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The content of 'O' and 'A' level papers on modern British and European History set by two GCE Examination Boards was analysed to find out what particular aspects of the past were emphasised and thus to throw light on the experience of history as a subject which was gained by the candidates. These papers, which are taken by the great majority of the candidates, were found to be dominated by political history, up to 77% of the questions being devoted to the affairs of governments and political leaders. Foreign politics was especially important in papers on European history reaching as high as 44% of the questions set and domestic politics was central to papers on British history attaining means in different groups of papers between 40 and 50%. At the end of the article the wisdom of the approach to school history evident in these papers is questioned. [ABSTRACT FROM AUTHOR]

The article reviews the November 2016 issue of the periodical 'The Financial Review.'

The clinical indications for anaesthetic drugs are developed through peer-reviewed publication of clinical trials. We performed a bibliometric analysis of all human research papers reported in nine general anaesthesia journals over 6 years ( n = 6489), to determine any effects of the 2004 European Clinical Trials Directive on reported drug research in anaesthesia originating from Europe and the United Kingdom. We found 89% studies involved patients and 11% volunteers. Of 3234 (50%) drug studies, 96% were phase IV (post-marketing) trials. Worldwide, the number of research papers fell by 3.6% (p < 0.004) in the 3 years following introduction of the European Clinical Trials Directive (5% Europe, 18% United Kingdom), and drug research papers fell by 12% (p < 0.001; 15% Europe, 29% United Kingdom). The introduction of the Clinical Trials Directive has therefore coincided with a decline in European drug research, particularly that originating from the United Kingdom. We suggest a number of measures researchers could take in response, and we propose a simplification of the application process for phase IV clinical trials, emphasising patient risk assessment. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to analyze the economics of taxing virgin raw materials for environmental reasons. The theoretical discussion is general in scope but empirically we focus on the case of aggregate taxation in three European countries. The motives for environmental taxation of aggregates are mixed, and not all motives find strong support in the economics literature. For instance, the conservation motive may be valid if a relevant market failure can be identified, but, in the presence of a well defined owner of the resource, resource scarcity is often not a sufficient condition for policy intervention. Under some conditions a tax levied per ton of aggregates extracted may be motivated by the presence of environmental externalities at the extraction stage. Still, such a tax provides no direct incentives to reduce the relevant externalities, since the only way of avoiding the tax is to reduce production. In this respect the UK tax appears to be particularly inefficient; it uses one policy instrument to address a number of different environmental externalities at the extraction stage (noise, dust, visual intrusion, loss of amenity and damage to biodiversity), and it is uniform across quarries although the associated externalities are likely to be highly site specific. Overall the paper concludes that taxing output or use typically represents a ‘second-best’ policy alternative, which could be used when, for instance, the monitoring of non-point-source emissions and/or efficient property rights regimes are hard to implement. The fact that virgin resource taxes often address rather diffuse (not to say unimportant) environmental problems may however make them hard to promote effectively on the political arena. Copyright © 2006 John Wiley & Sons, Ltd and ERP Environment. [ABSTRACT FROM AUTHOR]

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

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

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

The author discusses the challenges facing health services and their staff across Europe. She informs that although at the conferences many innovative oral presentations demonstrating how high quality patient-centred care is being implemented are presented, many of these projects are not shared with others once the conference is over. She states that she wants to support such authors who do not have the time or experience to write their project up as a full paper for publication.

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

In the UK, as elsewhere in Europe, government policy aims to reduce the use of private cars for consumer shopping trips. One major instrument of policy aims to ensure that new retail development is located in places accessible by all transport modes. This paper reviews the effectiveness of this and other such policies through analysis of survey evidence relating to routine shopping behaviour in the UK. It appears that these policies are likely to have little impact upon shopping travel, given the advantages to the consumer of private car use. However, demographic trends and increasing use of the Internet for food shopping are likely to stabilize or even reduce the use of private cars in the future. [ABSTRACT FROM AUTHOR]

This paper analyses the important changes to the European Union (EU) policy-making process within the UK core executive introduced by the Blair government between 1997 and 2007. Employing a strategic-relational network framework, it sets out to map the changing face of policy-making within the Whitehall EU network, and to evaluate and explain the impact of adaptation. The article argues that Labour's reform strategy has been double-edged: day-to-day coordination of EU policy has become increasingly informal, ad hoc and delegated downwards to departmental players while the role of the centre has been greatly strengthened in order to provide more effective strategic direction and political leadership. Despite these seemingly coherent reforms, however, many critical features of the process have been potentially detrimental to the projection of a more constructive European policy. [ABSTRACT FROM AUTHOR]

