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Background: The 2022/23 influenza season in the United Kingdom saw the return of influenza to prepandemic levels following two seasons with low influenza activity. The early season was dominated by A(H3N2), with cocirculation of A(H1N1), reaching a peak late December 2022, while influenza B circulated at low levels during the latter part of the season. From September to March 2022/23, influenza vaccines were offered, free of charge, to all aged 2–13 (and 14–15 in Scotland and Wales), adults up to 49 years of age with clinical risk conditions and adults aged 50 and above across the mainland United Kingdom. Methods: End‐of‐season adjusted vaccine effectiveness (VE) estimates against sentinel primary‐care attendance for influenza‐like illness, where influenza infection was laboratory confirmed, were calculated using the test negative design, adjusting for potential confounders. Methods: Results In the mainland United Kingdom, end‐of‐season VE against all laboratory‐confirmed influenza for all those > 65 years of age, most of whom received adjuvanted quadrivalent vaccines, was 30% (95% CI: −6% to 54%). VE for those aged 18–64, who largely received cell‐based vaccines, was 47% (95% CI: 37%–56%). Overall VE for 2–17 year olds, predominantly receiving live attenuated vaccines, was 66% (95% CI: 53%–76%). Conclusion: The paper provides evidence of moderate influenza VE in 2022/23. [ABSTRACT FROM AUTHOR]

This paper reports teacher and learner perspectives on how assessment and reform influences pedagogical practices and behaviours. The research was conducted in a context of policy reform, at a time when Wales' revised General Certificate of Secondary Education (GCSE) specifications had been implemented, and learners were preparing for their assessments; but, also during the period of debate on the development of Wales' new curriculum, which has taken a distinct and contrasting position on assessment to the assumptions underlying the reform of Welsh GCSEs implemented from 2015. These data, therefore, offer unique insights into the affordances and limitations of two sharply contrasting systems at a time of considerable change, offering reflections on the current curriculum and its attendant assessment practices, and also a prospective analysis of how the principles embedded in the new curriculum could challenge these existing assumptions and conventions. Findings suggest that teachers and learners currently inhabit an assessment‐driven system, which encourages performative practices in pedagogy and is governed by external accountability; and that these practices are at odds with the principles of assessment articulated in Successful Futures. Consequently, teachers in this study expressed uncertainty about how assessment for certification purposes at GCSE could be compatible with the principles of the Curriculum for Wales. [ABSTRACT FROM AUTHOR]

Despite predominantly lower social class origins, the second generation of established immigrant groups in the UK are now attaining high levels of education. However, they continue to experience poorer labour market outcomes than the majority population. These worse outcomes are often attributed in part to their disadvantaged origins, which do not, by contrast, appear to constrain their educational success. This paper engages with this paradox. We discuss potential mechanisms for second‐generation educational success and how far we might expect these to be replicated in labour market outcomes. We substantiate our discussion with new empirical analysis. Drawing on a unique longitudinal study of England and Wales spanning 40 years and encompassing one per cent of the population, we present evidence on the educational and labour market outcomes of the second generation of four groups of immigrants and the white British majority, controlling for multiple measures of social origins. We demonstrate that second‐generation men and women's educational advantage is only partially reflected in the labour market. We reflect on the implications of our findings for future research. [ABSTRACT FROM AUTHOR]

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An introduction is presented in which the editors discuss issues arising from the implementation of curriculum reform, based on a review of the education system, in Wales.

The paper explores tensions in the articulation of progression in learning across the Humanities disciplines. Informed by our review of research in the Humanities disciplines, international curricula on progression in these areas and reflections from professional activity within the newly defined Humanities 'Area of Learning and Experience' in the new Welsh curriculum, this paper describes how learning progression in Humanities has been conceptualised within the new curriculum and then delineates and critically reviews four challenges that emerged when identifying and describing the progression in learning in the new Humanities curriculum. Tensions include the relationship between disciplines; the balance between knowledge, skills and values; the differences between underlying models of progression in Humanities; and balancing the complexity of learning with practical considerations for a national curriculum. Underpinned by the Integrity Model of Change, this paper makes a contribution, through providing new insights on broad aspects of learning progression in Humanities and highlighting the potential benefits and challenges of taking particular decisions within each of these four tensions. Implications for curriculum planning and future research are offered, including the fundamental role of professional learning in curriculum development and enactment. [ABSTRACT FROM AUTHOR]

Introduction: In the United Kingdom, policy and guidance changes regarding the role of dental therapists (DTs) were implemented in recent years with a view to changing dental care to a more preventive‐focussed, teamwork approach. However, success in the adoption of this model of working has been varied. Aims: Adopting a realist approach, our aim was, to examine the use of DTs in general dental practices in Wales, exploring what works, why, how and in what circumstances. Materials and Methods: The research comprised two stages. (a) A structured literature search, dual‐coding papers for high‐level factors describing the conditions or context(s) under which the mechanisms operated to produce outcomes. From this, we derived theories about how skill‐mix operates in the general dental service. (b) Six case studies of general dental practices (three with a dental therapist/three without a dental therapist) employing a range of skill‐mix models incorporating semi‐structured interviews with all team members. We used the case studies/interviews to explore and refine the theories derived from the literature. Results: Eighty‐four papers were coded. From this coding, we identified seven theories which reflected factors influencing general dental practices within three broad contexts: the dental practice as a business, as a healthcare provider and as a workplace. We tested these theories in interviews with 38 dental team members across the six care studies. As a result, we amended five of the theories. Conclusion: Our analysis provides theory about outcomes that DTs may facilitate and the mechanisms that may assist the work of DTs within different contexts of general dental practice. [ABSTRACT FROM AUTHOR]

