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Background: Interest in the health and well-being of university students has increased in the UK and Ireland in the past two decades as their numbers have grown. Recent high-profile deaths of students after using illicit drugs have highlighted the importance of the topic for policy makers. This scoping review maps the state of the existing literature evaluating use of illicit drugs in university students in the UK and Ireland. It aims to highlight research gaps and inform policy. Method: We conducted a systematic search of papers related to psychoactive drug use in university students in the UK and Ireland published before August 2021. The 18 extracted study characteristics included author(s); year of publication; journal; location of data collection; study design; delivery method (e.g., online survey, in-person, postal survey); number of participants; response rate; participant course of study, year of study, degree level (i.e., undergraduate, postgraduate), gender and age; time-period assessed (e.g., lifetime, current use, past 12 months); primary aim; primary outcome; ethical approval; and funding source. Results: The PRISMA-guided search strategy identified 1583 papers for abstract review; of 110 papers retained for full-text review, 54 studies met criteria for inclusion for this paper. Primary outcomes were coded into five groups: prevalence and patterns of drug use; factors associated with drug use; attitudes and knowledge about, and motivation for, drug use; supply of drugs; consequences of drug use. The results show that there is no coherent body of research in this area. The prevalence of reported drug use has crept up and the range of substances reported has broadened over time, and attitudes to drugs on average have normalised. However, there are significant methodological limitations that limit the utility of these findings. There was little evidence of published work on prevention of, or intervention to reduce, drug-related harms. Conclusion: The domains identified offer a framework for university administrators, researchers and policy makers to understand the potential response to drug use in university students in the UK and Ireland. Recommendations are made to fill the gaps in the research evidence base. [ABSTRACT FROM AUTHOR]

Millions of sub‐daily sea‐level pressure observations taken between 1919 and 1960 over the British and Irish Isles were transcribed from paper records in the early 2000s but were not published and subsequently forgotten. A chance discussion led to the rediscovery of the transcribed data and 5.47 million observations from 160 locations are now made available, although the data have not been fully quality‐controlled. Much of the data are 3‐hourly, allowing for detailed examinations of synoptic weather variations for this region and time period, and will be invaluable for constraining future reanalyses. We illustrate the value of the data using a stormy period during October and November 1928 and discuss the remaining quality‐control issues. [ABSTRACT FROM AUTHOR]

Immigration has proven to be a major force driving entrepreneurial dynamics. In this paper I investigate how the geographical distribution of immigrants within a given country, and in particular the presence of "enclaves," affects the relationship between immigration and entrepreneurship. I examine the impact of Polish immigration to Great Britain following the unprecedented migration wave caused by the European Union enlargement in 2004. I address omitted variable concerns by using information on the location of historical Polish military settlements and the occupational composition and growth of Polish immigration in Ireland to construct instruments for enclaves and location choices of immigrants. The econometric results indicate, on the one hand, that immigration does increase immigrant entrepreneurship, but not in existing immigrant enclaves. On the other hand, immigrant entrepreneurs outside enclaves tend to achieve worse growth outcomes than those in enclaves. Further analyses provide an explanation to these findings due to blocked labor markets and to the higher prevalence of "necessity entrepreneurship" outside of enclaves. These results offer new insights to understand the influence of geography on entrepreneurship in the presence of immigration. This paper was accepted by Toby Stuart, entrepreneurship and innovation. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4776. [ABSTRACT FROM AUTHOR]

Many children with developmental language disorder (DLD) have emotion recognition and regulation difficulties, but there are currently no known interventions enhancing emotional awareness in this population. This study explores the impact of parents' perspectives regarding children with DLD emotional understanding through a parent-led online emotion recognition (ER) intervention. Ten parents of children with DLD aged 6–11 participated in the study. A nonconcurrent multiple baseline design was employed, allowing for a rigorous analysis of changes in parental beliefs over time. Weekly data were collected through the Parents' Beliefs About Children's Emotions Questionnaire. Interviews were also conducted to gain deeper insights into parents' perceptions regarding the ER skills of their children. Results indicated that parents' beliefs about the need for guiding and supporting their child's ER skills increased over the intervention. Interviews also supported this, and three main themes were generated. The intervention program increased parents' awareness of (a) the importance of ER for children with DLD, (b) emotion-focused communication and engagement with their child, and (c) the integration of emotions into daily life. This study is the first known study that explores parents' beliefs about children with DLD ER skills, highlighting the importance of supporting parents through accessible interventions. [ABSTRACT FROM AUTHOR]

Currently in the UK and Ireland, after a hip fracture most patients do not receive bone protection medication to reduce the risk of refracture. Yet randomised controlled trial data specifically examining patients with hip fracture have shown that intravenous zoledronate reduces refracture risk by a third. Despite this evidence, use of intravenous zoledronate is highly variable following a hip fracture; many hospitals are providing this treatment, whilst most are currently not. A range of clinical uncertainties, doubts over the evidence base and practical concerns are cited as reasons. This paper discusses these concerns and provides guidance from expert consensus, aiming to assist orthogeriatricians, pharmacists and health services managers establish local protocols to deliver this highly clinically and cost-effective treatment to patients before they leave hospital, in order to reduce costly re-fractures in this frail population. [ABSTRACT FROM AUTHOR]

Background: Preconception health has the potential to improve parental, pregnancy and infant outcomes. This scoping review aims to (1) provide an overview of the strategies, policies, guidelines, frameworks, and recommendations available in the UK and Ireland that address preconception health and care, identifying common approaches and health-influencing factors that are targeted; and (2) conduct an audit to explore the awareness and use of resources found in the scoping review amongst healthcare professionals, to validate and contextualise findings relevant to Northern Ireland. Methods: Grey literature resources were identified through Google Advanced Search, NICE, OpenAire, ProQuest and relevant public health and government websites. Resources were included if published, reviewed, or updated between January 2011 and May 2022. Data were extracted into Excel and coded using NVivo. The review design included the involvement of the "Healthy Reproductive Years" Patient and Public Involvement and Engagement advisory panel. Results: The searches identified 273 resources, and a subsequent audit with healthcare professionals in Northern Ireland revealed five additional preconception health-related resources. A wide range of resource types were identified, and preconception health was often not the only focus of the resources reviewed. Resources proposed approaches to improve preconception health and care, such as the need for improved awareness and access to care, preconceptual counselling, multidisciplinary collaborations, and the adoption of a life-course approach. Many behavioural (e.g., folic acid intake, smoking), biomedical (e.g., mental and physical health conditions), and environmental and social (e.g., deprivation) factors were identified and addressed in the resources reviewed. In particular, pre-existing physical health conditions were frequently mentioned, with fewer resources addressing psychological factors and mental health. Overall, there was a greater focus on women's, rather than men's, behaviours. Conclusions: This scoping review synthesised existing resources available in the UK and Ireland to identify a wide range of common approaches and factors that influence preconception health and care. Efforts are needed to implement the identified resources (e.g., strategies, guidelines) to support people of childbearing age to access preconception care and optimise their preconception health. [ABSTRACT FROM AUTHOR]

Introduction: This exploratory literature review seeks to examine the literature around commissioning processes in the co‐production of health and care services, focusing on two questions: How do health and care commissioning processes facilitate and/or pose barriers to co‐production in service design and delivery? What are the contextual factors that influence these processes? Method: A systematic search of three databases (Medline, Public Health and Social Policy and Practice) and a search platform (Web of Science) was conducted for the period 2008–2023. A total of 2675 records were retrieved. After deduplication, 1925 were screened at title and abstract level. Forty‐seven reports from 42 United Kingdom and Ireland studies were included in the review. A thematic synthesis of included studies was conducted in relation to the research questions. Results: The review identified one overarching theme across the synthesised literature: the complexity of the commissioning landscape. Three interconnected subthemes illuminate the contextual factors that influence this landscape: commissioners as leaders of co‐production; navigating relationships and the collective voice. Conclusion: Commissioning processes were commonly a barrier to the co‐production of health and care services. Though co‐production was an aspiration for many commissioners, the political and economic environment and service pressures meant that it was often not fully realised. More flexible funding models, longer‐term pilot projects, an increased emphasis in social value across the health and care system and building capacity for strong leadership in commissioning is needed. Patient and Public Contribution: Patients and the public did not contribute to this review as it was a small piece of work following on from a completed project, with no budget for public involvement. [ABSTRACT FROM AUTHOR]

