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People with intellectual disabilities face health disparities, including in high‐income countries such as the United Kingdom, despite publicly funded healthcare. This paper describes the healthcare system in England (a nation of the United Kingdom) for the general population, and more specifically for people with intellectual disabilities. Key legislation that impacts the lives of people with intellectual disabilities, such as the UK Equality Act 2010 (https://www.legislation.gov.uk/ukpga/2010/15/contents), the Mental Capacity Act 2005 (https://www.legislation.gov.uk/ukpga/2005/9/contents), and the UN Convention on the Rights of Persons with Disabilities, and its implementation in the United Kingdom, is discussed. The role of deinstitutionalization and the shift to living in the community for people with intellectual disabilities is also discussed. Programmes that have been implemented to address the health disparities experienced by people with intellectual disabilities are reviewed. Finally, the recent changes to healthcare organization in the UK, the COVID‐19 pandemic, and the implementation of the Valuing People white paper are discussed. [ABSTRACT FROM AUTHOR]

It is often difficult to ascertain the durability or longevity of construction products. Two opportunities arose to examine old AAC masonry material that had been used in construction with a reasonable knowledge of the manufactured characteristics of the product. The first of these was from blocks sampled from three locations within the internal and external walls of the H+H factory in England that was being dismantled in 2013. In the second case, a partly demolished wall provided an opportunity to salvage two almost complete blocks for testing. This paper will describe the tests, and the results and compare the results with the predicted physical characteristics of the manufactured products [ABSTRACT FROM AUTHOR]

As the United Kingdom reduces its CO2 emissions in order to meet its 2050 net zero greenhouse gas targets, there will be a significant evolution of the UK's energy mix. The reliance on hydrocarbons will decrease while there is predicted to be an increase in low carbon energy sources such as renewables and nuclear. In order to decarbonise and achieve the net zero emissions targets while concurrently producing enough energy to provide for national energy needs, large‐scale, low carbon energy generation projects need to be developed alongside energy storage facilities to provide flexibility within a low carbon energy supply. Robust CCUS programmes will need be developed in order to capture and store unavoidable carbon dioxide emissions. The subsurface geology of the UK provides opportunities for the development of low carbon energy generation, energy storage and CCS, and the Upper Permian Zechstein Supergroup deposited in eastern England and offshore in the Southern North Sea is a potential host for these new developments. In NE England, salt cavern gas storage sites have been developed in thick Zechstein evaporites since the mid 20th centrury. In this paper we present new isopach maps and well correlation panels which will help to outline optimal locations for the development of additional salt caverns for gas storage. A review of the Zechstein Supergroup indicates that it does not exhibit great potential for the development of CCS, due both to its complex reservoir characteristics and to difficulties with both subsurface imaging and monitoring. However thick Zechstein evaporites could provide an excellent seal for CO2 storage in the underlying Lower Permian Rotliegend Group. [ABSTRACT FROM AUTHOR]

Background: Very young children from lower socioeconomic status (SES) backgrounds often show poorer language development. Whilst there have been attempts to provide early intervention programmes, these sometimes miss the most disadvantaged groups. Aims: This report presents preliminary feasibility and effectiveness data for a novel language intervention designed for parents of toddlers in the United Kingdom. Methods and Procedures: In total, 43 UK families of 2–4‐year‐olds were recruited to the study, half of whom completed an 8‐week course (Tots Talking) focussed on parent interaction, and half of whom acted as wait‐list controls. Results and Outcomes: Results suggest that such programmes are feasible for families with 86% staying in the intervention. In addition, greater changes in underlying communication skills such as joint attention and gesture were evident compared to wait‐list controls. Conclusions and Implications: We conclude that pre‐verbal skills may be more important to measure as initial outcomes than language or vocabulary change in this population. What This Paper Adds: What is already known on the subject: Children from lower socioeconomic status (SES) backgrounds are at higher risk of communication difficulties and there is a need for community intervention programmes for very young children. What this study adds: This study suggests that such programmes can be feasible and effective, but that very early/basic communicative skills (such as joint attention) may be boosted first rather than language or vocabulary. What are the clinical implications of this work?: Children's centres and other community services could feasibly run short parent facing courses emphasising contingent communication in low SES families and other diverse groups. These may be more successful run with younger preschoolers. Joint attention may be a better focus of intervention before expecting vocabulary or language change. Community health professionals may find this information useful in referring and supporting families in need. [ABSTRACT FROM AUTHOR]

Introduction: Co‐production with communities is increasingly seen as best practice that can improve the quality, relevance and effectiveness of research and service delivery. Despite this promising position, there remains uncertainty around definitions of co‐production and how to operationalize it. The current paper describes the development of a co‐production strategy to guide the work of the ActEarly multistakeholder preventative research programme to improve children's health in Bradford and Tower Hamlets, UK. Methods: The strategy used Appreciative Inquiry (AI), an approach following a five‐step iterative process: to define (Step 1) scope and guide progress; to discover (Step 2) key issues through seven focus groups (N = 36) and eight in‐depth interviews with key stakeholders representing community groups, and the voluntary and statutory sectors; to dream (Step 3) best practice through two workshops with AI participants to review findings; to design (Step 4) a co‐production strategy building on AI findings and to deliver (Step 5) the practical guidance in the strategy. Results: Nine principles for how to do co‐production well were identified: power should be shared; embrace a wide range of perspectives and skills; respect and value the lived experience; benefits should be for all involved parties; go to communities and do not expect them to come to you; work flexibly; avoid jargon and ensure availability of the right information; relationships should be built for the long‐term; co‐production activities should be adequately resourced. These principles were based on three underlying values of equality, reciprocity and agency. Conclusion: The empirical insights of the paper highlight the crucial importance of adequate resources and infrastructure to deliver effective co‐production. This documentation of one approach to operationalizing co‐production serves to avert any misappropriations of the term 'co‐production' by listening to service users, stakeholders and other relevant groups, to develop trust and long‐term relationships, and build on the learning that already exists amongst such groups. Patient or Public Contribution: The work was overseen by a steering group (N = 17) of individuals, both professional and members of the public with experience in undertaking co‐production, and/or with some knowledge of the context of the two ActEarly field sites, who provided regular oversight and feedback on the AI process. [ABSTRACT FROM AUTHOR]

The Upper Permian Zechstein Supergroup has the potential to play an important role in the UK's future energy production and energy transition. However the Supergroup is comparatively poorly understood in the UK, particularly the link between the onshore and offshore geology. In this paper we re‐evaluate available data in order to present a consistent regional interpretation of the Z1 to Z3 Zechstein Supergroup cycles. This review is based on an interpretation and re‐evaluation of 620 offshore wells located in the UK portion of the SW Southern North Sea and 83 onshore wells located in Yorkshire and Lincolnshire (eastern England). The Zechstein Supergroup was interpreted in each well, and the data was used to compile seven SW‐NE oriented correlation panels which show the development of the Supergroup in the study region. Five isopach maps for key formations in the Zechstein Supergroup were created, together with depositional environment maps for each of the main Zechstein carbonate formations. In combination, these regional‐scale maps and diagrams have resulted in a consistent interpretation of the Zechstein Supergroup over an area which extends from the onshore outcrop in the west to the UKCS boundary in the Southern North Sea in the east. [ABSTRACT FROM AUTHOR]

