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Background The Medical Certificate of Stillbirth (MCS) records data about a baby's death after 24 weeks of gestation but before birth. Major errors that could alter interpretation of the MCS were widespread in two UK-based regional studies. Methods A multicentre evaluation was conducted, examining MCS issued 1 January 2018 to 31 December 2018 in 76 UK obstetric units. A systematic case-note review of stillbirths was conducted by Obstetric and Gynaecology trainees, generating individual 'ideal MCSs' and comparing these to the actual MCS issued. Anonymized central data analysis described rates and types of error, agreement and factors associated with major errors. Results There were 1120 MCSs suitable for assessment, with 126 additional submitted data sets unsuitable for accuracy analysis (total 1246 cases). Gestational age demonstrated 'substantial' agreement [K = 0.73 (95% CI 0.70–0.76)]. Primary cause of death (COD) showed 'fair' agreement [K = 0.26 (95% CI 0.24–0.29)]. Major errors [696/1120; 62.1% (95% CI 59.3–64.9%)] included certificates issued for fetal demise at <24 weeks' gestation [23/696; 3.3% (95% CI 2.2–4.9%)] or neonatal death [2/696; 0.3% (95% CI 0.1–1.1%)] or incorrect primary COD [667/696; 95.8% (95% CI 94.1–97.1%)]. Of 540/1246 [43.3% (95% CI 40.6–46.1%)] 'unexplained' stillbirths, only 119/540 [22.0% (95% CI 18.8–25.7%)] remained unexplained; the majority were redesignated as either fetal growth restriction [FGR: 195/540; 36.1% (95% CI 32.2–40.3%)] or placental insufficiency [184/540; 34.1% (95% CI 30.2–38.2)]. Overall, FGR [306/1246; 24.6% (95% CI 22.3–27.0%)] was the leading primary COD after review, yet only 53/306 [17.3% (95% CI 13.5–22.1%)] FGR cases were originally attributed correctly. Conclusion This study demonstrates widespread major errors in MCS completion across the UK. MCS should only be completed following structured case-note review, with particular attention on the fetal growth trajectory. [ABSTRACT FROM AUTHOR]

As an increasing number of British universities are now requiring/encouraging mathematics applicants to have taken ‘extension papers’ such as the Mathematics Admissions Test (MAT), Advanced Extension Award (AEA) and Sixth Term Examination Paper (STEP), current students were asked how useful they were in preparation for their degree. The MAT was most commonly described as good preparation for undergraduate mathematics, whilst most participants who had taken the AEA were indifferent regarding its usefulness. Participants were positive about STEP, commending its similarity to undergraduate-style assessment and its challenging questions. The students’ views suggested that those wishing to be well prepared for tertiary mathematics should take one of these papers, preferably STEP. However, whilst universities may not necessarily wish to require applicants to pass extension papers, it may be beneficial for universities to recommend students to take them in order to improve their mathematical thinking and expectations of undergraduate mathematics study. [ABSTRACT FROM AUTHOR]

Aims The literature review aimed to identify the barriers the Punjabi and/or Sikh community have in accessing support for alcohol addiction. Method A systematic review of the literature was undertaken of four scholarly databases, Google Scholar and grey literature on UK-based research conducted after 1980 into alcohol addiction in the Punjabi and/or Sikh community. Fourteen papers met the inclusion criteria outlined in the paper and were included in the review. Results Ten main barriers to accessing support were found; stigma, religion, lack of understanding of addiction, over reliance on a medical model of treatment and disregard of therapy, cultural implications of being a member of the Punjabi and/or Sikh community and the addiction community, gender and generational differences and a lack of government commitment to alcohol support for BME communities with a lack of culturally specific services. Conclusion Despite the many barriers explored, the role of stigma remained a powerful theme throughout often underpinning other barriers. A key recommendation across many papers was the need for culturally sensitive support services. Several areas for future research were identified. [ABSTRACT FROM AUTHOR]

This article performs a close reading of a newly discovered archive of letters to and from Charles de Gaulle, written between 1941 and 1944, to show how de Gaulle engaged in a process of auto-mythification. The archive features wartime correspondence between de Gaulle and various leaders of the British government, intelligence, and military, such as Prime Minister Winston Churchill, Secretary of State for Foreign Affairs (1941) Anthony Eden, and Chief of the Imperial General Staff General Alan Brooke. The study illuminates the problematic nature of Anglo-French collaboration in terms of shifting cultural perspectives, particularly with regard to the notion of authority. Such notions are inevitably contested, and this collection of letters is an unusually effective resource to reconstruct the essentially dialogic aspects of this contestation. Through contextualization of the correspondence, including both contemporary and retrospective accounts of the war, the article enriches our understanding of the implicit and explicit conflicts between British and French forces and the rhetorical strategies utilized to further each writer's aims. [ABSTRACT FROM AUTHOR]

It is well documented in both the British press and mathematics education literature that many considerA-levels (qualifications for secondary school leavers in England,Wales and Northern Ireland) to be insufficient preparation for undergraduate mathematics study in theUK. A-levelMathematics and FurtherMathematics are not solely intended for those wishing to go on to study undergraduatemathematics, though this is often the onlymathematics study and preparation available to, and done by, most students. A number of British universities now require applicants to perform well on entrance examinations or 'extension' papers in addition to achieving certain grades in A-level Mathematics and, sometimes, Further Mathematics. This article outlines research which used the Mathematical Assessment Task Hierarchy (Smith et al., 1996) and builds upon the work of Darlington (2014) to describe the mathematical skills required to answer the questions in extension papers.These are then contrasted with skills required at A- and undergraduate level. Each of the three extension papers analysed (Advanced Extension Awards, Sixth Term Examination Papers and university admissions tests) were found to differ from each other, as well as from A-level and undergraduate examinations. This suggests that there are benefits for students doing such papers before university mathematics study. The advantages of doing these papers are not only for admissions tutors, who can use them as additional indicators of candidates'aptitudes, but also for the students themselves as they gain insights into the nature of undergraduatemathematics and related furthermathematical challenges. [ABSTRACT FROM AUTHOR]

