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Summary: After more than 120 hand‐upper extremity and 37 face transplant procedures performed worldwide, vascularized composite allotransplantation (VCA) now falls under the scope of organ transplant legislation in Europe and the United States. While in the USA, VCA has been considered as standard care since 2014, VCA in Europe is still performed through clinical research trials, except in United Kingdom. However, after two decades of favourable experience with upper extremity transplantation (UET), professionals in Europe are proposing hand allotransplantation as "controlled standard" care, as opposed to face transplantation (FT), which is still a challenging activity. The European Committee on Organ Transplantation (CD‐P‐TO) has elaborated a position paper to provide recommendations concerning regulatory aspects for UET and FT. It is aimed at Health Authorities in charge of the oversight – and coordination – of organ donation and transplantation, and at professional groups to help them manage such complex and costly programs dedicated to properly selected patients. [ABSTRACT FROM AUTHOR]

Aims This article explores the care British nurses provided to victims of typhus during the Second World War. Background Typhus is associated with poverty and overcrowding. During wars in the pre-antibiotic era, civilians were particularly susceptible to epidemics, which military governments feared would spread to their troops. Design This discussion paper draws on archival data from three typhus epidemics in the Second World War to examine the expert work of British nurses in caring for victims during these potential public health disasters. Data Sources The published sources for the paper include material from nursing and medical journals published between 1940-1947. Archival sources come from the National Archives in Kew, the Wellcome Library and the Army Medical Services Museum, between 1943-1945. Of particular interest is the correspondence with Dame Katharine Jones from nurses on active service overseas. Implications for Nursing Whilst epidemics of typhus are now rare, nurses in the present day may be required to care for the public in environments of extreme poverty and overcrowding, where life-threatening infectious diseases are prevalent. This article has demonstrated that it is possible for expert and compassionate nursing to alleviate suffering and prevent death, even when medical technologies are unavailable. Conclusion Expert and compassionate care, adequate nutrition and hydration and attention to hygiene needs are crucial when there are limited pharmacological treatments and medical technologies available to treat infectious diseases. The appreciation of this could have implications for nurses working in current global conflicts. [ABSTRACT FROM AUTHOR]

This document was developed by a group of over two dozen pain clinicians and investigators from Austria, Belgium, Denmark, France, Germany Ireland, Israel, Italy, The Netherlands, Norway. Poland, Portugal, Spain, Sweden, Switzerland and the United Kingdom and funded by an educational grant form Mundipharma International, Limited. The stated aim of the White Paper is to identify inequalities in government policies towards opioids that contribute to inadequate treatment of pain. It calls for their replacement with policies that will support doctors and patients in their efforts to relieve pain. [ABSTRACT FROM AUTHOR]

The paper discusses changes that have occurred over the last 15 years in how maps are sold, where they are sold and who is buying them. The emphasis is on the situation in the United States of America, but developments in Europe and the United Kingdom are also included. [ABSTRACT FROM AUTHOR]

Research into pedagogical approaches used in early years' nature education, more specifically European and UK forest schools, remains according to Leather, 'undertheorised.' In a similar situation in Australia, the bush kindergarten programmes (referred to as 'bush kinders'), have had limited research attention. Influenced by European and UK forest school approaches, bush kinders are a recent development in Australian early years nature education. We discuss an ethnographic study where teaching and learning in three bush kinder settings was observed, each with different pedagogical approaches. The paper reports one main finding, where a wide range of pedagogical approaches were observed across the different bush kinder sites. To theoretically frame these pedagogical approaches, our analysis builds on Edwards' notion of play-based learning, along with a model of inquiry-based teaching proposed by Furtak et al. Using ethnographic methods we draw on fieldwork data and research literature to analyse bush kinder pedagogies. The paper contributes to the conceptualisation of pedagogy in early childhood nature and bush kinder programmes. [ABSTRACT FROM AUTHOR]

The first Transplant Games took place in 1978 in Portsmouth, England. Since then, numerous Olympic-style sporting 'Games' have been established, each aiming to increase public awareness of organ donation, demonstrate the benefits of transplantation, and encourage patient fitness. Despite this, there is limited research exploring the psycho-social and health impacts of the Games. Drawing on qualitative research conducted at the 2022 British Transplant Games and the 2022 European Transplant and Dialysis Games, this paper explores the Games through a therapeutic landscapes framework, a concept that examines the ways in which environments contribute to health and wellbeing. Building upon work that acknowledges the relational and contingent nature of health-in-place, I argue that the Games are a therapeutic landscape of social relations for transplant recipients in three ways: providing a landscape of belonging , a landscape of hope , and a landscape of motivation. Through this therapeutic landscapes perspective, the Transplant Games are presented as a peer-to-peer clinic – a care space where individuals are more actively involved in their health on a reciprocal level than in the traditional hospital clinic. In turn, this paper emphasises the crucial role of affective peer support in producing health-promoting environments. This research seeks to make a practical contribution to the wider transplant community by promoting the Games as an environment which may positively contribute to both physical and mental wellbeing. • The Transplant Games function as a therapeutic landscape for organ recipients. • They provide a peer-to-peer clinic where participants are active in their health. • The Games provide a landscape of belonging, acceptance, understanding and family. • In showing you can still lead a healthy life, the Games become a landscape of hope. • As a landscape of motivation, the Games improve both physical and mental health. [ABSTRACT FROM AUTHOR]