Plain Language Summary: Nearly synchronous global changes in geomagnetic polarity give both a detailed irregular pacing to geological time and provide a glimpse into heat transfer processes across the core—mantle boundary which drives the Earth's geodynamo. Although the Late Carboniferous is characterized by some well‐studied reversals, details of the tempo of polarity changes in the Early Carboniferous are unknown. This work addresses this by providing a detailed record of polarity changes over a ∼2 million year interval at around 334.5–332.5 million years ago‐from the Trowbarrow Quarry section in NW England. We demonstrate that these limestones likely preserve magnetization from close to their time of formation and record at least 31 polarity reversals. These observations support the idea that the Earth's dynamo was in a hyperactive reversing state similar to those sustained for tens of Myr in the Late Jurassic, parts of the Cambrian and the Late Ediacaran. It further corroborates a ∼200 Myr cyclicity in paleomagnetic field behavior since the Precambrian, potentially linked to variable core heat flow forced by mantle convection. The pattern of geomagnetic polarity changes during the Early Carboniferous (Mississippian) is not known in detail. This information sparsity is addressed by determining a magnetostratigraphy from the late Asbian (late Visean at ∼333 Ma) in Trowbarrow Quarry, UK. This is the stratotype section of the late Asbian and has a detailed foraminiferal zonation based on the same set of paleomagnetic samples, establishing a detailed biostratigraphy. The 195 m‐thick section was sampled at an average spacing of 1.1 m, yielding a detailed magnetostratigraphy comprising nine major magnetozone couplets, and seven submagnetozones. The section dataset has a 78% bias to normal polarity determined from 177 sampling levels. The magnetization is carried by a mixture of hematite and detrital magnetite, with 68% of specimens dominated by hematite magnetizations. The primary magnetization passes a fold test showing its age was prior to the latest Carboniferous. The hematite is inferred to be largely of detrital, eolian origin, although some reddened levels are associated with emergent surfaces, suggesting that a small fraction of hematite is associated with platform emergence. The Mississippian age magnetization is partly overprinted with Kiaman Superchron‐age and Brunhes‐age magnetizations. Using the duration of the section based on astrochronology indicates a reversal frequency of 15.7 ± 0.75 Myr−1, indicating that the geodynamo was in a hyperactive reversing state between 335 and 333 Ma. Key Points: A 195 m section, representing ∼2 Myr, yields a magnetostratigraphy comprizing nine major magnetozone couplets and seven submagnetozonesPrimary magnetizations are predominantly carried by hematite with lesser important detrital magnetite. Data pass regional fold testsA reversal frequency of 15.7 ± 0.75 Myr−1 is calculated, suggesting that the geodynamo was in a hyperactive state at ∼333 Ma [ABSTRACT FROM AUTHOR]

Existing research has extensively documented that those living in the most deprived neighbourhoods and individuals from some ethnic minority groups have low rates of labour market participation in the United Kingdom. This paper brings together these two established areas of research to ask whether ethnic minority groups have better employment participation when living in more deprived neighbourhoods. We hypothesise that this could be due to different socialisation processes enabling ethnic minorities to secure employment more easily in deprived neighbourhoods as well as in neighbourhoods where there is greater ethnic density. Data from the United Kingdom Household Longitudinal Study in England are linked to the Index of Multiple Deprivation 2014 and the 2011 Census to model unemployment and economic inactivity between 2009 and 2019 separately for women and men. The results show that some ethnic minority groups face disadvantage in the labour market, especially Pakistani and Bangladeshi women. There is little support to suggest that these penalties are lessened in more deprived neighbourhoods or in more ethnically dense neighbourhoods. There is some suggestion that groups who do not face ethnic penalties compared with the White British group have lower rates of unemployment and economic inactivity in more deprived neighbourhoods. We suggest policies aimed at improving labour market outcomes for disadvantaged ethnic minorities should target them wherever they live. [ABSTRACT FROM AUTHOR]

Effective conservation decisions rely on accurate survey data, but methods can be resource‐intensive and risk false negative results. Presence of the threatened hazel dormouse (England, UK) is typically confirmed by looking for its nest in survey tubes, over a 6‐month period. As an alternative, environmental DNA (eDNA) surveys have proven benefits in efficiency and accuracy for other taxa, but generally rely on the extraction and amplification of DNA from water, soil or sediment, which are not yet dependable samples for rare terrestrial mammals like the hazel dormouse.At a known occupancy site, paper‐lined survey tubes were used to capture a DNA sample. Like other species of rodent, the hazel dormouse excretes urine freely, and this was highlighted by ultraviolet torch, swabbed from the paper, extracted and hazel dormouse eDNA amplified by quantitative polymerase chain reaction (qPCR).Hazel dormouse presence was confirmed in this way in three out of 50 tubes within 8 days. Detection by conventional nest survey occurred on day 63 when a hazel dormouse nest was found in a single survey tube. We calculate that amplification of eDNA left behind in tubes increased survey efficiency here at least 12‐fold.Synthesis and applications. In this study we demonstrate that eDNA swabbed from a clean substrate placed in survey apparatus can significantly hasten the detection of a rare species. This method has the potential to broaden the application of eDNA to other terrestrial vertebrates, including surveys at large spatiotemporal scales. Beyond presence/absence, the non‐invasive DNA sample could also offer insights into sex ratio, abundance, behaviour and population genetics. [ABSTRACT FROM AUTHOR]

Figures are showing that ethno‐cultural issues are increasingly related to most school bullying incidents happening lately. While many theoretical arguments and empirical investigations scrutinize the effects of foreign migration on hostile behaviors enacted by the adult population, there is insufficient evidence on the effects of immigration on youth. This paper provides evidence by exploiting the shock from migration that occurred in the UK after the 2004 European Union Enlargement to estimate the magnitude and the directionality of the effect exerted by the resulting inflow of migrants on school bullying. Multilevel logit, generalized estimating equations, and control function with two‐stage residual inclusion are used on a novel data set containing spatially fine‐grained observations on school bullying across the UK. Findings highlight a relevant effect of the shock from migration in triggering bullying, which is robust to the accounting for potential endogeneity with respect to immigrants' location choice. The role of existing language barriers as a channel for the effect of the migration shock is also scrutinized, to find that they increase its effect. [ABSTRACT FROM AUTHOR]

Introduction: The UK low‐risk drinking guidelines were revised in 2016. Drinkers were primarily informed about the guidelines via news media, but little is known about this coverage. This study investigated the scale and content of print and online textual news media coverage of drinking guidelines in England from February 2014 to October 2017. Methods: We searched the Nexis database and two leading broadcasters' websites (BBC and Sky) for articles mentioning the guidelines. We randomly selected 500 articles to code for reporting date, accuracy, tone, context and purpose of mentioning the guidelines, and among these, thematically analysed 200 randomly selected articles. Results: Articles mentioned the guidelines regularly. Reporting peaked when the guidelines revision was announced (7.4% of articles). The most common type of mention was within health‐ or alcohol‐related articles and neutral in tone (70.8%). The second most common was in articles discussing the guidelines' strengths and weaknesses, which were typically negative (14.8%). Critics discredited the guidelines' scientific basis by highlighting conflicting evidence and arguing that guideline developers acted politically. They also questioned the ethics of limiting personal autonomy to improve public health. Criticisms were partially facilitated by announcing the guidelines alongside a 'no safe level of drinking' message, and wider discourse misrepresenting the guidelines as rules, and highlighting apparent inconsistencies with standalone scientific papers and international guidelines. Discussion and Conclusions: News media generally covered drinking guidelines in a neutral and accurate manner, but in‐depth coverage was often negative and sought to discredit the guidelines using scientific and ethical arguments. [ABSTRACT FROM AUTHOR]

The research goals were to obtain an understanding of who the users of e‐books in the NHS are, what they are using e‐books for, and when and how they use them. This article presents the methodology used and the findings from the research. It also explores the outputs and next steps from the research, both for the individual countries and collectively. The Five Nations group, (library leads in England, Northern Ireland, Ireland, Scotland and Wales) commissioned research into healthcare staff use and non‐use of e‐books to understand the behaviours, needs and expectations of healthcare staff and to identify shared challenges around e‐books to inform policy and practice. [ABSTRACT FROM AUTHOR]

