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The number of older people dying in long-term care facilities (LTCFs) is increasing globally, but care quality may be variable. A framework was developed drawing on empirical research findings from the Palliative Care for Older People (PACE) study and a scoping review of literature on the implementation of palliative care interventions in LTCFs. The PACE study mapped palliative care in LTCFs in Europe, evaluated quality of end-of-life care and quality of dying in a cross-sectional study of deceased residents of LTCFs in 6 countries, and undertook a cluster-randomized control trial that evaluated the impact of the PACE Steps to Success intervention in 7 countries. Working with the European Association for Palliative Care, a white paper was written that outlined recommendations for the implementation of interventions to improve palliative and end-of-life care for all older adults with serious illness, regardless of diagnosis, living in LTCFs. The goal of the article is to present these key domains and recommendations. Transparent expert consultation. International experts in LTCFs. Eighteen (of 20 invited) international experts from 15 countries participated in a 1-day face-to-face Transparent Expert Consultation (TEC) workshop in Bern, Switzerland, and 21 (of 28 invited) completed a follow-up online survey. The TEC study used (1) a face-to-face workshop to discuss a scoping review and initial recommendations and (2) an online survey. Thirty recommendations about implementing palliative care for older people in LTCFs were refined during the TEC workshop and, of these, 20 were selected following the survey. These 20 recommendations cover domains at micro (within organizations), meso (across organizations), and macro (at national or regional) levels addressed in 3 phases: establishing conditions for action, embedding in everyday practice, and sustaining ongoing change. We developed a framework of 20 recommendations to guide implementation of improvements in palliative care in LTCFs. [ABSTRACT FROM AUTHOR]

Staphylococcus argenteus and Staphylococcus schweitzeri, previously known as divergent Staphylococcus aureus clonal lineages, have been recently established as novel, difficult-to-delimit, coagulase-positive species within the S. aureus complex. Methicillin-resistant strains of S. argenteus are known from Australia and the UK. Knowledge of their epidemiology, medical significance and transmission risk is limited and partly contradictory, hampering definitive recommendations. There is mounting evidence that the pathogenicity of S. argenteus is similar to that of 'classical' S. aureus , while as yet no S. schweitzeri infections have been reported. To provide decision support on whether and how to distinguish and report both species. PubMed, searched for S. argenteus and S. schweitzeri. This position paper reviews the main characteristics of both species and draws conclusions for microbiological diagnostics and surveillance as well as infection prevention and control measures. We propose not distinguishing within the S. aureus complex for routine reporting purposes until there is evidence that pathogenicity or clinical outcome differ markedly between the different species. Primarily for research purposes, suitably equipped laboratories are encouraged to differentiate between S. argenteus and S. schweitzeri. Caution is urged if these novel species are explicitly reported. In such cases, a specific comment should be added (i.e. 'member of the S.aureus complex') to prevent confusion with less- or non-pathogenic staphylococci. Prioritizing aspects of patient safety, methicillin-resistant isolates should be handled as recommended for methicillin-resistant Staphylococcus aureus (MRSA). In these cases, the clinician responsible should be directly contacted and informed by the diagnosing microbiological laboratory, as they would be for MRSA. Research is warranted to clarify the epidemiology, clinical impact and implications for infection control of such isolates. [ABSTRACT FROM AUTHOR]

• Drivers on slip roads want vehicles on the target lane to decelerate. • Drivers in target lanes rate the behaviour of vehicles on slip roads ambiguously. • AVs are rated identically or even more positively than MVs with identical behaviour. • No different safety distance is kept from automated vehicles. • Results show that cross-border traffic between Germany and UK with AVs is feasible. • Intercultural aspects must still be considered in the development of AVs. To ensure safe and uninterrupted traffic flow, (semi-)automated vehicles must be capable of providing comprehensible and agreeable implicit communication cues to human drivers. This driving simulator study investigated the assessment of implicit communication at a motorway slip road through longitudinal driving dynamics (acceleration, deceleration, and maintaining speed). The second aim of the study was to determine whether expectations of automated vehicles are different from those of human drivers. And thirdly, we investigated whether these findings are country-specific or can be (partially) generalised to other countries. The perception of three means of communication in connection with the presence of a labelling as an automated vehicle (eHMI) was examined in two samples in Germany and England. 27 participants drove from a slip road onto the motorway and interacted with another vehicle. After a stretch on the motorway, they passed a second slip road on which there was a vehicle merging onto the participants lane. This was repeated six times to test all variables. After each situation, the perceived cooperativity and criticality was recorded, as well as the time headway (THW) to the other vehicle. This paper presents the findings from the UK sample and compares them with the German results, which were previously published. Results show, that when the cooperating vehicles are on the slip road, participants from both countries prefer this vehicle to decelerate. However, when participants themselves are on the slip road, expectations for vehicles on the target lane are ambiguous in the UK sample. Except for one aspect (perceived cooperativity of decelerating vehicles on the slip road), the perception of automated vehicles is similar to those of manual drivers. Also, UK participants do not maintain a different safety distance from these vehicles, while this is the case in the German sample. This paper contributes valuable insights into the cross-cultural evaluation of driving dynamics, shedding light on implications for the development and acceptance of automated vehicles. [ABSTRACT FROM AUTHOR]

Shifting from fossil fuels to clean alternative fuel options such as hydrogen is an essential step in decarbonising the road freight transport sector and facilitating an efficient transition towards zero-emissions goods distribution of the future. Designing an economically viable and competitive Hydrogen Supply Chain (HSC) to support and accelerate the widespread adoption of hydrogen powered Heavy Goods Vehicles (H 2 -HGVs) is, however, significantly hindered by the lack of the infrastructure required for producing, storing, transporting and distributing the required hydrogen. This paper focuses on a bespoke design of a hydrogen supply chain and distribution network for the long-haul road freight transportation in the UK and develops an improved end-to-end and spatially-explicit optimisation tool to perform scenario analysis and provide important first-hand managerial and policy making insights. The proposed methodology improves over existing grid-based methodologies by incorporating spatially-explicit locations of Hydrogen Refuelling Stations (HRSs) and allowing further flexibility and accuracy. Another distinctive feature of the method and the analyses carried out in the paper pertains to the inclusion of bulk geographically agnostic, as well as geological underground hydrogen storage options, and reporting on significant cost saving opportunities. Finally, the curve for H 2 -HGVs penetration levels, safety stock period decisions, and the transport mode capacity against hydrogen levelized cost at pump have been generated as important policy making tools to provide decision support and insights into cost, resilience and reliability of the HSC. [ABSTRACT FROM AUTHOR]

[Display omitted] • Insights into the waste electrical and electronic equipment (WEEE) management. • Developed a generic system dynamics model simulating the stock and flow of WEEE. • Applied the model to eleven WEEE categories in the United Kingdom. • Sensitivity and backcasting scenario analyses of landfilled WEEE targets. • Identified enhancing collection rates as the best way to reduce landfilled WEEE. Every year an estimated two million tonnes of waste electrical and electronic equipment (WEEE) are discarded by householders and companies in the United Kingdom (UK). While the UK has left the European Union (EU), its waste-related policies still mirror those of the EU, including the WEEE-related policies. Motivated by the recent introduction the so-called 'Right to Repair' policy for electrical and electronic equipment (EEE) across the EU and UK, this paper aims to demonstrate that, depending on the commitment and behavioural changes by the consumers and the government, the future of the WEEE management of the UK will vary. To this end, focusing on landfilled WEEE reduction we develop a generic system dynamics model and apply it to eleven WEEE categories. They depict the flow of EEE and WEEE representing the interaction among the stakeholders (e.g., consumers and producers of EEE) and relevant government regulations of the UK. Our four scenario analyses find that longer use of EEE and better WEEE collection seem to be effective in reducing landfilled WEEE, while more reuse and more recycling and recovery have negligible impacts, despite excluding the additional generation of landfilled WEEE as a result of recycling and recovery. Comparing with the business-as-usual scenario, one year longer EEE use and 10% more of WEEE collection could at maximum reduce landfilled WEEE by 14.05% of monitoring and control instruments and 93.93% of display equipment respectively. Backcasting scenario analyses reveal that significant efforts are required to reduce the targeted amounts. [ABSTRACT FROM AUTHOR]