This article examines young people's experiences of open access youth work in settings in the UK, Finland, Estonia, Italy and France. It analyses 844 individual narratives from young people, which communicate the impact of youthwork on their lives. These accounts are then analysed in the light of the European youth work policy goals. It concludes that it is encouraging that what young people identify as the positive impact of youth work are broadly consistent with many of these goals. There are however some disparities which require attention. These include the importance young people place on the social context of youth work, such as friendship, which is largely absent in EU youth work policy; as well as the importance placed on experiential learning. The paper also highlights a tension between 'top down' policy formulation and the 'youth centric' practices of youth work. It concludes with a reminder to policy makers that for youth work to remain successful the spaces and places for young people must remain meaningful to them 'on their terms'. [ABSTRACT FROM AUTHOR]

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

This paper focuses on the various movements in the UK, Europe and in the United States which precipitated the formation of the Hypnosis Section at the Royal Society of Medicine (RSM). Close attention is given to meetings at the RSM in preparation for the inaugural Section meeting in June 1978. [ABSTRACT FROM AUTHOR]

The paper critiques key international teaching excellence and higher education outcomes frameworks for their lack of attention to epistemic equality. It subsequently argues that adequate 'datafication' of these frameworks, to demonstrate the extent to which universities offer teaching experiences which promote intellectual equivalence of all 'knowers' could advance present understandings of teaching excellence beyond benchmarked performativity. The paper theorises the philosophical basis of a changed 'datafication' process under selected national and supra-national frameworks for measuring teaching excellence at universities and shows, by statistically modelling selected national data, how a 'metric' evaluating universities on epistemic equality could work in practice. [ABSTRACT FROM AUTHOR]

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

Introduction: Several forces are contributing to an increase in the number of people living with and surviving colorectal cancer (CRC). However, due to the lack of available data, little is known about the implications of these forces. In recent years, the use of administrative records to inform research has been increasing. The aim of this paper is to investigate the potential contribution that administrative data could have on the health economic research of CRC. Methods: To achieve this aim, we conducted a systematic review of the health economic CRC literature published in the United Kingdom and Europe within the last decade (2009–2019). Results: Thirty‐seven relevant studies were identified and divided into economic evaluations, cost of illness studies and cost consequence analyses. Conclusions: The use of administrative data, including cancer registry, screening and hospital records, within the health economic research of CRC is commonplace. However, we found that this data often come from regional databases, which reduces the generalisability of results. Further, administrative data appear less able to contribute towards understanding the wider and indirect costs associated with the disease. We explore several ways in which various sources of administrative data could enhance future research in this area. [ABSTRACT FROM AUTHOR]

Dual or multiple earnership has been considered an important factor to prevent in-work poverty. The aim of this paper is to quantify the impact of second earnership on the risk of in-work poverty and the role of the tax-benefit system in moderating this risk. Our analysis refers to 2014 and employs EUROMOD, the tax-benefit microsimulation model for the European Union and the United Kingdom. In order to assess the role of second earners in preventing in-work poverty we simulate a counterfactual scenario where second earners become unemployed. Our results show that the effect of net replacement rates (i.e. the ratio of household income before and after the transition of second earners to unemployment) on the probability of in-work poverty is negative and statistically significant, but in relative terms it appears to be small compared to the effects of individual labour market characteristics, such as low pay and part-time employment. [ABSTRACT FROM AUTHOR]

