Patterns of ill health in the UK are monitored through the use of statistics. The UK National Statistic organisation is responsible for producing these statistics in order to illustrate and identify patterns of ill health within the UK. Government statistical departments play a vital role in identifying and monitoring patterns of ill health in the UK, of which include:
The Department of Health
Health and Safety Executive
NHS Information Centre for Health and Social Care
Statistics can be collected from records such as birth certificates, the death register and hospital admissions records. Records can be used for further analysis in order to gain more specific information, for example the weight of a new-born baby, or the reason an individual was admitted into hospital. The government has made the use of having these records available a legal requirement so that the statistics may be available when they are required. Statistics can be collected through the use of surveys, i.e. the national census of which is held every 10 years in the UK by the government. The national census survey has been in place since 1801 and takes into account each individual within a household. It is able to provide an outline of the UK which enables us to compare geographical areas. However statistics are not always accurate for what they represent, as there will always be information on illness which may not be reported therefore the statistics can only provide a general idea on what health in England is actually like.
Patterns of ill health can also be identified through other means, such as using reports; one such example includes the Black Report which took place back in 1980, and discovered that there were gross inequalities in health during that time period. The Black Report illustrated that the death rate of men in the lowest social class was two times higher than that of the death rate of men in the highest social class; therefore the gap in inequality was increasing rather than decreasing as it was expected to do so.
At present there are an extensive amount of various patterns of ill health within the UK today. Patterns of ill health can vary depending on their geographical locations in England.
Acheson Report (1998) – The Acheson Report was an independent study commissioned by the new Labour government in 1997, under the advisement of former Chief Medical Officer for England and Wales Sir Donald Acheson in regard to the state of health inequalities in the UK. It was a comprehensive survey about those in society who were described as being at a disadvantage. The findings provided by Acheson mirrored the previous findings in the Black Report back in 1980 which stated that the main cause of the inequalities to health was poverty. The report concluded that in order to improve the health of the nation the gap between the higher and lower classes in society in the UK needed to be reduced.
Our Healthy Nation (1999) – Our Healthy Nation was an action plan established to tackle poor health within the UK by setting attainable targets in areas where peoples health is at most risk of which include cancer, coronary heart disease, stroke, accidents and mental illness. Our Healthy Nation believe that social, economic and environmental factors are what leads to poor health, and that by making healthier choices to not only their health but their families’ health, they would make a huge difference. They believed that people can improve their own health through physical activity, better diet and stopping smoking, but in order to do so, individuals and their families need to be properly informed about the risks they taken when making their decisions.
Health inequality is seen throughout the UK and affects the most disadvantaged who suffer the most from poor health. By the government addressing inequality with a range of initiatives regarding to education, welfare to work, housing, neighbourhoods, transport and the environment would thereby improve the overall quality of health. As well as tackling important issues in regards to sexual health, drugs, alcohol, food safety, communicable diseases etc.
Tackling Health Inequalities: a Programme for Action (2003) – A Programme for Action sets out targets in order to tackle heath inequalities in the UK and is used in order to establish the foundations that are required in order to reduce the gap in infant mortality across the social groups, and to raise life expectancy in the most disadvantaged areas in the UK. The programme is also used to address the short-term consequences of avoidable health in the UK as well as its long term causes. Its main priority is to address the inequalities which are found across different geographical areas, between genders and different ethnic communities along with different social and economic groups.
Tackling health inequalities on a local level have already improved due to the help of front-line practitioners that were working in tandem with community groups and non-government organisations.
Choosing Health: Making healthy choices easier (2004) – The White Paper Choosing Health: making healthier choices easier lays out the government’s plan of action in order to undertake a variety of public health challenges which range from smoking, obesity, drinking to mental and sexual health. For example labelling the amount of fat, sugar and salt there is in food in order to broaden the public’s awareness on how it affects their health and the impact it has on their lives. This has made a substantial impact due to the amount of media coverage it has gotten in the past. (P4) (M2): Explain the main factors affecting current patterns of health in the UK –
There are a variety of factors that affect current patterns and trends of ill health in the UK, as each factor has a significant impact on an individual’s health. These factors include: Socio-economic, Education, Residing in a rural area, Pollution, Sexuality, genetics, Culture and Diet.
