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Introduction: Patient recollection of details discussed during medical consultation is often limited (Figure 1a). For genital gender-affirming surgery (gGAS) consultations, lengthy discussions and deep contemplation surrounding surgical options are critical. Inadequate communication can result in patient complaints and medico-legal action, whereupon issues such as a lack of discussion or poor documentation can lead to medico-legal liability against the care provider and hospital system. As a result, strategies must be developed to ensure that information discussed during complex medical consultations are made available so patients can properly weigh out the care options presented. Objective: 1) Assess medico-legal incidents in Urologic and surgical specialties in the UK, US, and a Californian quaternary care center, 2) evaluate the advantages and feasibility of offering audio-recordings of patient consultations, and 3) create a user-friendly smartphone app for recording healthcare consultations. Methods: A literature review evaluated current evidence on medical liability claims in the UK and US was conducted. Additionally, our center's Department of Risk Management provided information pertaining to medico-legal cases against our institution. Separately, gGAS patients consented to audio-record their consultation. Copies were provided to patients and kept in their medical records. A follow-up survey assessed its usefulness, and based upon patient feedback, a smartphone application was developed. Results: A PubMed search yielded 921 results on "medical malpractice claims" from 2013–2023. In Urologic Surgery, 32 papers addressed medical malpractice, with 2 providing data over the last 15 years. In the UK, 660 claims were made from 2010–2020, of which 8.2% were due to poor communication (37 = informed consent; 17 = lack of follow-up). In the US, from 2020–2022, 38.3% of Urologists faced at least one legal proceeding in their career, and 5.3% were sued within 1 year for any reason. Our institution's Department of Risk Management reported 32% of lawsuits were related to surgical care. Informed consent involved 8% of cases and had a component in 32%. The average financial settlement for medical malpractice was $125,000.00 USD, and trial costs averaged $75,000.00 USD. 50/71 patients completed an anonymized, online survey post-audio recording. Positive results were noted regarding recording quality, comfort whilst being recorded, and wishes for future consultation recordings (Figure 1b). In addition, most patients felt less anxiety, and had greater confidence in their treatment choice (Figure 1c) Based upon patient responses, we developed a smartphone App which records 90 minutes of audio, allows for file and hyperlink attachments to be sent to patients before immediately deleting all information (Figure 1d). Routine use of audio-recordings led to a reduction in patient queries to our office. Conclusions: Routine audio recording of patient consultations provides significant benefits with minimal cost to providers. As per our institution's Office of Risk Management, it offers protection against medico-legal risks. Adequate discussion, good documentation and providing adjuncts for patients can help prevent a large proportion of medicolegal complaints in addition to optimizing patient care. Considering that patients face similar challenges across different disciplines and regions, a larger study (multi-center, international, multi-language) is warranted. Disclosure: No. [ABSTRACT FROM AUTHOR]

Introduction: Patient recollection of details discussed during medical consultation is often limited (Figure 1a). For genital gender-affirming surgery (gGAS) consultations, lengthy discussions and deep contemplation surrounding surgical options are critical. Inadequate communication can result in patient complaints and medico-legal action, whereupon issues such as a lack of discussion or poor documentation can lead to medico-legal liability against the care provider and hospital system. As a result, strategies must be developed to ensure that information discussed during complex medical consultations are made available so patients can properly weigh out the care options presented. Objective: 1) Assess medico-legal incidents in Urologic and surgical specialties in the UK, US, and a Californian quaternary care center, 2) evaluate the advantages and feasibility of offering audio-recordings of patient consultations, and 3) create a user-friendly smartphone app for recording healthcare consultations. Methods: A literature review evaluated current evidence on medical liability claims in the UK and US was conducted. Additionally, our center's Department of Risk Management provided information pertaining to medico-legal cases against our institution. Separately, gGAS patients consented to audio-record their consultation. Copies were provided to patients and kept in their medical records. A follow-up survey assessed its usefulness, and based upon patient feedback, a smartphone application was developed. Results: A PubMed search yielded 921 results on "medical malpractice claims" from 2013–2023. In Urologic Surgery, 32 papers addressed medical malpractice, with 2 providing data over the last 15 years. In the UK, 660 claims were made from 2010–2020, of which 8.2% were due to poor communication (37 = informed consent; 17 = lack of follow-up). In the US, from 2020–2022, 38.3% of Urologists faced at least one legal proceeding in their career, and 5.3% were sued within 1 year for any reason. Our institution's Department of Risk Management reported 32% of lawsuits were related to surgical care. Informed consent involved 8% of cases and had a component in 32%. The average financial settlement for medical malpractice was $125,000.00 USD, and trial costs averaged $75,000.00 USD. 50/71 patients completed an anonymized, online survey post-audio recording. Positive results were noted regarding recording quality, comfort whilst being recorded, and wishes for future consultation recordings (Figure 1b). In addition, most patients felt less anxiety, and had greater confidence in their treatment choice (Figure 1c) Based upon patient responses, we developed a smartphone App which records 90 minutes of audio, allows for file and hyperlink attachments to be sent to patients before immediately deleting all information (Figure 1d). Routine use of audio-recordings led to a reduction in patient queries to our office. Conclusions: Routine audio recording of patient consultations provides significant benefits with minimal cost to providers. As per our institution's Office of Risk Management, it offers protection against medico-legal risks. Adequate discussion, good documentation and providing adjuncts for patients can help prevent a large proportion of medicolegal complaints in addition to optimizing patient care. Considering that patients face similar challenges across different disciplines and regions, a larger study (multi-center, international, multi-language) is warranted. Disclosure: No. [ABSTRACT FROM AUTHOR]

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'A Survey of Childhood Malignant Melanoma in the East of Scotland,' by B.D. De Silva and V.R. Doherty; 'Earliest Clinical Features of Childhood Haemangiomas,' by K. Batta, H. Goodyear, R. Waters and C. Moss.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'Facial Dermatitis: An Evaluation of the Final Diagnoses and Role of Prick Testing in 209 Patch Test Patients,' by N.M. Stone and S.M. Powell; 'Dermatitis Affecting Abdominal Stomas: How Much is Allergic?,' by C.C. Lyon, M. Bruze and M.H. Beck.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'Pyoderma Gangrenosum, Bronchial Carcinoma and Tacrolimus,' by C.C. Lyon, C.E.M. Griffiths and M.M. Beck; 'Birt Hogg Dubé Syndrome and Multiple Pilar Cysts,' by S. Laube and M. Ali.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'Pulsed Tunable Dye Laser Treatment of Generalized Essential Telangiectasia,' by Y.A.I. Beshir and S.W. Lanigan; 'Efficacy of Pulsed Dye Laser (PDL) Treatment of Port Wine Stain (PWS) Malformations on the Upper Limb,' by J.C. Avenscroft, R. Mahendran and R. Sheehan-Dare.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'What is the Incidence of Lichen Sclerosus?,' by J. Powell, F. Wojnarowska, K. Hollowood and M. Vessey; 'Genital Carriage of Human Papiloma Virus (HPV) in Prepubertal Girls With and Without Vulval Disease,' by J. Powell, J. Gray and E. Ewojnarowska.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'A Systematic Review of Antistreptococcal Interventions for Guttate and Chronic Plaque Psoriais,' by C.M. Owen, R.J.G. Chalmers, T. O'Sullivan and C.E.M. Griffiths; 'Fixed Drug Eruptions in the U.K.—An Ever-Changing Scene,' by J.A. Savin.