Simple Summary: For dogs and their owners to live in harmony, owner expectations and the behaviour of their dogs need to be aligned. Limited socialisation can contribute to the development of undesirable behaviours, so the reduced socialisation opportunities for many puppies during the COVID-19 lockdown is a concern. This United Kingdom/Republic of Ireland study used data collected between May 2016 and November 2022 to examine the impact of age and lockdown phase (pre-, during, and post-) on the types of socialisation experiences of 8-to-19-week-old puppies and the recency of socialisation experiences of 6-month-old puppies. The findings showed that puppies under 19-weeks had more types of experiences as they aged, and during pre-lockdown compared to post-lockdown, but not between other lockdown phases. Most 6-month-old puppies had met new adults or dogs, familiar dogs, or children within the last 1–7 days, regardless of lockdown phase. However, during lockdown, 6-month-old puppies experienced longer periods between meeting new adults in their homes. Overall, lockdown had a smaller impact on socialisation experiences than expected, but the quantity and quality of these experiences may have been affected. Future research will explore whether these early-life experiences relate to adult behaviour as the dogs in the study grow older. Limited socialisation can contribute to the development of undesirable dog behaviours. The COVID-19 lockdown potentially limited socialisation opportunities, which may negatively impact the future behaviour of puppies raised during lockdown. Data were gathered from longitudinal study participants in the United Kingdom/Republic of Ireland via multiple questionnaires between May 2016 and November 2022. The impact of age and lockdown phase (pre-, during, and post-) on the types of socialisation experiences of 8-to-19-week-old puppies and the recency of socialisation experiences of approximately 6-month-old puppies were examined. Puppies under 19-weeks had significantly more types of socialisation experiences (from a predefined list) as they aged, and pre-lockdown compared to post-lockdown, but not between other lockdown phases. Most 6-month-old puppies had met a new adult or dog outside the household, a familiar dog, and/or a child within the last 1–7 days, and this was similar between lockdown phases. During lockdown, 6-month-old puppies experienced longer periods between meeting a new adult in their home. Puppies were hypothesised to have had fewer experiences during lockdown, but this was not found. However, the quantity and quality of these experiences may have been affected. Future research within this longitudinal study will explore relationships between the timing and type of experiences had by puppies and their subsequent behaviour. [ABSTRACT FROM AUTHOR]

Background: Providing informed consent for trials requires providing trial participants with comprehensive information about the trial, including information about potential risks and benefits. It is required by the ethical principle of respecting patient autonomy. Our study examines the variation in the way information about potential trial benefits and harms is shared in participant information leaflets (PILs). Methods: A total of 214 PILs and informed consent forms from clinical trials units (CTUs) and Clinical Research Facilities (CRFs) in Ireland and the UK were assessed by two authors independently, to check the extent to which they adhered to seven recently developed principles. Discrepancies were resolved by a third. Results: Usage of the seven principles varied widely between PILs regardless of the intended recipient or trial type. None of the PILs used more than four principles, and some (4%) used none. Twenty-seven per cent of PILs presented information about all known potential harms, whereas 45% presented information on all known potential benefits. Some PILs did not provide any potential harms or potential benefits (8%). There was variation in the information contained in adult and children PILs and across disease areas. Conclusion: Significant variation exists in how potential trial benefits and harms are described to potential trial participants in PILs in our sample. Usage of the seven principles of good practice will promote consistency, ensure informed ethical decision-making and invoke trust and transparency. In the long term, a standardised PIL template is needed. [ABSTRACT FROM AUTHOR]

Recovering additional historical weather observations from known archival sources will improve the understanding of how the climate is changing and enable detailed examination of unusual events within the historical record. The UK National Meteorological Archive recently scanned more than 66,000 paper sheets containing 5.28 million hand‐written monthly rainfall observations taken across the UK and Ireland between 1677 and 1960. Only a small fraction of these observations were previously digitally available for climate scientists to analyse. More than 16,000 volunteer citizen scientists completed the transcription of these sheets of observations during early 2020 using the RainfallRescue.org website, built using the Zooniverse platform. A total of 3.34 million observations from more than 6000 locations have so far been quality controlled and made openly available. This has increased the total number of monthly rainfall observations that are available for this time period and region by a factor of six. The newly rescued observations will enable longer and much improved reconstructions of past variations in rainfall across the British and Irish Isles, including for periods of significant flooding and drought. Specifically, this data should allow the official gridded monthly rainfall reconstructions for the UK to be extended back to 1836, and even earlier for some regions. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a leading cause of non-traumatic disability in young adults. Accumulating evidence indicates early diagnosis and early treatment improves long-term outcomes. However, the MS diagnostic pathway is increasingly complex, and delays may occur at several stages. Factors causing delays remain understudied. We aim to quantify the time taken for MS to be diagnosed, and characterise the diagnostic pathway and initial care provided, in the United Kingdom (UK) and Republic of Ireland (ROI). Methods: Delays In MultiplE Sclerosis diagnosis (DIMES) in the UK and ROI is a multicentre, observational, retrospective study that will be conducted via the Neurology and Neurosurgery Interest Group (NANSIG) collaborative network. Any hospital in the UK and ROI providing an MS diagnostic service is eligible to participate. Data on consecutive individuals newly diagnosed with MS between 1st July 2022 and 31st December 2022 will be collected. The primary outcomes are 1) time from symptoms/signs prompting referral to neurology, to MS diagnosis; and 2) time from referral to neurology for suspected MS, to MS diagnosis. Secondary outcomes include: MS symptoms, referring specialties, investigations performed, neurology appointments, functional status, use of disease modifying treatments, and support at diagnosis including physical activity, and follow up. Demographic characteristics of people newly diagnosed with MS will be summarised, adherence to quality standards summarised as percentages, and time-to-event variables presented with survival curves. Multivariable models will be used to investigate the association of demographic and clinical factors with time to MS diagnosis, as defined in our primary outcomes. Discussion: DIMES aims to be the largest multicentre study of the MS diagnostic pathway in the UK and ROI. The proposed data collection provides insights that cannot be provided from contemporary registries, and the findings will inform approaches to MS services nationally in the future. [ABSTRACT FROM AUTHOR]

Background: Patient and public involvement (PPI) is a critical priority in research, policy, academia and advocacy organizations. PPI in dementia research is gaining momentum. However, these efforts are missing in international projects aimed at those living with advanced dementia in long‐term care (LTC) homes. Additional complexities can arise in enacting PPI within the context of integration of a palliative approach to care and experiences around end‐of‐life in (EOL) dementia. The mySupport study involved implementing the Family Carer Decision Support (FCDS) intervention for care partners of those living with advanced dementia in LTC in six countries. Research Design and Objective: An interpretive description study was conducted to explore the perspectives of international researchers from six countries on engaging people with lived experiences of dementia and EOL care in research processes. The findings from this study informed the development of a PPI strategy and a subsequent toolkit for the FCDS intervention. Findings: Thirty‐eight interviews were completed with project researchers: 12 from the United Kingdom, 8 from Canada, 7 from Ireland, 4 each from Italy and The Netherlands and 3 from the Czech Republic. Four broad themes describe international researchers' perspectives on advancing methods of engagement for people with lived experiences of dementia and EOL in international PPI activities: (1) Groundwork to engage in research; (2) planning for research activities is key; (3) focus on meaningful engagement and (4) having foresight for practical issues shaping PPI. Discussion and Implications: International projects that involve PPI can present many sources of challenges. The findings in this study highlight important considerations for foundational work for incorporating PPI in international projects. Learning from world leaders and those with lived experiences in various regions can be insightful and help share tools and resources. Patient or Public Contribution: PPI was envisioned as a critical part of conducting the mySupport study. The findings from this study informed the development of a PPI strategy and an international Strategic Guiding Council that included family carers of those living with advanced dementia in LTC homes in six countries. This manuscript focused on the perspectives of researchers on their engagement with people with lived experiences of dementia and EOL. The perspectives of persons with lived experiences on engaging in the mySupport research study will be reported in a forthcoming manuscript. [ABSTRACT FROM AUTHOR]

