Public health risk communication by text message in response to a cluster of invasive meningococcal infection in a primary school

Public health risk communication during emergencies should be rapid and accurate in order to allow the audience to take steps to prevent adverse outcomes. Delays to official communications may cause unnecessary anxiety due to uncertainty or inaccurate information circulating within the at-risk group. Modern electronic communications present opportunities for rapid, targeted public health risk communication. We present a case report of a cluster of invasive meningococcal disease in a primary school in which we used the school's mass short message service (SMS) text message system to inform parents and guardians of pupils about the incident, to tell them that chemoprophylaxis would be offered to all pupils and staff, and to advise them when to attend the school to obtain further information and antibiotics. Following notification to public health on a Saturday, an incident team met on Sunday, sent the SMS messages that afternoon, and administered chemoprophyaxis to 93% of 404 pupils on Monday. The use of mass SMS messages enabled rapid communication from an official source and greatly aided the public health response to the cluster.

The integrated school in a conflict society: a comparative analysis of two integrated primary schools in Northern Ireland

The purpose of this paper is to compare the approach to promoting positive relationships between Catholics and Protestants in two types of integrated primary school in Northern Ireland. Drawing on qualitative interviews with teachers, governors and parents in one transforming school and one grant maintained integrated school, i.e. one representative of each of the two types, the paper shows that whilst there are distinctions in the ways that the schools promote their image and ethos, the ‘lived reality’ of the schools, as reported by the research participants, is almost indistinguishable. The paper suggests that both schools tend not to refer to or explore cultural difference and that this tendency to ‘minimise difference’ seems to have the potential to silence school members who do wish to explore their own and other cultures. It is argued that such practices are likely to impede rather than facilitate the progress of good inter-community relations.

Obesity associated severe asthma represents a distinct clinical phenotype - Analysis of the British Thoracic Society Difficult Asthma Registry patient cohort according to body mass index

BACKGROUND: Obesity has emerged as a risk factor for the development of asthma and it may also influence asthma control and airways inflammation. However, the role of obesity in severe asthma remains unclear. OBJECTIVE: To explore the association between obesity (defined by BMI) and severe asthma. METHODS: Data from the National Registry for dedicated UK Difficult Asthma Services were used to compare patient demographics, disease characteristics and healthcare utilisation between three body mass index (BMI) categories (normal weight: 18.5 -24.99, overweight: 25 -29.99, obese: =30) in a well characterised group of severe asthmatic adults. RESULTS: The study population consisted of 666 severe asthmatics with a median BMI of 29.8 (interquartile range 22.5 -34.0). The obese group exhibited greater asthma medication requirements in terms of maintenance corticosteroid therapy (48.9% versus 40.4% and 34.5% in the overweight and normal weight groups, respectively), steroid burst therapy and short-acting ß2-agonist (SABA) use per day. Significant differences were seen with gastro-oesophageal reflux disease (GORD) (53.9% versus 48.1% and 39.7% in the overweight and normal weight groups, respectively) and proton pump inhibitor (PPI) use. Bone density scores were higher in the obese group, whilst pulmonary function testing revealed a reduced FVC and raised Kco. Serum IgE levels decreased with increasing BMI and the obese group were more likely to report eczema, but less likely to have a history of nasal polyps. CONCLUSIONS: Severe asthmatics display particular characteristics according to BMI that support the view that obesity associated severe asthma may represent a distinct clinical phenotype.1Royal Brompton Hospital, London, UK;2Department of Computing, Imperial College, UK3Airways Disease, National Heart & Lung Institute, Imperial College, UK;4Centre for infection and immunity, Queen's University of Belfast, UK;5University of Leicester, UK;6The University of Manchester and University Hospital of South Manchester, UK;7Birmingham Heartlands Hospital, University of Birmingham, UK;8Gartnavel General Hospital, University of Glasgow, UK;9Glasgow Royal Infirmary, Glasgow, UKCorrespondence: Dr Andrew N. Menzies-Gow, Royal Brompton Hospital, Fulham Road, London SW3 6HP.