Social class – Social class is a term defined by an individual’s status within the social hierarchy of today’s society. A person’s status within the hierarchy depends on how much wealth the individual has, and how successful they are. The most commonly recognised of the social classes within the UK are the lower class, middle class, and upper class. An individual’s geographical location (where they come from and/or live in) is a contributing factor as to where they are placed in the social hierarchy.
The gap between the upper class and lower class in the UK is very slim due to the fact that most of the individuals living in the UK fall into the category of the middle class. In today’s society however, there are still signs of inequality; this can be shown through using statistics to show that individuals born in a lower class area are more likely to have worse health prospects than those born in an upper class geographical area.
Individuals born into a lower social class are more likely to face more problems in terms of their day to day life than those born into a less deprived geographical location. The day to day problems make it exceedingly difficult for individuals to stay healthy due to the fact that they may have very little income or enough time in order to feed themselves and their family’s healthy meals. In some cases people in the lower social class may not have enough money to allow them to take time off work or off caring for their family in order to use the healthcare services made available to them as effectively as they could, compared to those who live in a richer geographical area. People who live in poorer areas are more likely to suffer from mental health illnesses due to depression than those in the upper class due to the amount of depravation they face on a daily basis, for example unemployment.
Housing – ‘There is a correlation between poor housing and ill health and previous attempts to address the situation of poor housing that causes ill health have failed. For example individuals who suffer from ill health and live in poor quality housing due to low income. The highest risks to an individual include: cold, damp and mouldy conditions. The first study was conducted in 1986 by a man named Martin et al, in an area of North Edinburgh in which the resident were concerned about the dampness and its effects on their health. Through all the data collected, there was no clear evidence that suggested that the damp was causing health problems.
A separate study was undertaken by the Council of Environmental Health Officers and also found that there was no substantial difference between those living in damp housing, compared to those living in non-damp homes. However defective housing was associated with ill health among children. It was 85% more likely for children in damp housing to experience aches, pains, nerves, diarrhoea, headaches and respiratory problems over the course of two months, compared to the 60% of children residing in non-damp housing. Children in homes that had visible mould had higher rates of vomiting, and sore throats.
Evidence for adults living in damp housing had decidedly mixed results, however several studies have been able to link damp and mould to symptoms similar to that which were experienced by the children. The prevalence of illness increases with the levels of dampness in the homes.
Another example of poor housing includes the levels of overcrowding and living in high rise flats in association with various psychological conditions such as depression, although there are other outside influences such as social and economic influences which can add to the detrition of the individual’s mental health. The rates of anxiety and depression are gradually increasing due to the number of housing problems.
The better educated the individual, the more likely they are to have better health and knowledge on health, and this includes:
The individual would be more knowledgeable about the health care services available to them; therefore it would increase their likelihood of being able to use them more efficiently. There is a greater chance of having a well-paid job, if the individual is better educated, of which increases their chances of a better quality of life – thereby improving their mental health. Overall improvement of health due to their improved quality of life, as they are able to afford healthier food leading to living a healthier lifestyle. The individual would be more informed on what is considered healthier to do/eat and what is not. This knowledge would allow them to make more informed decisions on eating, the consumption of alcohol, smoking cigarettes and exercising in general.
Residing in a Rural Area
Living in a rural area has its merits and its faults for an individual in regards to their mental and physical health. Rural areas are the complete opposite to urban areas, the case being that rural areas do not have as many buildings but instead consist mostly of large areas of land otherwise known as the countryside. Living in a rural area can have a positive impact on an individual’s health, this includes:
Levels of pollution are considerably lower compared to urban areas such as towns, which are much denser with pollutants for example cars and planes. Those who live in rural areas are less likely to develop breathing difficulties, of which is one such example. The open spaces in rural areas provides those residing there uplifting views, this would have a positive effect on their mental health. These open spaces are also able to provide a good place for exercise. Individuals are less likely to become a victim of an assault compared to those living in urban area where it is considerably more populated, due to the fact there are far less people living in a rural area.
Negative effects on an individual’s health include:
Individuals living in rural areas are more likely to end up feeling isolated due to the fact that there is a smaller number of people living there, in this case it can affect their mental health which may lead to death by suicide. It can be difficult to access health care services for those who live in rural areas as they may live too far away from any hospitals and GP surgeries. In addition healthcare services may have to travel for a long period of time in in order to reach those who live in rural area because of the distance they must travel. This can lead to an increase in death rates caused by accidents. There is a higher risk of road traffic collisions in rural areas opposed to those in urban areas.
