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Background The Medical Certificate of Stillbirth (MCS) records data about a baby's death after 24 weeks of gestation but before birth. Major errors that could alter interpretation of the MCS were widespread in two UK-based regional studies. Methods A multicentre evaluation was conducted, examining MCS issued 1 January 2018 to 31 December 2018 in 76 UK obstetric units. A systematic case-note review of stillbirths was conducted by Obstetric and Gynaecology trainees, generating individual 'ideal MCSs' and comparing these to the actual MCS issued. Anonymized central data analysis described rates and types of error, agreement and factors associated with major errors. Results There were 1120 MCSs suitable for assessment, with 126 additional submitted data sets unsuitable for accuracy analysis (total 1246 cases). Gestational age demonstrated 'substantial' agreement [K = 0.73 (95% CI 0.70–0.76)]. Primary cause of death (COD) showed 'fair' agreement [K = 0.26 (95% CI 0.24–0.29)]. Major errors [696/1120; 62.1% (95% CI 59.3–64.9%)] included certificates issued for fetal demise at <24 weeks' gestation [23/696; 3.3% (95% CI 2.2–4.9%)] or neonatal death [2/696; 0.3% (95% CI 0.1–1.1%)] or incorrect primary COD [667/696; 95.8% (95% CI 94.1–97.1%)]. Of 540/1246 [43.3% (95% CI 40.6–46.1%)] 'unexplained' stillbirths, only 119/540 [22.0% (95% CI 18.8–25.7%)] remained unexplained; the majority were redesignated as either fetal growth restriction [FGR: 195/540; 36.1% (95% CI 32.2–40.3%)] or placental insufficiency [184/540; 34.1% (95% CI 30.2–38.2)]. Overall, FGR [306/1246; 24.6% (95% CI 22.3–27.0%)] was the leading primary COD after review, yet only 53/306 [17.3% (95% CI 13.5–22.1%)] FGR cases were originally attributed correctly. Conclusion This study demonstrates widespread major errors in MCS completion across the UK. MCS should only be completed following structured case-note review, with particular attention on the fetal growth trajectory. [ABSTRACT FROM AUTHOR]

European countries in which universities rely on public funding increasingly follow the lead of the United Kingdom and run Research Assessment Exercises. Given the subjective nature of such evaluations, some scientists prefer verifiable measures such as citation counts. This, however, also is prone to problems since the number of cites is correlated, among others, with the order of appearance in an issue. In particular, leading papers are more cited. It is, thus, difficult to assess whether they are of better quality, or whether this happens because they appear first in an issue. We make use of a natural experiment that was carried out by a journal in which papers are randomly ordered in some issues, while this order is at the editors’ discretion in other issues. Our estimates suggest that approximately two thirds of the additional cites are due to going first, and one third to higher quality. [ABSTRACT FROM PUBLISHER]

This article talks about international trade in the period between 1862-1879, or the greenback period. F.W. Taussig, a professor, concluded in 1917 that with the U.S., which was using inconvertible paper money as monetary standard, borrowing heavily and continuously from Great Britain, which was using gold as basis, there will be increased sterling supply in New York and lowered cost, in U.S. paper, of imported commodities. The author noted that when both countries are on a gold basis, there will be an influx of gold from Great Britain in the U.S. and general prices will rise, while they fall in Great Britain. He concluded that the large borrowing operations of the U.S. in the 1860s was an important factor in the disturbance of the normal course of trade.

Health inequalities research has a long history in the United Kingdom, and the development of government policies that are intended to explicitly address the existing health inequalities has been gathering pace since the Labour Party returned to power in 1997. In this paper, using the influential Acheson Report as a reference point, one of us (D.N.) describes how health inequalities policies have been developed, and the other (A.O.) assesses how, ideally, such policies ought to be developed. Although progress in the development of health inequalities policies has been made, the policies, and the evidence that has informed them, have been less than ideal. [ABSTRACT FROM PUBLISHER]

— Alcohol misuse constitutes a major problem in our modern society and both physical and mental alcohol-related harm result in a large number of Accident and Emergency (A&E) attendances, thus imposing a significant burden on the workload and financial resources of the department. The current management of problem drinking by most A&E departments could be further improved. The introduction of a holistic approach that includes efficient screening instruments and effective brief, anti-alcoholic interventions, for the management of these patients must be considered. This should strengthen the preventive role of A&E departments, and, in the long term, may result in a decrease in the number of cases of alcohol misuse and in alcohol-related attendances. [ABSTRACT FROM PUBLISHER]