This paper aims to expand understandings of 'public geographies', not usually associated with historical geography, through considering voluntarism. It seeks to bring together debates on research practice, positionality and the 'surprise' instances of user engagement. To do so, it draws on two experiences and opportunities that emerged during my doctoral research in Wales on the cultural-historical geographies of scouting in Britain: first, curating an exhibition and second, cataloguing and 'making' an archive collection. Both of these were voluntary collaborative activities and outside 'the research project', and yet they shaped and influenced the research process in unique and unforeseen ways. Overall, the paper uses these examples as a way into exploring geographical debates on research users, non-academic communities and the role of the researcher as a volunteer. [ABSTRACT FROM AUTHOR]

Curriculum integration is a feature of many new curricula that have emerged in different countries since around the turn of the millennium. It focuses on removing the boundaries between traditional subject specialisms, to enable more holistic and 'joined‐up' learning opportunities. This study draws on the experiences of a group of primary and secondary teachers in Wales, engaged in creating a framework for an integrated curriculum for expressive arts. Whilst the teachers are united in their ambition for establishing a curriculum that gives greater status to the arts, curriculum integration presents significant challenges, notably in how subject knowledge is understood and presented within an integrated curriculum. The teachers take different approaches to curriculum integration, with primary teachers favouring a transdisciplinary approach, with child‐led learning and themes taking precedence, and secondary teachers opting for multidisciplinary approaches, where the themes are organising devices but where subjects take priority. Differing practices suggest differing conceptions of subject knowledge and mastery within an integrated curriculum. Drawing, in particular, on Bernstein's concepts relating to knowledge discourses, this paper suggests that the danger of an integrated curriculum is weakened disciplinary knowledge. Whilst this paper relates to the arts, the messages about curriculum integration might be applied more widely. [ABSTRACT FROM AUTHOR]

Sustainable Intensification (SI) has been popularised in recent years as an approach seeking to balance the potentially conflicting demands of enhancing agricultural outputs with reducing the negative impacts arising from the current food system. Proponents have argued that SI can benefit from collaboration between farmers, but understanding is limited by a lack of data on current collaborative practices. Questions have also been raised as to whether the SI agenda pays sufficient attention to social sustainability as part of a fully integrated conception of SI. Tackling these issues, this paper reports on mixed methods data collection from seven case areas across the UK, with a particular focus on the experience of upland livestock farmers in north Wales. We evidence: (1) The extent, forms and preferences associated with farmers' collaboration; with findings demonstrating higher levels of collaboration than anticipated and a preference for informal forms of co‐working. (2) The underpinning and mutually reinforcing role of social interconnectedness in the delivery of diverse outcomes from collaboration. (3) How SI is perceived to threaten social sustainability, and thus work against a more integrated model of delivery. The paper concludes by arguing for a genuinely integrative model of SI to secure collaborations going forwards. [ABSTRACT FROM AUTHOR]

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

The article examines the long-term growth of the banking sector in Great Britain and money stock in the period 1844-1880. Detailed estimates of long-term monetary and banking growth in the country exist for the years after the late 1870s, although controversy remains as to their precise accuracy, but even reasonably accurate figures for the greater part of the nineteenth century have proved elusive. It is here that this paper makes a contribution by drawing heavily upon archive material to present new estimates for England and Wales for part of that early period, 1844-80. New estimates are made for commercial bank liabilities to the public and long-term trends in the growth of the money stock are calculated. Data for the number of banks and banking offices are readily available from 1844 in the directory "Banking Almanac," providing one measure of the growth of the commercial banking sector with some breakdown as to the institutional nature and geographical location of firms within the sector. However, they can provide but a crude measure of the growth and density of banking services.

This paper introduces new, homogenized UK national and regional rainfall series derived from 5-km gridded daily and monthly precipitation data. These new series have the advantage that they are based on readings from a dense network of rain gauges rather than a maximum of seven per region. Series developed by alternative statistical methods are analysed and compared. Error estimates are derived for the series, based on linear regressive residuals. Using individual regressions for each calendar month, the monthly series are extended back to 1766 for monthly precipitation in England and Wales (EW), to 1873 for monthly values for each of the five EW sub-regions, and to 1931 for daily values in all regions. A follow-up paper will provide analysis of how mean precipitation totals and extremes have changed over the respective periods. Copyright © 2011 Royal Meteorological Society [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]

This paper discusses developments in the last five to six years in the provision of operational flood forecasting in England, Wales, and Scotland. Before the formation of the Environment Agency EA in England and Wales and the Scottish Environment Protection Agency SEPA, flood forecasting capabilities were fragmented. Just over a decade ago both organisations received governmental mandates for the provision of flood forecasting and warning nationally, and have as a result in recent years established systems providing national coverage: the National Flood Forecasting System, and Flood Early Warning System FEWS Scotland. These have facilitated a rapid expansion of catchments for which forecasts are provided, and the common framework used has enabled a more rapid introduction of scientific advances in forecasting techniques. This paper gives an overview of some of these recent developments, as well as providing an outlook to further developments to be undertaken in the near future. Copyright © 2009 Royal Meteorological Society [ABSTRACT FROM AUTHOR]