This paper reworks the notion of active ageing through analysis of a case which reverses the retirement-migration nexus – people in the post-socialist realm who approach retirement age and then migrate to begin a new working life. They are thereby introducing a new and complex arrangement to the general concept of 'international retirement migration'. In the post-socialist world, new retirement migration frontiers emerge in the context of a severe weakening of welfare systems. I illustrate this case with data from long-term research with ageing Latvian migrant women to the United Kingdom and the Nordic countries. Even those whose old-age pensions are more or less adequate nevertheless seek temporary employment and new cultural experiences abroad. However, the dominant trend has been towards the pauperisation of older parents and those approaching retirement age due to the significant decline in state welfare. This case of many older-age Latvians who de facto cannot retire due to low disposable income reveals 'reverse frontiers of retirement': working as long as they can, pushing their personal geographical frontiers outward by emigrating for work and making national frontiers more porous through transnational practices. Conceptually and geographically, the research holds relevance for a wider discussion of trends and contextual factors in other post-Soviet and post-socialist countries with increasing diversities among retirees. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the role that Donor Transplant Co‐ordinators have played and the future potential of Specialist Nurses for Organ Donation (SN‐ODs), within organ donation strategies in the UK and other countries. Background: Organ donation and transplantation rates vary extensively around the world. However, there is a universal shortage of deceased donors, prompting different approaches to increase transplantation rates. Within the UK, the Clinical Lead for Organ Donation and Specialist Nurse in Organ Donation undertake a key role in the implementation of the Organ Donation Strategy. The Human Transplantation (Wales) Act 2015 is a recent development which facilities a deemed (presumed) consent approach to organ donation, the Specialist Nurse in Organ Donation undertakes a major role identifying the potential donor in this situation by confirming the deemed consent status of the donor and supporting bereaved relatives. UK governments in England and Scotland are currently seeking legislative changes to an opt‐out system of organ donation, in line with the Wales change. Design: This discursive paper explores the role from Donor Transplant Co‐ordinator to Specialist Nurse in Organ Donation (SN‐OD) within organ donation policy in different settings, but with a specific focus on the UK. The paper clarifies the current and future potential of nurses working with bereaved families when requesting authorisation for donation. Implications for nursing: The current scope and future potential of Donor Transplant Co‐ordinator and Specialist Nurse in Organ Donation roles need better recognition. Little empirical data exist about the key role that these nurses play in the organ donation process, especially in relation to gaining authorisation to proceed to donation. Conclusion: There is a need to clarify the role of the Specialist Nurse in Organ Donation and their impact on improving rates of organ donation. [ABSTRACT FROM AUTHOR]

In the light of the outcome of the 23rd June 2016 UK referendum to leave the European Union and the May government’s consequent approach to Brexit, this paper explores the likely changes that these will bring to a key EU-UK relationship, the competition policy relationship. It is suggested that changes are likely not only in public enforcement and private actions but also in the need for a new competition cooperation architecture between the EU and the UK. In order to appreciate how the competition relationship is likely to change after Brexit, an understanding of the current architecture in respect of the said areas is necessary and thus outlined early in the paper. Thereafter, it is argued that, post the implementation period, as the UK will no longer come under the direct jurisdiction of the European Court of Justice or indeed be a member of the Single European Market, a considerable loosening or separation of the strands that shape the current EU-UK competition relationship will occur. This unwinding of the currently intertwined EU and UK competition regimes will affect both public enforcement and private actions, thereby opening up the possibility of further regulatory divergence, unless consciously checked. Moreover, as the separation will see the Commission’s jurisdictional remit no longer include the UK, the domain will become the sole regulatory concern of UK institutions, particularly the Competition and Markets Authority. This will lead to dual regulatory capture, often of significant and complex antitrust and merger cases, given the overlapping nature of EU and UK markets. Clearly, this necessitates the UK regulator having the appropriate staffing to vet such cases, as it moves from essentially a regional player to one on a par with the Commission and regulators in the USA and China. In fact, the dual capture of such cases reinforces the importance of effective cooperation between the EU and UK regulators. However, given that the current competition cooperation relationship will end at the conclusion of the implementation period, the paper articulates a likely new EU-UK competition cooperation architecture, reflecting the fact that the UK would be outside the EU, but still enabling close, effective cooperation. Of course, and echoing the EU, it is also in the UK’s interest to agree similar competition cooperation bilaterals with key non-EU regulators. Yet, because this will take time, and because cooperation can indeed fail, the UK, like the EU, must ensure its competition instruments have the necessary extra-territorial reach. [ABSTRACT FROM AUTHOR]

The engagement of young people has been a neglected area in youth justice and drug policy and practice. This paper explores the concept of 'engagement' in relation to drug interventions in custodial and community settings in different European countries. Interviews were undertaken with young people (aged 14–25 years) in contact with the criminal justice system who use illegal drugs and with practitioners involved in the delivery of interventions for our target group in Denmark, Italy, Poland, and the UK. The key techniques to engage young people were described in similar terms across the countries. These included forming relationships based on trust, honesty, and empathy, setting goals collaboratively, and employing practitioners with lived experience and understanding. The objectives and activities on offer are often constrained by criminal justice contexts. Despite the differences between the countries in terms of criminal justice systems and the structure of drug interventions, there were remarkable similarities in the ways young people and practitioners described effective engagement. Strong emphasis on operational engagement to ensure positive relationships between young people and practitioners was important in the design and delivery of interventions. Practitioners working in criminal justice contexts need to have flexibility and autonomy to work creatively to find ways to engage, connect, and inspire young people. [ABSTRACT FROM AUTHOR]