The humble ballot paper is a defining technology of elections throughout the world. This article interrogates its contested past by demonstrating - over a long period and in the context of three contrasting countries - how and why it emerged in the early modern period and how it was then used, abused and regulated in the context of the expanded, and eventually mass, electoral arenas of the nineteenth and twentieth centuries. Ironically, by the time that the ballot paper was firmly established, its monopoly was already being challenged by mechanical and then electronic media, which may eventually condemn it to extinction. [ABSTRACT FROM AUTHOR]

In this article I begin by discussing the persistent problem of relations between educational inequality and the attainment gap in schools. Because benefits accruing from an education are substantial, the 'gap' leads to large disparities in the quality of life many young people can expect to experience in the future. Curriculum knowledge has been a focus for debate in England in relation to educational equality for over 40 years. Given the contestation surrounding views about curriculum knowledge and equality I consider the thinking of two philosophers, Jacques Derrida and Emmanuel Levinas, and their work on justice, to trouble the curriculum framework and discourse of knowledge promoted through the policy text of The Importance of Teaching: The Schools White Paper (2010) and later associated policy reforms to the General Certificate of Secondary Education ( GCSE) curriculum in England. The Schools White Paper aims to make the curriculum more challenging to students by introducing tight controls in terms of the assessment framework and curriculum knowledge. I argue that, when considered through Derrida's perspective on language and meaning and Levinas' view on the ethical responsibility for the other, the reforms present obstacles to the search for a just curriculum. I look to the work of Sharon Todd and Paul Standish for a re-imagination of curriculum as or through relations in the light of Derrida's and Levinas' philosophies. [ABSTRACT FROM AUTHOR]

Elites often use merit to explain, justify, and make sense of their advantaged positions. But what exactly do they mean by this? In this paper, we draw on 71 interviews with elites in Denmark and the UK to compare self-justifications of meritocratic legitimacy. Our results indicate that while elites in both countries are united by a common concern to frame their merits as spontaneously recognized by others (rather than strategically promoted by themselves), the package of attributes they foreground vary significantly. In the UK, elites tend to be "talent meritocrats" who foreground their unique capacity for ideational creativity or risk taking, innately good judgment, and "natural" aptitude, intelligence, or academic ability. In contrast, in Denmark, elites are more likely to be "hard work meritocrats" who emphasize their unusual work ethic, extensive experience (as a signal of accumulated hard work), and contributions outside of work, particularly in civil society. We tentatively argue that one explanation for this cross-national variation is the role that different channels of elite recruitment play in amplifying legitimate notions of merit. In the UK, for example, elite private schools act to nurture ideas of exceptionalism and natural talent, whereas in Denmark elite employers socialize the connection between hard work and success. These findings suggest that nationally specific understandings of merit can have quite different implications for the legitimation of inequality. [ABSTRACT FROM AUTHOR]

Motivation Polygenic risk scores (PRSs) predict individuals' genetic risk of developing complex diseases. They summarize the effect of many variants discovered in genome-wide association studies (GWASs). However, to date, large GWASs exist primarily for the European population and the quality of PRS prediction declines when applied to other ethnicities. Genetic profiling of individuals in the discovery set (on which the GWAS was performed) and target set (on which the PRS is applied) is typically done by SNP arrays that genotype a fraction of common SNPs. Therefore, a key step in GWAS analysis and PRS calculation is imputing untyped SNPs using a panel of fully sequenced individuals. The imputation results depend on the ethnic composition of the imputation panel. Imputing genotypes with a panel of individuals of the same ethnicity as the genotyped individuals typically improves imputation accuracy. However, there has been no systematic investigation into the influence of the ethnic composition of imputation panels on the accuracy of PRS predictions when applied to ethnic groups that differ from the population used in the GWAS. Results We estimated the effect of imputation of the target set on prediction accuracy of PRS when the discovery and the target sets come from different ethnic groups. We analyzed binary phenotypes on ethnically distinct sets from the UK Biobank and other resources. We generated ethnically homogenous panels, imputed the target sets, and generated PRSs. Then, we assessed the prediction accuracy obtained from each imputation panel. Our analysis indicates that using an imputation panel matched to the ethnicity of the target population yields only a marginal improvement and only under specific conditions. Availability and implementation The source code used for executing the analyses is this paper is available at https://github.com/Shamir-Lab/PRS-imputation-panels. [ABSTRACT FROM AUTHOR]

Interpellation, the production and hailing of subjectivities, is key to poststructuralist international relations (IR) theory and yet with some notable exceptions interpellation/hailing as an analytical concept remains somewhat undertheorized. This paper presents a Lacanian–Žižekian psychoanalytical theorization of interpellation in IR, while engaging with the ontology and epistemology of belonging. More specifically, this paper develops four major psychoanalytical concepts: void/lack, fantasy, jouissance, and desire, as it argues that void/lack at the subjective and objective levels renders interpellation possible and destabilises it, thus accounting for the im/possibility of belonging. This paper illustrates the psychoanalytical framework of interpellation by analyzing national-populism as manifested in the Brexit discourse in the UK as well as the interpellation in homonationalism. [ABSTRACT FROM AUTHOR]

