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The article discusses the closure of local paper "Chronicle and Echo" in Northampton, England. It narrates that the National Union of Journalists has demanded a better mileage rate for old Beetles and Minis around the villages of Northamptonshire from general manager Bill Rodgers. Rodgers lamented about missing out on real journalism with the freedom to write about the people and events in hometown.

Examining the entanglement of democracy and social justice in education and the relationship to social mobility, this paper critiques the individualising nature of social mobility in policy discourse as inimical to human flourishing and education as a public good. The rhetoric of social mobility which responsibilises individuals for their success, without due regard to the systemic changes needed to enable this and the societal barriers to social mobility experienced disproportionately by some groups in society, is detrimental to social justice. A conception of education as a pathway to social mobility must be located in a wider vision of civic engagement in a more inclusive and fairer society. Yet civic engagement in education at the local level has been eroded, as illustrated in this paper by the example of an evolving model of school governance in England. As a corporatist, market driven reform, this model exemplifies how local democratic ties between schools and engagement with their communities can be undermined. Social mobility to enable opportunities, access and participation in democratic civic society becomes a fantasy when society is riven with systemic inequalities, lacks the necessary conditions to enable human flourishing and links to community engagement in education for democratic renewal are downplayed. [ABSTRACT FROM AUTHOR]

This editorial reports on the 2006 MRS (Market Research Society) Annual Conference, held at the London Barbican centre. The conference examined the role of blogs and blogging in market research. The conference also centered on the importance of word of mouth in market research. The article also previews the papers contained in the issue including one by Cramphorn on how to measure advertising effectiveness and another by Johnston and Harris about whether respondents in surveys are statistically different than those people that do not respond.

Over the past decade, there has been a growing trend towards the use of 'big qualitative data' in applied health research, particularly when used as part of mixed methods evaluations of health policy in England. These 'big qualitative' studies tend to be longitudinal, complex (multi-site and multi-stakeholder) and involve the use of multiple methods (interviews, observations, documents) and large numbers of participants (n = 100+). Despite their growing popularity, there is no methodological guidance or methodological reflection on how to undertake such studies. Qualitative researchers are therefore faced with a series of unknowns when designing large qualitative studies, particularly in terms of knowing whether existing qualitative sampling and analysis methods are appropriate in this context. In this paper, we use our experience of undertaking a big qualitative study, as part of a national mixed methods evaluation of a health policy in England to reflect on some of the key challenges that we faced in our qualitative study, which broadly related to: sample size, data analysis and the role of patient and public engagement. Underpinning these difficulties was the challenge of being flexible and innovative within the largely positivist research climate of applied health research and being comfortable with uncertainty relating to the three issues outlined. The reflections we present are not to be viewed as a method 'how to' guide, but rather as a platform to raise key issues relating to the qualitative methods that we found challenging, in order to stimulate discussion and debate amongst the qualitative community. Through this paper, we therefore hope to demystify what it is like to undertake such a study and hope to spark much needed discussion and innovation to support the future design and conduct of qualitative research at scale. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at the 15th European Group for Organizational Studies (EGOS) Colloquium in Warwick, England is presented. One research being presented during the event is on fads and fashions in organizations. The rules set by the organizers to present are also presented. Organizers decided to wear informal clothes during the forum to foster a relaxed environment.

BACKGROUND: A greater understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse amongst adults accessing substance misuse services (SMS) during COVID-19 is required to identify how SMS can better meet the needs of the people who require treatment. AIM: To use a questionnaire to explore OTC/POM misuse during COVID-19 in adults accessing community SMS in England. METHODS: In 2020 to 2021 anonymous self-administered online/paper questionnaires which collated quantitative and qualitative data were completed. They were piloted for suitability and ethical approval was obtained. Thematic analysis was conducted for qualitative data and chi-square tests used to assess the relationship between quantitative variables. RESULTS: Participants were Caucasian (94.6% British), majority male (58.9%), aged 18 to 61 years. Most were prescribed medication for problematic substance use, with a 92.5% self-reported adherence rate. The misuse of benzodiazepines (22.2%) codeine products (30.8%) and pregabalin (14.5%) predominated and 37.5% misused 2 or more medicines. Administration was usually oral and concomitant use of other substances was common: alcohol 44.6% (52% daily), tobacco/vaping 73.2% and illicit substances 58.9%. There were statistically significant associations identified, including between changes during COVID-19 to OTC/POM misuse and illicit use. Only 56 questionnaires were included in the analysis: we believe this low number was because of infection control measures, limited footfall in services, pressures on staff limiting their capacity to distribute the paper questionnaires and reliance upon telephone consultations limiting online distribution. Increasing OTC/POM misuse and obtaining illicit supplies were reported when access to usual supplies were restricted; however, changes to doses/dispensing arrangement liberalisation in response to COVID-19 were positively viewed. CONCLUSION: OTC/POM misuse, including polypharmacy and concomitant use of other substances occurred during COVID-19: SMS need to be vigilant for these issues and mitigate the associated risks for example with harm reduction interventions. Further qualitative research is required to explore the issues identified. [ABSTRACT FROM AUTHOR]

