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Simple Summary: Travellers and Gypsies are recognised ethnic groups in the UK and Ireland. Horse ownership is an important part of their lives; however, poor horse welfare is often perceived to be associated with these horse-owning communities. Nevertheless, studies on the welfare of Traveller and Gypsy-owned horses are lacking. The welfare of 104 horses in the UK and Ireland was evaluated using a horse welfare protocol that assessed health conditions, resource provision, management and horse behaviour. In order to potentially understand how a horse was feeling, Qualitative Behaviour Assessment (QBA) was used to evaluate their body language. Most horses were found to have good body condition, a healthy coat and few skin problems or joint issues, however, 27% of horses were found to have neglected hooves. In the voluntary animal approach test, most horses showed a friendly response. Positive QBA terms were more prevalent than negative terms, therefore, the emotional state of Traveller and Gypsy owned horses was deemed to be positive overall. An association between QBA and various horse welfare measures was identified, e.g., improved mood was associated with better water availability. Findings in this study did not support previous negative perceptions of horse welfare in Traveller and Gypsy horse owning communities. Travellers and Gypsies are recognised ethnic groups in the UK and Ireland. Horse ownership is an important cultural tradition, however, practices associated with poor welfare are often perceived to be linked to these horse owning communities. Despite this, empirical studies on the welfare status of Traveller and Gypsy owned horses are lacking. To determine the welfare status of Traveller and Gypsy owned horses, 104 horses were assessed using a bespoke horse welfare protocol. This protocol assessed animal, resource and management-based measures. In addition, Qualitative Behaviour Assessment (QBA) identified horses' emotional state. Results indicated that 81% of horses had an optimal body condition score, with no horse recorded as very thin/fat. The absence of limb conditions (95%), ocular (98%) and nasal (93%) discharges were evident in most horses, and 81% of horses responded positively to the voluntary animal approach test. The most commonly observed welfare issues were hoof neglect (27%), with hoof cracks/breakages (19%) being the most prevalent. QBA indicated that positive emotional states were more commonplace than negative. A relationship between QBA and other horse welfare measures was observed, e.g., improved mood was associated with better water availability. This research provides novel data in the under-researched area of the welfare of Traveller and Gypsy owned horses and counters perceptions of a poor welfare state in this group of horses. [ABSTRACT FROM AUTHOR]

Background: The life expectancy of people with severe mental illness (SMI) is shorter than those without SMI, with multimorbidity and poorer physical health contributing to health inequality. Screening tools could potentially assist the optimisation of medicines to protect the physical health of people with SMI. The aim of our research was to design and validate a medicines optimisation tool (OPTIMISE) to help clinicians to optimise physical health in people with SMI. Methods: A review of existing published guidelines, PubMed and Medline was carried out. Literature was examined for medicines optimisation recommendations and also for reference to the management of physical illness in people with mental illness. Potential indicators were grouped according to physiological system. A multidisciplinary team with expertise in mental health and the development of screening tools agreed that 83 indicators should be included in the first draft of OPTIMISE. The Delphi consensus technique was used to develop and validate the contents. A 17-member multidisciplinary panel of experts from the UK and Ireland completed 2 rounds of Delphi consensus, rating their level of agreement to 83 prescribing indicators using a 5-point Likert scale. Indicators were accepted for inclusion in the OPTIMISE tool after achieving a median score of 1 or 2, where 1 indicated strongly agree and 2 indicated agree, and 75th centile value of ≤ 2. Interrater reliability was assessed among 4 clinicians across 20 datasets and the chance corrected level of agreement (kappa) was calculated. The kappa statistic was interpreted as poor if 0.2 or less, fair if 0.21–0.4, moderate if 0.41–0.6, substantial if 0.61–0.8, and good if 0.81–1.0. Results: Consensus was achieved after 2 rounds of Delphi for 62 prescribing indicators where 53 indicators were accepted after round 1 and a further 9 indicators were accepted after round 2. Interrater reliability of OPTIMISE between physicians and pharmacists indicated a substantial level of agreement with a kappa statistic of 0.75. Conclusions: OPTIMISE is a 62 indicator medicines optimisation tool designed to assist decision making in those treating adults with SMI. It was developed using a Delphi consensus methodology and interrater reliability is substantial. OPTIMISE has the potential to improve medicines optimisation by ensuring preventative medicines are considered when clinically indicated. Further research involving the implementation of OPTIMISE is required to demonstrate its true benefit. Trial registration: This article does not report the results of a health care intervention on human participants. [ABSTRACT FROM AUTHOR]

Generalist predators whose primary prey undergoes cyclic fluctuations, will predate on alternate food sources when the abundance of their primary prey is low. In this paper we have developed a general model of a predator that switches predation between its primary prey and two alternative, competing, prey species. When the predators primary prey is at high abundance, predation of the alternate, competing, prey species is low, which provides periods of temporal refuge for the alternate prey from predation. When the inter‐specific interactions between the competing prey species lead to different dynamical outcomes in the presence and absence of predation, increasing the duration of the temporal refuge promotes dominance of a competitively superior species that is vulnerable to predation. The general theoretical framework was extended to consider a key case study system of pine marten predation on red and grey squirrels. In the absence of predation, grey squirrels out‐compete red squirrels but preferential predation by pine marten on grey squirrels can suppress grey squirrel density and allow red squirrel recovery. A temporal refuge for both squirrel species can arise due to prey switching by pine marten in years when field voles, their primary prey in the UK, are abundant. The duration of the temporal refuge, quantified as the relative length of the multi‐annual vole population cycle where vole density is above a population threshold, is a critical factor determining the persistence of red and grey squirrels. Our findings therefore provide insights for the conservation of the endangered red squirrel in the UK and the Republic of Ireland and more generally on the influence of the population dynamics of primary prey species in determining community composition. [ABSTRACT FROM AUTHOR]

Purpose: Treatments for myopia progression are now available, but implementing these into clinical practice will place a burden on the eye care workforce. This study estimated the full‐time equivalent (FTE) workforce required to implement myopia control treatments in the UK and Ireland. Methods: To estimate the number of 6‐ to 21‐year‐olds with myopia, two models utilising separate data sources were developed. The examination‐based model used: (1) the number of primary care eye examinations conducted annually and (2) the proportion of these that are for myopic young people. The prevalence‐based model used epidemiological data on the age‐specific prevalence of myopia. The proportion of myopic young people progressing ≥0.25 dioptres (D)/year or ≥0.50 D/year was obtained from Irish electronic health records and the recommended review schedule from clinical management guidelines. Results: Using the examination and prevalence models, respectively, the estimated number of young people with myopia was 2,469,943 and 2,235,713. The extra workforce required to provide comprehensive myopia management for this target population was estimated at 226–317 FTE at the 0.50 D/year threshold and 433–630 FTE at the 0.25 D/year threshold. Extra visits required for myopia control treatment represented approximately 2.6% of current primary eye care examinations versus 13.6% of hospital examinations. Conclusions: Implementing new myopia control treatments in primary care settings over the medium‐term is unlikely to overwhelm the eye care workforce completely. Further increases to workforce, upskilling of current workforce and tools to reduce chair time will help to ensure sustainability of the eye care workforce into the future. [ABSTRACT FROM AUTHOR]

