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Scholars are interested in better understanding the low fertility observed in higher income countries. While some people are choosing to have smaller families, countries also report a 'fertility gap', which is the proportion of people who end up with fewer children than originally desired. This paper investigates some causes of the fertility gap in the UK. We amassed qualitative data from seven focus groups conducted among men and women of reproductive age with different educational backgrounds. These focus groups suggest that social support is an influential factor for Britons thinking about having children, although discussions differed in terms of whether this was support from partners or parents. Discussions with university-educated women featured themes of career opportunity costs, and non-university men contributed insights on the financial burden of parenthood. This exploratory study provides up-to-date material on unwanted childlessness and the low fertility in the UK, and highlights the merit of using qualitative methods in understanding the fertility gap. [ABSTRACT FROM AUTHOR]

The cancer-specific health-related quality of life (HRQoL) questionnaire of the European Organisation for Research and Treatment of Cancer (EORTC), the EORTC QLQ-C30, is a frequently applied questionnaire to assess cancer patients' self-reported health used as part of research and clinical practice. Normative data obtained from the general population can facilitate the interpretation of these data. Despite its frequent application, no detailed EORTC QLQ-C30 normative data have yet been published for the United Kingdom (UK). This study presents detailed EORTC QLQ-C30 normative data for the United Kingdom overall and by sex and age. The data are drawn from a larger published, international, cross-sectional online survey. For the recruitment, the sample was stratified by sex (males, females) and age in five age groups with a sample size of n = 100 per subgroup. A total of N = 1026 UK respondents completed the survey (n = 517 females, n = 509 males). There were no clear subgroup patterns by sex or age; however, older patients tended to show higher (i.e., better) scores in emotional and social functioning; they also reported some of the lowest (i.e., best) scores for symptoms, such as insomnia, appetite loss, diarrhoea, nausea/vomiting or financial difficulties. This paper provides EORTC QLQ-C30 general population normative data for the UK, further stratified by sex and age. These data will greatly support the interpretation of EORTC QLQ-C30 scale scores obtained from UK cancer patients, and also enable comparison with other detailed national normative datasets collected in the same project, across several other European countries and the US. • EORTC QLQ-C30 is a cancer quality of life (QoL) tool for functioning and symptoms. • Normative QoL data collected from 1026 respondents in UK general population. • No clear patterns, generally oldest had better functioning and fewer symptoms. • Look-up tables for EORTC QLQ-C30 scales for the UK general population. • Interpretation aid for data from individual and groups of UK cancer patients. [ABSTRACT FROM AUTHOR]

Covid-19 has had a major impact on public transport systems across the world. Public financial support has been needed to maintain services in the face of drastically reduced ridership and adjustment to the need for social distancing. This paper explores the challenge this poses to current methods of delivery of public transport services and argues that a simple return to the status quo is unlikely as public transport adjusts to a new normal of more home working and fear of crowded spaces. In turn this impacts most on the transport disadvantaged. The paper argues that this may spell the end of the prevailing model of a deregulated competitive public transport that has prevailed in the United Kingdom and require a major rethinking of the way to provide an efficient and effective transport system. Such a rethink will depend on understanding the interplay of private and social norms and building public trust. • Transport impacts of Covid-19. • Public transport. • Government funding. • Transport planning. • United Kingdom. [ABSTRACT FROM AUTHOR]

The fluctuation of tourism flow and its cartographic representation are crucial for transport companies, accommodation and regional tourism, but also for the future modelling of international tourism flow. The origin of tourists and their number represent the most important aspect in tourism flow mapping, which are recorded in statistical databases. One of the most popular and easiest way to obtain tourism flow maps is the Kernel Density function, available on ArcGIS, which uses the vector lines data and density mathematical function to represent the objects' characteristics at spatial scale. Spatial distribution of the tourist flow is a tool to observe and assess the origin and destination countries at spatial scale. In this paper, the modelling of tourist flow from their countries of origin to the United Kingdom (UK) was completed through Geographical Information Systems (GIS) considering four types of visitors. The analysis is based on flow lines and Kernel Density using 48 countries of tourists' source related to 2015. The high and very high densities were found in European countries, US, Australia, China, and Canada. Considering the types of visits, the higher number of tourists during 2015 is in respect with holiday visits (> 1.8 million). The model proposed in this paper and the original maps contribute to future strategies and plans for the international tourism over UK. [ABSTRACT FROM AUTHOR]

This paper's objective is to investigate the validity of the Environmental Kuznets Curve (EKC) hypothesis utilizing three unique approaches in this era of accelerating climate change and economic volatility. The first step is to introduce and employ a new cointegration test which allows smooth and sharp structural changes through a dummy variable and a Fourier function. Using a time-varying causality approach, the second stage is to assess the EKC hypothesis's validity for each year of a given period, as opposed to the entire period. The third stage is to conduct time-varying analyses not only of the effect of Gross Domestic Product or aggregate income on environmental degradation but also of the effects of the four major economic units' incomes, namely those of the government, non-financial corporations, households, and the rest of the world. This research derives three conclusions using the United Kingdom as a case study from 1830 to 2016. The impacts of aggregate income and the incomes of the three economic units on carbon emissions are consistent with the EKC hypothesis. Second, each of these effects occurs at different times. Thirdly, the EKC hypothesis regarding the association between the nation's trade income and carbon emissions cannot be validated. To provide policymakers with a dynamic, unit-specific, and effective strategy for mitigating environmental degradation, the paper proposes testing the EKC hypothesis for each year over a specific time period, as well as for the effects of both aggregate income and the disaggregate income of four major economic units. • Explains why to estimate income-emissions nexus using disaggregate income data. • Introducing base models for estimating a disaggregate income-emissions nexus. • Illustrating how to make this estimation using time-varying causality analysis. • Aggregate and disaggregate incomes affect emissions differently over time. • Accurate, precise, and specific policy strategies require disaggregate income data. [ABSTRACT FROM AUTHOR]

All secondary schools in England have been required to teach Relationships and Sex Education (RSE) since 2019, which has raised particular challenges for – and confrontations with – religious minorities. This paper draws on ethnographic research to centre analysis on the fraught moral binds felt by Jewish parents and educators as they struggle to decide when and how to equip children with knowledge while needing to conform to institutional positions on what protection means. Bodily knowledge is redacted across religious/state models of education, which propagates the maintenance of social boundaries and definitions of sexual transgression, but do not stop the quests and questions that adolescents harbour during puberty and development. The paper draws attention to the use of bracketed words in feminist scholarship to convey how terms are projected as having universal meanings or connotations, which are, in reality, socially situated or at least used in socially sanctioned ways. [ABSTRACT FROM AUTHOR]