Social work case files hold rich detail about the lives and needs of vulnerable groups. Traditional case-reading studies to gain generalisable knowledge are resource-intensive, however, and sample sizes thereby limited. The advent of 'big data' technology, and vast repositories of centrally stored electronic records offer social work researchers novel alternatives, including data linkage and predictive risk modelling using administrative data. Free-text documents, however – including assessments, reports, and case chronologies – remain a largely untapped resource. This paper describes how 5000 social work court statements held by the Child and Family Court Advisory Support Service in England (Cafcass) were analysed using natural language processing (NLP) based on simple rules and mathematical principles. Thirteen factors relating to harm and risk to children involved in care proceedings in England were identified by automated computer techniques, and almost 90% agreement with professional readers achieved when the factors were clear-cut. The study represents an innovative approach for social work research on complex social problems. In conclusion, the paper discusses learning points; practical implications; future research avenues; and the technical and ethical challenges of NLP. [ABSTRACT FROM AUTHOR]

The article describes some of the experiences involved in treating young adults with personality disorder in a residential setting through the medium of a therapeutic community at the Henderson Hospital in Surrey, England. It compares psychotherapy with sociotherapy. It discusses the pitfalls that complicate the normal processes of personality development and social learning. A description of personality disorder is given.

The article reports on clinical approaches to young disabled children in London, England. Many disabled children were victims of poliomyelitis, tuberculosis, rheumatic fever and chronic infections. These disabilities were acquired after a period of normal growth and development. In contrast, the disabled children have been affected from very early life, and therefore show multiple disabilities.

The article discusses the significance of examining soft tissue sarcoma through radiology, which form a large group of diverse forms of malignancy. According to sources, several imaging techniques are available, but most hospitals are unlikely to have an established scheme of investigation, as sarcomas are seen infrequently. Thus, based from experience of more than 70 patients at the Royal Marsden Hospital in London, England, relative merits of different imaging techniques are presented.

This paper considers the potential for the Mental Capacity Act (MCA) of England and Wales to incentivise the exclusion of people with dementia from research. The MCA is intended to standardise and safeguard the inclusion of people with cognitive impairments in research. This entails various procedural requirements, which in pressurised research contexts can lead researchers to exclude people with dementia as a means of simplifying bureaucratic constraints. I consider the risks of an 'unethical ethics', wherein procedural ethics indirectly causes the exclusion of people with dementia from research, undermining historic successes toward increased inclusivity. I suggest several solutions, including enhanced sensitivity to impairments and shifting the burden of proof from justifying inclusion to justifying exclusion. The paper responds to the 'ethics creep' tradition in procedural ethics, and critical appraisals of capacity legislation in dementia research. This approach recognises that institutional research ethics is itself a major ethical concern and can unwittingly beget unethical practices. Dementia researchers must be alert to such unethical ethics. [ABSTRACT FROM AUTHOR]

The article discusses the author's views on the factors that drive the closure of local papers. He refers to the "Advertiser and Times" in Hampshire, England using the four-unit double-width Hoe Crabtree Viscount press for black and white printing. The author reveals that changes in gathering information, technical innovations, emergence of digital recorders, and the birth of television have prompted the changes in local papers.

The article reports on the launch of "London Metro" at London Underground stations in England. It says that the paper's circulation has topped a million in 2005, and nominated for Newspaper of the Year in the British Press Awards. It indicates that the newspaper has grown worldwide and is excellent at presenting the information that is made available to them by various news agencies.

This paper demonstrates for the first time that prisons with a higher proportion of natural vegetation within their perimeter have lower levels of staff sickness absence. It makes three significant contributions. First, it extends studies of workplace nature contact into the un-researched carceral context. Second, whereas previous workplace nature contact studies have largely utilized single-site surveys, it presents national-level, statistically robust analysis. Third, it brings a novel new perspective to studies of sickness absence within correctional workforces, by considering the effect of the physical environment. Econometric estimations presented in the paper confirm lower levels of staff sick-leave in prisons with more greenspace. This relationship persists when we control for prison size, security level, age, level of crowding, levels of self-harm and violence among prisoners, and assaults against staff. The findings are significant in demonstrating the benefits of nature contact in workplaces in general, and carceral environments in particular. Importantly, this has the potential to influence future prison design. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at the 15th European Group for Organizational Studies (EGOS) Colloquium in Warwick, England is presented. One focus of the event is the presentation of the tips related to production, training and diffusion of management knowledge. Presenters are scholars who collaborate on the research project entitled "The Creation of European Managerial Practice (CEMP)."

This article discusses whether the "Journal of the Royal Society of Medicine" should publish more case reports. Numerous reasons have been put forward in favor of the guaranteed offer of publication for all cases presented at Section meetings. One is that the attendance of certain Sections at meetings is poor, represents a small proportion of the total membership of the Section, and increasingly makes up London, England-based Fellows of many years standing.

The article discusses certain issues related to inherited colorectal cancer in England. According to reports the risk of developing colorectal cancer in people who have a first-degree relative with the disease is higher. Medical research suggested that colonic ultrasonography is an effective method for diagnosis of cancer. A National Registry in England, which will contain family histories of cancer patients, would help improve the management and prognosis of cancer patient .

