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Introduction: The prevalence of gestational diabetes (GD) is increasing globally. While universal risk factors for GD are reasonably well understood, questions remain regarding risks for women living with HIV (WLWH). We aimed to describe GD prevalence, evaluate associated maternal risk factors and assess specific birth outcomes in WLWH in the UK and Ireland. Methods: We analysed all pregnancies (≥24 weeks' gestation) in women diagnosed with HIV before delivery, reported to the UK‐based Integrated Screening Outcomes Surveillance Service between 2010 and 2020. Every report of GD was considered as a case. A multivariable logistic regression model, adjusted for women with more than one pregnancy fitted with generalized estimating equations (GEE) assessed the effect of independent risk factors. Results: There were 10,553 pregnancies in 7916 women, of which 460 (4.72%) pregnancies had reported GD. Overall, the median maternal age was 33 years (Q1:29–Q3:37), and 73% of pregnancies were in Black African women. WLWH with GD (WLWH‐GD) were older (61% vs. 41% aged ≥35 years, p < 0.001) and more likely to be on treatment at conception (74% vs. 64%, p < 0.001) than women without GD. WLWH‐GD were more likely to have a stillbirth (odds ratio [OR]: 5.38, 95% CI: 2.14–13.5), preterm delivery (OR: 2.54, 95% CI: 1.95–3.32) and fetal macrosomia (OR: 1.14, 95% CI: 1.04–1.24). Independent risk factors for GD included estimated year of delivery (GEE‐adjusted odds ratio [GEE‐aOR]: 1.14, 95% CI: 1.10–1.18), advanced maternal age (≥35 years) (GEE‐aOR: 2.87, 95% CI: 1.54–5.34), Asian (GEE‐aOR: 2.63, 95% CI: 1.40–4.63) and Black African (GEE‐aOR: 1.55, 95% CI: 1.13–2.12) ethnicity. Timing and type of antiretroviral therapy showed no evidence of a relationship with GD in multivariable analyses; however, women with a CD4 count ≤350 cells/μl were 27% less likely to have GD than women with CD4 counts >350 cells/μl (GEE‐aOR: 0.73, 95% CI: 0.50–0.96). Conclusions: GD prevalence increased over time among WLWH but was not significantly different from the general population. Maternal age, ethnicity and CD4 count were risk factors based on available data. Stillbirth and preterm delivery were more common in WLWH‐GD than other WLWH over the study period. Further studies are required to build upon these results. [ABSTRACT FROM AUTHOR]

Background: Absorbable or non-absorbable sutures can be used for superficial skin closure following excisional skin surgery. There is no consensus among clinicians nor high-quality evidence supporting the choice of suture. The aim of the present study was to determine current suture use and complications at 30 days after excisional skin surgery. Methods: An international, prospective service evaluation of adults undergoing excision of skin lesions (benign and malignant) in primary and secondary care was conducted from 1 September 2020 to 15 April 2021. Routine patient data collected by UK and Australasian collaborator networks were uploaded to REDCap©. Choice of suture and risk of complications were modelled using multivariable logistic regression. Results: Some 3494 patients (4066 excisions) were included; 3246 (92.9 per cent) were from the UK and Ireland. Most patients were men (1945, 55.7 per cent), Caucasian (2849, 81.5 per cent) and aged 75-84 years (965, 27.6 per cent). The most common clinical diagnosis was basal cell carcinoma (1712, 42.1 per cent). Dermatologists performed most procedures, with 1803 excisions (44.3 per cent) on 1657 patients (47.4 per cent). Most defects were closed primarily (2856, 81.9 per cent), and there was equipoise in regard to use of absorbable (2127, 57.7 per cent) or non-absorbable (1558, 42.2 per cent) sutures for superficial closure. The most common complications were surgical-site infection (103, 2.9 per cent) and delayed wound healing (77, 2.2 per cent). In multivariable analysis, use of absorbable suture type was associated with increased patient age, geographical location (UK and Ireland), and surgeon specialty (oral and maxillofacial surgery and plastic surgery), but not with complications. Conclusion: There was equipoise in suture use, and no association between suture type and complications. Definitive evidence from randomized trials is needed. [ABSTRACT FROM AUTHOR]

Background: Cancer survivorship is associated with co‐morbidities including anxiety, depression and cardiovascular disease (CVD). Rehabilitative care post‐treatment is vital for survivors' psychological and physical well‐being. The present study aimed to investigate breast cancer survivors' attitudes towards their health post‐treatment; their awareness of co‐morbidities associated with treatment; and their awareness of support systems available. Methods: A qualitative research approach was employed, using semi‐structured interviews with breast cancer survivors from the UK and Ireland. Data were analysed using thematic analysis. Eight breast cancer survivors were recruited through purposive sampling. Results: Two themes emerged from the data: (1) health and rehabilitation post‐treatment, which included mental and physical health and a desire to control one's own health in survivorship as well as a discussion around co‐morbidities, and (2) access to support services in survivorship, which highlighted both positive and negative experiences of accessing support, as well as reasons for not accessing support in survivorship. Conclusions: Access to rehabilitation support, including diet, exercise and stress management, is key to survivorship. Rehabilitation and support services need to be more readily available for survivors to aid them in this journey and to educate them on the increased risk of conditions such as CVD with cancer treatment. Utilising current cardiac rehabilitation models could be a solution to provide a holistic cancer rehabilitation, thus providing the lifelong support that cancer survivors both want and need. Key points: Access to rehabilitation support, including diet, exercise and stress management, is key to survivorship; however, access to support differed and was lacking for many survivors. Longer‐term comorbidities of cancer treatment were not fully understood. Therefore, there is a need for rehabilitation and support services to educate survivors on the increased risk of conditions such as cardiovascular disease with cancer treatment. These services must also address long‐term risk through lifestyle factors, including diet and physical activity. Utilising current cardiac rehabilitation models could be a solution to provide a holistic cancer rehabilitation, thus providing the lifelong support that cancer survivors both want and need. [ABSTRACT FROM AUTHOR]

This account presents information on all aspects of the biology of Liparis loeselii (L.) Rich. (Fen Orchid) that are relevant to understanding its ecological characteristics and behaviour. The main topics are presented within the standard framework of the Biological Flora of Britain and Ireland: distribution, habitat, communities, responses to biotic factors, responses to environment, structure and physiology, phenology, floral and seed characters, herbivores and disease, and history and conservation.Liparis loeselii is a small terrestrial orchid that has a circumboreal distribution and is widespread in Europe and North America. Despite its wide distribution, the species is locally rare and has declined considerably in most of its range. In Britain, the species has a disjunct distribution and is now known to occur consistently at only six sites in eastern England and three in south Wales. It is absent from Ireland. Its most characteristic habitats in Britain are inland fens and coastal dune slacks, but outside Britain it can also be found in wet meadows, marshes, forested seep springs, at lake borders or on mats of floating peat.Populations of Liparis loeselii in dune slacks tend to be short‐lived, and can rapidly increase in size or decrease and disappear as environmental conditions change. The species does not tolerate high nutrient concentrations or low pH. It is susceptible to drought, which reduces seed germination, seedling recruitment and adult survival. Heavy predation by rabbits and rodents has been observed under drought conditions.Liparis loeselii reproduces both by sexual reproduction, and by vegetative propagation through the production of pseudobulbs. Although flowers are accessible to insects, entomophilous pollination is unusual, and most sexual reproduction is the result of selfing. Fruits ripen late in the growing season (mid‐October) and the dust‐like seeds are dispersed during winter by wind and water. Germination occurs during the following growing season and is supported by a wide variety of mycorrhizal fungi.Since the late 19th century Liparis loeselii has declined considerably in Britain and elsewhere in Europe, primarily due to habitat destruction and loss, natural succession, and habitat desiccation due to drainage. As a result, the species has been listed as endangered in the Bern Convention and the European Habitat Directive (92/43/EEC) and is the focus of intensive conservation efforts in many countries. Restoration of habitat by mowing, extensive grazing and peat removal, and the creation of new habitat by dune slack formation in dune systems and peat removal in fens may prolong population persistence and promote establishment of new populations. [ABSTRACT FROM AUTHOR]

