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At a time when the belief in a welfare crisis is being connected to a so‐called "migration crisis", in particular in the United Kingdom, it is important to look at the lived experiences of mobile EU citizens and the influence of transnational social protection practices. The article introduces the concept of a "migration‐welfare corridor" – as opposed to the widespread welfare magnet hypothesis – taking into consideration the role of welfare systems in origin and destination countries at different stages of a migrant's life cycle, the changing nature of the welfare habitus as well as migrants' attitudes towards what can be defined as welfare chauvinism. Looking specifically at the case of Spanish and Polish migrants in the UK who have reacted to this protracted environment of deterrence, particularly in respect to their welfare rights, this paper discusses several dimensions that should be taken into consideration when analyzing transnational social protection practices from below. [ABSTRACT FROM AUTHOR]

The development of crops that by harvest have accumulated higher amounts of a particular micronutrient than standard crops is known as biofortification. Biofortified staple crops such as provitamin A‐biofortified sweet potato ('orange sweet potato'), zinc‐biofortified rice ('zinc rice') and iron‐biofortified beans ('iron beans'), developed by selective breeding, have been introduced into developing countries with the goal of reducing micronutrient deficiencies. In these settings, micronutrient deficiencies caused by low dietary intakes and exacerbated by inflammation and infection result in considerable morbidity and mortality worldwide. The aim of this review is twofold: (1) to describe the impact of biofortified crops on micronutrient intake, nutritional status and other biological endpoints in developing countries and (2) to consider the relevance of these nutritional effects in other parts of the world such as Europe. Regular consumption of biofortified crops in developing countries where micronutrient deficiency is common has been shown to increase micronutrient intakes and thus help meet the World Health Organization's dietary recommendations. In terms of micronutrient status, most research has been conducted using provitamin A‐biofortified crops (particularly orange sweet potato), with large 2‐ to 3‐year studies indicating increases in plasma retinol, though additional studies measuring change in body stores would provide more definitive evidence. There is some evidence to suggest that iron‐biofortified crops can increase iron status (measured by serum ferritin and total body iron), but further studies are required to demonstrate the efficacy of zinc‐biofortified foods. Intakes of some micronutrients are low in some UK population subgroups (in particular adolescents and young adult women), with sizeable proportions having intakes below the lower reference nutrient intake. There is also evidence of low status for some nutrients (e.g. iron and in particular vitamin D), although the prevalence of iron deficiency is much less, and therefore the consequences less severe, than seen in the developing world. The final part of the paper describes strategies used to improve micronutrient intake in Europe, such as fortification of bread flour post‐harvest and supplementation with vitamin D and folic acid, and discusses whether there is a role for biofortified crops in the UK. [ABSTRACT FROM AUTHOR]

Context As a contribution to this special issue commemorating the journal's 50th volume, this paper seeks to explore directions for national licensing examinations ( NLEs) in medicine. Increases in the numbers of new medical schools and the mobility of doctors across national borders mean that NLEs are becoming even more important to ensuring physician competence. Objectives The purpose of this paper is to explore the use of NLEs in the future in the context of global changes in medical education and health care delivery. Methods Because the literature related to NLEs is so large, we have not attempted a comprehensive review, but have focused instead on a small number of topics on which we think we have something useful to say. The paper is organised around five predicted trends for NLEs. Discussion The first section discusses reasons why we think the use of NLEs will increase in the coming years. The second section discusses the ongoing problem of content specificity and its implications for the design of NLEs. The third section examines the evolution of large-scale, standardised cognitive assessments in NLEs and suggests some future directions. Reflecting the fact that NLEs are, increasingly, attempting to assess more than just knowledge, the fourth section addresses the future of large-scale clinical skills assessments in NLEs, predicting both increases in their use and some shifts in the nature of the stations used. The fifth section discusses workplace-based assessments, predicting increases in their use for formative assessment and identifying some limitations in their direct application in NLEs. The concluding section discusses the cost of NLEs and indulges in some further speculations about their evolution. [ABSTRACT FROM AUTHOR]