Objectives: Psoriatic arthritis (PsA) has a strong genetic component, and the identification of genetic risk factors could help identify the ~30% of psoriasis patients at high risk of developing PsA. Our objectives were to identify genetic risk factors and pathways that differentiate PsA from cutaneous‐only psoriasis (PsC) and to evaluate the performance of PsA risk prediction models. Methods: Genome‐wide meta‐analyses were conducted separately for 5,065 patients with PsA and 21,286 healthy controls and separately for 4,340 patients with PsA and 6,431 patients with PsC. The heritability of PsA was calculated as a single‐nucleotide polymorphism (SNP)–based heritability estimate (h2SNP) and biologic pathways that differentiate PsA from PsC were identified using Priority Index software. The generalizability of previously published PsA risk prediction pipelines was explored, and a risk prediction model was developed with external validation. Results: We identified a novel genome‐wide significant susceptibility locus for the development of PsA on chromosome 22q11 (rs5754467; P = 1.61 × 10−9), and key pathways that differentiate PsA from PsC, including NF‐κB signaling (adjusted P = 1.4 × 10−45) and Wnt signaling (adjusted P = 9.5 × 10−58). The heritability of PsA in this cohort was found to be moderate (h2SNP = 0.63), which was similar to the heritability of PsC (h2SNP = 0.61). We observed modest performance of published classification pipelines (maximum area under the curve 0.61), with similar performance of a risk model derived using the current data. Conclusion: Key biologic pathways associated with the development of PsA were identified, but the investigation of risk classification revealed modest utility in the available data sets, possibly because many of the PsC patients included in the present study were receiving treatments that are also effective in PsA. Future predictive models of PsA should be tested in PsC patients recruited from primary care. [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]

Fifty years since Dr Tudor-Hart's publication of the 'Inverse Care Law', all-cause mortality rates and COVID-19 mortality rates are higher in more deprived areas. Part of the solution is to increase access and availability to healthcare in underserved and deprived areas. This paper examined how socio-economically representative the undergraduate general practice placements are in Northern Ireland (NI). A quantitative study of general practices involved in undergraduate medical placements through Queen's University Belfast, comparing practice lists by deprivation indices, examining both blanket deprivation and deprivation quintile trends for teaching and non-teaching practices. Deprivation data for 135 teaching practices were compared against the 323 NI practices. Teaching practices had fewer patients living in the most deprived quintiles compared with non-teaching practices. Fewer practices with blanket deprivation were involved in undergraduate medical education, 32% compared with 42% without blanket deprivation. Practices in areas of blanket deprivation were under-represented as teaching practices, 10%, compared to 14% of NI general practices that met this criterion. Practices with blanket deprivation were under-represented as teaching practices. Exposure to general practice in deprived areas is an essential step to improving future workforce recruitment and ultimately to closing the health inequalities gap. Ensuring practices in high-need areas are proportionately represented in undergraduate placements is one way to direct action in addressing the 'Inverse Care Law'. This study is limited to NI and further work is required to compare institutions across the UK and Ireland. [ABSTRACT FROM AUTHOR]

Understanding and communicating the environmental impacts of food products is key to enabling transitions to environmentally sustainable food systems [El Bilali and Allahyari, Inf. Process. Agric. 5, 456-464 (2018)]. While previous analyses compared the impacts of food commodities such as fruits, wheat, and beef [Poore and Nemecek, Science 360, 987-992 (2018)], most food products contain numerous ingredients. However, because the amount of each ingredient in a product is often known only by the manufacturer, it has been difficult to assess their environmental impacts. Here, we develop an approach to overcome this limitation. It uses prior knowledge from ingredient lists to infer the composition of each ingredient, and then pairs this with environmental databases [Poore and Nemecek Science 360, 987-992 (2018); Gephart et al., Nature 597, 360-365 (2021)] to derive estimates of a food product's environmental impact across four indicators: greenhouse gas emissions, land use, water stress, and eutrophication potential. Using the approach on 57,000 products in the United Kingdom and Ireland shows food types have low (e.g., sugary beverages, fruits, breads), to intermediate (e.g., many desserts, pastries), to high environmental impacts (e.g., meat, fish, cheese). Incorporating NutriScore reveals more nutritious products are often more environmentally sustainable but there are exceptions to this trend, and foods consumers may view as substitutable can have markedly different impacts. Sensitivity analyses indicate the approach is robust to uncertainty in ingredient composition and in most cases sourcing. This approach provides a step toward enabling consumers, retailers, and policy makers to make informed decisions on the environmental impacts of food products. [ABSTRACT FROM AUTHOR]

Simple Summary: Early-onset cancers, defined as cancers in adults aged 18 to 49 years, are increasing in a number of cancer sites in developed countries. Cancers commonly seen in older people are now being diagnosed in younger adults, for example bowel, breast, stomach and pancreatic cancers. In this review, we report statistics about early-onset cancers using exemplar data from a UK region and discuss issues unique to this age group. Topics covered include the long-term consequences of cancer treatment, how cancer treatment affects fertility and the use of social media by patients, healthcare professionals and researchers. We also outline important future research priorities for early-onset cancers. Rising incidence of specific types of early-age onset cancers in adults aged 18–49 years has been reported in high-income countries. In this review, we summarise the epidemiology of early-onset cancers using exemplar data from a high-income UK region, discuss supportive care needs for young patients and outline future research directions. The incidence rate of early-onset cancers increased by 20.5% from 1993 to 2019 in Northern Ireland. Differences in types of cancer were observed between sexes and across age groups of 18–29, 30–39 and 40–49 years. One and five-year net survival was mostly better in 18–29-year-olds for all cancers combined compared to older age groups for both sexes, but there were variations in specific cancer types. Poorer survival was observed for patients with brain/central nervous system, connective and soft tissue or lung cancers. Patients with early-onset cancers face unique supportive care needs and require holistic care. The impact of cancer treatment on fertility and fertility preservation treatments is an important consideration. Social media can be used for patient support, information, fundraising, advocacy work and recruitment to research studies. We also outline suggested future research priorities for early-onset cancers, spanning prevention, diagnosis, treatment and supportive care needs. [ABSTRACT FROM AUTHOR]

Background: In 2010, a national enquiry into elderly patient outcomes after surgery identified that only 36% received 'good' care. Guidance was subsequently published by the Association of Anaesthetists of Great Britain and Ireland regarding perioperative care of the elderly and those with dementia; this study aims to assess current adherence to these guidelines in anaesthetic departments across Scotland. Methods: A web-based survey was sent to all Scottish departments. The questions assessed department patient demographic, access to specialist pre-assessment services, availability of multidisciplinary input, perioperative care of patients with cognitive impairment and departmental training on geriatric perioperative care. Results: Responses were collected from November-December 2020 with a 92.6% response rate. A total of 64% of departments stated that > 50% of their workload involved patients over 75. One department had a lead clinician for geriatric anaesthesia, whilst 20% could access a geriatric specialist when coordinating perioperative care. Specialist geriatric pre-assessment services operate in 20% of centres. A total of 60% of respondents used a clinical frailty score when pre-assessing patients over 75, with 48% specifically screening for cognitive impairment. The vast majority of centres, 76%, did not routinely provide information regarding post-operative delirium and 24% 'never or very rarely' invite caregivers to accompany patients with dementia into the department. Education sessions regarding perioperative elderly care had occurred in 56% of departments. Conclusions: Elderly patients represent a significant proportion of anaesthetic workload in Scotland. Despite this, adherence to recommended practice is low. The vast majority of centres lack access to specialist multidisciplinary input or specialist pre-assessment services which are essential to providing good care. Reported screening for frailty and cognitive impairment is variable, with opportunities for improvement in communication and education (patient and clinician) surrounding these conditions. [ABSTRACT FROM AUTHOR]