International Union for the Conservation of Nature (IUCN) guidelines state that anticipated impacts must be considered in wildlife reintroduction, including the impacts on humans. Further, since reintroduction projects can be halted by resulting human–wildlife conflicts or human–human conflicts about wildlife, the perceptions of stakeholders and publics are of great importance. Eurasian beaver (Castor fiber) reintroduction is being debated in Great Britain at a devolved level. A decision has already been taken in Scotland to allow beavers already present to remain, while a number of reintroduction trials are taking place in England (both fenced and unfenced). There are also proposals for a reintroduction trial in Wales. We use a sub‐set of results from a nationwide survey (n = 2,759) to identify four social areas that we propose decision‐makers should consider in the debate: key stakeholder perceptions; engagement methods; attitudes towards legal protection and management responsibilities; and support for management techniques. In this paper, we investigate the complex social dimensions of wildlife reintroduction and we argue that emphasis should be placed on the need to recognise societal perceptions of potential management solutions, beyond perceptions of reintroduction itself. This is paramount in order to develop a management strategy that is more likely to garner social support and reduce potential future conflicts, should beaver reintroduction proceed. [ABSTRACT FROM AUTHOR]

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

Until the latter part of the twentieth century, Iron Age burial in Britain was thought to be largely archaeologically invisible. However, over the last 40 years the recovery of large assemblages of human remains, often from pits and ditches rather than beneath monumental structures, has changed our understanding of Iron Age funerary practices. The problem, though, is that the majority of this material derives from core areas of study, particularly southern England and Yorkshire. Our knowledge of burial in the more peripheral areas of Britain, such as Wales, is much more poorly understood. The perceived paucity of burials from such regions is often still interpreted as resulting from the practice of archaeologically invisible disposal methods such as excarnation or the scattering of cremated remains. This paper presents a comprehensive review and analysis of Iron Age human remains in Wales. Although the resource for study is relatively small, a variety of practices, disposal methods and treatments of bodies can be recognized which challenge our current narratives. The scarcity of burials when compared to other parts of Britain, such as Wessex, is suggested to be a result of both poor preservation and bias in archaeological research strategies, rather than the dominance of an 'invisible' burial rite. [ABSTRACT FROM AUTHOR]

The debate about the financing of devolved government in Scotland, Wales and Northern Ireland has acquired a new vigour since 2007, with commissions and reviews taking place in Scotland, Wales and at Westminster. Although of considerable constitutional as well as political importance, the technical detail has obscured many of the wider issues involved. This paper surveys the options now open to the UK government, as it prepares its response to the Welsh Holtham Commission, a bill implementing the Calman Commission's recommendations for Scotland, and looks at ways of altering corporation tax in Northern Ireland. It examines six options that in principle are open to the UK government, and argues that the range of options open to the UK government are narrower than they often appear, and that pressure for it to act is such that it will no longer be possible to avoid far-reaching action. [ABSTRACT FROM AUTHOR]

Since the 1970s, there has been growing academic interest in children and young people living in state care and, more recently, in the lives of disabled children. However, there has been little attention on the lives of disabled children who are looked after by the state. This paper compares and critiques what is known about the numbers of disabled children who are looked after in England, Northern Ireland, Scotland and Wales. We discuss the conceptual and methodological limitations of systematically collecting data on disabled children in state care across the UK. We argue that to ensure that the rights of disabled children in state care are identified, acknowledged and upheld, ‘being counted’ is a fundamental first step. [ABSTRACT FROM AUTHOR]

Little research has been conducted on the changing geographical distribution of organic farming in England and Wales in the 1990s. Using officially published secondary data, this paper examines the changing patterns of organic farming between 1993 and 1997, based on the number of organic farms, the area devoted to organic farming, the number of exits from and conversions to organic farming, and specific organic enterprises. The analysis indicates a process of spatial rationalisation, in which organic farming is becoming increasingly concentrated in a core area in Central-Southern England. Further, more detailed work is required, of both an empirical and conceptual nature, before a full explanation of such patterns can be given. [ABSTRACT FROM AUTHOR]

ABSTRACT In Simpson and Jones (2012) we introduced new, homogenized UK national and regional rainfall series derived from 5 km gridded daily and monthly precipitation data. The monthly series were extended back to 1766 for monthly England and Wales ( EW) precipitation, to 1873 for monthly values for each of the five EW sub-regions, and to 1931 for daily values in all regions. Using data from those series, this paper provides analysis of how mean precipitation totals and extremes have changed over the respective periods. The results showed statistically significant upward trends in mean and extreme winter, spring and autumn precipitation for some Scottish regions, but trends over England and Wales were mostly insignificant, though England and Wales had a significant increase in winter precipitation over 1766-2011. The trend in summer precipitation over 1931-2011 has been statistically insignificant, though with a significant long-term downward trend for England and Wales over 1766-2011. Prior observations of a trend towards drier summers and wetter winters have been complicated by a recent succession of wet summers and dry winters. Many of the observed changes in seasonal precipitation totals are most likely associated with changes in the North Atlantic Oscillation. [ABSTRACT FROM AUTHOR]

ABSTRACT Demographic characteristics vary between ethnic groups, as a function of cultural preferences and norms, consequences of immigration, compositional differences in age structure, and discriminatory practices. The differences are of policy relevance, but one should not expect a single pattern of convergence, persistence, or divergence. This paper's key distinction between child and adult contributions to household size allows an explanatory account that recognises both fertility and traditional preferences for extended family households. Aggregating small area populations allows the statistical analysis of a demographic indicator across ethnic groups in relation to both area composition and time. Convergence over time of the number of children per household is interpreted as a fall from high fertility immediately after immigration. Stable high numbers of adults per household among Indian, Pakistani and Bangladeshi groups suggest continued demand for larger houses. These two patterns for England and Wales from 1991 to 2001 are confirmed with survey data for 2010. There is relatively little relationship between household size and local co-ethnic concentrations. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