Digital pathology – the digitalisation of clinical histopathology services through the scanning and storage of pathology slides – has opened up new possibilities for health care in recent years, particularly in the opportunities it brings for artificial intelligence (AI)‐driven research. Recognising, however, that there is little scholarly debate on the ethics of digital pathology when used for AI research, this paper summarises what it sees as four key ethical issues to consider when deploying AI infrastructures in pathology, namely, privacy, choice, equity, and trust. The themes are inspired from the authors' experience grappling with the challenge of deploying an ethical digital pathology infrastructure to support AI research as part of the National Pathology Imaging Cooperative (NPIC), a collaborative of universities, hospital trusts, and industry partners largely located across the North of England. Though focusing on the UK case, internationally, few pathology departments have gone fully digital, and so the themes developed here offer a heuristic for ethical reflection for other departments currently making a similar transition or planning to do so in the future. We conclude by promoting the need for robust public governance mechanisms in AI‐driven digital pathology. [ABSTRACT FROM AUTHOR]

Introduction: While screening uptake is variable, many individuals feel they 'ought' to participate in screening programmes to aid the detection of conditions amenable to early treatment. Those not taking part in screening are often presented as either hindered by practical or social barriers or personally at fault. Why some people choose not to participate receives less consideration. Methods: We explored screening nonparticipation by examining the accounts of participants who chose not to participate in screening offered by a national research trial of atrial fibrillation (AF) screening in England (SAFER: Screening for Atrial Fibrillation with ECG to Reduce stroke). AF is a heart arrhythmia that increases in prevalence with age and increases the risk of stroke. Systematic screening for AF is not a nationally adopted programme within the United Kingdom; it provides a unique opportunity to explore screening nonparticipation outside of the norms and values attached to existing population‐based screening programmes. We interviewed people aged over 65 (n = 50) who declined an invitation from SAFER and analysed their accounts thematically. Results: Beyond practical reasons for nonparticipation, interviewees challenged the utility of identifying and managing AF earlier. Many questioned the benefits of screening at their age. The trial's presentation of the screening as research made it feel voluntary—something they could legitimately decline. Conclusion: Nonparticipants were not resistant to engaging in health‐promoting behaviours, uninformed about screening or unsupportive of its potential benefits. Instead, their consideration of the perceived necessity, legitimacy and utility of this screening shaped their decision not to take part. Patient or Public Contribution: The SAFER programme is guided by four patient and carer representatives. The representatives are embedded within the team (e.g., one is a co‐applicant, another sits on the programme steering committee) and by participating in regular meetings advise on all aspects of the design, management and delivery of the programme, including engaging with interpreting and disseminating the findings. For the qualitative workstream, we established a supplementary patient and public involvement group with whom we regularly consult about research design questions. [ABSTRACT FROM AUTHOR]

People with learning disabilities are living longer. Older people with learning disabilities should be included in policies and plans that are for all older people. National plans and policies for older people often do not say anything about older people with learning disabilities, and it is hard to know whether older people with learning disabilities are benefiting. People who plan services locally often do not have good information on older people with learning disabilities. Using the Equalities Act 2010 could help people who plan services and write policy to think about older people with learning disabilities but this is not happening at the moment. People who work with older people with learning disabilities should be aware of policy for all older people, so that older people with learning disabilities do not miss out. This paper seeks to explore the opportunities and challenges generated by current policy, guidance and legislation in England relating to older people, in terms of the practical implications for older people with learning disabilities. Using the broad themes housing, employment, social inclusion and isolation, care and support, and promoting better health and well-being, this paper discusses potential practical opportunities and concerns for older people with learning disabilities arising from policy and legislation such as current initiatives regarding integration, personalisation and the dementia policy. Consideration is given to the implications of changing policy and practice for both current and future generations of people with a learning disability as they reach older age. This discussion paper concludes that whilst there is potential for older people with a learning disability to benefit from policy and practice aimed at improving the lives of older people generally, the tendency for policy to be targeted at specific groups without adequately considering the diversity of those groups often leaves those with a learning disability at the margins of being able to make the most of changes. [ABSTRACT FROM AUTHOR]

Agricultural land use can increase runoff and erosion leading to detrimental downstream impacts. This paper examines the impact of agricultural land cover change on runoff and sediment generation at event scales using a model‐based approach. SHETRAN, a physically based, spatially distributed model, was applied in two southwest England catchments to represent: (a) changes in the land cover (cropland extent and spatial arrangement), (b) changes in crop type and (c) use of riparian buffer strips. A total of 84 simulated events within a 4‐year period were used to quantify impacts on flow and sediment generation. We found past changes in land cover resulted in significant differences in sediment yield (p < 0.05). Linear regression showed an increase in flow and sediment yield proportional to increases in arable crop area (p < 0.001). The spatial arrangement of cropped fields and riparian buffer strips produced no significant differences in event flow or sediment yield (p > 0.05). However, buffer strip scenarios compared with the base run showed sediment load reductions for specific events, up to 20% and 15% for woodland and grass riparian buffers, respectively. When comparing crop types with and without the use of post‐harvest cover crops, we observed non‐significant differences for event flow and sediment yield. However, large reductions in modelled sediment yields occurred for some events (e.g., up to 60% for winter cereals, 50% for maize and 74% for spring cereals). For these scenarios, examination of rainfall event magnitude emphasized the importance of ground cover in mitigating soil erosion for maize and spring cereals, but not for winter cereals. Our findings indicate that significant changes in sediment delivery at the event scale over a multi‐year period are associated with variations in cropland extent and crop types, depending on rainfall magnitude, but not on the spatial arrangement of cropped fields or the use of riparian buffer strips. [ABSTRACT FROM AUTHOR]

The Equals Formal Curriculum English Scheme of Work has been designed for that very small percentage of the school population, perhaps as low as one or two per cent, who have global learning difficulties (GLD) to such a degree that they are consistently working at levels significantly below their age‐related peers for all of their academic lives. The term GLD includes all those in England currently ascribed as having severe learning difficulties (SLD) and many if not most, currently ascribed as having moderate learning difficulties (MLD). Evidence of the difficulties faced by such pupils will become increasingly obvious beyond Year 1 at age 6, because the difficulties are global rather than specific. That is, they are likely to affect all learning, but will be particularly apparent in numeracy and literacy. This paper, the first of two, seeks to clarify why reading and writing are so extraordinarily difficult for this population and posits that the answers lie in challenging perceived wisdoms within the education system's predilections towards (i) regarding phonics as the only solution to reading difficulties (ii) persisting over time (and in the face of evidence to the contrary) with the view that children, young people and adults with GLD can make sufficient progress within phonics teaching and (iii) the use of differentiation of a standardised national curriculum model as being a sufficient answer to global learning difficulties. Clearly the main language used in England is English, but the principles and ideas outlined in this paper should apply in any language which uses a phonic structure when teaching language. [ABSTRACT FROM AUTHOR]

This article examines the spaces, materiality, and practices of (in)formal education and citizenship bound up in the educational cultures of the Council for the Preservation of Rural England (CPRE) in 1930s England. Founded in 1926, the CPRE aimed to preserve rural amenities through concerted action, by working through their constituent societies as a centre for furnishing or obtaining advice and information, and importantly, by educating public opinion. While much work has examined inter‐war preservationism and the CPRE's focus on planning legislation and design, less attention has been paid to the CPRE's cultures of education for children and young people. Drawing on archival research, this paper considers two educational topics, namely, nature study and school design, and makes three key contributions to the geographies of education. First, that the CPRE mobilised the notion of amenity to provide an experiential and intuitive education in preservationism: amenity was both education and educator. Second, that this education was linked to notions of (future) citizenship, hope, and (future) preservationism, becoming an education that would remain with the child throughout their life. Third, this article explores the CPRE's authority, revealing the ways in which it was often complex and precarious, as well as the ways in which the Council drew on other forms of authoritative identities, spaces, and structures. In so doing, this paper contributes to ongoing academic debates on the complex and fluid boundaries of (in)formal education. [ABSTRACT FROM AUTHOR]