Background: This study investigates the extent to which the GHQ-12 exhibits configural, metric and scalar invariance across six ethnic groups in Britain and Northern Ireland, using the UK Household Longitudinal Study (N = 35 410). Methods: A confirmatory factor analysis was carried out on a white British group in order to establish an adequate measurement model. Secondly, a multi-group confirmatory factor analysis was conducted in order to assess measurement invariance. A sensitivity analysis comparing summated and latent means across groups was carried out. Finally, revised estimates of scale reliability were derived using two different methods. Results: A one-factor model including correlated error terms on the negatively phrased items showed superior fit in all ethnic groups. Tests for equal factor loadings and intercepts also showed adequate fit demonstrating metric and scalar invariance. Latent and summated scale estimates of mean group differences were similar for all groups. Scale reliability using McDonald's ω is lower than when using the more conventional Cronbach's α. Reliability across groups is reasonably consistent. Conclusions: We find that the GHQ-12 does not display obvious bias in regard to ethnic groups in the UK and that valid comparisons across these groups can be made for the purposes of population research. Caution is needed when using as a screening tool for individuals. [ABSTRACT FROM AUTHOR]

Background Patch testing is an important investigation when dermatitis is unresponsive to, or worsened by, topical corticosteroid treatment. There is a balance to be struck between testing too many allergens, which is expensive, time consuming and risks causing sensitization, and testing too few, which risks missing the diagnosis. The current British Society for Cutaneous Allergy (BSCA) corticosteroid series comprises eight allergens and was last updated in February 2007. Aim To review and update the BSCA corticosteroid series. Methods We retrospectively analysed data from 16 patch test centres in the UK and Ireland for all patients who were patch tested to a corticosteroid series between August 2017 and July 2019. We recorded the allergens tested, the number and percentage tested to a corticosteroid series and the number of positive results for each allergen. We identified the allergens that test positive in ≥ 0.1% of selectively tested patients. Results Overall, 3531 patients were tested to a corticosteroid series in the 16 centres. The number of allergens tested ranged from 7 to 18 (mean 10). The proportion of patch test patients who were tested to a corticosteroid series ranged from 1% to 99%. Six allergens in the 2017 BSCA series tested positive in ≥ 0.1% of patients. Nine allergens not in the BSCA corticosteroid series tested positive in ≥ 0.1% of patients. Conclusion This audit demonstrates the importance of regular review of recommended series and the significant variations in practice. The new BSCA corticosteroid series that we recommend contains 13 haptens, with the addition of the patient's own steroid creams as appropriate. [ABSTRACT FROM AUTHOR]

Recovering additional historical weather observations from known archival sources will improve the understanding of how the climate is changing and enable detailed examination of unusual events within the historical record. The UK National Meteorological Archive recently scanned more than 66,000 paper sheets containing 5.28 million hand‐written monthly rainfall observations taken across the UK and Ireland between 1677 and 1960. Only a small fraction of these observations were previously digitally available for climate scientists to analyse. More than 16,000 volunteer citizen scientists completed the transcription of these sheets of observations during early 2020 using the RainfallRescue.org website, built using the Zooniverse platform. A total of 3.34 million observations from more than 6000 locations have so far been quality controlled and made openly available. This has increased the total number of monthly rainfall observations that are available for this time period and region by a factor of six. The newly rescued observations will enable longer and much improved reconstructions of past variations in rainfall across the British and Irish Isles, including for periods of significant flooding and drought. Specifically, this data should allow the official gridded monthly rainfall reconstructions for the UK to be extended back to 1836, and even earlier for some regions. [ABSTRACT FROM AUTHOR]

Mentorship has long since been acknowledged as an integral part of Neurosurgical training. The authors sought to evaluate the state of mentorship in Neurosurgical training in the United Kingdom (UK). A 28-point questionnaire was sent to all neurosurgical trainees in the UK and Ireland via the British Neurosurgical Trainee's Association (BNTA), comprising 180 trainees. There were 75 responses (180 trainees on the mailing list, 42% response rate). Despite all respondents reporting it to be at least somewhat important to have a mentor, 16% felt they had no mentors. The mean number of mentors was 2.91 with 72% of respondents having more than 1 mentor. In terms of the content of mentorship relationships, 63% were comfortable discussing career related topics with their mentor to a high or very high degree but only 29% felt comfortable discussing their general wellbeing. With regards to allocated educational supervisors, 43% thought this person to be a 'low' or 'very low' source of mentorship. The three most important traits of the ideal mentor as reported by respondents were: someone chosen by them (48%), working in the same hospital (44%) and having received formal mentorship training (36%). The current perception of mentorship in Neurosurgery from the surveyed trainees is mixed. A healthy majority of trainees benefit from mentorship of some kind, whilst a significant minority feel underserved. The surveyed trainees feel mentorship is slanted more towards clinical and professional aspects of development than it is towards personal ones. Suggestions for future insight would be an evaluation of senior registrar and consultant sentiments towards mentorship, whilst exploration into more flexible models for establishing mentoring relationships may help to address the heavy importance of trainee choice which is voiced by this survey's results. [ABSTRACT FROM AUTHOR]

Purpose: The low rates of colonic malignancy detected on interval colonoscopy for patients diagnosed with diverticulitis have led recent studies to question the utility of the practice. The aim of this study was to assess the detection rate of colorectal cancer on colonoscopy for patients with a first episode of acute uncomplicated diverticulitis across three separate centres in Ireland and the UK. Methods: A retrospective review was performed of patients with a first episode of acute, uncomplicated diverticulitis who underwent interval colonoscopy at three separate centres in the UK and Ireland between 2007 and 2019. The follow-up period was one year. Results: A total of 5485 patients were admitted with acute diverticulitis between the three centres. All patients had CT verified diverticulitis. A 90.8% (n = 4982) underwent subsequent colonic evaluation with colonoscopy. Of these, a histologically proven diagnosis of colorectal carcinoma was made in 1.28% (n = 64). Conclusion: Routine colonoscopy following an episode of acute, uncomplicated diverticulitis may not be necessary in every patient. It may be appropriate to reserve this more invasive investigation for those with higher risk factors for malignancy. [ABSTRACT FROM AUTHOR]

Background: Interest in the health and well-being of university students has increased in the UK and Ireland in the past two decades as their numbers have grown. Recent high-profile deaths of students after using illicit drugs have highlighted the importance of the topic for policy makers. This scoping review maps the state of the existing literature evaluating use of illicit drugs in university students in the UK and Ireland. It aims to highlight research gaps and inform policy. Method: We conducted a systematic search of papers related to psychoactive drug use in university students in the UK and Ireland published before August 2021. The 18 extracted study characteristics included author(s); year of publication; journal; location of data collection; study design; delivery method (e.g., online survey, in-person, postal survey); number of participants; response rate; participant course of study, year of study, degree level (i.e., undergraduate, postgraduate), gender and age; time-period assessed (e.g., lifetime, current use, past 12 months); primary aim; primary outcome; ethical approval; and funding source. Results: The PRISMA-guided search strategy identified 1583 papers for abstract review; of 110 papers retained for full-text review, 54 studies met criteria for inclusion for this paper. Primary outcomes were coded into five groups: prevalence and patterns of drug use; factors associated with drug use; attitudes and knowledge about, and motivation for, drug use; supply of drugs; consequences of drug use. The results show that there is no coherent body of research in this area. The prevalence of reported drug use has crept up and the range of substances reported has broadened over time, and attitudes to drugs on average have normalised. However, there are significant methodological limitations that limit the utility of these findings. There was little evidence of published work on prevention of, or intervention to reduce, drug-related harms. Conclusion: The domains identified offer a framework for university administrators, researchers and policy makers to understand the potential response to drug use in university students in the UK and Ireland. Recommendations are made to fill the gaps in the research evidence base. [ABSTRACT FROM AUTHOR]