Road traffic collisions which occur in a rural area compared to that of an urban area, are more likely to lead to a fatality as the speed limit in rural areas are significantly higher than in urban areas. Collisions occur more frequently in rural areas as public transport is not as good as it could be, therefore leads more people to drink and drive because they cannot take the bus or a train. This is another reason as to why road traffic collisions have a higher mortality rate in rural areas, due to the amount of people who travel in a single vehicle due to the lack of public transport.
Pollution occurs when the environment is harmed by pollutants in the forms of gas, liquid, light and sound.
Gas pollutants: Toxins released from cigarettes and aeroplanes Liquid pollutants: Toxic waste or pesticides used by farmers to increase crop growth. Light/Sound pollutants: Street lights and vehicles
Pollution has a negative impact on the environment and in turn can have a harmful effect on an individual’s physical health. The severity of the harm to a person’s health can depend on amount of exposure they have had, and much harm the pollutants can cause. Some individuals can be more sensitive to pollution than others, such as babies, pregnant women, the elderly and people with health problems.
Low levels of pollution can cause minor effects to an individual’s physical condition, such as irritation to the eyes and throat. However even low concentrations of pollution can have a lasting effect on a person’s health if they are exposed to it on a regular basis. Pregnant women how have been exposed to continuous low concentration of pollution have a greater risk of their child being born with asthma.
Exposure to high concentration levels of pollution on a short term basis can prove extremely damaging and in some cases can even be fatal. In London in 1952, the great “Smog Disaster” caused a total of four thousand people to die over the course of a few days due to the high concentration of pollution.
Living in a big city where there is a lot of noise and light pollution can have detrimental effect to an individual’s mental health, and can lead them to becoming depressed.
A person’s sexuality defines what gender they are and what their sexual orientation is. What sexuality an individual is cannot only affect their physical health but also have a significant impact on their mental health as well. Physically being sexually active whether they are homosexual or heterosexual does have its risks, of which include STD’s, HIV and unwanted pregnancies.
However mentally being homosexual can prove hard to come to terms with for some individuals due to discrimination and prejudice homosexual individuals receive from society.
The stress of coming out to friends and family can be too great of a pressure for some individuals that they end up suffering from depression. However society in England in this day and age, homosexuality is widely accepted. In some cases homosexuality is not always as accepted and this can be the case in religious families where homosexuality is considered a sin. If their sexuality is not accepted this can lead to some individuals ending up homeless and feeling rejected by society. Young gay men have the highest rate of suicide due to feeling rejected from society.
Cystic Fibrosis – Cystic Fibrosis is a genetic disorder that is caused by a recessive allele. Both parents need to be carrying the recessive allele in order for the child to be born with the disorder. There is a 1 in 4 chance of the child being born with Cystic Fibrosis if a couple with allele decide to a baby. Cystic Fibrosis affects the internal organs of the body clogging them up with mucus, which can make it hard for the individual to breathe. Cystic Fibrosis is a progressive disorder with no current cure, and an individual’s average life expectancy with the disease is 31. There are measures in place in order to help the individual to stay healthy for as long as possible, despite the fact that there is no cure at present. Treatments include a healthy diet, exercising, physiotherapy and medicine treatment.
The result of the mucus clogging up the lungs, the individual can find that it is difficult to breathe and eat properly and this can have an impact on how they live and go about their day-to-day life. Cystic Fibrosis is a major factor which can affect the patterns and trends of ill health in the UK. In the future it is expected that over 2 million people in the UK will carry the gene.
Thalassemia- Is a group of inherited disorders where part of the blood otherwise known as haemoglobin is abnormal. This means that the red blood cells that are affected are unable to function properly, this can cause anaemia.
In thalassemia the production of haemoglobin is abnormal, of which can lead to anaemia due to the reduction of oxygen being carried around the body. The symptoms include feeling tired, breathless, drowsy and faint.
If thalassemia is left untreated, it can cause a variety of complications of which include: organ damage, restricted growth, liver disease, heart failure and death.
Thalassemia is a condition inherited from your parents, however there is now known reason as to what causes the genetic mutations of which are associated with thalassemia.