Background There is a challenging lack of evidence to inform best practice in the routine clinical care of juvenile idiopathic arthritis (JIA). Wide inter-centre variation in the definition and documentation of clinical data items is a major barrier to improvement. In response, we have developed a consensus agreed standardised core dataset called CAPTURE-JIA (n = 62 data items and a 'data dictionary' including agreed definitions of terms) designed to support routine collection of high-quality clinical data. The feasibility and acceptability of CAPTURE-JIA in clinical practice is not yet known and was the focus of this pilot study. Methods A purposeful sample of six paediatric rheumatology centres across England was invited to collect the CAPTURE-JIA dataset using paper collection forms (n = 20 patients/centre). The dataset was analysed for missing data. Six focus groups (n = 3-10) explored clinicians' views on acceptability and feasibility. Results One hundred and twenty-one patients were recruited over three months. The completeness of the dataset was similar across centres, with minor variations. The majority of data items (eg demographics, dates, ILAR type and examination) were >80% completed. However, 14/62 data items received >40% missing data. (Table 1) Further descriptive analyses highlighted incorrect completion of paper forms. Three themes emerged from the focus groups: problematic data items (missing from >10% forms at > 1 centre), format of clinician data forms and the role of digital data collection. Suggested solutions included minor changes to data item definitions and formatting. There were no refinements to the data items. Development of a digital data collection system was identified by all as essential. Due to a lack of clear consensus, the original CAPTURE forms included a number of ways to record joint count data. This proved confusing and a unanimous decision was taken to collect joint count data on all 83 joints in a tabular format. P10 Table 1: CAPTURE JIA data items with >40% missing data Data item  % forms with data item missing (if item required)  Relevant co-morbidities?  60  Macrophage activation syndrome?  100  Has the ILAR subtype changed?  50  Morning stiffness lasting >15 minutes?  42  History of any form of uveitis?  52  Date started uveitis mediation?  50  Strength of uveitis medication?  83  Counselled prior to new DMARD / biologic?  56  Enrolled in BECS/BCRD if new DMARD / biologic?  48  Joint count (homunculus or table format)  48  Physician assessment of systemic disease activity (VAS)  75  ESR  74  CRP  92  Plasma viscosity  100  Data item  % forms with data item missing (if item required)  Relevant co-morbidities?  60  Macrophage activation syndrome?  100  Has the ILAR subtype changed?  50  Morning stiffness lasting >15 minutes?  42  History of any form of uveitis?  52  Date started uveitis mediation?  50  Strength of uveitis medication?  83  Counselled prior to new DMARD / biologic?  56  Enrolled in BECS/BCRD if new DMARD / biologic?  48  Joint count (homunculus or table format)  48  Physician assessment of systemic disease activity (VAS)  75  ESR  74  CRP  92  Plasma viscosity  100  P10 Table 1: CAPTURE JIA data items with >40% missing data Data item  % forms with data item missing (if item required)  Relevant co-morbidities?  60  Macrophage activation syndrome?  100  Has the ILAR subtype changed?  50  Morning stiffness lasting >15 minutes?  42  History of any form of uveitis?  52  Date started uveitis mediation?  50  Strength of uveitis medication?  83  Counselled prior to new DMARD / biologic?  56  Enrolled in BECS/BCRD if new DMARD / biologic?  48  Joint count (homunculus or table format)  48  Physician assessment of systemic disease activity (VAS)  75  ESR  74  CRP  92  Plasma viscosity  100  Data item  % forms with data item missing (if item required)  Relevant co-morbidities?  60  Macrophage activation syndrome?  100  Has the ILAR subtype changed?  50  Morning stiffness lasting >15 minutes?  42  History of any form of uveitis?  52  Date started uveitis mediation?  50  Strength of uveitis medication?  83  Counselled prior to new DMARD / biologic?  56  Enrolled in BECS/BCRD if new DMARD / biologic?  48  Joint count (homunculus or table format)  48  Physician assessment of systemic disease activity (VAS)  75  ESR  74  CRP  92  Plasma viscosity  100  Conclusion Paper collection of the CAPTURE-JIA data items is feasible and acceptable in the routine clinical setting, but unlikely to be sustainable in the longer term if collected in duplicate with medical notes. A digital tool in the clinical domain, ideally interlocking with local systems, would offer many advantages, including more complete and time-efficient data collection. Conflicts of Interest The authors declare no conflicts of interest. [ABSTRACT FROM AUTHOR]

The author reflects on his tenure as an editor and informs that from the next issue a new person will be taking over as the editor of the journal.m He states that when he took over as editor in 1997, he did not foresee that an evolution would take place that would completely change the way journals are published. The author predicts that more revolutions will come but hopes that they would not undermine the value of evidence-based scientific research.

As people age they are at increased risk of cardiovascular disease, the leading cause of mortality and morbidity worldwide. Understanding cardiovascular ageing is essential to preserving healthy ageing and preventing serious health outcomes. This collection of papers published in Age and Ageing since 2011 cover key themes in cardiovascular ageing, with a separate collection on stroke and atrial fibrillation planned. Treating high blood pressure remains important as people age and reduces strokes and heart attacks. That said, a more personalised approach to blood pressure may be even more important as people age to lower blood pressure to tight targets where appropriate but avoid overtreatment in vulnerable groups. As people age, more people experience blood pressure drops on standing (orthostatic hypotension), particularly as they become frail. This can predispose them to falls. The papers in this collection provide an insight into blood pressure and orthostatic hypotension. They highlight areas for further research to understand blood pressure changes and management in the ageing population. Inpatient clinical care of older people with heart attacks differs from younger people in UK national audit data. People aged over 80 had improved outcomes in survival after heart attack over time, but had lower rates of specialist input from cardiology compared with younger people. This may partly reflect different clinical presentations, with heart attacks occurring in the context of other health conditions, frailty and multimorbidity. The care and outcomes of acute and chronic cardiovascular disease are impacted by the frailty and health status of an individual at baseline. The research included in this collection reinforces the wide variations in the ageing population and the necessity to focus on the individual needs and priorities, and provide a person-centred multidisciplinary approach to care. [ABSTRACT FROM AUTHOR]