ABSTRACT Until recently, little was known about kinship care in the UK. Research has begun to illuminate the circumstances which lead to children being cared for by relatives, and the stresses and strains experienced by carers. However, most UK research has only considered 'looked-after' children placed with formal approved kinship foster carers, although this group forms the smallest proportion of children in kinship arrangements. In this paper, we use microdata from the 2001 UK Population Census to examine the characteristics of kinship carers and children, and demonstrate that most children in kinship care are growing up in informal unregulated arrangements. Implications for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

SummaryIntroduction1Definitions of ethnic groups and demographics of minority ethnic groups in the UK○ 1.1 Definitions of 'ethnic groups' and 'ethnicity'○ 1.2 Demographics and characteristics of minority ethnic groups in the UK– Countries of origin– Age/sex distribution and life expectancy– Geographical distribution and size of household– Religious beliefs– Education and employment patternsKey points2Overview of the health profile and dietary habits of minority ethnic groups in the UK○ 2.1 Available surveys○ 2.2 Overview of the health profiles among adults from minority ethnic groups– Overall health– Cardiovascular disease (CVD)– Coronary heart disease (CHD)– Stroke– Type 2 diabetes– Obesity○ 2.3 Possible causes of increased disease risk among minority ethnic groups○ 2.4 Smoking, drinking and physical activity habits○ 2.5 Dietary habits and nutritional status○ 2.6 Overview of the health profiles and dietary and health behaviour patterns of children from minority ethnic groups– Overall health– Diet and health behaviour patterns○ 2.7 Gaps in data availabilityKey points3Factors affecting food choice– Income and socio‐economic status– Food availability and access– Awareness of healthy eating– Religious beliefs– Food beliefs– Time and cooking skills– Generation and genderKey points4Traditional diets of minority ethnic groups○ 4.1 Overview of traditional diets of minority ethic groups– South Asians– African‐Caribbeans– Chinese○ 4.2 Dietary acculturation○ 4.3 Nutritional composition of ethnic‐style cuisineKey points5Nutritional interventions and health promotion among minority ethnic groups○ 5.1 Effective nutritional interventions○ 5.2 Health promotion interventions to prevent problems associated with fasting○ 5.3 Priorities for nutritional interventions and health promotion○ 5.4 Using behaviour change models○ 5.5 Current community initiatives○ 5.6 Catering for institutionalised individuals○ 5.7 Recommendations for future research, policy and practiceKey points6Conclusion• Acknowledgements• References Summary: According to the latest census, non‐white minority ethnic groups made up 7.9% of the UK's population in 2001. The largest of these groups were South Asians, Black African‐Caribbeans and Chinese. Studies have shown that some minority ethnic groups are more likely to experience poorer health outcomes compared with the mainstream population. These include higher rates of cardiovascular disease (CVD), type 2 diabetes and obesity. The differences in health outcomes may reflect interactions between diet and other health behaviours, genetic predisposition and developmental programming, all of which vary across different groups. As is the case for the rest of the population, the dietary habits of minority ethnic groups are affected by a wide variety of factors, but acquiring a better understanding of these can help health professionals and educationalists to recognise the needs of these groups and help them to make healthier food choices. Unfortunately, to date, there have been few tailored, well‐designed and evaluated nutritional interventions in the UK targeting minority ethnic population groups. Further needs assessment and better evaluation of nutritional interventions have been recommended to enhance the understanding of the effectiveness of different approaches amongst minority ethnic groups. This briefing paper will provide an overview of the health profile, dietary habits and other health behaviours of the three largest non‐white minority ethnic groups in the UK, explore the factors affecting their food choices, provide a summary of their traditional diets and review the evidence base to identify the factors that support successful nutrition interventions in these groups. [ABSTRACT FROM AUTHOR]

This paper describes how a strategy for health services has been developed for NHS Wales and examines the role of accruals accounting in asset management and development. It uses archival investigation as well as interviews and a questionnaire. The role of accruals accounting in the operation of the service, particularly as it relates to the capital asset base of the Trusts and how these are managed, is discussed in the context that Trusts are autonomous units that develop services, and hence their capital asset base, through their own internal planning structure. It is found that, on devolution, there was a lack of consistent information about the stock of capital assets and that capital charges, based on accruals accounting, were not penetrating asset management within individual Trusts. Although strategies were being developed centrally, their implementation at a Trust level can be impeded as a consequence of accruals accounting. [ABSTRACT FROM AUTHOR]

Using data on the patent portfolios of UK universities, the paper compares the levels of patenting activity (filings), success (grants) and quality (patents with commercial co-assignees and patent citations) at Welsh, Scottish and Northern Irish institutions. Patent activity, per researcher, in Wales is on a par with that in Scotland and about twice the rate in Northern Ireland, but the numbers of researchers relative to population in Wales and Northern Ireland are around half of the number in Scotland. Patent quality indicators are less favourable to Wales, while both activity levels and conversion of applications into grants are poor in Northern Ireland. It is suggested that greater cross-university collaboration in Wales and Northern Ireland would help improve performance. [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]