The increasing visibility of sexualities beyond heterosexual, gay/lesbian, and bisexual is often associated with progressive politics and the questioning of heteronormativity. Yet non‐majoritarian sexualities can also include self‐identifications premised upon an opposition to LGBTQ+ equality and inclusion, including those who identify as "ex‐gay." Drawing on fieldwork with evangelical Christian activists in London, UK, this paper uses a court case in which the "legality" of ex‐gay sexuality was contested to discuss the law's simultaneous desire and inability to render contested identities legally legible. In seeking recognition as a sexual minority, self‐described ex‐gay evangelicals reveal the inadequacy of modern law's efforts to regulate difference as either "innate" or "chosen," thus upsetting the terms of the hetero‐secular legal gaze even as they embrace heterosexual supremacy. As such, this activism, which is typically analyzed in terms of evangelicalism's commitment to heteronormativity, works to denaturalize the concept of sexual orientation(s)—including, I argue, the heterosexuality ex‐gay Christians pursue. [ABSTRACT FROM AUTHOR]

In the two decades of economic recovery in post-Independence Timor-Leste (2002–2022), there has been a growing interest and commitment, especially among young people, to pursue temporary and circular labour migration. In this paper I draw on a survey of returned Fataluku-speaking labour migrants who have spent varying periods of time working in the UK (Britain) and reflect on their experiences and the benefits or otherwise that have resulted from these efforts. The survey was undertaken in late 2019, just before the onset of the global Covid-19 pandemic. The subsequent lockdown and border closures marked the effective end of this remarkable, two-decade long, informal Timorese circular labour migration to the UK. A post-Covid landscape may yet see a lively resumption of this livelihood pathway, but it will do so in the uncertain terrain of a post-Brexit landscape in the UK and the prospects of new labour migration options available closer to home in Australia under the Seasonal Workers Program and Pacific Labour Schemes (PLS). [ABSTRACT FROM AUTHOR]

Background: Mental health crisis requiring emergency access to psychiatric service can occur at any time. Psychiatric Emergency Service (PES) is described as one that provides an immediate response to an individual in crisis within the first 24 h. Presently, several types of PESs are available in the United Kingdom (UK) with the aim of providing prompt and effective assessment and management of patients. Therefore, this study aims to provide a detailed narrative literature review of the various types of Psychiatric Emergency Service (PES) currently available in the UK. Method: Electronic search of five key databases (MEDLINE, PsychINFO, EMBASE, AMED and PUBMED) was conducted. Studies were included if it described a mental health service in the UK that provides immediate response in mental health crisis within the first 24 h. Excluded studies did not describe a PES, non-English, and were not conducted in UK. Results: Nine types of PESs were found. Amongst the 9 services, more papers described crisis resolution home treatment. Majority of the papers reported services within England than other countries within the UK. Conclusion: All types of PESs were described as beneficial, particularly to mental health service users, but not without some shortcomings. There is a need to continue carrying out methodological research that evaluate impact, cost-effectiveness as well as identify methods of optimising the beneficial outcomes of the various types of PESs. This may help inform researchers, policy makers and commissioners, service users and carers, service providers and many more on how to ensure current and future PESs meet the needs as well as aid recovery during crisis. [ABSTRACT FROM AUTHOR]

Research examining the effects of spinal cord injury on sexuality has largely focused on physiological functioning and quantification of dysfunction following injury. This paper reports a systematic review of qualitative research that focused on the views and experiences of people with spinal cord injury on sex and relationships. The review addressed the following research question: What are the views and experiences of people with spinal cord injury of sex, sexuality and relationships following injury? Five databases were relevant and employed in the review: CINAHL (1989–2016 only), PsychInfo, PubMed, Scopus and Web of Science, for research published between 1 January 1980 and 30 November 2019. After removing duplicates, 257 records remained and were screened using a two-stage approach to inclusion and quality appraisal. Following screening, 27 met the criteria for inclusion and are reported in the paper. The review includes studies from fifteen countries across five continents. Two main approaches to data analysis summary and thematic synthesis were undertaken to analyze the qualitative data reported in the papers. The analysis revealed four main themes: sexual identity; significant and generalized others, sexual embodiment; and; sexual rehabilitation and education. [ABSTRACT FROM AUTHOR]

Identification of genomic variability in population plays an important role in the clinical diagnostics of human genetic diseases. Thanks to rapid technological development in the field of massive parallel sequencing technologies, also known as next-generation sequencing (NGS), complex genomic analyses are now easier and cheaper than ever before, which consequently leads to more effective utilization of these techniques in clinical practice. However, interpretation of data from NGS is still challenging due to several issues caused by natural variability of DNA sequences in human populations. Therefore, development and realization of projects focused on description of genetic variability of local population (often called "national or digital genome") with a NGS technique is one of the best approaches to address this problem. The next step of the process is to share such data via publicly available databases. Such databases are important for the interpretation of variants with unknown significance or (likely) pathogenic variants in rare diseases or cancer or generally for identification of pathological variants in a patient's genome. In this paper, we have compiled an overview of published results of local genome sequencing projects from United Kingdom and Europe together with future plans and perspectives for newly announced ones. [ABSTRACT FROM AUTHOR]

Conditions and warranties, which are generally referred to as policy terms in insurance contracts, are crucial in the determination of the rights and obligations of the contracting parties. The article examines the enforcement of policy terms in insurance contracts at common law and the legislative measures that have been deployed in some common law countries, including Nigeria, the United Kingdom and Australia, to ensure fairness as well as to balance the inequality in the bargaining power of the contracting parties. In as much as the principle of freedom of contract will generally be honoured by the court, the paper argues that through legislative intervention in policy terms in these countries, the principle is being discountenanced with, in appropriate cases, in order to effectuate the just and reasonable expectation of the insured. It concludes by proffering suggestions to identified lacunae in the Nigerian Insurance law. [ABSTRACT FROM AUTHOR]