This article argues that reforms of higher education finance for undergraduates in England introduced by the Blair government in 2006 provided a progressive strategy for achieving the central objectives of higher education of quality (better), access (wider) and size (larger). Reforms in 2012 are a not a strategy but a collection of ad hoc arrangements. They include the good (a higher fees cap, a higher interest rate on student loans, better information and improved support for part-time study), the bad (abolishing most taxpayer support for teaching in the arts and humanities and the social sciences, and raising excessively the threshold at which loan repayments start) and the unspeakable (abolishing Education Maintenance Allowances and AimHigher). The reforms are fiscally costly and hence perpetuate the central problem of capped student numbers, and will not stand the test of time. The concluding section outlines the next White Paper. [ABSTRACT FROM AUTHOR]

Background: The importance of good oral hygiene for patients in Intensive Care Units (ICUs) is well recognized, however, the most effective way to achieve good oral care in the ICU is unclear. Aim: This study aimed to provide a national picture of oral care practices in adult ICUs in the United Kingdom (UK) to identify areas for improvement. Study Design: A national one‐day point prevalence study was undertaken in adult ICUs in the UK in the period from 30th September to 14th October 2021. Data were collected on all patients in the ICU on the date of data collection. Using a validated electronic data collection form, anonymised data were collected on methods and frequency of oral care provided, and the use of oral care protocols within the ICU. Data were analysed using descriptive analysis. Results: Data from 195 patients in 15 ICUs in England, Wales and Northern Ireland were collected. Written oral care protocols were available for use in the care of 65% (n = 127) of patients. 73% (n = 142) of patients received oral care within the 24‐h period. Oral care methods included toothbrushing 41% (n = 79), foam sticks 3% (n = 5), moisturizing the oral cavity 10% (n = 19) and mouth rinse with chlorhexidine 3% (n = 5) and other oral care methods not specified 12% (n = 23). 44% (n = 85) of patients had an oral assessment within the 24‐h period and variable assessment methods were used. Conclusion: There is large variability in oral care provision and methods for intubated ICU patients and a lack of consensus was revealed in the study. Oral assessment is conducted less frequently using multiple tools. Optimal oral care standards and further research into oral care provision is pivotal to address this important patient‐relevant practice. Relevance to Clinical Practice: Oral care is a fundamental part of care for ICU patients, however, there is a large degree of variability, and oral care is often not based upon oral assessment. The use of an oral care protocol and oral assessments would help to improve patient care, ease of use for staff and provide a tailored oral care plan for patients, improving efficiency and preventing wasted resources. [ABSTRACT FROM AUTHOR]

Background: Care home staff working during the COVID‐19 pandemic experienced higher levels of stress and increased workloads. People from diverse ethnic backgrounds were disproportionately affected by the COVID‐19 pandemic. This study explored the identity experiences of care home staff from diverse ethnic backgrounds in the context of working during the COVID‐19 pandemic. Methods: Fourteen semistructured interviews were conducted between May 2021 and April 2022 with ethnic minority care home staff in England, who worked during the pandemic. Participants were recruited using convenience and theoretical sampling. Interviews were conducted via telephone or online platforms. A social constructivist grounded theory methodology was utilised in analysing the data. Findings: Participants described five key processes which facilitated or hindered the impact that their experiences had on their identity: dealing with uncertainty and transitioning into a COVID‐19 world; difficult emotions; experiences of discrimination and racism; the response from the care home and societal systems; and the personal vs collective responsibility. When participants' physical and psychological needs went unmet by support structures within the care home and/or society, they experienced a sense of injustice, lack of control and being unvalued or discriminated against by others. Conclusions: This study highlights the importance of recognising the unique needs of staff from diverse ethnic backgrounds working in care homes and adapting working practices to improve impact on identity, job satisfaction and staff retention. Patient and Public Involvement: One care home worker was involved in developing the topic guide and helping to interpret the findings. [ABSTRACT FROM AUTHOR]

In England, pupils aged 16 take the General Certificate of Secondary Education (GCSE) examinations for a range of subjects. The current assessment models for GCSE include a two-tier structure for some subjects and a non-tier model for the others. The tiered subjects have a higher tier designed for high achieving pupils and a lower tier for low achieving pupils. The higher tier paper is targeted at grades A*–D (with A* the highest grade available), while the lower tier paper at grades C–G (with G the lowest grade). The UK government has proposed a comprehensive reform of GCSEs. It suggested that, with tiered papers, pupils are forced to choose between higher and lower tier papers, which will place a cap on the ambition of those entering for the lower tier. The government therefore suggests avoiding tiering in the reformed GCSEs when possible. This paper discusses the technical and equity issues with the use of tiered examinations in current GCSEs and reviews potential alternative assessment approaches for effective differentiation between pupils for the reformed GCSEs. [ABSTRACT FROM PUBLISHER]

Health and employment are strongly correlated. This paper reviews the existing evidence and brings in new evidence on the following issues: (a) the measurement of health; (b) the impact of health on employment rather than just the association between health and employment; (c) the mechanisms by which health impacts employment; and (d) the likely effect of recent retirement and disability policy changes in the UK. Although the magnitude of the estimated effect of health on employment varies greatly from study to study, some of this variation is driven by the health measure used. Given our preferred measure, the evidence suggests that 5–10 per cent of the employment decline between ages 50 and 70 is due to declining health in England, with the largest effects among low‐educated men. Most of the effect comes through declining preferences for work and lower productivity when in bad health, although some of the effect is from government‐provided incentives to not work when in bad health, such as from disability benefits. [ABSTRACT FROM AUTHOR]

This paper reports research commissioned by an English City Council. Its aim was to gather data to identify and prioritise the council's efforts to develop, co‐ordinate and monitor services and support for young people with SEND in the city as they move into their adult lives. This included the four areas identified by the English government in the SEND Code of Practice, these being: employment, community inclusion, health and independent living. The study used qualitative and quantitative research methods including semi‐structured interviews and questionnaires to investigate the experiences of students, teachers, National Health Service staff and social workers in identifying processes and structures that support or hinder the transition process as children prepare for adulthood. As such the study gathered generic data to indicate the expectations, needs, aspirations and views of young persons between the ages of 14 and 22 with regards to employment, education, community inclusion and health. An interpretation of data from the research illustrated the effectiveness of the support structures that are in place to help with planning and delivery of the strategic direction for services supporting children and young people with SEND as they become adults. [ABSTRACT FROM AUTHOR]

Although breastfeeding is known to improve health, economic and environmental outcomes, breastfeeding initiation and continuation rates are low in the United Kingdom. The global WHO/UNICEF Baby Friendly Hospital Initiative (BFHI) aims to reverse declining rates of breastfeeding by shifting the culture of infant feeding care provision throughout hospital maternity settings. In the United Kingdom, the global BFHI has been adapted by UNICEF UK reflecting a paradigm shift towards the experiences of women and families using maternity services. This research used a critical ethnographic approach to explore the influence of the national UNICEF UK Baby Friendly Initiative (BFI) standards on the culture of one typical maternity service in England, over a period of 8 weeks, across four phases of data collection between 2011 and 2017. Twenty‐one staff and 26 service users were recruited and engaged in moderate‐level participant observation and/or guided interviews and conversations. Basic, organising and a final global theme emerged through thematic network analysis, describing the influence of the BFI on providing, receiving and leading infant feeding care in a hospital maternity setting. Using Antonovsky's sense of coherence construct, the findings discussed in this paper highlight how the BFI offers 'informational' (comprehensible), 'practical' (manageable) and 'emotional' (meaningful) support for both staff and service users, strengthened by effective, local leadership and a team approach. This is juxtaposed against the tensions and demands of the busy hospital maternity setting. It is recommended that ongoing infant feeding policy, practice and leadership balance relational and rational approaches for positive infant feeding care and experiences to flourish. [ABSTRACT FROM AUTHOR]