Based on research undertaken as part of the EU funded EPPIC project, this paper aims to update and elaborate on the relationship between drug use and offending behaviours by exploring variations within a cross-national sample of drug-experienced young people in touch with criminal justice systems. Adopting a trajectory-based approach, interviews were undertaken with 198 young people aged 15–25 in six European countries (Austria, Denmark, Germany, Italy, Poland, and UK). Data were analysed by applying the Bennett and Holloway categorization of the drugs-crime link, with a focus on the concept of social exclusion as developed by Seddon. Three main types of mechanisms (economic, pharmaceutical, and lifestyles) are used to interpret the data, showing how the relationship between drugs and offending can vary according to type of substances and over time. Furthermore, it can be associated with very different degrees of social exclusion and needs. The results suggest that while economic inequalities still play key roles in explaining drug use and offending, both behaviours can originate from a state of relative deprivation, resulting from the contradictions inherent in 'bulimic societies' that raise aspirations and desires while providing young people scarce opportunities for self-realisation and social recognition. [ABSTRACT FROM AUTHOR]

On 1 January 2014 the transitional controls on free movement adopted by the UK when Bulgaria and Romania joined the EU in 2007, ended. This paper demonstrates how the discourses of politicians relating to their removal, amplified via news media contributed to the extension of state bordering practices further into everyday life. Based on ethnographic research into everyday bordering during 2013–15 the paper uses an intersectional framework to explore how this homogenizing, bordering discourse was experienced and contested from differently situated perspectives of Roma and non-Roma social actors from established communities. [ABSTRACT FROM AUTHOR]

The Golden Digger wasp Sphex funerarius (Gussakovskij 1934) is the largest native European sphecid wasp. Whilst it is a species with a mainly Mediterranean distribution, it can be found sporadically in central Europe during periods of warm and dry weather. The exact reasons for its appearance and disappearance are not well understood, but are probably connected to the abundance of prey. It is probable that recent climate change, caused by long term global warming through human activity, has led to the spread of S. funerarius over central Europe, which makes it likely to appear, sooner or later, in northern Europe and Great Britain. This paper describes the breeding behaviour and general biology as well as the current range expansion of Sphex funerarius. [ABSTRACT FROM AUTHOR]

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

Biscuits are a major product category in the global confectionary sector. Despite this, their environmental impacts are poorly characterised. Therefore, this paper sets out to evaluate the life cycle environmental sustainability of the following widely-consumed types of biscuit, both at the product and sectoral levels: crackers, low fat/sugar, semi-sweet, chocolate-coated and sandwich biscuits with chocolate or vanilla cream. The results obtained through life cycle assessment demonstrate that, in addition to being healthier, low fat/sugar biscuits have the lowest impacts across most of the 18 categories considered. Chocolate-coated biscuits are environmentally the least sustainable. The most significant life cycle stage for all types is the raw materials production, causing 41%–61% of the total impacts, with flour, sugar and palm oil being the key hotspots. Replacing palm with rapeseed oil would improve five impacts but worsen another five, including a 34% increase in agricultural land occupation and marine eutrophication. Therefore, the cultivation and production of palm oil, rather than its replacement, should be targeted for improvements. The second most crucial stage is manufacturing, contributing up to 54% of the impacts, followed by transport with up to 35%. Reducing energy consumption by 25% in manufacturing would reduce primary energy demand by 8%–12%, fossil fuel depletion by 9%–12% and global warming potential by 6%–9%. The latter would increase by 55% if land use change related to cocoa was involved, despite a very small amount of cocoa in the biscuits (∼1%). The analysis at a sectoral level in the UK, the leading consumer of biscuits in Europe, reveals that biscuits contribute 7.4% of primary energy demand and 0.5% of greenhouse gas emissions of the whole UK food sector. These results can help guide manufacturers in mitigating the hotspots in the supply chain and consumers in selecting environmentally more sustainable biscuits. • The environmental sustainability of six types of biscuit is evaluated for the first time. • Low fat/sugar biscuits have the lowest impacts and chocolate-coated the highest. • Global warming potential of chocolate biscuits is 55% higher with land use change. • Flour, sugar and palm oil are the key hotpots, followed by biscuits manufacturing. • Biscuits contribute 7.4% of energy demand and 0.5% of GWP of the UK food sector. [ABSTRACT FROM AUTHOR]