This article addresses the methodological challenge of capturing and comparing children's experiences of everyday life by using a novel rhythmanalysis approach to explore the experiences of a small sample (N = 16) of home based children aged 7–10 in England and Greece during the 2020 global lockdown. The children kept a 1 day diary in which they recorded their activities and feelings at regular intervals during their waking hours. The data collected indicates that the children's lives were both disrupted and synchronised during this period, and highlights how their individual experiences were interconnected in time and space by shared rhythms which underpinned the patterns of their day. The paper highlights the utility of the specially designed rhythmanalysis data collection tool and analytical approach for future comparative international studies of children's everyday lives. [ABSTRACT FROM AUTHOR]

In this paper, I explore how different conceptions of public value influence the types of co-production that professionals undertake in delivering projects to reduce loneliness and isolation of older people. The analysis shows a preponderance of individual and group co-production by the case in England, driven by aims to create user and group value, whereas the French case emphasizes collective co-production linked to social and political value. The research contributes to the co-production literature by showing how types of co-production are prioritized to a different extent to address the same social problem, shaped in part by cultural and political context. [ABSTRACT FROM AUTHOR]

Objectives: The National Health Service Bowel Cancer Screening Programme (NHS BCSP) in England has replaced guaiac faecal occult blood testing by faecal immunochemical testing (FIT). There is interest in fully exploiting FIT measures to improve bowel cancer (CRC) screening strategies. In this paper, we estimate the relationship of the quantitative haemoglobin concentration provided by FIT in faecal samples with underlying pathology. From this we estimate thresholds required for given levels of sensitivity to CRC and high-risk adenomas (HRA). Methods: Data were collected from a pilot study of FIT in England in 2014, in which 27,238 participants completed a FIT. Those with a faecal haemoglobin concentration (f-Hb) of at least 20 µg/g were referred for further investigation, usually colonoscopy. Truncated regression models were used to explore the relationship between bowel pathology and FIT results. Regression results were applied to estimate sensitivity to different abnormalities for a number of thresholds. Results: Participants with CRC and HRA had significantly higher f-Hb, and this remained unchanged after adjusting for age and sex. While a threshold of 20 μg/g was estimated to capture 82.2% of CRC and 64.0% of HRA, this would refer 7.8% of participants for colonoscopy. The current programme threshold used in England of 120 μg/g was estimated to identify 47.8% of CRC and 25.0% of HRA. Conclusions: Under the current diagnostic policy of dichotomising FIT results, a very low threshold would be required to achieve high sensitivity to CRC and HRA, which would place further strain on colonoscopy resources. The NHS BCSP in England might benefit from a diagnostic policy that makes greater use of the quantitative nature of FIT. [ABSTRACT FROM AUTHOR]

There are many different forms and interpretations of rewilding: the concept and its practice vary from country to country, with distinct interpretations according to its geographical location. Despite the term rewilding having been present in the lexicon for three decades, the concept of rewilding in England has experienced a prolonged developmental stage. This paper argues that a unique form of English rewilding is now emerging, which is distinct from rewilding in other parts of the world. Compared to other locations rewilding in England operates at smaller spatial scales; its ambitions to increase biodiversity, restore ecosystem functioning and increase natural autonomy are somewhat curtailed; it involves higher levels of human intervention; and, perhaps most tellingly of all, it goes by another name – ‘wilding’, ‘wild’ or ‘wilder’ with little mention of the much-maligned prefix ‘re’. This conclusion has been developed following a comparative case study of two English ‘rewilding’ sites (the Avalon Marshes and Wild Ennerdale) involving 49 semi-structured interviews: twelve expert interviews and nineteen and eighteen stakeholder/practitioner interviews at the Avalon Mashes and Wild Ennerdale respectively. [ABSTRACT FROM AUTHOR]

The article profiles obstetrician Robert Lee, member of the Royal Society of Medicine Press Ltd. in London, England. Lee was born in 1793 and graduated in medicine in 1814 in Scotland. He practiced midwifery and obstetrics in several medical institutions and became a professor of midwifery in Glasgow. He made a series of observations related to obstetrics including the gravid and non-gravid uteruses.

We investigated the reasons why the transition from paper to electronically formatted records during patient handover between ambulance crews and emergency department staff in a North East England Emergency Department has not always been viewed positively. Interviews with seven paramedics and three emergency department staff were conducted in addition to observations of 74 ambulance staff during 37 handovers in the emergency department. In just over half of the handovers (20), paramedics found it necessary to provide written information to aid emergency department staff, in addition to that recorded electronically. There were a number of issues that impeded the ready utilisation of electronic records in this context. The major factors identified as contributing to this were the choice of system architecture, the design of user interfaces, and the procurement process used by the National Health Service. We have made some suggestions about how the system could evolve from one focused on providing management information to one that also supports operational needs. [ABSTRACT FROM AUTHOR]