Drawing on evidence from the United Kingdom and elsewhere in Europe, this paper explores how people have responded to flood warning information and how these responses impact upon the effectiveness of a flood warning through saving lives and injuries, and reducing economic damages. Methods of flood warning that the public rely upon are discussed alongside empirical evidence of how flood victims prepare for, and respond to, flood warnings in rapid to mediumonset floods. The paper investigates why some members of the public fail to act appropriately, or most effectively, to flood warning information, touching on ideas of a lack of understanding, mistrust in authority and a lack of ownership of flood reducing actions. The paper examines the styles of public learning about flood warning response which might be most appropriate and effective, and how recent positive steps to increase the publics understanding of effective response might be further enhanced in the United Kingdom. Copyright © 2009 Royal Meteorological Society [ABSTRACT FROM AUTHOR]

In this paper we review – from a UK perspective – how the UK government and its policy process have adapted to European integration. Has adaptation been a quiet revolution, a step-change, or both? In exploring this question we draw upon the conceptual literature of Europeanization. We employ it to shed light on the longer-term pattern of UK adaptation as well as to put into context the domestic changes currently under way. Our argument is that a step-change is under way in the Europeanization of the UK government. However, at the end of the paper we will reflect on how this development remains over-shadowed by broader circumstances: the continued weak public support for the EU and the divisions which emerged with key EU partners from the UK's policy over Iraq. [ABSTRACT FROM AUTHOR]

The paper presents a brief and personal history of the main developments in British vascular plant taxonomy and distribution studies in a European setting since the Second World War. It assesses the importance of the 'European view', and considers recent and current work under two main heads: the factual information itself, and the presentation of the facts, especially in the form of dot distribution maps. [ABSTRACT FROM AUTHOR]

The progressive nature of Type 2 diabetes necessitates treatment intensification over time in order to maintain glycaemic control, with many patients ultimately requiring insulin therapy. While insulin has unlimited potential efficacy, its initiation is often delayed and improvements in glycaemic control are typically accompanied by weight gain and an increased risk of hypoglycaemia, particularly as HbA1c approaches and falls below target levels. This may account for the sub-optimal control often achieved after insulin initiation. Combining insulin with antihyperglycaemic therapies that have a low risk of hypoglycaemia and are weight-neutral or result in weight loss is a therapeutic strategy with the potential to improve Type 2 diabetes management. Although the effects differ with each individual class of therapy, clinical trials have shown that adding a glucagon-like peptide-1 receptor agonist, dipeptidyl peptidase-4 inhibitor or sodium-glucose co-transporter-2 inhibitor to insulin regimens can offer a significant reduction in HbA1c without substantially increasing hypoglycaemia risk, or weight. The evidence and merit of each approach are reviewed in this paper. Once-daily co-formulations of a basal insulin and a glucagon-like peptide-1 receptor agonist have been developed (insulin degludec/liraglutide) or are under development (lixisenatide/insulin glargine). Insulin degludec/liraglutide phase III trials and a lixisenatide/insulin glargine phase II trial have shown robust HbA1c reductions, with weight loss and a low risk of hypoglycaemia. With insulin degludec/liraglutide now approved in Europe, an important consideration will be the types of patients who may benefit most from a fixed-ratio combination; this is discussed in the present review, and we also take a look toward future developments in the field. [ABSTRACT FROM AUTHOR]

'Green-grabbing', in which environmental arguments support expropriation of land and resources, is a recognized element in neoliberal conservation. However, capitalism's strategic interest in promoting the neoliberalization of conservation is accompanied by attempts to exploit hitherto protected natures without any pretence at 'greenness'. In this paper we explore the dialectics between 'green' and 'un-green' grabbing as neoliberal strategies in the reconstruction of nature conservation policies after the 2008 financial 'crash' in Greece and the UK. In both countries, accelerated neoliberalization is manifested in diverse ways, including initiatives to roll back conservation regulation, market-based approaches to 'saving' nature and the privatization of public nature assets. The intensification of 'green' and 'un-green' grabbing reflects capitalism's strategic interest in both promoting and obstructing nature conservation, ultimately leaving for 'protected natures' two choices: either to be further degraded to boost growth or to be 'saved' through their deeper inclusion as commodities visible to the market. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Differences in the performance of medical care may be due to variation in the introduction and diffusion of medical innovations. The objective of this paper is to compare seven European countries ( United Kingdom, the Netherlands, West Germany, France, Spain, Estonia and Sweden) with regard to the year of introduction of six specific pharmaceutical innovations (antiretroviral drugs, cimetidine, tamoxifen, cisplatin, oxalaplatin and cyclosporin) that may have had important population health impacts. Methods We collected information on introduction and further diffusion of drugs using searches in the national and international literature, and questionnaires to national informants. We combined various sources of information, both official years of registration and other indicators of introduction (clinical trials, guidelines, evaluation reports, sales statistics). Results and conclusions The total length of the period between first and last introduction varied between 8 years for antiretroviral drugs and 22 years for cisplatin. Introduction in Estonia was generally delayed until the 1990s. The average time lags were smallest in France (2.2 years), United Kingdom (2.8 years) and the Netherlands (3.5 years). Similar rank orders were seen for year of registration suggesting that introduction lags are not only explained by differences in the process of registration. We discuss possible reasons for these between-country differences and implications for the evaluation of medical care. [ABSTRACT FROM AUTHOR]