This paper introduces a set of papers analysing the likely economic impact of Brexit across key aspects of the UK economy as the country comes to the end of its first full year outside the European Union. The Brexit vote in 2016 was not just a vote on the UK's relations with the institutions of the European Union but was also a referendum on the fractured state of the UK as a nation. The resulting conflation of Brexit with domestic economic policy debates is reflected in this issue. A first cluster of papers focuses on the consequences of choosing to abandon the 'four freedoms' enshrined in the Treaty of Europe, the free movement of goods, services, capital, and labour across the EU, and a second is concerned with the indirect effects of Brexit in those areas of domestic policy that have been opened up by the Brexit decision. The economic consequences of Brexit are only just emerging, but these papers provide an informed perspective on the state of debate, and the likely implications of Brexit across a range of policy areas, both international and domestic. [ABSTRACT FROM AUTHOR]

Background Whilst there has been recognition of the need to strengthen the evidence base for occupational health in the UK, it is not clear how much different groups contribute to the emerging research.Aims To establish the research contribution from different types of organization and how this has changed.Methods All original research papers published in Occupational Medicine in the 5-year periods July 1996 to June 2001 and July 2006 to June 2011 were reviewed. The lead authors’ affiliations were classified in the most relevant sector.Results The number of research papers published by authors affiliated to UK organizations was greater in the past 5 years than in a similar period a decade ago. The increase is wholly explained by a large increase in papers from universities. About one-fifth of all papers published in Occupational Medicine from UK sources had a principal affiliation with the National Health Service (NHS). The number of papers affiliated to large private sector companies reduced from 14 to 2. No papers arose from the work of established specialists employed by the large commercial providers of occupational health services.Conclusions Services provided in the NHS and other public sector organizations are important contributors of new evidence in occupational health. Commissioners of public sector services should take account of the importance of this to the research and innovation in occupational health. [ABSTRACT FROM PUBLISHER]

Background Obesity is the greatest health issue for this generation; schools have improved food offered within their grounds. The built environment surrounding schools and pupils' journeys home have not received the same level of attention. This review identified papers on impacts of hot food takeaways surrounding schools in the UK. Methods Methods were informed by the PRISMA (QUORUM) guidelines for systematic reviews. Searches were completed in 12 databases. Results A total of 14 papers were included and quality assured before data extraction. Three descriptive themes were found; descriptions of hot food takeaway's geography and impacts concerning schools, strategic food policy and pupils reported food behaviour. Conclusions Most included studies compared anthropometric measures with geographical location of hot food takeaways to find correlations between environment and childhood obesity. There was good evidence of more hot food takeaways in deprived areas and children who spend time in deprived neighbourhoods tend to eat more fast food and have higher BMIs. Few studies were able to quantify the correlation between school's environment and obesity amongst pupils. This lack of evidence is likely a factor of the studies' ability to identify the correlation rather than lack of a correlation between the two variables. [ABSTRACT FROM AUTHOR]

Discusses papers which attempted to devise methods of measuring the performance of universities in Great Britain. Defence of the institutional profiling method; Critical weaknesses presented by the first-destination survey data used; Issues on institutional progression rates and the employability of its graduates.

Discusses the paper presented by Bailey and Hewson regarding monitoring local government traffic safety performance using multiple indicators. Target set by the British government for the reduction of road accident casualties by 2000; Benefits of deploying a generalized linear mixed model; Avenues of statistical enquiry that seek to offer insights into organizational performance.

The euro and prices DID EMU AFFECT PRICE SETTING AND INFLATION PERSISTENCE? Surprisingly not; or at least not directly. Using data on individual consumer prices and on sectoral inflation rates from six euro area countries spanning several years before and after the introduction of the euro, we look at whether EMU has altered the behaviour of price setters and/or the dynamics of inflation. We find no evidence of such change in 1999, when the euro was introduced as an electronic unit of account. At the start of 2002, when the paper currency appeared, the frequency of price adjustments (both upward and downward) increased suddenly, while the average magnitude of price changes fell; both, however, quickly settled back to the earlier patterns. Conversely, we do find evidence of a permanent decline in the persistence of inflation after the mid-1990s. While in principle this could be attributable to the preparation of EMU, this interpretation is put into question by the fact that a similar decline occurred also in the UK and in the US. [ABSTRACT FROM AUTHOR]

The article presents a speech delivered before The Royal Statistical Society on January 26, 2011 at an Ordinary Discussion Meeting on "Resource allocation models" prepared by Jane Galbraith and Mervyn Stone of the University College London, England. It is a response to the paper of the Department of Health in Great Britain in 2007. It contends that the basis of the allocation formulae in the National Health Service is inaccurate. It argues on the misuse of regression analysis in the formulae.

Background: Surgical waiting lists have risen dramatically across the UK as a result of the COVID-19 pandemic. The effective use of operating theatres by optimal scheduling could help mitigate this, but this requires accurate case duration predictions. Current standards for predicting the duration of surgery are inaccurate. Artificial intelligence (AI) offers the potential for greater accuracy in predicting surgical case duration. This study aimed to investigate whether there is evidence to support that AI is more accurate than current industry standards at predicting surgical case duration, with a secondary aim of analysing whether the implementation of the models used produced efficiency savings. Method: PubMed, Embase, and MEDLINE libraries were searched through to July 2023 to identify appropriate articles. PRISMA extension for scoping reviews and the Arksey and O'Malley framework were followed. Study quality was assessed using a modified version of the reporting guidelines for surgical AI papers by Farrow et al. Algorithm performance was reported using evaluation metrics. Results: The search identified 2593 articles: 14 were suitable for inclusion and 13 reported on the accuracy of AI algorithms against industry standards, with seven demonstrating a statistically significant improvement in prediction accuracy (P < 0.05). The larger studies demonstrated the superiority of neural networks over other machine learning techniques. Efficiency savings were identified in a RCT. Significant methodological limitations were identified across most studies. Conclusion: The studies suggest that machine learning and deep learning models are more accurate at predicting the duration of surgery; however, further research is required to determine the best way to implement this technology. Waiting lists for elective surgeries are rising in the UK. We conducted a scoping review with the aim to understand if artificial intelligence has the potential to improve the utilization of operating theatre resources through improved scheduling. [ABSTRACT FROM AUTHOR]