This paper examines the structure of wages in a very specific labor market: care assistants in residential homes for the elderly on England's "sunshine coast." This sector corresponds closely to economists' notion of what should be a competitive labor market, both because it has a large number of small firms undertaking a very homogeneous activity in a concentrated geographical area, and because the workers are neither unionized nor covered by any minimum wage legislation, so that there are effectively no external constraints on the wage-setting process. The authors find that the wage structure deviates in important respects from what would be expected in a competitive labor market. In particular, wage dispersion is small within firms, but large between firms; and the wage dispersion that is present does not seem to be closely related to workers' productivity-related characteristics. A test rejects the hypothesis that unobserved labor quality can explain these findings. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at the 15th European Group for Organizational Studies (EGOS) Colloquium in Warwick, England is presented. One session focuses on a research that concerns the role of gender, race and class in organizations. Other sessions focus on gendered identities presented by Yvonne Guerrier and Amel Adib and on industrial relations.

Recent educational reforms in England have sought to reshape public education by extending central government control of curriculum and assessment, while replacing local government control of schools with a quasi-private system of academies and multi academy trusts. In this paper, we resist reading this as the latest iteration of the debate between "traditional" and "progressive" education. Instead, we note how, despite the mobilisation of the rhetoric of the public and public education, schooling in England has never been public in any deeply meaningful sense. We develop a genealogical reading of public education in England, in which ideas of British universalism – "the public" – and inequality and exclusion in education and society have not been opposed but have gone hand-in-hand. This raises the question whether it is possible to envisage and enact another form of collective – one that is based on action rather than fantasy and that is co-authored by, comprising, and exists for, the people. The final part of this paper seeks to grapple with this challenge, in the context of past, present and future potential developments in education, and to consider possibilities for the imaginary reconstitution of public education in England in the twenty-first century. [ABSTRACT FROM AUTHOR]

Substance use and mental ill health constitute a major public health burden, and a key global policy priority is to reduce illicit and other harmful substance use. Amphetamine-type stimulants (ATS) are the second most used class of illicit drugs and a range of mental health issues have been documented amongst users. This paper explores the relationship between mental health and ATS use, through a thematic analysis of qualitative interviews with n = 18 current and former ATS users in England. The findings are presented by trajectory point of; (1) Initiation of ATS use; (2) continued and increased ATS use and (3) decreased and remitted ATS use. This work helps to develop understanding around the complex and bi-directional relationship between ATS use and mental health. Many ATS users lead chaotic lives and engage in multiple risk behaviours, however there is a need to better understand and conceptualise the dynamic interaction between different individual, social, environment and cultural factors that determine individuals' mental health and substance use. There is no 'one size fits all' approach to prevention and treatment, and these findings highlight the need for more joined-up, tailored and holistic approaches to intervention development. [ABSTRACT FROM AUTHOR]

The article focuses on caring for patients with chronic mental illness. Such patients suffer from severe problems, such as aggression or socially unacceptable behavior. Problems are faced in the management of such patients, because community mental health centers don't give priority to their care service. In Newcastle, England, there is a unit for such aggressive patients. The unit consists of a consultant psychiatrist, a behavior therapist, and a clinical nurse specialist.

Focuses on the 1999 Conference of the European Group for Organizational Studies at the University of Warwick in Warwickshire, England. Multi-cultural conference; Informal atmosphere of the conference; Role of paper discussants; Pros and cons of the venue; Plenary talk by Silvia Gherardi.

Information about several papers discussed at the 15th European Group for Organizational Studies (EGOS) Colloquium in Warwick, England is presented. One forum is entitled "Organizational Change in Transforming Societies," which analyzes the processes of organizational changes in countries of radical socio-political and economic changes. Conveners of the research include Ed Clark, Rainhart Lang and Károly Balaton.

Background: The clinical and economic burden of pulmonary arterial hypertension (PAH) is poorly understood outside the United States. This retrospective database study describes the characteristics of patients with PAH in England, including their healthcare resource utilisation (HCRU) and associated costs. Methods: Data from 1 April 2012 to 31 March 2018 were obtained from the National Health Service (NHS) Digital Hospital Episode Statistics database, which provides full coverage of patient events occurring in NHS England hospitals. An adult patient cohort was defined using an algorithm incorporating pulmonary hypertension (PH) diagnosis codes, PAH-associated procedures, PH specialist centre visits and PAH-specific medications. HCRU included inpatient admissions, outpatient visits and Accident and Emergency (A&E) attendances. Associated costs, calculated using national tariffs inflation-adjusted to 2017, did not include PAH-specific drugs on the High Cost Drugs list. Results: The analysis cohort included 2527 patients (68.4% female; 63.6% aged ⩾50 years). Mean annual HCRU rates ranged from 2.9 to 3.2 for admissions (21–25% of patients had ⩾5 admissions), 9.4–10.3 for outpatient visits and 0.8–0.9 for A&E attendances. Costs from 2013 to 2017 totalled £43.2M (£33.9M admissions, £8.3M outpatient visits and £0.9M A&E attendances). From 2013 to 2017, mean cost per patient decreased 13% (from £4400 to £3833) for admissions and 13% (from £1031 to £896) for outpatient visits, but increased 52% (from £81 to £123) for A&E attendances. Conclusion: PAH incurs a heavy economic burden on a per-patient basis, highlighting the need for improved treatment strategies able to reduce disease progression and hospitalisations. The reviews of this paper are available via the supplemental material section. [ABSTRACT FROM AUTHOR]