This paper reviews the question of whether the wide separation double quasar Q2138-431 is a gravitational lens. From early work, the two quasar images are known to have almost identical spectra and redshifts, but no lensing galaxy has so far been detected. In this paper, we used recent deep surveys in infrared and optical bands to search for the presence of a galaxy with the expected properties of a gravitational lens. The search revealed a 5σ detection of a faint galaxy between the two quasar images on a deep J -band frame from the VISTA Science Archive, with apparent magnitude J  = 20.68. Non-detection in the I -band implied a redshift z > 0.6, and mass modelling of the quasar system gave a mass of |$1.31 \times 10^{12} \, \mathrm{M}_\odot$| for the lensing galaxy, with mass-to-light ratio M⊙/L⊙ = 9.0. Archival photographic data from the UK 1.2m Schmidt telescope covering 25 yr were used to construct light curves for the two quasar images, which were then cross-correlated to measure any time lag. This showed image B to lead image A by around a year, consistent with 410 d from the mass model. Although the similarity of the spectra and the detection of the lensing galaxy are the most compelling arguments for the classification of Q2138-431 as a gravitational lens, the time delay and mass-to-light ratio provide a consistent picture to support this conclusion. The wide separation of the quasar images and the simplicity of the mass model make Q2138-431 an excellent system for the measurement of the Hubble constant. [ABSTRACT FROM AUTHOR]

In this article we develop a method based on model-X knockoffs to find conditional associations that are consistent across environments, while controlling the false discovery rate. The motivation for this problem is that large datasets may contain numerous associations that are statistically significant and yet misleading, as they are induced by confounders or sampling imperfections. However, associations replicated under different conditions may be more interesting. In fact, sometimes consistency provably leads to valid causal inferences even if conditional associations do not. Although the proposed method is widely applicable, in this paper we highlight its relevance to genome-wide association studies, in which robustness across populations with diverse ancestries mitigates confounding due to unmeasured variants. The effectiveness of this approach is demonstrated by simulations and applications to UK Biobank data. [ABSTRACT FROM AUTHOR]

This paper examines the development of the impact of family background on young people's political engagement during adolescence and early adulthood in order to test a number of hypotheses derived from the impressionable years and family socialization perspectives. The study analyses data of the British Household Panel Study and Understanding Society to assess these hypotheses. Political interest and voting intentions are used as outcomes of political engagement. The study finds parental education to have no effect on initial levels of these outcomes at age 11 but to be positively related to the change in these outcomes between ages 11 and 15. This indicates that the effect of parental education becomes stronger over time and that social disparities in political engagement are widening significantly during early adolescence. In contrast, parental political engagement is positively related to initial levels of voting intentions at age 11 but not related to the change in voting intentions between ages 11 and 15, which supports the hypothesis drawn from the family socialization perspective. Neither parental education nor parental political engagement are related to post-16 changes in political engagement. These results point to early adolescence as a crucial period for the manifestation of social inequalities in political engagement. They provisionally suggest that the influence of parental education runs through educational conditions in lower secondary and that these conditions could play an important role in amplifying the said inequalities. [ABSTRACT FROM AUTHOR]

Generating negative news coverage of state welfare provision has been identified as a strategy designed to create public support for radical policies aimed to reduce such provision. To date, research of this kind has focused on scandals and crises. However, little is known about the complex relationship between media representations of specific events, and those of media representations in the lead up to these events, what we refer to as periphery representations. Employing a content and frame analysis, this paper analyses the frequency and intensity of peripheral representations of the National Health Service (NHS) in the British print media for 1 week a month before and for 1 week during three key events in recent NHS history: the official consultation period for the Health and Social Care Act; the publication of Five-Year Forward View, and the first Junior Doctor Strike. This article finds that negative NHS representations in articles that are peripheral to particular topical issues of controversy evidence fluctuations, amplifications and intensities across time periods, depending on the particular context. The paper concludes by arguing that repetition of negative themes in news helps to build a sensibility of 'inadequacy' of vital services. We hope that this focus on the ways in which amplifications and de-amplifications in negative intensity of peripheral NHS representations across time and content, helps to contribute to debate about the complex interplay between public health services, media representation and policy consent. [ABSTRACT FROM AUTHOR]

Background The dissemination of scientific data on coronavirus disease 2019 (COVID-19) continually builds but, in April 2020, could not keep up with the spread of the disease. Through technology, surgeons in Italy and the UK, representing both peak and pre-peak infective time zones, were able to communicate so that the urgent lessons on the huge expected demands of care learned in Italy could be brought to the UK in advance. This paper specifically discusses the issues related to paediatric surgery, currently under-reported in the literature. Methods The aim of this paper is to conjoin experience from the field to provide a framework for a safe assessment and treatment of paediatric patients by adopting a systemic approach aimed at reducing the risk of contamination. We reviewed the processes and good practices that were undertaken in contexts of emergency such as in Italy and the UK and then adapted them within the Systems Engineering Initiative for Patient Safety (SEIPS) framework to provide an assessment of how to reorganize the services in order to cope with an unexpected situation. The SEIPS model is the adopted theoretical framework, which allows to analyse the system in its main components with a human factors and ergonomics (HFE) perspective. Results The results introduce some of the good practices and recommendations developed during the emergency in the surgical scenario with a focus on the paediatric patients. They represent the lessons learned from the combination of the little existing evidence of literature and the experience from surgical teams who responded in an impromptu and unrehearsed way. Conclusions Lessons learned from the frontline 'on the fly' during COVID-19 emergency should be consolidated and taken into the future. In order to prepare proactively for the next phases and get ahead of the curve of these hospital accesses, there is a need for a risk assessment of the new clinical pathways with a multidisciplinary approach centred on HFE with the adoption of the SEIPS model and an involvement of all the surgical teams. [ABSTRACT FROM AUTHOR]