Female involvement in sexual offences against children is more common than is generally thought and has serious implications for the long-term emotional and psychological well-being of victims. Drawing on findings from: a comprehensive review of the literature; an overview of relevant literature and legislation; and an electronic survey of Multi-Agency Public Protection Panels; this paper explores the criminal justice response to female sex offending in England, Wales and Northern Ireland. The literature highlights that the way in which professionals identify and respond to child sexual abuse has been shown to be influenced by the gender of the perpetrator. Equally, whilst similar to male sex offending in terms of the intrusiveness and seriousness of the abuse, some aspects of female sex offending can cause particular problems for professionals. The fact that some sexual abuse can be disguised as childcare can make it difficult for professionals to identify this type of abuse whilst high rates of co-offending bring additional difficulties in determining the degree of female involvement and assigning responsibility. The survey findings indicate that risk assessment tools for female sex offenders is a key area requiring development and point towards small inconsistencies in the current practice of risk assessing females in the community. The survey also identifies the lack of treatment programmes for this group of offenders as well as drawing attention to the need for national policies and procedures, staff training and the identification of areas of good practice. Increased discussion and debate about how best to work with this group of sex offenders is also required. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Since 1991, the evidence-in-chief of child witnesses in United Kingdom (UK) criminal proceedings can be an initial video-recorded interview between a police officer/social worker and the child witness. This paper reports on the results of a survey of the attitudes and opinions of police officers who conduct video interviews with child witnesses in 18 police forces in England and Wales. Notably, officers' views were sought on the conduct of interviews. This builds on previous surveys which have focused on general views of videotaping children's evidence (for example, Davies and others 1995) and training issues (for example, Davies, Marshall and Robertson, 1998). Our findings support previous reports in that police officers view current provisions for child witnesses as a step in the right direction (Davies and others, 1995) but there are some reported limitations for example, gaps in training (Davies, Marshall and Robertson, 1998). In addition, we highlight the difficulties that can arise in relation to language use and some differences of opinion amongst officers (for example, with respect to the use of props in interviewing). Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

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

Following the finding of the World Breastfeeding Trends Initiative 2016 assessment that infant feeding is not mentioned in United Kingdom emergency planning guidance, in 2017 information was sought about Local Resilience Forum (LRF) planning. This research covered both guidance for parents on LRF websites and local planning. Considerable variation between areas and a dependence on the existing knowledge and experience of frontline staff was found. In 2020−2022 LRF websites in England and Wales were revisited and information requested about rest centre facilities, procurement of items needed by evacuated parents, provision of skilled support and staff training. Twenty‐nine of the 42 LRFs replied, partially or fully, directly or through their local authorities. The variation between areas found in 2017 was confirmed. Areas endeavour to provide for the needs of families but specific training in infant feeding was lacking, although several requested relevant resources or responded that the lack of training would now be reviewed. A short leaflet was produced and circulated to LRFs that had responded to aid training. Using established international guidance to include infant feeding in United Kingdom emergency planning guidance, implemented by national coordinators, would improve consistency between LRFs and better protect infant, child and maternal health and well‐being. [ABSTRACT FROM AUTHOR]

Brown macroalgae habitats provide a range of ecosystem services, offering coastal protection, supporting and increasing biodiversity, and more recently have been recognized for their potential role as blue carbon habitats. Consequently, accurate areal estimates of these habitats are vitally important. Satellite imagery is often utilized for areal estimates of vegetated habitats due to their ability to capture vast areas but are disadvantaged by their lower resolution. In contrast, imagery collected by unmanned aerial vehicles (UAV) provide high‐resolution datasets but are unable to cover the necessary spatial scale required for calculating areal estimates at regional, national or international scales. This study successfully and accurately corrects the outputs from low‐resolution Sentinel 2 imagery to the standard of high‐resolution UAV imagery by using a novel brown algae index and a simple regression model to provide accurate spatial estimates. This model was applied to rocky shores across Wales, UK to predict a spatial extent of 6.2 km2 for three fucoid macroalgae species; Ascophyllum nodosum, Fucus vesiculosus and F. serratus. The regression model was validated in two ways. First, the data used to create the regression model was split to train and test (50:50) the model, with a root mean square error of ~8%–14%. Secondly, spatial estimates of fucoids in independent aerial imagery were assessed using aerial photography interpretation and compared to that of the regression model (7% difference). The carbon standing stock of fucoids calculated from the spatial estimate (6.2 km2) was found to be significantly lower than that of other marine carbon stores, indicating that fucoids do not significantly contribute as a blue carbon habitat based on biomass alone. This study produces a robust and accurate remote sensing technique to estimate spatial extent of macroalgae at large spatial scales, with possible worldwide applicability. [ABSTRACT FROM AUTHOR]

Recent writing on the professions has given little consideration to the state's potential for threatening a professional formation. This paper argues that the reorganization of probation officer training in England and Wales is an instance of state-led de-professionalization. The process of problematizing the issue and the steps taken to try and mobilize public endorsement for radical policy change are traced, as are the counter-moves of groups attempting to maintain the existing training arrangements. This illuminates two aspects of contemporary public debate in the UK. First, it demonstrates the impact of the requirement that public sector organizations and occupations show ‘enterprise’ by successful self-promotion. Second, the episode is located within Habermas's concept of the public sphere, in which participation itself - let alone any possibility of achieving the desired outcome - now appears to depend upon relative resources and on attracting the attention of influential news media. [ABSTRACT FROM AUTHOR]

This paper gives a brief description of a research project carried out to test the assumption that there is a relationship between a student nurse's description, on paper, of how she would care for a patient, and the actual observed behaviour. No relationship was found in more than two-thirds of subjects in 19 hospitals. The paper goes on to look at the possible reasons for this phenomenon and suggests alterations in the training programmes for nurses in England and Wales which could crate a greater correlation between the theory and practice of nursing. The views expressed are those of the author and not necessarily of any organization. [ABSTRACT FROM AUTHOR]

This short paper presents some results of an attempt to derive a suitable function to explain unit costs in the water supply industry in England and Wales. The data we used were the latest available at the time of writing. The data, in effect, were for the year 1965-66. It was not possible, because of lack of data, to carry out a time-series analysis to supplement our cross-section findings. At the moment the industry is composed of some 331 undertakings; our sample, which is based on data provided by I.M.T.A.,' covers 162 of those under- takings. In effect, it covers: 67 local authorities; 75 water boards; and 20 water companies. In this paper then we are concerned with the derivation of an industry average cost curve, or function. Although the resulting curve could be similar to the envelope curve, or to part of the envelope curve, as we know it, it will differ from the usual conception of that curve because of the nature of production conditions in the water supply industry. Section II notes the type and characteristics of the four cost functions we have fitted to the data. Section III briefly presents and assesses the statistical results obtained from using those functions. Section IV then makes some comments on the major issue of amalgamation in the light of the statistical results.