The article presents news and information related to organization studies worldwide in 1989 and 1990. The 1990 World Congress of Sociology will be held by the Sociology of Organizations in Madrid, Spain. The annual conference titled "Organisation and Control of the Labour Process" will be held by Aston University in England. The Second Conference on Socio-Economics will be held at George Washington University in Washington, D.C. Information on the Coudenhove-Kalergi Foundation, European University Award for 1989 is given. The Seventh International Conference on Organizational Symbolism and Corporate Culture will be held at the University of Saarland in Saarbrucken, Germany.

This paper describes an ethnographic study of customers' experiences of travelling on the London Underground. The research was applied to help identify why there was an apparent perception gap between the more positive results from passenger satisfaction surveys and the negative results, and low levels of advocacy, measured in brand image surveys. The crucial insight from the research was that brand associations are almost wholly independent of the actual journey experience: the journeys themselves were mainly satisfactory, but negative associations persisted. Alongside rational complaints about the Tube -- such as reliability and the ageing infrastructure -- there sat a more emotional and deep-rooted set of feelings that focused on the experience of being underground. The implications of this research are now embedded into London Underground's long-term strategy in a wide range of areas. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare professionals have development needs related to their consumption, use, and practice of clinical research. Little is known about these issues in mental health services specifically. Objectives: A survey of healthcare staff working in an NHS Mental Health and Disability Trust in England was conducted to describe research capacity and culture compared with previously reported samples, and to examine subgroup differences. Methods: An online questionnaire was utilized. The main measure was the Research Capacity and Culture tool comprising measures of individual's perceived research skills and of team and organizational research culture. Previous studies using the same measure were systematically identified, and pooled results, weighted by sample size, were calculated. Analyses were descriptive (current sample versus previous results) and inferential (comparisons between demographic and professional groups within the current sample). Results: N = 293 people completed the survey. The median item scores were poorer than those of pooled samples from studies reporting median item scores on 39/51 (76.5%) occasions and poorer than those pooled samples of studies reporting mean item scores on 51/51 (100.0%) occasions. Individual capability for research was in the 'less than adequate' range more than in previous samples (71.4% vs. 42.9%). For team culture items, the proportions were 84.2% vs. 78.9%, while most responses about organizational culture were in the 'adequate' range (55.6% vs. 66.7%). Staff >20 years employment had poorer perceptions of team and organizational culture. Conclusion: Perceptions of individual research capacity and team and organizational culture were poor compared with previous studies, most of which were conducted in non-mental health settings. There is need for development of research capacity and culture in mental health services including opportunities to develop basic research skills through to strategic developments to promote clinical academic careers. There is considerable room for improvement in the way organizations support research and signpost opportunities. [ABSTRACT FROM AUTHOR]

Objective Some degree of general worry about cancer may facilitate screening participation, but specific worries about the potential consequences (e.g. treatment, death) may act as deterrents. No studies have examined these associations in the same sample. We assessed associations between general versus specific cancer worries and cancer screening participation. Methods In 2016, a population-based cross-sectional survey of adults living in England was carried out. This paper reports analyses of a subsample (n = 1694). Measures included (i) frequency of general cancer worry, (ii) specific worries about the emotional and physical consequences of a cancer diagnosis, and (iii) specific worries about the social consequences of a cancer diagnosis. Logistic regression analyses examined their association with self-reported screening uptake among participants eligible for cervical (n = 671), breast (n = 323), and colorectal (n = 368) cancer screening. Results Frequency of general cancer worry was not associated with screening participation. Specific worry about the emotional and physical consequences increased the odds of participants reporting regular uptake of colorectal screening (OR 1.41, 95% CI 1.04–1.90). Specific worry about the social consequences of diagnosis was negatively associated with regular attendance for cervical and breast screening in unadjusted analyses only. In adjusted models, the associations were no longer statistically significant for cervical (OR 0.82, 95% CI 0.65–1.03) or breast (OR 0.69, 95% CI 0.45–1.04) screening. Conclusions Specific worries about cancer may be differentially associated with participation across screening programmes. Further research is needed, as interventions to optimise informed participation may be improved if the specific worries associated with low participation in each programme are understood. [ABSTRACT FROM AUTHOR]