Head injury is an important cause of death among young adults in the UK, and a significant burden on NHS resources. However, management is inconsistent, governed largely by local resources. The latest version of the NICE head injury guidelines suggests that more patients with traumatic brain injury should be transferred to receive specialist care. However, this raises issues about the capacity of regional neurosurgical units, particularly to accommodate patients who do not require surgical intervention. OBJECTIVES: To critically evaluate the basis of the NICE recommendations about transfer for neurosurgical care, and examine the configuration of specialist services to assess the implications of increasing the existing number of transfers. METHODS: A systematic literature review was conducted of articles discussing the provision of emergency neurosurgical care for adult head injuries in the UK. RESULTS: Fifty-eight papers met the criteria for inclusion in the literature review, including seven papers cited in the NICE guidance. Fifty-one papers related to neurosurgical care, including papers on bed occupancy, transfer times and transfer policies. CONCLUSIONS: The evidence NICE cited is of variable quality. Much of the research was conducted outside the UK, which raises questions about its relevance to the NHS. Care of traumatic brain injuries in the UK is already hampered by the inadequate capacity of regional neurosurgical units to meet demand, and transferring more patients would be likely to exacerbate this. Increasing the number of transfers could also worsen inequalities of access for other groups, such as elective patients, particularly in areas where facilities are most stretched. [ABSTRACT FROM AUTHOR]

The article presents the summaries of papers on dermatology presented at the main plenary sessions. The National Health Service (NHS) Plan 2000 proposed the development of specialist general practitioners (GPs) to take referrals from other GPs in specialties including dermatology. The NHS Modernization Agency Action on Dermatology program funded pilot site studies of dermatology GPwSI, services and preliminary results were encouraging. By the end of 2005, all referrals from primary care will be performed electronically using a referral template. Currently only a proportion of referrals are electronic, allowing comparison with established paper referrals.

This note draws attention to the recent discovery of the papers of the Chartist and newspaper editor W. E. Adams (1832–1906), summarizes their contents and explains why they are to be found in the Russian State Archive of Socio-Political History in Moscow. [ABSTRACT FROM AUTHOR]

The article presents the summaries of papers related to dermatological surgery. The reported frequencies of dermatological malignancies in Great Britain population suggests an incidence of 125 basal cell carcinomas, 27 squamous cell carcinomas and 7 malignant melanomas per 100 000. Another study reports that the number of patients attending the researchers' melanoma screening clinic since its inception in 1997 has increased fourfold. This is in contrast to the number of melanomas diagnosed, which has remained constant. During that time, 15000 patients have attended and 500 melanomas have been diagnosed; 18 melanomas have been missed.

The article presents the summaries of papers related to paediatric dermatology. Atopic dermatitis (AD) accounts for at least 15% of referrals to secondary care dermatology, often requiring multiple visits and occupying much valuable time and resources. The researchers audited the usefulness of two quality-of-life measures, the Infants Dermatitis Quality of Life index (IDQOL) and Dermatitis Family Impact (DFI), which are easy to use in a routine clinical setting. A retrospective study on allergic contact dermatitis in children was conducted in Great Britain. 503 children were identified who had undergone patch testing consecutively in the reserchers' department between the years 1995 and 2004. This represents the largest study of children who have undergone patch testing in Great Britain.

Health inequalities research has a long history in the United Kingdom, and the development of government policies that are intended to explicitly address the existing health inequalities has been gathering pace since the Labour Party returned to power in 1997. In this paper, using the influential Acheson Report as a reference point, one of us (D.N.) describes how health inequalities policies have been developed, and the other (A.O.) assesses how, ideally, such policies ought to be developed. Although progress in the development of health inequalities policies has been made, the policies, and the evidence that has informed them, have been less than ideal. [ABSTRACT FROM PUBLISHER]

Background Older people are often explicitly or implicitly excluded from research, in particular clinical trials. This means that study findings may not be applicable to them, or that older people may not be offered treatments due to an absence of evidence. Aims The aim of this work was to develop recommendations to guide all research relevant to older people. Methods A diverse stakeholder group identified barriers and solutions to including older people in research. In parallel, a rapid literature review of published papers was undertaken to identify existing papers on the inclusion of older people in research. The findings were synthesised and mapped onto a socio-ecological model. From the synthesis we identified themes that were developed into initial recommendations that were iteratively refined with the stakeholder group. Results A range of individual, interpersonal, organisational, community and policy factors impact on the inclusion of older people in research. A total of 14 recommendations were developed such as removing upper age limits and comorbidity exclusions, involving older people, advocates and health and social care professionals with expertise in ageing in designing the research, and considering flexible or alternative approaches to data collection to maximise opportunities for participation. We also developed four questions that may guide those developing, reviewing and funding research that is inclusive of older people. Conclusion Our recommendations provide up to date, practical advice on ways to improve the inclusion of older people in health and care research. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the utility of a novel Paediatric Consultation Assessment Tool (PCAT). DESIGN: Developed to measure clinicians' communication behaviour with children and their parents/guardian, PCAT was designed according to consensus guidelines and refined at a number of stages. Volunteer clinicians provided videotaped real consultations. Assessors were trained to score communication skills using PCAT, a novel rating scale. SETTING: Eight UK paediatric units. PARTICIPANTS: 19 paediatricians collected video-recorded material; a second cohort of 17 clinicians rated the videos. MAIN OUTCOME MEASURES: Itemised and aggregated scores were analysed (means and 95% confidence intervals) to determine measurement characteristics and relationship to patient, consultation, clinician and assessor attributes; generalisability coefficient of aggregate score; factor analysis of items; comparison of scores between groups of patients, consultations, clinicians and assessors. RESULTS: 188 complete consultations were analysed (median per doctor = 10). 3 videos marked by any trained assessor are needed to reliably (r>0.8) assess a doctor's triadic consultation skills using PCAT, 4 to assess communication with just children or parents. Performance maps to two factors – "clinical skills" and "communication behaviour"; clinicians score more highly on the former (mean (SD) 95% CI 0.52 (0.075)). There were significant differences in scores for the same skills applied to parent and child, especially between the ages of 2 and 10 years, and for information-sharing rather than relationshipbuilding skills (2-tailed significance <0.001). CONCLUSIONS: The PCAT appears to be reliable, valid and feasible for the assessment of triadic consultation skills by direct observation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To report the evidence for and challenges to the validity of Sheffield Peer Review Assessment Tool (SPRAT) with paediatric Specialist Registrars (SpRs) across the UK as part of Royal College of Paediatrics and Child Health workplace based assessment programme. DESIGN: Quality assurance analysis, including generalisability, of a multisource feedback questionnaire study. SETTING: All UK Deaneries between August 2005 and May 2006. PARTICIPANTS: 577 year 2 and 4 Paediatric SpRs. INTERVENTIONS: Trainees were evaluated using SPRAT sent to clinical colleagues of their choosing. Data were analysed reporting totals, means and SD, and year groups were compared using independent t tests. A factor analysis was undertaken. Reliability was estimated using generalisability theory. Trainee and assessor demographic details were explored to try to explain variability in scores. MAIN OUTCOME MEASURES: 4770 SPRAT assessments were provided about 577 paediatric SpRs. The mean scores between years were significantly different (Year 2 mean=5.08, SD=0.34, Year 4 mean=5.18, SD=0.34). A factor analysis returned a two-factor solution, clinical care and psychosocial skills. The 95% CI showed that trainees scoring ≥4.3 with nine assessors can be seen as achieving satisfactory performance with statistical confidence. Consultants marked trainees significantly lower (t=–4.52) whereas Senior House Officers and Foundation doctors scored their SpRs significantly higher (SHO t=2.06, Foundation t=2.77). CONCLUSIONS: There is increasing evidence that multisource feedback (MSF) assesses two generic traits, clinical care and psychosocial skills. The validity of MSF is threatened by systematic bias, namely leniency bias and the seniority of assessors. Unregulated self-selection of assessors needs to end. [ABSTRACT FROM AUTHOR]