Official figures from the Home Office show an increase in mobility of the highly-skilled from the United Kingdom ( UK) to other European countries. This paper analyses the social composition of intra- European mobile graduates from the UK in the context of recent political developments ( Bologna- Process, European Higher Education Area). Using quantitative and qualitative data from a longitudinal study of students and its follow-up study, the paper compares the social composition and current activity of intra- European mobile graduates with those remaining in the UK. Personal and higher education-related variables together with the current type of employment were significant for the distinction between intra- European mobile graduates and ' UK stayers'. UK-educated mobile graduates were identified as ' Eurostars', who come from high social classes or studied at high tariff higher education institutions. Mobility was identified as one way for UK-educated graduates to avoid employment in non-graduate jobs and add further value to their undergraduate degrees. [ABSTRACT FROM AUTHOR]

The progressive nature of Type 2 diabetes necessitates treatment intensification over time in order to maintain glycaemic control, with many patients ultimately requiring insulin therapy. While insulin has unlimited potential efficacy, its initiation is often delayed and improvements in glycaemic control are typically accompanied by weight gain and an increased risk of hypoglycaemia, particularly as HbA1c approaches and falls below target levels. This may account for the sub-optimal control often achieved after insulin initiation. Combining insulin with antihyperglycaemic therapies that have a low risk of hypoglycaemia and are weight-neutral or result in weight loss is a therapeutic strategy with the potential to improve Type 2 diabetes management. Although the effects differ with each individual class of therapy, clinical trials have shown that adding a glucagon-like peptide-1 receptor agonist, dipeptidyl peptidase-4 inhibitor or sodium-glucose co-transporter-2 inhibitor to insulin regimens can offer a significant reduction in HbA1c without substantially increasing hypoglycaemia risk, or weight. The evidence and merit of each approach are reviewed in this paper. Once-daily co-formulations of a basal insulin and a glucagon-like peptide-1 receptor agonist have been developed (insulin degludec/liraglutide) or are under development (lixisenatide/insulin glargine). Insulin degludec/liraglutide phase III trials and a lixisenatide/insulin glargine phase II trial have shown robust HbA1c reductions, with weight loss and a low risk of hypoglycaemia. With insulin degludec/liraglutide now approved in Europe, an important consideration will be the types of patients who may benefit most from a fixed-ratio combination; this is discussed in the present review, and we also take a look toward future developments in the field. [ABSTRACT FROM AUTHOR]

The clinical indications for anaesthetic drugs are developed through peer-reviewed publication of clinical trials. We performed a bibliometric analysis of all human research papers reported in nine general anaesthesia journals over 6 years ( n = 6489), to determine any effects of the 2004 European Clinical Trials Directive on reported drug research in anaesthesia originating from Europe and the United Kingdom. We found 89% studies involved patients and 11% volunteers. Of 3234 (50%) drug studies, 96% were phase IV (post-marketing) trials. Worldwide, the number of research papers fell by 3.6% (p < 0.004) in the 3 years following introduction of the European Clinical Trials Directive (5% Europe, 18% United Kingdom), and drug research papers fell by 12% (p < 0.001; 15% Europe, 29% United Kingdom). The introduction of the Clinical Trials Directive has therefore coincided with a decline in European drug research, particularly that originating from the United Kingdom. We suggest a number of measures researchers could take in response, and we propose a simplification of the application process for phase IV clinical trials, emphasising patient risk assessment. [ABSTRACT FROM AUTHOR]

Drawing on evidence from the United Kingdom and elsewhere in Europe, this paper explores how people have responded to flood warning information and how these responses impact upon the effectiveness of a flood warning through saving lives and injuries, and reducing economic damages. Methods of flood warning that the public rely upon are discussed alongside empirical evidence of how flood victims prepare for, and respond to, flood warnings in rapid to mediumonset floods. The paper investigates why some members of the public fail to act appropriately, or most effectively, to flood warning information, touching on ideas of a lack of understanding, mistrust in authority and a lack of ownership of flood reducing actions. The paper examines the styles of public learning about flood warning response which might be most appropriate and effective, and how recent positive steps to increase the publics understanding of effective response might be further enhanced in the United Kingdom. Copyright © 2009 Royal Meteorological Society [ABSTRACT FROM AUTHOR]