Background: Palliative medicine physicians may be at higher risk of burnout due to increased stressors and compromised resilience during the COVID-19 pandemic. Burnout prevalence and factors influencing this among UK and Irish palliative medicine physicians is unknown. Aim: To determine the prevalence of burnout and the degree of resilience among UK and Irish palliative medicine physicians during the COVID-19 pandemic, and associated factors. Design: Online survey using validated assessment scales assessed burnout and resilience: The Maslach Burnout Inventory Human Services Survey for Medical Personnel [MBI-HSS (MP)] and the Connor-Davidson Resilience Scale (CD-RISC). Additional tools assessed depressive symptoms, alcohol use, and quality of life. Setting/participants: Association of Palliative Medicine of UK and Ireland members actively practising in hospital, hospice or community settings. Results: There were 544 respondents from the 815 eligible participants (66.8%), 462 provided complete MBI-HSS (MP) data and were analysed. Of those 181/462 (39.2%) met burnout criteria, based on high emotional exhaustion or depersonalisation subscales of the MBI-HSS (MP). A reduced odds of burnout was observed among physicians who worked ⩽20 h/week (vs 31–40 h/week, adjusted odds ratio (aOR) 0.03, 95% confidence interval (CI) 0.002–0.56) and who had a greater perceived level of clinical support (aOR 0.70, 95% CI 0.62–0.80). Physicians with higher levels of depressive symptoms had higher odds of burnout (aOR 18.32, 95% CI 6.75–49.73). Resilience, mean (SD) CD-RISC score, was lower in physicians who met burnout criteria compared to those who did not (62.6 (11.1) vs 70.0 (11.3); p < 0.001). Conclusions: Over one-third of palliative medicine physicians meet burnout criteria. The provision of enhanced organisational and colleague support is paramount in both the current and future pandemics. [ABSTRACT FROM AUTHOR]

Purpose: Across the UK and Ireland, there are a range of processes and interventions offered to adults who, because of personal characteristics or life circumstances, require help to keep themselves safe from potential harm or abuse. The ways in which the statutory and voluntary sectors have chosen to safeguard these adults varies. Different models of intervention and the utilisation of a range of assessment tools, frameworks and approaches have evolved, often in response to policy and practice wisdom. Empirical research in this area is limited. The primary research purpose of the project on which this paper is based is to gather information on the range of tools and frameworks that are used in adult safeguarding practice across the UK and Ireland. In so doing, this paper seeks to contribute and inform the future development of an evidence based adult safeguarding assessment framework. Design/methodology/approach: A team of academics from England, Scotland, Northern Ireland and Ireland wanted to explore the possibility of adapting a pre-existing assessment framework currently in use in family and childcare social work to consider its utility in assessing carers involved in adult safeguarding referrals. This paper reports on a small pilot study which sought to inform the adaptation of this framework for use in adult safeguarding. This paper is based on a qualitative study involving 11 semi-structured telephone interviews with adult safeguarding social work managers and experienced practitioners. Two to four professionals from each region of England, Scotland, Northern Ireland and Ireland were interviewed to elicit their perceptions and experiences of engaging in adult safeguarding assessment processes and their views about models of assessment. Findings: This study identified considerable variation in and between the nations under review, in terms of the assessment frameworks and tools used in adult safeguarding practice. To a large extent, the assessment frameworks and tools in use were not evidence based or accredited. Participants acknowledged the value of using assessment frameworks and tools whilst also identifying barriers in undertaking effective assessments. Originality/value: There is limited evidence available in the literature regarding the utility of assessment frameworks and tools in adult safeguarding practice. This primary research identifies four themes derived from professional's experiences of using such frameworks and identifies broader recommendations for policy and practice in this area. [ABSTRACT FROM AUTHOR]

COVID19 is inherently geographical in its impact on society. Not only has it deepened pre-existing inequalities and further isolated groups that rely on physical spaces, such as LGBTQ people, the pandemic required a restructuring of multiple forms of time–space relations including activism. Using interview and questionnaires responses from early 2021, we explore the impact of COVID19 on the activities of those expressing concerns about, and opposition to, socio-legal changes related to sexualities and genders in Canada, Great Britian and Ireland. Participants' perceptions of the effects of COVID19 regimes (lockdowns and restrictions) highlight four key trends. First, the biggest group of questionnaire respondents understood their views/activities as unchanging. Second, some participants noted a disengagement with sexual and gender politics. Third, those who were activists before/during COVID19 noted challenges in continuing their activities online with the loss of face-to-face interactions, and how they negotiated new spatialities. Finally, for some participants COVID19 regimes meant either newly engaging in, or increasing their pre-pandemic, activism with time to 'research' and to develop their activities. Further work is needed to investigate if our findings are similar to other groups engaged in other forms of activism and the longitudinal effects and implications of COVID19 geographies on activism. [ABSTRACT FROM AUTHOR]

Background: Online knowledge translation (KT) approaches are becoming increasingly prevalent within healthcare due to their accessibility and facilitation of international support networks. Online platforms enable timely and far‐reaching dissemination of current evidence and best‐practice recommendations. Although there is potential to improve the uptake of rehabilitation guidelines, it is essential to consider the acceptability of online approaches to healthcare professionals to ensure their successful integration within everyday clinical settings. Aims: To establish the prospective acceptability of a theoretically informed online intervention for speech pathologists, Aphasia Nexus: Connecting Evidence to Practice, that aims to facilitate the implementation of aphasia best practice. Methods & Procedures: A mixed‐methods multinational electronic survey based on the Theoretical Framework of Acceptability (TFA) completed by aphasia researchers and clinicians. Outcomes & Results: A total of 43 participants completed the survey with 91% (n = 39) indicating that they would use Aphasia Nexus. Understanding the intervention and how it works (intervention coherence as per the TFA) was the key factor influencing the likelihood of integration within everyday clinical practice. Participants identified potential areas where the intervention could influence service change and also recommended further design and content changes to improve the intervention. Conclusions & Implications: Aphasia Nexus is an acceptable platform for further feasibility testing in the form of a pilot trial within an Australian‐based health service. The study progresses the theory of TFA as it was a valuable framework facilitating the identification of prominent factors influencing acceptability. The study also informs further intervention refinements in preparation for the next stage of research. WHAT THIS PAPER ADDS: What is already known on the subject: Online strategies have the potential to enhance KT and promote the uptake of rehabilitation guidelines. An online intervention, however, can only be effective if implemented well. For this reason, it is essential to establish the acceptability of online interventions to the intended recipients and therefore increase the likelihood of successful implementation. What this paper adds to existing knowledge: This study used a theoretically based framework to establish the acceptability of an online implementation intervention, Aphasia Nexus, to multinational aphasia clinicians and researchers. It demonstrated the value in identifying the prominent factors influencing acceptability to inform further intervention refinements and warrant continuing research. What are the potential or actual clinical implications of this work?: Speech pathologists should use online platforms to drive the implementation of best practice on an international scale. It is important for clinicians to have an in‐depth understanding of online interventions and how they work to enhance their successful uptake into routine clinical practice. Aphasia Nexus is an acceptable online platform for implementing best practice in aphasia. [ABSTRACT FROM AUTHOR]