Migrants in the UK from the Central and Eastern European states that acceded to the European Union in 2004 and 2007 often have close proximity to precarity. This contribution illustrates that the positioning of the migrants in the casualised labour market has not occurred by accident but has been brought about by the (disingenuous) way in which nationals of the accession states were permitted access to the UK labour market. The positioning has been further maintained through the increasingly restrictive direction of the intertwined EU-UK response to claims for support from vulnerable EU migrant citizens. This piece presents the idea of 'confined labour market citizenship' as a way to understand the way many migrants have experienced working and living in the UK in the years following EU enlargement. This concept, it is argued, is able to capture: the role of the UK state as it regulated post-accession migration rules and implemented laws relating to social security entitlement; the influence of the broader EU framework on free movement and citizenship of the Union; and the impact of employers 'on the ground' in creating and exacerbating conditions of precarity and exploitation. The analysis throughout the paper exposes how EU8 and EU2 migrants have served as scapegoats for the result of the Brexit referendum, deflecting attention from the instrumentalisation of the migration issue by politicians. They have also been guinea pigs, testing out a confined version of EU citizenship with less tolerance for those in precarious and insecure work. [ABSTRACT FROM AUTHOR]

The current COVID-19 pandemic confines people to their homes, disrupting the fragile social fabric of deprived neighbourhoods and citizen's participation options. In deprived neighbourhoods, community engagement is central in building community resilience, an important resource for health and a prerequisite for effective health promotion programmes. It provides access to vulnerable groups and helps understand experiences, assets, needs and problems of citizens. Most importantly, community activities, including social support, primary care or improving urban space, enhance health through empowerment, strengthened social networks, mutual respect and providing a sense of purpose and meaning. In the context of inequalities associated with COVID-19, these aspects are crucial for citizens of deprived neighbourhoods who often feel their needs and priorities are ignored. In this perspectives paper, illustrated by a varied overview of community actions in the UK and The Netherlands, we demonstrate how citizens, communities and organizations may build resilience and community power. Based on in-depth discussion among the authors we distilled six features of community actions: increase in mutual aid and neighbourhood ties, the central role of community-based organizations (CBOs), changing patterns of volunteering, use of digital media and health promotion opportunities. We argue that in order to enable and sustain resilient and confident, 'disaster-proof', communities, areas which merit investment include supporting active citizens, new (digital) ways of community engagement, transforming formal organizations, alignment with the (local) context and applying knowledge in the field of health promotion in new ways, focussing on learning and co-creation with citizen initiatives. [ABSTRACT FROM AUTHOR]

Good data curation is integral to cohort studies, but it is not always done to a level necessary to ensure the longevity of the data a study holds. In this opinion paper, we introduce the concept of data curation debt-the data curation equivalent to the software engineering principle of technical debt. Using the context of UK cohort studies, we define data curation debt-describing examples and their potential impact. We highlight that accruing this debt can make it more difficult to use the data in the future. Additionally, the long-running nature of cohort studies means that interest is accrued on this debt and compounded over time-increasing the impact a debt could have on a study and its stakeholders. Primary causes of data curation debt are discussed across three categories: longevity of hardware, software and data formats; funding; and skills shortages. Based on cross-domain best practice, strategies to reduce the debt and preventive measures are proposed-with importance given to the recognition and transparent reporting of data curation debt. Describing the debt in this way, we encapsulate a multi-faceted issue in simple terms understandable by all cohort study stakeholders. Data curation debt is not only confined to the UK, but is an issue the international community must be aware of and address. This paper aims to stimulate a discussion between cohort studies and their stakeholders on how to address the issue of data curation debt. If data curation debt is left unchecked it could become impossible to use highly valued cohort study data, and ultimately represents an existential risk to studies themselves. [ABSTRACT FROM AUTHOR]

The article comments on a paper by M. Pineda-Moncusi and colleagues on the association of patients with osteoarthritis and comorbid conditions with mortality. Topics mentioned include the impact of osteoarthritis on function, pain, and quality of life of patients and treatment decisions, the use of latent class analysis, the hazard ratio of patients with multimorbidity, and the value of iterative decisions in the application of K-means and LCA clustering algorithms.

A significant yet overlooked aspect in many states' extraterritorial migration control efforts is their immigration liaison officers (ILOs) posted to foreign jurisdictions, who make decisions and take actions abroad to support their country's immigration goals. Importantly, this occurs within an interconnected system of nation-states, requiring mid-level officials from multiple states to co-operate. Yet, there is very little analysis on what happens in these foreign jurisdictions where officials from across national and organisational boundaries interact and negotiate the management of migration flows. This article aims to fill this gap by drawing on empirical research on the UK's overseas immigration liaison network. Analysis is based on original interviews with Home Office officials, Freedom of Information requests, and documentary research. I find that UK ILOs are a main contact point between the country they represent, local authorities in the host state, and Global North counterparts from other states, making them key sites for the transnational exchange of information, 'intelligence' and 'know-how'. In this way, they are like 'knowledge brokers', contributing to a 'global–local diffusion' of ideas. Despite power hierarchies, this is not a one-way transfer from the Global North to the South. Instead, I find Global South actors are also key subjects in this process. By going beyond policies on paper and formal inter-state agreements, this study offers important insight into a largely hidden yet central part of a state's extraterritorial migration control: informal spaces of negotiation between mid-level officials from across national and organisational boundaries who negotiate and contest migration control practices. [ABSTRACT FROM AUTHOR]

Background vaccination uptake in the UK and increased care home testing are likely affecting care home visitation. With scant scientific evidence to date, the aim of this longitudinal qualitative study was to explore the impact of both (vaccination and testing) on the conduct and experiences of care home visits. Methods family carers of care home residents with dementia and care home staff from across the UK took part in baseline (October/November 2020) and follow-up interviews (March 2021). Public advisers were involved in all elements of the research. Data were analysed using thematic analysis. Results across 62 baseline and follow-up interviews with family carers (n  = 26; 11) and care home staff (n  = 16; 9), five core themes were developed: delayed and inconsistent offers of face-to-face visits; procedures and facilitation of visits; variable uptake of the COVID-19 vaccine; misinformation, education and free choice; frustration and anger among family carers. The variable uptake in staff, compared to family carers, was a key factor seemingly influencing visitation, with a lack of clear guidance leading care homes to implement infection control measures and visitation rights differently. Conclusions we make five recommendations in this paper to enable improved care home visitation in the ongoing, and in future, pandemics. Visits need to be enabled and any changes to visiting rights must be used as a last resort, reviewed regularly in consultation with residents and carers and restored as soon as possible as a top priority, whilst more education needs to be provided surrounding vaccination for care home staff. [ABSTRACT FROM AUTHOR]

In recent years, there has been a risen interest in heat recovery systems for building applications due to concerns about the energy crisis and global climate change. In this paper, the intention to understand the performance of a window thermoelectric heat pump/heat recovery system (Ecopump) for heating has been developed. An overview to the prototype design, heat transfer model, experimental parameters and environmental feasibility is discussed. The variation of MATLAB modelling results followed the same regularity as the experimental results. The MATLAB model along with Revit has been used to simulate the Ecopump's performance when installed in a sustainable house in the UK. From the calculation, Ecopump can provide 670 kWh heating energy and reduce 90.6 kg CO2 emissions per year. The proposed Ecopump system combined with window frame could be a promising technology to enhance space heating for domestic buildings while reducing energy consumption during daily ventilation. Further in situ experiments should be conducted to explore its comprehensive performance in the future. [ABSTRACT FROM AUTHOR]