Mushrooms support the Irish economy, with a farm gate value of roughly EUR 130 million in 2022 and with 80%–85% of Irish production exported to the United Kingdom. In order to apply cutting edge technologies and offer creative solutions to increase the shelf life of mushrooms, it is essential to understand the mechanisms of action and preservation effects of the current trends in edible mushroom packaging systems. This review summarises the mechanisms of action for nanopackaging, biodegradable packaging, edible coatings, modified atmosphere packaging (MAP), and active packaging in terms of their enzyme activity, antimicrobial activity, antioxidant activity, and rate of respiration along with the changes in texture, colour, nutritional value, and shelf life of mushrooms reflected in the preservation effects of these packaging systems. SWOT analysis highlights the strengths, weaknesses, and threats of these packaging systems and provides potential opportunities for trialing innovative packaging materials for fresh edible mushrooms in Ireland. [ABSTRACT FROM AUTHOR]

Milk and beef derived from pasture-based systems have been characterized by higher nutritional values and a lower environmental footprint than their equivalents obtained via indoor systems. However, intensification of pasture-based production can have adverse impacts on biodiversity and the environment. To date, studies on pro-environmental diversification options leading to improvement of environmental performance of pasture-based dairy and beef production have rarely been synthesized. The present study sought to review current on-farm pro-environmental measures with the potential for enhancing biodiversity status and/or reducing the environmental impacts of pasture-based agriculture. Literature on farmer attitudes toward these measures was also reviewed to identify potential obstacles and opportunities for transitioning to pro-environmental agriculture. A systematic search of published research from high-income island countries characterized by oceanic temperate climate with a high dependence on pasture-based agriculture--the Republic of Ireland, the United Kingdom and New Zealand, was conducted. Thirty studies that assessed the impact of pro-environmental measures, eight 'attitudinal' studies of dairy and beef farmers and one study covering both aspects were identified. Inductive thematical analysis was subsequently undertaken. Environmentally sensitive management practices such as hedgerows and field margins management, mixed grazing (where two or more herbivorous animals graze the same land), rare livestock breeds, multispecies swards, organic farming and agroforestry were identified as primary themes studied under the auspices of pro-environmental diversification, while forestry, bioenergy crops and organic farming were the main themes identified within attitudinal research studies. Findings suggest that environmentally sensitive practices have varied effects on biodiversity. Mixed grazing was found to improve livestock production, while studies of organic farming reported multiple positive impacts on biodiversity and animal welfare. Effect of multispecies swards on methane emissions and urinary nitrogen extraction were found to be inconsistent. Attitudinal research suggests that the main barrier to implementing afforestation is its lack of attractiveness compared to 'traditional' farming and that organic farmer decisions regarding agricultural management practices might be less profit-oriented and influenced by ecological beliefs to a greater extent than decisions of conventional farmers. The results of this study confirm that pro-environmental diversification inherently encompasses multiple scientific disciplines; however, previous study designs and outcomes were found to be fragmented and narrowly focused. Considering the urgency and importance of climate and biodiversity crises, pro-environmental diversification of pasture-based dairy and beef production has rarely been holistically approached and remains understudied. The development of practical, sustainable solutions for farming based on circular economy and respect to nature and additional strategies to increase farmer and consumer environmental awareness should be prioritized by policymakers, advisory and scientific bodies. [ABSTRACT FROM AUTHOR]

Background: Pertussis and influenza cause significant morbidity and mortality in pregnancy and the neonatal period. Maternal vaccination in pregnancy would reduce harm, but low vaccine uptake is a concern. This scoping review aimed to understand the reasons for, and approaches, to non-uptake of pertussis and influenza vaccinations in pregnant women in the UK and Ireland. Methods: The inclusion criteria of this scoping review consist of pregnant women who avail of pertussis and influenza vaccines in the UK and Ireland. MEDLINE, EMBASE, Web of Science and CINAHL databases were searched in June 2021 and updated in October 2022. Searches were limited to English language reports published after 2011. We followed the Joanna Briggs Institute guidance on scoping reviews. Data were extracted and charted. Results: Five themes emerged from the literature. Acceptability, as well as organisational and awareness issues, were overarching themes regarding reasons for and approaches to non-uptake of the vaccines respectively. Other themes included healthcare professional factors, information interpretation and pregnancy-related factors. Conclusions: Women need clear, comprehensible information, ideally provided by their healthcare professionals, in a way that is meaningful and addresses their circumstances and risk perceptions. This research will serve as a base for future work that aims behaviour science interventions at the wider pregnant population as well as the target groups that have been identified in this review. [ABSTRACT FROM AUTHOR]

The future quantum internet will leverage existing communication infrastructures, including deployed optical fibre networks, to enable novel applications that outperform current information technology. In this scenario, we perform a feasibility study of quantum communications over an industrial 224 km submarine optical fibre link deployed between Southport in the United Kingdom (UK) and Portrane in the Republic of Ireland (IE). With a characterisation of phase drift, polarisation stability and the arrival time of entangled photons, we demonstrate the suitability of the link to enable international UK–IE quantum communications for the first time. [ABSTRACT FROM AUTHOR]

Background: PROs are valuable tools in clinical care to capture patients' perspectives of their health, symptoms and quality of life. However the COVID-19 pandemic has had profound impacts on all aspects of life, in particular healthcare and research. This study explores the views of UK and Irish health professionals, third sector and pharmaceutical industry representatives and academic researchers on the impact of COVID-19 on PRO collection, use and development in clinical practice. Methods: A volunteer sample took part in a 10 question cross sectional qualitative survey, on the impact of COVID-19, administered online via Qualtrics. Demographic data was descriptively analysed, and the qualitative free text response data was subject to thematic analysis and summarised within the Strengths, Weaknesses, Opportunities and Threats (SWOT) framework. Results: Forty nine participants took part located in a range of UK settings and professions. Participants highlighted staff strengths during the pandemic including colleagues' flexibility and ability to work collaboratively and the adoption of novel communication tools. Weaknesses were a lack of staff capacity to continue or start PRO projects and insufficient digital infrastructure to continue studies online. Opportunities included the added interest in PROs as useful outcomes, the value of electronic PROs for staff and patients particularly in relation to integration into systems and the electronic patient records. However, these opportunities came with an understanding that digital exclusion may be an issue for patient groups. Threats identified included that the majority of PRO research was stopped or delayed and funding streams were cut. Conclusions: Although most PRO research was on hold during the pandemic, the consensus from participants was that PROs as meaningful outcomes were valued more than ever. From the opportunities afforded by the pandemic the development of electronic PROs and their integration into electronic patient record systems and clinical practice could be a lasting legacy from the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Optimum nutrition plays a major role in the achievement and maintenance of good health. The Nutrition Society of the UK and Ireland and the Sabri Ülker Foundation, a charity based in Türkiye and focused on improving public health, combined forces to highlight this important subject. A hybrid conference was held in Istanbul, with over 4000 delegates from sixty-two countries joining the proceedings live online in addition to those attending in person. The primary purpose was to inspire healthcare professionals and nutrition policy makers to better consider the role of nutrition in their interactions with patients and the public at large to reduce the prevalence of non-communicable diseases such as obesity and type 2 diabetes. The event provided an opportunity to share and learn from different approaches in the UK, Türkiye and Finland, highlighting initiatives to strengthen research in the nutritional sciences and translation of that research into nutrition policy. The presenters provided evidence of the links between nutrition and disease risk and emphasised the importance of minimising risk and implementing early treatment of diet-related disease. Suggestions were made including improving health literacy and strengthening policies to improve the quality of food production and dietary behaviour. A multidisciplinary approach is needed whereby Governments, the food industry, non-governmental groups and consumer groups collaborate to develop evidence-based recommendations and appropriate joined-up policies that do not widen inequalities. This summary of the proceedings will serve as a gateway for those seeking to access additional information on nutrition and health across the globe. [ABSTRACT FROM AUTHOR]