Thalassemia can be diagnosed through a series of blood tests and DNA tests in order to determine the type of thalassemia. Pregnant women for example have a routine check-up to look to see if they have an inherited disorder such as sickle cell anaemia.
Treatments for the disorder can include bone marrow transplants and cord blood transplantations. However the procedures can cause a variety of complications and are not suitable for everyone.
Culture is a term generally used to describe a person’s ethnicity, diet and religion. Culture comes hand in hand with rules and traditions which are enforced by the family, of which can influence an individual’s health. In some cases culture can affect an individual’s health, as if the individual has been taught that blood transfusions are wrong and that they should not accept a blood transfusion even at the cost of their own life then they are more likely to stick to that belief and die when it could have been prevented. Once again referring back to homosexuality and how it can lead to the individual being rejected by their family. However culture can prove beneficial to an individual’s health, for example those who follow a traditional Japanese diet are the most likely to live the longest out of all other national diets due to how healthy the diet is. The Japanese diet is mostly comprised of fish, rice and vegetables.
These examples indicate just how much culture can affect the patterns of ill health, as they show just how much culture can be detrimental and beneficial to an individual’s health mentally and physically.
Diet is a major contributing factor affecting health today. Poor diet can lead to type 2 diabetes, coronary heart disease, malnutrition, obesity, cancer, high blood pressure and strokes. Obesity is not only a concern in the UK but is also a concern throughout the world. The World Health Organisation (WHO) predicts that 2.3 billion overweight adults in the world by 2015 and that over 700 million of them will be obese. Large groups of teenagers (mostly females) who suffer from eating disorders which can lead them to suffering from malnutrition.
(M2) (D1): Discuss the factors likely to influence current and future patterns of health in the UK –
How factors are likely to influence current and future health patterns of health in the UK. For example how factors such as an individual’s diet can affect current patterns of health such as life expectancy.
Social class is a key influence of life expectancy. The higher the individual’s social status, the wealthier means the better overall quality of life they have. Individual’s with a better quality of life are more likely to live longer than those with a poorer quality of life, due to the fact that they are more likely to eat healthier and are less likely to vulnerable and become a victim of crime and be more mentally stable than those of a lower social class, as their lives are not as stressful therefore they have les to worry about.
For example the argument that males which are born into a setting where their quality of life is of a good standard due to the fact that their parents are professionals compared to individuals born into a family where their quality of life is not as good as their parents are not as skilled. This theory can be backed up through the use of statistics from 2007:
However the gap between the social classes should start to become smaller in the future, as it has been doing throughout the years due to the fact that equality has improved exponentially in the UK.
An individual is more likely to be successful in life and have a good career and quality of life rather than doing unskilled manual labour if they are well educated. Compared to those who are not well educated therefore are less likely to be successful in life and are more likely to get poorly paid jobs, leading to a lower quality of life of which can have a significant to their health as they will be unable to afford to eat as healthily compared to those in well-paid jobs.
This claim that professionals are more likely to live longer compared to unskilled manual workers can be backed up through the use of statistics previously used in social class:
National Statistics – “Males in the professional class had a life expectancy at birth of 80.0, compared with 72.7 years for those in the manual unskilled class”.
Residing in a Rural Area
Living in a rural area can have an overall negative influence on an individual’s health due to the fact that it is exceedingly difficult to access health services, along with increased risk of road traffic collisions are much more common and in most cases prove to be fatal. These effects can influence the life expectancy of individuals born in rural areas in a negative way.
Through the use of the National Statistics report, the average life expectancy for individuals who live in London is 2 years higher than for those residing in a rural area. However the same statistics also state that the life expectancy in rural areas is on the increase and will continue to do so in the future. http://www.ons.gov.uk/ons/dcp171778_238743.pdf
Pollution can affect patterns of life expectancy due to the fact that it can increase the chances of the individual developing problems and breather disorders, for example asthma. During 2009 the NHS reported that a study which was conducted in the USA had found that individuals living in polluted areas are expected to live 10 months less than those who lived in non-polluted areas, like the countryside for example as the air is cleaner. www.nhs.uk/ news/2009/01January/Pages/Pollutionandlifeexpectancy.aspx
As previously stated, Cystic Fibrosis is a progressive disorder which at present has no cure and an individual’s average life expectancy with the disorder is 31, this can affect the patterns of health as an estimated 7,500 people have the disorder and 2 million people carry the gene. Although there may be no cure there are treatments, and new treatments are constantly being researched and the current treatments continually improved. Due to the vast improvement in treatments and the research of other treatments, the life expectancy for those with Cystic Fibrosis is likely to continue to rise, as it has been doing over the last few years. According to www.disabled-world.com the life expectancy for individuals who had the disorder back in the 1980’s was just 14 years old. This illustrates how much the life expectancy rate for someone with the disorder has improved immensely.