Fleas in the genus Ctenocephalides are the most clinically important parasitic arthropods of dogs and cats worldwide yet risk factors that might increase the risk of infestation in small animals remains unclear. Here we developed a supervised text mining approach analysing key aspects of flea epidemiology using electronic health records from domestic cats and dogs seen at a sentinel network of 191 voluntary veterinary practices across Great Britain between March 2014 and July 2020. Our methods identified fleas as likely to have been present during 22,276 of 1,902,016 cat consultations (1.17%) and 12,168 of 4,844,850 dog consultations (0.25%). Multivariable logistic regression modelling found that animals originating from areas of least deprivation were associated with 50% reductions in odds of veterinary‐recorded flea infestation compared to the most deprived regions in England. Age of the animal was significantly associated with flea presentation in both cats and dogs, with cases peaking before animals reached 12 months. Cases were recorded through each study years, peaking between July and October, with fluctuations between each year. Our findings can be used towards healthcare messaging for veterinary practitioners and owners. [ABSTRACT FROM AUTHOR]

From 1794, when the British volunteer movement began in earnest, to 1802, when the French Revolutionary Wars came to an end, the established clergy preached numerous sermons to volunteer military units throughout England and in parts of Scotland. These sermons sought to articulate a sense of Britishness in such a way as to command more or less universal assent, meaning assent both to the ongoing war effort and to the national enterprise more broadly considered. Volunteers across the country were taught to see Great Britain as a nation chosen by God to stand alone against the onslaught of French principles, and they were encouraged to derive a sense of purpose and meaning from their local contributions to the national struggle. The volunteer sermons bridged the gap between local attachments and national commitments, and in so doing they played a significant role in the formation of a national consciousness. [ABSTRACT FROM AUTHOR]

Purpose: Myopia prevalence has increased in the UK at age 10‐16y, but little is known about younger children. We hypothesise that if the 'myopia epidemic' is affecting young children, then there will be increasing rates of bilateral reduced unaided vision (V) at vision screenings of children 4–5 years of age. Methods: Retrospective anonymised data from computerised vision screening at age 4–5 years were analysed from serial cross‐sectional data. Refractive error is not assessed in UK vision screening, so vision was investigated. Data were only included from schools that screened every year from 2015/16 to 2021/22. The criterion used was unaided monocular logMAR (automated letter‐by‐letter scoring) vision >0.20 in both the right and left eyes, so as to maximise the chances of detecting bilateral, moderate myopia rather than amblyopia. Results: Anonymised raw data were obtained for 359,634 screening episodes from 2075 schools. Once schools were excluded where data were not available for every year and data were cleaned, the final database comprised 110,076 episodes. The proportion (percentage and 95% CI) failing the criterion from 2015/16 to 2021/22 were 7.6 (7.2–8.0), 8.5 (8.1–8.9), 7.5 (7.1–7.9), 7.8 (7.4–8.2), 8.7 (8.1–9.2), 8.5 (7.9–9.0) and 9.3 (8.8–9.7), respectively. The slope of the regression line showed a trend for increasing rates of reduced bilateral unaided vision, consistent with increasing frequency of myopia (p = 0.06). A decreasing linear trendline was noted for children 'Under Professional Care'. Conclusions: For children 4–5 years of age, there were signs of reduced vision over the last 7 years in England. Consideration of the most likely causes support the hypothesis of increasing myopia. The increase in screening failures highlights the importance of eye care in this young population. [ABSTRACT FROM AUTHOR]

Food insecurity in the UK has been described as a public health emergency. Although programmes exist to alleviate food insecurity for children and families, there is a lack of focus on 16–17 year olds across research, policy and practice. The current study set out to address this gap by investigating the food insecurity status and food intake of 16‐17‐year‐olds relative to current nutritional guidelines. An online, cross‐sectional survey design was utilised to collect data on self‐reported food security status, food intake and access to and uptake of free college meals. Eighty‐three students aged 16–17 years from two sixth form colleges based in the North East of England, UK participated. Food intake data were compared to current dietary recommendations on fruit and vegetable intake and high fat/salt/sugar foods; food intake was compared between food secure and food insecure young people. A minority of young people consumed enough fruit and vegetables to meet or exceed current 5‐a‐day dietary recommendations, but the majority of young people consumed two or more high fat/salt/sugar items, consumption of which was higher in food insecure young people. Additionally, despite almost half the current sample identifying as food insecure, only four young people reported being entitled to free college meals.The current study was the first to identify food insecurity and poor food intake specifically amongst 16–17 year olds in England. A lack of uptake of free college meals shows that current policy is not sufficient to address food insecurity amongst this group [ABSTRACT FROM AUTHOR]

The structure and evolution of a cold front that produced a tornadic narrow cold‐frontal rainband (NCFR) over the UK on 20 November 2013 is explored using reanalysis data, high‐resolution model simulations and observations. Physical links are found to exist across a range of spatiotemporal scales, through which the evolving large‐scale flow field exerts an influence on the timing and location of miso‐scale vortex genesis, and therefore the potential for tornado genesis. The synoptic‐scale flow pattern exhibited amplification, consisting of upstream ridge building and downstream trough extension. A prominent jet streak and associated positive potential vorticity (PV) anomaly and tropopause fold moved rapidly southeastward on the rear flank of the extending upper‐level trough, the leading edge of these features eventually overspreading the surface cold front over the UK. Increasing 850 hPa frontogenesis occurred underneath the left exit of the jet streak and associated, intensifying, PV anomaly. A filament of dry, high‐PV air was extruded from the overlying tropopause fold within an intensifying front‐transverse circulation in this region. This dry filament eventually penetrated to low levels immediately behind the front, where it undercut the upper, rearward parts of the wide cold‐frontal precipitation band. Model fields and observations suggest that diabatic cooling, associated with sublimation of solid hydrometeors falling into the dry filament, led to the development of local downdraft and near‐surface divergence maxima and a prominent cold pool immediately behind the surface cold front over central England. Increases in horizontal convergence, updraft speed, and horizontal temperature gradients along the frontal boundary immediately ahead of the cold pool resulted in development of a locally well‐defined cold front and associated NCFR, where the surface front was formerly (and elsewhere continued to be) relatively weak. Tornadoes occurred in association with miso‐scale vortices that developed rapidly along an intensifying vertical vortex sheet at the NCFR. [ABSTRACT FROM AUTHOR]

Regional disparities in social mobility have long been apparent in Britain. Recent decades have seen a growing level of spatial inequalities in terms of social, economic and employment opportunities. Empirical studies suggest not only what do your parents do, but also where do you come from, profoundly influences one's life opportunities, London and the Southeast are consistently shown to be areas with more social mobility than the rest of country. This study presents an updated estimate of the extent of social mobility across regions in England, and more importantly, how this has been conditional on cross‐region migration. By using national representative survey data covering a decade (2005–2015), the results show considerable variations in the regional estimates of both absolute and relative mobility. In particular, London was found to be leading on social mobility measures in nationwide comparisons, supporting previous findings that London plays an important national role in Britain's social mobility. In addition, separate analysis for samples of cross‐region 'movers' and 'stayers' suggests that migration is associated with social upward mobility, with London still functioning as an 'escalator' region providing better opportunities for those who move there from elsewhere the country. This persistence of the 'escalator region' effect for the millennial generation in England underlines how unequal economic geography continues to shape opportunity and trajectories of mobility for individuals. [ABSTRACT FROM AUTHOR]