Background: Identifying clusters of co-occurring diseases may help characterise distinct phenotypes of Multiple Long-Term Conditions (MLTC). Understanding the associations of disease clusters with health-related outcomes requires a strategy to assign clusters to people, but it is unclear how the performance of strategies compare. Aims: First, to compare the performance of methods of assigning disease clusters to people at explaining mortality, emergency department attendances and hospital admissions over one year. Second, to identify the extent of variation in the associations with each outcome between and within clusters. Methods: We conducted a cohort study of primary care electronic health records in England, including adults with MLTC. Seven strategies were tested to assign patients to fifteen disease clusters representing 212 LTCs, identified from our previous work. We tested the performance of each strategy at explaining associations with the three outcomes over 1 year using logistic regression and compared to a strategy using the individual LTCs. Results: 6,286,233 patients with MLTC were included. Of the seven strategies tested, a strategy assigning the count of conditions within each cluster performed best at explaining all three outcomes but was inferior to using information on the individual LTCs. There was a larger range of effect sizes for the individual LTCs within the same cluster than there was between the clusters. Conclusion: Strategies of assigning clusters of co-occurring diseases to people were less effective at explaining health-related outcomes than a person's individual diseases. Furthermore, clusters did not represent consistent relationships of the LTCs within them, which might limit their application in clinical research. [ABSTRACT FROM AUTHOR]

Background: Length of stay (LOS) is frequently employed as a performance metric for trauma care. Following the establishment of the trauma network worldwide, the assessment and prediction of LOS in different levels of trauma centres have been extensively studied. However, assessing the total patient length of stay from a whole trauma network perspective is unclear. The objective of this study was to systematically analyse the overall Length of Stay (LOS) pattern within the SWTN before its establishment and in the immediate time after its foundation and, secondly, to assess the association between relevant impact factors and LOS. Methodology: A retrospective secondary analysis based on the trauma admission dataset from Trauma Audit and Research Network(TARN) dataset was conducted. The studied sample covered around 18000 patients admitted to trauma centres from South Wales Major trauma network between January 2012 and October 2021. The primary outcome is the total length of stay in the trauma network. Statistical tests were applied to examine the difference between normal and outlier LOS. Data visualisation was utilised to demonstrate the LOS patterns and potential association between LOS and relevant demographic and clinical predictors. Results: The distribution of length of stay in SWTN follows a right-skewed distribution with a median of 10 (IQR, 5–18) and a mean of 15.92 days. There were 1520 patients with outliers for LOS. A significant difference (p¡ 0.05) was found between the normal and outlier groups of LOS based on demographic (age, gender and residential information) and clinical characteristics(ward type, maximum of anatomically-based injury severity score(AIS) and probability of survival). Age group, maximum AIS score on specific injured region, ward type and its interaction effect with the number of admissions may associated with the LOS. Specifically, patients admitted to the geriatric ward exhibited notably prolonged LOS, and individuals with more than 2 admissions to long-term care and recovery-related wards such as neurosurgical rehabilitation, spinal injuries and burns wards also displayed elevated LOS. Conclusion: Our finding supports prior evidence indicating elderly people are vulnerable to longer stays. Moreover, concerning the types of admission wards, patients admitted to rehabilitation wards who underwent more than 2 hospitalisations also faced an increased risk of prolonged stay. Based on these results, policymakers and healthcare providers should contemplate expanding the allocation of medical resources to this demographic to mitigate the length of stay and optimise associated healthcare costs. [ABSTRACT FROM AUTHOR]

Objectives The NHS bowel screening programme offers people aged 60-69 screening by faecal occult blood (FOB) testing, with colonoscopy as the diagnostic test. This paper describes the calculation of targets for the purpose of monitoring screening performance in the programme. Methods Targets were calculated for the prevalent round of screening in people aged 60-69, and for the 'steady state' of the programme when people will be offered their first screen at age 60 and subsequent screens at ages 62-69. Targets for the cancer and adenoma detection rates per 1000 people screened and per 100 colonoscopies were calculated using information from the English bowel cancer screening pilot. Results For the prevalent round, prevalent screen and incident screens the calculated targets for the cancer detection rate are 2.3, 1.3 and 1.7 per 1000 people respectively. For the adenoma detection rate the targets are 6.7, 5.2 and 5.5 per 1000 respectively. Targets for the cancer detection rate per 100 colonoscopies are 11.3, 7.5 and 8.4 and those for the adenoma detection rate are 32.0, 30.4 and 32.5 respectively. Conclusions The purpose of these targets is to ensure that the national bowel cancer screening programme is effective with a high quality of screening. The cancer detection and adenoma detection rates per 1000 people are those estimated to be necessary to achieve the expected mortality reduction. Rates per 100 colonoscopies (equivalent to the positive predictive value of referral to colonoscopy) are designed to maintain a high quality of screening by minimizing the number of false-positive referrals. [ABSTRACT FROM AUTHOR]

The article reports on the development of "The Times" newspaper in London, England. It says that the newspaper features new format that uses digest to ensure more headlines on the front of the compact than on the broadsheet. It shows that newspaper sell more at full price, and the average Saturday sale has increased from 680,000 to 780,000.

This paper explores the neglected issue in the 'globalisation' debate concerning the contraction and withdrawal of capital from the territories. The analysis is built upon consideration of the institutional architecture, state inter-relations and territoriality and nationality of capital. The paper concludes that historical evolution and contingency are critical to left analysis of the 'globalisation' of capital and may help to resist and contest regressive changes and lay the foundations of collaboration and alliance building for more progressive economic and social strategies. [ABSTRACT FROM AUTHOR]

The authors discusses their experiences while attending the 15th European Group for Organizational Studies (EGOS) Colloquium in Warwick, England. They are presenters at one of the forums where they discuss their organizational research. They also describe their enjoyment during the evening gala. Part of the event is the exhibition participated by publishers.

