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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]

Technology has become an integral part of our educational systems, and its importance in our schools cannot be overstated. However, digital skills, unlike other literacy skills, such as reading, writing, and numeracy, still have many discontinuities between how children use them at home versus in school. Therefore, in Wales (UK), digital skills are being promoted as part of the Digital Competence Framework (DCF) and feature highly in the new Curriculum for Wales (2022). Moreover, the new Digital Technology General Certificate of Secondary Education (GCSE) in Wales has been introduced to provide learners with the opportunity to gain a qualification that builds digital skills, knowledge, and understanding. However, this also brings many challenges for teachers, such as a lack of confidence, knowledge, and training, as well as a lack of resources and fear of change, to name a few. These challenges, in turn, have an impact on pupils' motivation and performance, as well as parents' ability to support their children. This paper presents a qualitative case study on the development of a new digital technology learning community for primary and secondary school pupils, their teachers, and parents in Blaenau Gwent, Wales (UK). Firstly, the paper will provide insight into what was required to establish an effective learning community, including ensuring engagement and buy-in from all stakeholders. Secondly, through the description, analysis, and interpretation of findings from two studies, the paper will highlight the impact of the DTLSN learning community on teachers and pupils in Blaenau Gwent, especially in terms of their learning and teaching. [ABSTRACT FROM AUTHOR]

Simple Summary: Existing cross-cultural research on animal welfare often overlooks the way that policy and law are not the exclusive domain of central government. This can result in an over-simplification or misrepresentation of the true situation. The political culture and institutional arrangements for governing the modern state are more complex than a "one-size-fits-all" approach. It is argued that cross-cultural research needs to give greater attention to differences within as well as between unitary states. Specifically, it needs to examine developments in constituent nations and territories. Here we illustrate this by drawing on new research in the United Kingdom, and examine how 'devolution'—or decentralized government for Wales and Scotland—is providing contrasting opportunities for NGOs, campaigners, and the public to lobby to improve animal welfare policy based on local practices, beliefs, and demands (collectively known as the "political culture"). Our findings show how this is important because it results in contrasting animal welfare policies and laws in the constituent nations of the UK. It is argued that extant cross-cultural research on animal welfare often overlooks or gives insufficient attention to new governance theory, civil society, politics, and the realities of devolved or (quasi-)federal, multi-level governance in the modern state. This paper synthesizes relevant social theory and draws on new empirical findings of civil society accounts of campaigning on animal welfare policies and law in the United Kingdom. It is presented as a corrective to arguably reductive, earlier unitary state-based analyses. Our core, evidence-based argument is that cognizance of civil society activism and the contrasting institutional governance structures and political cultures of constituent nations in unitary states—such as the UK—are providing opportunities for the territorialization of legally grounded animal welfare regimes, and culturally distinctive practices. [ABSTRACT FROM AUTHOR]

Using administrative data linkage, this paper sought to quantify the impacts of family homelessness on pupil absence from school. It addresses a gap in United Kingdom (UK) homelessness research, which draws predominantly on qualitative methods and where there is a greater focus on people who fall outside of the statutory system, i.e., single people living on the streets, rather than families. Education records for the academic years 2012/13 to 2015/16 relating to pupils aged 5 to 15 years old living in a coastal city in Wales, UK, were linked to data on households assessed by the statutory housing service operating across the same region. Analysis of mean half-day sessions absent from school, and Poisson panel regression were used to explore associations between absenteeism (authorised, unauthorised, and total), and whether pupils were living in a household making a statutory homelessness application, i.e., experiencing family homelessness. On average, in any given academic year, pupils experiencing family homelessness (PEFH) missed 5 days more of school than pupils not experiencing family homelessness (PnEFH). Adjusted regression analysis found that the rate of total absence was 7% higher amongst PEFH compared to PnEFH, whilst for unauthorised absence it was 13% higher. When a student experienced family homelessness, this led to an increase in their rate of total absences by 5%--adjusting for other factors--compared to when they were not homeless. Findings have implications for statutory education and housing provision, specifically the need for greater cross-disciplinary working to prevent and alleviate the harms caused when families experience homelessness. [ABSTRACT FROM AUTHOR]