Due to the different traditions and beliefs of different individuals, people may live longer than others due to their health lifestyles because that is the way they believe they should live. Ethnic groups come under the topic of culture and across the UK there are differences in equality based on a person’s ethnicity. Since the Black Report was first published, the gap that was between the white British population and the ethnic minorities has decreased dramatically, however there are still un-equalities between the groups. White British people are expected to live around 2 years longer than those in the ethnic minority according to statistics taken from the government. The statistics state that on average white British people are expected to live to 77.7 years of age compared to people in the ethnic minority, who on average are expected to live to 75.5 years of age. www.lancashire.gov.uk
It is well known that a healthy diet can increase a person’s lifespan. This can be backed up from mass media (news reports) stating the positive aspects of healthy eating and the negative effects of an unhealthy diet. In one such report it states how a good healthy diet can increase an individual’s lifespan and reduce the risks of developing cancer, cardiovascular disease, diabetes etc. www.livestrong.com/article/479611-organic-diet-life-expectancy
By eating unhealthy foods on a regular basis for a long period of time, the individual is more likely to become obese. Obesity is a killer and is currently on the rise. Obesity can cause arthritis, diabetes, cancer, coronary heart disease and high blood pressure. 60.8% of adults within the UK are estimated to be overweight according to the report by the BBC, and that the problem of obesity is on the rise and in 15 years it could affect 75% of the population in the UK. www.bbc.co.uk/health/physical_health/conditions/obesity.shtml
(D1) Evaluate the influence of government on factors that contribute to the current patterns of health and illness in the UK –
Over the course of the last 50 years in the UK the government (England, Wales, Northern Ireland and Scotland) have made a great effort in order to improve the overall health of the general population in the UK. This has been achieved through the use of making the general population more aware of the dangers to their health and what they are along with they can do in order to improve it, thereby making better informed decisions in regards to their health when it comes to things such as diet, road safety (driving), exercise, smoking and education.
The greatest influence that the government has had on the population in general on patterns of health over the last 50 years has been to increase the awareness on the negative effects smoking can have on a person’s health. The ill effects of smoking were originally discovered in 1961 and from that point onwards the government have worked continuously in order to stop people from smoking in order to prevent individuals from dying. The first government initiative was put into place in 1971 which led to manufactures agreeing to display on their packaging compulsory anti-smoking adverts, such as “smoking kills”. This new initiative made a significant impact on raising people’s awareness in the UK about the damaging effects smoking can cause to their health.
Adverts promoting smoking were officially band in 2002 through the use of another government initiative; known as “The Tobacco Advertising and Smoking Bill 2001” Smoking has dropped significantly since 1948 which is proof enough that the government initiatives have had a positive impact on
patterns of health and ill health in the UK.
The government have been campaigning to make driving safer in the UK. Driving under the influence of alcohol increases the chance of an individual having a road accident. The government has taken measures to prevent situations like this from occurring by releasing health campaigns in order to tackle drink drivers over the past couple of years in order to decrease the rates of road traffic collisions in the UK or to even prevent them completely. However the government have not just been attempting to raise awareness about the effects of drink driving but also putting in place stricter measures for offenders so that people are deterred even more from driving whilst they are under the influence of alcohol.
At present the maximum penalty for being caught drinking and driving is a ?5000 fine, a ban on the individual’s driving licence and 6 months imprisonment. If the individual causes a road collision whilst they are under the influence of alcohol and cause a fatality, they can be sentenced to a maximum of 14 years in prison. Apart from the initiatives in place to prevent drinking and driving, there have been other government initiatives used in order to stop people from using their phones when they are driving, to wear their seatbelt whilst they are driving and to prevent road rage by raising awareness.