Background: Students must be proficient in surgical skills according to General Medical Council and Royal College of Surgeons of England guidelines. If these skills are not appropriately taught, there is a risk of an incoming junior workforce with inadequate surgical skills. This paper aimed to review the literature relating to undergraduate teaching of surgical skills in the UK and summarize future suggested training methods. Methods: The databases MEDLINE, Embase and SCOPUS were searched, and the existing literature relating to methodology of undergraduate teaching of surgical skills in the UK over the past 10 years was summarized. The Medical Education Research Quality Instrument was used to assess research quality. Results: A total of 19 papers were included. Cross-sectional evaluations and survey-based studies highlight a clear deficit in surgical skills teaching in the UK. Medical students are currently unable to fulfil their own learning needs and meet requirements set out by the General Medical Council. This lack of surgical teaching appears to negatively affect student desire to pursue a surgical career. The three main themes for improvement are extracurricular surgical skills days, near-peer teaching and simulation. Each method appeared to improve learning, although no studies utilized medium- to long-term follow-up to demonstrate efficacy and there lacks a clear consensus as to the 'standard' of undergraduate surgical skill education. There was also potential for selection bias and response shift bias in many of the studies assessing pre- and postintervention confidence and opinions. Conclusion: There is a concerning lack of surgical skills teaching that has resulted in medical students and junior doctors not having the necessary surgical skills as per General Medical Council guidance and students feel that their own learning needs are not met. This failure to address the learning deficit may be responsible for the fall in surgical competition ratios. While surgical skills teaching must be improved urgently, more robust evidence is required to evaluate the optimal ways of approaching this issue. Undergraduate medical students must be proficient in certain surgical skills as set out by General Medical Council and Royal College regulations. There appears a deficit in such teaching which we have discussed and attempted to address in terms of alternative methodology reported in the literature that can be used to teach these basic surgical skills. [ABSTRACT FROM AUTHOR]

Shows how the policy proposals contained in the government's Green Paper on pensions (DSS, 1998) affect the long term sustainability of Great Britain's public finances and redistribution. Description of the main proposals contained in the Green Paper; Assessment of the effect of the Green Paper on the sustainability of the public finances.

This paper analyses the Trade and Cooperation Agreement (TCA) between the EU and the UK. We focus on two specific features: rules of origin and non-tariff barriers. The putative purpose of the TCA was to promote free trade between the signatories, and both of the features identified have 'level-playing-field' objectives which are designed to promote that purpose. However, both can also be used for covert protectionism against the other party to the agreement. The paper recommends that rules of origin and non-tariff barriers should be recrafted where possible, and there is a description of how this might be done. The aim of such action would be to make transparent the role of these features in preserving a level playing field. Doing this would also make clear that any residual unadulterated rules of origin and non-tariff barriers existed for purely protectionist reasons and jeopardized open borders. Hopefully, the exposure of such protectionism would encourage its dismantlement. [ABSTRACT FROM AUTHOR]

This volume contains a small sample of papers presented to the fiftieth UK History of Economic Thought Conference, held at Balliol College, Oxford, on 29–31 August 2018. Over forty papers were presented, and this special issue contains nine of the thirty-one submitted for possible publication. [ABSTRACT FROM AUTHOR]

This paper examines some drivers behind substantial changes in tax policy in recent decades. Using existing theories and our definition of 'beneficial major tax reforms', we discuss three case studies: the US in the 1980s, the UK in the 1980s, and the UK's failed 'mini-budget' of 2022. Our analysis reveals that the US's TRA86 has, to some degree, improved efficiency, while the UK reforms may have exacerbated inequality with ambiguous effects on efficiency. Finally, we outline the potential for future reforms and conclude that political conditions are more likely to instigate major change than economic motivations. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue, including one on alcohol abuse by parents, one on Hungarian Roma refugees in Canada, and one on the privatization of state social work in Great Britain.

Motivation Polygenic risk scores (PRSs) predict individuals' genetic risk of developing complex diseases. They summarize the effect of many variants discovered in genome-wide association studies (GWASs). However, to date, large GWASs exist primarily for the European population and the quality of PRS prediction declines when applied to other ethnicities. Genetic profiling of individuals in the discovery set (on which the GWAS was performed) and target set (on which the PRS is applied) is typically done by SNP arrays that genotype a fraction of common SNPs. Therefore, a key step in GWAS analysis and PRS calculation is imputing untyped SNPs using a panel of fully sequenced individuals. The imputation results depend on the ethnic composition of the imputation panel. Imputing genotypes with a panel of individuals of the same ethnicity as the genotyped individuals typically improves imputation accuracy. However, there has been no systematic investigation into the influence of the ethnic composition of imputation panels on the accuracy of PRS predictions when applied to ethnic groups that differ from the population used in the GWAS. Results We estimated the effect of imputation of the target set on prediction accuracy of PRS when the discovery and the target sets come from different ethnic groups. We analyzed binary phenotypes on ethnically distinct sets from the UK Biobank and other resources. We generated ethnically homogenous panels, imputed the target sets, and generated PRSs. Then, we assessed the prediction accuracy obtained from each imputation panel. Our analysis indicates that using an imputation panel matched to the ethnicity of the target population yields only a marginal improvement and only under specific conditions. Availability and implementation The source code used for executing the analyses is this paper is available at https://github.com/Shamir-Lab/PRS-imputation-panels. [ABSTRACT FROM AUTHOR]