Flooding in 2021 has highlighted the increased risk to national resilience. This is against a backdrop of the UK climate projected to become more extreme over the next few decades. This paper considers the notable river and surface water flood events within England and Wales during 2021 and examines the performance of the Flood Forecasting Centre in highlighting the flood risk to our customers. We reflect on team debriefs as well as feedback and surveys from our customers. We distil our learnings and make connections with improvements in our underpinning science, forecasting tools, products and services. Finally, we highlight challenges associated with surface water flooding and suggest how we may collectively start to overcome these. [ABSTRACT FROM AUTHOR]

British supermarket-panel data suggest no increases in overall sales and purchases of alcohol following COVID-19 lockdowns, yet survey and mortality data suggest otherwise. This paper attempts to unravel the paradox. Based on purchase data of 79,417 British households from Kantar Worldpanel, we undertake controlled interrupted time series analysis of the impact of COVID-19 confinement introduced on 23rd March 2020, and variably applied during 2020, compared to purchases during 2015 to 2019 as controls. We also undertook Poisson regression analyses to estimate if changes in purchases differed by household socio-demographic and economic factors. Excess off-trade household alcohol purchases (expressed as grams of ethanol) following the introduction of confinement, were 29.2% higher (95% CI = 25.8% to 32.5%) for the post-confinement months of 2020, being larger until mid-July 2020 (37.5%, 95%CI = 33.9 to 41.26%) when pubs re-opened with restrictions, and smaller (24.6%, 95%CI = 21.6 to 27.7) thereafter. During the time of complete pub closures, and fully adjusting for no on-trade purchases, household purchases of alcohol did not change when compared with the same time period during 2015–2019 (coefficient = -0.9%, 95%CI = -5.6 to 3.8). Excess purchases from 23rd March to 31st December 2020 varied by region of Great Britain, being higher in the north of England, and lower in Scotland and Wales. Excess purchases were greater in the most deprived households, compared with the least deprived households. Excess purchases increased substantially as the amount of alcohol normally purchased by a household increased, with the top one fifth of households that normally bought the most alcohol increasing their purchases more than 17 times than the bottom one fifth of households that bought the least alcohol. That the heaviest buyers of alcohol increased their purchases the most, with some independent impact of socio-economic disadvantage, might explain why reported alcohol problems and recent alcohol-related death rates might have increased. A conclusion of this is that alcohol policy to reduce high consumption of alcohol, and the availability of help and treatment to reduce alcohol consumption become more important during extraordinary times, such as COVID lockdowns. [ABSTRACT FROM AUTHOR]

Due to its progressive nature, dementia is now the leading cause of death in England and Wales, so a palliative approach to care is beneficial because of its emphasis on supportive care. Many people with dementia also have other comorbid health conditions common in older age, that in themselves may induce pain. However, people with dementia may have difficulty in understanding what they are feeling and in describing and locating the pain due to having issues with communicating their needs as their dementia progresses. This paper considers the recognition, assessment, treatment and management of pain in older people with dementia. It introduces the learner to what is known about the subject and why it is important to know the person's past history and previous ways of self-managing pain and discomfort using information gained from their family, carers and friends. [ABSTRACT FROM AUTHOR]