The Clay Minerals Group (CMG), the first of the Special Interest Groups of the Mineralogical Society of the UK and Ireland, was inaugurated in January 1947. The CMG, together with its Belgian equivalent (originally the Comité Belge pour l'Etude des Argiles, later the Belgian Clay Group, now defunct), formed the world's first organizations dedicated to clay mineral research. The CMG celebrated its 75th anniversary in 2022. The Group's aims are to stimulate interest in clay mineralogy, to facilitate an exchange of information between members by providing facilities for reading and discussing papers on research on clay minerals (and allied topics) and to expedite their publication and to encourage practical applications of such research, and these have remained reassuringly the same throughout its history. A founder and active member of both the European Clay Groups Association and the Association Internationale Pour L'Etude des Argiles, the CMG has promoted clay science through the publication of the highly regarded journal Clay Minerals and a series of influential book titles, organizing international and national scientific conferences and meetings, the George Brown Lecture series, providing bursaries and grants to assist researchers and hosting the Images of Clay archive. The initial and sustained success of the CMG has been largely due to the labours of many officers and committee members, some of whom have been recognized for their science and service with awards from the Mineralogical Society of the UK and Ireland and elsewhere. By maintaining this effort, the evident, continuing demand for clay mineral research to assist with changing societal needs should ensure the relevance and health of the CMG for the foreseeable future. [ABSTRACT FROM AUTHOR]

Reviewing the historiography of education provides insights into both the past and present of this growing area of research across the UK and Ireland. In the nineteenth century research reveals a close association with national identities. These were often Whig histories that celebrated the present and emphasised the progressive nature of educational development, sometimes characterised by an 'acts and facts' approach. From the 1960s, it is possible to identify a series of revisionist histories, which diversified further in the coming decades and morphed into the familiar patterns that we can identify today: theoretical and conceptual complexity; a concern with inequalities; an eclectic and widening interest in primary sources; a focus on schooling but moving beyond it, for instance to childhood, welfare and literacy; and a (re)discovery of new topics such as the emotions, senses and identities. [ABSTRACT FROM AUTHOR]

In this paper, we report on the outcomes of a survey of students across 12 higher education institutions in Ireland and the UK. Participants were asked to give their views on what tutors should do and not do when they are providing Mathematics Learning Support to students. We present the categories that emerged from an analysis of student responses, including tutor behaviour, teaching methods, content knowledge and management items. We discuss the implications that these responses have for tutor selection and training, how they relate to mathematical pedagogy and we consider the high expectations that students appear to have for tutors, who are providing this supplemental support. [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]

Background the mySupport advance care planning intervention was originally developed and evaluated in Northern Ireland (UK). Family caregivers of nursing home residents with dementia received an educational booklet and a family care conference with a trained facilitator to discuss their relative's future care. Objectives to investigate whether upscaling the intervention adapted to local context and complemented by a question prompt list impacts family caregivers' uncertainty in decision-making and their satisfaction with care across six countries. Second, to investigate whether mySupport affects residents' hospitalisations and documented advance decisions. Design a pretest–posttest design. Setting in Canada, the Czech Republic, Ireland, Italy, the Netherlands and the UK, two nursing homes participated. Participants in total, 88 family caregivers completed baseline, intervention and follow-up assessments. Methods family caregivers' scores on the Decisional Conflict Scale and Family Perceptions of Care Scale before and after the intervention were compared with linear mixed models. The number of documented advance decisions and residents' hospitalisations was obtained via chart review or reported by nursing home staff and compared between baseline and follow-up with McNemar tests. Results family caregivers reported less decision-making uncertainty (−9.6, 95% confidence interval: −13.3, −6.0, P  < 0.001) and more positive perceptions of care (+11.4, 95% confidence interval: 7.8, 15.0; P  < 0.001) after the intervention. The number of advance decisions to refuse treatment was significantly higher after the intervention (21 vs 16); the number of other advance decisions or hospitalisations was unchanged. Conclusions the mySupport intervention may be impactful in countries beyond the original setting. [ABSTRACT FROM AUTHOR]

Language disorder (LD) is a common childhood condition affecting language development, which can in turn impact children's peer relationships. Although most children with LD are included in mainstream classrooms, there is limited knowledge about the way friendships support or hinder the learning experiences of children with LD in inclusive settings. Typically developing (TD) peers' views tend to get overlooked when considering inclusion but they need to be heard as they too adapt to inclusive classrooms. In this small-scale study, we explored the perspectives of peers on their friendship quality with children with LD. We conducted friendship interviews with classroom friends (n = 9) of 6–8-year-old children with LD (n = 9), who attended the enhanced provision and mainstream classrooms in the United Kingdom and the Republic of Ireland. We used sociometric nomination methods to identify the reciprocal friends of children with LD. We then interviewed these friends using art-based methods and analysed our interview data using thematic framework. Friends of children with LD attending the enhanced provision showed an inclusive mindset and revealed their own strategies for overcoming potential communication barriers. In contrast, friends in full-time mainstream classrooms did not report experiencing communication difficulties when interacting with a peer with LD. We conclude that educational practice should build on those inclusion strategies that children find natural and consider the importance of teaching all children about adjustments that can support inclusion of those with communication difficulties. [ABSTRACT FROM AUTHOR]

Aim: To test whether poor childhood pulmonary function explains the relationship between extremely preterm (EP) birth and attention‐deficit/hyperactivity disorder (ADHD) symptoms in young adulthood. Methods: EPICure birth cohort participants include children born <26 weeks' gestation in the United Kingdom and Ireland in 1995 and their term‐born classmates. Predictor was EP birth. Outcomes were inattention/hyperactivity subscale z‐scores at 19 years. Forced expiratory volume (FEV1) z‐scores in childhood and young adulthood were mediators. We used recursive path analysis to determine the direct effect of EP birth on inattention/hyperactivity and its indirect effect through pulmonary function. Results: Ninety EP and 47 term‐born participants had pulmonary function testing at 11 and 19 years. Inattention z‐scores were higher in the EP group (mean difference 0.55 [95% CI 0.11, 0.99]) but not hyperactivity. Compared to term‐born peers, EP participants had lower FEV1 z‐scores at 11 (mean difference−1.35 [95% CI −1.72, −0.98]) and 19 (mean difference−1.29 [95% CI −1.65, −0.92]). Path models revealed that childhood pulmonary function explained the relationship between EP birth and inattention. Conclusions: Extremely preterm young adults have increased risk for inattention compared to term‐born peers. Poor pulmonary function appears to underlie this risk. The mechanisms responsible remain unclear and warrant further study. [ABSTRACT FROM AUTHOR]

The present study examined trainee clinical psychologists' experiences of the therapeutic alliance while pregnant. There is a dearth of literature that has explored trainee clinical psychologists' lived experiences of the therapeutic alliance while pregnant. To address this gap in the literature, the present study explored trainee clinical psychologists' experiences of the therapeutic alliance while pregnant. Using a qualitative design, 11 trainee clinical psychologists from clinical doctorate programmes in Ireland and the United Kingdom were invited to take part in a semi-structured interview about their experiences. From the analysis, three superordinate themes emerged: a) disclosure of the pregnancy; b) perception of the alliance and c) changes within the therapeutic interaction. The findings suggest that trainees may experience changes in their relationships with clients during their pregnancy. Recommendations from this study include the development of specific guidelines for responding to these relational changes that may emerge within the therapeutic space, in response to their pregnancy. Directions for future studies are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Due to the risk of intracranial aneurysm (IA) recurrence and the potential requirement for re-treatment following endovascular treatment (EVT), radiological follow-up of these aneurysms is necessary. There is little evidence to guide the duration and frequency of this follow-up. The aim of this study was to establish the current practice in neurosurgical units in the UK and Ireland. Methods: A survey was designed with input from interventional neuroradiologists and neurosurgeons. Neurovascular consultants in each of the 30 neurosurgical units providing a neurovascular service in the UK and Ireland were contacted and asked to respond to questions regarding the follow-up practice for IA treated with EVT in their department. Results: Responses were obtained from 28/30 (94%) of departments. There was evidence of wide variations in the duration and frequency of follow-up, with a minimum follow-up duration for ruptured IA that varied from 18 months in 5/28 (18%) units to 5 years in 11/28 (39%) of units. Young patient age, previous subarachnoid haemorrhage and incomplete IA occlusion were cited as factors that would prompt more intensive surveillance, although larger and broad-necked IA were not followed-up more closely in the majority of departments. Conclusions: There is a wide variation in the radiological follow-up of IA treated with EVT in the UK and Ireland. Further standardisation of this aspect of patient care is likely to be beneficial, but further evidence on the behaviour of IA following EVT is required in order to inform this process. [ABSTRACT FROM AUTHOR]