The article refers to a June 1753 letter written by English author Samuel Richardson to British poet Elizabeth Carter, as well as Carter's letter in response, which discuss the British Jewish naturalization Act of 1753. Richardson refers to a "little paper" which he included with his letter to Carter. The article argues that this was a pamphlet attributed to Philip Carteret Webb having the abbreviated title "The Bill, Permitting Jews to be Naturalized by Parliament, Having Been Misrepresented in the London Gazetteer, of Friday the 18th May."

The article presents summaries related to studies in dermatology in Great Britain. Medical students from the country conducted a survey to evaluate final year medical students' experience of dermatology. Another study conducted a retrospective review on the use of azathioprine in a childhood population over an 8-year period. Furthermore, a retrospective study on all skin surgical specimens processed by the teaching hospital hispathology department for 3-month period is conducted.

The article presents research summaries related to clinicopathological cases in Great Britain. In one of the studies, it presented a patient having deeply pigmented Eccrine porocarcinoma (EP) which occurs at a site of previous radiotherapy. Another study presents the case of patient whose diagnosis is mycosis fungoides several years after a successful treatment of chronic myeloid leukaemia. Moreover, the case of cholesterol embolization syndrome presented as lobular panniculitis is cited.

The article presents summaries regarding the symposium of registrars. One of the symposiums aimed in identifying the departments concerned in the management of skin lesions, the accurateness of the clinical diagnosis, and the appropriateness of the treatment. Another is an audit which aims to look at the number of sentinel lymph node biopsy (SLNB) in the management of melanoma in Great Britain. Moreover, a retrospective analysis on toxic epidermal necrolysis is presented.

The article presents research summaries related to dermatological surgery in Great Britain. It includes an evaluation among doctors if they informed their patients on their level of training in skin surgery before performing a practical procedure. In another study, pulsed dye laser treatment has been depicted to have a low incidence of adverse events. Moreover, a case series on the results of treatment for hidradenitis suppurativa having carbon dioxide laser is presented.

The article presents research summaries related to dermatitis in Great Britain. According to a study, it has found out that the new fungicide could be the allergen responsible for sofa dermatitis. Another study examines the use of hair dye and the frequency and nature of reported adverse reactions and the risk factors. Furthermore, a study stresses the need for education of all users of epoxy resins in regard to the skin hazard in the workplace and using proper protective equipment.

The article presents research summaries related to dermatopathology in Great Britain. In one of the studies, it aims to increase the awareness of prototheca wickerhamii which causes neutropenic sepsis after a chemotherapy. Another study reports a case of histiocyctic sarcoma having secondary skin involvement and a presumed primary in the lung. Furthermore, a case report on symplastic haemangioma which is developing on a background of chronic leg ulcer is given.

The article presents several summaries related to health studies in the Great Britain. It has been proven that there is growing risk of skin cancer with the use of artificial tanning devices. On the hand, the prevalence of and characteristic of polymorphic light eruption (PLE) in a larger cohort of the healthy British population has been assessed. Moreover, a case report concerning solar urticaria with a carrier state for erythropoietic protoporphyria is presented.