Introduction: Regulatory processes for Oral health care professionals are considered essential for patient safety and to ensure health workforce quality. The global variation in their registration and regulation is under-reported in the literature. Regulatory systems could become a barrier to their national and international movement, leading to loss of skilled human resources. The General Dental Council is the regulatory authority in the UK, one of the nine regulators of health care overseen by the Professional Standards Authority.Aim: The aim of this paper is to present the professional integration experiences of internationally qualified dentists (IQDs) working in the UK, against the background of regulation and accreditation nationally.Methods: Registration data were obtained from the General Dental Council to inform the sampling and recruitment of research participants. Semi-structured interviews of 38 internationally qualified dentists working in the United Kingdom were conducted between August 2014 and October 2017. The topic guide which explored professional integration experiences of the dentists was informed by the literature, with new themes added inductively. A phenomenological approach involving an epistemological stance of interpretivism, was used with framework analysis to detect themes.Results: Internationally qualified dentist's professional integration was influenced by factors that could be broadly classified as structural (source country training; registration and employment; variation in practising dentistry) and relational (experiences of discrimination; value of networks and support; and personal attributes). The routes to register for work as a dentist were perceived to favour UK dental graduates and those qualifying from the European Economic Area. Dentists from the rest of the world reported experiencing major hurdles including succeeding in the licensing examinations, English tests, proving immigration status and succeeding in obtaining a National Health Service performer number, all prior to being able to practice within state funded dental care.Conclusion: The pathways for dentists to register and work in state funded dental care in UK differ by geographic type of registrant, creating significant inconsistencies in their professional integration. Professional integration is perceived by an individual IQD as a continuum dictated by host countries health care systems, workforce recruitment policies, access to training, together with their professional and personal skills. The reliance of the UK on internationally qualified dentists has increased in the past two decades, however, it is not known how these trends will be affected by UK's exit from the European Union and the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The pursuit of inclusion in elite universities has been widely explored from a structural lens concerned with issues of access faced by traditionally underrepresented students and staff. Building from a sociological institutionalist approach, this paper proposes the concept of 'agentic inclusion' to capture the growing valorisation of universities' agency in the pursuit of inclusion, and the underlying shift from inclusion as 'structural pursuit' to inclusion as 'organisational commitment'. Drawing on primary data mapping the presence of inclusion offices, units and teams across 124 UK universities as of 2018, and secondary data such as student and staff inclusion statistics, I show that elite universities are leading in the organisational display of inclusion, irrespective of the actual levels of inclusion across traditionally underrepresented students and staff. The findings call for further research into the gap between universities' organisational commitments to inclusion and inclusion at the structural level and inform several policy recommendations. [ABSTRACT FROM AUTHOR]

A recent rise in Euro-scepticism in the European Union can be linked to its unequal economic development as a consequence of globalisation. It has manifested itself in increasing support for radical right-wing parties, which is partly based on anti-globalist sentiments. One of the major expressions of this anti-globalist and Eurosceptic views has been "Brexit", the UK's withdrawal from the EU in 2020. Seven years before Brexit, another European country, Croatia, joined the EU. The main aim of this paper is to understand how attitudes towards globalisation differ between UK and Croatian students by analysing and comparing the students' values, beliefs and perceptions regarding globalisation generally and EU integration more specifically. The study was conducted in 2019-2020 and consisted of a questionnaire survey on a sample of n=283 geography students (154 in Croatia and 129 in the UK). The results demonstrate that both Croatian and UK students tend to see globalisation as a positive process (57.6 %) with the largest benefits being an increase in exchange of knowledge and scientific advancements, and growth of economy. While both cohorts agree that the main negative consequences globally are increased economic inequalities and exploitation of workers, several differences in perception of negative consequences of globalisation in their respective countries are also identified. [ABSTRACT FROM AUTHOR]

The integrated nature of well-being produces difficulty in evaluating poverty levels and one issue is the neglected of human life aspects, multiple feedback loops, and an over-emphasis on income. In the light of current structural changes a multidimensional poverty measure (MPI), which includes some of those missing dimensions, closely related to the well-being of individuals, is constructed in this paper. Using data from the EU Statistics on Income and Living Conditions Survey, this paper provides a fresh insight into the analysis of multidimensional poverty in the United Kingdom. One of the distinctive feature of the study is the use of polychoric factor loadings to estimate dimensional weights of the MPI, in addition to more arbitrary weighting schemes. This technique consists of a coherent hierarchy of principles, to verify which of the many acknowledged dimensions of poverty hold both theoretical and practical importance. Findings indicate that, the MPI is highly consistent with the conventional measures of poverty and multidimensional poverty has decreased over the period of examination. [ABSTRACT FROM AUTHOR]

Responses to the Great Recession are varied across welfare states and gendered in their consequences. Combining gender, social policy and social movement scholarship, this paper investigates how the differential policy responses to the Financial Crisis in three European countries shaped gender-differences in anti-austerity demonstrations. We compare the involvement and characteristics of women and men in anti-austerity protests using data collected at street demonstrations (2010–2012). We conduct cross-national multi-level analysis of demonstrators from countries representing different gender regimes (Spain, Sweden and the United Kingdom). Our results show that gender regimes have a significant impact on women's and men's involvement in anti-austerity protests. We thus make an important contribution to research on gender differences in participation in anti-austerity demonstrations post-Great Recession. Our comparison of women's and men's participation in anti-austerity street demonstrations suggests that at the country or regime level resources matter more than grievances, but that grievances matter at the individual level. This innovative paper links scholarship on gender regimes with research on protest participation. Resources and experiences of grievances are shaped by gender regimes which provide access to decision-making and social support. We reveal novel insights into the connection between gender regimes and demonstration participation. [ABSTRACT FROM AUTHOR]

It is widely acknowledged across the global health sector that research programmes need to be designed and implemented in a way that maximise opportunities for strengthening local capacity. This paper examines how the United Kingdom Research and Innovation (UKRI) Grand Challenges Research Fund (GCRF) funded PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network has been established as a platform to strengthen global capacity for research focused on the improvement of maternal, fetal and newborn health in sub-Saharan Africa. Best practice principles outlined in an ESSENCE on Health Research report have been considered in relation to the PRECISE Network capacity-building activities described in this paper. These activities are described at the individual, programmatic and institutional levels, and successes, challenges and recommendations for future work are outlined. The paper concludes that the PRECISE leadership have an opportunity to review and refresh activity plans for capacity building at this stage in the project to build on achievements to date. [ABSTRACT FROM AUTHOR]

Housing is a very important human need along with food and clothing. The process of providing housing should be such that does not alienate the beneficiaries from the process. This study examined residents' participation schemes in the United Kingdom for drawing lessons for the Nigerian housing environment. It used case study method to explore three residents' participation schemes in the UK and collect data for this study. While drawing useful information from approaches and processes of residents' participation in housing in the UK, the paper proposes approaches that can suit the local conditions in Nigeria. Specifically, the paper outlines how policy makers, housing agencies and professionals could adapt the lessons to Nigeria in order to ensure positive outcome from the housing process. It concludes that residents' participation in housing should be more widely practiced in Nigeria to improve the likelihood of meeting the housing needs of residents. [ABSTRACT FROM AUTHOR]