In the field of radioactive waste management, particularly the geological disposal of higher activity radioactive waste, support for the longevity of engineering solutions in the repository is partly based on studies of natural systems, especially geological examples, often referred to as natural analogues (NA). Since the radioactive waste can be hazardous over hundreds of thousands of years, the long-term safety has to be assessed to very far future, e.g. up to 1 Ma from now. NA studies cover and exceed the time spans of interest. Despite of the long-acknowledged importance of NAs in the safety case for the geological disposal of radioactive waste, there is a lack of guidance and strategic planning to incorporate this information to the safety cases that assess the overall safety of the repositories – this leads to a certain lack of resilience. This paper presents the work undertaken to develop a strategy for utilising natural analogues (NAs) in Nuclear Waste Services (NWS), UK, geological disposal facility (GDF) programme. The work is largely based on the extensive review of the strategic use of NAs in the international context, lessons learnt from various past programmes and by considering how the strategy could look like in the current framework of the UK's GDF programme. The strategy presented aims to support this programme. The main message is that NA information and projects can and should be handled through the same procedures as any research utilising existing and upcoming NWS protocols. This means that NAs need to be a part of knowledge management, rather than, for example, a stagnant database. Including NAs as part of the data screening allows the knowledge base to be updated according to needs arising from the changes in the GDF programme when moving from generic stage towards more site and design specific phases. It is foreseen that key to the best utilisation of NA information is to include it in the NWS' digital safety case, making the information and the related methodology transparent. This paper refers to NWS' GDF siting programme as at September 2023. [ABSTRACT FROM AUTHOR]

The growing number of space debris is alarming as it threatens space-borne services. Hence, there is an increasing demand to remove space debris to ensure sustainability and protect valuable orbital assets. Over the past few years, the research community, agencies and industries have studied many passive and active debris removal methods. However, the current technology readiness for space debris removal is still low. This paper first presents a comparative study of various space debris removal technologies to address the knowledge gap and quantify the challenges. This paper reviews the current state-of-the-art space technologies relevant to Active Debris Removal (ADR) missions. Detailed trade-off analysis is then presented based on the Low Earth Orbit Pursuit for Active Removal of Debris (LEOPARD) Phase 0-A study; this study is part of the United Kingdom (UK) Space Agency's Active Debris Removal programme. The ADR mission scenario considered in this paper comprises a chaser spacecraft equipped with recommended technologies to capture non-cooperative targets safely. The final capture technology for the LEOPARD mission consists of an active robotic manipulator and a passive net capture mechanism. An analysis of the coupled-body dynamics of the chaser spacecraft carrying the robot manipulator and the targeted debris is carried out in simulation using SimscapeTM. The chaser spacecraft comprises Airbus's Versatile In-Space and Planetary Arm (VISPA) mounted on a base spacecraft from Surrey Satellite Technology Ltd. (SSTL); the targeted debris is SSTL's Tactical Operational Satellite (TOPSAT). The simulation results show dynamic changes in the chaser robot and the target satellite while performing non-cooperative capture. The simulation study accounted for various operational scenarios where the target is stationary or in motion. Further, for different modes of operation, the worst-case end-effector capture force limits were determined using open-loop control to execute a safe capture. Overall, the results presented in the paper advance the current state-of-the-art of robotic ADR and offer a significant leap in designing close-range motion and force control for stabilising the coupled multi-body system during capture and post-capture phases. In summary, this paper pinpoints the technological gaps, identifies barriers to realising ADR missions and offers solutions to catalyse technology maturity for protecting the space ecosystem. [ABSTRACT FROM AUTHOR]

Objectives In line with the aims of this special issue, the purpose of this paper is to forward a position on the concept of sport parenting expertise through the presentation of six key postulates. Design Literature review and position statement. Method By adopting methods associated with an academic position paper, a statement is presented that we believe encapsulates sport parenting expertise. Six key postulates of parenting expertise, formulated from critically reviewing and interpreting relevant literature, are then presented. Results We propose that sport parenting expertise is dependent on the degree to which parents demonstrate a range of competencies; namely that parents, (a) select appropriate sporting opportunities and provide necessary types of support, (b) understand and apply appropriate parenting styles, (c) manage the emotional demands of competitions, (d) foster healthy relationships with significant others, (e) manage organizational and developmental demands associated with sport participation, and, (f) adapt their involvement to different stages of their child's athletic career. Conclusion Expertise in sport parenting requires parents to develop knowledge and utilize a range of intrapersonal, interpersonal, and organizational skills in order to support their child, manage themselves, and operate effectively in the wider youth sport environment. Recommendations for applied researchers to further investigate these postulates and substantiate the components of sport parenting expertise are offered. [ABSTRACT FROM AUTHOR]

Hydrogen energy technologies are envisioned to play a critical supporting role in global decarbonisation. While low-carbon hydrogen is primarily targeted for reducing industrial emissions, alongside decarbonising parts of the transport sector, environmental benefits could also be achieved in the residential context. Presently, gas-dependent countries such as Japan and the United Kingdom are assessing the feasibility of deploying hydrogen home appliances, as part of their national energy strategies. However, prospects for the transition will hinge on consumer acceptance, alongside an array of other socio-technical factors. To support potential ambitions for large-scale and sustained technology diffusion, this study advances a Unified Theory of Domestic Hydrogen Acceptance. Through an integrative, comparative literature review targeting hydrogen and domestic energy studies, the paper proposes a novel Domestic Hydrogen Acceptance Model (DHAM), which accounts for the cognitive and emotional dimensions of human perceptions. Through this dual interplay, the proposed framework can increase the predictive power of hydrogen acceptance models. [Display omitted] • A unified theory of domestic hydrogen acceptance is proposed. • Researchers should integrate multiple acceptance constructs into survey studies. • Comprehensive perceived risks, costs, and benefits predict attitudes toward hydrogen. • Cognitive and emotional processes influence perceptions of hydrogen homes. • Community-level factors should be incorporated into hydrogen acceptance research. [ABSTRACT FROM AUTHOR]

This paper summarizes the results of the Improving Mood with Psychoanalytic and Cognitive Therapies (IMPACT) study and its implications for psychological treatment of adolescents with moderate to severe unipolar major depression. IMPACT was a pragmatic, superiority, randomized controlled trial conducted in the United Kingdom, which compared the clinical and cost-effectiveness of short-term psychoanalytic therapy (STPP), cognitive−behavioral therapy (CBT), and a brief psychosocial intervention (BPI) in reducing depression symptoms in 465 adolescents with unipolar major depression, aged 11 to 17 years. Although this was a clinically heterogeneous group of adolescents, some symptoms (eg, sleep and concentration difficulties, irritability/anger) were common and disabling. The trial reported no significant difference among the 3 treatments in reducing depression symptoms. One year after treatment, 84% of participants showed improvement in depressive symptoms (<50% of baseline symptoms) and improved psychosocial functioning, achieving this through different symptom reduction trajectories. Although participants attended fewer treatment sessions than planned, the 3 treatments were delivered with fidelity to their respective models. Ending treatment without therapist agreement occurred in 37% of cases. This was not associated with outcomes by treatment group. Adolescents emphasized the importance of the therapeutic relationship in all 3 treatments. Results suggest that although most adolescents respond to time-limited, structured psychological therapy, subgroups of depressed adolescents are likely to need additional treatment or support. These include adolescents who live in complex circumstances and/or who believe that their needs are not met in therapy, some who stop treatment early, and the 16% to 18% of adolescents who do not respond to treatment. Improving Mood and Preventing Relapse With Psychoanalytic Psychotherapy and Cognitive Behaviour Therapy; https://www.isrctn.com ; ISRCTN83033550. [ABSTRACT FROM AUTHOR]