Much of the literature on domestic abuse focuses on those in intimate partner relationships or ex-partners, however, in the UK the Home Office definition also includes those in familial relationships. The Domestic Abuse, Stalking, and Harassment and Honour-Based Violence Risk Assessment assumes homogeneous risk factors across all relationships. This paper therefore examines the risk factors for repeat victimization of domestic abuse by relationship type between the victim and perpetrator in a UK police force. Using police-recorded domestic abuse incident and crime data, a logistic regression model found that the most similar repeat victimization risk profiles for 14,519 victims were amongst partners and ex-partners, with both relationships demonstrating the greatest degree of gender asymmetry, compared with other familial relationships. Physical violence was the strongest predictor of repeat victimization and was a statistically significant predictor for ex-partners, partners, and all familial relationships. Coercive behaviour was also a significant predictor for all relationships apart from partners, but not at the same magnitude as physical abuse. Recognizing the difference in risk by relationship type may assist the police in deciding the most appropriate response and interventions to reduce the risk of further harm. [ABSTRACT FROM AUTHOR]

This paper considers the question of how police-related AI projects and data projects in general are normatively assessed in the UK. After locating data ethics in relation to policing ethics, I shall consider the workings of perhaps the leading regional data ethics committee in the UK. I go on to consider the approach of another committee that might in the future provide national data ethics advice for the police. Finally, I summarize the normative ethics frameworks in use in the two committees and their heavy reliance on the concepts of necessity and proportionality. I suggest that these concepts may have to be supplemented by systematic thinking about varieties of harm and the way in which severe harm may generate obligations to prevent it, where prevention may be assisted by AI models. [ABSTRACT FROM AUTHOR]

Background Alcohol increases cancer risk, but less is known about public awareness of this link. This scoping review summarizes recent findings on the public awareness of alcohol as a cancer risk factor in European Union and UK. Methods Four databases (Web of Science, MEDLINE, PsycInfo, CINAHL) were searched for papers containing data on awareness of alcohol as cancer risk factor in EU or UK published between January 2017 and December 2022, and complemented with grey literature searches. Results In total, 45 studies were included covering 18 EU countries (Austria, Belgium, Cyprus, Czechia, Denmark, Finland, France, Germany, Hungary, Ireland, Italy, Netherlands, Poland, Romania, Slovakia, Slovenia, Spain, Sweden) and UK, presenting data collected between 2009 and 2022. Studies covered general population (17 studied a nationally representative sample), women, health professionals, patients and young people. Awareness of alcohol causing cancer in general was higher and studied more often than awareness of alcohol's impact on specific cancers. Among the EU general population, awareness of the link between alcohol and breast cancer ranged between 10% and 20%, head and neck cancer 15–25%, colorectal and oesophagus cancer 15–45% and liver cancer 40%. Awareness was higher among young people and specialized health professions and lower among women (the latter specifically for the breast cancer). Conclusions While awareness rates varied depending on the exact question wording, many studies showed low awareness of the alcohol-cancer link, especially for specific types such as breast and colon cancer. Public should be better informed about alcohol consumption-related cancer risk. [ABSTRACT FROM AUTHOR]

Background Given the globally ageing population, care homes have an important role in delivering palliative and end-of-life care. Advance care planning (ACP) is promoted to improve the quality of end-of-life care in this setting. While many professionals can be involved in ACP, little is known about what influences multi-professional involvement and how multi-professional working impacts the ACP process in the UK. This study investigated multi-professional practice in relation to ACP in nursing homes. Design and methods An ethnography was undertaken in two UK nursing homes using multiple methods of data collection: observations, interviews and document review. Participants included the following: nursing home residents (n  = 6), relatives (n  = 4), nursing home staff (n  = 19), and visiting health and social care professionals (n  = 7). Analysis integrated thematic analysis, mapping of resident ACP trajectories and documentary analysis. Findings This paper suggests that multi-professional and relatives' involvement in ACP was disjointed. Continuity and coordination were disrupted by misalignment of visiting professional and nursing home organisational structures. Findings show a 'knotworking' approach to teamwork and power imbalance between nursing home staff and visiting professionals, such as general practitioners. While residents wished their relatives to be involved in their ACP, this was not formally recognised, and limited support existed to facilitate their involvement. Conclusion The structure and organisation of multi-professional and relatives' involvement in ACP led to fragmentation of the process. This marginalised the voice of both the resident and nursing home staff, thereby limiting ACP as a tool to enhance quality of end-of-life care. [ABSTRACT FROM AUTHOR]

— Alcohol misuse constitutes a major problem in our modern society and both physical and mental alcohol-related harm result in a large number of Accident and Emergency (A&E) attendances, thus imposing a significant burden on the workload and financial resources of the department. The current management of problem drinking by most A&E departments could be further improved. The introduction of a holistic approach that includes efficient screening instruments and effective brief, anti-alcoholic interventions, for the management of these patients must be considered. This should strengthen the preventive role of A&E departments, and, in the long term, may result in a decrease in the number of cases of alcohol misuse and in alcohol-related attendances. [ABSTRACT FROM PUBLISHER]

Although health education programmes have been implemented in higher music education (HME) and their evaluations published in peer-reviewed journals, guidelines as to what ought to be included in these programmes are still missing. This study aimed to document expert discussions on the content of an ideal health education curriculum for HME students in the UK, integrating critical thinking. Four interdisciplinary workshops were conducted, where 67 experts in relevant fields took part, and were asked to discuss four lists of topics and concepts created based on literature reviews (cognitive biases, logical fallacies, critical appraisal tools and health topics). Only the list on health topics is relevant here. Notes taken by the participants and ourselves were thematically analysed. Four themes were identified, two of which are reported in this paper: (i) The health education curriculum and (ii) A settings-based approach to health. Part I of this project (published elsewhere) is focussed on the critical thinking content of health education for conservatoire students. The present paper focusses on the ideal health education curriculum and its implications for the wider context of health promotion. [ABSTRACT FROM AUTHOR]

Focuses on the number of centers involved in kidney donor programs in Great Britain. Basis of donor assessment guidelines; Consequences of associated physiological, ethical and clinical implications; Number of renal transplants performed annually.