Matched sampling methodology (MSM) has been used in remittance studies to understand remittance transfers. However, a detailed examination of the role of trust as a central element in producing reliable and valid research conclusions when a matched sample methodology is used has been missing in the literature. This paper fills this lacuna by arguing that cultivating trust in matched sampling research on remittance transfers, a sensitive subject matter, between African immigrants and their relatives presents a more nuanced narrative of remittance transfers. This approach shows that not only do African immigrants in the 'Global North' send remittances back home, but immigrants also receive remittances (reverse remittances) from their relatives on the continent. Using remittance research conducted among Ghanaian immigrants in the UK and their relatives in Ghana, this article identifies three 'avenues of trust'—'public avenues of trust', 'intermediate avenues of trust', and 'private avenues of trust'—to highlight the processes and challenges that researchers encounter while establishing contact with research participants and the role that trust plays in gathering accurate information. Focusing on the role of trust in MSM is in line with recent theoretical paradigms of remittance research that call for soliciting information from both origin and destination countries. [ABSTRACT FROM AUTHOR]

Presents an abstract of the research paper 'Pruritus Vulvae–Allergic Contact Dermatitis to Textile Dyes and Toilet Roll Paper,' by I.C. Hay, A.D. Ormerod and M.I. White presented at the annual meeting of the British Contact Dermatitis Group in Great Britain.

The use of bibliometric indicators would simplify research assessments. The 2014 Research Excellence Framework (REF) is a peer review assessment of UK universities, whose results can be taken as benchmarks for bibliometric indicators. In this study, we use the REF results to investigate whether the e p index and a top percentile of most cited papers could substitute for peer review. The probability that a random university's paper reaches a certain top percentile in the global distribution of papers is a power of the e p index, which can be calculated from the citation-based distribution of university's papers in global top percentiles. Making use of the e p index in each university and research area, we calculated the ratios between the percentage of 4-star-rated outputs in REF and the percentages of papers in global top percentiles. Then, we fixed the assessment percentile so that the mean ratio between these two indicators across universities is 1.0. This method was applied to four units of assessment in REF: Chemistry, Economics and Econometrics joined to Business and Management Studies, and Physics. Some relevant deviations from the 1.0 ratio could be explained by the evaluation procedure in REF or by the characteristics of the research field; other deviations need specific studies by experts in the research area. These results indicate that in many research areas the substitution of a top percentile indicator for peer review is possible. However, this substitution cannot be made straightforwardly; more research is needed to establish the conditions of the bibliometric assessment. [ABSTRACT FROM AUTHOR]

Historians have begun to think about the emergence of the early modern 'state' in complex and creative ways, far from the conventional focus on overweening central bureaucracies. One component of this discourse is the role of criminal law and criminal prosecution, which, it has been argued (particularly by English scholars), assisted state-forming processes by providing a universal interface between ruler and ruled, and by demarcating common patterns of behaviour. This paper attempts to apply these ideas to the case of early modern Scotland—whose decentralised legal system and reputation for judicial barbarity has tended to discourage research—through detailed analysis of the judicial activities of the Privy Council. Focusing on the reigns of Charles II and James VII & II, the paper assesses the Council's theoretical competence as a criminal court, and also reconstructs its day-to-day activities in terms of the kinds of cases tried, the varieties of punishment imposed, and the use of alternative mechanisms such as judicial commissions. The paper argues that the Restoration Privy Council was clearly able to utilise its judicial powers as a state-building tool, despite the general diffuseness of judicial authority in Scotland. It is suggested, therefore, that the Scottish data confirms the utility of criminal prosecution in early modern projects of state formation, underlining historians' need to conceptualise the process in broad, multi-faceted terms. [ABSTRACT FROM AUTHOR]

Immigration detention and deportation are being increasingly utilised in many countries as key state responses to irregular migration. These practices work together to force migrants to their countries of origin or third countries, offering limited choice about whether to stay or leave. Drawing on a multi-sited ethnographic study of British immigration detention, this paper explores how detainees negotiate deportability and their accounts of the spectre of departing the United Kingdom, often against their wishes and occasionally by force. It analyses how deportability and the institutional structures and logics of immigration detention coalesce to shape detainees' understandings of their positions and options as deportable subjects. The paper highlights the materiality of return from immigration detention and the complexities and multiplicities of how detainees account for their possible departures in relation to the themes of identity, belonging, and home. British immigration removal centres can be understood as 'sites of struggle' in which those subject to detention and deportation negotiate these interconnected practices, acting as best they can within coercive and isolating carceral institutions. [ABSTRACT FROM AUTHOR]

Introduction: Patient recollection of details discussed during medical consultation is often limited (Figure 1a). For genital gender-affirming surgery (gGAS) consultations, lengthy discussions and deep contemplation surrounding surgical options are critical. Inadequate communication can result in patient complaints and medico-legal action, whereupon issues such as a lack of discussion or poor documentation can lead to medico-legal liability against the care provider and hospital system. As a result, strategies must be developed to ensure that information discussed during complex medical consultations are made available so patients can properly weigh out the care options presented. Objective: 1) Assess medico-legal incidents in Urologic and surgical specialties in the UK, US, and a Californian quaternary care center, 2) evaluate the advantages and feasibility of offering audio-recordings of patient consultations, and 3) create a user-friendly smartphone app for recording healthcare consultations. Methods: A literature review evaluated current evidence on medical liability claims in the UK and US was conducted. Additionally, our center's Department of Risk Management provided information pertaining to medico-legal cases against our institution. Separately, gGAS patients consented to audio-record their consultation. Copies were provided to patients and kept in their medical records. A follow-up survey assessed its usefulness, and based upon patient feedback, a smartphone application was developed. Results: A PubMed search yielded 921 results on "medical malpractice claims" from 2013-2023. In Urologic Surgery, 32 papers addressed medical malpractice, with 2 providing data over the last 15 years. In the UK, 660 claims were made from 2010-2020, of which 8.2% were due to poor communication (37 = informed consent; 17 = lack of follow-up). In the US, from 2020-2022, 38.3% of Urologists faced at least one legal proceeding in their career, and 5.3% were sued within 1 year for any reason. Our institution's Department of Risk Management reported 32% of lawsuits were related to surgical care. Informed consent involved 8% of cases and had a component in 32%. The average financial settlement for medical malpractice was $125,000.00 USD, and trial costs averaged $75,000.00 USD. 50/71 patients completed an anonymized, online survey post-audio recording. Positive results were noted regarding recording quality, comfort whilst being recorded, and wishes for future consultation recordings (Figure 1b). In addition, most patients felt less anxiety, and had greater confidence in their treatment choice (Figure 1c) Based upon patient responses, we developed a smartphone App which records 90 minutes of audio, allows for file and hyperlink attachments to be sent to patients before immediately deleting all information (Figure 1d). Routine use of audio-recordings led to a reduction in patient queries to our office. Conclusions: Routine audio recording of patient consultations provides significant benefits with minimal cost to providers. As per our institution's Office of Risk Management, it offers protection against medico-legal risks. Adequate discussion, good documentation and providing adjuncts for patients can help prevent a large proportion of medicolegal complaints in addition to optimizing patient care. Considering that patients face similar challenges across different disciplines and regions, a larger study (multi-center, international, multi-language) is warranted. Disclosure: No. [ABSTRACT FROM AUTHOR]