In 1910, David Lloyd George, who was serving as chancellor of the exchequer in the Liberal government, opined that: 'Wales had been solid for disestablishment for 40 years' (The Times, 18 Jan. 1910, p.12). According to Lloyd George, this aspiration had been thwarted by the political reality that: 'if a Bill went up to the House of Lords it would not have the slightest chance of getting through'. At its core, the quest for the disestablishment of the Anglican church in Wales was viewed as an unprecedented constitutional and political change. It threatened to dismember one of the pillars of the English state and thereby sever a church/state relationship which, it was argued, predated parliament itself. This article will address the democratic deficit in Wales where the desire of the electorate had been repeatedly frustrated over decades, and the way disestablishment legislation would eventually be enacted through the provisions of the Parliament Act 1911. The final ignominy was that the delay inherent in the new parliamentary process would jeopardise the disestablishment that it had enabled, and this was evident in the first years of the Great War. [ABSTRACT FROM AUTHOR]

Our knowledge of the endophytic fungal community associated with needles of Sitka spruce (Picea sitchensis) is rather limited, which contrasts with the importance of this tree species for forestry in the UK. In our study, we focused on the detailed characterization of multiple isolates tentatively placed into the genera Nothophaeocryptopus and Rhizosphaera that were obtained from needles of Sitka spruce and co‐occurring Norway spruce (Picea abies) and Douglas fir (Pseudotsuga menziesii) at four sites in Scotland and Wales. After a thorough analysis of their phenotype and analysis of two nuclear regions (ITS rDNA and gene for β‐tubulin), we propose two species new to science and one new combination. Nothophaeocryptopus piceae was isolated from healthy green or brown needles from spruces and is currently known only as a sterile culture, but the taxonomic novelty is well supported by host affinity and results of molecular data analysis. Rhizosphaera minteri may also be distinguished based on the combination of host and molecular data, but morphologically, it is similar to R. pini. Finally, Hormonema merioides and R. pseudotsugae are found to be conspecific and a new combination R. merioides is proposed following the phylogenetic placement of this species. Our study highlights the importance of multiple approaches used in the identification of microfungi associated with coniferous needles. It is evident that morphologically identical fungi may represent distinct species differing in their host range and severity on the host. This study also provides a basis for future monitoring of these fungi associated with important coniferous forestry trees in the UK. [ABSTRACT FROM AUTHOR]

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

Agricultural plastic waste from nonpackaging polymers, such as those used in silage production, constitutes the majority of the UK's agricultural plastic waste due to inadequate management. This study included online and telephone interviews with 12 British dairy farmers (nine from England, three from Wales) to understand the use of non‐packaging plastic in silage production on British dairy farms. It examined their current silage production techniques and agricultural plastic waste management behaviours and highlighted the challenges of reducing plastic waste on dairy farms through the lens of circular economy. The findings show that UK dairy farmers have adhered to the mantra of reduce, reuse and recycle. They use silage clamps for high volumes of silage production, try to reuse some used silage sheets and express a strong interest in having their waste plastic collected and recycled. However, the lack of effective agricultural plastic waste collection services, inequitable enforcement of plastic waste management regulations and rising costs of waste plastic collection in the UK make it difficult for them to recycle effectively. © 2022 The Author. Polymer International published by John Wiley & Sons Ltd on behalf of Society of Industrial Chemistry. [ABSTRACT FROM AUTHOR]

Background and purpose: Although psychiatric diagnoses are recognized in idiopathic dystonia, no previous studies have examined the temporal relationship between idiopathic dystonia and psychiatric diagnoses at scale. Here, we determine rates of psychiatric diagnoses and psychiatric medication prescription in those diagnosed with idiopathic dystsuponia compared to matched controls. Methods: A longitudinal population‐based cohort study using anonymized electronic health care data in Wales (UK) was conducted to identify individuals with idiopathic dystonia and comorbid psychiatric diagnoses/prescriptions between 1 January 1994 and 31 December 2017. Psychiatric diagnoses/prescriptions were identified from primary and secondary health care records. Results: Individuals with idiopathic dystonia (n = 52,589) had higher rates of psychiatric diagnosis and psychiatric medication prescription when compared to controls (n = 216,754, 43% vs. 31%, p < 0.001; 45% vs. 37.9%, p < 0.001, respectively), with depression and anxiety being most common (cases: 31% and 28%). Psychiatric diagnoses predominantly predated dystonia diagnosis, particularly in the 12 months prior to diagnosis (incidence rate ratio [IRR] = 1.98, 95% confidence interval [CI] = 1.9–2.1), with an IRR of 12.4 (95% CI = 11.8–13.1) for anxiety disorders. There was, however, an elevated rate of most psychiatric diagnoses throughout the study period, including the 12 months after dystonia diagnosis (IRR = 1.96, 95% CI = 1.85–2.07). Conclusions: This study suggests a bidirectional relationship between psychiatric disorders and dystonia, particularly with mood disorders. Psychiatric and motor symptoms in dystonia may have common aetiological mechanisms, with psychiatric disorders potentially forming prodromal symptoms of idiopathic dystonia. [ABSTRACT FROM AUTHOR]