Background: Within the European Union (EU), substantial efforts are being made to achieve economic and social cohesion, and the reduction of health inequalities between EU regions is integral to this process. This paper is the first to examine how self-reported conditions and non-communicable diseases (NCDs) vary spatially between and within countries. Methods: Using 2014 European Social Survey (ESS) data from 20 countries, this paper examines how regional inequalities in self-reported conditions and NCDs vary for men and women in 174 regions (levels 1 and 2 Nomenclature of Statistical Territorial Units, 'NUTS'). We document absolute and relative inequalities across Europe in the prevalence of eight conditions: general health, overweight/obesity, mental health, heart or circulation problems, high blood pressure, back, neck, muscular or joint pain, diabetes and cancer. Results: There is considerable inequality in self-reported conditions and NCDs between the regions of Europe, with rates highest in the regions of continental Europe, some Scandinavian regions and parts of the UK and lowest around regions bordering the Alps, in Ireland and France. However, for mental health and cancer, rates are highest in regions of Eastern European and lowest in some Nordic regions, Ireland and isolated regions in continental Europe. There are also widespread and consistent absolute and relative regional inequalities in all conditions within countries. These are largest in France, Germany and the UK, and smallest in Denmark, Sweden and Norway. There were higher inequalities amongst women. Conclusion: Using newly available harmonized morbidity data from across Europe, this paper shows that there are considerable regional inequalities within and between European countries in the distribution of self-reported conditions and NCDs. [ABSTRACT FROM AUTHOR]

This paper argues that a two-tier system has evolved dividing intra-UK/EU marriages from extra-UK/EU marriages. For the former, marriage is a contract between two individuals overseen by a facilitating state. For the latter, marriage has become more of a legal status defined and controlled by an intrusive and obstructive state. I argue that this divergence in legislating regulation is steeped in an ethnicized imagining of ‘Britishness’ whereby the more noticeably ‘other’ migrants (by skin colour or religion) are perceived as a threat to the national character. The conceptualization of women as legally ‘disabled’ citizens (1870 Naturalisation Act) for whom a state must act as responsible patriarch, is a fundamental part of this imagining of the nation. The paper therefore examines the social (gendered and ethnicized) assumptions and political aims embedded within the legislation. [ABSTRACT FROM PUBLISHER]

Background: Patient and public involvement (PPI) is a requirement for UK health and social care research funding. Evidence for how best to implement PPI in research programmes, such as National Institute for Health Research (NIHR) Collaborations for Applied Health Research and Care (CLAHRCs), remains limited. This paper reports findings from an action research (AR) project called IMPRESS, which aims to strengthen PPI within CLAHRC East of England (EoE). IMPRESS combines AR with Normalisation Process Theory (NPT) to explore PPI within diverse case study projects, identifying actions to implement, test and refine to further embed PPI. Methods: We purposively selected CLAHRC EoE case study projects for in-depth analysis of PPI using NPT. Data were generated from project PPI documentation, semi-structured qualitative interviews with researchers and PPI contributors and focus groups. Transcripts and documents were subjected to abductive thematic analysis and triangulation within case. Systematic across case comparison of themes was undertaken with findings and implications refined through stakeholder consultation. Results: We interviewed 24 researchers and 13 PPI contributors and analysed 28 documents from 10 case studies. Three focus groups were held: two with researchers (n = 4 and n = 6) and one with PPI contributors (n = 5). Findings detail to what extent projects made sense of PPI, bought in to PPI, operationalised PPI and appraised it, thus identifying barriers and enablers to fully embedded PPI. Conclusion: Combining NPT with AR allows us to assess the embeddedness of PPI within projects and programme, to inform specific local action and report broader conceptual lessons for PPI knowledge and practice informing the development of an action framework for embedding PPI in research programmes. To embed PPI within similar programmes teams, professionals, disciplines and institutions should be recognised as variably networked into existing PPI support. Further focus and research is needed on sharing PPI learning and supporting innovation in PPI. [ABSTRACT FROM AUTHOR]