Background: In 2010, a national enquiry into elderly patient outcomes after surgery identified that only 36% received 'good' care. Guidance was subsequently published by the Association of Anaesthetists of Great Britain and Ireland regarding perioperative care of the elderly and those with dementia; this study aims to assess current adherence to these guidelines in anaesthetic departments across Scotland. Methods: A web-based survey was sent to all Scottish departments. The questions assessed department patient demographic, access to specialist pre-assessment services, availability of multidisciplinary input, perioperative care of patients with cognitive impairment and departmental training on geriatric perioperative care. Results: Responses were collected from November-December 2020 with a 92.6% response rate. A total of 64% of departments stated that > 50% of their workload involved patients over 75. One department had a lead clinician for geriatric anaesthesia, whilst 20% could access a geriatric specialist when coordinating perioperative care. Specialist geriatric pre-assessment services operate in 20% of centres. A total of 60% of respondents used a clinical frailty score when pre-assessing patients over 75, with 48% specifically screening for cognitive impairment. The vast majority of centres, 76%, did not routinely provide information regarding post-operative delirium and 24% 'never or very rarely' invite caregivers to accompany patients with dementia into the department. Education sessions regarding perioperative elderly care had occurred in 56% of departments. Conclusions: Elderly patients represent a significant proportion of anaesthetic workload in Scotland. Despite this, adherence to recommended practice is low. The vast majority of centres lack access to specialist multidisciplinary input or specialist pre-assessment services which are essential to providing good care. Reported screening for frailty and cognitive impairment is variable, with opportunities for improvement in communication and education (patient and clinician) surrounding these conditions. [ABSTRACT FROM AUTHOR]

Livestock cause many fatal and non-fatal agricultural accidents. It is crucial to understand how farmers perceive and manage different risks associated with livestock handling to devise better solutions for accident reduction. The current study investigated farmers' perception and management of four types of livestock handling risks related to self, animal, environment, and equipment. Additionally, farmers' and agricultural stakeholders' perspectives were compared. Two samples comprising 56 farmers and 55 stakeholders from the UK and Ireland completed the online study. Participants were presented with eight short livestock handling vignettes, two per risk type, and were asked to decide whether they would proceed with the task, to report their reasoning, and to detail their risk management strategies. Likert-scale responses across scenarios were compared. Thematic analysis was used to identify qualitative data patterns. Stress and fatigue were perceived as low risk by both samples based on quantitative and qualitative results. The thematic analysis revealed that risk was evaluated in terms of broader aspects, including animal welfare and duty. Participants reported the use of cognitive non-technical skills when mitigating risks associated with handling livestock alone. By changing safety messages to capture farmer priorities, agricultural organisations could encourage risk avoidance, especially in situations involving stress or fatigue. Furthermore, the cognitive non-technical skills identified could be trained within existing courses for farmers. [ABSTRACT FROM AUTHOR]

During the last eight years, over 8000 academic faculty and professional services women working in the United Kingdom and the Republic of Ireland have participated in a women-only leadership in higher education programme called Aurora. The organization that designed and delivers the programme (Advance HE) sees it as an important force for change in the sector. However, the potential for meaningful change in traditionally male domains through greater representation of women may be undermined by organizations that remain gendered. To address these issues this article outlines findings from a longitudinal, mixed-methods study on women working in higher education (HE), drawing on data from 1094 research participants. Women completed online surveys at different time points before and after participation in Aurora, with a smaller sample of participants taking part in in-depth interviews and diaries. Analysis of these data shows that the leadership programme is perceived to have a significant impact on some behaviours and attitudes of women and this impact does not on the whole diminish over time. This research is important as it is the first longitudinal study of its kind that includes both professional services and academic women. The findings will be of interest to higher education institutions (HEIs) globally that wish to develop organizational contexts in which women go on to lead. [ABSTRACT FROM AUTHOR]

Background: Haemolysis, icterus and lipaemia (HIL) are common interferants in laboratory medicine, potentially impacting patient care. This survey investigates HIL management in medical laboratories across the UK and Republic of Ireland (ROI). Methods: A survey was sent to members of key professional organisations for laboratory medicine in the UK and ROI. Questions related to the detection, monitoring, quality control, and management of HIL. Results: In total, responses from 124 laboratories were analysed, predominantly from England (52%) and ROI (36%). Most responses were from public hospitals with biochemistry services (90%), serving primary care (91%), inpatients (91%), and outpatients (89%). Most laboratories monitored H (98%), I (88%), and L (96%) using automated indices (93%), alone or in combination with visual inspection. Manufacturer-stated cut-offs were used by 83% and were applied to general chemistries in 79%, and immunoassays in 50%. Where HIL cut-offs are breached, 64% withheld results, while 96% reported interference to users. HIL were defined using numeric scales (70%) and ordinal scales (26%). HIL targets exist in 35% of laboratories, and 54% have attempted to reduce HIL. Internal Quality Control for HIL was lacking in 62% of laboratories, and just 18% of respondents have participated in External Quality Assurance. Laboratories agree manufacturers should: standardise HIL reporting (94%), ensure comparability between platforms (94%), and provide information on HIL cross-reactivity (99%). Respondents (99%) showed interest in evidence-based, standardised HIL cut-offs. Conclusions: Most respondents monitor HIL, although the wide variation in practice may differentially affect clinical care. Laboratories seem receptive to education and advice on HIL management. [ABSTRACT FROM AUTHOR]

This study evaluates a range of scenarios to reduce soluble reactive phosphorus (SRP) losses using the surface runoff phosphorus transport model (Surphos) to simulate the application of liquid manure (slurry) to grassland catchments. Surphos was applied using data from two contrasting sites in the Republic of Ireland and Northern Ireland. It explored scenarios that investigated changes to the timing of slurry applications, based both on policy (i.e. a "closed" period where regulations prohibit any slurry spreading) and on climate-based restrictions, where soil moisture and antecedent rainfall were important factors. The observed data showed a considerable spatial variability in runoff at both sites, which resulted in a corresponding variable range of SRP losses predicted by the model. However, at both sites the model results showed that maintaining a closed period led to a greater reduction in SRP losses than opening this period up to slurry applications under climate-based restrictions. [ABSTRACT FROM AUTHOR]

We conducted a systematic review to answer the following: (a) Is there any evidence to support increased prevalence of suicidality and self-harm (i.e. self-harm or suicidality) in urban versus rural environments? (b) What aspects of the urban environment pose risk for suicidality and self-harm? Thirty-five studies met our criteria. Our findings reflect a mixed picture, but with a tendency for urban living to be associated with an increased risk of suicidality and self-harm over rural living, particularly for those living in deprived areas. Further research should focus on the clustering and additive effects of risk and protective factors for suicidality and self-harm in urban environments. [ABSTRACT FROM AUTHOR]