With approximately 1.5 billion people at risk, the staggeringly high risk of Type 2 diabetes in South Asians comprises a global problem. The causes of this high risk are complex, with 23 major risk factors identified in a Lancet seminar. This paper proposes a four-stage explanatory model: (1) the birth of a small, adipose, lowlean mass South Asian baby-the phenotype tracking through life; (2) in childhood and early adulthood, the deposition of any excess energy intake preferentially in upper body and ectopic fat stores rather than in the lower body or superficial subcutaneous fat stores; (3) as a consequence of points 1 and 2, and exacerbated by an environment of low physical activity and excess calories, the accelerated appearance of high levels of plasma insulin, triglycerides and glucose, and the fatty-liver vicious cycle; (4) β-cell failure as a result of fewer β-cells at birth, exposure to apoptotic triggers such as fat in the pancreas, and high demand from insulin resistance, which causes diabetes. Other risk factors-especially energy-dense hyperglycaemic diet and low physical activity-play into this pathway. The recommended behavioural changes fit with this model, which brings clarity to guide future research, policy, practice and health promotion. [ABSTRACT FROM AUTHOR]

TAYLOR G., PAPADOPOULOS I., DUDAU V., MAERTEN M., PELTEGOVA A. & ZIEGLER M. (2011) Intercultural education of nurses and health professionals in Europe (IENE). International Nursing Review, 188-195 This paper presents the results of a needs analysis carried out during a 2-year European Union-funded project titled 'Intercultural education of nurses and health professionals in Europe'. The study aimed to explore the perceived learning and teaching needs of students and practitioners of health-care professions in relation to preparation for working in another European country and/or in a multicultural environment. The participating countries were: Belgium, Bulgaria, Germany, Romania and the UK. Questionnaires, consisting of open questions, were completed by a total of 118 participants. Data analysis adopted both a priori and inductive approaches. The predetermined constructs of cultural awareness, cultural knowledge, cultural sensitivity and cultural competence were used to structure suggestions for theoretical input and practical activities and experiences. Inductive analysis revealed other emergent themes that underpin all four of these constructs. Practical experiences form a fundamental part of preparation for labour mobility and/or for practice within a multicultural environment. However, health-care practitioners need to be adequately prepared for such experiences and value the opportunity to learn about culture, to explore values and beliefs, and to practise intercultural skills within the safe environment of an educational establishment, facilitated by skilled teachers. [ABSTRACT FROM AUTHOR]

This paper provides an update of a previous review ' Red Meat in the Diet' published in the Nutrition Bulletin in 2005. An update on red meat consumption levels in the UK and other countries is provided, and a summary of the nutritional content of red meat in the diet is given. Current evidence on dietary and lifestyle factors associated with red meat consumption and the effects of red meat intake on health and chronic disease outcomes are discussed. As there is now continued debate about the environmental impact of different aspects of our diet, sustainability issues regarding red meat were also discussed. [ABSTRACT FROM AUTHOR]

This paper exploits survey information on reservation wages and data on actual wages from the European Community Household Panel to deduce, in the manner of Lancaster and Chesher, additional parameters of a stylized structural search model; specifically, reservation wage and transition/duration elasticities. The informational requirements of this approach are minimal, thereby facilitating comparisons between countries. Further, its policy content is immediate in so far as the impact of unemployment benefit rules and measures increasing the arrival rate of job offers are concerned. These key elasticities are computed for the United Kingdom and 11 other European nations. [ABSTRACT FROM AUTHOR]

The method of how surface water from highway drainage systems is assessed has been refined and the changes have been implemented towards achieving compliance with the Water Framework Directive (WFD). This directive has identified the need to significantly improve the surface water quality in the United Kingdom and Europe. Our road network plays a significant part in achieving a legacy of better environmental standards, and developments in the assessment and control of the drainage discharge, demonstrate commitment towards this. This paper discusses some of these changes and presents how the M1 Widening project addressed the requirement of obtaining appropriate source data. [ABSTRACT FROM AUTHOR]

The article examines Great Britain within the context of the European Union (EU) and argues that future continuation within the international body will create political challenges within the nation. It is attested that the unity of the country’s Conservative party depends upon the Prime Minister opposing any further progress toward European integration. At the same time, the paper alleges that the Labour party and the Liberal Democrats both support further European integration, particularly the strengthening of the European Parliament. Options relevant to these varying political doctrines are presented.