This dissertation study investigates the ways that NHS libraries are currently marketing their services within their organisation and was submitted as part of the MA Library and Information Management at the University of Sheffield in 2019. This paper presents the findings from twelve semi‐structured interviews carried out with NHS library managers in the East of England to identify the most and least successful methods, and in comparison with that which is currently in the general marketing literature. The study found that outreach marketing was the most effective and that librarians are currently conducting marketing to the best of their ability, but they lack time and funding to be able to make the most of their promotional campaigns. F.J. [ABSTRACT FROM AUTHOR]

This TACTYC funded research highlights the role that Maintained Nursery Schools (MNS) play in supporting families within areas of extreme social deprivation in the UK. Data collected through survey and interview demonstrated the positive impact that these schools have upon disadvantaged children and their families, providing a breadth and depth of ongoing care, against a backdrop of ongoing fiscal cuts and uncertainty. Often this provision was in lieu of the reported minimisation of other social services support for struggling families. We argue in this paper that the loss of these state institutions could be highly detrimental to the families that they currently support. [ABSTRACT FROM AUTHOR]

Brexit, the withdrawal of the United Kingdom from the European Union, has offered the UK government a unique opportunity to fundamentally reform agricultural policy. In England, the new policy—called Environmental Land Management—will reward farmers for activities that produce environmental public goods, such as clean air and water and a thriving wildlife, and prevent environmental hazards. It could lead to the biggest changes in land management since the end of World War II. This photo essay and the process of making it contributes to a better understanding of how farmers feel about the changes underway. [ABSTRACT FROM AUTHOR]

Aims: People with type 2 diabetes can enter remission but may relapse or develop legacy complications. This analysis assesses whether people with remission from type 2 diabetes continue receiving annual care processes recommended in national guidelines and the potential impacts of formal recognition of remission. Methods: People with type 2 diabetes with and without formal recognition (diagnostic code) of remission, and with and without evidence of remission (HbA1c < 48 mmol/mol without prescription for glucose‐lowering drugs in preceding 26 weeks), included in the 2018/19 National Diabetes Audit (NDA) for England and Wales were followed up to identify care processes received between 1 January 2019 and 31 March 2020. Results: Of the 2,822,145 people with type 2 diabetes in the cohort, 16,460 (0.58%) were coded with remission in the 2018/19 NDA. After adjustment for age, sex, socioeconomic deprivation and ethnicity, people coded with remission were less likely to receive each care process than those without such coding irrespective of HbA1c measurements (relative risk (RR) of receiving all 8 care processes 0.70 (95% CI 0.69–0.72)). For the 339,235 people with evidence of remission, irrespective of diagnostic coding compared to those without such evidence, the RR for receiving all 8 care processes was 0.94 (95% CI 0.93–0.94). Conclusions: People coded with remission of type 2 diabetes were less likely to receive diabetes care processes than those without such coding. People with evidence of remission had only a slightly reduced likelihood of receiving care processes. Formal recognition of remission may affect the provision or uptake of care processes. [ABSTRACT FROM AUTHOR]

The biodiversity and climate crises demand ambitious policies lowering the environmental impacts of farming. Most current interventions incentivise so‐called land‐sharing approaches to address the widespread trade‐off between farm yields and on‐farm environmental outcomes by compensating farmers who adopt yield‐reducing interventions that encourage wildlife or reduce net emissions within farmed land.Here, we present the first quantification of the likely costs to taxpayers of land sharing compared with land sparing, in which large areas are removed from production altogether because of high‐yielding practices elsewhere in the landscape. Focusing on arable production in the United Kingdom, we used a choice experiment to explore farmer preferences and estimated the overall costs of contrasting agri‐environment schemes that delivered increased populations of three well‐studied farmland birds and reduced net carbon emissions in England. We included capital, administration and monitoring costs, and lost food production.Sparing delivered our target biodiversity and carbon emission outcomes at 79% of the food production cost and 48% of the taxpayer cost of sharing. The difference in subsidy payments required by farmers roughly tracked lost food production but other costs favoured sparing even more strongly.The cost‐related merits of sparing would probably increase further in studies incorporating (1) the many species and ecosystem services not deliverable on farmland, (2) the costs of food imports to compensate domestic lost production and (3) countries without as long and extensive a history of agriculture as the United Kingdom.Our results suggest that, for at least some conservation outcomes, continuing a land‐sharing approach in countries such as the United Kingdom is not only an inefficient use of government funds but also undermines conservation and food security in food‐exporting countries which bear the burden of compensating domestic production forgone in the name of conservation. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

The initial purposes of regulation of medicines in England, and latterly in the United Kingdom, were principally to raise government revenue, to discourage murder by poisoning and to regulate the activities of pharmacists. It was only much later that regulators sought to ensure that medicines were of good quality, reasonably safe, and at least somewhat effective, and to curtail misuse of drugs. Here we survey the history of the regulation of medicines and poisons in England from the perspective of clinicians with an interest in therapeutics. [ABSTRACT FROM AUTHOR]

Accessible Summary: This paper shows what people with learning disabilities can get out of enjoying books and reading even when they cannot read words easily.The writers think about how people with learning disabilities can be helped to enjoy books. They say that this can happen through reading with other people, enjoying lots of activities about books and making books part of their daily routine.The writers also think about the way that books and stories help us to learn about the world and the people in it.The writers are annoyed about the way that enjoyment of books by people with learning disabilities has been ignored by people.This matters to people with learning difficulties because enjoying books, even when we cannot read words easily, can give us good feelings and help us to learn and develop. This paper presents the findings of an original research project commissioned by BookTrust, a respected UK charity that gifts books to children, young people (CYP) and their families. It explored the impact and modus of pleasurable engagement with books among CYP with severe and profound learning disabilities and applied a critical, phenomenological stance on what it means to read through drawing on "inclusive literacy" as a conceptual framework. Data were collected from four local areas in England and included 43 CYP aged 4–14. In keeping with a phenomenological stance, it employed interpretivist methods involving 13 deep‐level interviews with families to include observations and structured play; 13 observations of CYP sharing books with others in home, play or school settings, and interviews with 27 practitioners working in a range of organisations (e.g., Portage service and advisory teams). Findings were that books had a positive impact on well‐being, social inclusion and development. CYP were engaged in enjoying the content of books through personalisation, sensory stimulation, social stimulation and repetition. This affirmed the theoretical and practical approaches espoused by "inclusive literacy" but made a critical and original contribution to our understanding of the special place that books occupy as ordinary artefacts of literary citizenship among this cohort. The benefits of volitional reading among CYP who do not have learning disabilities are well known, but the authors urge publishers and policymakers to recognise CYP with severe and profound learning disabilities as equally important, active consumers of books who have much to gain from reading for pleasure. [ABSTRACT FROM AUTHOR]

This paper critically explores how survey and routinely collected data could aid in assessing the generalisability of public health evidence. We propose developing approaches that could be employed in understanding the relevance of public health evidence, and investigate ways of producing meta‐analytic estimates tailored to reflect local circumstances, based on analyses of secondary data. Currently, public health decision makers face challenges in interpreting global review evidence to assess its meaning in local contexts. A lack of clarity on the definition and scope of generalisability, and the absence of consensus on its measurement, has stunted methodological progress. The consequence of failing to tackle generalisability means that systematic review evidence often fails to fulfil its potential contribution in public health decision making. Three approaches to address these problems are considered and emerging challenges discussed: (1) purposeful exploration after a review has been conducted, and we present a framework of potential avenues of enquiry and a worked example; (2) recalibration of the results to weight studies differentially based on their similarity to conditions in an inference population, and we provide a worked example using UK Census data to understand potential differences in the effectiveness of community engagement interventions among sites in England and Wales; (3) purposeful exploration before starting a review to ensure that the findings are relevant to an inference population. The paper aims to demonstrate how a more nuanced treatment of context in reviews of public health interventions could be achieved through greater engagement with existing large sources of secondary data. [ABSTRACT FROM AUTHOR]