Simple Summary: In Great Britain, private animal keepers such as pet owners and farmers require a licence from their local government authority to keep wild animals of species formally categorised as "dangerous". No central record of these licences is maintained by the national Governments in Britain, and the last formal examination of the situation was published more than 20 years ago. We examined the scale and scope of private keeping of dangerous wild animals in England, Scotland, and Wales in 2020. We found a total of 3950 individual dangerous wild animals kept by 210 licensees across more than one-third of British local authorities. While overall numbers of licensed dangerous wild animals have declined over the preceding 20 years, there have been notable increases in the keeping of some taxa such as wild cats, venomous snakes, and crocodilians. There is evidence that the average relative cost to obtain a licence to keep a dangerous wild animal has decreased since the earlier study, and that local authorities with licensed animals have lower licensing fees than those without. We discuss the current system of licensing with a view to making recommendations for improvement. We analysed the licences issued by British local government authorities under the Dangerous Wild Animals Act 1976, which regulates the private keeping of wild animals categorised as "dangerous", to assess the scope and scale of private keeping of dangerous wild animals in Great Britain. Results are compared with historical data from England and Wales, showing that there has been an overall decrease both in the total population of dangerous wild animals privately kept under licence and the number of licences, resulting primarily from a decrease in the farming of wild boar and ostrich, and from certain other species no longer requiring a licence to be kept. Nonetheless, the private keeping of dangerous wild animals remains prevalent, with a total population of 3950 animals kept under licence, and at least one-third of local authorities in Britain licensing keepers of one or more such animals. The population of non-farmed dangerous taxa has increased by 59% in 20 years, with notable increases in crocodilians (198%), venomous snakes (94%), and wild cats (57%). We present evidence that the average cost of a licence to keep dangerous wild animals has fallen over time, and that there is a negative association between cost and licensing. The current schedule of species categorised as dangerous is compared to a formally recognised list of species kept in zoos assessed by risk to the public. Problems with the legislation, enforcement of the licensing system, and animal welfare for privately kept dangerous wild animals are identified and discussed. [ABSTRACT FROM AUTHOR]

Background: The FROM-16 is a generic family quality of life (QoL) instrument that measures the QoL impact of patients' disease on their family members/partners. The study aimed to assess the responsiveness of FROM-16 to change and determine Minimal Important Change (MIC). Methods: Responsiveness and MIC for FROM-16 were assessed prospectively with patients and their family members recruited from outpatient departments of the University Hospital Wales and University Hospital Llandough, Cardiff, United Kingdom. Patients completed the EQ-5D-3L and a global severity question (GSQ) online at baseline and at 3-month follow-up. Family members completed FROM-16 at baseline and a Global Rating of Change (GRC) in addition to FROM-16 at follow-up. Responsiveness was assessed using the distribution-based (effect size-ES, standardized response mean -SRM) and anchor-based (area under the receiver operating characteristics curve ROC-AUC) approaches and by testing hypotheses on expected correlation strength between FROM-16 change score and patient assessment tools (GSQ and EQ-5D). Cohen's criteria were used for assessing ES. The AUC ≥ 0.7 was considered a good measure of responsiveness. MIC was calculated using anchor-based (ROC analysis and adjusted predictive modelling) and distribution methods based on standard deviation (SD) and standard error of the measurement (SEM). Results: Eighty-three patients with 15 different health conditions and their relatives completed baseline and follow-up questionnaires and were included in the responsiveness analysis. The mean FROM-16 change over 3 months = 1.43 (SD = 4.98). The mean patient EQ-5D change over 3 months = −0.059 (SD = 0.14). The responsiveness analysis showed that the FROM-16 was responsive to change (ES = 0.2, SRM = 0.3; p < 0.01). The ES and SRM of FROM-16 change score ranged from small (ES = 0.2; SRM = 0.3) for the distribution-based method to large (ES = 0.8, SRM = 0.85) for anchor-based methods. The AUC value was above 0.7, indicating good responsiveness. There was a significant positive correlation between the FROM-16 change scores and the patient's disease severity change scores (p < 0.001). The MIC analysis was based on data from 100 family members of 100 patients. The MIC value of 4 was suggested for FROM-16. Conclusions: The results of this study confirm the longitudinal validity of FROM-16 which refers to the degree to which an instrument is able to measure change in the construct to be measured. The results yield a MIC value of 4 for FROM-16. These psychometric attributes of the FROM-16 instrument are useful in both clinical research as well as clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: Lamb production systems are under increasing pressure to reduce their environmental footprint, particularly emissions of greenhouse gases (GHGs) such as methane. However, the metrics used to express the carbon footprint of lamb seldom consider its nutritional density and contribution to balanced diets in humans. Lamb production systems vary considerably, from low-input pastoral systems to higher-input systems feeding concentrates for the latter 'finishing' period. To date, no studies have explored the effect of finishing diet on the carbon footprint of lamb meat on a nutritional basis. Methods: Data from 444 carcasses were collected from four abattoirs across Wales, United Kingdom. Lambs were derived from 33 farms with one of four distinct finishing diets: forage crops (n = 5), grass (n = 11), concentrates (n = 7), and grass and concentrates (n = 15). Carcass data were analysed using mixed effects models. Significant differences were found in fatty acid composition of two large commercial cuts of meat from different finishing diets. To illustrate the effect of different measures of footprint, mass (kg dwt) and omega-3 polyunsaturated fatty acid content (g omega-3) were selected as functional units. GHG emission estimates were calculated using Agrecalc. Results: The concentrates diet had the lowest average mass-based product emissions [25.0 kg CO2e/kg deadweight (dwt)] while the grass systems had the highest (28.1 kg CO2e/kg dwt; p < 0.001). The semimembranosus muscle cut from the forage crops diet had the lowest average nutrition-based product emissions (19.2 kg CO2e/g omega-3); whereas the same muscle cut from lambs finished on the grass and concentrates diet had the highest nutrition-based product emissions (29.4 kg CO2e/g omega-3; p < 0.001). Discussion: While mass-based functional units can be useful for comparing efficiencies of different farming systems, they do not reflect how farming systems impact the nutritional differences of the final product. This study demonstrates the importance of considering nutrition when expressing and comparing the carbon footprints of nutrient-dense foods such as lamb. This approach could also help inform discussions around the optimal diets for lamb production systems from both a human nutrition and environmental sustainability perspective. [ABSTRACT FROM AUTHOR]