Background and aims: Mortality and drug treatment data suggest that the median age of people who inject drugs is increasing. We aimed to describe changes in the characteristics of people injecting drugs in the United Kingdom (UK). Design: Repeat cross‐sectional surveys and modelling. Setting: Low‐threshold services in the United Kingdom such as needle and syringe programmes. Participants: A total of 79 900 people who recently injected psychoactive drugs in the United Kingdom, recruited as part of the Unlinked Anonymous Monitoring Survey (England, Wales, Northern Ireland, 1990–2019) and Needle Exchange Surveillance Initiative (Scotland, 2008–2019). Measurements Age of people currently injecting, age at first injection, duration of injecting (each 1990–2019) and estimates of new people who started injecting (1980–2019). Findings In England, Wales and Northern Ireland between 1990 and 2019, the median age of people injecting increased from 27 (interquartile range [IQR], 24–31) to 40 (IQR, 34–46); median age at first injection increased from 22 (IQR, 19–25) to 33 (IQR, 28–39); and median years of injecting increased from 7 (IQR, 3–11) to 18 (IQR, 9–23). Values in Scotland and England were similar after 2008. The estimated number that started injecting annually in England increased from 5470 (95% prediction interval [PrI] 3120‐6940) in 1980 to a peak of 10 270 (95% PrI, 8980‐12 780) in 1998, and then decreased to 2420 (95% PrI, 1320‐5580) in 2019. The number in Scotland followed a similar pattern, increasing from 1220 (95% PrI, 740–2430) in 1980 to a peak of 3080 (95% PrI, 2160–3350) in 1998, then decreased to a 270 (95% PrI, 130–600) in 2018. The timing of the peak differed between regions, with earlier peaks in London and the North West of England. Conclusions: In the United Kingdom, large cohorts started injecting psychoactive drugs in the 1980s and 1990s and many still inject today. Relatively few people started in more recent years. This has led to changes in the population injecting drugs, including an older average age and longer injecting histories. [ABSTRACT FROM AUTHOR]

Organisations funded by Sport England or UK Sport must work towards achieving standards for safeguarding and protecting children in sport as set by the National Society for the Prevention of Cruelty to Children's Child Protection in Sport Unit (CPSU) and encourage a culture of listening to children. The present research was commissioned by the NSPCC CPSU to understand the practices of UK sports clubs regarding this objective. An electronic questionnaire was distributed through the national governing bodies of sport working with the CPSU. Some 64 clubs/squads representing 6,000+ juniors (under 18 years) responded. Quantitative data were analysed using simple statistics and qualitative data were themed utilising Foucault's theory of power and following Braun and Clark's six‐phase guide. Discourse, hierarchical judgement and docility were considered with reference to formal management and cultural environments. Semantic and latent themes were explored. The themes identified were: expectation awareness, reframing voice and preserving discourse. Clubs recognise the value of listening to children. However, existing power relations valorise adult knowledge fields over the experiences of juniors. Technology could provide an effective solution as it is remote, potentially anonymous and culturally accessible. As power is a productive force, problematisation of organisational culture could centralise children's voices and limit/prevent abuse. [ABSTRACT FROM AUTHOR]

This paper describes a qualitative study of practitioner perspectives on regulated water resources planning practice in England and Wales. The study focuses on strengths and weaknesses of existing practice and the case for change towards a risk-based approach informed by stochastic modelling assessments. In-depth, structured interviews were conducted to capture the views of planners, regulators and consultants closely involved in the planning process. We found broad agreement that the existing water availability assessment methods are fallible; they lack transparency, are often highly subjective and may fail to adequately expose problems of resilience. While most practitioners believe these issues warrant a more detailed examination of risk in the planning process, few believe there is a strong case for a fundamental shift towards risk-based planning informed by stochastic modelling assessments. The study identifies perceived business risks associated with change and exposes widespread scepticism of stochastic methods. [ABSTRACT FROM AUTHOR]

Background: A third of children admitted to paediatric intensive care units (PICUs) in the United Kingdom (UK) are transported by paediatric critical care transport services (PCCTs). Parents have described the transfer journey as particularly stressful. Critical care nurses have a key role in mitigating the impact of the journey on parents. Evaluating parents' experiences is important to inform service improvements. Aim and objectives: Our aim was to describe the development of a new measure of parents' experiences of PCCTs, derived from data collected in the Differences in access to Emergency Paediatric Intensive Care and care during Transport (DEPICT) study. Design: A descriptive cross‐sectional survey was used. Methods: As part of the DEPICT study, a 17‐item transport experience questionnaire was developed and given to parents of children transported by PCCTs to 24 UK PICUs during a 12‐month period. Analyses included exploratory factor analysis and a validation review by a PCCT stakeholder group. Results: Families of 1722 children (1798 journeys) completed questionnaires. Five items were excluded from further analysis as correlation coefficients were <0.3. Two factors explained 53% of the variance and all 12 items loaded on one of these factors. Factor 1 (8 items) explained 47% of the variance, had excellent internal reliability and the clustered items were conceptually coherent with a specific relevance to PCCTs; these were offered for consideration, with other items possibly discarded. Twenty‐eight PCCT clinicians reviewed the questions. Using a 70% agreement threshold, one additional, previously discarded, item was identified for inclusion, resulting in a nine‐item experience measure. Conclusion: Our brief measure of parents' experience of critical care transport provides a standardized measure that can be used across all PCCTs, enabling national benchmarking of services and potentially increasing the collection and use of parent experience data to improve services. Relevance to clinical practice: Being able to measure experience provides an opportunity to understand how to make services better to improve experience. [ABSTRACT FROM AUTHOR]