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'A New Formulation TiO[sub 2] and ZnO[sub 2] Cream: Visible Wavelength Photoprotection,' by H. Cameron, C. Clark, T. McLeod, H. Moseley and J. Ferguson; 'The Treatment of Vitiligo With Topical Khellin and Solar Radiation,' by J.T. Milne, G. Todd and L. Godggryp.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'Occupational Contact Dermatitis Has an Appreciable Impact on Quality of Life,' by C.V. Hutchings, K.W. Shum and D.J. Gawkrodger; 'Photopatch Test Methodology— A Reassessment,' by B. Pollock and M. Wilkinson.

This paper analyses promissory discourse for genome editing and human health in the UK, attending to the articulation of public goods and their beneficiary publics. Focusing on promissory reasoning about an emerging technology field as anticipatory and ethical considerations as integral to such debates, the notion of ethical regime as a mode of governance is applied to the concept of promissory regime. By analyzing key documents and interviews with opinion leaders—thus focusing on the discursive dimension—an enabling promissory ethical regime for genome editing and its contestation are identified. This regime posits scientific knowledge production now, and improved treatment or prevention of hereditary diseases later, as key goods of genome editing for human health and as a sociotechnical project worthy of support. Specific publics are created as beneficiaries. These publics and goods play out as ethical rationales for the promissory governance of the emerging field of human genome editing. [ABSTRACT FROM AUTHOR]

With the development of genome-wide association studies, how to gain information from a large scale of data has become an issue of common concern, since traditional methods are not fully developed to solve problems such as identifying loci-to-loci interactions (also known as epistasis). Previous epistatic studies mainly focused on local information with a single outcome (phenotype), while in this paper, we developed a two-stage global search algorithm, Greedy Equivalence Search with Local Modification (GESLM), to implement a global search of directed acyclic graph in order to identify genome-wide epistatic interactions with multiple outcome variables (phenotypes) in a case–control design. GESLM integrates the advantages of score-based methods and constraint-based methods to learn the phenotype-related Bayesian network and is powerful and robust to find the interaction structures that display both genetic associations with phenotypes and gene interactions. We compared GESLM with some common phenotype-related loci detecting methods in simulation studies. The results showed that our method improved the accuracy and efficiency compared with others, especially in an unbalanced case–control study. Besides, its application on the UK Biobank dataset suggested that our algorithm has great performance when handling genome-wide association data with more than one phenotype. [ABSTRACT FROM AUTHOR]

Objective Real-world secukinumab gastrointestinal-related adverse events (GIRAE) data during treatment for AS and PsA are lacking. We aimed to obtain this through baseline evaluation of pre-existing IBD rates and predictors of GIRAE. Methods Patient electronic and paper records commencing secukinumab from 10 UK hospitals between 2016 and 2019 were reviewed. GIRAE after initiation were defined as: definite [objective evidence of IBD (biopsy proven), clear temporal association, resolution of symptoms on drug withdrawal, no alternative explanation felt more likely], probable (as per definite, but without biopsy confirmation) or possible (gastrointestinal symptoms not fulfilling definite or probable criteria). Results Data for all 306 patients started on secukinumab were analysed: 124 (40.5%) AS and 182 (59.5%) PsA. Twenty-four of 306 (7.8%) experienced GIRAE after starting secukinumab. Amongst patients who developed GIRAE, four (1.3%) had definite, seven (2.3%) probable and 13 (4.2%) possible IBD. All definite cases were patients with AS and stopped secukinumab; two had pre-existing IBD and two (0.7%) were de novo cases of which one required surgical intervention. Seven patients (2.3%) had pre-existing diagnoses of IBD prior to initiation, of which five patients experienced GIRAE. Conclusion Absolute rates of new IBD in patients starting secukinumab are low. The majority of patients developing new GIRAE did not develop objective evidence of IBD or stop therapy. For patients with pre-existing IBD and AS the risk of GIRAE is much higher, and prescribing alternatives should be considered. [ABSTRACT FROM AUTHOR]

Today's technological frontrunners are tomorrow's economic champions. In order to triumph in the global innovation race, nations go to great lengths to boost domestic innovation. An increasingly popular instrument of such government support is known as the 'R&D tax incentive'. Scholars have particularly noted its greater incentive impact on small- and medium-sized enterprises (SMEs). However, correct use of this fiscal tool remains clouded by legal and economic complexities, often leading to misallocation of tax money. This study draws on the rich experience of the UK as a seasoned lawmaker in this field, to derive internationally transferrable policy lessons and principles that may be used in assessing and optimizing the potency of research and development tax incentives for SMEs. Following a theoretical analysis of the historical legal developments, annual government statistics, literature, and policy papers, this study argues that policymakers must take into account appropriateness, cost-efficiency, and accessibility in the design. [ABSTRACT FROM AUTHOR]

The publication of the recent Consultation Document, proposing a new legislative framework for a Single Equality Bill for Great Britain, provides the opportunity for consideration of the regulatory approaches that might be adopted in such legislation. The regulatory approaches adopted in previous anti-discrimination legislation are considered, followed by a discussion of a newer approach to regulation, which has been termed ‘reflexive regulation’. This newer form of regulation appears to form the preferred basis for regulation in the Consultation Paper. The potential problems with this method of regulation are examined, in particular the need to ensure that the pre-conditions for effective reflexive regulation are identified and created. It is argued that the Consultation Paper has failed to address this issue, and that several changes need to be made before the use of reflexive regulation in the area of equality is likely to be successful. [ABSTRACT FROM AUTHOR]