Violence is recognised as a cause of health harm, but it is not consistently or adequately captured in healthcare data systems. While administrative health records could be valuable sources of information for measuring violence, they remain underutilised in violence-related research. The present research aims to examine the suitability of violence indicators in emergency care, primary care, and linked healthcare datasets. Descriptive analyses were conducted with the 2015/16 Hospital Episode Statistics Accident and Emergency (HES A&E) and the 2021/22 Emergency Care Data Set (ECDS). The potential of the Clinical Practice Research Datalink (CPRD) and the South Wales Violence Surveillance dataset (a police and emergency department (ED) dataset linked by Public Health Wales) were shown using available evidence. Among the discussed datasets, the South Wales Violence Surveillance dataset has the most detail about violent acts and their contexts, while the CPRD includes a more extensive range of socioeconomic factors about patients and extensive linkage with other datasets. Currently, detailed safeguarding information is routinely removed from the ECDS extracts provided to researchers, limiting its utility for violence research. In the HES A&E, only physical violence was consistently recorded. Addressing these issues has the potential to improve the use of health administrative data in research on violence. [ABSTRACT FROM AUTHOR]

Background There is an urgent need to address high levels of work-related violence (WRV) in Britain to improve the workplace experience of both employers and employees. Aims This study specifically explores prevalence rates of work-related violence assaults (WRVAs) for staff at high risk that have supervisor responsibilities and work full-time. Methods Five years of data were used for analysis from the Crime Survey of England and Wales (CSEW). Data were filtered for victims of crime from a working population in Britain. Results Forty-four per cent of respondents who are supervisors and have full-time jobs report that they had been victims of WRVAs. This figure is higher than other previous studies of WRV. Conclusions The current study provides further alternative evidence to support high prevalence rates of WRV by selecting for analysis specific work characteristics data that are strongly associated with WRV (supervisor responsibilities and full-time work). It is therefore recommended that future work explores different means of intervention for organizations to implement within the workplace to reduce WRV and protect workers from harm. [ABSTRACT FROM AUTHOR]