This paper documents that a large-scale government subsidy aimed at encouraging people to eat out in restaurants in the wake of the first 2020 COVID-19 wave in the United Kingdom has had a significant causal impact on new cases, accelerating the subsequent second COVID-19 wave. The scheme subsidised 50% off the cost of food and non-alcoholic drinks for an unlimited number of visits in participating restaurants on Mondays–Wednesdays from 3–31 August 2020. Areas with higher take-up saw both a notable increase in new COVID-19 infection clusters within a week of the scheme starting and a deceleration in infections within two weeks of the program ending. Similarly, areas that exhibited notable rainfall during the prime lunch and dinner hours on the days the scheme was active record lower infection incidence—a pattern that is also measurable in mobility data—and non-detectable on days during which the discount was not available or for rainfall outside the core lunch and dinner hours. [ABSTRACT FROM AUTHOR]

Background Older people are often explicitly or implicitly excluded from research, in particular clinical trials. This means that study findings may not be applicable to them, or that older people may not be offered treatments due to an absence of evidence. Aims The aim of this work was to develop recommendations to guide all research relevant to older people. Methods A diverse stakeholder group identified barriers and solutions to including older people in research. In parallel, a rapid literature review of published papers was undertaken to identify existing papers on the inclusion of older people in research. The findings were synthesised and mapped onto a socio-ecological model. From the synthesis we identified themes that were developed into initial recommendations that were iteratively refined with the stakeholder group. Results A range of individual, interpersonal, organisational, community and policy factors impact on the inclusion of older people in research. A total of 14 recommendations were developed such as removing upper age limits and comorbidity exclusions, involving older people, advocates and health and social care professionals with expertise in ageing in designing the research, and considering flexible or alternative approaches to data collection to maximise opportunities for participation. We also developed four questions that may guide those developing, reviewing and funding research that is inclusive of older people. Conclusion Our recommendations provide up to date, practical advice on ways to improve the inclusion of older people in health and care research. [ABSTRACT FROM AUTHOR]

The UK left the European single market in energy on 31 December 2020, having been a leading light in its promotion. It entered into a new energy relationship with the EU-27 as outlined in the EU–UK Trade and Cooperation Agreement (TCA) on 1 January 2021. This paper discusses what has happened to the UK energy sector since the Brexit referendum of June 2016. Since our previous paper on this topic in 2017, there has been a significant clarification in the impact of Brexit on the energy sector in the UK. We outline what the TCA says about energy. We then discuss the current and potential future effects of Brexit on the UK electricity and gas systems in turn. We observe that the likely economic welfare impacts on electricity are larger than the impacts on gas, but the overall microeconomic impact appears likely to be modest (but negative). We offer a number of concluding observations. [ABSTRACT FROM AUTHOR]

The article introduces papers published within the issue, including "The extent and correlates of the utilisation of empowerment strategies: Survey on social workers in the field of partner violence," by Li-yu Song, "Co-producing community justice: The transformative potential of personalisation for penal sanctions," by Beath Weaver, and "Introducing the Mental Capacity Advocate (IMCA) service and the reform of adult safeguarding procedures," by Marcus Redley and colleagues.

According to a 1958 report by the Central Office of Information, the British public buys more newspapers per person than does the public of any other country in the world. In that year the 16 million families in Great Britain bought over 16 million national morning newspapers, about 2&half; million London evening papers, about 27 million national Sunday papers, as well as huge quantities of weekly and monthly publications and over 9 million provincial morning and evening newspapers. There was then, and there is now, an enormous circulation of newspapers and magazines. Even so, the circulation figures for the national publications have, for several years, declined, as of September 1, 1961. By newspaper standards that decline is serious. It is serious because it means much more than a loss in revenue from sales or a declining service to readers. It means a loss in advertising revenue at a time when production costs are extremely high. It is understandable that the press should look for a cause. One of the things that pressmen and others have seen is that this period of decline coincided with a period in which the proportion of homes with television sets in them was still rapidly growing. This comparison constitutes part of the case for a fairly widespread view that television is responsible for declining circulation figures. This case has the support of an appealing argument that if people are spending their time watching television they will have less time for reading papers and that if papers go unread for a long period they will cease to be bought. This is, in fact, a large part of the case for suggesting that television is responsible.