This paper considers the influence of ecofeminism on policy concerning gender (in)equality and the environment during the past 20 years. It reviews the broad contours of the ecofeminist debate before focusing on the social construction interpretation of women's relationship with the environment. It will argue that there have been substantial policy shifts in Europe and the UK in both the environmental and equalities fields, and that this is in part a result of lobbying at a range of scales by groups informed by ecofeminist debates. Nevertheless, the paper cautions that these shifts are largely incremental and operate within existing structures, which inevitably limit their capacity to create change. As policy addresses some of the concerns highlighted by ecofeminism, academic discourse and grass roots activity have been moving on to address other issues, and the paper concludes with a brief consideration of contemporary trajectories of ecofeminism and campaigning on issues that link women's, feminist and environment concerns. [ABSTRACT FROM AUTHOR]

'Green-grabbing', in which environmental arguments support expropriation of land and resources, is a recognized element in neoliberal conservation. However, capitalism's strategic interest in promoting the neoliberalization of conservation is accompanied by attempts to exploit hitherto protected natures without any pretence at 'greenness'. In this paper we explore the dialectics between 'green' and 'un-green' grabbing as neoliberal strategies in the reconstruction of nature conservation policies after the 2008 financial 'crash' in Greece and the UK. In both countries, accelerated neoliberalization is manifested in diverse ways, including initiatives to roll back conservation regulation, market-based approaches to 'saving' nature and the privatization of public nature assets. The intensification of 'green' and 'un-green' grabbing reflects capitalism's strategic interest in both promoting and obstructing nature conservation, ultimately leaving for 'protected natures' two choices: either to be further degraded to boost growth or to be 'saved' through their deeper inclusion as commodities visible to the market. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Differences in the performance of medical care may be due to variation in the introduction and diffusion of medical innovations. The objective of this paper is to compare seven European countries ( United Kingdom, the Netherlands, West Germany, France, Spain, Estonia and Sweden) with regard to the year of introduction of six specific pharmaceutical innovations (antiretroviral drugs, cimetidine, tamoxifen, cisplatin, oxalaplatin and cyclosporin) that may have had important population health impacts. Methods We collected information on introduction and further diffusion of drugs using searches in the national and international literature, and questionnaires to national informants. We combined various sources of information, both official years of registration and other indicators of introduction (clinical trials, guidelines, evaluation reports, sales statistics). Results and conclusions The total length of the period between first and last introduction varied between 8 years for antiretroviral drugs and 22 years for cisplatin. Introduction in Estonia was generally delayed until the 1990s. The average time lags were smallest in France (2.2 years), United Kingdom (2.8 years) and the Netherlands (3.5 years). Similar rank orders were seen for year of registration suggesting that introduction lags are not only explained by differences in the process of registration. We discuss possible reasons for these between-country differences and implications for the evaluation of medical care. [ABSTRACT FROM AUTHOR]

With approximately 1.5 billion people at risk, the staggeringly high risk of Type 2 diabetes in South Asians comprises a global problem. The causes of this high risk are complex, with 23 major risk factors identified in a Lancet seminar. This paper proposes a four-stage explanatory model: (1) the birth of a small, adipose, lowlean mass South Asian baby-the phenotype tracking through life; (2) in childhood and early adulthood, the deposition of any excess energy intake preferentially in upper body and ectopic fat stores rather than in the lower body or superficial subcutaneous fat stores; (3) as a consequence of points 1 and 2, and exacerbated by an environment of low physical activity and excess calories, the accelerated appearance of high levels of plasma insulin, triglycerides and glucose, and the fatty-liver vicious cycle; (4) β-cell failure as a result of fewer β-cells at birth, exposure to apoptotic triggers such as fat in the pancreas, and high demand from insulin resistance, which causes diabetes. Other risk factors-especially energy-dense hyperglycaemic diet and low physical activity-play into this pathway. The recommended behavioural changes fit with this model, which brings clarity to guide future research, policy, practice and health promotion. [ABSTRACT FROM AUTHOR]