This article examines the pronouncements and positions of the leading political parties on the Human Rights Act and the proposals for a new British Bill of Rights and Responsibilities. It analyses the main arguments made in support of a British Bill of Rights and Responsibilities, which are advanced around five main issues: security, the judges, parliamentary sovereignty, responsibilities and ‘British rights’. The article was written before the government published the Green Paper Rights and Responsibilities: developing our constitutional framework in March 2009 and provides a political context with which to analyse it. [ABSTRACT FROM AUTHOR]

Across Europe, spatial planning has acquired an important role in steering wind power to more socially acceptable locations. However, the tendency for planning decisions to become a focus of opposition has also led to planning being represented as ‘a problem’ in meeting renewable energy targets. Using Jessop's dialectical relationship between modes and objects of governance, this paper seeks to understand why certain states are inclined to resolve ‘the planning problem’ for wind through strengthened national control. The case study is the Welsh Assembly Government's 2005 planning guidance on renewable energy, which superimposes centrally-determined ‘Strategic Search Areas’ for large-scale, onshore wind farm development onto local decision-making processes. Motivations for adopting this approach reflect the UK's centralizing planning culture, and beliefs that local planning processes will not yield sufficient sites to meet targets for wind power expansion. Responses to this planning guidance suggest that it may stabilizing the regulatory conditions for large-scale wind investment in the short term, in some parts of Wales, but faces a number of points of vulnerability in the longer term. Copyright © 2007 John Wiley & Sons, Ltd and ERP Environment. [ABSTRACT FROM AUTHOR]

The article discusses the applicable environmental laws regarding the integrated pollution prevention and control in Great Britain and in Europe. A discussion concerning the origin and scope of these laws is presented. It also overviews the European Union's Integrated Pollution Prevention and Control Directive, a requirement for industrial and agricultural activities with a high pollution potential to have a permit which can only be issued if certain environmental conditions are met, and summarizes efforts to apply this Directive within Great Britain. Moreover, two environmental issues that are significant to the integrated efforts which includes the energy policy and climate change is discussed. Both countries unified laws are expected to reduce pollution to air, water, and land.

Background Children born into poverty have lifelong disadvantages compared with those more fortunate; social interventions seek to break this cycle of poverty and deprivation. Early Years Centres are one such intervention. These were established in deprived areas in the UK to provide high quality out-of-home day care. This paper reports the results of an economic evaluation conducted alongside a randomized controlled trial of one of these centres in the Borough of Hackney, London. Methods Participants were randomized to receive either high quality day care as provided by the centre or to other child care that they secured for themselves where they chose to do so. Information on resource use (early years education and care, as well as health and social care) was collected over an 18-month period; this was valued using appropriate unit costs. The cost of education, social and health care together with the value of productivity gains and out-of-pocket costs were then compared with the effectiveness of the intervention, increased labour force participant in mothers. Results From the societal perspective, the value of employment outweighs the costs of health and social services used, and in both groups there are cost savings. These are greater in the intervention group, therefore Early Years day care is an efficient use of resources. However, there is a net cost to the public sector of providing the intervention. The cost of achieving an additional mother in the labour force at 18 months is £38 550 (85% CI of –£1273, £416 172). Conclusion From the societal perspective, over an 18-month period, all child care is cost saving, but high quality day care provided by the Early Years Centre is a cost-effective alternative to day care provided by other local services in Hackney. The public sector, however, incurs added expense from this intervention. [ABSTRACT FROM AUTHOR]

This paper examines long-run convergence between US, UK and seven European stock markets. We report evidence to suggest that while real short-run diversification gains may occur, in general they tend to be short-lived. However we also find that US and UK markets are relatively less bound to a common trend, which would imply that increased stock market merger activity, and any transition to the European common currency by the UK, may lead to relatively large stock market adjustments as markets adapt to these institutional changes. [ABSTRACT FROM AUTHOR]

