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Abstract: This article traces the development of the term ‘outrages’, which by the nineteenth century was used in an almost exclusively Irish context. It argues that British and Irish politicians used the term to communicate the collective insecurity they felt particular forms of Irish violence exposed, especially concerning the stability of the Act of Union. ‘Outrages’ was deployed rhetorically to brand Irish violence as politically subversive. Simultaneously, its meaning was systematized by the newly reformed Irish constabulary who surveilled particular forms of Irish violence and quantified its existence. Politicians used these statistics as one vital measure of British progress in Ireland. [ABSTRACT FROM AUTHOR]

We carried out a study looking at the use of biosimilars in the UK and Ireland using data from the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR), a large multicentre register of patients with severe psoriasis based in the UK and Ireland. Psoriasis is a chronic skin disease that affects 1.5% of the UK population, causing itchy and scaly skin patches. Tumour necrosis factor-alpha inhibitors (TNFi) are effective but previously costly injectable treatments for moderate-to-severe psoriasis. [Extracted from the article]

This paper aims to provide one of the first cross-country empirical analyses of the intensity and diversity of knowledge exchange activities by academics. Focusing on the wide perspective of knowledge exchange, the results are based on two large-scale surveys with academics in the UK and Ireland and compare them in terms of: modes of interactions, types of partners, motivations and impacts of interactions, constraints on interactions and mission of higher education perceived by academics. It is found that academics in both countries are involved in a wide range of activities, with intellectual property activities being the interactions that they are least frequently engaged in. However, academics working at Irish and UK universities show distinct patterns of interactions with private sector companies and public sector organisations. Our analysis calls for caution over one country seeking to borrow policies from another without understanding the specific context of the higher education sector. [ABSTRACT FROM AUTHOR]

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

The article discusses the British government Information Research Department's (IRD's) involvement in secret and covert, or unattributable, propaganda in Northern Ireland during the Troubles period of 1971 through 1973, including IRD officer Hugh Mooney's role in this regard. The IRD's negative propaganda against the Irish Republican Army (IRA), including its claim that the IRA was involved in drug trafficking, is discussed. The IRD's concerns on the influence of communism in the Troubles conflict is also discussed.

Background: delirium is under-recognised in comparison to other common and serious acute disorders. A 2006 survey of UK junior doctors (not undertaking specialist training) identified poor knowledge of the diagnostic criteria and treatment of delirium. We hypothesised that increased prominence accorded to delirium in the form of national initiatives and guidelines may have had an impact on understanding among junior doctors. Objective: we repeated a multi-centre survey of knowledge of and attitudes to delirium in junior doctors (not undertaking specialist training) assessing unselected acute medical presentations (the 'medical take'). Design: questionnaire-based survey in 48 acute hospitals in UK and Ireland. Methods: we used questionnaires designed to test understanding of delirium, including prevalence, knowledge of the DSM-IV diagnostic criteria, use of specific screening tools, association with adverse outcomes and pharmacological management. Results: one thousand two hundred and fifteen trainee physicians participated. Compared with the 2006 cohort, improvements were seen in 9 of 17 knowledge-based questions and overall score improved in the 2013 cohort. Nonetheless, significant deficits in knowledge, particularly for the diagnostic criteria for delirium, remained. Conclusions: despite improvements in some aspects of delirium knowledge, the diagnostic criteria for delirium remain poorly understood. Challenges remain in ensuring adequate training for junior doctors in delirium. [ABSTRACT FROM AUTHOR]

Interest in citizen science has been increasing rapidly, although the reviews available to date have not clearly outlined the links between the long-established practice of recording plant species' distributions for local and national atlases, or other recording projects, and the gradual development of more structured monitoring schemes that also rely on volunteer effort. We provide a review of volunteer-based plant monitoring in Britain and Ireland, with a particular focus on the contributions of expert volunteers working with biological recording schemes and natural history societies; in particular, we highlight projects and practices that have improved the quality of data collected. Although the monitoring of plant distributions at larger scales has led to numerous insights into floristic change and its causes, these activities have also led to the recognition that knowledge of species' abundances at finer-scales often provides a more powerful means of detecting and interpreting change. In the UK, this has led to the development of a new, abundance-based 'National Plant Monitoring Scheme'. We outline this new structured scheme, and review some of the design considerations that have been made during its development. New monitoring projects require a clear justification, and the launch of a new scheme is also an opportune moment to review whether some basic assumptions about the collection of monitoring data can withstand scrutiny. A distinction is often made between monitoring that is focused on answering particular, focused questions, and that which is more generally seeking to detect changes; for example, in species' distributions or abundances. Therefore, we also review the justification for such general 'surveillance' approaches to the monitoring of biodiversity, and place this in the context of volunteer-based initiatives. We conclude that data collected by biological recorders working within atlas or monitoring scheme frameworks will continue to produce datasets that are highly valued by governments, scientists, and the volunteers themselves. [ABSTRACT FROM AUTHOR]