TAYLOR G., PAPADOPOULOS I., DUDAU V., MAERTEN M., PELTEGOVA A. & ZIEGLER M. (2011) Intercultural education of nurses and health professionals in Europe (IENE). International Nursing Review, 188-195 This paper presents the results of a needs analysis carried out during a 2-year European Union-funded project titled 'Intercultural education of nurses and health professionals in Europe'. The study aimed to explore the perceived learning and teaching needs of students and practitioners of health-care professions in relation to preparation for working in another European country and/or in a multicultural environment. The participating countries were: Belgium, Bulgaria, Germany, Romania and the UK. Questionnaires, consisting of open questions, were completed by a total of 118 participants. Data analysis adopted both a priori and inductive approaches. The predetermined constructs of cultural awareness, cultural knowledge, cultural sensitivity and cultural competence were used to structure suggestions for theoretical input and practical activities and experiences. Inductive analysis revealed other emergent themes that underpin all four of these constructs. Practical experiences form a fundamental part of preparation for labour mobility and/or for practice within a multicultural environment. However, health-care practitioners need to be adequately prepared for such experiences and value the opportunity to learn about culture, to explore values and beliefs, and to practise intercultural skills within the safe environment of an educational establishment, facilitated by skilled teachers. [ABSTRACT FROM AUTHOR]

This paper provides an update of a previous review ' Red Meat in the Diet' published in the Nutrition Bulletin in 2005. An update on red meat consumption levels in the UK and other countries is provided, and a summary of the nutritional content of red meat in the diet is given. Current evidence on dietary and lifestyle factors associated with red meat consumption and the effects of red meat intake on health and chronic disease outcomes are discussed. As there is now continued debate about the environmental impact of different aspects of our diet, sustainability issues regarding red meat were also discussed. [ABSTRACT FROM AUTHOR]

The article examines Great Britain within the context of the European Union (EU) and argues that future continuation within the international body will create political challenges within the nation. It is attested that the unity of the country’s Conservative party depends upon the Prime Minister opposing any further progress toward European integration. At the same time, the paper alleges that the Labour party and the Liberal Democrats both support further European integration, particularly the strengthening of the European Parliament. Options relevant to these varying political doctrines are presented.

This article examines the pronouncements and positions of the leading political parties on the Human Rights Act and the proposals for a new British Bill of Rights and Responsibilities. It analyses the main arguments made in support of a British Bill of Rights and Responsibilities, which are advanced around five main issues: security, the judges, parliamentary sovereignty, responsibilities and ‘British rights’. The article was written before the government published the Green Paper Rights and Responsibilities: developing our constitutional framework in March 2009 and provides a political context with which to analyse it. [ABSTRACT FROM AUTHOR]

Background Children born into poverty have lifelong disadvantages compared with those more fortunate; social interventions seek to break this cycle of poverty and deprivation. Early Years Centres are one such intervention. These were established in deprived areas in the UK to provide high quality out-of-home day care. This paper reports the results of an economic evaluation conducted alongside a randomized controlled trial of one of these centres in the Borough of Hackney, London. Methods Participants were randomized to receive either high quality day care as provided by the centre or to other child care that they secured for themselves where they chose to do so. Information on resource use (early years education and care, as well as health and social care) was collected over an 18-month period; this was valued using appropriate unit costs. The cost of education, social and health care together with the value of productivity gains and out-of-pocket costs were then compared with the effectiveness of the intervention, increased labour force participant in mothers. Results From the societal perspective, the value of employment outweighs the costs of health and social services used, and in both groups there are cost savings. These are greater in the intervention group, therefore Early Years day care is an efficient use of resources. However, there is a net cost to the public sector of providing the intervention. The cost of achieving an additional mother in the labour force at 18 months is £38 550 (85% CI of –£1273, £416 172). Conclusion From the societal perspective, over an 18-month period, all child care is cost saving, but high quality day care provided by the Early Years Centre is a cost-effective alternative to day care provided by other local services in Hackney. The public sector, however, incurs added expense from this intervention. [ABSTRACT FROM AUTHOR]