Background: Adherence to physical activity (PA) recommendations during pregnancy is low. A common reason for low adherence is concern of harm to mother and/or baby. The Necessity-Concerns Framework (NCF), is a well-established framework in medicine adherence, however it has not been used to explore adherence to antenatal PA. This study aims to explore (1) what influences pregnant women's PA in the context of the NCF; and (2) if the NCF is an appropriate framework to understand antenatal PA engagement. Methods: Semi-structured interviews were conducted with 18 pregnant women in the UK and Ireland (mean gestation 27 weeks). Interviews explored beliefs, experiences, perceived necessities and concerns about PA. Interviews were transcribed verbatim and analysed using thematic framework analysis. Results: Five themes were identified as influential to antenatal PA: (1) Perceived benefits and necessity of PA, (2) Concerns regarding antenatal PA, (3) Balancing the necessity and concern, (4) Barriers to antenatal PA, (5) Facilitators of antenatal PA. Women described a number of perceived necessities and concerns regarding antenatal PA. These necessities and concerns were described as being consciously balanced, supporting the NCF. However, a number of additional influences (for example, feelings of nausea and lack of advice and knowledge) seemed to impact antenatal PA engagement before women could consider their perceived necessities and concerns around antenatal PA. Conclusions: The Necessity Concerns Framework is a useful framework to help explain how and why women engage with antenatal PA, more specifically why women do and do not engage in antenatal PA at different times during their pregnancy. However, there are a number of other interpersonal and intrapersonal influences on antenatal PA (e.g. physical symptoms, motivation and time), suggesting the NCF alone may be too simplistic to understand and influence complex behaviour such as antenatal PA. [ABSTRACT FROM AUTHOR]

Background: Over the next two decades, the numbers of people who will need palliative care in the United Kingdom and Ireland is projected to increase. Hospices play a vital role supporting people who require specialist palliative care input through community-based and inpatient palliative care services. Evidence is needed to understand the role of these different services to inform future service development. Objectives: To describe the reasons for admission, and outcomes at the end of the stay, for patients admitted to two hospice inpatient units (IPUs). Design: This was a mixed-methods study using a convergent, parallel mixed-methods design. Methods: We reviewed the case notes of all patients admitted to two hospice inpatient units from July to November 2019; conducted semi-structured interviews with patients and families; as well as brief structured interviews with inpatient unit staff. Results: Two hundred fifty-nine patients were admitted to a hospice IPU, accounting for 276 admissions in total. Overall, 53% were female; median age was 71 years (range: 26–95 years). Most patients (95%) were White British or Scottish, and 95% had a cancer diagnosis. Most patients were admitted from the community, under one-third were admitted from hospital. Most (85%) had previous palliative care involvement. Nearly, half had district nurse support (48%). Worry and anxiety was frequently reported as a reason for admission, alongside physical concerns. Median length of stay was 12 days, and 68% died during their stay. Hospice was recorded as the preferred place of care for 56% of those who died there. Conclusions: Sustained efforts to promote the hospice as place of care for people with conditions other than cancer are needed alongside greater clarity regarding of the role of the hospice IPU, and who would benefit most from IPU support. [ABSTRACT FROM AUTHOR]

In this paper, it is argued that the industrial revolution in eighteenth century Great Britain had its origins in the arrival of 100,000–140,000 Protestant refugees in England and Ireland in the sixteenth, seventeenth and eighteenth centuries. Specifically, it is argued that their arrival prompted both Schmooklerian pull and push factors. The pull factor was the thousands of refugee merchants and ship owners/captains to England and Ireland resulting in the creation of the Protestant International (1550-1750). This increased the demand for tradables which in turn spurred invention and innovation among refugees (push factor) and their descendants as well as in the local population. These factors were self-reinforcing, leading in time to the industrial revolution. The result is a novel account of the origins of the industrial revolution, one that is consistent with competing explanations. [ABSTRACT FROM AUTHOR]

Many types of guidance documents inform conservation by providing practical recommendations for the management of species and habitats. To ensure effective decisions are made, such guidance should be based upon relevant and up‐to‐date evidence. We reviewed conservation guidance for mitigation and management of species and habitats in the United Kingdom and Ireland, identifying 301 examples produced by over 50 organizations. Of these, only 29% provided a reference list, of which only 32% provided reference(s) relevant to justify the recommended actions (9% of the total). Furthermore, even this guidance was often outdated, lacked a methodology for production, or did not highlight uncertainty in the key evidence that supported the recommendations. These deficiencies can lead to misguided and ineffective conservation practices, policies, and decisions, and a waste of resources. Based on this review and co‐design by experts from 14 organizations, we present a set of principles for ensuring sufficient and relevant evidence is transparently incorporated into future conservation guidance. Producing evidence‐based guidance in line with these principles would enable more effective conservation outcomes. [ABSTRACT FROM AUTHOR]

Background In Europe, more than 15 million people live with heart failure (HF). It imposes an enormous social, organizational and economic burden. As a reaction to impending impact on healthcare provision, different country-specific structures for HF-care have been established. The aim of this report is to provide an overview and compare the HF-care approaches of Germany, Ireland, the Netherlands and the UK, and to open the possibility of learning from each other's experience. Methods A mixed methods approach was implemented that included a literature analysis, interviews and questionnaires with HF-patients and caregivers, and expert interviews with representatives from healthcare, health service research and medical informatics. Results The models of HF-care in all countries analyzed are based on the European Society of Cardiology guidelines for diagnosis and treatment of HF. Even though the HF-models differed in design and implementation in practice, key challenges were similar: (i) unequal distribution of care between urban and rural areas, (ii) long waiting times, (iii) unequal access to and provision of healthcare services, (iv) information and communication gaps and (v) inadequate implementation and financing of digital applications. Conclusion Although promising approaches exist to structure and improve HF-care, across the four countries, implementation was reluctant to embrace novel methods. A lack of financial resources and insufficient digitalization making it difficult to adopt new concepts. Integration of HF-nurses seems to be an effective way of improving current models of HF-care. Digital solutions offer further opportunities to overcome communication and coordination gaps and to strengthen self-management skills. [ABSTRACT FROM AUTHOR]

This account presents information on all aspects of the biology of Liparis loeselii (L.) Rich. (Fen Orchid) that are relevant to understanding its ecological characteristics and behaviour. The main topics are presented within the standard framework of the Biological Flora of Britain and Ireland: distribution, habitat, communities, responses to biotic factors, responses to environment, structure and physiology, phenology, floral and seed characters, herbivores and disease, and history and conservation.Liparis loeselii is a small terrestrial orchid that has a circumboreal distribution and is widespread in Europe and North America. Despite its wide distribution, the species is locally rare and has declined considerably in most of its range. In Britain, the species has a disjunct distribution and is now known to occur consistently at only six sites in eastern England and three in south Wales. It is absent from Ireland. Its most characteristic habitats in Britain are inland fens and coastal dune slacks, but outside Britain it can also be found in wet meadows, marshes, forested seep springs, at lake borders or on mats of floating peat.Populations of Liparis loeselii in dune slacks tend to be short‐lived, and can rapidly increase in size or decrease and disappear as environmental conditions change. The species does not tolerate high nutrient concentrations or low pH. It is susceptible to drought, which reduces seed germination, seedling recruitment and adult survival. Heavy predation by rabbits and rodents has been observed under drought conditions.Liparis loeselii reproduces both by sexual reproduction, and by vegetative propagation through the production of pseudobulbs. Although flowers are accessible to insects, entomophilous pollination is unusual, and most sexual reproduction is the result of selfing. Fruits ripen late in the growing season (mid‐October) and the dust‐like seeds are dispersed during winter by wind and water. Germination occurs during the following growing season and is supported by a wide variety of mycorrhizal fungi.Since the late 19th century Liparis loeselii has declined considerably in Britain and elsewhere in Europe, primarily due to habitat destruction and loss, natural succession, and habitat desiccation due to drainage. As a result, the species has been listed as endangered in the Bern Convention and the European Habitat Directive (92/43/EEC) and is the focus of intensive conservation efforts in many countries. Restoration of habitat by mowing, extensive grazing and peat removal, and the creation of new habitat by dune slack formation in dune systems and peat removal in fens may prolong population persistence and promote establishment of new populations. [ABSTRACT FROM AUTHOR]