The EU's work on climate change is key to the regional and international fight against the problem, and disruptions to it have global implications. When analyzing the effects of the UK's decision to leave the EU (Brexit) on EU climate action, this paper looks at two types of impact. The first is related to UK absence from EU climate policy, finance and diplomacy following the actual UK departure from the EU. The second is related to the costs attached to the withdrawal process, including the additional costs and uncertainty created by the delayed UK departure. These latter implications of Brexit have been less explored by the literature, although the last years provide plenty of evidence for them. The paper finds that the impact of Brexit on EU climate action is mainly negative, without denying some potential positive impact and while acknowledging the limitations of a study that entails forecasting in an uncertain political context. Key policy insights Following Brexit, the EU will lose a member that supported its climate action internally and internationally through commitment to high emissions reduction targets at the EU level, policy solutions, and financial and diplomatic support. The withdrawal process itself has had a negative impact on EU climate action: Brexit has hijacked the EU agenda, captured EU human and administrative resources and increased the uncertainty in which investors and businesses operate. Planning for separate European Councils to deal with Brexit could prevent agenda hijacking. Both the EU and UK also need to provide businesses with a clear regulatory framework. A repeatedly postponed Brexit has caused additional damage, by prolonging uncertainty. Continuing to work with the UK on climate during the Brexit negotiations and after the UK departure should be a priority for the EU, as well as ensuring the willingness to cooperate is not spoiled by mutual resentment. [ABSTRACT FROM AUTHOR]

Veterinary medicine is the profession that is widely perceived as being at the forefront of animal care in the United Kingdom (UK). It is a form of care that is multi‐spatial and multi‐species: veterinary surgeons are involved in broad debates about animal welfare while also intimately caring for our pet companions. In order to regulate the profession, the Royal College of Veterinary Surgeons provides the Code of Professional Conduct (CPC) as the principal ethical framework that must be adhered to by all UK veterinary surgeons. The main aim of the CPC claims to ensure that the animal is, first and foremost, the primary consideration in veterinary medicine. By exploring the CPC in relation with animal geographies, emotional geographies and science and technology studies, this paper shows how the CPC remains anthropocentric and focused on a rational scientism that limits affective attunement with non‐human animals and distrusts the role of emotion and affect in veterinary medicine. These ethical‐spatial implications are then shown to extend beyond the CPC and into the conceptual terrain of ethics teaching in undergraduate veterinary education. As a way through this ethical tangle, a more‐than‐human geography of empathy is proposed. This notion takes the site of empathy as its geographical focus and suggests that a more critical, situated and holistic understanding of empathy might allow for a more thorough consideration of the tensions between human and animal and science and emotion in veterinary medicine and human geography more widely. Veterinary medicine is the profession that is widely perceived as being at the forefront of animal care in the United Kingdom (UK). In order to regulate the profession, the Royal College of Veterinary Surgeons provides the Code of Professional Conduct (CPC) as the principal ethical framework which must be adhered to by all UK veterinary surgeons. By exploring the CPC in relation with animal geographies, emotional geographies and science and technology studies, this paper shows how the CPC remains anthropocentric and focused on a rational scientism which limits affective attunement with non‐human animals and distrusts the role of emotion and affect in veterinary medicine. [ABSTRACT FROM AUTHOR]

Rationale, aims and objective: Substituting outpatient hospital care with primary care is seen as a solution to decrease unnecessary referrals to outpatient hospital care and decrease rising healthcare costs. This systematic review aimed to evaluate the effects on quality of care, health and costs outcomes of substituting outpatient hospital care with primary care-based interventions, which are performed by medical specialists in face-to-face consultations in a primary care setting. Method: The systematic review was performed using the PICO framework. Original papers in which the premise of the intervention was to substitute outpatient hospital care with primary care through the involvement of a medical specialist in a primary care setting were eligible. Results: A total of 14 papers were included. A substitution intervention in general practitioner (GP) practices was described in 11 papers, three described a joint consultation intervention in which GPs see patients together with a medical specialist. This study showed that substitution initiatives result mostly in favourable outcomes compared to outpatient hospital care. The initiatives resulted mostly in shorter waiting lists, shorter clinic waiting times and higher patient satisfaction. Costs for treating one extra patient seemed to be higher in the intervention settings. This was mainly caused by inefficient planning of consultation hours and lower patient numbers. Conclusions: Despite the fact that internationally a lot has been written about the importance of performing substitution interventions in which preventing unnecessary referrals to outpatient hospital care was the aim, only 14 papers were included. Future systematic reviews should focus on the effects on the Triple Aim of substitution initiatives in which other healthcare professions than medical specialists are involved along with new technologies, such as e-consults. Additionally, to gain more insight into the effects of substitution initiatives operating in a dynamic healthcare context, it is important to keep evaluating the interventions in a longitudinal study design. [ABSTRACT FROM AUTHOR]

This paper provides a narrative review of the existing literature on differences in demographic and biological features of breast cancer at time of diagnosis between Black and White women in Canada, the United Kingdom and the United States. Electronic database searches for published peer-reviewed articles on this topic were conducted, and 78 articles were included in the final narrative review. Differences between Black and White women were compared for eight categories including age, tumour stage, size, grade, lymph node involvement, and hormone status. Black women were significantly more likely to present with less favourable tumour features at the time of diagnosis than White women. Significant differences were reported in age at diagnosis, tumour stage, size, grade and hormone status, particularly triple negative breast cancer. Limitations on the generalizability of the review findings are discussed, as well as the implications of these findings on future research, especially within the Canadian context. [ABSTRACT FROM AUTHOR]

Despite ongoing efforts to encourage the use of urban morphology tools into current practice, uptake remains limited. Shortcomings are largely attributed to time and resource intensive methods of historical settlement transformation study. However, developments in quantitative morphological approaches offer new possibilities for efficiency and easier adoption of research tools in practice. This paper proposes the use of typo-morphology methods to inform the adoption of form-based design guidance in neighbourhood master plans. The aim of the study is to develop a comprehensive yet flexible method for form-based character assessment (FBCA) of residential streets. The resulting FBCA classification identifies streets where compliance with form-based design rules could be tightened. The FBCA method is empirically tested in the context of the local neighbourhood plan for Radlett, Hertfordshire in the United Kingdom, offering reflections from practice on the usefulness and limitations of the method. [ABSTRACT FROM AUTHOR]