• There has been a limited scope of investigation of the contextual factors affecting driver decision-making during narrow passage interactions. • The study found that the likelihood of giving way may alter due to characteristics of the interaction partners, including their vehicle type. • It was also found that factors, external to the direct interaction partners, may affect the likelihood of giving way, such as the presence of vehicles beyond the direct interaction partners. • This paper validates previous communication findings in a UK context. Narrow passage interactions have received increased attention from academics seeking to create behavioural models of the interaction and those looking to define how autonomous vehicles (AVs) should interact with their human counterparts in a composite road system. Despite this increased attention, many factors remain unexplored in the narrow passage literature, with the literature also encompassing few driving culture contexts. To this end, this study employs an explorative survey to identify additional factors that affect driver decision-making during narrow passage interactions, as well as driver perceptions of different communications in a UK context. The study's 243 participants were presented with a range of different narrow passage scenarios and asked to indicate how likely they were to give way/yield to a vehicle approaching the narrow passage from the opposite direction. In addition, they also completed the Multidimensional Driving Style Inventory to identify their driving styles and asked to identify which signals they look for from their interaction partner during narrow passage interactions, as well as the meaning of those signals. The results of the study show that situational characteristics such as the vehicle type being interacted with, being in a rush and being followed by vehicles alter the likelihood of drivers giving way at narrow passages, whilst a person's driving style can also indicate how likely someone is to give way to another vehicle. These results highlight the factors that are considered by drivers, increasing our understanding of the factors that need to be incorporated in driver behaviour models and in AV development. [ABSTRACT FROM AUTHOR]

Disposable paper cups comprise typical single-use plastic items, as they are lined internally with a thin plastic coating for waterproofing. They are consumed at a staggering rate worldwide, with the UK alone consuming around 7 million cups daily, thus annually producing around 30,000 tonnes of paper cup waste. Contrary to popular belief, less than 1 in 400 paper cups is currently recycled in the UK, which is in stark contrast to the waste hierarchy and the European Commission's ambitious Circular Economy Action Plan. Paper cups typically end up in landfill sites or even improperly disposed of, contributing to (micro)plastic waste and potentially polluting the world's oceans. The implications of the latter are not fully known yet and cannot be quantified by existing life cycle impact assessment methods. By employing the life cycle assessment methodology, UK's annual carbon footprint from paper cup consumption was found to be 75 kt of carbon dioxide equivalents, which is similar to that of manufacturing 11,500 mid-size passenger cars. Globally, their environmental footprint was found to be comparable to that of some 1.5 M average European inhabitants, indicating the nature and extent of the single-use plastics problem, which paper cups are just a typical example of. Paper cup recycling could reduce this environmental footprint by up to 40%, whereas switching to reusable cups appears to be more environmentally sustainable, achieving a threefold reduction in carbon emissions, which at global scale is more than twice Malta's annual carbon footprint. Results indicate that consumerism along with small daily choices, such as using reusable cups or bags instead of their disposable counterparts, could play a huge role in climate change. At policy level, no concrete measures to curb the superfluous consumption of paper cups, as well as of other single-use plastic items that are becoming increasingly ubiquitous, have materialised. Furthermore, it appears that decision- and policy-makers tend to step in to curtail wasteful and polluting practices only when environmental problems have started to generate widespread concern, instead of undertaking preventative policy measures. Image 1 • The environmental sustainability of disposable paper cups was examined. • 75 kt CO 2eq are emitted annually in the UK and 7.5 Mt CO 2eq globally. • Switching to reusable cups axes carbon emissions by threefold. • Robust LCIA methods should be introduced to account for (micro)plastic pollution. • Existing policy on single use plastics appears to be too little too late. [ABSTRACT FROM AUTHOR]

Liver transplantation (LT) for unresectable colorectal liver metastases (CRCLM) demonstrates good overall survival for selected patients in contemporary studies, with 5-year survival of 80%. A Fixed Term Working Group (FTWG), set up by NHS Blood and Transplant (NHSBT) Liver Advisory Group (LAG), advised whether CRCLM should be considered for LT in United Kingdom. Their recommendation was that LT may be undertaken for isolated and unresectable CRCLM using strict selection criteria as a national clinical service evaluation. Opinions were sought from colorectal cancer/LT patient representatives, experts in colorectal cancer surgery/oncology, LT surgery, hepatology, hepatobiliary radiology, pathology, and nuclear medicine, and appropriate patient selection criteria, referral and transplant listing pathways were identified. This paper summarises selection criteria for LT in United Kingdom for isolated and unresectable CRCLM patients, and highlights referral framework and pre-transplant assessment criteria. Finally, oncology-specific outcome measures to be utilised for assessing applicability of LT are described. This service evaluation represents a significant development for colorectal cancer patients in United Kingdom and a meaningful step forward in the field of transplant oncology. This paper details the protocol for the pilot study, scheduled to begin in the fourth quarter of 2022 in United Kingdom. [ABSTRACT FROM AUTHOR]

The paper explores the scope of transportation infrastructure appraisal approaches for capturing in-process (during design/development and construction) socio-economic impacts. In-process socio-economic impacts are explored through the case of a major road infrastructure improvement programme in South Wales, United Kingdom. The study posits that monitoring in-process benefits can provide a more holistic understanding of impacts to better inform appraisal approaches, addressing concerns over existing appraisal transparency and accountability. Advancing monitoring and appraisal in this way means that more unexpected socio-economic outcomes for regional economies can be understood. These impacts are illustrated through the labour market, skills and wider supply side legacy benefits resulting from direct project activity. The paper reveals the potential outcomes of capturing these in-process socio-economic benefits when supporting local economies in lagging regions. • Infrastructure construction (in-process) development benefits are often overlooked. • In-process outcomes contribute to longer-term regional development gains. • Monitoring allows labour market gains and supply side legacies to be advanced. • In process socio-economic outcomes are valuable for lagging regions. [ABSTRACT FROM AUTHOR]

This paper discusses the introduction, development and utility of post-mortem imaging relating specifically to conflict-related and terrorist-related deaths and considers the use of computed tomography (CT) in the investigations. We demonstrate how a multi-disciplinary approach involving direct communication between forensic pathologist and radiologist can maximise evidential yield, reduce the need for unnecessary dissection and further our understanding of such injuries. This summarises our shared experience of hundreds of cases, each having been individually discussed and reviewed, and has helped shape our understanding of conflict injury as well as contributing to the development of mitigation strategies and adaptations to protective equipment. A series of clinical cases are presented to demonstrate some of the strengths and weaknesses of the process. • Development of post-mortem CT in forensic radiology by UK military. • Collaborative learning and working between radiology, pathology and police. • What the forensic pathologist and police want from CT. • What radiology can answer from a pragmatic PMCT study. • Strengths and weaknesses of the technique through case scenarios. [ABSTRACT FROM AUTHOR]