This paper considers the influence of ecofeminism on policy concerning gender (in)equality and the environment during the past 20 years. It reviews the broad contours of the ecofeminist debate before focusing on the social construction interpretation of women's relationship with the environment. It will argue that there have been substantial policy shifts in Europe and the UK in both the environmental and equalities fields, and that this is in part a result of lobbying at a range of scales by groups informed by ecofeminist debates. Nevertheless, the paper cautions that these shifts are largely incremental and operate within existing structures, which inevitably limit their capacity to create change. As policy addresses some of the concerns highlighted by ecofeminism, academic discourse and grass roots activity have been moving on to address other issues, and the paper concludes with a brief consideration of contemporary trajectories of ecofeminism and campaigning on issues that link women's, feminist and environment concerns. [ABSTRACT FROM AUTHOR]

This paper analyses the short-term wealth effects of large intra-European takeover bids. We find announcement effects of 9% for the target firms compared to a statistically significant announcement effect of only 0.7% for the bidders. The type of takeover bid has a large impact on the short-term wealth effects with hostile takeovers triggering substantially larger price reactions than friendly operations. When a UK firm is involved, the abnormal returns are higher than those of bids involving both a Continental European target and bidder. There is strong evidence that the means of payment in an offer has an impact on the share price. A high market-to-book ratio of the target leads to a higher bid premium, but triggers a negative price reaction for the bidding firm. We also investigate whether the predominant reason for takeovers is synergies, agency problems or managerial hubris. Our results suggest that synergies are the prime motivation for bids and that targets and bidders share the wealth gains. [ABSTRACT FROM AUTHOR]

The aim of the present paper is to describe and compare services for adults with intellectual disability (ID) and mental health needs in five European countries: Austria, England, Greece, Ireland and Spain. A framework and structure for collecting information about service provision was designed. This information was collected through a mixture of interviews with service providers, questionnaires and a review of the research literature within each country. Information was collected on historical context, policy, legislation, assessment, treatment and the structure of services for people with ID and mental health problems. Overall, the needs of those with additional mental health needs have not been specifically addressed at a national level with perhaps the exception of England and Ireland, although there are still gaps in services in these nations. Normalization has been adopted in each of the five countries, and there are moves toward deinstitutionalization, integration and inclusion. Families and self‐advocacy groups have grown. The pace of this change varies between and even within countries. The main findings of the study include: unclear policy, trends for legislative changes, increased prevalence of mental health problems, inadequate generic service provision, a need for specialist mental health services, a need for improved interconnections of services, and a need for training developments. Policy and legislation in the five European countries under consideration tend to separate the disability aspects of people with ID from their mental health needs. Consequently, the service needs of this group remain largely invisible. This might be a direct reflection of policy clarity and legislation, or could be the result of a failure to implement existing guidelines. This has a detrimental effect on the lives of people with ID, and their families and carers. [ABSTRACT FROM AUTHOR]

Recent developments within the regulation approach have highlighted the importance of discourse in securing the conditions for the stabilisation of new modes of regulation. This paper considers the discursive construction in the UK of Britain's relationship to European integration. Despite claims that the politics of the ‘Third Way’ offer an innovative and coherent framework for New Labour's political strategy, the evidence suggests that discourses of national sovereignty and pragmatic economic national self-interest dominate. In conclusion it is suggested that the development of transnational discursive formations is a necessary precondition for the consolidation of regulatory forms and processes that break with previous nationally focused modes of regulation. [ABSTRACT FROM AUTHOR]

Background: Studies revealed unidirectional associations between frailty and medication‐related problems (MRPs) among older adults. Less is known about the association between frailty and the risk of MRPs. We aimed to assess the bi‐directional association between frailty and the risk of MRPs in community‐dwelling older adults in five European countries. Methods: Participants were 1785 older adults in the population‐based Urban Health Centres Europe project. Repeated assessments were collected at baseline and one‐year follow‐up, including frailty, the risk of MRPs, and covariates. Linear regression analyses were conducted to examine the unidirectional associations. A cross‐lagged panel modeling was used to assess bi‐directional associations. Results: The unidirectional association between frailty at baseline and the risk of MRPs at follow‐up remained statistically significant after adjusting for covariates (β = 0.10, 95%CI:0.08, 0.13). The association between the risk of MRPs at baseline and frailty at follow‐up shows similar trends. The bi‐directional association was comparable with reported unidirectional associations, with a stronger effect from frailty at baseline to the risk of MRPs at follow‐up than reversed path (Wald test for comparing lagged effects: p < 0.05). Conclusion: This longitudinal study suggests that a cycle may exist where older adults with higher frailty levels are more likely to have a higher risk of MRPs, which in turn contributes to developing a higher level of frailty. Further research is needed to validate our findings and explore underlying pathways. [ABSTRACT FROM AUTHOR]