Background There is a challenging lack of evidence to inform best practice in the routine clinical care of juvenile idiopathic arthritis (JIA). Wide inter-centre variation in the definition and documentation of clinical data items is a major barrier to improvement. In response, we have developed a consensus agreed standardised core dataset called CAPTURE-JIA (n = 62 data items and a 'data dictionary' including agreed definitions of terms) designed to support routine collection of high-quality clinical data. The feasibility and acceptability of CAPTURE-JIA in clinical practice is not yet known and was the focus of this pilot study. Methods A purposeful sample of six paediatric rheumatology centres across England was invited to collect the CAPTURE-JIA dataset using paper collection forms (n = 20 patients/centre). The dataset was analysed for missing data. Six focus groups (n = 3-10) explored clinicians' views on acceptability and feasibility. Results One hundred and twenty-one patients were recruited over three months. The completeness of the dataset was similar across centres, with minor variations. The majority of data items (eg demographics, dates, ILAR type and examination) were >80% completed. However, 14/62 data items received >40% missing data. (Table 1) Further descriptive analyses highlighted incorrect completion of paper forms. Three themes emerged from the focus groups: problematic data items (missing from >10% forms at > 1 centre), format of clinician data forms and the role of digital data collection. Suggested solutions included minor changes to data item definitions and formatting. There were no refinements to the data items. Development of a digital data collection system was identified by all as essential. Due to a lack of clear consensus, the original CAPTURE forms included a number of ways to record joint count data. This proved confusing and a unanimous decision was taken to collect joint count data on all 83 joints in a tabular format. P10 Table 1: CAPTURE JIA data items with >40% missing data Data item  % forms with data item missing (if item required)  Relevant co-morbidities?  60  Macrophage activation syndrome?  100  Has the ILAR subtype changed?  50  Morning stiffness lasting >15 minutes?  42  History of any form of uveitis?  52  Date started uveitis mediation?  50  Strength of uveitis medication?  83  Counselled prior to new DMARD / biologic?  56  Enrolled in BECS/BCRD if new DMARD / biologic?  48  Joint count (homunculus or table format)  48  Physician assessment of systemic disease activity (VAS)  75  ESR  74  CRP  92  Plasma viscosity  100  Data item  % forms with data item missing (if item required)  Relevant co-morbidities?  60  Macrophage activation syndrome?  100  Has the ILAR subtype changed?  50  Morning stiffness lasting >15 minutes?  42  History of any form of uveitis?  52  Date started uveitis mediation?  50  Strength of uveitis medication?  83  Counselled prior to new DMARD / biologic?  56  Enrolled in BECS/BCRD if new DMARD / biologic?  48  Joint count (homunculus or table format)  48  Physician assessment of systemic disease activity (VAS)  75  ESR  74  CRP  92  Plasma viscosity  100  P10 Table 1: CAPTURE JIA data items with >40% missing data Data item  % forms with data item missing (if item required)  Relevant co-morbidities?  60  Macrophage activation syndrome?  100  Has the ILAR subtype changed?  50  Morning stiffness lasting >15 minutes?  42  History of any form of uveitis?  52  Date started uveitis mediation?  50  Strength of uveitis medication?  83  Counselled prior to new DMARD / biologic?  56  Enrolled in BECS/BCRD if new DMARD / biologic?  48  Joint count (homunculus or table format)  48  Physician assessment of systemic disease activity (VAS)  75  ESR  74  CRP  92  Plasma viscosity  100  Data item  % forms with data item missing (if item required)  Relevant co-morbidities?  60  Macrophage activation syndrome?  100  Has the ILAR subtype changed?  50  Morning stiffness lasting >15 minutes?  42  History of any form of uveitis?  52  Date started uveitis mediation?  50  Strength of uveitis medication?  83  Counselled prior to new DMARD / biologic?  56  Enrolled in BECS/BCRD if new DMARD / biologic?  48  Joint count (homunculus or table format)  48  Physician assessment of systemic disease activity (VAS)  75  ESR  74  CRP  92  Plasma viscosity  100  Conclusion Paper collection of the CAPTURE-JIA data items is feasible and acceptable in the routine clinical setting, but unlikely to be sustainable in the longer term if collected in duplicate with medical notes. A digital tool in the clinical domain, ideally interlocking with local systems, would offer many advantages, including more complete and time-efficient data collection. Conflicts of Interest The authors declare no conflicts of interest. [ABSTRACT FROM AUTHOR]

The forum shows that I correctly diagnosed the place that 'people's war' has in the historiography of the Second World War; that, if anything, I underestimated the grip that the connected series of beliefs about 'people's war' have come to have over some historians of the British Second World War; and how difficult it is to start a conversation about framing assumptions and the nature of the historiography of the war. In this response I aim to get above the din of detail and try to understand the underlying positions being taken by the respondents. I will try to tease out their rather hidden assumptions, in order to clarify better what is at issue and at stake, thereby making a fresh attempt to take this discussion forward. I will also extend the discussion by considering works that have already rejected the conceptualisation of 'people's war' defended in this forum. I hope that my original paper and the forum itself will together make the case that we need fresh ways of thinking about the British Second World War, as well as suggest that new ways are already in being and that the concept of 'people's war' as currently used by many historians needs to be abandoned. [ABSTRACT FROM AUTHOR]

Over the past few decades, a small but growing group of people have worked remotely from their homes. With the arrival of the coronavirus pandemic, millions of people found themselves joining this group overnight. In this position paper, we examine the kinds of work that 'went remote' in response to the pandemic, and consider the ways in which this transition was influenced by (and in turn came to influence) contemporary trends in digital workplace measurement and evaluation. We see that employers appeared reluctant to let certain classes of employee work remotely. When the pandemic forced staff home, employers compensated by turning to digital surveillance tools, even though, as we argue, these tools seem unable to overcome the significant conceptual barriers to understanding how people are working. We also observed that, in the United Kingdom context, the pandemic didn't mean remote work for a significant proportion of the population. We assert that, to maximize its impact, 'future of work' research in human-centred computing must be more inclusive and representative of work, rather than focusing on the experiences of knowledge workers and those involved in new forms of work. [ABSTRACT FROM AUTHOR]