The UK government aims to transition its modern natural gas infrastructure towards Hydrogen by 2035. Since hydrogen is a much lighter gas than methane, it is important to understand the change in parameters when transporting it. While most modern work in this topic looks at the transport of hydrogen-methane mixtures, this work focuses on pure hydrogen transport. The aim of this paper is to highlight the change in gas distribution parameters when natural gas is replaced by hydrogen in the existing infrastructure. This study uses analytical models and computational models to compare the flow of hydrogen and methane in a pipe based on pressure loss. The Darcy-Weisbach and Colebrook-White equations were used for the analytical models, and the k- ε model was used for the computational approach. The variables considered in the comparison were the pipe material (X52 Steel and MDPE) and pipe diameters (0.01m–1m). It was observed that hydrogen had to be transported 250–270% the velocity of methane to replicate flow for a fixed length of pipe. Furthermore, it was noted that MDPE pipes has 2–31% lower pressure losses compared to X52 steel for all diameters when transporting hydrogen at a high velocity. Lastly, it was noted that the analytical model and computational model were in agreement with 1–5% error in their findings. [Display omitted] • Hydrogen is expected to replace methane by 2035 for domestic heating applications. • Analytical and computational models were used to compare flow of hydrogen and methane. • Hydrogen velocity must be up to 2.7 times faster than methane to replicate flow. • MDPE pipes showed lower pressure losses than steel pipes due to reduced roughness. [ABSTRACT FROM AUTHOR]

Over the last two decades, there has been a growing emphasis on the publication quality in Foot & Ankle research. A level-of-evidence rating system for clinical scientific papers has been proposed by the Centre for Evidence-based medicine in Oxford, United Kingdom. As opposed to other subspecialities, foot & ankle surgery deals with a wide variety of clinical problems and surgical solutions, which in turn leads to a generally low number of patients available for study groups. However, level III and IV studies still have a valuable place in orthopaedic research, given the challenges in running high-level studies.The measurement of outcomes in medicine from the patients' perspective (PROMS:(patient reported outcome measures) has grown almost exponentially in all surgical specialties including foot & ankle surgery. There are many PROMs available to foot & ankle surgeons, but there is little consensus on which assessment is most appropriate for a given procedure or diagnosis. Their use in research and clinical practice offers many advantages in clinical practice and research, however, besides the advantages there are also some downsides. [ABSTRACT FROM AUTHOR]

Focuses on a study which discussed the meaning of femininity, with emphasis on its theory and practice in Great Britain. Economistic metaphors on capital, according to Bourdieu; Definition of the femininity process; Criticisms made by critics about feminism.

Since 2015, the United Kingdom (UK) has increased its investment in transportation infrastructure to compensate for years of underinvestment in comparison with peer countries. It is of critical importance to evaluate the effect of these recent investments, as well as historical ones, on economic development, both theoretically and empirically, to provide guidance on future infrastructure investment. However, few research looks into such policy adjustment on economic growth in the UK. To fill this gap, this paper investigates the relationship between transport infrastructure development and economic growth in the UK from different time spans. Principal component analysis (PCA) is used to construct a comprehensive measure of transport infrastructure development. This paper then applies Vector Error Correction Model (VECM) to investigate both long-run and short-run relationships between transport infrastructure development and economic growth from 1970 to 2017 in the UK. Empirical results suggest that transportation infrastructure has a long-run promotive effect on economic development. However, in the short run, this effect turns out to be significantly negative. The analysis of this paper indicates differentiated roles that the UK's transport infrastructure played in economic growth, which should be considered in future policy design of achieving economic sustainability in the UK. • This paper investigates the relationship between transport infrastructure development and economic growth in the UK. • Transportation infrastructure has a long-run promotive effect on economic development. • In the short run, transportation infrastructure fails to promote economic development. [ABSTRACT FROM AUTHOR]

• A quarter of people have experienced crime when travelling. • Only approx. 50% of the respondents indicated that crime never impacts their decision to not make a trip. • People who worry about crime are more likely to change how they travel. • The same applies for those who perceived higher levels of crime in their neighborhood. • Women were twice as likely as men to adjust their travel behavior. Although the risk of becoming a victim of crime in a transport setting is higher than in many other settings, research on how crime-related aspects impact travel has mostly focused on certain socioeconomic groups or certain modes, or by linking objective crime rates with mode choice. This limits our understanding of how crime-related aspects may impact decisions on whether, when, and how to travel. This paper aims to explore experiences with crime-related aspects in transport settings and how past experiences, together with perceptions and worry, are associated with self-reported alterations as a result of fear in travel behavior. In the absence of existing datasets, we collected primary data on experiences with crime, fear of crime, perceptions of crime, and travel behavior alterations as a result of fear of crime from 1,000 inhabitants in Great Britain. Our sample was representative in terms of gender, age, and socioeconomic groups, and revealed that experiences with crime in transport settings were common. Furthermore, we found that at least 25% of our respondents had experienced crime in any of the transport modes they used. We used ordinal regression models to test the impact of worry, crime experiences and perceptions on self-reported levels of travel behavior alteration due to fear. A previous experience of crime has impacts on travel behavior to a certain extent. For example, individuals who experienced crime while walking report an increased likelihood of not making a trip at all or altering their travel times. Having higher levels of worry is also significantly associated with an alteration in travel behavior. Women were on average more worried. They were also twice as likely as men to alter their travel behavior. However, stratified analyses by gender did not demonstrate that women were very differently impacted by experiences or worry. These findings provide insights into the extent to which travel behavior is impacted by experiences, perception, and fear of crime, as well as the existence of inequalities in this relationship. Based on our findings, we recommend including questions on social safety in travel surveys to enable additional modeling of these impacts, which may consequently help reduce inequalities. [ABSTRACT FROM AUTHOR]

• Systematic mass testing in closed settings provides information on infection rates. • Test positivity was 11.6%, with only one-quarter reporting symptoms. • The prison wing handling new admissions reported the second-lowest positivity rate. • Testing uptake was higher in residents than in staff members. • Mass testing is a valuable tool to bring outbreaks under control quickly. The aim of this paper was to describe the results of mass asymptomatic testing for COVID-19 in a male prison in England following the declaration of an outbreak. It provides novel data on the implementation of a mass testing regime within a prison during the pandemic. The paper is an observational evaluation of the mass testing conducted for 6 months following the declaration of a COVID-19 outbreak within a prison. It investigated the incidence of positive cases in both staff and residents using polymerase chain reaction testing. Data from October 2020 until March 2021 was included. A total of 2170 tests were performed by 851 residents and 182 staff members; uptake was 48.3% for people living in prison and 30.4% for staff. Overall test positivity was 11.6% (14.3% for residents, 3.0% for staff), with around one-quarter of these reporting symptoms. The prison wing handling new admissions reported the second-lowest positivity rate (9.4%) of the eight wings. Mass testing for COVID-19 over a short space of time can lead to rapid identification of additional cases, particularly asymptomatic cases. Testing that relies on residents and staff reporting symptoms will underestimate the true extent of transmission and will likely lead to a prolonged outbreak. [ABSTRACT FROM AUTHOR]

Do 'green' environmental concerns – such as about biodiversity, climate change, pollution – deter citizens from having children? This paper reports the first longitudinal evidence consistent with that increasingly discussed hypothesis. It follows through time a random sample of thousands of initially childless men and women in the UK. The paper shows that those individuals who are committed to a green lifestyle are found to be substantially less likely to go on later to have offspring. Probit and Weibull survival models are estimated. The results are robust to controlling for people's age, education, income, marital status, mental health, life satisfaction, optimism, and physical health. The paper's key estimated effect-size is substantial. A person entirely unconcerned about environmental behaviour is estimated to be just over 50% more likely to go on to have a child than a deeply committed environmentalist. • Will fertility decline because humans become so concerned about environmental damage? • Using UK data on thousands of randomly selected young adults, we provide the first longitudinal evidence that those who have environmental concerns and act in a 'green' way go on to have fewer children. • The estimated effect-size is large. [ABSTRACT FROM AUTHOR]