The water beetle recording scheme for Britain and Ireland is over 100 years old. For at least half of that time, it has been under the control of Professor Frank Balfour- Browne, who was motivated by a wish to understand the origin of the fauna. The current state of the scheme is discussed in relation to developments from the 1970s onwards, with recognition of the continuing values of an active scheme offered to professional scientists and amateur enthusiasts, as well as a hard copy atlas in the age of electronic data. The next phase of recording will be difficult, requiring a genetic analysis of water beetles that is beyond the reach of most recorders to resolve what Balfour- Browne set out to explore in 1904. © 2015 The Linnean Society of London, Biological Journal of the Linnean Society, 2015, ●●, ●●-●●. [ABSTRACT FROM AUTHOR]

Changing air quality has been one of the most important drivers of change for bryophytes and lichens in Britain and Ireland over the 20th Century, with acidic pollutants such as sulphur dioxide having large effects on the ranges and abundances of many species. At the same time, expert amateur and professional naturalists have put enormous efforts into recording the distributions of species within these groups. These efforts have provided much evidence for declines and recoveries within the bryophytes and lichens, with species distribution data being linked to airborne pollutants in many different ways. We provide a broad overview of some of the changes that have occurred in affected species, using biological records collected by national recording schemes to illustrate the various effects of air pollution; we also review the direct and indirect impacts of air pollutants on these groups. Environmental change affecting one group of species is also likely to cascade to other groups where trophic or other relationships exist between them. Using data from the volunteer-based National Moth Recording Scheme, we provide the first evidence for an indirect association between reductions in air pollution and increases in lichenivorous moths. © 2015 The Linnean Society of London, Biological Journal of the Linnean Society, 2015, ●●, ●●-●●. [ABSTRACT FROM AUTHOR]

The death of Earl Richard Marshal at Kildare in 1234 at the hands of his Irish enemies could not be let pass by his family and political affinity. The sources are such that we are able to follow the actions and motives of his younger brother and heir, Gilbert Marshal, in punishing Richard's opponents and re-establishing his family's damaged prestige. Gilbert can be seen to be both an exploiter and victim of the social mechanism called by contemporaries 'mortal enmity'. Gilbert's actions bring us nearer to an understanding of aristocratic honour and mores in the high middle ages, at a time when the aristocracy was pitted against the statist impulses of royal government. [ABSTRACT FROM AUTHOR]

The second review by Dr Gupta and colleagues of the Institute of Post Graduate Medical Education and Research, West Bengal, India relates to the rarer occurrence of herpes simplex encephalitis in the post-acute COVID-19 infection period. Does anti-viral treatment in acute COVID infection decrease the risk of developing the Long-COVID Syndrome? It was W.B. Yeats, Nobel Laureate and renowned poet who once wrote: Education is not the filling of a pail but the lighting of a fire As the academic home for Translational Medicine, the Association seeks to promote and sustain this lighting of that fire of scientific curiosity. [Extracted from the article]

The article presents abstracts of studies on connective tissue diseases which include the benefit of vitamin D in improving endothelial function in systemic lupus erythematosus (SLE), the response of SLE patients to rituximab and the safety of subcutaneous tocolizumab.