Summary: This paper sheds light on the causality linkages between economic growth and energy production, that is, natural gas, bioenergy and waste, coal, nuclear, petroleum, wind, solar and hydro for the United Kingdom over the period 1998Q1 to 2017Q4. To this end, we apply time‐domain causality tests—Toda‐Yamamoto causality test and gradual shift causality test, and frequency domain causality (FDC) test for empirical analysis to sort out the causality among the outlined variables under consideration. Empirical findings from the spectral BC causality test reveal that (a) changes in energy production from natural gas and petroleum spur significant changes in economic growth in the United Kingdom; (b) economic growth causes energy production from natural gas, petroleum, wind, solar, hydro and nuclear and (c) it is worthy of mentioning that time and FDC tests provide consistent outcomes at different significance and frequency levels. On the causality analysis, the hypothesis that natural gas triggers economic growth is valid, while the result also reveals a feedback causality the variables of concern. Similarly, economic growth drives nuclear energy production one‐way as well as total energy drives economic growth. These results provide policy implications for energy and environmental sustainability in the United Kingdom where renewable energy sources drive economic growth. Thus, necessitates the need to maintain the current trajectory for more renewable energy promotion in energy mix relative to fossil‐fuel energy sources. Highlights: Economic impact is revisited for the United Kingdom over the period 1998Q1 to 2017Q4.Toda‐Yamamoto, gradual shift and frequency domain causality tests were employed.Distinct roles of natural gas, fossil, nuclear and mix of renewables were explored.Changes in natural gas and petroleum significantly spur economic growth.Frequency domain causality tests offer consistent time and frequency changes. [ABSTRACT FROM AUTHOR]

Hydrogen has been identified as a potential gamechanger and ambitious national targets have been announced by many governments around the world. However, the lack of clear policy signals at the country level remains a barrier and significant cost reduction progress is unlikely to be made unless the issue is addressed. The paper aims to assess whether current UK energy policies support an economic case for low-carbon and competitive H2 production. A financial model is developed for hypothetical H2 projects based in the UK. Price assumptions are assigned to a specific set of policies in combination with the key technical considerations for H2 production and estimated return. The study concludes that H2 development featuring electrolysers or carbon capture and storage cannot rely on market forces alone to reach full commercialisation and competitiveness in the UK. While policies improve the economic case for H2 in some key areas, existing frameworks are not ambitious enough to advance the transition to low carbon options such as Blue and Green H2. Moreover, current policies do not sufficiently disincentivise investments in emission-intensive alternatives. • Explore potential for power-to-gas and steam methane reforming H2 with CCS in the UK. • Consider how current energy policy impacts the economics of both H2 production types. • Power-to-gas H2 can profit from security of supply policies and market-based support. • Blue H2 represents high-risk investment due to depleting domestic gas resources. • Current carbon price is too low to stimulate investment in low-carbon H2 projects. [ABSTRACT FROM AUTHOR]

The question of whether high immigration produces anti-immigration hostility has vexed researchers across multiple disciplines for decades. And yet, understanding this relationship is crucial for countries dependant on immigrant labour but concerned about its impact on social cohesion. Absent from most of this research are theories about the impact of early-years socialisation conditions on contemporary attitudes. Using the British sample of the European Social Survey (2002–2017) and two innovative approaches to modelling generational differences – generalised additive models and hierarchical age‒period‒cohort models – this paper shows that rather than producing hostility to immigration, being socialised in a context of high immigrant-origin diversity is likely to result in more positive attitudes to immigration later in life. This implies that through generational replacement, countries like the UK are likely to become increasingly tolerant of immigration over time. Importantly, however, a context of high-income inequality may diminish this effect. [ABSTRACT FROM AUTHOR]

For most analysts, Brexit reveals the highly contingent power of finance and the clear limits to its ability to influence crucial policymaking outcomes. By contrast, I contend that UK-EU negotiations demonstrate the unique capacity of finance to secure substantial commercial protections relative to all other business sectors and that the structural sources of the City's political power remain exceptionally robust. Elaborating a notion of 'structural interdependence', the paper demonstrates how policy officials on both sides came to perceive that the future prosperity and stability of their economies relied upon maintaining open trading relations in financial services. This necessitated broad continuity in access to London's deep financial markets for EU firms and preservation of the City's leading role in the UK growth regime. In establishing these claims empirically, I document an extensive range of contingency measures designed throughout December 2018-April 2019 that would function to protect the financial industry from economic disruption in the event of a no-deal Brexit. The outcome illustrates how finance benefits from a form of structural power that does not require instrumental mobilisation, but rather shapes policy decisions on the basis of deeply entrenched and commercially vital cross-border financial entanglements. [ABSTRACT FROM AUTHOR]

Drawing on participant-generated photo-elicitation in telephone interviews conducted with private tenants in Britain, we contribute to a new strand of home literature that engages with the vibrant materiality of things. In particular, the paper reflects on how our innovative methodological approach empowered participants to introduce their own points of view through 'thick' descriptions, revealed previously undocumented home practices and enabled researchers' reflexivity and the co-production of knowledge with participants located miles away. The method powerfully captures home's tangible and intangible materialities and their importance to wellbeing in ways that words-alone interviews cannot. We conclude by introducing the metaphor of 'the fold' and the allegory of 'the invisible tether' to reflect on the methodological benefits and substantive findings enabled by our approach. We argue that housing studies can benefit from engaging photo-elicitation in questions spanning from the abstract to the concrete, and from the inside to the outside of the home. [ABSTRACT FROM AUTHOR]

Background: Research nurses, midwives and allied health professionals are members of an important emergent profession delivering clinical research and, in the United Kingdom, have been the focus of considerable investment by the National Institute for Health Research (NIHR). This paper considers the experiences of research nurses, midwives and allied health professionals in relation to professional identity work, recognizing these are coproduced alongside others that they interact with (including patients, clinical staff and other research staff).Methods: Semi-structured interviews were conducted with 45 nurses, midwives and allied health professionals in the UK about their experiences of working in research delivery. Interviews were transcribed verbatim and thematically coded and analysed.Results: Our analysis highlights how research nurses, midwives and allied health professionals adjust to new roles, shift their professional identities and undertake identity work using uniforms, name badges and job titles as they negotiate complex identities.Conclusions: Research nurses, midwives and allied health professionals experience considerable challenges as they enter and transition to a research delivery role, with implications for their sense of professional identities. A change in the work that they undertake and how they are (or perceive they are) viewed by others (including clinical non-research colleagues and patients) has implications for their sense of professional and individual identity. The tensions involved extend to their views on symbols of professional identity, such as uniforms, and as they seek to articulate and demonstrate the value of their conjoined role in research and as a healthcare professional, within the unfolding landscape of health research. We embed our study findings in the context of the newly emerging clinical research practitioner workforce, which further exacerbates and complicates the role and identity complexity for nurses, midwives and allied health professionals in research delivery. [ABSTRACT FROM AUTHOR]