The aim of the present paper is to describe and compare services for adults with intellectual disability (ID) and mental health needs in five European countries: Austria, England, Greece, Ireland and Spain. A framework and structure for collecting information about service provision was designed. This information was collected through a mixture of interviews with service providers, questionnaires and a review of the research literature within each country. Information was collected on historical context, policy, legislation, assessment, treatment and the structure of services for people with ID and mental health problems. Overall, the needs of those with additional mental health needs have not been specifically addressed at a national level with perhaps the exception of England and Ireland, although there are still gaps in services in these nations. Normalization has been adopted in each of the five countries, and there are moves toward deinstitutionalization, integration and inclusion. Families and self‐advocacy groups have grown. The pace of this change varies between and even within countries. The main findings of the study include: unclear policy, trends for legislative changes, increased prevalence of mental health problems, inadequate generic service provision, a need for specialist mental health services, a need for improved interconnections of services, and a need for training developments. Policy and legislation in the five European countries under consideration tend to separate the disability aspects of people with ID from their mental health needs. Consequently, the service needs of this group remain largely invisible. This might be a direct reflection of policy clarity and legislation, or could be the result of a failure to implement existing guidelines. This has a detrimental effect on the lives of people with ID, and their families and carers. [ABSTRACT FROM AUTHOR]

Recent developments within the regulation approach have highlighted the importance of discourse in securing the conditions for the stabilisation of new modes of regulation. This paper considers the discursive construction in the UK of Britain's relationship to European integration. Despite claims that the politics of the ‘Third Way’ offer an innovative and coherent framework for New Labour's political strategy, the evidence suggests that discourses of national sovereignty and pragmatic economic national self-interest dominate. In conclusion it is suggested that the development of transnational discursive formations is a necessary precondition for the consolidation of regulatory forms and processes that break with previous nationally focused modes of regulation. [ABSTRACT FROM AUTHOR]

The understanding and interpretation of the presumed "secularization" of Britain and other European nations is clouded by a lack of adequate information regarding the substance and timing of religious change. This paper represents the first systematic effort to collect and analyze existing survey data on religious belief in Britain from the late 1930s to the present. Overall, the results show an increase in general scepticism about the existence of God, the related erosion of dominant, traditional Christian beliefs, and the persistence of nontraditional beliefs. A theoretical perspective is needed that recognizes the often corrosive effects of modern life on the transmission of religious beliefs and the continued popularity of worldviews which presume a transcendent referent, however broadly defined.

The paper presents a brief and personal history of the main developments in British vascular plant taxonomy and distribution studies in a European setting since the Second World War. It assesses the importance of the 'European view', and considers recent and current work under two main heads: the factual information itself, and the presentation of the facts, especially in the form of dot distribution maps. [ABSTRACT FROM AUTHOR]

This paper is based on the Nursing Lecture 1977, delivered on the occasion of the Annual General Meeting of the Royal College of Nursing in London on November 23, 1977. The author traces the history and discusses the implications of the EEC Nursing Directives, put into the perspective of the nursing histories of the nine countries within the European Economic Community. She focuses, in particular, on the strengths of the nursing profession in the United Kingdom and argues that the Nursing Directives can lead to enhancement of nursing services and nursing education, better cooperation between health care professions and a stronger voice for the nursing profession, throughout the EEC. [ABSTRACT FROM AUTHOR]

The author reflects on a paper by researcher Kim and colleagues that discusses drink driving in Hong Kong. He argues that random breath testing would help to build up the cohort of drivers with those who comply with the law and those who are discouraged by a single offence. He states that road safety is connected with the long-term damage that alcohol can cause; hence it is important to deal with this issue.