Background We present an updated case series of patients treated with a novel Transgastric (TG) drainage technique, previously published by the senior author in 2008 [Ref], which has now been used in 6 hospitals across United Kingdom and Ireland. The technique establishes vacuum drainage of the lumen of the injured oesophagus whilst maintaining its patency, effectively exteriorizing complex oesophageal perforations to allow healing. Methods Patients presenting with Boerhaave or iatrogenic rupture, undergo an initial decontamination of the chest with drainage as required. A 32–36 Fr Chest drain is inserted in a PEG guided technique, where the proximal end of the drain is positioned 5 cm above the perforation site within the oesophagus, whilst the distal end is pulled out through the stomach and abdominal wall. Continuous low-pressure suction at -10 cm water is applied. Patients continue to drink water. Further intervention is not required until the leak has healed and the drain removed. Results We have used this technique in 20 patients in our institution (3 iatrogenic perforations, 17 Boerhaave), with a median age of 72 (range; 55–85). Perforation length ranged from 1–15 cms. Three cases were performed after stenting failed to control the leak. Pleural decontamination required thoracotomy (n = 12), VATS (n = 2); in 6 cases, no pleural decontamination was required. There were four in-hospital deaths. Median duration from surgery to removal of TG drain was 31 days (range; 10 - 71). Two patients required post discharge dilatation for stricture and are currently asymptomatic. Conclusion TG drainage in effect exteriorizes the oesophageal lumen at the site of oesophageal perforation, encouraging the perforated edges to appose and allow healing by secondary intention. Mediastinal sepsis drains through the transgastric drain (on suction) and intercostal drains placed at decontamination (off suction). Patients tolerate it well, drinking while their perforation heals, avoiding nasogastric intubation. [Ref] Berrisford RG, Krishnadas R, Froeschle P, Wajed S. European Journal of Cardiothoracic Surgery 33(2008):742–744. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Allergic contact dermatitis (ACD) is a localised form of dermatitis or eczema which occurs 48‐72 hours after a substance which causes allergy (an allergen) has been in contact with the skin. It affects 20% of people. ACD to cosmetics is widely reported, with facial eczema being the main presenting complaint. ACD to cosmetics is diagnosed by patch testing to the British Society of Cutaneous Allergy (BSCA) facial series. Patch testing is a specialist test performed by a dermatologist which involves applying a series of allergens to the patient's back, which remains in place for 48 hours until they are removed. The patient then returns, 72 hours after the initial application of the allergens, for the final readings to see if they have any positive allergic reactions. To ensure we are accurately diagnosing ACD, patch test series should be continually reviewed to identify relevant and emerging allergens and remove those that are outdated. The BSCA facial series currently recommends 26 allergens and was last modified in 2012. We set out to update the BSCA facial series. We assessed the results from 12 U.K. and Ireland patch test centres', facial series from January 2016 to December 2017. We recorded the number of allergens tested in each centre and calculated the patch test rate for each allergen, using a 0.3% positive patch test rate as the threshold criterion for inclusion. A total of 4224 patients were patch tested to the BSCA facial series. The number of allergens included in individual centres facial series ranged from 24 to 66 with a total of 103 allergens tested across all centres. Twelve of the 26 allergens in the BSCA facial series had a positive patch test rate of less than 0.3% and 14 had a rate more than 0.3%. Twenty‐five allergens not recommended in the BSCA facial series had a positive patch test rate more than 0.3%. Despite a recommended facial series, there is wide variation in practice amongst patch test centres. Using our results, we have updated the BSCA facial series which now contains 24 allergens. Fifteen allergens remain, 11 allergens have been dropped and nine new allergens have been added. Linked Article: Rolls et al. Br J Dermatol 2021; 184:151–155. Linked Article: Rolls et al. Br J Dermatol 2021; 184:151–155. [ABSTRACT FROM AUTHOR]

Psoriasis is a common skin condition affecting approximately 2% of the population, with up to 1.8 million people affected in the U.K. alone. This article reports the work from a group of U.K. and Republic of Ireland based researchers who set out to determine if secukinumab, a medicine known as an IL‐17A inhibitor, was safe and effective in patients with moderate/severe chronic plaque psoriasis for whom previous treatment with a medicine called a TNFα inhibitor had not remained effective. 53 dermatology centres in the U.K. and Republic of Ireland took part. Patients were randomly assigned to to receive secukinumab at a dose of either 300mg or 150 mg subcutaneously (by injection) every week for 4 weeks, then 4‐weekly thereafter. The Psoriasis Area Severity Index (PASI) is used to record the redness, thickness and scaling of a patient's psoriasis and to measure how well a treatment works, as a reduction in the PASI score means a reduction in these symptoms. If a patient achieves PASI 75, it means they had a 75% or more reduction in their PASI score from the start. In total, 233 patients were analysed. 77 of 118 patients (65·3%) in the 300mg dose group and 51 of 115 patients (44·3%) in the 150mg dose group had achieved PASI 75 at week 16. After 72 weeks of treatment, 77.1% of patients in the 300 mg group who remained on that treatment throughout the study achieved PASI 75. Improvements in patients' quality of life were also seen at week 16 and were maintained to week 72. The safety profile of secukinumab was generally consistent with previous secukinumab studies, although a higher incidence of some adverse events, meaning unwanted side effects, were observed (e.g. candida infections, a type of fungal infection). This study has shown evidence of the efficacy and safety of secukinumab for treatment of psoriasis patients for whom prior TNFα‐inhibitor therapy has not been effective. Linked Article: Warren et al. Br J Dermatol 2020; 183:60–70. [ABSTRACT FROM AUTHOR]