Orthopaedic surgeons have a responsibility to minimise risks of ionising radiation to patients, themselves and staff. This study aims to establish the understanding of radiation practice, legislation and risk by orthopaedic surgeons. A nationwide online survey of UK-based orthopaedic surgeons was conducted. Participants answered 18 multiple-choice questions assessing level of radiation safety training, basic principles/knowledge of ionising radiation, relevant legislation and operating practice. A total of 406 surgeons completed the survey. 92% reported using intraoperative ionising radiation at least once per week. 38% received no formal training on radiation safety. Knowledge of basic principles of radiation and legislation was limited. There was variable knowledge when labelling an image intensifier machine and choosing its safest orientation. Poor uptake of radiation protection equipment was noted. Only 19% agreed they had adequate training in ionising radiation safety and 27% reported receiving adequate training in equipment emitting ionising radiation in the operating theatre. Many orthopaedic surgeons in the UK do not believe they are adequately trained in radiation safety. There is a deficiency amongst practicing surgeons in basic knowledge, relevant legislation and practicalities of the use of ionising radiation in the operating room. This could potentially put patients and health-care professionals at additional risk. We recommend that a standardised national training programme on the basic principles and safety of ionising radiation is implemented for all practicing orthopaedic surgeons. This paper is the first UK national survey amongst orthopaedic surgeons and is one of the largest reported internationally. [ABSTRACT FROM AUTHOR]

Introduction process evaluations (PE) are increasingly used in parallel with randomised controlled trials (RCT) to inform the implementation of complex health interventions. This paper explores the learning accrued from conducting a PE within the Falls in Care Homes Study (FinCH), a large UK RCT. Methods in the FinCH study, six purposively sampled care homes provided data for the PE, which followed a realist approach. In this study researchers kept written diaries of their experiences in completing the interviews, focus groups and observations. We have reflected on these and present the main themes for discussion. Findings care home staff were enthusiastic to participate in the PE but researchers found it difficult to collect data due to staff not having time to take part, environmental factors such as no space for focus groups and low levels of research understanding. Researchers found that the expectations of the PE protocol were often unrealistic due to these limitations. Flexible and pragmatic approaches such as interviews in place of focus groups enabled data collection but required a reduced sample size and length of data collection to be accepted by researchers. Conclusion to enable care home staff to participate in successful PEs, researchers should build flexibility into research schedules, spend time building trust, collaborate with all levels of care home staff prior to data collection, increase research capacity in care home staff and co-design research projects. [ABSTRACT FROM AUTHOR]

Neither the idea that Britain 'stood alone' in 1940, nor that the British war was a 'people's war', were at all common during the Second World War. If anything was thought to be 'alone', it was the empire, though the more common view was that the empire always had allies. 'People's war' was a rare synonym for 'total war' and was sometimes used in an internationalist sense of a war of many peoples, and as the sort of war Britain should be, but was not, fighting. However, from 1945 a national 'alone' came into usage, for example by Churchill; but only from the 1960s was it a commonplace in history books. 'People's war' became more widely used in histories written in the 1960s, which defined it in a national progressive sense, although the term did not become common until the 1990s. Both ideas were essentially the creations of historians, who nationalised the history of what was an imperial and internationalist war, often turning it into a radically different domestic story focused on a national Home Front (ignoring the many imperial home fronts), a story which marginalised the military, foreign and political history of the war, and indeed the social history of the military as well. Historians later assumed that 'alone' and 'people's war' represented wartime nationalist ideologies, and wrote about them critically. Yet until recently they did not recognise that it was the very particular nature of the histories written in the 1960s which had generated these terms, and which embodied very particular analyses of British history and of the Second World War. The paper ends by arguing that much greater understanding is needed of the core assumptions which lie beneath the historiography of twentieth-century Britain. [ABSTRACT FROM AUTHOR]

Background dementia policy suggests diagnosing dementia early can reduce the risk of potentially harmful hospital admissions or emergency department (ED) attendances; however, there is little evidence to support this. A diagnosis of mild cognitive impairment (MCI) before dementia is a helpful proxy to explore early diagnosis. This study investigated the association between an early diagnosis of dementia and subsequent hospitalisations and ED attendances. Method a retrospective cohort study of electronic health care records from 15,836 patients from a large secondary care database in South London, UK. Participants were divided into two groups: those with a diagnosis of MCI before dementia, an early diagnosis, and those without. Cox regression models were used to compare the risk of hospitalisation and ED attendance after dementia diagnosis and negative binomial regression models were used to compare the average length of stay and average number of ED attendances. Results participants with an early diagnosis were more likely to attend ED after their diagnosis of dementia (HR = 1.09, CI = 1.00–1.18); however, there was no difference in the number of ED attendances (IRR = 1.04, CI = 0.95–1.13). There was no difference in the risk of hospitalisation (HR = 0.99, CI = 0.91–1.08) or length of stay between the groups (IRR = 0.97, CI = 0.85–1.12). Conclusion the findings of this study do not support the assumption that an early diagnosis reduces the risk of hospitalisation or ED attendance. The patterns of health service use in this paper could reflect help-seeking behaviour before diagnosis or levels of co-morbidity. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide Open in new tab Download slide OBJECTIVES We sought to provide further evidence on the safety and efficacy of aortic valve neocuspidization (AVNeo) using autologous pericardium in adult patients with aortic valve disease by reporting clinical and echocardiographic results from the first UK experience and performing a meta-analytic comparison with other biological valve substitutes. METHODS We reported clinical and echocardiographic outcomes of 55 patients (mean age 58 ± 15 years) undergoing AVNeo with autologous pericardium in 2 UK centres from 2018 to 2020. These results were included in a meta-analytic comparison between series on AVNeo (7 studies, 1205 patients, mean weighted follow-up 3.6 years) versus Trifecta (10 studies, 8705 patients, 3.8 years), Magna Ease (3 studies, 3137 patients, 4.1 years), Freedom Solo (4 studies, 1869 patients, 4.4 years), Freestyle (4 studies, 4307 patients, 7 years), Mitroflow (4 studies, 4760 patients, 4.1 years) and autograft aortic valve (7 papers, 3839 patients, 9.1 years). RESULTS In the present series no patients required intraoperative conversion. After mean follow-up of 12.5 ± 0.9 months, 3 patients presented with endocarditis and 1 required reintervention. The remaining patients had absent or mild aortic valve insufficiency with very low peak and mean transvalvular gradients (16 ± 3.7 and 9 ± 2.2 mmHg, respectively). Meta-analytic estimates showed non-significant difference between AVNeo and all but Magna Ease valves with regards to structural valve degeneration, reintervention and endocarditis. When compared Magna Ease valve, AVNeo and other valve substitutes showed an excess of valve-related events. CONCLUSIONS AVNeo is safe, associated with excellent haemodynamic profile. Its midterm risk of valve-related events is comparable to most biological valve substitutes. Magna Ease is potentially the best biological choice as far as risk of reintervention is concerned. [ABSTRACT FROM AUTHOR]