Introduction: Complete and understandable information is vital for informed consent and this includes how and when potential participants can expect to receive trial results. Informing participants during informed consent about the sharing of trial results is important for addressing participants' needs, ensuring adherence to regulatory guidance, and in fulfilling a moral obligation. Methods: Patient Information Leaflets (PILs) were collated from across the UK and Ireland. Trial characteristics and data on disseminating trial results was extracted. Analysis included descriptive statistics and a directed content analysis approach. The content analysis framework was informed by regulatory guidance on PIL content and existing research on dissemination of trial results. Results were analysed using descriptive statistics and presented as a narrative summary as appropriate. Results: 238 PILs from 178 trials were analysed. Of the 238 PILs, 74% (n = 176) provided information on sharing results with participants, 70% (n = 123) of which described passive methods of disseminating results that require active engagement from the trial participants, i.e., effort required by the participant to seek the results. The majority (90%) of PILs included more than one proposed mode of dissemination that largely targeted healthcare professionals rather than participants. Only 8% of PILs specified a time period for when results could be expected, 47% did not specify a time period (e.g. at end of trial), and 45% included no information on when trial results would be available. Conclusion: This study found that majority of the PILs included did include some information about dissemination of trial results. However, modes of dissemination tended to target researchers and clinicians rather than participants and information on when results would be available was often lacking. The findings highlight the need for further research that includes stakeholder input to identify what information on results summaries participants need at the point of making a decision about trial participation. [ABSTRACT FROM AUTHOR]

This article explores the impact of online Irish traditional singing sessions on health and well-being during the COVID-19 pandemic. Singing sessions are unique facets of Ireland's music tradition that saw dramatic closure, interruption and digital transition in response to COVID-19 social distancing measures. This study highlights a gap in health promotion literature with regard to traditional singing sessions as a group singing activity and examines the potential for online group singing activities to have positive impacts on the health and well-being of participants. While traditional singing sessions foreground solo performances, they are quintessentially group activities, and include community engagement and active participation from singers and listeners alike. Through an online survey (n  = 108), and ethnographic interviews (n  = 3), this study explores potential health and well-being implications of online traditional singing sessions, and reveals four main areas of impact: social connection, enjoyment, cognitive motivation and timekeeping. The study suggests that online traditional singing sessions can promote health and well-being in participants, particularly during times of isolation. [ABSTRACT FROM AUTHOR]

Many types of guidance documents inform conservation by providing practical recommendations for the management of species and habitats. To ensure effective decisions are made, such guidance should be based upon relevant and up‐to‐date evidence. We reviewed conservation guidance for mitigation and management of species and habitats in the United Kingdom and Ireland, identifying 301 examples produced by over 50 organizations. Of these, only 29% provided a reference list, of which only 32% provided reference(s) relevant to justify the recommended actions (9% of the total). Furthermore, even this guidance was often outdated, lacked a methodology for production, or did not highlight uncertainty in the key evidence that supported the recommendations. These deficiencies can lead to misguided and ineffective conservation practices, policies, and decisions, and a waste of resources. Based on this review and co‐design by experts from 14 organizations, we present a set of principles for ensuring sufficient and relevant evidence is transparently incorporated into future conservation guidance. Producing evidence‐based guidance in line with these principles would enable more effective conservation outcomes. [ABSTRACT FROM AUTHOR]

Resistance to insecticides used to control pests is an issue of increasing concern for agriculture. The grain aphid, Sitobion avenae, is a pest of cereals and grasses worldwide, and one of growing concern due to the evolution of resistance to certain insecticides. Resistance confers benefits to insects by enabling them to survive exposure to insecticide compounds; however, the mutations conferring resistance may also penalise the insect in pesticide‐free environments due to fitness costs associated with the new phenotype. Here we tested the hypothesis of a reproductive penalty linked to the knockdown resistance mutation (kdr) to pyrethroid insecticides. The mutation occurs predominantly in a single SA3 clone. To date, only heterozygous‐resistant forms (kdr‐SR) have been detected in populations in Ireland and the UK, and this suggests that a fitness penalty may preclude the formation of both male and female heterozygous‐resistant sexual forms. By designing an experiment which included a resistant and a non‐resistant clone, we were able to simulate reduced daylight and temperature conditions which, in nature, trigger sexual reproduction and therefore study the responses of each clone. This allowed us to detect the switch from asexual females to sexual females and males and report on the conditions associated with the production of sexual forms. The results showed that both aphid clones were able to produce sexual forms with no difference in the onset of sexual reproduction, although reproductive strategies differed between clones. The later onset of male forms in the SA3 clone may decrease the likelihood of mating interactions to create fully resistant (kdr‐RR) genotypes and this may constitute a fitness penalty due to pyrethroid resistance. [ABSTRACT FROM AUTHOR]

Genetic evaluations in sheep have proven to be an effective way of increasing farm profitability. Much research has previously been conducted on producing within‐country genetic evaluations; however, to date, no across‐country sheep genetic evaluations have been produced between Ireland and the UK. The objective of the present study was to examine the feasibility of an across‐country genetic evaluation of live body weight and carcass composition traits for Texel sheep raised in Ireland and the UK. The benefit of genetic selection based on across‐country genetic evaluations, in comparison with within‐country genetic evaluations, was also quantified. Animal traits included early‐life and postweaning live body weights, and muscle and fat depth ultrasound measurements. Irish and UK data were combined, common animals with progeny with records in both countries were identified and a series of bivariate analyses were performed separately for each trait to produce across‐country genetic evaluations. Fixed effects included contemporary group, age at first lambing of the dam, parity of the dam (Ireland), dam age at lamb's birth (UK), a gender by age of the lamb interaction, a birth type by rearing type of the lamb interaction and country of birth of the lamb. Random effects included the animal additive genetic, dam maternal, litter common environment and residual effect. The model for postweaning weight, muscle depth and fat depth included only the animal additive genetic and litter common environmental random effects. Genetic correlations between the two countries ranged from 0.82 to 0.88 for the various traits. Across‐country breeding values were estimated for all animals and response to selection was predicted using the top 10 and top 20 sires in both within‐ and across‐country analyses for the two countries. Overall, results showed that rates of genetic gain could potentially increase from between 2.59% and 19.63% from selection based on across‐country genetic evaluations compared to within‐country evaluations alone. Across‐country evaluations are feasible and would be of significant benefit to both the Irish and UK sheep industries. In order to realize these potential gains though, there would need to be a switch in emphasis by sheep breeders towards using objective traits as their primary selection criteria. [ABSTRACT FROM AUTHOR]

This paper summarises the state of the art for strength grading of construction timber grown in the United Kingdom and the Republic of Ireland. It includes the latest approvals based on recent research on spruce, larch and Douglas-fir. It lists the following information along with the primary references: visual grading grades and strength class assignments; grading machines with approved settings for machine control grading; the species, size ranges and strength class combinations covered; and grade determining properties of specific strength classes for the UK and Irish markets. This paper is useful for those grading timber, and those specifying UK and Irish grown timber. [ABSTRACT FROM AUTHOR]

Migraine and chronic migraine are caused by a combination of modifiable and non-modifiable genetic, social, behavioral and environmental risk factors. Further research of possible modifiable risk factors for this headache disorder is merited, given its role as one of the leading causes of years lived with disability per year. The first aim of this online cross-sectional study was to investigate the psychosocial risk factors that predicted chronic migraine and severe migraine-related disability in 507 Irish and UK participants, focusing specifically on childhood maltreatment, attachment and tendency to dissociate, or experience depressed mood and/or anxiety. Additionally, this study aimed to examine variables that mediated the relationships between these psychosocial risk factors and migraine chronicity or severe migraine-related disability. Adjusted binary logistic regression revealed that shutdown dissociation (Odds Ratio [OR] 4.57, 95% Confidence Interval [CI] 2.66–7.85) and severe physical abuse (OR 4.30, 95% CI 1.44–12.83 had significant odds of predicting migraine chronicity, while depression (OR 3.28, 95% CI 1.86–5.77) significantly predicted severe migraine-related disability. Mediation analyses indicated that shutdown dissociation mediated the relationship between seven predictor variables and both chronicity and severe disability including possible predisposing factors emotional abuse, physical neglect, avoidant attachment and anxious attachment. These findings suggest that early life stressors (such as childhood trauma and avoidant attachment style), shutdown dissociation and depression may impact on migraine trajectory. To investigate whether these psychosocial factors are risk factors for migraine chronicity or disability, prospective research should be conducted in this area to account for fluctuations in migraine chronicity over time. [ABSTRACT FROM AUTHOR]