The UK is, like its peers in the EU, just under 80% dependent on fossil fuels. This figure has come down just over 10% since the 1970s, a period when the UK had major energy-intensive industries, most of which are now gone. The government is committed to achieving net zero for the electricity sector by 2035 on the pathway to net zero for the whole economy by 2050.. The Labour opposition has set 2030 as its electricity target. Setting out the scale of this challenge, this paper demonstrates how implausible the 2035 target is. On present policies there is little prospect that the 2035 target will be met (and virtually none for the Labour 2030 target). This paper reviews the multiple current policies and the capacity objectives and explores what would have to happen to meet the target. It sets out some of the consequences of failure to deliver, and the expectation of that failure. [ABSTRACT FROM AUTHOR]

Background Alcohol increases cancer risk, but less is known about public awareness of this link. This scoping review summarizes recent findings on the public awareness of alcohol as a cancer risk factor in European Union and UK. Methods Four databases (Web of Science, MEDLINE, PsycInfo, CINAHL) were searched for papers containing data on awareness of alcohol as cancer risk factor in EU or UK published between January 2017 and December 2022, and complemented with grey literature searches. Results In total, 45 studies were included covering 18 EU countries (Austria, Belgium, Cyprus, Czechia, Denmark, Finland, France, Germany, Hungary, Ireland, Italy, Netherlands, Poland, Romania, Slovakia, Slovenia, Spain, Sweden) and UK, presenting data collected between 2009 and 2022. Studies covered general population (17 studied a nationally representative sample), women, health professionals, patients and young people. Awareness of alcohol causing cancer in general was higher and studied more often than awareness of alcohol's impact on specific cancers. Among the EU general population, awareness of the link between alcohol and breast cancer ranged between 10% and 20%, head and neck cancer 15–25%, colorectal and oesophagus cancer 15–45% and liver cancer 40%. Awareness was higher among young people and specialized health professions and lower among women (the latter specifically for the breast cancer). Conclusions While awareness rates varied depending on the exact question wording, many studies showed low awareness of the alcohol-cancer link, especially for specific types such as breast and colon cancer. Public should be better informed about alcohol consumption-related cancer risk. [ABSTRACT FROM AUTHOR]

Amid escalating apprehensions surrounding content regulation, the USA has discreetly integrated provisions reminiscent of its Communications Decency Act Section 230 (CDA 230) into trade agreements, offering broad immunity. This scholarly analysis critically assesses this manoeuvre by juxtaposing such CDA 230-like provisions against the UK's established legal framework governing online content and freedom of expression. Utilizing a comparative legal methodology, the paper underscores the pronounced differences between the USA and UK stances on intermediary liability for third-party content, moulded by their unique constitutional foundations and jurisprudential interpretations of free speech rights. The insertion of CDA 230-aligned clauses into trade agreements poses a potential threat to the UK's nuanced equilibrium between safeguarding free speech and upholding other paramount interests, such as privacy and reputation. An scrutiny of UK defamation statutes and content regulation protocols reveals inherent challenges in transplanting CDA 230 provisions into trade contexts. In summation, the paper ardently supports a diversified approach to online content governance and cautions against standardizing intermediary liability laws via trade agreements, especially between nations with divergent foundational beliefs. It fervently endorses a cross-disciplinary discourse involving both trade and legal specialists to ensure the preservation of free expression while concurrently recognizing the intricacies of crafting universally applicable standards for online platforms and content regulation. [ABSTRACT FROM AUTHOR]

The change in scale in wood processing in the UK over the past 70 years is huge. From a position where sawmilling was on small scale satisfying local market needs with native broadleaf species, it is now a huge industry supplying about 26 per cent of our sawn softwood demand; mainly from the exotic, Sitka spruce. Development has seen the industry reach levels of technology equivalent to those in the Nordic countries and north America. Seventy years ago the only board manufacturing plants were producing plywood from imported tropical logs. Now the board industries produce chipboards, strand boards, MDF and cement bonded particleboards from the home grown resource. Overall we produce some 56 per cent of UK consumption of these products whilst in the growing MDF sector home production represents 78 per cent of demand. The wood pulp industry has developed over the past 15--20 years from a position where it had almost ceased to exist to the present situation of large volumes of newsprint, magazine papers, packaging board and fluting being produced, largely on four capital intensive sites. The sawmilling, board manufacturing and pulp and paper industries are mutually dependent upon one another for their successful operation. Residue material from sawmills for example, provides an important income source, whilst the market for small roundwood provides cash flow for forest owners prior to felling of the final sawlog crop. [ABSTRACT FROM AUTHOR]

The article discusses various papers published within the issue including "Poverty and Social Work," by Greg Mantle and Dave Backwith, a study on the application of ethical theories on risk assessment and supervision, and an article on the interconnecting systems that social workers use to help their clients.

The Research Excellence Framework (REF) is the main research assessment for universities in the UK. It informs university league tables and the allocation of government research funding. This paper analyses the evaluations of the REF 2014 for Economics, Business, Politics and History. First, we analyse from which journals articles have been submitted; second, to what extent journal ratings and journal impact factors predict the REF's evaluations; third, how many articles from heterodox economics journals have been submitted. We find that a small group of journals dominate the outputs submitted. Journal ratings and impact factors explain 80% of the variation in the output evaluations for Economics. These values are lower but still substantial for other disciplines. Few papers from heterodox economics journals were submitted to Economics. Overall, the REF in its present form marginalises heterodox economics, pushes it out of the discipline and endangers pluralism in economics research. [ABSTRACT FROM AUTHOR]

Currently in the UK and Ireland, after a hip fracture most patients do not receive bone protection medication to reduce the risk of refracture. Yet randomised controlled trial data specifically examining patients with hip fracture have shown that intravenous zoledronate reduces refracture risk by a third. Despite this evidence, use of intravenous zoledronate is highly variable following a hip fracture; many hospitals are providing this treatment, whilst most are currently not. A range of clinical uncertainties, doubts over the evidence base and practical concerns are cited as reasons. This paper discusses these concerns and provides guidance from expert consensus, aiming to assist orthogeriatricians, pharmacists and health services managers establish local protocols to deliver this highly clinically and cost-effective treatment to patients before they leave hospital, in order to reduce costly re-fractures in this frail population. [ABSTRACT FROM AUTHOR]