This paper uses evidence on employment, labour force and wage differentials by education from OECD countries to investigate the characteristics and the consequences of a skill-biased shift in the structure of labour demand and supply. The empirical analysis shows that there has been some increase in skill mismatch in a few OECD countries over the past two decades, but this has not been a generalized phenomenon. Moreover, the rise in mismatch cannot explain much of the rise in unemployment in continental Europe, while it does explain a significant proportion of the increase in the rate of joblessness in Britain. [ABSTRACT FROM AUTHOR]

This paper is based on the Nursing Lecture 1977, delivered on the occasion of the Annual General Meeting of the Royal College of Nursing in London on November 23, 1977. The author traces the history and discusses the implications of the EEC Nursing Directives, put into the perspective of the nursing histories of the nine countries within the European Economic Community. She focuses, in particular, on the strengths of the nursing profession in the United Kingdom and argues that the Nursing Directives can lead to enhancement of nursing services and nursing education, better cooperation between health care professions and a stronger voice for the nursing profession, throughout the EEC. [ABSTRACT FROM AUTHOR]

Restriction of shop opening hours is current, but controversial, practice in Britain and most other European countries. The economic case commonly presented for such restrictions is that, given the constraint that individual shops may not vary their price by time of day, competitive pressures would induce excessive opening at times when high costs would be incurred, such as on Sundays. The paper shows that inefficient equilibria of this type are indeed a theoretical possibility. Empirical evidence on costs and demand in the UK shows, however, that this case does not in practice arise and that deregulation of opening hours would lead to lower costs and prices in the retail sector. [ABSTRACT FROM AUTHOR]

The understanding and interpretation of the presumed "secularization" of Britain and other European nations is clouded by a lack of adequate information regarding the substance and timing of religious change. This paper represents the first systematic effort to collect and analyze existing survey data on religious belief in Britain from the late 1930s to the present. Overall, the results show an increase in general scepticism about the existence of God, the related erosion of dominant, traditional Christian beliefs, and the persistence of nontraditional beliefs. A theoretical perspective is needed that recognizes the often corrosive effects of modern life on the transmission of religious beliefs and the continued popularity of worldviews which presume a transcendent referent, however broadly defined.

This paper presents the findings of an exploratory study of the content of and differences between managerial frames of references with regard to the structure and dynamics of competitive environments. These frames of references are examined and compared at both the industry level and the country level; and the paper shows the influences of both industry and institutional structures and national culture on managerial thinking. It therefore contributes to the field of comparative management, as well as the growing interest in cognitive analysis in the field of management. The study is particularly significant since (a) its context is the rapidly changing industry environment of Europe, and (b) the managers are all involved in the development of strategies for their firms. Thirty three top managers (16 English and 17 French) were interviewed in four industries (brewing, car manufacturing, retail banking and book publishing) on their understanding of their industry and the strategy of their company. Content analysis of the transcribed interviews surfaces cognitive constructs which facilitate the identification of similarities and differences between managers, (a) within industries, (b) across industries, (c) within countries, (d) between countries and (e) between countries within the different industries. The analysis also provides means whereby the constructs can be represented in the form of cognitive maps. [ABSTRACT FROM AUTHOR]

Background: The prevalence of obesity has risen in recent decades and reached epidemic proportions worldwide. The proportion of those living with obesity is also increasing in nursing homes. This could impact the nursing care required, equipment and facilities provided, and morbidity in these settings. Limited evidence exists on clinical consequences of obesity in nursing home residents and their care. Objective: Therefore, the aim was to examine the rate and associated factors of obesity (BMI ≥30; class I (BMI 30.0–34.9 kg/m2), class II (BMI 35.0–39.9 kg/m2), and class III (BMI >40.0 kg/m2)) amongst older nursing home residents in European countries. Methods: We analysed data from 21,836 people who reside in nursing homes in Austria, the Netherlands, and the United Kingdom. They participated in the "International Prevalence Measurement of Care Quality", a cross sectional study between 2016 and 2019, where trained nurses interviewed the residents, reviewed care records, and conducted clinical examinations. A tested and standardised questionnaire comprised questions on demographic data, measured BMI, medical diagnosis according to ICD‐10, and care dependency. Descriptive and logistic regression analyses were performed. Results: Obesity rates were highest in Austria (17.1%) and lowest in the UK (13.0%) (p =.006). Residents with obesity were younger and less likely to be care dependent or living with dementia and had more often diabetes mellitus, endocrine, metabolic, and skin diseases compared to residents without obesity (p <.05). Most obese residents had obesity class I. Therefore, two subgroups were built (class I vs. class II + III). Residents with obesity class II + III were more frequently care dependent for mobility, getting dressed and undressed, and personal hygiene compared to residents with class I (p <.05). Conclusions: This study identified several factors that are associated with obesity amongst older nursing home residents in selected European countries. Implications for practice: The division into obesity classes is important for planning targeted care according to the individual needs of nursing home residents. [ABSTRACT FROM AUTHOR]