• Latent class analyses identify 15 types of drinking in Great Britain in 2019. • Alcohol consumption varies substantially across types of occasion. • Occasions that span the off-trade and on-trade involve particularly heavy drinking. • Heavy drinking is common across most occasion types, but so is moderate drinking. • Most heavy drinking takes place in off-trade only drinking occasions. This paper aimed to (i) update a previous typology of British alcohol drinking occasions using a more recent and expanded dataset and revised modelling procedure, and (ii) estimate the average consumption level, prevalence of heavy drinking, and distribution of all alcohol consumption and heavy drinking within and across occasion types. The paper uses a cross-sectional latent class analysis of event-level diary data that includes characteristics of 43,089 drinking occasions in 2019 reported by 17,821 adult drinkers in Great Britain. The latent class indicators are characteristics of off-trade only (e.g. home), on-trade only (e.g. bar) and mixed trade (e.g. home and bar) drinking occasions. These describe companions, locations, purpose, motivation, accompanying activities, timings, consumption volume in units (1 UK unit = 8g ethanol) and beverages consumed. The analysis identified four off-trade only, eight on-trade only and three mixed-trade occasion types (i.e. latent classes). Mean consumption per occasion varied between 4.4 units in Family meals to 17.7 units in Big nights out with pre-loading. It exceeded ten units in all mixed-trade occasion types and in Off-trade get togethers, Big nights out and Male friends at the pub. Three off-trade types accounted for 50.8% of all alcohol consumed and 51.8% of heavy drinking occasions: Quiet drink at home alone, Evening at home with partner and Off-trade get togethers. For thirteen out of fifteen occasion types, more than 25% of occasions involved heavy drinking. Conversely, 41.7% of Big nights out and 16.4% of Big nights out with preloading were not heavy drinking occasions. Alcohol consumption varies substantially across and within fifteen types of drinking occasion in Great Britain. Heavy drinking is common in most occasion types. However, moderate drinking is also common in occasion types often characterised as heavy drinking practices. Mixed-trade drinking occasions are particularly likely to involve heavy drinking. [ABSTRACT FROM AUTHOR]

• Many mental health disorders first emerge during early childhood or adolescence. • Wait times for children's mental health services have been an international and widespread problem. • Long wait times prolong the emotional distress of children and/or adolescents and their caregivers which can exacerbate mental health difficulties. • The majority of research in this area has been conducted in the United Kingdom and Canada and focus on one waitlist strategy. • Common strategies include alternative service delivery models, increasing system capacity, and improving intake and assessment processes. Background: Although many mental health disorders first emerge during early childhood or adolescence, there is a significant gap between demand and availability of mental health resources, leading to long waitlists for services. Objective: The objective of this scoping review was to identify and characterize the research literature related to the range of waitlist management strategies that have been implemented in outpatient child and adolescent mental health care. Methods: Electronic databases reviewed included: Medline (Ovid), Embase (Ovid), PubMed, PsychINFO, SCOPUS, CINAHL, and ISI Web of Science. Grey literature databases included: OpenGrey, Conference Papers Index, and Proquest Digital Dissertations. Articles were screened by two reviewers in two steps: first by title and abstract, then full text level. Data were extracted using an a-priori developed data extraction framework, which was piloted and modified iteratively. Results: A total of 119 papers related to waitlist interventions in child and adolescent mental health were reviewed. Of these 119 papers, 11% were reviews, summary, or theoretical papers; 8% used a randomized control trial design and 2.5% were trial protocols. Most studies used less rigorous designs, such as uncontrolled before-and- after designs. The large majority focused on just one waitlist strategy each. The most commonly used approaches included: prioritization/triage and initial assessment; brief consultation and advice or brief therapy approaches; group-based models; interim services; increasing capacity; and strategies to decrease non-attendance. Most studies were conducted in the United Kingdom or Canada. Discussion: While mental health systems are complex, most studies examining waitlist initiatives explored the implementation of single initiatives. It is unlikely that a single waitlist strategy can be effective in managing wait times for children's mental health. Rather, consistent and systemic approaches to address wait times that consider the impact of the reduction approach on the patient, the program, and the community are needed. [ABSTRACT FROM AUTHOR]

Autonomous Vehicles (AVs) present enormous uncertainties and challenges for future urban transport and mobility. While urban and transportation planning have significant roles to play in shaping these futures, a critical challenge is identifying and reconciling divergent values and competing visions in relation to this potentially disruptive transport technology and the associated mobility services. In this paper, we demonstrate the use of a participatory multi-criteria visioning and appraisal framework and methodology to enable stakeholders to envision, identify and interrogate essential tensions between imagined AV futures and long-term transport and mobility imperatives. Based on workshops with stakeholders at the forefront of policy and practice, and academia in Greater Manchester (UK) and Melbourne (Australia), we reveal several insights. Regarding the prospects of AVs, our participants are neither 'opponents' nor 'evangelists', but instead, manifest the contrasting attitudes and perspectives of excitement, optimism, ambivalence, scepticism and uncertainty all at the same time. In the visions outlined and appraised, our stakeholders identify AVs prospects in various use cases, such as public transport, personal and shared-use and urban freight and delivery applications, while at the same time recognising the inherent contradictions between automated driving futures outlined and imperatives such as reversing auto-mobility and creating safe and inclusive urban environments. Finally, the study brings to the fore the significant role of governance in mediating the politics and resolving contestations in critical areas including data management and privacy, cybersecurity and implementing viable business models and ownership arrangements. • Develop and apply participatory multi-criteria framework to envision and appraise automated driving futures. • Identify and interrogate essential tensions between imagined AV futures and long-term transport and mobility imperatives. • Identify AVs prospects in various use cases, such as public transport, personal and shared-use. • Inherent contradictions between automated driving, reversing auto-mobility and creating safe urban environments. [ABSTRACT FROM AUTHOR]

The NHS accounts for 5.4% of the UK's total carbon footprint, with the perioperative environment being the most resource hungry aspect of the hospital. The aim of this systematic review was to assimilate the published studies concerning the sustainability of the perioperative environment, focussing on the impact of implemented interventions. A systematic review was performed using Pubmed, OVID, Embase, Cochrane database of systematic reviews and Medline. Original manuscripts describing interventions aimed at improving operating theatre environmental sustainability were included. 675 abstracts were screened with 34 manuscripts included. Studies were divided into broad themes; recycling and waste management, waste reduction, reuse, reprocessing or life cycle analysis, energy and resource reduction and anaesthetic gases. This review summarises the interventions identified and their resulting effects on theatre sustainability. This systematic review has identified simple, yet highly effective interventions across a variety of themes that can lead to improved environmental sustainability of surgical operating theatres. Combining these interventions will likely result in a synergistic improvement to the environmental impact of surgery. • Perioperative environments use 3–6 times more energy than the hospital in general. • Paper/cardboard recycling bins in operating areas led to a 50–67% recycling rate. • Reusable items can lead to 70% reduction in waste generation. • Alcohol scrub solutions vs handwashing saves ∼930,000 L/year/hospital of water. • Dispensing propofol in 20 mL bottles instead of 50/100 mL reduces drug wastage by 90%. [ABSTRACT FROM AUTHOR]

Cardiac Rehabilitation (CR) has become an established intervention to support patient recovery after a cardiac event, with evidence supporting its effectiveness and cost-effectiveness in improving patient health and reducing future burden on healthcare systems. However, this evidence has focussed on the national value case for CR rather than at the point at which it is commissioned. This analysis uses the UK as a case-study to explore variation in current CR engagement and disassemble the value case from a commissioner perspective. Using data collected by the National Audit of CR (NACR), and an existing model of cost-effectiveness, we present details on the current level of CR uptake by commissioning region (Specialist Clinical Networks) in light of the current UK target of achieving 85% uptake. We then interrogate the value case for achieving the target at a commissioner level, highlighting the expected profile of health benefits and healthcare system costs over the long-term. Importantly we consider where this may differ from the national value case. Each commissioning region has a unique level of CR uptake and sociodemographic profile. Concurrently, the value case for commissioning CR relies on the upfront cost of the service being offset by long-term healthcare savings, and health improvements. The shift in the UK and internationally to more localised commissioning necessitates evidence of cost-effectiveness that better reflects the realities of those decision makers. This paper provides vital additional data to facilitate such commissioners to understand the value case in increasing CR uptake in line with national policy. • Many nations are aiming to increase rates of CR uptake. • Commissioning of services is complex and different from national decision making. • The challenges in reaching targets are different for each region. • It is important to consider equity when commissioning CR. [ABSTRACT FROM AUTHOR]