This paper presents a framework for studying international differences in the distribution of household income. Integrating micro-econometric and micro-simulation approaches in a decomposition analysis, it quantifies the role of tax-benefit systems, employment and occupational structures, labour and financial market returns, and demographic composition in accounting for differences in income inequality across countries. Building upon EUROMOD (the European tax-benefit calculator) and its harmonised datasets, the model is portable and can be implemented for cross-country comparisons between any participating country. An application to the UK and Ireland—two countries that have much in common while displaying different levels of inequality—shows that differences in tax-benefit rules between the two countries account for over one third of the observed difference in disposable household income inequality. Demographic differences play negligible roles. The Irish tax-benefit system is more redistributive than UK's due to a higher tax progressivity and higher average transfer rates. These are largely attributable to policy parameter differences, but also to differences in pre-tax, pre-transfer income distributions. [ABSTRACT FROM AUTHOR]

Background: Despite extensive research, many questions remain unanswered about common problems that impact dog welfare, particularly where there are multiple contributing factors that can occur months or years before the problem becomes apparent. The Generation Pup study is the first longitudinal study of dogs that recruits pure- and mixed-breed puppies, aiming to investigate the relative influence of environmental and genetic factors on a range of health and behaviour outcomes, (including separation related behaviour, aggression to familiar/unfamiliar people or dogs and obesity). This paper describes the study protocol in detail. Methods: Prior to commencing recruitment of puppies, the study infrastructure was developed, and subject specialists were consulted to inform data collection methodology. Questionnaire content and timepoint(s) for data collection for outcomes and potential predictors were chosen with the aim of providing the best opportunity of achieving the aims of the study, subject to time and funding constraints. Recruitment of puppies (< 16 weeks, or < 21 weeks of age if entering the United Kingdom or Republic of Ireland through quarantine) is underway. By 23 January 2020, 3726 puppies had been registered, with registration continuing until 10,000 puppies are recruited. Data collection encompasses owner-completed questionnaires issued at set timepoints throughout the dog's life, covering aspects such as training, diet, exercise, canine behaviour, preventative health care, clinical signs and veterinary intervention. Owners can elect to submit additional data (health cards completed by veterinary professionals, canine biological samples) and/or provide consent for access to veterinary clinical notes. Incidence and breed associations will be calculated for conditions for which there is currently limited information (e.g. separation related behaviour). Multivariable statistical analysis will be conducted on a range of outcomes that occur throughout different life stages, with the aim of identifying modifiable risk factors that can be used to improve canine health and welfare. Discussion: The Generation Pup project is designed to identify associations between early-life environment, genotypic make-up and outcomes at different life stages. Modifiable risk factors can be used to improve canine health and welfare. Research collaboration with subject specialists is welcomed and already underway within the fields of orthopaedic research, epilepsy, epigenetics and canine impulsivity. [ABSTRACT FROM AUTHOR]

The Isle of Man is a large island which lies in the middle of the northern Irish Sea between Britain and Ireland and, because of its insularity and size, has an impoverished flora compared with the two main islands. This has been the case throughout the postglacial and warrants the island's description as a separate phytogeographic province. We have considered Holocene tree pollen data from seventeen sites on the island which together preserve a vegetation history that spans the six thousand years of the early and mid-postglacial from the end of the Lateglacial at 11,700 cal. BP to the mid-Holocene Ulmus decline at ca. 5800 cal. BP. Radiocarbon dating of the rational limits of the pollen curves for the main tree taxa has allowed an appraisal of the timing of each one's expansion to become a significant component of the island's woodland, and comparison with the dates of their expansion on the adjacent regions of Britain and Ireland. The radiocarbon dates show that, although some variability exists probably due to local factors, there is considerable concordance between the timings of major pollen zone boundaries in Britain and Ireland around the northern Irish Sea. On the Isle of Man the expansions of both Juniperus and Betula were delayed by several centuries compared to the British/Irish data, however the timing of the expansions of Corylus, Ulmus, Quercus, Pinus and Alnus on the Isle of Man all appear closely comparable to the ages for these pollen stratigraphic events in north Wales, northwest England, southwest Scotland and eastern Ireland, as are those for the Ulmus decline. It is likely that local pedological and edaphic factors on the island account for the differences in the first Holocene millennium, while regional climatic factors governed the timings for the rest of the expansions of tree taxa across the wider region, including the Isle of Man. Disturbance, including by human agency, was important at the site scale and perhaps triggered early tree expansion in some places, including Quercus, Ulmus and Alnus. Insularity seems not to have been a significant factor in the expansion of the major forest trees. [ABSTRACT FROM AUTHOR]

Background the mySupport advance care planning intervention was originally developed and evaluated in Northern Ireland (UK). Family caregivers of nursing home residents with dementia received an educational booklet and a family care conference with a trained facilitator to discuss their relative's future care. Objectives to investigate whether upscaling the intervention adapted to local context and complemented by a question prompt list impacts family caregivers' uncertainty in decision-making and their satisfaction with care across six countries. Second, to investigate whether mySupport affects residents' hospitalisations and documented advance decisions. Design a pretest–posttest design. Setting in Canada, the Czech Republic, Ireland, Italy, the Netherlands and the UK, two nursing homes participated. Participants in total, 88 family caregivers completed baseline, intervention and follow-up assessments. Methods family caregivers' scores on the Decisional Conflict Scale and Family Perceptions of Care Scale before and after the intervention were compared with linear mixed models. The number of documented advance decisions and residents' hospitalisations was obtained via chart review or reported by nursing home staff and compared between baseline and follow-up with McNemar tests. Results family caregivers reported less decision-making uncertainty (−9.6, 95% confidence interval: −13.3, −6.0, P  < 0.001) and more positive perceptions of care (+11.4, 95% confidence interval: 7.8, 15.0; P  < 0.001) after the intervention. The number of advance decisions to refuse treatment was significantly higher after the intervention (21 vs 16); the number of other advance decisions or hospitalisations was unchanged. Conclusions the mySupport intervention may be impactful in countries beyond the original setting. [ABSTRACT FROM AUTHOR]

Aim: To test whether poor childhood pulmonary function explains the relationship between extremely preterm (EP) birth and attention‐deficit/hyperactivity disorder (ADHD) symptoms in young adulthood. Methods: EPICure birth cohort participants include children born <26 weeks' gestation in the United Kingdom and Ireland in 1995 and their term‐born classmates. Predictor was EP birth. Outcomes were inattention/hyperactivity subscale z‐scores at 19 years. Forced expiratory volume (FEV1) z‐scores in childhood and young adulthood were mediators. We used recursive path analysis to determine the direct effect of EP birth on inattention/hyperactivity and its indirect effect through pulmonary function. Results: Ninety EP and 47 term‐born participants had pulmonary function testing at 11 and 19 years. Inattention z‐scores were higher in the EP group (mean difference 0.55 [95% CI 0.11, 0.99]) but not hyperactivity. Compared to term‐born peers, EP participants had lower FEV1 z‐scores at 11 (mean difference−1.35 [95% CI −1.72, −0.98]) and 19 (mean difference−1.29 [95% CI −1.65, −0.92]). Path models revealed that childhood pulmonary function explained the relationship between EP birth and inattention. Conclusions: Extremely preterm young adults have increased risk for inattention compared to term‐born peers. Poor pulmonary function appears to underlie this risk. The mechanisms responsible remain unclear and warrant further study. [ABSTRACT FROM AUTHOR]

Background: Mental health is a global health priority, and pharmacists have a valuable role in improving outcomes in all sectors of practice. This study sought to explore pharmacy students' views on teaching and learning of mental health and future practice. Methods: An anonymous online questionnaire was distributed to pharmacy students in the UK and Ireland in February 2020 via the Qualtrics™ platform and 232 students responded. The questionnaire was originally intended to explore the provision of Mental Health First Aid (MHFA) teaching and the quantitative analysis has been previously reported. Students were invited to comment on their views about MHFA. The open-ended question: 'Do you have any other comments about mental health teaching and learning in the MPharm degree?' was also included. The rich free-text data were analysed, and themes identified. Results: Three major themes were identified: (i) Mental Health is important; (ii) Pharmacist roles and (iii) So, Teach me. A fourth theme, Stigma, crosscut all the themes. Conclusions: Pharmacy students appreciate the importance of mental health care. The majority recognise the role of the pharmacist in providing person-centred care and the potential to enhance this role. Students are keen to learn more, and acquire the confidence and skills to contribute in the future. They would like an integrated approach and have more opportunities to learn from patients. Addressing stigma is an important consideration for educators. [ABSTRACT FROM AUTHOR]