Background: Health and social care systems face difficulties in managing multimorbidity, disease burden and complex needs in long‐term conditions such as Parkinson's disease. Objective: This study aimed to develop a European understanding of how health and social care professionals can collaborate with stakeholders from different organizations and sectors to enhance the management of Parkinson's disease in a community setting by identifying the existing gaps in this process and how people with Parkinson's disease and their family carers could benefit from these partnerships. Methods: A mixed‐methods sequential study was conducted in Denmark, Norway, Spain and the United Kingdom. The findings from the qualitative phase are presented. Individual semistructured interviews were analysed using Braun's and Clarke's thematic analysis. A meta‐ethnography approach was used to analyse and synthesize cross‐national findings. Results: A total of 41 healthcare professionals and 39 stakeholders from different disciplines and sectors were interviewed in the four countries. The participants acknowledged a lack of awareness of available resources and poor communication between the different support systems in the management of Parkinson's disease. To promote multiagency collaborations, the participants highlighted the need to organize services along the Parkinson's disease journey, patient involvement and strategic involvement of carers in organizing resources and Parkinson's disease care pathways. According to the participants, the benefits from multiagency partnerships could lead to an enhanced continuity of care and specialized knowledge, mobilization of resources in the community, personalized support and improved access to services. Conclusions: Policymakers are called upon to create formal structures that facilitate multisectoral collaborations to promote an integrated system of care for the management of Parkinson's disease in the community. To address this challenge, we propose five strategies showing how organizations can work together to optimize the use of resources and enhance the management of Parkinson's disease throughout the illness trajectory. Patient or Public Contribution: Patient and Public Involvement groups made up of stakeholders, healthcare professionals, patients with Parkinson's disease and family carers participated in the design of the study, the development of the interview guides and the validation of the findings. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including the diabetes in childhood, aspects of diabetes epidemiology, and the management of diabetic ketoacidosis among adolescents and young adults.

Context North American medical students are more depressed and anxious than their peers. In the UK, the regulator now has responsibility for medical students, which may potentially increase scrutiny of their health. This may either help or hinder medical students in accessing appropriate care. The prevalences of anxiety, depression and psychological distress in medical students outside North America are not clear. A better understanding of the prevalence of, risk factors for and results of psychological distress will guide the configuration of support services, increasingly available for doctors, for medical students too. Objectives The aim of this study was to examine the prevalences of depression, anxiety and psychological distress in students in medical schools in the UK, Europe and elsewhere in the English-speaking world outside North America. Methods A systematic review was conducted using search terms encompassing psychological distress amongst medical students. Ovid SP was used to search the following databases: Ovid MEDLINE (R) from 1948 to October 2013; Psyc INFO from 1806 to October 2013, and EMBASE from 1980 to October 2013. Results were restricted to medical schools in Europe and the English-speaking world outside North America, and were evaluated against a set of inclusion criteria including the use of validated assessment tools. Results The searches identified 29 eligible studies. Prevalences of 7.7-65.5% for anxiety, 6.0-66.5% for depression and 12.2-96.7% for psychological distress were recorded. The wide range of results reflects the variable quality of the studies. Almost all were cross-sectional and many did not mention ethical approval. Better-quality studies found lower prevalences. There was little information on the causes or consequences of depression or anxiety. Conclusions Prevalences of psychological distress amongst medical students outside North America are substantial. Future research should move on from simple cross-sectional studies to better-quality longitudinal work which can identify both predictors for and outcomes of poor mental health in medical students. [ABSTRACT FROM AUTHOR]

Many researchers and practitioners consider ethnic segregation in neighbourhoods or schools detrimental to migrants' acculturation in host societies. Empirically, however, segregation is a 'mixed bag' and its effects depend crucially on the investigated acculturation domain (e.g., negative for language skills, positive for well‐being). As most prior studies have focused on a restricted spectrum of acculturation, a comprehensive assessment within one single study is needed to establish comparability across different acculturation domains. Among over 8000 immigrant‐background students from four countries, we investigated the association of classroom segregation, defined as opportunities for contact with natives and other migrants, with a broad spectrum of acculturation (academic, attitude‐related, identity‐related, social, health‐related, and psychological criteria). Some findings were consistent (e.g., academic acculturation), some were contrary to prior research (e.g., social acculturation). In sum, our results shed light on the 'mixed bag' of segregation and contribute to the understanding of a crucial social issue. [ABSTRACT FROM AUTHOR]

The article offers news briefs related to addiction as of 2016. The unregulated cannabidiol (CBD) market in Great Britain has been halted by the UK Medicines and Healthcare Products Regulatory Agency (MHRA). The public is supporting minimum unit pricing (MUP) for alcohol products in Great Britain. A World Health Organization (WHO) report has found that the alcohol-attributable mortality burden has increased slightly in Europe since 1990.