Circumferential deep burns on the limb lead to a constrictive, tourniquet-like effect causing critical limb ischaemia. The treatment, escharotomy, is a time-critical procedure that sometimes is required before the patient arrives at a burn centre. At present, no practical method of teaching this procedure is incorporated into formal educational courses. The feasibility of a comprehensive education package to teach upper limb escharotomy was assessed in a group of plastic and general surgery trainees in Wales. Small group workshops focused on the clinical presentation of patients requiring escharotomy. Participants then executed this on a custom-made high-fidelity simulation upper limb model. The articulated limb has subcutaneous silicone fat which bulges upon decompression and a finger-tip which turns pink indicating satisfactory reperfusion. A before and after five-point Likert scale was used to evaluate changes in participants' self-assessed confidence in the surgical management of escharotomy. Statistical significance between scores was assessed using the Wilcoxon signed-rank test. A total of 34 participants took part. Following completion of the course, general surgery trainees' confidence in executing the procedure increased from a median score of 1.00 "not confident at all" (IQR 1.00–2.00) to 4.00 "fairly confident" (IQR 4.00–5.00, p < 0.01). Plastic surgery trainees' confidence increased from a median score of was 3.00 "somewhat confident" (IQR 1.75–4.00) to 4.00 "fairly confident" (IQR 3.00–4.25, p < 0.01). We developed a comprehensive simulator course that has been demonstrated to improve candidate's confidence in performing escharotomy. The next stage in the course development is to confirm the results in a larger cohort. By developing this simulator course we aim to improve emergency burn care education in the UK and globally. • Escharotomy is a time critical procedure. • This paper outlines the development of a novel, high fidelity model. • It has improved confidence in a cohort of trainees with and without prior experience. [ABSTRACT FROM AUTHOR]

• The incidence of silver trauma and associated open lower limb fractures continues to increase. • There is an increased clinical need to consider microsurgical procedures for lower limb reconstruction in the older population. • This systematic review identified 51 free flaps and compared the complication profile of fasciocutaneous free flaps and muscle free flaps. There are 12.5 million people aged 65 years and older living in the UK. The annual incidence of open fracture is 30.7 per 10,000 person-years. In females, 42.9% of all open fractures occur in patients ≥ 65 years. Preferred Reporting for Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the study is registered with PROSPERO (CRD42020209149). The aim was to compare the complication profiles of free fasciocutaneous flaps and free muscular flaps in patients aged over 60 years undergoing lower limb soft tissue reconstruction following an open lower limb fracture. The search strategy based on strict inclusion criteria included PubMed, Embase and Google Scholar. 15 papers were identified, including 46 patients with 10 free fasciocutaneous flaps and 41 free muscle flaps. There were 3 complications in the fasciocutaneous group (30%) and 9 complications in the muscle group (22%). There was a total of 1 secondary procedure in the fasciocutaneous group and 4 in the muscle group. There is insufficient data to provide statistical comparison between free fasciocutaneous versus free muscle flaps for lower limb reconstruction performed in those aged over 60 years. This systematic review highlights evidence for the successful use of free tissue transfer in the older population following an open fracture injury and requiring lower limb reconstruction. There is no evidence to suggest the superiority of one tissue type over the other, with the inference that well vascularised tissue is the most significant factor impacting outcome. [ABSTRACT FROM AUTHOR]

Various studies have assessed the energy performance alterations affected by the novel technology of Building-Integrated Photovoltaic in Double-Skin Facades (BIPV-DSF), while lighting performance tied to the BIPV-DSF has not received much attention. This paper provides numerical modelling to assess the effect of BIPV-DSF on both indoor visual condition and energy consumption for an office module under a typical climate in the United Kingdom. The proposed study was focused on the comparisons between a reference case (a DSF office module with both layers using clear double glazing) and a design case of the same office module with BIPV-DSF using semi-transparent Amorphous Silicon PV glazing. Results show a significant drop in maximum daylight illuminance of 73% by configuring the BIPV-DSF with reference to the regular DSF. It was also reported the resultant average and minimum daylight factors (0.65% and 0.00%) were not able to meet indoor visual comfort requirements for office environments. Furthermore, it was found that the use of BIPV-DSF resulted in a net increase of 8% in building energy consumption over the reference DSF. Therefore, it is concluded that in the present context the BIPV-DSF is not viable for a commercial installation under the UK's climate conditions. [ABSTRACT FROM AUTHOR]

Abstract: In July 2010, the new Coalition Government unveiled its plans to make major changes to the English National Health Service (NHS). This paper, which provides a commentary on the NHS White Paper, Equity and Excellence: Liberating the NHS, casts doubt upon the extent to which the proposals will bring about the fundamental reform that the Government intends, not least because both the British public and GP commissioners (who are expected to play a central role in transforming the NHS) appear to have a limited appetite for radical market reform. The paper also identifies a number of unintended risks, including the large transitional costs and organisational turbulence resulting from further NHS reorganisation; and the fact that key aspects of the White Paper proposals could result in significant financial instability. Given the real world limitations to translating a rhetoric of localism and democratic legitimacy into reality and a lack of hard evidence about the benefits of market reform, the Government would be well advised to take a more cautious approach to health policy formulation and implementation and to ensure that any further changes to the NHS are based on evidence, piloting and evaluation. [Copyright &y& Elsevier]

In the debate on the decarbonisation of heat, renewable electricity tends to play a much more dominant role than green gases, despite the potential advantages of gas in terms of utilising existing transportation networks and end-use appliances. Informed comparisons are hampered by information asymmetry; the renewable electricity has seen a huge grid level deployment whereas low-carbon hydrogen or bio-methane have been limited to some small, stand-alone trials. This paper explores the regulatory and commercial challenges of implementing the first UK neighbourhood level 100% low-carbon hydrogen demonstration project. We draw on existing literature and action research to identify the key practical barriers currently hindering the ability of strategically important actors to accelerate the substitution of natural gas with low carbon hydrogen in local gas networks. This paper adds much needed contextual depth to existing generic and theoretical understandings of low-carbon hydrogen for heat transition feasibility. The learnings from pilot projects, about the exclusion of hydrogen calorific value from the Local Distribution Zone calorific value calculation, Special Purpose Vehicle companies, holding of liability and future costs to consumers, need to be quickly transferred into resilient operational practice, or gas repurposing projects will continue to be less desirable than electrification using existing regulations, and with more rapid delivery. • This paper explores barriers for the first UK 100% hydrogen distribution project. • Learnings from pilot projects need to be transferred into UK operational practice. • Existing regulations present barriers to gas distribution innovation projects. [ABSTRACT FROM AUTHOR]