Aim: Patients diagnosed with a malignant polyp generally have favourable overall survival (OS) and cancer‐specific survival (CSS). However, it is unclear how choice in management for malignant polyps may affect survival. Methods: Data from the Queensland Oncology Repository was analysed to derive a population wide assessment of the impact of management strategy on OS and CSS for patients diagnosed with malignant polyps. Log‐rank testing, Kaplan–Meier and Cox‐regression models were performed. Patients were matched using propensity score and Mahalanobis distance matching. Results: A total of 1,646 patients were included with 240 deaths and 52 colorectal cancer related deaths until censor date. Following propensity score and Mahalanobis distance matching of patients undergoing polypectomy alone versus colorectal resection, there was no significant difference in the age groups (<60 years of age or ≥60 years of age), American Society of Anesthesiology score, comorbidity count or Association of ColoProctology of Great Britain and Ireland risk category. However, of note Log‐rank testing demonstrated a significant difference in OS (p < 0.001) and CSS (p = 0.0061) between management strategies. Multivariable Cox‐regression models in matched and un‐matched patient cohorts demonstrated significantly lower hazards of death for OS with resection (p < 0.001). However, CSS was no longer significantly different between management groups in multivariable Cox‐regression analysis (p = 0.073). Conclusion: Patients who underwent colorectal resection had significantly improved OS and CSS compared with polypectomy alone. Improved OS was furthermore seen on multivariable analysis, and in matched cohorts. Future research should investigate why this unexpected finding may be the case and whether updates to guidelines should be considered. [ABSTRACT FROM AUTHOR]

Background: Mental health is a global health priority, and pharmacists have a valuable role in improving outcomes in all sectors of practice. This study sought to explore pharmacy students' views on teaching and learning of mental health and future practice. Methods: An anonymous online questionnaire was distributed to pharmacy students in the UK and Ireland in February 2020 via the Qualtrics™ platform and 232 students responded. The questionnaire was originally intended to explore the provision of Mental Health First Aid (MHFA) teaching and the quantitative analysis has been previously reported. Students were invited to comment on their views about MHFA. The open-ended question: 'Do you have any other comments about mental health teaching and learning in the MPharm degree?' was also included. The rich free-text data were analysed, and themes identified. Results: Three major themes were identified: (i) Mental Health is important; (ii) Pharmacist roles and (iii) So, Teach me. A fourth theme, Stigma, crosscut all the themes. Conclusions: Pharmacy students appreciate the importance of mental health care. The majority recognise the role of the pharmacist in providing person-centred care and the potential to enhance this role. Students are keen to learn more, and acquire the confidence and skills to contribute in the future. They would like an integrated approach and have more opportunities to learn from patients. Addressing stigma is an important consideration for educators. [ABSTRACT FROM AUTHOR]

The phrase 'in it together' has been used liberally since the outbreak of COVID‐19, but the extent that frontline workers felt 'in it together' is not well understood. Here, we consider the factors that built (or eroded) solidarity while working through the pandemic, and how frontline workers navigated their lives through periods of disconnection. Semi‐structured interviews with 21 frontline workers, across all sectors, were conducted in the United Kingdom and Ireland. The qualitative data were analysed systematically using reflexive thematic analysis. The three themes identified in the data were: (1) Solidarity as central to frontline experiences; (2) Leadership as absent, shallow and divisive: highlighting 'us‐them' distinctions and (3) The rise of 'us' and 'we' among colleagues. Our research offers insights into how frontline workers make sense of their experiences of solidarity and discordance during the first year of the COVID‐19 pandemic, with relevance for government and organizational policy‐makers shaping future conditions for frontline workers. [ABSTRACT FROM AUTHOR]

Aim: The aim of this scoping review is to synthesise current evidence around the clinical skill development of preregistration registered nurses (RNs) in Australia, United Kingdom (UK), Ireland, United States (US), Canada and New Zealand, to inform nurse education, policy and clinical practice. Background: Nursing is a practical profession, and registered nurses require specific skills, knowledge and attributes in order to care for patients safely. The context for health care delivery is shifting, and the education of nurses must adapt to effectively equip the registered nurse of the future. Design: A scoping review was conducted of clinical skill development in preregistration nurses. CINAHL Plus, MEDLINE, Health Source (Nursing/Academic edition) and Scopus were searched. Included studies were primary Australian studies and international literature reviews, which focussed on preregistration nursing education. Papers were written in the English language and focussed on clinical skill development. Results were synthesised narratively. The review is reported here in accordance with the Preferred Reporting Items for Systematic Review and Meta‐analyses Scoping Review extension (PRISMA‐ScR) guidelines. Results: One hundred fifty‐five Australia studies and 89 international reviews were included in the review. Six key themes were identified, namely clinical skills, approaches to teaching and learning, interprofessional education, assessment of learning, clinical placement and simulation. Conclusion: There is substantial variation in strategies and programmes to facilitate clinical skill development both within Australia and internationally, indicating a genuine shift away from traditional didactic pedagogy. New graduate registered nurses were expected to be "work‐ready," albeit at a novice level, when they enter the workplace. Future research should consider measures of impact on actual clinical practice and focus on developing work‐ready graduates for the range of clinical settings in which they may practice. Educators, policymakers and educational institutions can use these findings to inform curriculum developments to ensure that clinical skill development is evidence‐based. [ABSTRACT FROM AUTHOR]

Issues of migration writing (see Kosmalska) and migrant theatre have recently gained prominence, leading to an increase in research focused on analyzing the theatrical works of artists with a migrant background. This phenomenon is part of a broader trend in intercultural and, often, postcolonial studies. Contemporary Polish migrant theatre is a subject that has not been thoroughly explored yet. Among many methods applied in the study of migrant theatre, intercultural studies or the so-called new interculturalism take the lead. These concepts draw on bilingualism or multilingualism practices, which are slowly taking a more significant role in migrant theatre studies. This article analyzes two theatre plays staged by Polish migrants in Ireland and in the United Kingdom in the context of linguistic practices that exemplify and help define the concept of transnational drama. [ABSTRACT FROM AUTHOR]

Under Strand Three of the 1998 Belfast 'Good Friday' Agreement, institutions were set up to promote the 'harmonious and mutually beneficial development' of the 'totality of relationships' between the peoples and governments of Ireland and the UK, including its devolved administrations and Crown Dependencies. According to the text of the 1998 Agreement this 'east‐west' dimension was to have two elements with corresponding institutions: an intergovernmental one reflected in the British‐Irish Intergovernmental Conference (BIIC) and an interjurisdictional one reflected in the British‐Irish Council (BIC). These Strand Three institutions were designed to provide fora for, respectively, intergovernmental cooperation on 'non‐devolved Northern Ireland matters' in the case of the BIIC and information exchange and cooperation 'on matters of mutual interest within the competence of the relevant Administrations' in the case of the BIC. Nowhere in the 1998 Agreement text is the concept of 'east‐west' used to refer to relations between Northern Ireland and Great Britain. Yet, in the wake of Brexit, and in the midst of controversy over the implications of the Protocol on Ireland / Northern Ireland, relations between Great Britain and Northern Ireland (GB–NI) have been newly framed as 'east‐west'. The creation of this new discursive face of 'east‐west' relations marks an important, but little discussed, impact of Brexit on the political and constitutional landscape of the UK and Ireland. Against this backdrop, this article considers the impacts of Brexit, and the Protocol, on three faces of 'east‐west' relations—the BIIC, the BIC and, newly, GB–NI—and discusses their implications for the future of Strand 3 institutions and the 'totality of relationships' they represent. [ABSTRACT FROM AUTHOR]