The author reflects on a paper by researcher Kim and colleagues that discusses drink driving in Hong Kong. He argues that random breath testing would help to build up the cohort of drivers with those who comply with the law and those who are discouraged by a single offence. He states that road safety is connected with the long-term damage that alcohol can cause; hence it is important to deal with this issue.

The clinical signs, treatments used and spread of psoroptic mange in cattle from October 2007 until March 2011 are described. The disease was first diagnosed in South West Wales, having not been reported in Great Britain since the 1980s. The likely source was identified as a farm that had imported two animals from mainland Europe in the summer of 2006. Since that time, disease has been diagnosed on a further 22 premises, the majority in South West Wales but also in South East and Mid Wales and on one farm in England. Bought in animals harbouring the Psoroptes species mite but not showing clinical signs were considered the greatest risk of introducing the infestation into a herd. This, together with the difficulties of treatment to eliminate the parasite, means that it is unlikely that this outbreak has been controlled. There is also a continuing threat of importing the disease from abroad. The disease is not notifiable in the UK. [ABSTRACT FROM AUTHOR]

The global financial crisis has been one of the most significant economic shocks in the post-war period. At its core, the crisis originated in credit markets in developed countries – centred particularly in the United States, the United Kingdom and Europe – but the fallout has had a significant effect on activity in every country and region. As the crisis intensified, there was a large swing in the appetite of world financial markets for risk, and in their capacity to accept risk. The result was a shift from the easy credit conditions that had prevailed for some years to a situation of tight credit and in some cases dysfunctional markets. This was accompanied by a loss of consumer and business confidence, with significant effects on global activity. This article focuses on the main causes of the crisis, how it has affected the world economy, and how governments and central banks have responded. [ABSTRACT FROM AUTHOR]

The topic of empire has loomed large in recent writings on eighteenth-century Britain. This article attempts to encourage greater appreciation of Britain's multifarious connections with continental Europe in this period. It also seeks to establish that empire and Europe were seen by many Britons as complementary rather than competing areas of interest and engagement. [ABSTRACT FROM AUTHOR]

Introduction: Chemsex in a European context is the use of any of the following drugs to facilitate sex: crystal methamphetamine, mephedrone and gamma‐hydroxybutyrate (GHB)/gamma‐butyrolactone (GBL) and, to a lesser extent, cocaine and ketamine. This study describes the prevalence of self‐reported recreational drug use and chemsex in HIV‐positive men who have sex with men (MSM) accessing HIV services in four countries. It also examines the problematic impacts and harms of chemsex and access to chemsex‐related services. Methods: This is a cross‐sectional multi‐centre questionnaire study of HIV‐positive MSM accessing nine HIV services in the UK, Spain, Greece and Italy. Results: In all, 1589 HIV‐positive MSM attending HIV services in four countries completed the questionnaire. The median age of participants was 38 years (interquartile range: 32–46 years) and 1525 (96.0%) were taking antiretroviral therapy (ART). In the previous 12 months, 709 (44.6%) had used recreational drugs, 382 (24.0%) reported chemsex and 104 (6.5%) reported injection of chemsex‐associated drugs ('slamsex'). Of the 382 engaging in chemsex, 155 (40.6%) reported unwanted side effects as a result of chemsex and 81 (21.2%) as a result of withdrawal from chemsex. The reported negative impacts from chemsex were on work (25.1%, 96), friends/family (24.3%, 93) and relationships (28.3%, 108). Fifty‐seven (14.9%) accessed chemsex‐related services in the past year, 38 of whom (67%) felt the service met their needs. Discussion: A quarter of participants self‐reported chemsex in the past 12 months. There were high rates of harms from chemsex across all countries, including negative impacts on work, friends/family and relationships. Although a minority of those engaging in chemsex accessed support, most found this useful. [ABSTRACT FROM AUTHOR]

We examine the patterns and determinants of business cycle correlations among 11 UK regions and six euro-zone countries over the 1966–97 period, using the generalized method of moments to allow for sampling error in comparing estimated correlations. The British business cycle is found to be persistently out of phase with that of the main euro-zone economies, and the trend is towards lower correlations. We detect only minor cyclical heterogeneity among UK regions. Differences in sectoral specialization drive some of the asymmetry in GDP fluctuations, but they do not appear significant in explaining the observed reduction in UK–EU business cycle correlations over time. [ABSTRACT FROM AUTHOR]