Objective: Despite progress in endonasal skull-base neurosurgery, cerebrospinal fluid (CSF) rhinorrhoea remains common and significant. The CRANIAL study sought to determine 1) the scope of skull-base repair methods used, and 2) corresponding rates of postoperative CSF rhinorrhoea in the endonasal transsphenoidal approach (TSA) and the expanded endonasal approach (EEA) for skull-base tumors. Methods: A prospective observational cohort study of 30 centres performing endonasal skull-base neurosurgery in the UK and Ireland (representing 91% of adult units). Patients were identified for 6 months and followed up for 6 months. Data collection and analysis was guided by our published protocol and pilot studies. Descriptive statistics, univariate and multivariable logistic regression models were used for analysis. Results: A total of 866 patients were included - 726 TSA (84%) and 140 EEA (16%). There was significant heterogeneity in repair protocols across centres. In TSA cases, nasal packing (519/726, 72%), tissue glues (474/726, 65%) and hemostatic agents (439/726, 61%) were the most common skull base repair techniques. Comparatively, pedicled flaps (90/140, 64%), CSF diversion (38/140, 27%), buttresses (17/140, 12%) and gasket sealing (11/140, 9%) were more commonly used in EEA cases. CSF rhinorrhoea (biochemically confirmed or requiring re-operation) occurred in 3.9% of TSA (28/726) and 7.1% of EEA (10/140) cases. A significant number of patients with CSF rhinorrhoea (15/38, 39%) occurred when no intraoperative CSF leak was reported. On multivariate analysis, there may be marginal benefits with using tissue glues in TSA (OR: 0.2, CI: 0.1-0.7, p<0.01), but no other technique reached significance. There was evidence that certain characteristics make CSF rhinorrhoea more likely - such as previous endonasal surgery and the presence of intraoperative CSF leak. Conclusions: There is a wide range of skull base repair techniques used across centres. Overall, CSF rhinorrhoea rates across the UK and Ireland are lower than generally reported in the literature. A large proportion of postoperative leaks occurred in the context of occult intraoperative CSF leaks, and decisions for universal sellar repairs should consider the risks and cost-effectiveness of repair strategies. Future work could include longer-term, higher-volume studies, such as a registry; and high-quality interventional studies. [ABSTRACT FROM AUTHOR]

Issues of migration writing (see Kosmalska) and migrant theatre have recently gained prominence, leading to an increase in research focused on analyzing the theatrical works of artists with a migrant background. This phenomenon is part of a broader trend in intercultural and, often, postcolonial studies. Contemporary Polish migrant theatre is a subject that has not been thoroughly explored yet. Among many methods applied in the study of migrant theatre, intercultural studies or the so-called new interculturalism take the lead. These concepts draw on bilingualism or multilingualism practices, which are slowly taking a more significant role in migrant theatre studies. This article analyzes two theatre plays staged by Polish migrants in Ireland and in the United Kingdom in the context of linguistic practices that exemplify and help define the concept of transnational drama. [ABSTRACT FROM AUTHOR]

This case study traces the evolution of the Make Film History project, an award-winning archival resource which gives emerging filmmakers and educators in the UK and Ireland access to 270 films for creative reuse on course-related projects. It explores the barriers to the creative reuse of audiovisual archive material in education; and how the project overcame these with the support of our project partners at the participating archives to create a new, sustainable model for creative reuse in a range of educational settings and in partnership with film festivals. [ABSTRACT FROM AUTHOR]

Background: The importance of infection prevention and control (IPC) services to prevent threats from healthcare-associated infections and improve the quality of healthcare delivery is undeniable. However, IPC services across the UK and Ireland have substantial variability in terms of team structures and delivery models. Aim: The aim of this study was to define an optimal IPC service in different contexts and settings within the United Kingdom and Ireland. Methods: This mixed methods study adopted discussion huddles with IPC teams to explore various components of IPC programmes and services. A Nominal Group technique was then undertaken to achieve a group consensus of what an optimal infection prevention service should look like. Results: Five discussion huddles were conducted which included 53 participants in total. Key themes arising were IPC Service Priorities, IPC Service Enablers for Success, and Necessary Skills and Expertise Required for Delivering an Effective IPC Service. For the nominal technique, 45 responses were identified which were determining the key priorities for an effective IPC service and 69 responses for establishing key enablers for success. Discussion: These findings supported the development of a conceptual model for designing an optimal infection prevention service, which can be used to develop IPC services at an international, national, regional and local level. A focus is required around implementation of these highlighted enablers, so are effectively embedded into infection prevention and control services, and wider healthcare settings. [ABSTRACT FROM AUTHOR]

Background: Healthcare-associated infections (HCAIs) pose a significant threat to the health and safety of patients, staff, and visitors. Infection prevention and control (IPC) teams play a crucial role in ensuring that systems and processes are in place to keep everyone safe within the healthcare environment. Aim: The aim of this study was to identify components of infection prevention services, priorities, indicators of successes and how they are measured, and facilitators and barriers to success. Methods: A s urvey questionnaire was developed and circulated to infection prevention leaders and managers. Findings/results: Seventy IPC leaders/managers completed the survey. Participants were responsible for a range of IPC services within and across healthcare organisations, with significant variations to IPC delivery components. Additionally, a range of budget availability was reported. Several IPC service requirements were considered core work of IPC teams, including providing IPC advice and support, surveillance and audit and education and training. Discussion: An optimal IPC service needs to be in place to ensure HCAIs are minimised or prevented. In a post pandemic era, this is more important than ever before. This is also as crucial for the health and wellbeing of those working in IPC, who have endured unprecedented demand for their services during the pandemic. [ABSTRACT FROM AUTHOR]

This paper examines the impact that climate change may have on the lodging of oats in the Republic of Ireland and the UK. Through the consideration of a novel lodging model representing the motion of an oat plant due to the interaction of wind and rain and integrating future predictions of wind and rainfall due to climate change, appropriate conclusions have been made. In order to provide meteorological data for the lodging model, wind and rainfall inputs are analysed using 30 years' time series corresponding to peak lodging months (June and July) from 38 meteorological stations in the United Kingdom and the Irish Republic, which enables the relevant probability density functions (PDFs) to be established. Moreover, climate data for the next six decades in the British Isles produced by UK climate change projections (UKCP18) are analysed, and future wind and rainfall PDFs are obtained. It is observed that the predicted changes likely to occur during the key growing period (June to July) in the next 30 years are in keeping with variations, which can occur due to different husbandry treatments/plant varieties. In addition, the utility of a double exponential function for representing the rainfall probability has been observed with appropriate values for the constants given. [ABSTRACT FROM AUTHOR]

The evidence base available to trialists to support trial process decisions-e.g. how best to recruit and retain participants, how to collect data or how to share the results with participants-is thin. One way to fill gaps in evidence is to run Studies Within A Trial, or SWATs. These are self-contained research studies embedded within a host trial that aim to evaluate or explore alternative ways of delivering or organising a particular trial process.SWATs are increasingly being supported by funders and considered by trialists, especially in the UK and Ireland. At some point, increasing SWAT evidence will lead funders and trialists to ask: given the current body of evidence for a SWAT, do we need a further evaluation in another host trial? A framework for answering such a question is needed to avoid SWATs themselves contributing to research waste.This paper presents criteria on when enough evidence is available for SWATs that use randomised allocation to compare different interventions. [ABSTRACT FROM AUTHOR]