Aim: To review the existing evidence regarding the use of language in clinical encounters. Background: Awareness of the importance of language in clinical encounters is mostly lacking or located within broader discussions on communication. Methods: A scoping study was conducted to review existing research that could increase our understanding of the role language plays as well as identify gaps in knowledge and inform the development of a position statement on language in diabetes care. Results: Evidence shows that, although carefully chosen language can have a positive effect, there is a potential negative impact of language on people's experiences of diabetes care. The use of stigmatizing and discriminatory words during communication between healthcare practitioners and people with diabetes can lead to disengagement with health services as well as sub‐optimal diabetes self‐management. Clinical encounters can be compromised where language barriers exist or where there is limited understanding of cultural differences that may have an impact on diabetes self‐management. What little empirical evidence there is shows that training can improve language and communication skills. Conclusion: This review raises a number of questions that are being addressed by the NHS England Language Matters Group, which has developed a set of recommendations to support the use of appropriate language in clinical encounters. What's new?: This paper reviews existing evidence regarding the use of language in clinical encounters.Poor language practices can lead to stigma, lack of engagement with self‐management, low satisfaction with care and poor clinical outcomes.Research has demonstrated the importance of good communication skills and that appropriate use of language can benefit psychosocial well‐being and support optimal diabetes self‐management.Our review has directly informed the publication of a UK Position Statement on Language Matters. [ABSTRACT FROM AUTHOR]

Background and Aims: Youth alcohol consumption has declined significantly during the past 15 years in many high‐income countries, which may have significant public health benefits. However, if the reductions in drinking occur mainly among lighter drinkers who are at lower risk, then rates of alcohol‐related harm among young people today and adults in future may not fall in line with consumption. There is conflicting evidence from Swedish school studies, with some suggesting that all young people are drinking less, while others suggest that alcohol consumption among heavier drinkers may be stable or rising while average consumption declines. This paper extends the geographical focus of previous research and examines whether the decline in youth drinking is consistent across the consumption distribution in England. Design Quantile regression of 15 waves of repeat cross‐sectional survey data. Setting: England, 2001–16. Participants: A total of 31 882 schoolchildren (50.7% male) aged 11–15 who responded to the Smoking Drinking and Drug Use among Young People surveys. Measurements Past‐week alcohol consumption in UK units at each fifth percentile of the consumption distribution. Findings Reductions in alcohol consumption occurred at all percentiles of the consumption distribution analysed between 2001 and 2016, but the magnitude of the decline differed across percentiles. The decline in consumption at the 90th percentile [β = −0.21, confidence interval (CI) = −0.24, −0.18] was significantly larger than among either lighter drinkers at the 50th percentile (β = −0.02, CI = −0.02, −0.01) or heavier drinkers at the 95th percentile (β = −0.16, CI = −0.18, −0.13). Conclusions: Alcohol consumption among young people in England appears to be declining across the consumption distribution, and peaks among heavy drinkers. The magnitude of this decline differs significantly between percentiles of the consumption distribution, with consumption falling proportionally less among the lightest, moderate and very heaviest youth drinkers. [ABSTRACT FROM AUTHOR]

As the frequency and magnitude of storm events increase with climate change, understanding how season and management influence flood peaks is essential. The influence of season and management of grasslands on flood peak timing and magnitude was modelled for Swindale and Calderdale, two catchments in northern England. Spatially‐Distributed TOPMODEL was used to investigate two scenarios across four storm events using empirically‐based soil and vegetation data. The first scenario applied seasonal changes in vegetative roughness, quantifying the effect on flood peaks at catchment scale. The second scenario modelled the influence of grassland management from historical high‐intensity grazing to a series of natural succession stages between grassland and woodland, and a conservation‐based management. Model outputs were analysed by flow type, measuring total, overland and base flow peaks at the catchment outlet. Seasonal changes to vegetation were found to increase overland flow peaks by up to +2.2% in winter and reduce them by −5.5% in summer compared to the annual average. Percentage changes in flood peak due to hillslope grassland management scenarios were more substantial; overland flow peaks were reduced by up to 41% in Calderdale where extensive woodland development was the most effective mitigation strategy, and up to 35% in Swindale, where a rank grassland dominated catchment was the most effective. Conservation‐based farming practices were also useful, reducing overland flow peak by up to 42% compared to the high intensity grazing scenario. Neither management nor seasonality changed the timing of runoff peaks by >45 min. Where overland flow dominates, especially in catchments with shallow soils, surface roughness was found to be more influential than soil permeability for flood mitigation. We recommend that seasonal changes to roughness are considered alongside the spatial distribution of Natural Flood Management in mosaiced upland catchments. [ABSTRACT FROM AUTHOR]

Rewilding is an increasingly common conservation approach, aiming to restore ecosystem processes and minimise human intervention. Rewilding has the potential to profoundly change landscapes and people–nature relations. These issues prompt an ongoing debate about how and if rewilding should be done.Farmers are key stakeholders in this debate; they stand to be both affected by and influence the trajectory of rewilding initiatives developing in the United Kingdom and globally. Despite this, a comprehensive understanding of farmers' perceptions towards rewilding is lacking.Here, we focus on how members of the farming community in England perceive common rewilding scenarios (beaver release, farm‐level rewilding and landscape‐scale rewilding), and how these perceptions shape farmers' attitudinal support for rewilding practices.Using thematic analysis of semi‐structured interviews with 36 farmers and farming representatives, we show that the diversity of famers' attitudes can be understood through the prism of perceptions on five core issues: (a) the perceived need for restoration action, (b) the ecological effectiveness of rewilding, (c) rewilding's compatibility with ensuring food security, (d) rewilding's compatibility with rural lifestyles, livelihoods and economies and (e) multidimensional justice of rewilding initiatives. These issues are rooted in collective farming values, and farmers' perceptions of these issues are influenced by mental models, perceived social impacts and perceived ecological outcomes of rewilding initiatives. Diverse perceptions result in a range of attitudes, from enthusiastic support to strong opposition to different rewilding practices.We argue that the scope to increase support for rewilding varies depending on the type of underlying negative perceptions. Where the negative perceptions are based on objectively verifiable causal beliefs (mental models), opponents' minds may be changed through the provision of positive experiences, social learning, and adhering to good governance principles. However, where negative perceptions are based on values, for example, a preference for traditional rural landscapes, they are unlikely to change easily. Pursuing rewilding ambitions that clash with the values of local farmers may risk social conflicts, but accommodating these values too much may compromise rewilding's own goals. Rewilding initiatives will need dialogue and social engagement to navigate their path around this tension. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