In recent years, the study of species' occurrence has benefited from the increased availability of large‐scale citizen‐science data. While abundance data from standardized monitoring schemes are biased toward well‐studied taxa and locations, opportunistic data are available for many taxonomic groups, from a large number of locations and across long timescales. Hence, these data provide opportunities to measure species' changes in occurrence, particularly through the use of occupancy models, which account for imperfect detection. These opportunistic datasets can be substantially large, numbering hundreds of thousands of sites, and hence present a challenge from a computational perspective, especially within a Bayesian framework. In this paper, we develop a unifying framework for Bayesian inference in occupancy models that account for both spatial and temporal autocorrelation. We make use of the Pólya‐Gamma scheme, which allows for fast inference, and incorporate spatio‐temporal random effects using Gaussian processes (GPs), for which we consider two efficient approximations: subset of regressors and nearest neighbor GPs. We apply our model to data on two UK butterfly species, one common and widespread and one rare, using records from the Butterflies for the New Millennium database, producing occupancy indices spanning 45 years. Our framework can be applied to a wide range of taxa, providing measures of variation in species' occurrence, which are used to assess biodiversity change. [ABSTRACT FROM AUTHOR]

Between 1962 and 1965, a broad definition of dependence allowed for the migration of Commonwealth Citizens to join working family members in Britain. This article investigates how the Home Office targeted male dependent youth as a category that could reduce unwanted immigration from the Commonwealth, particularly South Asia. Home Office officials obscured the stories of dependent migrants, constructed the figure of the 'bogus child', and denigrated male familial connections, which resulted in the denial of family reunion. Colonial assumptions about the mendacity of South Asians and the illegibility of South Asian family forms shaped British policy. The 1965 White Paper and the 1968 Commonwealth Immigrants Act foreclosed the possibility of a broad definition of family and consolidated the legitimacy of the cisheterosexual family. Home Office discussions dovetailed with an emergent common sense circulated in newspapers and public debate about the illegitimacy of the South Asian family in Britain. This article interrogates the racist reasoning of the Home Office and this emergent common sense not only to show how immigration policy generates racialization but also to reveal the specificity of South Asian racialization in the post-imperial social formation. [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]

Taking the idea of refugee 'journeys to health' (Newbold and McKeary, 2018) as a point of departure this paper examines the case of Chilean exiles in the UK. Reflecting on interviews conducted with Chilean exiles the analysis highlights how the health-related challenges that many people have experienced change over time. For some the passing of time has enabled people to make sense of what happened to them following the military coup in Chile in 1979 and this has helped them to 'move on'. For others, on-going challenges remain, for example a number of people still experienced PTSD. The paper also reflects on the difficulties encountered by refugees when dealing with formal health providers. While all of the respondents had full entitlements to NHS services the paper reflects on the informal barriers that continue to shape refugees' engagement with health care providers and limit their ability to address health concerns. [ABSTRACT FROM AUTHOR]

As people age they are at increased risk of cardiovascular disease, the leading cause of mortality and morbidity worldwide. Understanding cardiovascular ageing is essential to preserving healthy ageing and preventing serious health outcomes. This collection of papers published in Age and Ageing since 2011 cover key themes in cardiovascular ageing, with a separate collection on stroke and atrial fibrillation planned. Treating high blood pressure remains important as people age and reduces strokes and heart attacks. That said, a more personalised approach to blood pressure may be even more important as people age to lower blood pressure to tight targets where appropriate but avoid overtreatment in vulnerable groups. As people age, more people experience blood pressure drops on standing (orthostatic hypotension), particularly as they become frail. This can predispose them to falls. The papers in this collection provide an insight into blood pressure and orthostatic hypotension. They highlight areas for further research to understand blood pressure changes and management in the ageing population. Inpatient clinical care of older people with heart attacks differs from younger people in UK national audit data. People aged over 80 had improved outcomes in survival after heart attack over time, but had lower rates of specialist input from cardiology compared with younger people. This may partly reflect different clinical presentations, with heart attacks occurring in the context of other health conditions, frailty and multimorbidity. The care and outcomes of acute and chronic cardiovascular disease are impacted by the frailty and health status of an individual at baseline. The research included in this collection reinforces the wide variations in the ageing population and the necessity to focus on the individual needs and priorities, and provide a person-centred multidisciplinary approach to care. [ABSTRACT FROM AUTHOR]

Background COVID-19 brought additional challenges to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision-making, which was already a contentious issue. In the UK, reports of poor DNACPR decision-making and communication emerged in 2020, including from the regulator, the Care Quality Commission. This paper explores the experiences of people who discussed DNACPR with a healthcare professional on behalf of a relative during the coronavirus pandemic, with the aim of identifying areas of good practice and what needs to be improved. Methods a total of 39 people participated in semi-structured interviews via video conferencing software or telephone. Data were evaluated using Framework Analysis. Findings results are presented around three main themes: understanding, communication and impact. Participants' understanding about DNACPR was important, as those with better understanding tended to reflect more positively on their discussions with clinicians. The role of relatives in the decision-making process was a frequent source of misunderstanding. Healthcare professionals' communication skills were important. Where discussions went well, relatives were given clear explanations and the opportunity to ask questions. However many relatives felt that conversations were rushed. DNACPR discussions can have a lasting impact—relatives reported them to be significant moments in care journeys. Many relatives perceived that they were asked to decide whether their relative should receive CPR and described enduring emotional consequences, including guilt. Conclusion the pandemic has illuminated deficiencies in current practice around DNACPR discussion, which can have difficult to anticipate and lasting negative consequences for relatives. This research raises questions about the current approach to DNACPR decision-making. [ABSTRACT FROM AUTHOR]

