ObjectiveTo describe, for the first time, distribution (by geography, age, sex) and time trends in burn injury in England and Wales over the period that the international Burn Injury Database (iBID) has been in place.SettingData from the iBID for the years 2003–2011 were used for a retrospective descriptive observational study of specialised services workload and admissions in England and Wales.ParticipantsAll patients who have been visited or admitted to the burn injury specialised health service of England and Wales during the time period 2003–2011. Data cleaning was performed omitting patients with incomplete records (missingness never exceeded 5%).Outcome measuresWorkload, admissions, mortality, length of stay (LOS), geographical distribution, sex differences, age differences, total burn surface area, mechanism of Injury.ResultsDuring 2003–2011, 81 181 patients attended the specialised burn service for assessment and admission in England and Wales. Of these, 57 801 were admitted to the services. Males accounted for 63% of the total workload in specialised burn injury services, and females for 37%. The median (IQR) burn surface area was 1.5% (3.5%). The most frequent reason for burn injury was scald (38%). The median (IQR) age for all the referred workload for both genders was 21 (40). The overall mortality of the admitted patients was 1.51% and the median (IQR) LOS was 1 (5) days.ConclusionsMortality from burn injuries in England and Wales is decreasing in line with western world trends. There is an observed increase in admissions to burn services but that could be explained in various ways. These results are vital for service development and planning, as well as the development and monitoring of prevention strategies and for healthcare commissioning.

BackgroundThe UK introduced an ambitious national strategy to reduce population levels of salt intake in 2003. The aim of this study was to evaluate the impact of this strategy on salt intake in England, including potential effects on health inequalities.MethodsSecondary analysis of data from the Health Survey for England. Our main outcome measure was trends in estimated daily salt intake from 2003–2007, as measured by spot urine. Secondary outcome measures were knowledge of government guidance and voluntary use of salt in food preparation over this time period.ResultsThere were significant reductions in salt intake between 2003 and 2007 (−0.175grams per day per year, p<0.001). Intake decreased uniformly across all other groups but remained significantly higher in younger persons, men, ethnic minorities and lower social class groups and those without hypertension in 2007. Awareness of government guidance on salt use was lowest in those groups with the highest intake (semi-skilled manual v professional; 64.9% v 71.0% AOR 0.76 95% CI 0.58–0.99). Self reported use of salt added at the table reduced significantly during the study period (56.5% to 40.2% p<0.001). Respondents from ethnic minority groups remained significantly more likely to add salt during cooking (white 42.8%, black 74.1%, south Asian 88.3%) and those from lower social class groups (unskilled manual 46.6%, professional 35.2%) were more likely to add salt at the table.ConclusionsThe introduction a national salt reduction strategy was associated with uniform but modest reductions in salt intake in England, although it is not clear precisely which aspects of the strategy contributed to this. Knowledge of government guidance was lower and voluntary salt use and total salt intake was higher among occupational and ethnic groups at greatest risk of cardiovascular disease.

Forecasting the outcome of outbreaks as early and as accurately as possible is crucial for decision making and policy implementations. A significant challenge faced by forecasters is that not all outbreaks and epidemics turn into pandemics making the prediction of their severity difficult. At the same time, the decisions made to enforce lockdowns and other mitigating interventions versus their socioeconomic consequences are not only hard to make, but also highly uncertain. The majority of modeling approaches to outbreaks, epidemics, and pandemics take an epidemiological approach that considers biological and disease processes. In this paper, we accept the limitations of forecasting to predict the long-term trajectory of an outbreak, and instead, we propose a statistical, time-series approach to modelling and predicting the short-term behaviour of COVID-19. Our model assumes a multiplicative trend, aiming to capture the continuation of the two variables we predict (global confirmed cases and deaths) as well as their uncertainty. We present the timeline of producing and evaluating 10-day-ahead forecasts over a period of four months. Our simple model offers competitive forecast accuracy and estimates of uncertainty that are useful and practically relevant.