Objectives: A statistical study comparing osteological and ancient DNA determinations of sex was conducted in order to investigate whether there are sex biases in United Kingdom and Irish Neolithic megalithic burials. Materials and Methods: Genetic and osteological information from human individuals from 32 megalithic sites in the UK and Ireland dating from 4000 to 2500 cal. BCE was collected and statistically analyzed to test whether there is a true over‐representation of males at these sites. The published dataset from the study by Sánchez‐Quinto et al. in 2019 was initially analyzed before being refined and included in a larger dataset. Osteological analysis of sex bias was limited to adults with available sex estimations, and genetic analysis limited to published data Results: Two sites consistently returned significant p‐values suggesting a potential over‐representation in osteological males at one site (Knowe of Midhowe, Orkney) and genetic males in the other (Primrose Grange, Ireland). Cumulative statistical analyses point towards a male bias in the representation of sexes in Neolithic megalithic burials, but these results do not reflect the site‐by‐site and regional variation found in this study. Discussion: The interpretation of sex bias, that is, the over‐representation of one sex over another ‐ depends on other socio‐cultural variables (e.g., kinship) and the emphasis placed on statistical significance. The trend towards males being over‐represented in Neolithic megalithic burials is not as clear as previously thought, and requires further testing and data collection to uncover. [ABSTRACT FROM AUTHOR]

Sound general and sports nutrition knowledge in athletes is essential for making appropriate dietary choices. Assessment of nutrition knowledge enables evaluation and tailoring of nutrition education. However, few well-validated tools are available to assess nutrition knowledge in athletes. The objective of the present study was to establish the validity of the Platform to Evaluate Athlete Knowledge Sports – Nutrition Questionnaire (PEAKS-NQ) for use in the United Kingdom and Irish (UK-I) athletes. To confirm content validity, twenty-three sports nutritionists (SNs) from elite, UK-I sports institutes provided feedback on the PEAKS-NQ via a modified Delphi method. After minor changes, the UK-I version of the PEAKS-NQ was administered to UK-I SN from the British Dietetic Association Sport and Exercise Nutrition Register, and elite athletes (EA) training at elite sports institutes in the UK and Ireland. Independent samples t-test and independent samples median tests were used to compare PEAKS-NQ total and subsection scores between EA and SN (to assess construct validity). Cronbach’s alpha (good ≥ 0⋅7) was used to establish internal consistency. The SN achieved greater overall [SN (n 23) 92⋅3 (9⋅3) v. EA (n 154): 71⋅4 (10⋅0)%; P < 0⋅001] and individual section scores (P < 0⋅001) except Section B, Identification of Food Groups (P = 0⋅07). Largest knowledge differences between SN and EA were in Section D, Applied Sports Nutrition [SN: 88⋅5 (8⋅9) v. EA: 56⋅7 (14⋅5)%; P < 0⋅00]. Overall ES was large (2⋅1), with subsections ranging from 0⋅6 to 2⋅3. Cronbach’s alpha was good (0⋅83). The PEAKS-NQ had good content and construct validity, supporting its use to assess nutrition knowledge of UK-I athletes. [ABSTRACT FROM AUTHOR]

Background: Healthcare-associated infections (HCAIs) pose a significant threat to the health and safety of patients, staff, and visitors. Infection prevention and control (IPC) teams play a crucial role in ensuring that systems and processes are in place to keep everyone safe within the healthcare environment. Aim: The aim of this study was to identify components of infection prevention services, priorities, indicators of successes and how they are measured, and facilitators and barriers to success. Methods: A s urvey questionnaire was developed and circulated to infection prevention leaders and managers. Findings/results: Seventy IPC leaders/managers completed the survey. Participants were responsible for a range of IPC services within and across healthcare organisations, with significant variations to IPC delivery components. Additionally, a range of budget availability was reported. Several IPC service requirements were considered core work of IPC teams, including providing IPC advice and support, surveillance and audit and education and training. Discussion: An optimal IPC service needs to be in place to ensure HCAIs are minimised or prevented. In a post pandemic era, this is more important than ever before. This is also as crucial for the health and wellbeing of those working in IPC, who have endured unprecedented demand for their services during the pandemic. [ABSTRACT FROM AUTHOR]

Background: The importance of infection prevention and control (IPC) services to prevent threats from healthcare-associated infections and improve the quality of healthcare delivery is undeniable. However, IPC services across the UK and Ireland have substantial variability in terms of team structures and delivery models. Aim: The aim of this study was to define an optimal IPC service in different contexts and settings within the United Kingdom and Ireland. Methods: This mixed methods study adopted discussion huddles with IPC teams to explore various components of IPC programmes and services. A Nominal Group technique was then undertaken to achieve a group consensus of what an optimal infection prevention service should look like. Results: Five discussion huddles were conducted which included 53 participants in total. Key themes arising were IPC Service Priorities, IPC Service Enablers for Success, and Necessary Skills and Expertise Required for Delivering an Effective IPC Service. For the nominal technique, 45 responses were identified which were determining the key priorities for an effective IPC service and 69 responses for establishing key enablers for success. Discussion: These findings supported the development of a conceptual model for designing an optimal infection prevention service, which can be used to develop IPC services at an international, national, regional and local level. A focus is required around implementation of these highlighted enablers, so are effectively embedded into infection prevention and control services, and wider healthcare settings. [ABSTRACT FROM AUTHOR]

Altruism is consistently identified as the dominant motive for body donation. Over 12 months, 843 people who requested body donation information packs also completed research questionnaires that included open-ended questions about their motives. Abductive analysis suggested two distinct sets of altruistic motives: those seeking benefits for medical professionals and patient groups ("medical altruism") and those seeking benefits for friends and family ("intimate altruism"). Either could facilitate or impede body donation. Altruism may not be best understood as a unitary motive invariably promoting body donation. Rather, it is a characteristic of various motives, each of which seek benefits for specific beneficiaries. [ABSTRACT FROM AUTHOR]

Background: Family carers of people with profound and multiple intellectual disabilities (PMID) experienced a reduction in healthcare services due to the COVID-19 pandemic. Many subsequently turned to Non-Governmental Organisations who worked to support families. However, little research has sought to capture the experiences of family carers or identify effective interventions which might support them. To address these concerns we explored the views of Non-Governmental sector workers across the UK and Ireland who supported families people with PMID during the COVID-19 pandemic. We also sought to explore their views on the characteristics of online support programmes for family carers. Methods: This study employed a qualitative design using focus groups with participants (n = 24) from five Non-Governmental Organisations across the UK and Ireland. A focus group guide included questions on challenges, supports, coping and resources which helped during lockdown restrictions. Focus groups were held online, were audio recorded and transcribed verbatim. The resulting transcripts were pseudonymised and subjected to thematic analysis. Findings: Four themes were identified (i) 'mental and emotional health', (ii) 'they who shout the loudest' (fighting for services), (iii) 'lack of trust in statutory services' and (iv) 'creating an online support programme'. Mental and emotional health emerged as the most prominent theme and included three subthemes named as 'isolation', 'fear of COVID-19' and 'the exhaustion of caring'. Conclusions: The COVID-19 pandemic has increased the vulnerability of family carers who were already experiencing difficulties in accessing services and supports for their families. While Non-Governmental Organisations have been a crucial lifeline there is urgent need to design services, including online support programmes, in partnership with family carers which adequately address their needs. [ABSTRACT FROM AUTHOR]

This article discusses the rules applied by the courts in the Republic of Ireland and the United Kingdom in determining whether the defendant in a negligence action attained the required standard of care in performing a professional task. It will discuss the effect of the defendant's adherence to a practice widely accepted in the relevant profession at the time, and the effect of expert witnesses testifying that they regard the defendant's conduct as proper. This article also discusses the different rules applying to the provision of certain information by a professional. [ABSTRACT FROM AUTHOR]