Telecare technologies support people to live in the community safely. In the UK, the existing analogue telephone services for telecare will be switched off by 2025, as the telecommunications infrastructure is upgraded to digital connectivity. Internationally, analogue telephone services are also being decommissioned. The shift from analogue to digital presents a rare and major opportunity for new digital solutions that address current issues with adoption and use of telecare. This paper describes a user-centred study to design innovative digital telecare concepts. The main contributions are as follows: findings from user engagement activities, which identified issues that may be more important and less important to users; the synthesis of ideas generated through the design process, which identified four themes for future work in the field–community-based support, telecare you do not wear or notice, expand the use of telecare and introduce telecare earlier; and seven concept designs that illustrate how the themes could be approached. [ABSTRACT FROM AUTHOR]

Collecting sensitive data using surveys is one of the most challenging tasks facing survey methodologists as people may choose to answer questions untruthfully to present themselves in a positive light. In 2014, Mneimneh et al. proposed mixed Rasch models to detect socially desirable answering behaviors. This approach combines item response theory models with latent class analysis to differentiate substantive and biased answering patterns. Their results identified two latent classes, one of which was consistent with socially desirable answering. Our aim is to expand their approach to detecting social desirability by using a mixture confirmatory factor analysis (CFA) in round 7 of the European Social Survey. First, we attempt to estimate social desirability in three constructs separately (RQ1): effect of immigration on the country, allowing people to come in the country and social connection, using a mixture CFA. We then extend the analysis by (RQ2) introducing constraints between the latent classes, (RQ3) combining different constructs in one model, and (RQ4) comparing results in Belgium and the United Kingdom. In contrast with the paper published by Mneimneh et al. in 2014, the models with two latent classes do not have the best model fit. In addition, validation with the presence of a third person, the respondent's reluctance to give answers and personality traits are not systematically in line with our expectations. A small simulation shows that the method would work if the data would behave as we expect, with social desirability being the main factor influencing answering patterns. We conclude that a mixture CFA might not be able to identify social desirability in different survey contexts, especially in complex data as originating in cross-national social surveys. [ABSTRACT FROM AUTHOR]

Objective The aim of this paper is to present a UK-based consensus of principles and recommendations to guide rheumatology US training and practice. Method A Delphi process was conducted involving 19 US experts representing each of the 14 regions of the UK. A working group of experienced British Society for Rheumatology Ultrasound Special Interest Group (BSRUSSIG) members made seven proposals that were presented to the whole group for further discussion. This resulted in minor modifications and seven preliminary recommendations. Members were then asked to anonymously agree or disagree with each recommendation using an electronic ballot. A threshold of 75% was used to determine consensus agreement. Results were collated by an independent chairperson and presented to the BSRUSSIG in a face to face meeting where agreement for each recommendation was ratified and an action plan agreed for dissemination of the results and future development work. Results Using a validated process, experts in rheumatology US have worked through an iterative process and have unanimously agreed seven recommendations for rheumatology training and practice. These cover a hierarchy of practice indications, education and training, including the need for practitioners to demonstrate lifelong learning, as well as a commitment to support mentors and trainers through the BSRUSSIG. Conclusion These are the first specific education and practice recommendations for rheumatology US in the UK and have been developed and endorsed by the BSRUSSIG. We intend that these proposals will help to support and validate rheumatology US practice and inform the development of future rheumatology training curricula and education programmes. [ABSTRACT FROM AUTHOR]

The paper examines asylum seekers' perceptions of the prohibition to work policy through the lens of burden(s). Drawing from individual interviews with asylum seekers and key informants and group discussions, the findings show the multiple—economic, social, and emotional—burdens that the prohibition to work inflicts on asylum seekers and problematizes the static understanding of burdens to reveal the processes of 'becoming' a burden on others. A comparison of enforced joblessness and undocumented work highlights the benefits of being able to work, even when this is risky, and the different burdens associated with the choice to not work, and consequently experience forced unemployment, or to break the rules and work in the undocumented sector. The concept of the burden paradox highlights the inconsistencies between the UK government's goal to minimize burdens for asylum seekers and the host society and its policy implementation that increases them for both. [ABSTRACT FROM AUTHOR]

The case study presented in this paper is an innovative ground source heat pump (GSHP) system constituted by a hybrid Photovoltaic Thermal (PVT) solar system for poultry houses. Farmers tend to not to apply GSHPs because of the high prices of excavation and time consumption. The innovative heat pump system assessed in this study comprises of a new type of heat exchangers; a thin-tube solar polyethylene heat exchanger installed between roof tiles and PV panels and a novel vertical ground heat exchanger to utilize the heat stored in the soil. The heating system applied to a poultry house are monitored and evaluated under a variety of environmental and operating conditions to achieve annual/long-term efficiency of the heating system in Kirton, UK. The maximum heating demand of the poultry house is determined 34.4 MWh/PC while the minimum is 11,1 MWh/PC. The monitored results show that the heat pump produced 15.02 MWh of thermal energy per annum. Solar PV and heat pump worked very well together with solar PV covering all the heat pump's annual electrical energy requirement and generated 8.74 MWh of extra electricity exported to the grid. The seasonal coefficient of performance is found 3.73 through a year. The novel PVT-GSHP heating system is a very promising solution for high fossil fuel consumption in the agriculture industry and the energy savings of the whole system can be noticeably increased dependent up on the system controlling. [ABSTRACT FROM AUTHOR]

Background: Breast angiosarcomas are rare tumours of vascular origin. Secondary angiosarcoma occurs following radiotherapy for breast cancer. Angiosarcomas have high recurrence and poor survival rates. This is concerning owing to the increasing use of adjuvant radiotherapy for the treatment of invasive breast cancer and ductal cancer in situ (DCIS), which could explain the rising incidence of angiosarcoma. Outcome data are limited and provide a poor evidence base for treatment. This paper presents a national, trainee-led, retrospective, multicentre study of a large angiosarcoma cohort. Methods: Data for patients with a diagnosis of breast/chest wall angiosarcoma between 2000 and 2015 were collected retrospectively from 15 centres. Results: The cohort included 183 patients with 34 primary and 149 secondary angiosarcomas. Median latency from breast cancer to secondary angiosarcoma was 6 years. Only 78.9 per cent of patients were discussed at a sarcoma multidisciplinary team meeting. Rates of recurrence were high with 14 of 28 (50 per cent) recurrences in patients with primary and 80 of 124 (64.5 per cent) in those with secondary angiosarcoma at 5 years. Many patients had multiple recurrences: total of 94 recurrences in 162 patients (58.0 per cent). Median survival was 5 (range 0-16) years for patients with primary and 5 (0-15) years for those with secondary angiosarcoma. Development of secondary angiosarcoma had a negative impact on predicted breast cancer survival, with a median 10-year PREDICT prognostic rate of 69.6 per cent, compared with 54.0 per cent in the observed cohort. Conclusion: A detrimental impact of secondary angiosarcoma on breast cancer survival has been demonstrated. Although not statistically significant, almost all excess deaths were attributable to angiosarcoma. The increased use of adjuvant radiotherapy to treat low-risk breast cancer and DCIS is a cause for concern and warrants further study. [ABSTRACT FROM AUTHOR]