The timing, environmental setting and archaeological signatures of an early human presence in northern Europe have been longstanding themes of Palaeolithic research. In the space of 20 years, the earliest record of human occupation in Britain has been pushed back from 500 ka (Boxgrove) to 700 ka (Pakefield) and then to >800 ka (Happisburgh Site 3). Other sites also contribute to this record of human occupation; a second locality at Happisburgh, referred to as Site 1, attests to human presence at around 500 ka (MIS 13). This paper provides the first comprehensive account of research undertaken at Happisburgh Site 1 since 2000. The early human landscape and depositional environment was that of a river floodplain, where an active river channel, in which a grey sand was deposited, was abandoned, forming a floodplain lake, with marginal marsh/swamp environments, which was infilled with organic mud. This succession is sealed by Middle Pleistocene glacial deposits. An assemblage of 199 flint flakes, flake tools and cores was recovered from the grey sand and organic mud. The evidence from Happisburgh Site 1 is placed in the context of the wider British and European MIS 13 record. The growing evidence for a significant dispersal of humans into northern Europe around 500 ka raises critical questions concerning the environmental conditions under which this took place. We also consider the evolutionary and behavioural changes in human populations that might have enabled the more widespread and persistent period of human presence in northern Europe at this time. • Comprehensive account of the geology and archaeology at Happisburgh Site 1. • Lower Palaeolithic assemblage comprising flakes, flake tools, cores and a handaxe. • Reconstruction of local environment and landscape of human occupation. • Assessment of wider context for human occupation of Europe in MIS 13. [ABSTRACT FROM AUTHOR]

Objectives: (i) To determine the current state of online grocery shopping, including individuals' motivations for shopping for groceries online and types of foods purchased; and (ii) to identify the potential promise and pitfalls that online grocery shopping may offer in relation to food and beverage purchases. Design: PubMed, ABI/INFORM and Google Scholar were searched to identify published research. Setting: To be included, studies must have been published between 2007 and 2017 in English, based in the USA or Europe (including the UK), and focused on: (i) motivations for online grocery shopping; (ii) the cognitive/psychosocial domain; and (iii) the community or neighbourhood food environment domain. Subjects: Our search yielded twenty-four relevant papers. Results: Findings indicate that online grocery shopping can be a double-edged sword. While it has the potential to increase healthy choices via reduced unhealthy impulse purchases, nutrition labelling strategies, and as a method to overcome food access limitations among individuals with limited access to a brick-and-mortar store, it also has the potential to increase unhealthy choices due to reasons such as consumers' hesitance to purchase fresh produce online. Conclusions: Additional research is needed to determine the most effective ways to positively engage customers to use online grocery shopping to make healthier choices. [ABSTRACT FROM AUTHOR]

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

This article examines the relationships between space, ethnic identity and anti-state violence in twentieth century London. It will do so by comparing the Spitalfields violence of 1906 and the Brixton unrest of 1981. The association of physical metropolitan space with 'difference' in the Edwardian East End and post-consensus South London, and how this 'othering' was influenced both by the state and the anti-migrant far right will be analysed. The paper will then dissect relationships between the police and working class Jewish and Caribbean communities, and how these deteriorating relationships exploded into extreme violence in 1906 and 1981. [ABSTRACT FROM AUTHOR]

This paper attempts to explain the relationship between socialism and sport in Britain using a historical and comparative analysis of developments in Europe to identify the particular sociopolitical conditions and processes pertaining in the British case. It argues that a distinctively socialist sports culture failed to develop in Britain due to the interaction between two sets of forces: the powerful economic, political, and cultural constraints that are characteristic of Britain's development, and the character of British socialism's response to those constraints. It pinpoints the ways in which features specific to British socialism disabled socialists from adequately grasping the significance of sport in popular culture, from responding effectively to the way class, sex and gender, and national identities are formed in sporting activity, and from influencing processes of conflict and accommodation taking place around sport between dominant and subordinate groups. [ABSTRACT FROM AUTHOR]

This paper provides a critical review of recent research on the consumption of 'convenience' food, highlighting the contested nature of the term and exploring its implications for public health and environmental sustainability. It distinguishes between convenience food in general and particular types of convenience food, such as ready-meals, tracing the structure and growth of the market for such foods with a particular emphasis on the UK which currently has the highest rate of ready-meal consumption in Europe. Having established the definitional complexities of the term, the paper presents the evidence from a systematic review of the literature, highlighting the significance of convenience food in time-saving and time-shifting, the importance of recent changes in domestic labour and family life, and the way the consumption of convenience food is frequently moralized. The paper shows how current debates about convenience food are part of a longer discursive history about food, health and nutrition. It discusses current levels of public understanding about the links between convenience food, environmental sustainability and food waste. The paper concludes by making a case for understanding the consumption of convenience food in terms of everyday social practices, emphasising its habitual and routine character. [ABSTRACT FROM AUTHOR]