Context: Too many people living with chronic kidney disease are opting for and starting on hospital‐based dialysis compared to a home‐based kidney replacement therapy. Dialysis services are becoming financially unsustainable. Objective: This study aimed to assess the efficacy of coproductive research in chronic kidney disease service improvement to achieve greater sustainability. Design: A 2‐year coproductive service improvement study was conducted with multiple stakeholders with the specific intention of maximizing engagement with the national health kidney services, patients and public. Setting and Participants: A national health kidney service (3 health boards, 18 dialysis units), patients and families (n = 50), multidisciplinary teams including doctors, nurses, psychologists, social workers, and so forth (n = 68), kidney charities, independent dialysis service providers and wider social services were part of this study. Findings: Coproductive research identified underutilized resources (e.g., patients on home dialysis and social services) and their potential, highlighted unmet social care needs for patients and families and informed service redesign. Education packages were reimagined to support the home dialysis agenda including opportunities for wider service input. The impacts of one size fits all approaches to dialysis on specialist workforce skills were made clearer and also professional, patient and public perceptions of key sustainability policies. Discussion and Conclusions: Patient and key stakeholders mapped out new ways to link services to create more sustainable models of kidney health and social care. Maintaining principles of knowledge coproduction could help achieve financial sustainability and move towards more prudent adult chronic kidney disease services. Patient or Public Contribution: Involved in developing research questions, study design, management and conduct, interpretation of evidence and dissemination. [ABSTRACT FROM AUTHOR]

Objective: To compare pregnancy rates and outcomes for women with cystic fibrosis in the UK with those of the general population and assess the effect of the introduction of disease‐modifying treatment. Design: A population‐based longitudinal study, 2003–17. Setting: United Kingdom. Population: Women aged 15–44 years in the UK cystic fibrosis (CF) Registry compared with women in England and Wales. Methods: We calculated pregnancy and live‐birth rates for the CF population and the general population of England and Wales. For women with CF we compared pregnancy rates before and after ivacaftor was introduced in 2013. We further used CF registry data to assess pregnancy outcomes for mothers with CF, and to assess the relationship between maternal pre‐pregnancy lung function and nutritional status and child gestational age. Main outcome measures: Pregnancy and live‐birth rates and child gestational age. Results: Of 3831 women with CF, 661 reported 818 pregnancies. Compared with the general population, the pregnancy rate was 3.3 times lower in the CF population (23.5 versus 77.7 per 1000 woman‐years); the live‐birth rate was 3.5 times lower (17.4 versus 61.4 per 1000 woman‐years) with 70% of pregnancies in CF women resulting in live births; termination of pregnancy rates were also lower (9% versus 22%). Pregnancy rates increased post‐ivacaftor for eligible women with CF, from 29.7 to 45.7 per 1000 woman‐years. There was no association between pre‐pregnancy lung function/nutrition status and gestational age. Conclusions: Pregnancy rates in women with CF are about one‐third of the rates in the general population with favourable outcomes, and increased for eligible women post‐ivacaftor. Pregnancy rates in women with CF are about a third of the rate in England and Wales with 70% live births. Ivacaftor increases the rate. [ABSTRACT FROM AUTHOR]

This article presents an input-output table for England and Wales for the year 1688 which is based on the extensive dataset compiled by Gregory King in the 1690s, together with other contemporary and modern material relating to the end of the seventeenth century. As well as showing the inter-relationships between the different parts of the economy, the data in the table can be used to compute national income and the shares of different sectors such as agriculture, manufacturing, and services in total value added. Further, the approach used to compile the table provides a way to subject King's data to as much independent assessment as is possible given alternative sources of information. Sensitivity analysis is used to assess the impact on national income and sector shares of alternative estimates of the grain harvest, metal manufacture, and service sector output. [ABSTRACT FROM AUTHOR]

Aim: Delayed closure of ileostomy following an anterior resection for rectal cancer in the UK is common. The aims of this study were (i) to investigate the variation in patient pathways between hospitals, (ii) to identify the key learning points from units with the shortest time to closure and (iii) to develop guidance for a pathway to minimize delay in ileostomy closure. Method: This was a mixed methods study. Thirty-eight colorectal units in the UK completed a short online survey. Nine colorectal units in Wales filled in an additional, expanded version of the survey. Semi-structured interviews were performed with clinicians from the six best performing units in terms of timely ileostomy closure. The optimal pathway suggested is based on the best evidence available and the Association of Coloproctology of Great Britain and Ireland guidelines. Results: Qualitative analysis revealed that 5% of units (n = 2) have a local target time for ileostomy closure. Of all units, 90% (n = 34) would consider implementing a pathway if guidelines were developed. In-depth interviews highlighted the importance of a multidisciplinary approach, a dedicated coordinator to facilitate timely booking, and consensus on whether closure should be performed before or after adjuvant chemotherapy. Conclusion: There is a lack of national guidance in timing of contrast studies and ileostomy closure. Key aspects to consider are better information at consent regarding stoma closure timing, a dedicated person to track patients and the planning of contrast studies at discharge from initial surgery. With a dedicated approach closure of ileostomy within 10–12 weeks is feasible for most units. [ABSTRACT FROM AUTHOR]

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]