Collaboration and successful teamworking are important components of clinical practise, and these skills should be cultivated early in medical school. The breadth of current medical school curricula means that students often have limited exposure to clinical neurosciences. Since its inception in 2009, the Neurology and Neurosurgery Interest Group (NANSIG) has become a national (UK and Republic of Ireland) example of student and junior doctor synergistic collaboration to deliver educational materials, research, conferences, seminars and workshops, as well as advocating for diversity in this field. Recently, it has expanded to incorporate an international audience and cater for a larger group of young medical professionals. The organisation has overcome numerous challenges and is constantly innovating new approaches to harness the necessary knowledge, skills and network to succeed in a career in neurosciences, neurology and neurosurgery. This article summarises the initiatives undertaken by the group over its first 10 years of existence and its organisational structure, as well as its future plans. [ABSTRACT FROM AUTHOR]

Temperature management is an essential element of cardiopulmonary bypass (CPB), as indicated in the Guide to Good Practice in Clinical Perfusion, 'The safe conduct of CPB requires the clinical perfusionist to measure and control... blood temperature... during the period of bypass'. To review current practice, we have conducted a research survey into the management of temperature on CPB. Surveys were distributed to each centre in Great Britain and the Republic of Ireland, investigating numerous temperature management practices, to elucidate current practice and assess if recent research into temperature management marry routine clinical practice. Our results demonstrate that nasopharyngeal temperature is the most common (52%) temperature site used across the many centres, which correlates with previous research as a routine site for cerebral temperature management. The arterial outlet of the oxygenator temperature was used in 33% of centres, however, all centres lacked the knowledge to maintain this temperature below 37°C. There was significant variation between all centres, especially regarding rewarming times (20–40 minutes), demonstrating a lack of uniformity among perfusion centres. Interestingly, most centres have been using the same protocol that has been in place over the previous 10 years. To conclude, the practice of temperature management is changing with the awareness of new research. Lower target temperatures are recommended for rewarming, ensuring a lower temperature gradient and a longer mean rewarming time. [ABSTRACT FROM AUTHOR]

The United Kingdom and Ireland have a well-established research base in motor competence (MC) research, ranging from reporting and monitoring levels of MC, developing assessment tools for MC, providing innovative curriculum and intervention design to support learning and development, as well as providing advocacy for particular groups, such as those with motor impairments. This expert statement, on behalf of the International Motor Development Research Consortium, draws together what is currently known about levels of MC in the United Kingdom and Ireland as well as current approaches to intervention in both countries. Subsequently presented are recommendations for researchers and practitioners to advance the field of MC for the benefit of children and youth in the United Kingdom, Ireland, and worldwide. [ABSTRACT FROM AUTHOR]

Hyponatraemia is a common complication of aneurysmal subarachnoid haemorrhage (SAH). We aimed to determine current neurosurgical practice for the identification, investigation and management of hyponatraemia after SAH. An online questionnaire was completed by UK and Irish neurosurgical trainees and consultant collaborators in the Sodium after Subarachnoid Haemorrhage (SaSH) audit. Between August 2019 and June 2020, 43 responses were received from 31 of 32 UK and Ireland adult neurosurgical units (NSUs). All units reported routine measurement of serum sodium either daily or every other day. Most NSUs reported routine investigation of hyponatraemia after SAH with paired serum and urinary osmolalities (94%), urinary sodium (84%), daily fluid balance (84%), but few measured glucose (19%), morning cortisol (13%), or performed a short Synacthen test (3%). Management of hyponatraemia was variable, with units reporting use of oral sodium supplementation (77%), fluid restriction (58%), hypertonic saline (55%), and fludrocortisone (19%). Reported assessment of serum sodium after SAH was consistent between units, whereas management of hyponatraemia varied. This may reflect the lack of a specific evidence-base to inform practice. [ABSTRACT FROM AUTHOR]

Background: Perioperative trans-esophageal echocardiography ('TEE') is widely used for the assessment of anatomy/repair of congenital cardiac defects. It is recognised that there are risks associated with its use.Aims: We wished, by means of a contemporaneous prospective national audit over a six-month period, to establish what proportion of TEE studies in children are complicated by major upper gastrointestinal or upper aerodigestive tract trauma.Methods: After obtaining appropriate local institutional ethics committee approval, a national prospective audit of the rate and severity of gastrointestinal complications of trans-esophageal echocardiography studies in anaesthetised adult cardiology and cardiac surgical patients was conducted by the Association of Cardiothoracic Anaesthesia and Critical Care in the United Kingdom and Ireland during the twelve months of 2017. During the second six months of the audit, the Congenital Cardiac Anaesthesia Network (an organisation including anaesthetists with a paediatric cardiac anaesthetic practice in all the United Kingdom cardiac surgical centres) prospectively audited the incidence of such complications of TEE studies in children.Results: A total of 1,059 studies were included in this six-month paediatric audit. There were no reports of the specified major complication.Statistical Analysis: The zero incidence of the major complication is consistent with a worst possible incidence of five per thousand TEE examinations.Conclusions: Such potentially reassuring information could be included in discussions with patients or families about the risk of trans-esophageal studies in children. [ABSTRACT FROM AUTHOR]

Introduction: HIV treatment recommendations have evolved over time, reflecting both growing availability of new antiretrovirals and accumulating evidence on their safe and effective use. We analysed patterns of antiretroviral use among diagnosed pregnant women living with HIV delivering in the UK and Ireland between 2008 and 2018 using national surveillance data. Methods: All singleton pregnancies with known outcomes and known timing of antiretroviral initiation reported to the National Surveillance of HIV in Pregnancy and Childhood were included. Every individual instance of specific antiretroviral use was the unit of analysis in generating a snapshot of antiretroviral use overall and over calendar time. The final analysis was restricted to the 14 most frequently prescribed antiretrovirals. Results: There were 12 099 singleton pregnancies reported during 2008–2018 and a total of 38 214 individual uses of the 14 most commonly prescribed antiretrovirals, the majority of which were started before conception (70.9%). In 2008, 37.7% (482/1279) of pregnancies were conceived under treatment, reaching 80.9% (509/629) by 2018. Patterns of antiretroviral use have changed over time, particularly for third agents. Between 2008 and 2018 the most frequently used protease inhibitor shifted from lopinavir to darunavir, whereas use of integrase inhibitors increased steadily over time. Conclusions: These national surveillance data enable investigation of the 'real‐world' use of antiretrovirals in pregnancy on a population level. Findings demonstrate mixed responsiveness of antiretroviral prescription to changes in pregnancy guideline recommendations and may also reflect changes in commissioning and in the characteristics of pregnant women living with HIV. [ABSTRACT FROM AUTHOR]