Objectives: To examine the association between race and pre‐eclampsia and gestational hypertension after adjustment for factors in maternal characteristics and medical history in a screening study from the Fetal Medicine Foundation (FMF) in England, and to perform a systematic review and meta‐analysis of studies on pre‐eclampsia. Design: Prospective observational study and systematic review with meta‐analysis. Setting: Two UK maternity hospitals. Population: A total of 168 966 women with singleton pregnancies attending for routine ultrasound examination at 11–13 weeks of gestation without major abnormalities delivering at 24 weeks or more of gestation. Methods: Regression analysis examined the association between race and pre‐eclampsia or gestational hypertension in the FMF data. Literature search to December 2021 was carried out to identify peer‐reviewed publications on race and pre‐eclampsia. Main outcome measure: Relative risk of pre‐eclampsia and gestational hypertension in women of black, South Asian and East Asian race by comparison to white women. Results: In black women, the respective risks of total‐pre‐eclampsia and preterm‐pre‐eclampsia were 2‐fold and 2.5‐fold higher, respectively, and risk of gestational hypertension was 25% higher; in South Asian women there was a 1.5‐fold higher risk of preterm pre‐eclampsia but not of total‐pre‐eclampsia and in East Asian women there was no statistically significant difference in risk of hypertensive disorders. The literature search identified 19 studies that provided data on several million pregnancies, but 17 were at moderate or high‐risk of bias and only three provided risks adjusted for some maternal characteristics; consequently, these studies did not provide accurate contributions on different racial groups to the prediction of pre‐eclampsia. Conclusion: In women of black and South Asian origin the risk of pre‐eclampsia, after adjustment for confounders, is higher than in white women. In women of black and South Asian origin the risk of pre‐eclampsia, after adjustment for factors in maternal characteristics and medical history, is higher than in white women. This article includes Author Insights, a video abstract available at: https://vimeo.com/bjogabstracts/authorinsights17240 [ABSTRACT FROM AUTHOR]

Riverine communities have been subject to numerous biological invasion events, with crustaceans among the most successful group of invasive animals worldwide. Understanding what makes a river system prone to invasion is of considerable interest to environmental regulators, resource managers, scientists and wider society globally. The Ponto‐Caspian amphipod, Dikerogammarus haemobaphes (Crustacea: Gammaridae), is a hyper‐successful invasive species that was first recorded in the UK in 2012. The use of contemporary distribution data for D. haemobaphes (2009–2020) from England provided a unique opportunity to study faunal community patterns and differences between sites that experienced invasion compared to those that have not. Macroinvertebrate community taxonomic, functional and phylogenetic features, as well as the presence of co‐occurrent invaders and abiotic features of the river systems, were examined from sites before the invasion and compared to control sites that were not invaded during the study period. Sites that would later experience invasion by D. haemobaphes were characterized by higher abundances of other invaders (e.g., especially Ponto Caspian taxa), lower abundances of crustaceans and typically had greater channel width and water depth. These basic characteristics may help identify sites at risk of future invasion by D. haemobaphes. Most biomonitoring tools examined displayed no difference between control and pre‐invaded samples, while both taxonomic and functional richness displayed higher values at sites that were subsequently invaded, questioning classic biological invasion hypotheses. Recognizing specific community characteristics that may be a precondition for subsequent invasion is essential for understanding and better predicting their future trajectories of change. [ABSTRACT FROM AUTHOR]

This paper is prompted by the widespread acceptance that the rates of inter-county and inter-state migration have been falling in the USA and sets itself the task of examining whether this decline in migration intensities is also the case in the UK. It uses annual inter-area migration matrices available for England and Wales since the 1970s by broad age group. The main methodological challenge, arising from changes in the geography of health areas for which the inter-area flows are given, is addressed by adopting the lowest common denominator of 80 areas. Care is also taken to allow for the effect of economic cycles in producing short-term fluctuations on migration rates and to isolate the effect of a sharp rise in rates for 16-24 years old in the 1990s, which is presumed to be related to the expansion of higher education. The findings suggest that unlike for the USA, there has not been a substantial decline in the intensity of internal migration between the first two decades of the study period and the second two. If there has been any major decline in the intensity of address changing in England and Wales, it can only be for the within-area moves that this time series does not cover. This latter possibility is examined in a companion paper using a very different data set. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The National Institute for Health Research (NIHR) aims to improve national 'health and wealth' by providing infrastructural support to enable clinical research in National Health Service settings in England and Wales. Cognisant of the consequences of studies' failure to achieve required numbers of participants, it also actively campaigns to promote patient awareness of research, and willingness to participate in trials. In this paper, we analyse recent NIHR campaigns and policies designed to encourage patients to participate in clinical research to interrogate how they are implicated in the national bioeconomy. In doing so we expand the notion of 'clinical labour' to include the work of patient recruitment and highlight an emergent obligation on patients to contribute to research processes. Whereas once patient knowledge and experience may have been devalued, here we draw on the concept of 'assetisation' (Birch 2012) to explore the emergent relationship between healthcare system and patient as research participant. We consider how patients' contribution goes beyond the provision of standardised objects of valuation so that patients themselves may be perceived as assets to, not only recipients of, the national healthcare system. [ABSTRACT FROM AUTHOR]

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The fate of organic carbon deposited in floodplain sediments is an important control on the magnitude and direction of the carbon flux from anthropogenically accelerated erosion and channelization of the riverine network. Globally, carbon deposition rates and mean residence time (MRT) within different geomorphic settings remains poorly constrained. We sampled soil profiles to 0.8 m depth from two geomorphic zones: active channel belt (ACB) and lowland floodplain, under long‐term pasture adjacent to the river Culm in SW England, UK. We evaluated sedimentation rates and carbon storage using fallout radionuclide 137Cs, particle size and total carbon analyses. Variation in decomposition was assessed via empirical (soil aggregate size, density fractionation combined with natural abundance 13C analysis) and modelling simulation (using the RothC model and catchment implications explored using a floodplain evolution model). Sedimentation and carbon accumulation rates were 5–6 times greater in the ACB than the floodplain. Carbon decomposition rates also varied with geomorphic setting. In floodplain cores, faster decomposition rates were indicated by greater 13C‐enrichment and subsoils dominated by mineral‐associated soil organic carbon. Whereas, in the ACB, carbon was less processed and 13C‐depleted, with light fraction and macroaggregate‐carbon throughout the cores, and RothC modelled decomposition rates were 4‐fold less than lowland floodplain cores. Including the ACB in floodplain carbon MRT calculations increased overall MRT by 10%. The major differences in the balance of sedimentation and decomposition rates between active and inactive floodplains suggests the relative extent of these contrasting zones is critical to the overall carbon balance. Restoration projects could enhance soil carbon storage by maximizing active floodplain areas by increasing river channel complexity. [ABSTRACT FROM AUTHOR]

The fate of organic carbon deposited in floodplain sediments is an important control on the magnitude and direction of the carbon flux from anthropogenically accelerated erosion and channelization of the riverine network. Globally, carbon deposition rates and mean residence time (MRT) within different geomorphic settings remains poorly constrained. We sampled soil profiles to 0.8 m depth from two geomorphic zones: active channel belt (ACB) and lowland floodplain, under long‐term pasture adjacent to the river Culm in SW England, UK. We evaluated sedimentation rates and carbon storage using fallout radionuclide 137Cs, particle size and total carbon analyses. Variation in decomposition was assessed via empirical (soil aggregate size, density fractionation combined with natural abundance 13C analysis) and modelling simulation (using the RothC model and catchment implications explored using a floodplain evolution model). Sedimentation and carbon accumulation rates were 5–6 times greater in the ACB than the floodplain. Carbon decomposition rates also varied with geomorphic setting. In floodplain cores, faster decomposition rates were indicated by greater 13C‐enrichment and subsoils dominated by mineral‐associated soil organic carbon. Whereas, in the ACB, carbon was less processed and 13C‐depleted, with light fraction and macroaggregate‐carbon throughout the cores, and RothC modelled decomposition rates were 4‐fold less than lowland floodplain cores. Including the ACB in floodplain carbon MRT calculations increased overall MRT by 10%. The major differences in the balance of sedimentation and decomposition rates between active and inactive floodplains suggests the relative extent of these contrasting zones is critical to the overall carbon balance. Restoration projects could enhance soil carbon storage by maximizing active floodplain areas by increasing river channel complexity. [ABSTRACT FROM AUTHOR]