Police negotiators work in small units or teams. In a crisis negotiation, one of the team becomes the 'primary' negotiator and talks with the person in crisis. However, because the person in crisis may refuse to participate, and because several negotiators are co-present, there are multiple opportunities for negotiators to talk between themselves, 'behind-the-scenes'. We used conversation analysis to analyse these interstitial sequences in a corpus of audio-recorded UK suicide crisis negotiations. Our analysis focused on how negotiators talk about what, when, and how to communicate to people in crisis. We found that negotiators evaluated different communication technologies and modalities (e.g., telephone versus face-to-face) and physical locations (e.g., standing on the ground versus on a roof) in terms of their affordances for future interactions and impact on previous ones. Second, negotiators (re)formulated what and how to communicate with persons in crisis and evaluated hypothetical consequences. Third, they evaluated their progress in terms of specific (in)effective words and phrases. The analysis shows how negotiators, in contrast to individual post hoc reflection, come to share live scrutiny of their negotiation practice. Overall, the paper augments what we know about the low frequency but high-stakes activity of crisis negotiation. • The paper examines 'behind-the-scenes' communication between teams of crisis negotiators. • We analysed UK police negotiations with suicidal people in crisis. • Data were transcribed and analysed using conversation analysis. • Negotiators plan their ongoing communication in terms of precise words and phrases. • In contrast to individual post hoc reflection, negotiators evaluate practice in real time. [ABSTRACT FROM AUTHOR]

This paper explores the effect of having a nuclear baseload in a 100% carbon-free electricity system The study analyses numerous scenarios based on different penetrations of conventional nuclear, wind and solar PV power, different levels of overgeneration and different combinations between medium and long duration energy stores (hydrogen and compressed air, respectively) to determine the configuration that achieves the lowest total cost of electricity (TCoE). At their current cost, new baseload nuclear power plants are too expensive. Results indicate the TCoE is minimised when demand is supplied entirely by renewables with no contribution from conventional nuclear. However, small modular reactors may achieve costs of ∼£60/MWh (1.5× current wind cost) in the future. With such costs, supplying ∼80% of the country's electricity demand with nuclear power could minimise the TCoE. In this scenario, wind provides the remaining 20% plus a small percentage of overgeneration (∼2.5%). Hydrogen in underground caverns provides ∼30.5 TWh (81 days) of long-duration energy storage while CAES systems provide 2.8 TWh (∼8 days) of medium-duration storage. This configuration achieves costs of ∼65.8 £/MWh. Batteries (required for short duration imbalances) are not included in the figure. The TCoE achieved will be higher once short duration storage is accounted for. [ABSTRACT FROM AUTHOR]

This paper analyses and compares the performance between a bifacial and a monofacial PV system based on the tests conducted at Heriot-Watt University, UK. The module's performance was observed on different ground reflective surfaces: concrete, white tiles, soil, and white pebbles. The rear side irradiance and bifacial energy gains are analysed. The power output is examined for a sunny and cloudy days, and yearly energy mapping is shown. Correlation studies are performed, and empirical model are developed between (i) clearness index and rear irradiance gain: (ii) rear irradiance gain and bifacial energy gain; (iii) total irradiance and power output. Based on the annual rear irradiance gain analysis, the highest gain range is found for white pebbles and white tiles ground surface (>30 % gain) and lowest for soil surface within the 5 %–10 % range and for concrete, >20 %. Regardless of the ground reflective surface, the probability is low that the bifacial energy gain is more than 30 %. Finally, a case study is discussed to perform a sensitivity analysis of a bifacial PV project's Levelized cost of electricity (LCOE). The sensitivity analysis shows that by using an enhanced ground albedo surface, the LCOE of the bifacial PV project can be reduced to 7.15p/kWh. The results show consistency with simulations output ran in PVSyst for different locations across the UK and the reported bifacial gain worldwide. [ABSTRACT FROM AUTHOR]

• Many local authorities are preparing climate actions plans. • Policies to increase distributed energy generation such as PV are likely. • As capacities increase, PV can dominate system variability and predictability. • Predictive demand side response (DSR) may be too coarse to address this. • More granular techniques such as using system frequency may be required. Since 2018, over three quarters of UK local governments have signed climate emergency declarations signalling a new phase in local climate action. Many areas are developing climate action plans and considering what policies could be adopted to increase the use of distributed energy resources, such as building-integrated photo-voltaic (PV) generation. In this paper we demonstrate how city-scale backcasting can be used as a tool to go beyond technical feasibility and explore the policy, market and governance implications of decarbonisation pathways across the local and nation scales. Using urban PV as an example we model three scenarios for increasing installed capacity in the UK city of Bristol and demonstrate how, in each case, PV switches from being a minor 'negative load' on the energy system to being the dominant factor determining the volatility and predictability of the energy demand during daylight hours. Current approaches to integrating distributed energy resources into the wider system tend to focus on predictive modelling and half-hourly pricing to drive demand-side response. Our analysis indicates the risks of relying on these non-real time methods and suggests that more granular techniques such as triggering local DSR based on changes in electricity system frequency could better manage the variability of high levels of PV deployment at the local scale. We also demonstrate the importance of developing new local approaches to system integration that bring together network operators, local authorities and other local actors to deploy renewable generation and flexibility assets in coordination. [ABSTRACT FROM AUTHOR]

This paper explores distinct usages of the response particle right in American versus British English conversation. The analysis shows that, in American English, right conveys the speaker's knowing stance and, in certain environments, the speaker's claim of primary knowledge. In contrast, in British English, right registers provided information as previously unknown, informative, and relevant to the current speaker's ongoing project. The analysis draws on large corpora of audio- and video-recorded ordinary and institutional interactions in British and American English. We use the methodology of Conversation Analysis to examine sequential environments in which right is used, its interactional import, and prosodic realizations. • The response particle right is used differently in US versus UK English interaction. • In US English, right coneys a knowing stance and sometimes epistemic authority. • In UK English, right registers information as previously unknown but informative. • Implications of these findings are discussed. • The study employs Conversation Analysis to examine diverse data corpora. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI)-based healthcare applications (apps) are rapidly evolving, and radiology is a target specialty for their implementation. In this paper, we put the case for a national deployment registry to track the spread of AI apps into clinical use in radiology in the UK. By gathering data on the specific locations, purposes, and people associated with AI app deployment, such a registry would provide greater transparency on their spread in the radiology field. In combination with other regulatory and audit mechanisms, it would provide radiologists and patients with greater confidence and trust in AI apps. At the same time, coordination of this information would reduce costs for the National Health Service (NHS) by preventing duplication of piloting activities. This commentary discusses the need for a UK-wide registry for such apps, its benefits and risks, and critical success factors for its establishment. We conclude by noting that a critical window of opportunity has opened up for the development of a deployment registry, before the current pattern of localised clusters of activity turns into the widespread proliferation of AI apps across clinical practice. [ABSTRACT FROM AUTHOR]

For the physical model testing of wave energy converters (WECs) in the wave basin, it is necessary to test the models in a small number of sea states. Previously, the H – T binning method was widely used to determine the sea states that are representative of an ocean area. However, it omitted much useful information such as the wave directionality. In this paper, a novel method, the K -means clustering technique is used in combination with High Frequency (HF) radar measured data from Wave Hub, UK. The results show that K -means clustering method better preserves the characteristics of the ocean area than the binning method. Furthermore, the impact of different regrouping methods on assessing the annual energy output of the model is investigated, by applying the K -means clustering method to a 1:25 two-body hinged raft WEC. It is found that although non-linear performance can be clearly observed in the model both physically and numerically. Due to the fact that most sea states from Wave Hub are out of the non-linearity range of the model, the non-linear effect on the overall performance of the WEC model in this ocean area is limited. It allows the annual energy output to be accurately predicted by using only a small number of representative sea states (defined as K) ≤15, based on K -means clustering method. • K -means method selected representative sea states tested on a physical WEC model. • K -means method is effective in selecting the sea states for WEC model testing. • Representative sea states can obtain accurate annual energy output estimation. • Non-linearity of WEC tested had limited influence on annual energy output estimation. [ABSTRACT FROM AUTHOR]