The emergence of severe acute respiratory syndrome coronavirus 2 in December 2019, presumed from the city of Wuhan, Hubei province in China, and the subsequent declaration of the disease as a pandemic by the World Health Organization as coronavirus disease 2019 (COVID‐19) in March 2020, had a significant impact on health care systems globally. Each country responded to this disease in different ways, however this was done broadly by fortifying and prioritizing health care provision as well as introducing social lockdown aiming to contain the infection and minimizing the risk of transmission. In the United Kingdom, a lockdown was introduced by the government on March 23, 2020 and all health care services were focussed to challenge the impact of COVID‐19. To do so, the United Kingdom National Health Service had to undergo widespread service reconfigurations and the so‐called "Nightingale Hospitals" were created de novo to bolster bed provision, and industries were asked to direct efforts to the production of ventilators. A government‐led public health campaign was publicized under the slogan of: "Stay home, Protect the NHS (National Health Service), Save lives." The approach had a significant impact on the delivery of all surgical services but particularly cardiac surgery with its inherent critical care bed capacity. This paper describes the impact on provision for elective and emergency cardiac surgery in the United Kingdom, with a focus on aortovascular disease. We describe our aortovascular activity and outcomes during the period of UK lockdown and present a patient survey of attitudes to aortic surgery during COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

In 1976 David Murphy wrote his critique of the role of the UK regional press in local politics—The Silent Watchdog: The Press in Local Politics. Through the next two decades, local 'papers of record' attempted to report on the activities and decisions of their local councils regularly and diligently but the decline of the regional press in the twenty-first century has rendered Murphy's critique obsolete. This article will look at what was expected of local journalism in the 1970s. It will show what was delivered until the twenty-first century and then look at how local press coverage of local government has declined, raising the scenario of a 'local democratic deficit'1 whereby local politics in some communities receives little direct coverage, creating a danger of a disconnect between local government and local communities caused by the abandonment of its former role by the regional press. [ABSTRACT FROM AUTHOR]

Background: During the twentieth century, hip replacement became one of the most popular and successful operations. In the 1990s, a new type of hip replacement namely the metal‐on‐metal hip resurfacing was developed. This paper draws on one of the available implants, namely the DePuy Orthopaedics' Articular Surface Replacement (ASR) hip system which was withdrawn from the market because of higher than expected rates of failure. It examines media representations on the failure of the ASR metal‐on‐metal hip replacement device and its subsequent withdrawal from the market. Methods: Drawing on content analysis this paper explores how systemic failure of the medical implant was framed and performed by press media in the UK. Results: Two narratives were particularly important in framing press media coverage of the ASR case: the role of patients as passive recipients of care and a distinction between health and disability identities as related to how individuals' narratives about the past shaped their sense of present and future. In all cases, the voice of the orthopaedic surgeons responsible for the selection and implantation of the ASR devices remains silent. Conclusions: Press media coverage of medically induced harm in the UK is significantly less common than coverage of any other patient safety issues and public health debates. This study aims to contribute to the evidence base on how public discourse on medically induced harm becomes framed through the reported experiences of individuals in press media and also how this process influences the legitimacy of various solutions to medical errors or unanticipated outcomes. [ABSTRACT FROM AUTHOR]

This paper places a critical spotlight on the ways in which governance and social responsibility concerning labour standards work in the context of public sector procurement. Supply chains provisioning the public sector, incorporating a vast array of materials used in public services such as education, health, social housing and transportation, have been under‐researched and under‐theorised in the geographical and wider social science literature on Global Production Networks, Global Value Chains and consumption ethics. Against this backdrop, the paper evaluates the emergence of ethical trading programmes involving labour standards in UK public sector sourcing, drawing on examples from the health, higher education, construction and transportation sectors and a methodology combining interviews with participant observation. Findings show that ethical public procurement is shaped, and often constrained, by: the relatively low profile of many materials used in public services, which challenge effective campaigning and advocacy work; the consequent limits to reputational risk for state departments and first‐tier suppliers if labour issues are encountered in their supply chains; and the significant role of EU and UK procurement law, which until 2014 rendered social responsibility in public sector sourcing a legal risk to specify. Through a practice‐orientated approach and adopting the notion of responsibilisation inspired by governmentality perspectives, the paper grasps how these challenges for ethical public procurement are encountered and negotiated by procurement managers and those influencing them in a neoliberal environment. It is shown that ethical sourcing is significantly less advanced in the UK public sector than it is in consumer goods sectors, with implications for social justice in a whole realm of under‐researched global supply chains. This paper places a critical spotlight on the ways in which governance and social responsibility concerning labour standards work in the context of public sector procurement. Through a practice‐orientated approach and adopting the notion of responsibilisation inspired by governmentality perspectives, the paper grasps how challenges of ethical public procurement are encountered and negotiated by procurement managers and those influencing them in a neoliberal environment. It is shown that ethical sourcing is significantly less advanced in the UK public sector than it is in consumer goods sectors, with implications for social justice in a whole realm of under‐researched global supply chains. [ABSTRACT FROM AUTHOR]

While there has been a steady growth of women working in geography in UK universities since the mid-Twentieth Century, there are continuing challenges in gendered career progression and professional interactions within the contemporary discipline. These range from problems associated with employment precarity and inflexible work practices, life choices and obligations in the domestic arena, discrimination and bullying, to less tangible gendered norms and cultures in the workplace. This paper discusses these challenges and inequalities in the light of a brief overview of sector-wide statistical data on appointments by gender and career-stage and with the analysis of some 250 in-depth responses to a nationwide qualitative survey of gender and career experience in UK universities (Maddrell, Avril, Kendra Strauss, Nicola J Thomas, and Stephanie Wyse. 2016. "Mind the Gap: Gender Disparities Still to Be Addressed in UK Higher Education Geography." Area 48 (10): 48-56). While the term 'glass ceiling' still has significant relevance, findings show a more complicated picture which also includes 'stone floors' and stumbling blocks. It also shows how career experience varies by institution and individual: challenges in career progression can be compounded by institutional protocols and intersectional factors, and vary with career stage. The intersection of early-career job precarity, reproductive decisions and associated family responsibilities were particularly highlighted in this study. These 'pinch points' in career development disproportionately affect, but are not limited to, female early career scholars. Early career progress may be stalled in mid-career in multi-staged promotional systems such as that in UK universities; some from minorities face compound barriers; men with caring responsibilities may face prejudice. The paper concludes with suggested strategies for change, highlighting the importance of individual university and department protocols and practices; line manager and other senior colleagues' attitudes and leadership in creating workplaces with an equality-driven ethos and structures that allow individuals to flourish. [ABSTRACT FROM AUTHOR]