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

Accessible summary In the Western world, many people who have mental health problems experience poor physical health. Research suggests that those with mental illness often have difficulties in accessing health care services, reporting that when they do, their physical health needs are often overlooked., Nurses are expected to deliver safe and effective care that meets the needs of service users. In order to help mental health nurses address physical health care needs, changes to nurse education, supported by government policy, have been made in the United Kingdom. Despite these changes, mental health nurses still feel less confident and prepared to address physical health needs of service users. However, this same problem is also reported by nurses throughout Europe and in other Western countries, who have undergone different training and education programmes., This paper discusses important factors affecting the mental health nurses' ability to deliver physical care and how they impact on confidence and competence., The paper concludes by highlighting the role of the mental health nurse being key in addressing the physical health needs of those in their care, and how this will only be realized when education and practice provide sufficient opportunity for them to develop and maintain their knowledge and skills., Abstract In the Western world, there is increasing concern regarding the ability of health care professionals to meet the physical health care needs of those diagnosed with mental illness. This discussion paper seeks to explore some of the issues facing mental health nurses in delivering care to those who have both mental and physical illness. Criticism of the National Health Service for failing to meet the physical health needs of people with serious mental illness has generated a number of political strategies aimed at addressing inequalities between mental and physical health care, a consequence being a change in pre-registration nurse education. It is envisaged that such changes will enable all nurses to deliver safe, effective care to service users, with adult and mental health nurses being more adept at meeting both the mental and physical health needs of those in their care. The impact of three key areas identified within the literature will be considered: the impact of co-existing physical and mental illness; the role of mental health nurses and perceptions of service users re physical health care; and education, training and learning from others in the Western world. In conclusion, the complexities of delivering such care will be addressed. [ABSTRACT FROM AUTHOR]

This paper discusses the impact of neoliberalism on disability policy and activism. The paper highlights the neoliberalisation of postsocialist disability policy, as well as the convergence between the neoliberal critique of welfare-state paternalism and the advocacy of disabled people’s movement for deinstitutionalisation and direct payments (personal assistance). The discussion is supported by examples from Bulgaria and the United Kingdom. In conclusion, the paper argues that neoliberalism confronts the disabled people’s movement with two difficult tasks: to defend self-determination while criticising market-based individualism, and to defend the welfare state while criticising expert-based paternalism. [ABSTRACT FROM AUTHOR]

Background: The recognition of medical professionalism as a complex social construct makes context, geographical location and culture important considerations in any discussion of professional behaviour. Medical students, medical educators and practitioners are now much more on the move globally, exposing them to cultural and social attitudes, values and beliefs that may differ from their own traditional perceptions of professionalism. Aims and Methods: This paper uses the model of the intercultural development continuum and the concept of 'cultural fit' to discuss what might transpire when a student, teacher or doctor is faced with a new cultural environment. Using our own experiences as medical educators working abroad and supported by evidence in the literature, we have developed four anecdotal scenarios to highlight some of the challenges that different cultural contexts bring to our current (Western) understanding of professionalism. Results and Conclusions: The scenarios highlight some of the potentially different regional and/or cultural perspectives and nuances of professional behaviours, attitudes or values that many of us either take for granted or find difficult, depending on our training and socio-cultural upbringing. With this paper, we hope to start a long overdue conversation about global professionalism amongst medical educators, identify potential areas for research and highlight a need for medical schools to embrace a 'global' approach to how professionalism is embedded in their curricula. [ABSTRACT FROM AUTHOR]

This paper proposes a new perspective for higher education policy research. It introduces the concept of policy object to designate the discrete preoccupation(s) of a policy text (e.g. a new governance regime, a quality system, or new degrees) and suggests that actor conceptualisations of the policy object intersect with other elements in the policy process to shape enactment and outcomes. First, the policy object concept is described. It is argued that the policy object does not have an objective existence and two concepts are proposed to explain it: ontology and enacted ontology. The former refers to what actors believe the policy object is, a socially-construed context-determined conceptualisation, whereas enacted ontology refers to what the policy object becomes further to enactment under the influence of ontology. Second, the paper presents the findings of a comparative study of master degrees further to the Bologna process in different national and institutional settings to illustrate the policy object approach. This research puts forward arguments to suggest that the policy object could be an important variable to consider in policy research. This somewhat different lens, inviting fine-grained attention to a specific policy object (its ontologies and enacted ontologies), could bring additional insight into policy outcomes. [ABSTRACT FROM AUTHOR]

The literature on whether community diversity has a positive effect on individuals' inter-ethnic attitudes (contact hypothesis) or a negative effect (threat hypothesis) remains inconclusive. Most studies infer mechanisms of contact or threat based on the relationship between diversity and mean levels of prejudice in a community. We suggest that both processes of threat and contact may be occurring with increasing diversity. By applying a measure of individual-level contact, this paper demonstrates that increasing community diversity does have a negative effect on inter-ethnic attitudes but only among individuals without inter-ethnic ties. Among those who do form ties, increasing diversity has no effect – that is, contact moderates the negative effect of community diversity. However, this relationship is further moderated by levels of disadvantage in the community. This paper has important implications for the use of the contact/threat hypotheses in studies of contextual diversity and the wider debate on rising diversity in the UK. [ABSTRACT FROM AUTHOR]