Over the past few decades, a small but growing group of people have worked remotely from their homes. With the arrival of the coronavirus pandemic, millions of people found themselves joining this group overnight. In this position paper, we examine the kinds of work that 'went remote' in response to the pandemic, and consider the ways in which this transition was influenced by (and in turn came to influence) contemporary trends in digital workplace measurement and evaluation. We see that employers appeared reluctant to let certain classes of employee work remotely. When the pandemic forced staff home, employers compensated by turning to digital surveillance tools, even though, as we argue, these tools seem unable to overcome the significant conceptual barriers to understanding how people are working. We also observed that, in the United Kingdom context, the pandemic didn't mean remote work for a significant proportion of the population. We assert that, to maximize its impact, 'future of work' research in human-centred computing must be more inclusive and representative of work, rather than focusing on the experiences of knowledge workers and those involved in new forms of work. [ABSTRACT FROM AUTHOR]

A growing body of research emphasizes the importance of institutions for megaproject performance. Extant studies focus on understanding the characteristics of favourable institutional environments and the governance structures that projects can adopt to navigate both favourable and unfavourable environments. This paper contributes to this research by foregrounding the link between megaprojects and changes in the institutional environments within which they are embedded. Building on a case study of the Thames Tideway Tunnel—the UK's largest water and sewerage infrastructure project since the privatization of the industry in 1989—the paper presents two distinct ways that projects can interact with formal institutions: institutional compliance and institutional change. A more holistic understanding of the latter is essential because megaprojects can reconfigure production and consumption patterns to the benefit of some and the detriment of others. By contributing to changes in the institutional environment, megaprojects can further entrench these reconfigured patterns into long-enduring formal rules and practices. [ABSTRACT FROM AUTHOR]

This paper describes different forms of ownership across countries and how these forms influence the way companies are governed. In most stock markets in the world, listed companies frequently have a controlling shareholder, usually a family. However, Japan, the UK, and to a lesser extent the US, are exceptions. In these three countries, ownership is frequently highly fragmented, where share stakes are held by different institutional owners, including asset managers, both active and passive, and by shareholder activists. The paper focuses in particular on the governance structure of different institutional shareholders, how they engage with target firms, and their effectiveness. The paper concludes with recommendations for regulators to enhance different forms of ownership. [ABSTRACT FROM AUTHOR]

This article reports and reflects on an element of a recent survey of UK public health professionals, specifically in relation to the Public Health Knowledge and Skills Framework (PHSKF) and the ethical requirements that underpin public health practice. Only 38.4% of respondents reported accessing the PHKSF and a mere 13.7% reported accessing the accompanying background paper on ethical public health practice. Given that ethical practice underpins the PHSKF, it is concerning that so few respondents are familiar with the PHSKF and one of the source documents. While issuing frameworks and guidance is one way to support public health practice, there is a further need for greater integration of skills and knowledge around ethical public health practice within education and training initiatives. [ABSTRACT FROM AUTHOR]

The Brexit vote in 2016 caused consternation in higher education circles. Financial and reputational questions were raised concerning: the number of students from EU countries coming to study in the UK; the ability of the sector to retain and recruit staff from the EU; the threats to research funding; and the ability of UK students to study abroad. This paper tracks developments since then. Much remains uncertain and the picture has been complicated by the impact of Covid-19. Though enrolments of EU citizens for the 2021–22 academic year have fallen dramatically, this has been more than offset by larger numbers of UK entrants and entrants from non-EU countries. The main immediate threat is to research funding, partly because of restricted access to EU programmes and partly because of constrained government spending. The longer-term threat is to the sector's relationship with European academia. [ABSTRACT FROM AUTHOR]

The paper reviews the implications of the EU–UK Trade and Cooperation Agreement (TCA) for the control of subsidies. Controls will be less strict than under the EU state aid regime but tighter than with no deal and WTO rules. A subsidy control authority will be established by the UK which will oversee the application of broad principles set out in the TCA. A well-designed authority would help to prevent a repeat of the UK experience in the 1970s and 1980s, when subsidies were detrimental to economic performance. Regrettably, however, the government has decided to adopt a politicized approach to subsidy policy. [ABSTRACT FROM AUTHOR]

Modern computed tomography (CT) databases are becoming an accepted resource for the practice and development of identification methods in forensic anthropology. However, the utility of 3D models created using free and open-source visualization software such as 3D Slicer has not yet been thoroughly assessed for morphoscopic biological profiling methods where virtual methods of analysis are becoming more common. This paper presents a study that builds on the initial findings from Robles et al. (2020) to determine the feasibility of estimating sex on stereolithic (STL) 3D cranial models produced from CT scans from a modern, living UK population (n  = 80) using equation 2 from the Walker's (2008) morphoscopic method. Kendall's coefficients of concordance (KCC) indicated substantial agreement using cranial features scores in an inter-observer test and a video-inter-observer test. Fleiss' Kappa scores showed moderate agreement (0.50) overall between inter-observer sex estimations, and for observer sex estimations in comparison to recorded sexes (0.56). It was found that novice users could virtually employ morphoscopic sex estimation methods effectively on STL 3D cranial models from modern individuals. This study also highlights the potential that digital databases of modern living populations can offer forensic anthropology. Key points First example of Walker's (2008) method applied to a living UK population. Open-source software is a valuable resource for crime reconstruction approaches. Male scoring bias was observed in method application. Forensic anthropologists would benefit from virtual anthropology training to use and interpret 3D models. Digital databases offer more ethical, diverse, modern populations for future research. [ABSTRACT FROM AUTHOR]