Prison populations across the world are increasing. In the United Kingdom, numbers have doubled in the last two decades, and older prisoners now constitute the fastest growing section of the prison population. One key reason for this shifting prisoner demographic is the growing numbers of men convicted of ‘historic’ sexual offences, many of whom are imprisoned for the first time in old age, and housed in prisons not suited to their needs. These demographic changes have profound consequences, including increased demand for health and social care in prison, and rising numbers of anticipated deaths in custody. Using the findings from a recently completed study of palliative care in prison, this paper proposes that older prisoners face a ‘double burden’ when incarcerated. This double burden means that as well as being deprived of their liberty, older people experience additional suffering by not having their health and wellbeing needs met. For some, this double burden includes a ‘de facto life sentence’, whereby because of their advanced age and the likelihood that they will die in prison, they effectively receive a life sentence for a crime that would not normally carry a life sentence. There has been little popular or academic debate concerning the ethical and justice questions that this double burden raises. Drawing on the work of Wacquant and others, the paper proposes that these changes are best understood as unplanned but reasonably foreseeable consequences of neoliberal penal policies. Although the paper focuses on the UK (which by comparison with other European countries has high rates of imprisonment), many of the challenges discussed are emerging in other countries across the world. This paper illustrates starkly how neoliberal policies and discourses have shaped the expansion and composition of the prison population with its consequent implications for health and justice. [ABSTRACT FROM AUTHOR]

Purpose As libraries are required to become more accountable and demonstrate that they are meeting performance metrics, an assessment website can be a means for providing data for evidence-based decision making and an important indicator of how a library interacts with its constituents. The purpose of this paper is to share the results of a review of websites of academic libraries from four countries, including the UK, Canada, Australia and the USA.Design/methodology/approach The academic library websites included in the sample were selected from the Canadian Association of Research Libraries, Research Libraries of the United Kingdom, Council of Australian University Libraries, Historically Black College & Universities Library Alliance, Association of Research Libraries and American Indian Higher Education Consortium. The websites were evaluated according to the absence or presence of nine predetermined characteristics related to assessment.Findings It was discovered that “one size does not fit all” and found several innovative ways institutions are listening to their constituents and making improvements to help users succeed in their academic studies, research and creative endeavors.Research limitations/implications Only a sample of academic libraries from each of the four countries were analyzed. Additionally, some of the academic libraries were using password protected intranets unavailable for public access. The influences of institutional history and country-specific practices also became compelling factors during the analysis.Originality/value This paper seeks to broaden the factors for what is thought of as academic library assessment with the addition of qualitative and contextual considerations. [ABSTRACT FROM AUTHOR]

Quality-Adjusted Life-Years (QALYs) are central to healthcare decision-making in Britain and abroad, yet their history is poorly understood. In this paper, we argue that a more in-depth and political history of the QALY is needed to allow a critical evaluation of its current dominance. Exploiting rich data from archives and 44 semi-structured interviews conducted between 2015 and 2018, we employ Multiple Streams Analysis to construct a complex and dynamic picture of how the idea of QALYs emerged and was adopted within UK health policy. Through its historical and political approach, the paper illuminates the relative roles in the policy-making process of experts (especially economists) and politicians as ‘entrepreneurs’ in the development of new ideas; how these were influenced by negotiation within established and emerging institutional structures; and the role of serendipity and crisis. [ABSTRACT FROM AUTHOR]

Controlled organ donation after circulatory death (DCD) has recently been revived in the UK, as part of attempts to increase organ donation rates. The re-introduction of DCD has subsequently become the focus of bioethical controversy, since it necessitates intervening in the care of dying patients to obtain quality donor organs. Transplant policy responses to these concerns have generated new legal and ethical guidelines to address uncertainties around DCD, producing claims that the UK has overcome’ the ethical challenge of DCD. In contrast, by drawing on Lynch's call to ‘respecify’ ethics, this paper argues that ethics in DCD cannot be reduced to abstract directives for practice, but, instead, are composed and dealt with as an organisational problem. To do this, I utilise data from an ethnographic study examining the production of the ‘minority ethnic organ donor’ within UK organ donation settings; in particular, the data pertains to a case hospital which was in the process of developing a DCD programme during the period of fieldwork. Findings show that the ethics of DCD are encountered as practical sets of problems, constructed in relation to particular institutional locales. I describe how these issues are worked-around by creating conditions to make DCD organisationally possible, and through the animation of standard procedures into acceptable forms of practice. I argue that ethics in DCD go far beyond normative bioethical principles, to encompass concerns around: the reputation of hospital Trusts, public perceptions of organ donation, the welfare of potential donor families, and challenges to the work of health professionals caring for dying patients. The paper enriches understanding of ethics in science and medicine by showing how ethics are assembled and negotiated as a practical-organisational concern, and calls for further examination of how DCD gets constructed as a potential problem and is made to happen in practice. [ABSTRACT FROM AUTHOR]

This paper frames a critical evaluation of the progressive aspirations of localism partnerships by conceptualising them as informal associations. I show how the selective limitations and affordances of the Localism Act and its related policies necessitated and enabled direct, deliberative encounters, and pragmatic working between the Rural Urban Synthesis Society and its local authority, Lewisham Council. These practices allowed them to co‐produce a precedent for community‐led affordable housing development in London, as well as contribute to the growth of the sector. Informal associations are thus both means and end. They enable innovative articulations of localism and underpin a broader, ongoing project of progressive localism. They also form the conceptual basis for future research to delve more deeply and widely into analyses of localism partnerships and their relationalities to the institutions in which they are embedded. Within the vagarious and incoherent institutional landscape of austerity, informal associations invoke a local politics which embraces collaborative, direct experimentation between state agents and societal actors, working with uncertainty in planning to achieve progressive developmental and governance outcomes. [ABSTRACT FROM AUTHOR]

The United Kingdom continued to question some aspects of the European Union even after becoming a member state in 1973. The country's uneasiness with the European Union increased significantly in the 1990s, when the European Union member states took significant steps to deepen the level of integration in response to the changing dynamics of the international politics. Never-ending unrest in the country eventually led to the withdrawal from the EU, commonly known as the Brexit, after a decision basing upon a referendum in 2016. This paper analyses the role of the United Kingdom Independence Party in the Brexit process till the end of the referendum of 23 June 2016. The study argues that concomitant operation of the current and historical dynamics produced the result of the Brexit. [ABSTRACT FROM AUTHOR]

This paper aims to analyse the coordination and cooperation in Primary Health Care (PHC) measures adopted by the British government against the spread of the COVID-19. PHC is clearly part of the solution founded by governments across the world to fight against the spread of the virus. Data analysis was performed based on coordination, cooperation, and PHC literature crossed with documentary analysis of the situation reports released by the World Health Organisation and documents, guides, speeches and action plans on the official UK government website. The measures adopted by the United Kingdom were analysed in four periods, which helps to explain the courses of action during the pandemic: pre-first case (January 22- January 31, 2020), developing prevention measures (February 1 -February 29, 2020), first Action Plan (March 1- March 23, 2020) and lockdown (March 24-May 6, 2020). Despite the lack of consensus in essential matters such as Brexit, the nations in the United Kingdom are working together with a high level of cooperation and coordination in decision-making during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