We have used ultrasound imaging and technology as a tool for nonclinical teaching of basic physiological concepts for several years and are aware anecdotally that only a few others in the United Kingdom and Republic of Ireland (UK/ROI) are also using ultrasound with this intention in physiology and anatomy teaching. To better understand what areas ultrasound is used for by others, along with what barriers might exist to its use, we reached out to colleagues in UK/ROI institutions instructing on anatomy and physiology courses by asking them to complete a survey regarding their experiences. Relatively few institutions (9%) reported using the technology in this way but covered physiology and anatomy teaching in most major body systems. The perception of responding educators overall is that, overwhelmingly, ultrasound offers a useful addition to the teaching of physiology and anatomy and is very popular with students. Barriers to its implementation were identified, including unfamiliarity with equipment and potential uses. Lack of funding for equipment and staff, issues with class sizes, and lack of curriculum time were also identified. Despite these potential impediments, most nonusers were interested in finding out about the uses of ultrasound as a teaching tool. We conclude that the teaching community would benefit from wider dissemination of local practices. NEW & NOTEWORTHY We surveyed UK and Republic of Ireland institutions to establish the extent of ultrasound use in teaching undergraduate modules with significant anatomy or physiology content. Responses indicate that although ultrasound is used for a wide variety of systems, only a small proportion of courses use ultrasound for teaching. There is widespread interest in its use, with the main barriers being unfamiliarity with potential uses and the technology. We endorse further dissemination of this teaching practice. [ABSTRACT FROM AUTHOR]

The post-medieval fieldwork entries for 2021 follow the structure introduced into the fieldwork section of I PMA i in 2008. Although an effort has been made to create a fair representation of the variety of fieldwork undertaken across Britain and Ireland, this compilation only covers those submissions received; any gaps may represent a lack of submissions rather than an absence of fieldwork carried out in the area. [Extracted from the article]

Background: Family carers of people with profound and multiple intellectual disabilities (PMID) experienced a reduction in healthcare services due to the COVID-19 pandemic. Many subsequently turned to Non-Governmental Organisations who worked to support families. However, little research has sought to capture the experiences of family carers or identify effective interventions which might support them. To address these concerns we explored the views of Non-Governmental sector workers across the UK and Ireland who supported families people with PMID during the COVID-19 pandemic. We also sought to explore their views on the characteristics of online support programmes for family carers.  METHODS: This study employed a qualitative design using focus groups with participants (n = 24) from five Non-Governmental Organisations across the UK and Ireland. A focus group guide included questions on challenges, supports, coping and resources which helped during lockdown restrictions. Focus groups were held online, were audio recorded and transcribed verbatim. The resulting transcripts were pseudonymised and subjected to thematic analysis.Findings: Four themes were identified (i) 'mental and emotional health', (ii) 'they who shout the loudest' (fighting for services), (iii) 'lack of trust in statutory services' and (iv) 'creating an online support programme'. Mental and emotional health emerged as the most prominent theme and included three subthemes named as 'isolation', 'fear of COVID-19' and 'the exhaustion of caring'.Conclusions: The COVID-19 pandemic has increased the vulnerability of family carers who were already experiencing difficulties in accessing services and supports for their families. While Non-Governmental Organisations have been a crucial lifeline there is urgent need to design services, including online support programmes, in partnership with family carers which adequately address their needs. [ABSTRACT FROM AUTHOR]

Background: To describe long-term outcomes in JDM using patient questionnaires and link to longitudinal, prospectively collected data for each patient within the Juvenile Dermatomyositis Cohort and Biomarker Study, UK and Ireland (JDCBS) to determine outcome predictors. Methods: JDCBS participants aged ≥ 16y completed the SF36, HAQ and a questionnaire regarding current disease features, medications, education and employment. Data collected from the JDCBS included disease subtype, demographics, clinical and laboratory features. Intensity indices were calculated for physician VAS, modified skin DAS, CMAS and MMT8 by dividing area under the curve (AUC) from longitudinal score trajectories by duration of study follow-up (y). Relationships between questionnaire and JDCBS clinical / laboratory data were investigated fitting statistical models appropriate for cross sectional and longitudinal data. Results: Of 190 questionnaires sent, 84 (44%) were returned. Average age of respondents was 20.6 years (SD 3.9), time since diagnosis was 12.4 years (SD 5.0), age at onset was 9.2 years (SD 4.3), female to male ratio 4.25:1. Forty-nine (59%) self-reported persistently active disease, 54 (65%) were still taking immunosuppressive medication. 14/32 at school/higher education reported myositis adversely affecting academic results. 18–24 year-olds were twice as likely to be unemployed compared the UK population (OR = 0.456, 95% CI 0.24, 0.84, p = 0.001). Participants ≥ 18 years were three times as likely to be living with a parent/guardian (OR = 3.39, p < 0.001). SF36 MCS and MMT8 intensity index scores were significantly correlated (ρ = 0.328, p = 0.007). Conclusions: After 12.4 years, questionnaire responders reported self-perceived high rates of persistently active disease and medication use, reduced rates of employment and were more likely to live with a parent/guardian. Perceived persistently active muscle disease appeared to affect quality of life in these patients and was the most significant contributor to long-term outcomes. Our findings highlight the importance of including the patient perspective in the assessment of long term outcomes, so that that we can start to target initial management strategies more effectively based on a combination of clinical and patient-reported data. [ABSTRACT FROM AUTHOR]

Background: Limb strength is a central component of neurological assessment and monitoring in nursing practice, yet there is a lack of research examining the tools used by nurses or challenges nurses encounter when using these tools. The evidence base is lacking to inform effective practice and the underpinning educational approaches. Aim: To determine which tools are used by UK and Irish neuroscience nurses in the assessment of limb strength and the associated challenges and variations in practice. Methods: This study used an online self-reported survey design to ascertain which tools neuroscience nurses used and their experience of using these (n=160). Findings: Practices varied, with a dominance of two tools being used in practice: the Medical Research Council scale and the 'normal power' to 'no movement' scale found on the neurological observation chart. Most respondents used the same tool across all conditions. Conclusion: This study highlights variations in assessment practice and the absence of a sound evidence base behind choice of motor limb strength assessment tools used. [ABSTRACT FROM AUTHOR]

Background: Pulmonary complications are the most common morbidity after oesophagectomy, contributing to mortality and prolonged postoperative recovery, and have a negative impact on health-related quality of life. A variety of single or bundled interventions in the perioperative setting have been developed to reduce the incidence of pulmonary complications. Significant variation in practice exists across the UK. The aim of this modified Delphi consensus was to deliver clear evidence-based consensus recommendations regarding intraoperative and postoperative care that may reduce pulmonary complications after oesophagectomy. Methods: With input from a multidisciplinary group of 23 experts in the perioperative management of patients undergoing surgery for oesophageal cancer, a modified Delphi method was employed. Following an initial systematic review of relevant literature, a range of anaesthetic, surgical, and postoperative care interventions were identified. These were then discussed during a two-part virtual conference. Recommendation statements were drafted, refined, and agreed by all attendees. The level of evidence supporting each statement was considered. Results: Consensus was reached on 12 statements on topics including operative approach, pyloric drainage strategies, intraoperative fluid and ventilation strategies, perioperative analgesia, postoperative feeding plans, and physiotherapy interventions. Seven additional questions concerning the perioperative management of patients undergoing oesophagectomy were highlighted to guide future research. Conclusion: Clear consensus recommendations regarding intraoperative and postoperative interventions that may reduce pulmonary complications after oesophagectomy are presented. [ABSTRACT FROM AUTHOR]