Introduction: Penetrating Neck Injuries (PNIs) affected 3.2% of trauma patients attending US and UK deployed medical treatment facilities (MTFs) during the Iraq and Afghanistan conflicts. Injured military personnel requiring aeromedical evacuation for such injuries were managed at the Royal Centre for Defence Medicine (RCDM), Birmingham, UK. The aim of this paper was to review the management of PNI in both deployed MTFs and when evacuated back to the UK.Patients and Methods: A retrospective case note review was performed of all military patients who sustained PNI whilst on deployment overseas, and who were subsequently evacuated to RCDM between March 2003 and December 2014.Results: Forty casualties who sustained PNI were identified, of which 28/40 (70%) sustained injury from explosive fragmentation, and 11/40 (28%) from gunshot wounds. Hard signs of PNI were present in 3/40 (7.5%) patients, soft signs in 14/40 (35%), no signs in 12/40 (30%), and unknown signs in 11/40 (28%) patients. Computed tomography angiography (CTA) was used in 39/40 (98%) patients, and was effective at ruling out significant injury, with 100% (29/29) of casualties with a negative CTA not developing vascular or aerodigestive injury. There were 9/29 (31%) patients who had surgical neck exploration despite both a negative CTA and absence of hard signs of PNI. There were 12/40 (30%) patients who required operative intervention at RCDM.Conclusion: UK military surgeons in Role 3 MTFs had a low threshold for surgical exploration, even in the absence of CT findings or hard signs. This was likely due to the high-energy mechanisms responsible for military PNI, in addition to the limited availability of equipment and clinical expertise in visualising the larynx. [ABSTRACT FROM AUTHOR]

Abstract: Addressing workforce issues has increasingly become a central feature of the organisation and management of public sector services internationally. The introduction of new work roles to public services is one approach advocated in response to recruitment and retention difficulties with professional staff and to increasingly complex services. This paper aims to critically examine UK''s new roles policy in a health care context and explore its wider relevance by drawing on findings from an action research Ph.D. study aimed at exploring one such new role. This deliberately flexible role was held by individuals without a recognised qualification but study findings illustrate that, over the time, the role came to include the complex discharge planning work with patients previously carried out by registered nurses (RNs). The analysis presented highlights shortcomings in current new roles policy including the unacknowledged influence of competing policy goals; the erroneous assumption that defining who does what is clear-cut in practice; the lack of longer-term review of new roles; and the incompatibility between role flexibility and needs for role clarity. Policy makers, managers and practitioners are urged to acknowledge the subtleties and complexities of new work roles in the public sector highlighted by this study. [Copyright &y& Elsevier]

A patient view paper focused on hopes and challenges facing the never smoker lung cancer population – from lived experience, unexpected diagnosis, treatment and subsequent immersion in lung cancer research and patient advocacy over many years, citing examples, references and events organised to explore the subject by UK research institutions. Based on lived experience, invited patient perspective conference presentations including National Cancer Research Institute (NCRI) never smoker lung cancer research strategy event opening presentation and subsequent article, includes references to relevant papers/findings and points raised during research events/group discussions, alongside personal experiences and beliefs. Discussions with clinicians, events, surveys, meetings and virtual discussions all revealed a dearth of evidence available to identify the best way to deal with this patient cohort at almost every aspect of their experience – from missed/late diagnosis, to screening potential (non-existent), mutation driven treatments (what about those ineligible?), and psychosocial/psychological aspects given their different life stage from older traditional lung cancer patients. More effort and focus are needed to better understand what is driving these cases, how best to detect them sooner and respond/refer to treatments as well as developing screening methods alongside increased public and healthcare professional awareness raising and tools to support clinicians in earlier detection. [ABSTRACT FROM AUTHOR]

This paper begins with the common phrase 'good girl' as a lens through which to explore the insidious nature of patronising and paternalistic language on women's agency in obstetric care. Here we see how misogynistic language is both violence against women in its own right, and serves to create a context in which more extreme obstetric violence can be precipitated. Based on thematic analysis of discussion on Mumsnet, and on contributions to a research-focused Facebook group, this paper illustrates the complexity of recognising and refuting misogyny as a female patient as well as the damage that can occur from a cultural context in which this language is normalised. Here, words both boast a materiality through the environments they reify, and become transient and slippery, with semiotic uncertainty. • Use of misogynistic language in obstetric and fertility care is widespread. • This language may be difficult to identify and address. • Language that positions women as incompetent creates a context in which violence may occur during childbirth. • Experiences of obstetric violence are common even in the UK, amongst well-educated women. [ABSTRACT FROM AUTHOR]

The scale of the decarbonisation challenge and the short timeframes over which action is required demand urgent action. This paper is set within the surface transport sector, now the largest sector of emissions with the slowest pace of change in many advanced liberal economies. It focuses on the strategies and actions of local government which is recognised to be a central player in catalysing change. Our evidence is derived from the actions of two UK local areas which claim to be at the forefront of the decarbonisation challenge. The paper focuses on the role of funding and financial mechanisms in addressing the climate crisis. In the face of an established pattern of austerity and hollowing out of local government we explore how deep transformation is being envisaged. We find a recursive set of issues which derive from a dependence on funding from outwith. This dependence means that despite comprehensive overarching strategies and goals the funding available is the core of the strategy. This means that the nature of the funds, such as the requirement for experimentation, innovation or private sector leverage, defines direction. In turn, and to maintain success in attracting funds, there is an emphasis on presenting 'premium spaces of ambition' with little evidence of attention to broader systemic change. This duality is openly recognised. This paper advances a wider point that greater emphasis should be placed on the 'financialisation' of climate policy and the reality rather than the rhetoric of change. [ABSTRACT FROM AUTHOR]

This paper analyses the potential implications of the proposed European Union Deforestation Regulation (EUDR) and the recently adopted United Kingdom (UK) legislation on deforestation-free supply chains (henceforth 'the legislation') for different stakeholders in Brazil. These regulations intend to address global commodity-driven deforestation and forest degradation by ensuring that targeted commodities and products placed on (or exported from) markets are of minimal risk of being associated with - in the EU - deforestation and forest degradation or - in the UK - illegal deforestation. The paper examines potential compliance readiness in cattle, cocoa, coffee, palm oil, soybean and tropical timber supply chains in Brazil, indicating specific challenges that may arise. Through the construction of a "Compliance Likelihood Index", our research provides comparable indications to policymakers on sectors and stakeholders that may need stronger support to meet the requirements, in order to maintain Brazil's access to EU and UK markets. The paper indicates that coffee is the sector with the highest level of incentivization and smallest hurdles for compliance, while the cattle sector may face stronger challenges to rapidly adjust its production system towards a deforestation-free value chain and prove compliance. Results of our analysis also highlight the need for collaboration between the EU/UK and Brazil in order to promote alignment between domestic and demand-side legislations so that they are mutually reinforcing. Results of this exercise, which has a focus on the producer-country view of demand-side legislation, will contribute to discussions on the merits of different approaches to strengthen the governance of deforestation-risk commodity trade. [Display omitted] • Brazil's coffee sector may currently have the greatest likelihood of ready compliance. • Cattle may be the sector to which the regulations may pose the greatest challenges. • The EU and UK should focus on providing financial means and technical assistance for smallholders. • The EU and UK legislation will need to be accompanied by domestic policies and regulations in Brazil. [ABSTRACT FROM AUTHOR]

Much literature views South Asian women in the UK through the prism of arranged marriage and, when discussing gender-based violence, forced marriage. Little attention is paid to South Asian women's experiences of dating, with no commitment to marriage. This paper is based on qualitative research using the theoretical framework of Black Feminist Theory and Intersectionality to analyse how women, who feel they are making their own choices and exercising agency by dating, can, through gendered power dynamics be pressured into marriages. This paper explores how such experiences can elucidate the manifestations of forced marriage and adds to this complex picture of how women entering an intimate relationship of choice, can be entrapped into forced marriage. [ABSTRACT FROM AUTHOR]