Between January 1978 and December 1987 there were 23 557 surgical admissions to the University Surgical Unit in Southampton. During this period there were 543 deaths, an overall death per admission rate of 2.3%. During the 10-year period the number of admissions per year had risen from 1884 in 1978 (death per admission=3.6%) to 3467 in 1987 (death per admission rate= 1.7%). At the monthly audit meeting an attempt was made to classify each death as 'avoidable' or 'unavoidable'. During this 10-year period it was considered that there were 89 `avoidable' deaths. This represents an avoidable mortality rate (AMR) of 0.38%. These 'avoidable' deaths were due to a wide variety of causes and this paper discusses the lessons learnt from a review of surgical mortality and outlines how units might compare results. [ABSTRACT FROM AUTHOR]

Objectives: To establish principles informing a new scoring system for the UK’s Clinical Impact Awards and pilot a system based on those principles. Design: A three-round online Delphi process was used to generate consensus from experts on principles a scoring system should follow. We conducted a shadow scoring exercise of 20 anonymised, historic applications using a new scoring system incorporating those principles. Setting: Assessment of clinical excellence awards for senior doctors and dentists in England and Wales. Participants: The Delphi panel comprised 45 members including clinical excellence award assessors and representatives of professional bodies. The shadow scoring exercise was completed by 24 current clinical excellence award assessors. Main outcome measures: The Delphi panel rated the appropriateness of a series of items. In the shadow scoring exercise, a novel scoring system was used with each of five domains rated on a 0–10 scale. Results: Consensus was achieved around principles that could underpin a future scoring system; in particular, a 0–10 scale with the lowest point on the scale reflecting someone operating below the expectations of their job plan was agreed as appropriate. The shadow scoring exercise showed similar levels of reliability between the novel scoring system and that used historically, but with potentially better distinguishing performance at higher levels of performance. Conclusions: Clinical excellence awards represent substantial public spending and thus far the deployment of these funds has lacked a strong evidence base. We have developed a new scoring system in a robust manner which shows improvements over current arrangements. [ABSTRACT FROM AUTHOR]

The authors reflect on the performance of health in England, as published in the November 2004 White Paper of Great Britain's government. They stressed that most of the consumers wish to make their own health choices though they still need help in coping with harmful factors. They assessed that this paper differs from any previous document in proposing public health back to the public. They pointed out that the current emphasis on preventive targets boosts strong emotions among clinicians.

Introduction: Ulceration of the foot is a common problem among diabetic patients. Infection is a major risk in diabetic foot ulcers (DFU) and many of these are caused by Staphylococcus aureus, in particular meticillin-resistant strains (MRSA). The control and management of MRSA remains a significant challenge and all healthcare organisations in England are required to meet Zero Tolerance Objectives for cases of MRSA bacteraemia (MRSAB). This paper describes a collaborative approach across the health economy to investigate factors contributing to the acquisition of MRSA and MRSAB among DFU patients and make improvements to care to reduce the risk of healthcare-associated infections. Methods: A collaborative approach between acute and community healthcare providers and commissioners was used to conduct Root Cause Analysis and drive improvement to prevent MRSA transmission in DFU patients. Results: Screening of all DFU patients was initiated after 6 MRSAB were found to be associated with in DFU. In total 15 patients with the same MRSA antibiogram were identified. Following the implementation of actions focused on isolation, wound management, screening and cleaning no further cases were identified. Conclusion: This outbreak has demonstrated the value of cross-sector collaboration in investigating HCAI in patients with DFU, improving patient care and reducing the risk of MRSA transmission in these vulnerable patents. [ABSTRACT FROM AUTHOR]

Background: Screening for abdominal aortic aneurysm, and intervention with elective repair, can reduce the incidence of aneurysmal rupture by a half. If a screening programme is implemented, it is essential to determine appropriate follow up intervals for rescreening. This paper estimates probabilities of progression growth of aortic diameter to provide evidence for this. Methods: Data were taken from 2342 men aged 65–80 screened in the Chichester randomised control trial, who have been followed up for an average of 11 years. Aortic diameter was modelled as a Markov process with four categories: <30 mm (normal), 30–44 mm, 45–54 mm, and ≥55 mm. Estimates of the probabilities of progressing to each higher category were obtained. Results: The probabilities of progression increased with greater initial aortic diameter. The estimated rates/year were 0.018 (95% confidence interval 0.014 to 0.023), 0.16 (0.12 to 0.20), and 0.49 (0.35 to 0.70) respectively for moving up one category. The probabilities of moving from <30 mm to ≥55 mm were estimated as 1% in 5 years and 12% in 15 years, while the corresponding figures for moving from 45–54 mm to ≥55 mm were 91% and 99%. There were differences in rates of progression according to age, with men over 70 years having rates about three times those of men under 70. Conclusions: It seems unnecessary to follow up men with normal aortic diameter as they experience a low probability of reaching criteria for surgery even within 15 years. However, follow up intervals should be progressively shorter for those with greater aortic diameter, especially in those aged over 70. Active follow up, for example every 3 months, is appropriate for men with an aortic diameter of 45–54 mm. [ABSTRACT FROM AUTHOR]