Introduction: The cigarette stick is an important communications tool as well as the object of consumption. We explored young adults' responses to cigarettes designed to be dissuasive.Methods: Data come from a cross-sectional online survey, conducted in September 2015, with 16- to 24-year-old smokers and nonsmokers (N = 997) in the United Kingdom. Participants were shown images of a standard cigarette (white cigarette paper with imitation cork filter), a standard cigarette displaying the warning "Smoking kills" on the cigarette paper, and an unattractively colored cigarette (green cigarette paper and filter). They were asked to rate each of the three cigarettes, shown individually, on eight perception items, and to rate the three cigarettes, shown together, on how likely they would be to try them. Ordering of the cigarettes and questions, with the exception of the question on trial, was randomized.Results: The eight perception items were combined to form a composite measure of cigarette perceptions. For smokers and nonsmokers, the two dissuasive cigarettes (cigarette with warning, green cigarette) were rated significantly less favorably than the standard cigarette, and less likely to encourage trial. For cigarette perceptions, no significant interaction was detected between cigarette style and smoking status or susceptibility to smoke among never smokers. A significant interaction was found for likelihood of trying the cigarettes, with dissuasive cigarettes having a greater impact with smokers than nonsmokers.Conclusions: This study suggests that dissuasive cigarettes may help to reduce the desirability of cigarettes.Implications: The cigarette stick is the object of tobacco consumption, which is seen every time a cigarette is smoked. It is also an increasingly important promotional tool for tobacco companies. In this study, young adults rated two dissuasive cigarettes (a green colored cigarette and a cigarette displaying a health warning) more negatively than a standard cigarette, and considered them less likely to encourage product trial. Our findings suggest that it may be possible to reduce the desirability of cigarette sticks by altering their design, for example, with the addition of a warning or use of an unattractive color. [ABSTRACT FROM AUTHOR]

From 1807 onwards, bilateral slave-trade treaties stipulated how naval squadrons would rescue slaves from slave ships, and how states should arrange the settlement and apprenticeship of these slaves, to transform them into 'liberated Africans'. Comparing interactions between the state and liberated Africans at sea along the South African and Brazilian coasts, and in the port towns of Cape Town and Salvador, reveals how the legal status of liberated Africans changed over time. Current scholarship has framed liberated Africans in terms of whether they were attributed rights or suffered re-enslavement, and thus focused on their solidarity through claiming rights, 'ethnic survivals' or creolization. Instead, this paper argues anti-slave-trade legislation ascribed to liberated Africans a set of unguaranteed entitlements – promises regarding status and treatment without obligating states to uphold that status or treatment. By focusing on the precise aspects of legislation that operated at each point in the process of anti-slave-trade activity – rescuing slaves from slave ships, transportation to a port, processing through a court, and apprenticeship – this paper unearths how the law came into force in the encounter between state officials and liberated Africans, as part of the complex transition from slavery to free labour. [ABSTRACT FROM AUTHOR]

Excessive exposure to ultraviolet (UV) radiation from the sun in summer can cause skin cancer and in Britain there are around 1500 new cases of non-melanoma skin cancer (NMSC) each year, caused by exposure to solar UV at work. Little is known about the magnitude of UV exposure amongst outdoor construction workers in Britain, although this is one of the main groups at risk. The aim of this paper is to summarise measurements of erythema-weighted UVB radiation amongst construction workers in Scotland and the Southeast of England and interpret the data in terms of the risk of NMSC. The measurements were made as part of an intervention study using short mobile phone text messages to alter worker behaviour to either reduce UV exposure in summer or increase serum vitamin D in winter; the intervention is only briefly reported here. Data were collected from 67 workers from 9 worksites, of whom 41 provided measures of UV exposure for 758 working days. Daily exposure ranged from 0 to 13.47 standard erythema dose (SED), with the mean exposure for outdoor workers being 2.0 SED and the corresponding value for indoor workers being 0.7 SED. These data were obtained from a sensor located on the back of the workers hard hat; others have measured exposure on the wrist or upper arm and these locations probably, on average, have higher levels of UV exposure. It is likely that an outdoor construction worker in Britain could accumulate sufficient solar UV exposure over 30–40 years of work to more than double their risk of NMSC. We argue that employers in Britain should take a more proactive approach to manage sun safety and they should take responsibility for skin health surveillance for their workers. [ABSTRACT FROM AUTHOR]

Currently, there has been an obvious lack of innovation within poultry houses heating, ventilation and air conditioning (HVAC) system design that deals with both energy efficiency and poultry welfare issues. This paper presents an innovative and renewable heating system for poultry house application to meet the welfare living environment requirement for breeding, to improve the energy efficiency of HVAC system and to decrease fossil fuel consumption and harmful gas emissions. The purpose of this study is to design, develop and test the highly efficient hybrid heating system via an integrated photovoltaic/thermal array with polyethylene heat exchanger coupled to geothermal heat pump system based on the East Midlands' climate conditions in the UK. The numerical model is established based on finite volume method and solved by using Engineering Equation Solver, and a good agreement with less than 15% difference between the numerical and experimental results is achieved. The results indicate that the annual electrical and thermal output are 11867 kWh and 30245 kWh, respectively, which not only could fulfil the poultry house electrical need, but also can provide ~43.5% electricity demand of the heat pump compressor operating. [ABSTRACT FROM AUTHOR]

Background In October 2015, 65 people came into direct contact with a healthcare worker presenting with a late reactivation of Ebola virus disease (EVD) in the United Kingdom. Vaccination was offered to 45 individuals with an initial assessment of high exposure risk. Methods Approval for rapid expanded access to the recombinant vesicular stomatitis virus–Zaire Ebola virus (rVSV-ZEBOV) vaccine as an unlicensed emergency medicine was obtained from the relevant authorities. An observational follow-up study was carried out for 1 year following vaccination. Results Twenty-six of 45 individuals elected to receive vaccination between 10 and 11 October 2015 following written informed consent. By day 14, 39% had seroconverted, increasing to 87% by day 28 and 100% by 3 months, although these responses were not always sustained. Neutralizing antibody responses were detectable in 36% by day 14 and 73% at 12 months. Common side effects included fatigue, myalgia, headache, arthralgia, and fever. These were positively associated with glycoprotein-specific T-cell but not immunoglobulin (Ig) M or IgG antibody responses. No severe vaccine-related adverse events were reported. No one exposed to the virus became infected. Conclusions This paper reports the use of the rVSV-ZEBOV vaccine given as an emergency intervention to individuals exposed to a patient presenting with a late reactivation of EVD. The vaccine was relatively well tolerated, but a high percentage developed a fever ≥37.5°C, necessitating urgent screening for Ebola virus, and a small number developed persistent arthralgia. [ABSTRACT FROM AUTHOR]