TESOL postgraduate students come to the UK from China seeking an authentic environment in which to develop their English language skills and learn about their host culture. This paper provides a substantive review of the historical context of higher education in China, including its Confucian cultural heritage, and shows its evolution from a system of rote learning to one increasingly embracing critical thinking and active classrooms. Significant previous studies on the Chinese international student experience in Western academic contexts are then presented. Applying this, we present a needs analysis conducted at a British university to elucidate perceived missing adaptation support and the resulting programme, demonstrating what was successful and providing best practice recommendations for other universities looking to enhance sociocultural support for this changing student population. Our goal is to assert the need for Western higher education to acknowledge the changing profile Chinese international students, specifically postgraduates, will have upon matriculation. [ABSTRACT FROM AUTHOR]

This paper explores trade union strategies to protect wages in the face of EU migration after the enlargement of the European Union. We argue that unions have three instruments at their disposal to deal with the risks linked to downward wage pressure: closure through immigration control, equalisation through collective bargaining and minimum wages, and the organisation of migrant workers. Using comparative case studies of Sweden, Germany and the UK, we show how different types of power resources shape union strategies: unions with substantial organisational resources (in Sweden) relied on a large membership to pursue an equalisation strategy and expected to be able to 'afford' openness. German unions with low membership but access to the political system pushed for a mix of closure and equality drawing on political intervention (e.g. minimum wages). British unions, unable to pursue either, focused their efforts on organisation. [ABSTRACT FROM AUTHOR]

There has been a growing focus on uncertainty as a distinct concept in the risk literature. This paper is concerned with how those involved in the design and implementation of climate change policy conceptualize risk and uncertainty. Based on interviews with policy and industry elites in Australia, China and the UK, it finds that participants did not distinguish between "risk" and "uncertainty" in their conceptualization of climate threats. For the majority of them, politics was the most significant source of risk and uncertainty in climate policy, but delegation of otherwise political decisions to the market was seen as the best solution. The conclusion suggests that the conceptual distinction between risk and uncertainty is less important, for policy and industry elites, than the need to develop mechanisms that account for both persistent scientific uncertainties as well as interpretive and moral ambiguities in climate policy design and implementation. [ABSTRACT FROM AUTHOR]

The transformation of public infrastructure and services into vehicles of profit-making through privately financed and operated partnerships (PPPs) has successfully weathered high profile project failures, changes in government, scathing audits, public resistance, financial crises, fiscal austerity, and found a home around the world despite vastly different legal, cultural, and institutional contexts. Public procurement and traditional budgeting practices are now a distant memory in many jurisdictions – not by happenstance but through dogged efforts to transform public sectors from service provider into commodity purchaser. Understanding the political economy of global PPP markets requires knowing the connection to managerialism underpinning the story of public administration as contract management. This paper explores the emergence, sophistication, and normalization of PPP using primary and secondary sources including interviews with those involved in, or keenly aware of, the historical creation of pioneering PPP markets. It identifies three apposite categories of PPP management: models, methods, and mindsets. Models are homogenously portable yet malleable templates for partnering. Methods include accounting treatment and standards, and new budgeting and tendering practices. Mindsets are the ideas and ideals initially spread by enthusiasts like the Big Five consultancy firms and Macquarie Bank, later entrenched through specialized quasi-public agencies such as Partnerships UK and the World Bank's PPIAF. [ABSTRACT FROM AUTHOR]

This paper explores the UK National Occupational Standards to identify the breadth of occupations for which it has been determined that workers need some degree of religious literacy. A total of 465 standards documents which mention religion and beliefs relating to a diverse range of occupations were retrieved, of which 13 had a primary focus on religion and beliefs. Approximately 60 percent of these standards noted the need for knowledge about religion and beliefs, though only a quarter of these specified actual performance criteria. With some exceptions, most of the standards were vague as to what is meant by religion and its proxies, with very few attempts to define their terms. A lack of specificity renders the inclusion of references to religion largely tokenistic rather than reflecting a measure of religious literacy which could be practically operationalised. [ABSTRACT FROM AUTHOR]

For more than two decades, international healthcare crises and ensuing political debates have led to increasing professional governance and regulatory policy reform. Governance and policy reforms, commonly representing a shift from embodied trust in professionals to state enforceable trust, have challenged professional power and self-regulatory privileges. However, controversy remains as to whether such policies do actually shift the balance of power and what the resulting effects of policy introduction would be. This paper explores the roll-out and operationalisation of revalidation as medical regulatory reform within a United Kingdom National Health Service hospital from 2012 to 2013, and its impact upon professional power. Revalidation policy was subject to the existing governance and management structures of the organisation, resulting in the formal policy process being shaped at the local level. This paper explores how the disorganised nature of the organisation hindered rather than facilitated robust processes of professional governance and regulation, fostering formalistic rather than genuine professional engagement with the policy process. Formalistic engagement seemingly assisted the medical profession in retaining self-regulatory privileges whilst maintaining professional power over the policy process. The paper concludes by challenging the concept of state enforceable trust and the theorisation that professional groups are effectively regulated and controlled by means of national and organisational objectives, such as revalidation. [ABSTRACT FROM AUTHOR]

‘Experiential knowledge’ is increasingly recognised as an important influence on reproductive decision-making. ‘Experiential knowledge of disability’ in particular is a significant resource within prenatal testing/screening contexts, enabling prospective parents to imagine and appraise future lives affected by disability. However, the concept of ‘experiential knowledge’ has been widely critiqued for its idiosyncrasy, its impermanence and consequently its perceived inferiority to (medical) knowledge. This paper explores some of these key critiques of experiential knowledge through an analysis of its constitution and uses in the context of reproductive decision-making. Seventeen UK-resident women with Spinal Muscular Atrophy (SMA), or with SMA in their family, took part in two in-depth interviews: one in 2007–9 and the other in 2013–4. By comparing and contrasting these women's accounts at two time points, this paper demonstrates the stark contrast between ‘lived experience’ of SMA (the visceral everyday realities of life with the condition) and the various way(s) this experience was transformed into, and presented as, ‘knowledge’ through the processes of making, and accounting, for reproductive decisions. The analysis highlights that multiple, distinct and sometimes competing experiential frameworks are used to conceptualise SMA across time and context. However, rather than evidence of its fallibility, this finding highlights that ‘knowledge’ is an inappropriate vessel with which to capture and transfer ‘experiential knowledge’. Rather, we need to consider how to value such insight in ways that harnesses its inherent strength without leaving it vulnerable to the epistemological critiques attracted by labelling it ‘knowledge’. [ABSTRACT FROM AUTHOR]