS) ; 2014
    In:  PLoS Currents
    In: PLoS Currents, Public Library of Science (PLoS)
    Type of Medium: Online Resource
    ISSN: 2157-3999
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2014
    detail.hit.zdb_id: 2583641-9
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  • 5
    Online Resource
    Online Resource
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 10 ( 2022-05-18), p. 6123-
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 10 ( 2022-05-18), p. 6123-
    Abstract: High ambient temperatures pose a significant risk to health. This study investigates the heatwave mortality in the summer of 2020 during the SARS-CoV-2 coronavirus (COVID-19) pandemic and related countermeasures. The heatwaves in 2020 caused more deaths than have been reported since the Heatwave Plan for England was introduced in 2004. The total and cause-specific mortality in 2020 was compared to previous heatwave events in England. The findings will help inform summer preparedness and planning in future years as society learns to live with COVID-19. Heatwave excess mortality in 2020 was similar to deaths occurring at home, in hospitals, and in care homes in the 65+ years group, and was comparable to the increases in previous years (2016–2018). The third heatwave in 2020 caused significant mortality in the younger age group (0–64) which has not been observed in previous years. Significant excess mortality was observed for cardiovascular disease, respiratory disease, and Alzheimer’s and Dementia across all three heatwaves in persons aged 65+ years. There was no evidence that the heatwaves affected the proportional increase of people dying at home and not seeking heat-related health care. The most significant spike in daily mortality in August 2020 was associated with a period of high night-time temperatures. The results provide additional evidence that contextual factors are important for managing heatwave risks, particularly the importance of overheating in dwellings. The findings also suggest more action is also needed to address the vulnerability in the community and in health care settings during the acute response phase of a heatwave.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 6
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2021
    In:  Journal of Public Health Vol. 43, No. 2 ( 2021-06-07), p. 425-432
    In: Journal of Public Health, Oxford University Press (OUP), Vol. 43, No. 2 ( 2021-06-07), p. 425-432
    Abstract: Local authorities have a crucial role in preparing for the impacts of climate change. However, the extent to which health impacts are being prioritized and acted on is not well understood. Methods We investigated the role of public health in adapting to climate change through: (i) a content analysis of local authority climate change adaptation strategies in South West England and (ii) semi-structured telephone interviews with local authority public health consultants and sustainability officers and a regional Public Health England representative (n = 11). Results Adaptation strategies/plans varied in existence and scope. Public health consultants did not have an explicit remit for climate change adaptation, although related action often aligned with public health’s emergency planning functions. Key barriers to health-related adaptation were financial constraints, lack of leadership and limited public and professional awareness about health impacts. Conclusions Local authorities in South West England have differing approaches to tackling health impacts of climate change, and the prominence of public health arguments for adaptation varies. Improved public health intelligence, concise communications, targeted support, visible local and national leadership and clarity on economic costs and benefits of adaptation would be useful for local authorities in preparing for the health impacts of climate change.
    Type of Medium: Online Resource
    ISSN: 1741-3842 , 1741-3850
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 1497445-9
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  • 7
    In: International Journal of Disaster Risk Science, Springer Science and Business Media LLC, Vol. 12, No. 4 ( 2021-08), p. 528-539
    Abstract: Every year, numerous environmental disasters and emergencies occur across the globe with far-reaching impacts on human health and the environment. The ability to rapidly assess an environmental emergency to mitigate potential risks and impacts is paramount. However, collating the necessary evidence in the early stages of an emergency to conduct a robust risk assessment is a major challenge. This article presents a methodology developed to help assess the risks and impacts during the early stages of such incidents, primarily to support the European Union Civil Protection Mechanism but also the wider global community in the response to environmental emergencies. An online rapid risk and impact assessment tool has also been developed to promote enhanced collaboration between experts who are working remotely, considering the impact of a disaster on the environment and public health in the short, medium, and long terms. The methodology developed can support the appropriate selection of experts and assets to be deployed to affected regions to ensure that potential public health and environmental risks and impacts are mitigated whenever possible. This methodology will aid defensible decision making, communication, planning, and risk management, and presents a harmonized understanding of the associated impacts of an environmental emergency.