Background: Family carers of people with profound and multiple intellectual disabilities (PMID) experienced a reduction in healthcare services due to the COVID-19 pandemic. Many subsequently turned to Non-Governmental Organisations who worked to support families. However, little research has sought to capture the experiences of family carers or identify effective interventions which might support them. To address these concerns we explored the views of Non-Governmental sector workers across the UK and Ireland who supported families people with PMID during the COVID-19 pandemic. We also sought to explore their views on the characteristics of online support programmes for family carers. Methods: This study employed a qualitative design using focus groups with participants (n = 24) from five Non-Governmental Organisations across the UK and Ireland. A focus group guide included questions on challenges, supports, coping and resources which helped during lockdown restrictions. Focus groups were held online, were audio recorded and transcribed verbatim. The resulting transcripts were pseudonymised and subjected to thematic analysis. Findings: Four themes were identified (i) 'mental and emotional health', (ii) 'they who shout the loudest' (fighting for services), (iii) 'lack of trust in statutory services' and (iv) 'creating an online support programme'. Mental and emotional health emerged as the most prominent theme and included three subthemes named as 'isolation', 'fear of COVID-19' and 'the exhaustion of caring'. Conclusions: The COVID-19 pandemic has increased the vulnerability of family carers who were already experiencing difficulties in accessing services and supports for their families. While Non-Governmental Organisations have been a crucial lifeline there is urgent need to design services, including online support programmes, in partnership with family carers which adequately address their needs. [ABSTRACT FROM AUTHOR]

Background: Gay, bisexual and other men who have sex with men (GBMSM) are at far greater risk of experiencing poor mental health (MH) than wider society. This disparity was exacerbated by additional 'unique to sexual minority status' COVID-19 stressors. Objective: This sequential, mixed-methods study examined remote MH help-seeking among GBMSM in the U.K. and Ireland during the first COVID-19 lockdown. Methods and Results: Quantitative survey data (n = 1368), analysed with logistic regression, suggested GBMSM experiencing moderate-to-severe anxiety and those with a past MH diagnosis were most likely to seek MH support. Thematic analysis of qualitative interview (n = 18) data identified multiple barriers and enablers to GBMSM seeking remote MH help, with the help primarily sought from GBMSM-facing organisations and generic online resources. Finally, the behaviour change wheel was used to generate theoretically informed recommendations to promote MH help-seeking among GBMSM in Scotland. Implications: We discuss how applying these recommendations in the short, medium and long term will begin to address GBMSM's MH needs, post COVID-19. [ABSTRACT FROM AUTHOR]

Background: Family carers of people with profound and multiple intellectual disabilities (PMID) experienced a reduction in healthcare services due to the COVID-19 pandemic. Many subsequently turned to Non-Governmental Organisations who worked to support families. However, little research has sought to capture the experiences of family carers or identify effective interventions which might support them. To address these concerns we explored the views of Non-Governmental sector workers across the UK and Ireland who supported families people with PMID during the COVID-19 pandemic. We also sought to explore their views on the characteristics of online support programmes for family carers.  METHODS: This study employed a qualitative design using focus groups with participants (n = 24) from five Non-Governmental Organisations across the UK and Ireland. A focus group guide included questions on challenges, supports, coping and resources which helped during lockdown restrictions. Focus groups were held online, were audio recorded and transcribed verbatim. The resulting transcripts were pseudonymised and subjected to thematic analysis.Findings: Four themes were identified (i) 'mental and emotional health', (ii) 'they who shout the loudest' (fighting for services), (iii) 'lack of trust in statutory services' and (iv) 'creating an online support programme'. Mental and emotional health emerged as the most prominent theme and included three subthemes named as 'isolation', 'fear of COVID-19' and 'the exhaustion of caring'.Conclusions: The COVID-19 pandemic has increased the vulnerability of family carers who were already experiencing difficulties in accessing services and supports for their families. While Non-Governmental Organisations have been a crucial lifeline there is urgent need to design services, including online support programmes, in partnership with family carers which adequately address their needs. [ABSTRACT FROM AUTHOR]

The BRITICE‐CHRONO consortium of researchers undertook a dating programme to constrain the timing of advance, maximum extent and retreat of the British–Irish Ice Sheet between 31 000 and 15 000 years before present. The dating campaign across Ireland and Britain and their continental shelves, and across the North Sea included 1500 days of field investigation yielding 18 000 km of marine geophysical data, 377 cores of sea floor sediments, and geomorphological and stratigraphical information at 121 sites on land; generating 690 new geochronometric ages. These findings are reported in 28 publications including synthesis into eight transect reconstructions. Here we build ice sheet‐wide reconstructions consistent with these findings and using retreat patterns and dates for the inter‐transect areas. Two reconstructions are presented, a wholly empirical version and a version that combines modelling with the new empirical evidence. Palaeoglaciological maps of ice extent, thickness, velocity, and flow geometry at thousand‐year timesteps are presented. The maximum ice volume of 1.8 m sea level equivalent occurred at 23 ka. A larger extent than previously defined is found and widespread advance of ice to the continental shelf break is confirmed during the last glacial. Asynchrony occurred in the timing of maximum extent and onset of retreat, ranging from 30 to 22 ka. The tipping point of deglaciation at 22 ka was triggered by ice stream retreat and saddle collapses. Analysis of retreat rates leads us to accept our hypothesis that the marine‐influenced sectors collapsed rapidly. First order controls on ice‐sheet demise were glacio‐isostatic loading triggering retreat of marine sectors, aided by glaciological instabilities and then climate warming finished off the smaller, terrestrial ice sheet. Overprinted on this signal were second order controls arising from variations in trough topographies and with sector‐scale ice geometric readjustments arising from dispositions in the geography of the landscape. These second order controls produced a stepped deglaciation. The retreat of the British–Irish Ice Sheet is now the world's most well‐constrained and a valuable data‐rich environment for improving ice‐sheet modelling. [ABSTRACT FROM AUTHOR]

Background: Within the European Union (EU), substantial efforts are being made to achieve economic and social cohesion, and the reduction of health inequalities between EU regions is integral to this process. This paper is the first to examine how self-reported conditions and non-communicable diseases (NCDs) vary spatially between and within countries. Methods: Using 2014 European Social Survey (ESS) data from 20 countries, this paper examines how regional inequalities in self-reported conditions and NCDs vary for men and women in 174 regions (levels 1 and 2 Nomenclature of Statistical Territorial Units, 'NUTS'). We document absolute and relative inequalities across Europe in the prevalence of eight conditions: general health, overweight/obesity, mental health, heart or circulation problems, high blood pressure, back, neck, muscular or joint pain, diabetes and cancer. Results: There is considerable inequality in self-reported conditions and NCDs between the regions of Europe, with rates highest in the regions of continental Europe, some Scandinavian regions and parts of the UK and lowest around regions bordering the Alps, in Ireland and France. However, for mental health and cancer, rates are highest in regions of Eastern European and lowest in some Nordic regions, Ireland and isolated regions in continental Europe. There are also widespread and consistent absolute and relative regional inequalities in all conditions within countries. These are largest in France, Germany and the UK, and smallest in Denmark, Sweden and Norway. There were higher inequalities amongst women. Conclusion: Using newly available harmonized morbidity data from across Europe, this paper shows that there are considerable regional inequalities within and between European countries in the distribution of self-reported conditions and NCDs. [ABSTRACT FROM AUTHOR]

Castanea sativa is classified as non-indigenous in Britain and Ireland. It was long held that it was first introduced into Britain by the Romans, until a recent study found no corroborative evidence of its growing here before c. AD 650. This paper presents new data on the genetic diversity of C. sativa in Britain and Ireland and potential ancestral sources in continental Europe. Microsatellite markers and analytical methods tested in previous European studies were used to genotype over 600 C. sativa trees and coppice stools, sampled from ancient semi-natural woodlands, secondary woodlands and historic cultural sites across Britain and Ireland. A single overall genepool with a diverse admixture of genotypes was found, containing two sub groups differentiating Wales from Ireland, with discrete geographical and typological clusters. C. sativa genotypes in Britain and Ireland were found to relate predominantly to some sites in Portugal, Spain, France, Italy and Romania, but not to Greece, Turkey or eastern parts of Europe. C. sativa has come to Britain and Ireland from these western European areas, which had acted as refugia in the Last Glacial Maximum; we compare its introduction with the colonization/translocation of oak, ash, beech and hazel into Britain and Ireland. Clones of C. sativa were identified in Britain, defining for the first time the antiquity of some ancient trees and coppice stools, evincing both natural regeneration and anthropogenic propagation over many centuries and informing the chronology of the species’ arrival in Britain. This new evidence on the origins and antiquity of British and Irish C. sativa trees enhances their conservation and economic significance, important in the context of increasing threats from environmental change, pests and pathogens. [ABSTRACT FROM AUTHOR]