In the 21st century obesity within the UK was starting to become a major concern, after the issue of smoking had been dealt with. In order to get a handle on the growing problem of obesity, the prime minister at the time released a new piece of legislation otherwise known as “Choosing Health: Making healthy choices easier”. This piece of legislation was designed with the purpose to motivate people, improve emotional well-being and to make healthy choices easier for individuals to make in the UK. By making a healthier nation the government aimed to prevent individuals from becoming obese and in turn developing other various health problems as result, of which include type 2diabetes and coronary heart disease. However it is too early to tell whether this piece of legislation has had any real positive impact on the patterns of health and trends of health in the UK. On the other hand, this legislation has sparked other health campaigns to form from other government organisations such as the NHS.
A future health campaign is being set up targeted at the prevention of accidents especially in the workplace. The campaign is being released to tackle accidents that are currently a top cause of ill health and death in the UK. The campaign is aiming to raise awareness, so that individuals may take precautions and actions to prevent accidents from occurring, such as slips, trips and falls.
In conclusion I believe that the government has had a positive influence on the state of the population’s health in the UK thanks to their use of initiatives such as new legislation and health campaigns. The government’s most positive influences on patterns of health in the UK have been on smoking, driving and obesity. However I believe that the government needs to focus more on the current alcohol epidemic currently spreading across the UK, of which at present the government has not really done much about. Hospital admissions due to alcohol have cost the NHS billions, and if something is not done about it the admissions could be costing ?3.7 billion by 2015 according to the BBC. Besides the rise in hospital admissions, deaths due to alcohol related liver disease has also been on the rise. I think that the government should focus more on alcohol campaigns before the issue with alcohol becomes a major problem.
Bbc.co.uk, (2014). BBC – Health. [online] Available at: http://www.bbc.co.uk/health [Accessed 21 Oct. 2014].
World, D., Guidelines, T., Working?, H., Fruit, G., Spices, I., Released, E. and Therapies, B. (2014).Disabled World – Disability News & Information. [online] Disabled World. Available at: http://www.disabled-world.com [Accessed 21 Oct. 2014].
Lbl.gov, (2014). Berkeley Lab — Lawrence Berkeley National Laboratory. [online] Available at: http://www.lbl.gov [Accessed 21 Oct. 2014].
Lancashire.gov.uk, (2014). Lancashire County Council – Classic Homepage. [online] Available at: http://www.lancashire.gov.uk/home/2010/classic/index.asp [Accessed 21 Oct. 2014].
Ons.gov.uk, (2014). Office for National Statistics (ONS) – ONS. [online] Available at: http://www.ons.gov.uk [Accessed 21 Oct. 2014].
Berthoud, H. and Morrison, C. (2008). The Brain, Appetite, and Obesity. Annu. Rev. Psychol., [online] 59(1), pp.55-92. Available at: http://dx.doi.org/10.1146/annurev.psych.59.103006.093551 [Accessed 22 Oct. 2014].
Dh.gov.uk, (2014). Department of Health – GOV.UK. [online] Available at: http://www.dh.gov.uk [Accessed 22 Oct. 2014].
LIVESTRONG.COM, (2013). Health Benefits of Organic Foods Vs. Processed Foods | LIVESTRONG.COM. [online] Available at: http://www.livestrong.com/article/258734-health-benefits-of-organic-foods-vs-processed-food/ [Accessed 22 Oct. 2014].
Mapsofworld.com, (2014). World Map – Maps of the World. [online] Available at: http://www.mapsofworld.com [Accessed 21 Oct. 2014].
Nhs.uk, (2014). NHS Choices – Your health, your choices. [online] Available at: http://www.nhs.uk [Accessed 22 Oct. 2014].
Anon, (2014). [online] Available at: http://www.ons.gov.uk/ons/dcp171778_238743.pdf [Accessed 22 Oct. 2014]. References
Anon, (2014). [online] Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/265576/4386.pdf [Accessed 3 Nov. 2014].
Anon, (2014). [online] Available at:
http://www.bristol.ac.uk/poverty/downloads/keyofficialdocuments/Tackling%20HE%20program%20for%20action.pdf [Accessed 3 Nov. 2014].
Nhs.uk, (2014). Thalassaemia – NHS Choices. [online] Available at: http://www.nhs.uk/Conditions/thalassaemia/Pages/introduction.aspx [Accessed 3 Nov. 2014].