    Type of Medium: Online Resource
    ISSN: 2095-0055 , 2192-6395
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2633158-5
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  • 8
    Online Resource
    Online Resource
    SAGE Publications ; 2019
    In:  Journal of Health Services Research & Policy Vol. 24, No. 4 ( 2019-10), p. 219-228
    In: Journal of Health Services Research & Policy, SAGE Publications, Vol. 24, No. 4 ( 2019-10), p. 219-228
    Abstract: Our objective was to assess the health care system impacts associated with the December 2013 east coast flooding in Boston, Lincolnshire, in order to gain an insight into the capacity of the health care sector to respond to high-impact weather. Methods Semistructured interviews were held with regional strategic decision makers and local service managers within 1 km of the recorded flood outline to ascertain their experiences, views and reflections concerning the event and its associated health impacts and disruption to health care services. A snowballing sampling technique was used to ensure the study had participants across a broad range of expertise. Interviews were recorded and transcribed verbatim, and data analysis was preformed using NVivo (v10) to apply a thematic coding and develop a framework of ideas. Results The results of this case study provide a vital insight into the health care disruption caused by flooding. All sectors of the health care system suffered disruption, which placed a strain on the whole system and reduced the capacity of the sector to respond to the health consequences of flooding and delivering routine health care. The formal recovery phase in Lincolnshire was stood-down on 4th February 2014. The results of this work indicate limitations in preparedness of the health care system for the reasonable worse-case scenario for an east coast surge event. Conclusions The health care sector appears to have limited capacity to respond to weather-related impacts and is therefore unprepared for the risks associated with a future changing climate. Further work is required to ensure that the health care system continues to review and learn from such events to increase climate resilience.
    Type of Medium: Online Resource
    ISSN: 1355-8196 , 1758-1060
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2039416-0
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  • 9
    In: BMJ Open, BMJ, Vol. 13, No. 3 ( 2023-03), p. e068298-
    Abstract: To critically assess the impacts of very hot weather on (i) frontline staff in hospitals in England and (ii) on healthcare delivery and patient safety. Study design A qualitative study design using key informant semi-structured interviews, preinterview survey and thematic analysis. Setting England. Participants 14 health professionals in the National Health Service (clinicians and non-clinicians, including facilities managers and emergency preparedness, resilience and response professionals). Results Hot weather in 2019 caused significant disruption to health services, facilities and equipment, staff and patient discomfort, and an acute increase in hospital admissions. Levels of awareness varied between clinical and non-clinical staff of the Heatwave Plan for England, Heat-Health Alerts and associated guidance. Response to heatwaves was affected by competing priorities and tensions including infection control, electric fan usage and patient safety. Conclusions Healthcare delivery staff experience difficulty in managing heat risks in hospitals. Priority should be given to workforce development and strategic, long-term planning, prevention and investment to enable staff to prepare and respond, as well as to improve health system resilience to current and future heat-health risks. Further research with a wider, larger cohort is required to develop the evidence base on the impacts, including the costs of those impacts, and to assess the effectiveness and feasibility of interventions. Forming a national picture of health system resilience to heatwaves will support national adaptation planning for health, in addition to informing strategic prevention and effective emergency response.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2599832-8
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  • 10
    Online Resource
    Online Resource
    Frontiers Media SA ; 2022
    In:  Frontiers in Public Health Vol. 10 ( 2022-11-10)
    In: Frontiers in Public Health, Frontiers Media SA, Vol. 10 ( 2022-11-10)
    Abstract: Hot and cold weather events are increasingly becoming a global burden resulting in premature and preventable morbidity and mortality, particularly in vulnerable groups such as older people and people with chronic health conditions. However, risk perception regarding weather is generally poor among vulnerable groups which often acts as a barrier to the uptake of critical health-protective behaviours. A more cohesive understanding of determinants of risk perception is needed to inform public health risk communication and behaviour change interventions that promote protective health behaviours. This scoping literature review aimed to understand factors influencing perception of personal health risks in vulnerable groups as a result of exposure to hot and cold weather events. Methods A five-stage scoping review framework was followed. Searches were run across Medline, PsychInfo, Web of Science and EMBASE. Papers were included if they provided rationale for risk perceptions in vulnerable groups in indoor/domestic environments and focussed on samples from OECD countries. Results In total, 13 out of 15,554 papers met the full inclusion criteria. The majority of papers focused on hot weather events: one study exclusively examined cold weather events and one study addressed both cold and hot weather events. Included papers focused on older adults aged 65+ years. The papers identified eight factors that were associated with older adults' personal health risk perception of hot and cold weather events: (1) Knowledge of the relationship between hot/cold weather and health risks, (2) presence of comorbidities, (3) age and self-identity, (4) perceived weather severity, (5) Beliefs associated with regional climate, (6) past experience with weather, (7) misconceptions of effectiveness of protective behaviours, and (8) external locus of control. Conclusions Future research should explore risk communication methods by implementing the identified risk perception determinants from this review into health protection interventions targeting older adults. Further understanding is needed regarding risk perceptions in non-elderly vulnerable groups, for examples individuals with chronic diseases or disabilities.
    Type of Medium: Online Resource
    ISSN: 2296-2565
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2711781-9
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