Background: Assisted human reproduction (AHR) treatment is not regulated in Ireland although it has been practiced since 1987. Thus, Ireland is one of the only European countries without any form of AHR specific regulation. This literature review research aimed to provide a comprehensive and comparative overview of AHR regulation and any associated literature to compare Ireland and other developed countries. Methods: Systematic searches were conducted in several databases (Google Scholar, Web of Science, MEDLINE, SCOPUS and official government websites) utilising search strings in relation to AHR legislation for each country under review. A final review of 155 research articles were eligible after screening related to legislation in each country for inclusion. The findings were synthesised and summarised by legislation in each country. Results: Different countries offer different levels of ART and IVF provision and services in terms of the type of services allowed, financial support, age, sex and eligibility of recipients. The UK's oversight legislation combined with the Netherlands financial legislation section provides as being most effective hybrid model of best practice for adoption in Ireland. Conclusions: This research concluded that there is no AHR legislation in any country that can be described as all-encompassing in terms of the services allowed, financial support and age of recipients. It was concluded that significant changes need to be made to the Irish draft legislation which is in limbo with the government for the last 3 years in order to meet Irish patient needs. Plain language summary: Ireland is one of the only European countries without any form of assisted human reproduction specific regulation. This research aimed to review of assisted human reproduction regulations to compare Ireland with other developed countries. There is no assisted reproduction legislation in any country that can be described as perfect. The UK's legislation combined with the Netherlands financial legislation section is concluded as being most effective hybrid model of best practice for adoption in Ireland. It was concluded that significant changes need to be made to the Irish draft legislation which is in limbo with the government for the last 3 years. [ABSTRACT FROM AUTHOR]

Background: Assessing the quality of diagnostic images is subjective and influenced by factors such education, skills, and experience of the assessor. This study aims to explore the radiographers' assessments of medical usefulness or rejection of X-ray images in specific cases. Results: Eighty-one radiographers from different countries responded to the questionnaire distributed online at the EFRS research HUB at ECR 2020 (a 15% response rate). Forty-two percent of the respondents practiced in the UK and Ireland. In addition to rejecting or keeping images in the presented 30 cases and giving a main reason for the images rejected, the participants explained their choice using comments, 1176 comments were obtained. Sixty percent of the comments were on kept images. The respondents kept on average 63% of the images. In the "Keep", "Could keep", and "Reject" categories on average 84%, 63% and 43% of images were kept respectively. The most common reasons given for rejecting an image were suboptimal positioning and centering. Potential diagnostic value and radiation protection were indicated as reasons to keep an image perceived as of low quality reported in n = 353 and n = 33 comments respectively. Conclusions: There is an agreement internationally on what makes a good quality X-ray image. However, the opinion on medical usefulness of images of low or poor quality compared to image criteria varies. Diagnostic capability and radiation protection was the rationale used for keeping images not fulfilling image criteria. There seems to be a need for diagnostic quality to be included in image assessment in clinical practice. [ABSTRACT FROM AUTHOR]

As with the United States and Great Britain there has been a markedincrease in the prevalence of political sex scandal themed stories reported on by Irish media since the 1990s. This article considers the concept of the political sex scandal, and its relationship with media in the Irish case. It argues that political sex scandal was a frequent part of Irish journalism pre-independence but that, post-independence, this approach was replaced with a reticence to report such scandal until the 1990s. It finds that,today, Irish media avoid reporting on the private lives of politicians and instead focus on incidents wherein politicians intervene in sex-related court cases, when politicians are caught acting inappropriately on camera and on when politicians engage in matters sexual on social media. Thus, unlike the US and Britain, the key structural characteristic of contemporary Irish political sex scandals is not media intrusion into the private lives of politicians but rather media oversight of when and how politicians engage in sex-related issues in public fora such as the judicial system and social media. [ABSTRACT FROM AUTHOR]

This research, utilizing a case study design, focused on prison operations in women's prisons and compared those across each of the four jurisdictions of England and Wales, Scotland, Northern Ireland, and the Republic of Ireland. The numbers of women in prison, the crimes for which they are imprisoned, and their sentences are considered, along with women's prison policy initiatives in each jurisdiction. The differences between these policies and the realities of women's experiences in prison are highlighted. [ABSTRACT FROM AUTHOR]

To date, no measures of sexual fantasies and behaviors have been tested using modern structural equation modeling techniques. A total of 4,280 adults from the U.S., U.K., Canada, and Ireland completed a measure of diverse (paraphilic and normophilic) sexual fantasies and behaviors. Data were randomly split in half for a two-part analysis. First, an exploratory factor analysis (EFA) was performed to reduce the item pool and determine general factor structure. Second, we tested several models using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM). These were followed by tests of measurement invariance (based on sex and sexual orientation) and criterion validity. For both the fantasies and behaviors, bifactor ESEMs were the most appropriate models. Similar specific factors emerged: (a) normophilia, (b) rough sex, (c) interest of intrusion, (d) assuming power, and (e) relinquishing power. Findings suggest that sexual interests show a hierarchical measurement structure. Males and nonheterosexuals had higher general fantasy scores; nonheterosexuals had higher general behavior scores. Heterosexuals generally scored lower than nonheterosexuals. Fantasy and behavior scores were positively related to Dark Triad traits and sociosexuality, and there were weak or no relationships with depression and anxiety. Results support the psychometric validation of the Sexual Fantasies and Behaviors Inventory. Strengths of this study include a large nonclinical sample with relevant psychological correlates and the use of modern psychometric methods. However, the use of an internet sample with self-report measures may be unrepresentative, although the internet has the advantage of being able to recruit from stigmatized groups. Public Significance Statement: We developed a measure of sexual fantasies and behaviors using modern statistical analyses and results supported its test score validity in a large nonclinical convenience sample of people from the U.S., U.K., Canada, and Ireland. Both fantasy and behavior measures showed paraphilic and non-paraphilic ("normophilic") factors and a general factor, with higher scores being related to being male and nonheterosexual, having higher psychopathic traits, and increased sociosexuality. [ABSTRACT FROM AUTHOR]

Multiple airwaves crossing Britain and Ireland following the eruption of Hunga Tonga-Hunga Ha'apai on 15 January 2022 In conclusion, it seems certain that the airwaves resulting from the recent Hunga Tonga-Hunga Ha'apai volcanic eruption were as large as any previously documented in the British and Irish Isles within reliable instrumental records - at least 150 years. Several subsequent reverberations of this pressure wave could be detected in the British and Irish Isles up to 127 hours after the eruption, in what appears to have been the largest amplitude airwave event caused by a distant natural phenomenon since the Krakatoa eruption of August 1883. At 0415 utc on 15 January 2022, the large subterranean volcano Hunga Tonga-Hunga Ha'apai in the south Pacific Ocean exploded violently, sending an eruption cloud at least 40km into the atmosphere. [Extracted from the article]