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

Between 1933 and 1939, around 20,000 Jewish, ‘non-Aryan’ or politically active refugee women from Germany, Austria and Czechoslovakia entered Britain on domestic service permits. Their immigration, mostly organised by women in the British voluntary sector, served as a moral response to the humanitarian crisis caused by Fascism in Europe, and a practical response to the ‘servant crisis’ in Britain as working-class women increasingly rejected domestic labour. This paper considers the practical and emotional relationships around domestic service and argues that the acceptance of refugee women into the metropolitan British home was conditional on the tacit expectation they could fill the vacancy left by the working classes, becoming British through their labour. [ABSTRACT FROM PUBLISHER]

Framing has previously been studied in the field of pandemic preparedness and global health governance and influenza pandemics have usually been framed in terms of security and evidence-based medicine on a global scale. This paper is based on the pandemic preparedness plans, published after 2009, from eight European countries. We study how pandemic preparedness is framed and how pandemic influenza in general is narrated in the plans. All plans contain references to ‘uncertainty’, ‘pandemic phases’, ‘risk management’, ‘vulnerability’ and ‘surveillance’. These themes were all framed differently in the studied plans. The preparedness plans in the member states diverge in ways that will challenge the ambition of the European Union to make the pandemic preparedness plans interoperable and to co-ordinate the member states during future pandemics. [ABSTRACT FROM PUBLISHER]

Service of proceedings on the defendant must be effected in such a way that he is able to adequately defend his legal position and is therefore directly linked to Article 6(1) of the European Convention on Human Rights and to Article 47 of the Charter of the Fundamental Rights of the European Union (EU). The European Court of Human Rights (ECtHR) has dealt with service-related issues on many occasions, and so has also the Court of Justice of the European Union (CJEU), especially when dealing with difficulties detected by national courts facing the application of EU legislation. Indeed, the EU lawmaker has been aware of the relevance of first service of process and has afforded it a very significant attention: when regulating cross-border service of the claim; in the context of specific "EU" civil proceedings (like the EU order for payment procedure, the EU small claims procedure or the EU account preservation order); and in the framework of recognition and enforcement of foreign decisions. It is the aim of this paper to analyse the way in which first service of process has been addressed in European legislation, and also, from the point of view of case-law, the way in which the ECtHR and the CJEU have approached this issue. By analysing both Regulations and case-law it may be possible to extract minimum European standards regarding this procedural safeguard which, undoubtedly, can serve as a starting point for EU legislative implementation and, in a perhaps not-so-distant future, to standardize national codes of procedural law. [ABSTRACT FROM AUTHOR]

The right of children to be heard is acknowledged as a fundamental human right, as the European Court of Human Rights in the case Iglesias Casarrubios and Cantalapiedra Iglesias v Spain of 11 October 2016 emphasized. In the Brussels IIa Regulation this right plays a crucial role. On 30 June 2016, the European Union Commission issued a Recast Proposal of this Regulation, which suggests amending it in several aspects including the hearing of the child. This paper analyzes how the Brussels IIa Regulation addresses the right of the child to be heard and the amendments suggested by its Recast Proposal. [ABSTRACT FROM AUTHOR]

Background: The European Disability Strategy (2010-2020) seeks to significantly raise the proportion of people with disabilities working in the open labour market. The ERGO WORK project is a collaboration of academic and industrial partners in six European countries, focused on understanding and tackling barriers to workplace inclusion for workers with disabilities. Methods: This study sought to explore the perceptions and needs of stakeholders in terms of workplace adaptation to the needs of employees with disabilities. An exploratory online survey was completed by 480 participants across six countries. Results: The analysis suggests that workplaces could be further improved to meet the needs of employees with considerable scope for training within companies to raise awareness about employees' needs, employers' obligations and workplace adaptation. Conclusions: This snapshot suggests there is still a gap between intent and reality in workplace inclusion and further strategies are needed to improve the opportunities for employees with disabilities. The paper argues that ergonomics may have a key role to play in tackling these challenges and adapting the workplace environment and job design to suit the needs of individual employees. [ABSTRACT FROM AUTHOR]

There is a growing interest in island economies within Europe. In the European Union (EU) this has led to enhanced Cohesion Policy support for islands, along with a number of other regions facing geographical challenges. Because of major problems with data, comparative research on islands across different EU member states has been of limited extent. This paper explores the use of national data sets to undertake comparative cross-country analysis of islands. The paper concentrates on two member states, Greece and Britain, which have large numbers of offshore islands. Data from national population censuses are drawn upon to allow typologies of the islands to be developed. These typologies are utilised to identify similarities and differences between British and Greek islands. [ABSTRACT FROM AUTHOR]