In narratives around insurgencies, terrorism, and other forms of political violence, the media—and policymakers—frequently portray women as victims or unintelligent pawns of men. But these violent women get more media attention than their male counterparts because they are a shocking departure from gendered expectations of nurturing, peaceful women. However, even such narratives of deviance can reinforce societal stereotypes about women by emphasizing that they are emotional but not political, easily manipulated, often deranged, or simply unintelligent. Using in-depth interviews in Ireland and the United Kingdom with practitioners in counter terrorism (CT) and countering violent extremism (CVE), this paper argues that a failure to ask meaningful questions about women's roles in extremist violence has reinforced gender stereotypes, leading to disengagement and deradicalization practices that ignore or downplay women's importance in fostering violence. [ABSTRACT FROM AUTHOR]

Patterns of finds of continental coinage appear to vary considerably, related to fluctuations in trading relationships and economics, with finds of Venetian coinage and the Low Countries most common.[39] A mid-12th-century I petit denier i struck at Ypres (Belgium) from Temple Bruer with Temple High Grange (Lincolnshire; LIN-6D2321; Fig 2j) is of an earlier date than the main Low Countries incursions (mid-late 13th century) and the first PAS-recorded example from outside southern England. Evidence from graves shows that such copies were often pierced for suspension, playing the same role in burials as official coins - eg as pendants at Lechlade (Gloucestershire) and Ipswich (Suffolk), and unmodified at Carisbrooke Castle (Isle of Wight), where it was placed in the mouth of the deceased.[9] Other plated imitations with piercings have been recorded by the PAS.[10] PHOTO (COLOR): Fig 1 Early medieval coins. Two pennies of Offa of Mercia (757-96), non-portrait types belonging to the "Light Coinage" (c 784-92), extend the distribution of Mercian coinage into SW England with finds from Tarrant Hinton (Dorset; DOR-A6A573; Fig 1f) - the first from Dorset - and Chitterne (Wiltshire; SUR-7F7364; Fig 1g). I General Editor: i NEIL CHRISTIE I Portable Antiquities Scheme Report edited by: i JOHN NAYLOR[1] I Medieval Britain and Ireland compiled and edited by: i TIZIANA VITALI I and i PATRICK GLEESON I with i TOMÁS Ó CARRAGÁIN This section of the journal comprises two core sets of reports linked to work in 2021: finds and analyses relating to the Portable Antiquities Scheme (PAS) and related research reports; and site-specific discoveries and reports in medieval Britain and Ireland (MB&I), with a selection of highlighted projects. [Extracted from the article]

Causeway Construction Three distinct phases of causeway construction were identified (see Figs. This section comprises a selection of highlighted projects or discoveries made across Britain and Ireland in 2021, with illustrated overviews of results, finds and contexts. On the balance of the evidence, this building formed the gatehouse opening into the inner precinct of the abbey that contained the conventual buildings and the graveyard. Salvage recording assigned a 13th- to 15th-century occupation date to the remains of a manor house, several isolated rectangular buildings of unknown function, and an extensive limestone-cobbled yard.[5] Manor Excavations The causeway, revealed by open-area excavation in 2021,[6] was probably related to the 13th- to 14th-century manor (Fig 1). [Extracted from the article]

This paper examines how, when and where personal names are produced as 'migrant names'. Drawing on 21 interviews with young Irish and Latvian migrants in the UK, I demonstrate how mundane stories, linguistic details, and repertoires about migrant names are embodied, mobile, relational, and produce everyday social distinctions. Empirical analysis unpacks changes in naming stories throughout participants' multiple migration trajectories in Ireland, Latvia, the UK and beyond. I argue for a geographically sensitive take on migrant names because they are produced as such through recognisable repertoires of displacement and then re-emplaced in certain spaces and times. The paper makes three main original contributions. The first is to interdisciplinary literatures on names, specifically on the significance of temporal and spatial contexts and the relationalities underpinning the production of migrant names. Second, it brings to geographies of identities novel understandings of ethnic and national power relations in naming practices, including an emphasis on the process of ambiguous whiteness. Finally, I contribute much-needed methodological propositions on how to pseudonymise names in migration research. [ABSTRACT FROM AUTHOR]

The present study sets the psychological type profile and temperament of 190 Catholic priests serving in England, Wales, and Ireland alongside the profile of 1,298 Catholic priests reported by Ruppart in 1985. In the current study 68% of priests preferred introversion, 61% preferred sensing, 53% preferred feeling, and 84% preferred judging, confirming the findings of other recent studies of Catholic priests in Australia and Italy of a trend towards introversion, sensing, and judging, and away from feeling. In the current study 55% presented as Epimethean Temperament (SJ) and 21% as Apollonian Temperament (NF), also confirming other recent studies that report a move toward the SJ temperament and away from the NF temperament. The implications of these findings are discussed for the expression and experience of ministry within the Catholic Church. [ABSTRACT FROM AUTHOR]

Background: Individuals with a prior diagnosis of chronic lymphocytic leukaemia (CLL) have a higher risk of developing melanoma and exhibit poorer outcomes than patients without CLL. However, there are limited data reporting the clinicopathological features of melanoma diagnosed in patients with CLL. Aims: To review clinicopathological characteristics of patients with coexisting diagnoses of melanoma and CLL. Methods: A retrospective review was undertaken for patients with coexisting diagnoses of melanoma and CLL between 2005 and 2015 in 11 centres in the UK and Ireland. Results: Overall, 46 cutaneous melanomas identified in 45 patients were included. In 28 (62.2%) patients, melanoma was diagnosed after an existing diagnosis of CLL. In this group, mean Breslow thickness was 2.7 mm (range 0.2–25 mm). Ten patients (35.7%) developed locoregional recurrence and 8 (28.6%) developed distant metastases. Melanoma‐specific mortality was 5 of 28 (17.9%) and all‐cause mortality was 13 of 28 (46.4%). In 17 patients, melanoma was diagnosed before CLL. In this group, mean BT was 2.9 mm (range 0.4–14 mm); five patients (29.4%) developed locoregional recurrence and three (17.6%) developed distant metastases. Melanoma‐specific mortality was 1 of 17 (5.8%) and all‐cause mortality was 5 of 17 (29.4%) in this group. Conclusions: To our knowledge, this is the first and largest cohort study to report clinicopathological data of coexisting melanoma and CLL in the UK and Ireland. Although the thickness of primary melanoma was not different before or after a CLL diagnosis, melanoma recurrence and melanoma‐specific mortality appear to be more common in patients with a prior diagnosis of CLL. [ABSTRACT FROM AUTHOR]

Visual perceptual deficits are frequently underdiagnosed in stroke survivors compared to sensory vision deficits or visual neglect. To better understand this imparity, we evaluated current practice for screening post-stroke visual perceptual deficits. We conducted a survey targeted at professionals working with stroke survivors involved in screening visual perceptual deficits across the United Kingdom and the Republic of Ireland. Forty orthoptists and 174 occupational therapists responded to the survey. Visual perceptual deficit screening was primarily conducted by occupational therapists (94%), with 75∼100% of stroke survivors screened per month. Respondents lacked consensus on whether several common post-stroke visual deficits were perceptual or not. During the screening, respondents primarily relied on self-reports and observation (94%), while assessment batteries (58%) and screening tools were underutilised (56%) and selected inappropriately (66%). Respondents reported lack of training in visual perception screening (20%) and physical/cognitive condition of stroke survivors (19%) as extremely challenging during screening. Visual perceptual deficits are screened post-stroke at a similar rate to sensory vision or visual neglect. Underdiagnosis of visual perceptual deficits may stem from both reliance on subjective and non-standardised screening approaches, and conflicting definitions of visual perception held among clinicians. We recommend increased training provision and use of brief performance-based screening tools. Lack of agreement among clinicians on what constitutes as visual perceptual or sensory vision deficits may prove problematic, as precise and exact language is often required for clinical decision-making (e.g., referrals). Biases for more familiar visual (perceptual) deficits held among clinicians during the screening process may lead to other visual deficits being missed. To avoid problems being missed, clinicians should aim to use standardised assessments rather than stroke survivor self-report and observations of function when screening for visual perceptual difficulties. [ABSTRACT FROM AUTHOR]