Background: Multiple long-term health conditions (MLTCs) are common and increasing among older people, yet there is limited understanding of their prevalence and association with social care expenditure. Aim: To estimate the prevalence of MTLCs and association with English social care expenditure. Methods: Our study population included those aged ≥ 65 who died in England in the year 2018 with any of the following long-term conditions recorded on their death certificate: diabetes; cardiovascular diseases (CVDs) including hypertension; dementia; stroke; respiratory; and chronic kidney diseases (CKDs). Prevalence was based on the proportion of death reported for older people with MTLCs (≥ 2) in each of the 152 English Local Authorities (LAs). Ordinary least square regression (OLS) was used to assess the relationship between prevalence of MTLCs and adult social care expenditure, adjusting for LA characteristics. Results: Of the 409551 deaths reported, 19.9% (n = 81395) had ≥ 2 MTLCs, of which the combination of CVDs-diabetes was the most prevalent. Hospitals were the leading place of death for those with MTLCs. Results from the OLS regression model showed that an increased prevalence of MLTCs is associated with higher LA social care expenditure. A percentage point increase in prevalence of MLTCs is associated with an increase of about £8.13 in per capita LA social care expenditure. Conclusion: Our findings suggest that the increased prevalence of MTLCs is associated with increased LA social care expenditure. It is important for future studies to further explore the mechanisms or link between LA social care expenditure and the prevalence of MTLCs. [ABSTRACT FROM AUTHOR]

Background: Multimorbidity is a major challenge to health and social care systems around the world. There is limited research exploring the wider contextual determinants that are important to improving care for this cohort. In this study, we aimed to elicit and prioritise determinants of improved care in people with multiple conditions. Methods: A three-round online Delphi study was conducted in England with health and social care professionals, data scientists, researchers, people living with multimorbidity and their carers. Results: Our findings suggest a care system which is still predominantly single condition focused. 'Person-centred and holistic care' and 'coordinated and joined up care', were highly rated determinants in relation to improved care for multimorbidity. We further identified a range of non-medical determinants that are important to providing holistic care for this cohort. Conclusions: Further progress towards a holistic and patient-centred model is needed to ensure that care more effectively addresses the complex range of medical and non-medical needs of people living with multimorbidity. This requires a move from a single condition focused biomedical model to a person-based biopsychosocial approach, which has yet to be achieved. [ABSTRACT FROM AUTHOR]

Background: Diagnostic needle arthroscopy offers an alternative imaging modality to magnetic resonance imaging (MRI) for the diagnosis of intra-articular pathology. Purpose: To compare the accuracy of a needle arthroscopy device (Mi-eye2) versus MRI in identifying intra-articular anatomic abnormalities in the glenohumeral joint, with formal arthroscopy as the gold standard. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 22 patients underwent diagnostic needle arthroscopy of the shoulder, of whom 20 had preoperative MRI scans. A standardized 12-point noninstrumented diagnostic arthroscopy was performed on each patient using the 0° needle arthroscope, followed by a 30°, 4 mm–diameter conventional arthroscope. Intraoperative images were randomized and reviewed by 2 independent blinded fellowship-trained shoulder surgeons for identification of key pathology and anatomic structures. The MRI scans were reviewed by a single musculoskeletal radiologist to identify pathology in the same key areas. Results: For the identification of rotator cuff pathology, needle arthroscopy (sensitivity, 0.75; specificity, 1.00) was superior to MRI (sensitivity, 0.75; specificity, 0.75) with an interobserver reliability (κ) of 0.703. For long head of the biceps pathology, needle arthroscopy (sensitivity, 0.67; specificity, 0.95) was superior to MRI (sensitivity, 0.00; specificity, 0.83). It was less accurate for labral (sensitivity, 0.33; specificity, 0.50; κ = 0.522) and articular cartilage pathology (sensitivity, 0.00; specificity, 0.94; κ = 0.353). The number of anatomic structures that could be clearly identified was 8.35 of 12 (69.58%) for needle arthroscopy versus 10.35 of 12 (86.25%) for standard arthroscopy. Conclusion: Diagnostic needle arthroscopy was found to be more accurate than MRI for the diagnosis of rotator cuff and long head of the biceps pathology but was less accurate for diagnosing labral and cartilage pathology. Although the field of view of a 0° needle arthroscope is not equivalent to a 30° conventional arthroscope, it presents an alternative with potential for use in an outpatient setting. [ABSTRACT FROM AUTHOR]

The article offers a study on how one organization was able to achieve its goals through marketing research. Discussed are issues relevant to both councils and research agencies, and the case study demonstrates how consultation techniques must continue to evolve in order to meet the needs of its participants, if it wants to continue to be successful. Attention is given voter turnout in the 1998 Barnsley, England local election. The voters were grouped into four categories: conscientious voters, casual pragmatists, sceptical bystanders, and outright rejectors, and motivating and inhibiting factors are examined.