In Victorian Britain rags were not only associated with the inadequate clothing of the poor, they were also viewed as a valuable commodity, widely collected for recycling into paper. This essay examines rags as simultaneously despised and precious objects, tracing the connections between Victorian accounts of poverty, the industrial recycling of rags into paper, and the redemption narratives created by Charles Dickens about rescued children. A supporter of Ragged Schools and champion of rags recycling, Dickens drew on the idea of the transformation of dirty rags into clean paper in his representations of ragged children. To him, the recycling of rags indicated the civilizing forces of modernity, and reading Dickens's representations of ragged children in this context reveals how cloth recycling became a paradigm for society's duties towards destitute children. This essay explains Dickens's juxtaposition of ragged children with references to rag-dealing in his novels; by this means he suggested that street children, like their ragged clothing, were capable of being purified and transformed into social usefulness. [ABSTRACT FROM PUBLISHER]

China has become an impactful science superpower, but it is asserted that its influence provides it with disproportionate benefits that some national research policies have not thus far appreciated. To create context, Web of Science data are used to analyse research collaborations between the UK and China: trends in volume of output between 1981 and 2019; citation impact; and comparative performance across research fields. UK–China collaboration increased from fewer than 100 co-authored papers before 1990, to 750 per year in 2000, 3,324 in 2010, and 16,267 papers (10.9 per cent of UK output) in 2019. UK–China collaboration is concentrated in technology-based fields: in some (e.g. telecommunication), over 30 per cent of UK papers are in collaboration with Chinese-based researchers. The paper discusses the policy consequences to the UK of this indicative dependency, arguing that exiting from such collaborations is ill advised, provided the risks, perceived or real, are mapped, managed, and mitigated. [ABSTRACT FROM AUTHOR]

Inter-war Britain witnessed rising tax avoidance and evasion, reflecting a combination of elite opposition to higher tax rates and the almost complete absence of any effective legal or reputational sanctions against tax evaders. Legal tax avoidance carried little social stigma and even illegal evasion rarely led to criminal prosecution or public censure, on account of the confidential, non-judicial procedure by which cases were resolved. This paper explores how a combination of elite opposition to higher tax rates, a growing judicial ideology (especially in the higher courts) based around protecting 'civil liberties' (essentially construed in terms of private property rights), and an ambiguous stance on tax avoidance among policy-makers, created the conditions for the rapid growth of tax avoidance. This in turn fostered a booming tax avoidance industry that became a persistent feature of the British tax environment. The paper also explores the wider political economy of tax avoidance and evasion and how a political philosophy shared by leading judges, right-wing 'anti-waste' movements, some Conservative politicians, and many wealthy taxpayers, formed a precursor of neo-liberal political philosophy. Finally, it charts the changed tax climate of the late 1930s, when the growing threat of total war aligned the interests of the wealthy with those of the rest of society and allowed policy-makers to present tax payment as a patriotic duty. In this context, collective liberty and an ideology of 'fair shares' eclipsed the rhetoric of the rights of the propertied individual, thereby undermining the legitimacy of tax avoidance. [ABSTRACT FROM AUTHOR]

Following Greta Thunberg's school strike in Stockholm in August 2018 and the October 2018 'declaration of rebellion' by activists in the UK, 2019 saw several climate protest movements rise to public attention, including Fridays for Future (FFF), Extinction Rebellion (XR), and the US Sunrise Movement. What is striking about them is that they rather bluntly refer to science in their campaigns. In this paper, we present an in-depth and comparative study of how the new climate protest movements relate to scientific evidence. Employing a narrative analysis of different types of data (websites, press releases, and media coverage), we study the movements' understandings of 'the science' as well as of science's role in policy processes. We find that the movements in their initial phase predominantly rely on science for their legitimation and adopt a scientific worldview with very little 'green ambivalence'. Notably, FFF and XR hold a deficit model of existing climate communication and enact roles as science communicators. [ABSTRACT FROM AUTHOR]

Prevention and elimination of modern slavery is a priority of this era, eliciting responses at an international level and in domestic laws. The duty of organisations to ensure transparency in their supply chains is the strongest representation of corporate responsibility in this field. Less attention has been given to the current/potential role of insolvency mechanisms, in relation to companies' commission of modern slavery offences, and in relation to their failure to comply with their supply-chain obligations. This paper engages with this novel question by examining the proposition to incorporate a directors' disqualification sanction into the United Kingdom framework governing companies' modern slavery supply chain obligations. This represents an opportunity, insofar as the disqualification regime is ostensibly well-placed to address weaknesses in companies' compliance with their responsibilities. However, it represents a challenge in that adoption and implementation would have to navigate drawbacks such as the limitations of existing grounds for disqualification and potential weaknesses in the design and enforcement of a bespoke sanction. Moreover, it should confront uncertainty as to whether disqualification is an effective tool for preventing misconduct by the professional/executive class of managers at the helm of large companies. Increased emphasis on regulating the human rights obligations of companies makes it imperative that this question is addressed. [ABSTRACT FROM AUTHOR]

In the UK, the introduction of austerity measures for public services has intensified the thinking around inter-organizational collaboration between emergency services and other public and/or private sector organizations. Theoretically, while collaborative benefits are held up as beacons that drive organizations to participate in inter-organizational arrangements, a high number of such arrangements fail. In this paper, we explored the factors that influenced the collaboration process in the context of developing 'collaborative information infrastructures', from an organizational and collaboration level perspective, via a multiple case study approach. Our findings offer insights into how policymakers and public managers could improve their practices by considering their approach towards, and impact of, these factors when implementing collaborative projects in information technology and information systems. [ABSTRACT FROM AUTHOR]