Poster presentation Tuesday 8 October Background Sjögren's syndrome, a chronic multisystem autoimmune disease is characterised by inflammation of the exocrine glands, principally the salivary and lacrimal glands resulting in xerostomia and xerophthalmia. It can also present with more extensive exocrinopathy as well as extra-glandular, systemic features. Defined as primary SS (pSS) when there is no association with other autoimmune disease, reported incidence and prevalence rates vary. Juvenile-onset pSS is believed to be rare; however it is likely that it is under-recognised and therefore under-diagnosed. To date there have been no studies reporting accurate incidence or prevalence of paediatric pSS (PpSS). Diagnosing pSS can be challenging. Many of the cardinal symptoms are non-specific and no gold standard biomarker of disease exists. Between 1965–2002 eleven diagnostic criteria sets were developed, none of which have gained universal acceptance or been validated for use in a paediatric population. Until recently, the most widely used criteria were those developed by the American-European Consensus Group. It remains well-recognised that international consensus on classification is important for standardisation, particularly in relation to research and monitoring treatment outcomes. With this in mind, the 2016 ACR/EULAR criteria were developed. However, there still remains a paucity of validated classification criteria for diagnosis of juvenile-onset pSS. Paediatric-focused criteria are required as features of pSS in children differ from those observed in adults. Children experience less dryness and more frequently experience systemic symptoms and parotid enlargement. Hence, simply applying adult criteria to a paediatric population may lead to mis- and/or under-diagnosis. The overarching aim of this study is to identify epidemiological, clinical and laboratory characteristics of PpSS in a multi-centre cohort of patients. Using this data our goal is to develop universally accepted classification criteria validated for use in a paediatric population. Going forward, this would enable standardisation of PpSS classification allowing for robust studies into disease pathogenesis, management and prognosis. Methods Inclusion criterion for entry into the UK/Ireland PpSS cohort study and repository is diagnosis of pSS before 18 years. A data collection pack will be sent to authors willing to participate. Information collected will include demographic, clinical and laboratory/histological data at diagnosis and subsequent follow-up appointments. Biological samples including blood, tears, saliva, urine, and glandular and extra-glandular (e.g. renal) tissue will be collected prospectively if available. Outcome measures related to disease activity and damage, as well as patient reported outcomes will also be collected at set time-points. Results No results to report. Conclusion The UK/Ireland PpSS cohort study and repository will capture data on a significant cohort of children with pSS providing a powerful resource to help improve our understanding of this rare disease. Prospective data collection will allow a fuller analysis of poor prognostic features, impact of therapy, damage accrual and variable outcome of PpSS. Conflicts of Interest The authors declare no conflicts of interest. [ABSTRACT FROM AUTHOR]

Background The diagnosis and relevance of a hiatal hernia on different investigative modalities and the impact on treatment is important to outcomes after Antireflux surgery. Methods Aim To obtain perceptions from a surgeon's view on the diagnosis and importance of a Hiatal hernia. Methods A survey from the surgical community—AUGIS—Association of Upper GI Surgeons of Great Britain and Ireland. Results Results 55 surgeons participated in a 12 questionnaire survey performed through the AUGIS national portal. > 85% were consultant surgeons with > 60% performing over 100 OGD scopes per year. Greater than 50% of surgeons identified the OG junction by the Z line and < 50% identified the same by the upper border of the rugal folds. Only 12% of surgeons measured the hernia based purely on the rugal folds and the diaphragmatic impression. Over 70% of the surgeons felt that the diagnosis of a hiatal hernia was an indirect evidence of Gastro Oesophageal reflux disease (GERD). Over 90% felt that the presence of a hiatal hernia selectively altered the management thereafter. Conclusion There exists significant variation in the endosocpist surgeon's perspective on the landmarks of the OG junction, diagnosis and measurement of a hiatal hernia, which is a common entity in the diagnosis and management of GERD. This may selectively impact the treatment due to lack of uniform practice of this common condition. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

The article discusses the EuroHeartCare 2018 in Dublin, Ireland on June 9-11, 2018 which has preconference workshops, keynote speeches and networking reception activities.

The article cites studies on rheumatic disease and the kidney which include the management of lupus nephritis in the era of biologic therapies, the management of renal vasculitis and the prescription of rheumatic drugs.