Background: A woman and girl centred, rights-based approach to health care is critical to achieving sexual and reproductive health. However, women with female genital mutilation in high-income countries have been found to receive sub-optimal care. This study examined documents guiding clinicians in health and community service settings in English-speaking high-income countries to identify approaches to ensure quality women and girl-centred care for those with or at risk of female genital mutilation. Method: We undertook a scoping review using the integrative model of patient-centredness to identify principles, enablers, and activities to facilitate woman and girl-centred care interactions. We developed an inclusion criterion to identify documents such as guidance statements and tools and technical guidelines, procedural documents and clinical practice guidelines. We searched the databases and websites of health professional associations, ministries of health, hospitals, national, state and local government and non-government organisations working in female genital mutilation in the United Kingdom, Ireland, Canada, The United States, New Zealand, and Australia. The Appraisal of Guidelines for Research and Evaluation tool was used to appraise screened documents. Findings: One-hundred and twenty-four documents were included in this scoping review; 88 were developed in the United Kingdom, 20 in Australia, nine in the United States, three in Canada, two in New Zealand and two in Ireland. The focus of documents from the United Kingdom on multi-professional safeguarding (62), while those retrieved from Australia, Canada, Ireland, New Zealand and the US focused on clinical practice. Twelve percent of the included documents contained references to all principles of patient-centred care, and only one document spoke to all principles, enablers and activities. Conclusion: This study demonstrates the need to improve the female genital mutilation-related guidance provided to professionals to care for and protect women and girls. Professionals need to involve women and girls with or at risk of female genital mutilation in the co-design of guidelines and tools and evaluation of them and the co-production of health care. Plain Language Summary: High-quality health care for women and girls should be provided by health workers who are respectful and caring. Health workers should also work with others as a team and help women and girls make their own decisions about their health care. This approach is called patient-centred care. Female genital mutilation (FGM) is a cultural practice associated with poor health outcomes. Women who have experienced FGM have not always received quality health care. We studied the guidance and tools to help health workers provide care to women and girls with or at risk of FGM. This study aimed to understand how health workers are supported to provide woman and girl-centred health care in these documents. We searched for these documents on the websites of health professional associations, government health departments and organisations working in FGM in the United Kingdom, Ireland, Canada, The United States, New Zealand, and Australia. The documents were analysed using a tool that described all the important areas needed to provide patient-centred health care. Of the 124 documents, we found that only 12% contained information about all aspects of patient-centred care. Only one document had details about all the areas that are part of patient-centred care. This study shows that we need to improve the FGM-related guidance provided to health workers to care for and protect women and girls. There is a need for health workers to involve women and girls with or at risk of FGM in designing guidelines and tools and evaluating them to these documents best fit their needs. [ABSTRACT FROM AUTHOR]

The Allergy to Peanuts imPacting Emotions And Life study (APPEAL) explored the psychosocial burden of living with self-reported peanut allergy experienced by children, teenagers, adults and caregivers in the UK and Ireland. A two-stage (quantitative survey and qualitative interview [APPEAL-1]), cross-sectional study of the psychosocial burden of peanut allergy (APPEAL-2) was conducted. Quantitative data were evaluated using descriptive statistics and qualitative data were analysed using MAXQDA software. A conceptual model specific to UK and Ireland was developed using the concepts identified during the analysis. A total of 284 adults in the UK and Ireland completed the APPEAL-1 survey and 42 individuals participated in APPEAL-2. Respondents reported that peanut allergy restricts their choices in various situations, especially with regard to choosing food when eating out (87% moderately or severely restricted), choosing where to eat (82%), special occasions (76%) and when buying food from a shop (71%). Fifty-two percent of survey participants and 40% of interview participants reported being bullied because of PA. Psychological impact of peanut allergy included feeling at least moderate levels of frustration (70%), uncertainty (79%), and stress (71%). The qualitative analysis identified three different types of coping strategies (daily monitoring or vigilance, communication and planning) and four main areas of individuals' lives that are impacted by peanut allergy (social activities, relationships, emotions and work [adults and caregivers only]). The extent of the impact reported varied substantially between participants, with some reporting many negative consequences of living with peanut allergy and others feeling it has minimal impact on their health-related quality of life. This large survey and interview study highlight the psychosocial burden of peanut allergy for adults, teenagers, children and caregivers in the UK and Ireland. The analysis demonstrates the wide variation in level of impact of peanut allergy and the unmet need for those individuals who experience a substantial burden from living with peanut allergy. [ABSTRACT FROM AUTHOR]

Esophago-gastric malignancies are associated with a high recurrence rate; yet there is a lack of evidence to inform guidelines for the standardization and structure of postoperative surveillance after curatively intended treatment. This study aimed to capture the variation in postoperative surveillance strategies across the UK and Ireland, and enquire the opinions and beliefs around surveillance from practicing clinicians. A web-based survey consisting of 40 questions was sent to surgeons or allied health professionals performing or involved in surgical care for esophago-gastric cancers at high-volume centers in the UK. Respondents from each center completed the survey on what best represented their center. The first section of the survey evaluated the timing and components of follow-ups, and their variation between centers. The second section evaluated respondents perspective on how surveillance can be structured. Thirty-five respondents from 27 centers consisting 28 consultants, 6 senior trainees and 1 specialist nurse had completed the questionnaire; 45.7% of responders arranged clinical follow-up at 2–4 weeks. Twenty responders had a specific postoperative surveillance protocol for their patients. Of these, 31.4% had a standardized protocol for all patients, while 25.7% tailored it to patient needs. Patient preference, comorbidities and chance of recurrence were considered as major factors for necessitating more intense surveillance than currently practiced. There is a significant variation in how patients are monitored after surgery between centers in the UK. Randomized controlled trials are necessary to link surveillance strategies to both survival outcomes and quality of life of patients and to evaluate the prognostic value of different postoperative surveillance strategies. [ABSTRACT FROM AUTHOR]

Medical students' perception of neuroanatomy as a challenging topic has implications for referrals and interaction with specialists in the clinical neurosciences. Given plans to introduce a standardised Medical Licensing Assessment by 2023, it is important to understand the current framework of neuroanatomy education. This study aims to describe how neuroanatomy is taught and assessed in the UK and Ireland. A structured questionnaire capturing data about the timing, methods, materials, assessment and content of the 2019/2020 neuroanatomy curriculum in the UK and Ireland medical schools. We received 24/34 responses. Lectures (96%) were the most widely used teaching method, followed by prosection (80%), e-learning (75%), tutorials/seminars (67%), problem-based learning (50%), case-based learning (38%), and dissection (30%). The mean amount of core neuroanatomy teaching was 29.3 hours. The most common formats of assessing neuroanatomical knowledge were multiple-choice exams, spot tests, and objective structured clinical exams. Only 37.5% schools required demonstration of core clinical competency relating to neuroanatomy. Our survey demonstrates variability in how undergraduate neuroanatomy is taught and assessed across the UK and Ireland. There is a role for development and standardisation of national undergraduate neuroanatomy curricula in order to improve confidence and attainment. [ABSTRACT FROM AUTHOR]

Landslides involving peat are relatively common in Ireland, upland areas of Great Britain and subantarctic islands. Bogflows and bog slides are less common types of peat failure and almost unknown outside Ireland. Unusually, three of these occurred in 2020 including one bogflow at a windfarm that gained much adverse media attention, and a small but damaging peat slide was also reported. The aim of this paper is to determine the extent to which the new bog slide and bogflows are consistent with previous examples in terms of their contexts, characteristics and possible causes, particularly relating to commercial forestry operations. Aerial video footage of all three landslides obtained by local people using drones, and ground-based footage of one of them in progress, allowed a detailed examination of their characteristics and contexts to be made despite the global travel and activity restrictions caused by the coronavirus pandemic. The windfarm bogflow appears to have resulted from removal of toe support by an earlier peat flow that was itself probably caused by construction of an access road; the other two landslides were most likely triggered by rainfall. All three are consistent with previous examples of their respective types in their general characteristics and appear to be associated with well-known causal factors including hydrological, topographic and/or forestry influences. Forestry operations probably contributed to the occurrence of two of the landslides and restricted the expansion of two of them. [ABSTRACT FROM AUTHOR]