Background COVID-19 brought additional challenges to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision-making, which was already a contentious issue. In the UK, reports of poor DNACPR decision-making and communication emerged in 2020, including from the regulator, the Care Quality Commission. This paper explores the experiences of people who discussed DNACPR with a healthcare professional on behalf of a relative during the coronavirus pandemic, with the aim of identifying areas of good practice and what needs to be improved. Methods a total of 39 people participated in semi-structured interviews via video conferencing software or telephone. Data were evaluated using Framework Analysis. Findings results are presented around three main themes: understanding, communication and impact. Participants' understanding about DNACPR was important, as those with better understanding tended to reflect more positively on their discussions with clinicians. The role of relatives in the decision-making process was a frequent source of misunderstanding. Healthcare professionals' communication skills were important. Where discussions went well, relatives were given clear explanations and the opportunity to ask questions. However many relatives felt that conversations were rushed. DNACPR discussions can have a lasting impact—relatives reported them to be significant moments in care journeys. Many relatives perceived that they were asked to decide whether their relative should receive CPR and described enduring emotional consequences, including guilt. Conclusion the pandemic has illuminated deficiencies in current practice around DNACPR discussion, which can have difficult to anticipate and lasting negative consequences for relatives. This research raises questions about the current approach to DNACPR decision-making. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editors discuss various reports published within the issue which include papers on LGBT carers, risk-need assessment of minority ethnic offenders in Britain and lesbian women negotiating family care.

The article reports on the significance of the Act of Union between Great Britain and Ireland. The Act of Union between the two countries which come into force on January 1, 1800 was the outcome of immediate military necessity. It was also the outcome of decades of spasmodic thought by politicians on both sides of the Irish Sea concerning the relationship between the two islands. But while the overall intention was undoubtedly an integrative one, a failure to understand the nature of Irish politics and society together with the pressing imperatives of war with France generated a casual and shallow attitude towards administrative detail and undermined those master plans.

This article is concerned with the power of language to shape and confirm social work's identity and to control its essential direction and task. Social work has perennially concerned itself with communication but paid surprisingly little attention to the more abstract concept of language. The authors trace the changing language used throughout social work's UK history, placing this into sociopolitical and socio-economic context and analysing the discourses thus created and promoted. We identify three broad periods in the development of social work, characterized as the moral enterprise, the therapeutic enterprise and the managerial enterprise. We conclude by connecting this discussion with some key challenges, issues and dilemmas currently facing social work in the criminal justice and community care arenas, highlighting the language and discourse of punishment, risk management, consumerism and the market economy. The article concludes by arguing that social work must reclaim the language of its activity as it engages with the challenges to its identity. [ABSTRACT FROM AUTHOR]

This paper provides a quantitative general equilibrium evaluation of the repeal of Britain's Corn Laws in 1846. Using a detailed input-output matrix of the British economy in 1841, we find the abolition of Britain's tariff on imported grain left overall welfare roughly unchanged as the static efficiency gains are offset by terms-of-trade losses. Labourers and capital owners gained a slight amount at the expense of landowners. Combining these changes in factor payments with the different consumption patterns across income groups, we find that the top 10% of income earners lost while the bottom 90% of income earners gained. [ABSTRACT FROM AUTHOR]

The Global Forest Products Model was applied to forecast the effect of Brexit on the global forest products industry to 2030 under two scenarios: an optimistic and pessimistic future storyline regarding the potential economic effect of Brexit. The forecasts integrated a range of gross domestic product growth rates using an average of the optimistic and pessimistic projections from recent reports. According to the results, Brexit caused a sustained modest decline in UK demand for wood products through 2030. The consumption of sawnwood in Britain was 1.0-2.1% lower by 2030, 2.9-6.1% lower for wood-based panels and 1.9-4.1% lower for paper and paperboard. With Brexit, the UK net trade deficit in sawnwood decreased by 4.8-9.9% by 2030, 4.4-9.1% for wood-based panel and 5.5-10.8% for paper and paperboard. The effects on industrial roundwood consumption and production within the UK were negligible. Both scenarios had a modest adverse effect on the global market for wood products. The consequences of Brexit were mostly within Europe and driven predominantly by reduced consumption within the UK itself. While the effect was greater under the pessimistic scenario, the overall impact on the global wood products industry was small, and it had no discernable effect on prices. [ABSTRACT FROM AUTHOR]

The use of machine learning as an input into decision-making is on the rise, owing to its ability to uncover hidden patterns in large data and improve prediction accuracy. Questions have been raised, however, about the potential distributional impacts of these technologies, with one concern being that they may perpetuate or even amplify human biases from the past. Exploiting detailed credit file data for 800,000 UK borrowers, we simulate a switch from a traditional (logit) credit scoring model to ensemble machine-learning methods. We confirm that machine-learning models are more accurate overall. We also find that they do as well as the simpler traditional model on relevant fairness criteria, where these criteria pertain to overall accuracy and error rates for population subgroups defined along protected or sensitive lines (gender, race, health status, and deprivation). We do observe some differences in the way credit-scoring models perform for different subgroups, but these manifest under a traditional modelling approach and switching to machine learning neither exacerbates nor eliminates these issues. The paper discusses some of the mechanical and data factors that may contribute to statistical fairness issues in the context of credit scoring. [ABSTRACT FROM AUTHOR]