This paper examines the impacts of the introduction of the UK National Minimum Wage (NMW) in 1999 and the introduction of the UK National Living Wage (NLW) in 2016 in Northern Ireland (NI) on employment and hours. NI is the only part of the UK with a land border where the NMW and NLW cover those working on one side of the border but not those working on the other side of the border (i.e., Republic of Ireland). This discontinuity in minimum wage coverage enables a research design that estimates the impacts of the NMW and NLW on employment and hours worked using difference-in-differences estimation. We find a small decrease in the employment rate of 22–59/64-year-olds in NI, of up to 2% points, in the year following the introduction of the NMW, but no impact on hours worked. We find no clear evidence that the introduction of the NLW impacted either employment or hours worked in NI. [ABSTRACT FROM AUTHOR]

Background: The life expectancy of people with severe mental illness (SMI) is shorter than those without SMI, with multimorbidity and poorer physical health contributing to health inequality. Screening tools could potentially assist the optimisation of medicines to protect the physical health of people with SMI. The aim of our research was to design and validate a medicines optimisation tool (OPTIMISE) to help clinicians to optimise physical health in people with SMI. Methods: A review of existing published guidelines, PubMed and Medline was carried out. Literature was examined for medicines optimisation recommendations and also for reference to the management of physical illness in people with mental illness. Potential indicators were grouped according to physiological system. A multidisciplinary team with expertise in mental health and the development of screening tools agreed that 83 indicators should be included in the first draft of OPTIMISE. The Delphi consensus technique was used to develop and validate the contents. A 17-member multidisciplinary panel of experts from the UK and Ireland completed 2 rounds of Delphi consensus, rating their level of agreement to 83 prescribing indicators using a 5-point Likert scale. Indicators were accepted for inclusion in the OPTIMISE tool after achieving a median score of 1 or 2, where 1 indicated strongly agree and 2 indicated agree, and 75th centile value of ≤ 2. Interrater reliability was assessed among 4 clinicians across 20 datasets and the chance corrected level of agreement (kappa) was calculated. The kappa statistic was interpreted as poor if 0.2 or less, fair if 0.21–0.4, moderate if 0.41–0.6, substantial if 0.61–0.8, and good if 0.81–1.0. Results: Consensus was achieved after 2 rounds of Delphi for 62 prescribing indicators where 53 indicators were accepted after round 1 and a further 9 indicators were accepted after round 2. Interrater reliability of OPTIMISE between physicians and pharmacists indicated a substantial level of agreement with a kappa statistic of 0.75. Conclusions: OPTIMISE is a 62 indicator medicines optimisation tool designed to assist decision making in those treating adults with SMI. It was developed using a Delphi consensus methodology and interrater reliability is substantial. OPTIMISE has the potential to improve medicines optimisation by ensuring preventative medicines are considered when clinically indicated. Further research involving the implementation of OPTIMISE is required to demonstrate its true benefit. Trial registration: This article does not report the results of a health care intervention on human participants. [ABSTRACT FROM AUTHOR]

Understanding and communicating the environmental impacts of food products is key to enabling transitions to environmentally sustainable food systems [El Bilali and Allahyari, Inf. Process. Agric. 5, 456-464 (2018)]. While previous analyses compared the impacts of food commodities such as fruits, wheat, and beef [Poore and Nemecek, Science 360, 987-992 (2018)], most food products contain numerous ingredients. However, because the amount of each ingredient in a product is often known only by the manufacturer, it has been difficult to assess their environmental impacts. Here, we develop an approach to overcome this limitation. It uses prior knowledge from ingredient lists to infer the composition of each ingredient, and then pairs this with environmental databases [Poore and Nemecek Science 360, 987-992 (2018); Gephart et al., Nature 597, 360-365 (2021)] to derive estimates of a food product's environmental impact across four indicators: greenhouse gas emissions, land use, water stress, and eutrophication potential. Using the approach on 57,000 products in the United Kingdom and Ireland shows food types have low (e.g., sugary beverages, fruits, breads), to intermediate (e.g., many desserts, pastries), to high environmental impacts (e.g., meat, fish, cheese). Incorporating NutriScore reveals more nutritious products are often more environmentally sustainable but there are exceptions to this trend, and foods consumers may view as substitutable can have markedly different impacts. Sensitivity analyses indicate the approach is robust to uncertainty in ingredient composition and in most cases sourcing. This approach provides a step toward enabling consumers, retailers, and policy makers to make informed decisions on the environmental impacts of food products. [ABSTRACT FROM AUTHOR]

Background: In 2010, a national enquiry into elderly patient outcomes after surgery identified that only 36% received 'good' care. Guidance was subsequently published by the Association of Anaesthetists of Great Britain and Ireland regarding perioperative care of the elderly and those with dementia; this study aims to assess current adherence to these guidelines in anaesthetic departments across Scotland. Methods: A web-based survey was sent to all Scottish departments. The questions assessed department patient demographic, access to specialist pre-assessment services, availability of multidisciplinary input, perioperative care of patients with cognitive impairment and departmental training on geriatric perioperative care. Results: Responses were collected from November-December 2020 with a 92.6% response rate. A total of 64% of departments stated that > 50% of their workload involved patients over 75. One department had a lead clinician for geriatric anaesthesia, whilst 20% could access a geriatric specialist when coordinating perioperative care. Specialist geriatric pre-assessment services operate in 20% of centres. A total of 60% of respondents used a clinical frailty score when pre-assessing patients over 75, with 48% specifically screening for cognitive impairment. The vast majority of centres, 76%, did not routinely provide information regarding post-operative delirium and 24% 'never or very rarely' invite caregivers to accompany patients with dementia into the department. Education sessions regarding perioperative elderly care had occurred in 56% of departments. Conclusions: Elderly patients represent a significant proportion of anaesthetic workload in Scotland. Despite this, adherence to recommended practice is low. The vast majority of centres lack access to specialist multidisciplinary input or specialist pre-assessment services which are essential to providing good care. Reported screening for frailty and cognitive impairment is variable, with opportunities for improvement in communication and education (patient and clinician) surrounding these conditions. [ABSTRACT FROM AUTHOR]

Background: In 2010, a national enquiry into elderly patient outcomes after surgery identified that only 36% received 'good' care. Guidance was subsequently published by the Association of Anaesthetists of Great Britain and Ireland regarding perioperative care of the elderly and those with dementia; this study aims to assess current adherence to these guidelines in anaesthetic departments across Scotland. Methods: A web-based survey was sent to all Scottish departments. The questions assessed department patient demographic, access to specialist pre-assessment services, availability of multidisciplinary input, perioperative care of patients with cognitive impairment and departmental training on geriatric perioperative care. Results: Responses were collected from November-December 2020 with a 92.6% response rate. A total of 64% of departments stated that > 50% of their workload involved patients over 75. One department had a lead clinician for geriatric anaesthesia, whilst 20% could access a geriatric specialist when coordinating perioperative care. Specialist geriatric pre-assessment services operate in 20% of centres. A total of 60% of respondents used a clinical frailty score when pre-assessing patients over 75, with 48% specifically screening for cognitive impairment. The vast majority of centres, 76%, did not routinely provide information regarding post-operative delirium and 24% 'never or very rarely' invite caregivers to accompany patients with dementia into the department. Education sessions regarding perioperative elderly care had occurred in 56% of departments. Conclusions: Elderly patients represent a significant proportion of anaesthetic workload in Scotland. Despite this, adherence to recommended practice is low. The vast majority of centres lack access to specialist multidisciplinary input or specialist pre-assessment services which are essential to providing good care. Reported screening for frailty and cognitive impairment is variable, with opportunities for improvement in communication and education (patient and clinician) surrounding these conditions. [ABSTRACT FROM AUTHOR]