Frontline workers have shown extraordinary resilience and sustained efforts since the outbreak of COVID-19. The present study used semi-structured interviews with 38 frontline workers in the UK and Ireland to explore the psychological impact of working through COVID-19. The qualitative data were analysed systematically using thematic analysis. Four themes were interpreted: 1)) "I've stopped turning the telly on. I've had to because the news was making me ill": An ecosystem of influence; 2) "Dead, dead, dead": The emotional and psychological toll: 3) "It's shone a light on what we're failing on as well": Injustices, hierarchies and heroes: and 4) "I definitely think COVID happened for a reason to stop us in our tracks and to slow us down": Unexpected positives. This research offers insights into how frontline workers make sense of their experiences during periods of enormous societal and occupational stress. The learnings generated have relevance for government and organisational policy-makers who have opportunities to shape future conditions for frontline workers. [ABSTRACT FROM AUTHOR]

The goals of the Earth Biogenome Project--to sequence the genomes of all eukaryotic life on earth--are as daunting as they are ambitious. The Darwin Tree of Life Project was founded to demonstrate the credibility of these goals and to deliver at-scale genome sequences of unprecedented quality for a biogeographic region: the archipelago of islands that constitute Britain and Ireland. The Darwin Tree of Life Project is a collaboration between biodiversity organizations (museums, botanical gardens, and biodiversity institutes) and genomics institutes. Together, we have built a workflow that collects specimens from the field, robustly identifies them, performs sequencing, generates high-quality, curated assemblies, and releases these openly for the global community to use to build future science and conservation efforts. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has created a set of unprecedented challenges for healthcare services and staff. The authors conducted a national online survey of nurses employed to work in HIV services in England, Wales, Scotland, Northern Ireland and the Republic of Ireland to establish how the COVID-19 pandemic has impacted on the professional quality of life of HIV nurses. Professional quality of life was assessed using the ProQOL scale; 132 nurses completed the survey, 99 of whom completed the ProQOL scale. Just over 1 in 3 were redeployed in the first pandemic wave, dropping to 1 in 6 in subsequent waves. In multivariate analysis, redeployment in both waves increased burnout scores by nearly 10 points and decreased compassion satisfaction scores by nearly 5 points, with no effect on secondary traumatic stress scores. A supportive workplace environment will have a key role in supporting the path to recovery. [ABSTRACT FROM AUTHOR]

Background: Point-of-care testing (POCT) is diagnostic testing performed at or near to the site of the patient. Understanding the current capacity, and scope, of POCT in this setting is essential in order to respond to new research evidence which may lead to wide implementation.Methods: A cross-sectional online survey study of POCT use was conducted between 6th January and 2nd February 2020 on behalf of two United Kingdom (UK) and Ireland-based paediatric research networks (Paediatric Emergency Research UK and Ireland, and General and Adolescent Paediatric Research UK and Ireland).Results: In total 91/109 (83.5%) sites responded, with some respondents providing details for multiple units on their site based on network membership (139 units in total). The most commonly performed POCT were blood sugar (137/139; 98.6%), urinalysis (134/139; 96.4%) and blood gas analysis (132/139; 95%). The use of POCT for Influenza/Respiratory Syncytial Virus (RSV) (45/139; 32.4%, 41/139; 29.5%), C-Reactive Protein (CRP) (13/139; 9.4%), Procalcitonin (PCT) (2/139; 1.4%) and Group A Streptococcus (5/139; 3.6%) and was relatively low. Obstacles to the introduction of new POCT included resources and infrastructure to support test performance and quality assurance.Conclusion: This survey demonstrates significant consensus in POCT practice in the UK and Ireland but highlights specific inequity in newer biomarkers, some which do not have support from national guidance. A clear strategy to overcome the key obstacles of funding, evidence base, and standardising variation will be essential if there is a drive toward increasing implementation of POCT. [ABSTRACT FROM AUTHOR]

Background and purpose -- The main treatments for severe medial compartment knee arthritis are unicompartmental (UKR) and total knee replacement (TKR). UKRs have higher revision rates, particularly for aseptic loosening, therefore the cementless version was introduced. We compared the outcomes of matched cementless UKRs and TKRs. Patients and methods -- The National Joint Registry was linked to the English Hospital Episode Statistics and Patient Reported Outcome Measures (PROMs) databases. 10,552 cementless UKRs and 10,552 TKRs were propensity matched and regression analysis used to compare revision/ reoperation risks. 6-month PROMs were compared. UKR results were stratified by surgeon caseload into low- (< 10 UKRs/year), medium- (10 to < 30 UKRs/year), and highvolume (≥ 30 UKRs/year). Results -- 8-year cementless UKR revision survival for the 3 respective caseloads were 90% (95% CI 87--93), 93% (CI 91--95), and 96% (CI 94--97). 8-year reoperation survivals were 76% (CI 71--80), 81% (CI 78--85), and 84% (CI 82--86) respectively. For TKR the 8-year implant survivals for revision and reoperation were 96% (CI 95--97) and 81% (CI 80--83). The HRs for the 3 caseload groups compared with TKR for revision were 2.0 (CI 1.3--2.9), 2.0 (CI 1.6--2.7), and 1.0 (CI 0.8--1.3) and for reoperation were 1.2 (CI 1.0--1.4), 0.9 (CI 0.8--1.0), and 0.6 (CI 0.5--0.7). 6-month Oxford Knee Score (OKS) (39 vs. 37) and EQ-5D (0.80 vs. 0.77) were higher (p < 0.001) for the cementless UKR. Interpretation -- Cementless UKRs have higher revision and reoperation rates than TKR for low-volume UKR surgeons, similar reoperation but higher revision rates for midvolume surgeons, and lower reoperation and similar revision rates for high-volume surgeons. Cementless UKR also had better PROMs. [ABSTRACT FROM AUTHOR]

Background: Radio-frequency ablation (RFA) for Barrett's oesophagus (BE)-related neoplasia is currently used after endoscopic resection of visible neoplasia. The HALO 360 balloon has been used to ablate long segment BE. The Barrx™ 360 Express RFA self-sizing catheter ('RFA Express') may potentially allow quicker ablation times and improved treatment outcomes. The aim of this paper is to present real world data on the use of the 360 Express Device. Methods: Centres in the UK and Ireland submitted cases where the RFA Express was used. The primary outcome was regression of BE at 3 months. Secondary outcomes were the rate of symptomatic stricture formation and resolution of intestinal metaplasia (CR-IM) and dysplasia (CR-D) at End of Treatment (EoT). Results: 11 centres submitted 123 consecutive patients. 112 had a follow up endoscopy. The median age was 67 years (IQR 62–75). 3 dosimetries were used. The mean reduction in Circumferential (C) length was 78% ± 36 and mean reduction in Maximal length (M) was 55% ± 36. 17 patients (15%) developed strictures requiring dilation. There was a higher rate of stricture formation when the 12 J energy was used (p < 0.05). 47 patients had EoT biopsies, 40 (85%) had CR-D and 34(76%) had CR-IM. Conclusions: The RFA 360 Express catheter shows reduction in length of baseline BE at 3 months after index treatment, and eradication of intestinal metaplasia and dysplasia at 12 months similar to other studies with earlier devices. It appears that the symptomatic stricture rate is slightly higher than previous series with the HALO 360 catheter. This study was performed as part of the HALO registry and has been approved by the Research Ethics Committee - MREC Number 08/H0714/27 Local project reference 08/0104 Project ID 15,033 IRAS Number 54678 EudraCT 2009-015980-1. Registered on ISRCTN as below: ISRCTN93069556. https://doi.org/10.1186/ISRCTN93069556 [ABSTRACT FROM AUTHOR]