Screening for vulnerability factors associated with historic suicidality and self-harm on entry to prison is critical to help prisons understand how to allocate extremely limited mental health resources. It has been established that having previous suicide attempts increases odds of future suicidality and self-harm in prison. We utilised administrative screening data from 665 adult male prisoners on entry to a category B prison in Wales, UK, collected using the Do-IT Profiler. This sample represents 16% of all prisoners who entered that prison during a 26-month period. 12% of prisoners reported a history of attempted suicide, 11% reported historic self-harm, and 8% reported a history of both. Historic traumatic brain injury and substance use problems were associated with a 3.3- and 1.9- times increased odds of a historic suicide attempt, respectively, but no significant increased risk of historic self-harm (95% CI: 1.51–6.60 and 1.02–3.50). However, those who were bullied at school had 2.7 times increased odds of reporting a history of self-harm (95% CI: 1.63–6.09). The most salient risk factors associated with both historic suicide and self-harm were higher levels of functional neurodisability (odds ratio 0.6 for a 1 standard deviation change in score, 95% CI: 0.35–0.75), and mood disturbance (odds ratio 2.1 for a 1 standard deviation change in score, 95% CI: 1.26–3.56). Therefore, it could be beneficial for prisons to screen for broader profiles of needs, to better understand how to provide appropriate services to prisoners vulnerable to suicide and self-harm. Multidisciplinary care pathways for prisoner mental health interventions are important, to account for complex multimorbidity. Adaptations may be needed for mental health interventions to be appropriate for, for example, a prisoner with a brain injury. Understanding this broad profile of vulnerability could also contribute to more compassionate responses to suicide and self-harm from prison staff. [ABSTRACT FROM AUTHOR]

A new species of bubble-headed trilobite, Staurocephalus oliveae sp. nov., is described from 250 specimens collected from a recently discovered locality in the Sholeshook Limestone Formation (upper Katian, Upper Ordovician; Ashgill, Cautleyan Zone 1 equivalent) in the village of Llanddowror, Carmarthenshire. Although no fully articulated specimens were found, the material is the most abundant and well-preserved of any Ordovician Staurocephalus species known from Britain and Ireland, and enables the complicated 3D structure of its cephalon to be reconstructed. Staurocephalus oliveae sp. nov. is the earliest representative of the genus recorded in Avalonia, following its presumed migration into the area from Laurentia or Baltica. Recognition of this Cautleyan species resurrects the potential usefulness of the long established, widely distributed, Staurocephalus clavifrons as a latest Katian (= Rawtheyan) indicator. [ABSTRACT FROM AUTHOR]

Within the context of reopening society in the summer of 2021, as the UK moved away from 'lockdowns', the Government of Wales piloted the return of organized 'mass gatherings' of people at a number of test events. The current study reports behavioral observations that were made at two of the test events to inform this process. The researchers were particularly interested in four key factors: how (1) context within a venue, (2) environmental design, (3) staffing and social norms, and (4) time across an event, affected the personal protective behaviors of social distancing and face-covering use. Data collection was undertaken by trained observers. Adherence to protective behaviors was generally high, but there is clear evidence that these behaviors were shaped in a systematic way by the environment, situational cues, and the passage of time during the events. Some instances of large-scale non-adherence to personal protective behaviors were documented. An analysis within a dual-process framework suggests ways to understand and respond to supporting target health behaviors in groups of people where intervention is deemed valuable, such as in complex or ambiguous contexts. This is one of the first studies to include a 'true' behavioral measure in understanding human responses to COVID-19. It demonstrates that behavioral observations can add precision and granularity to understanding human behavior in complex real-world contexts. Given the significant physical and mental health burden created acutely and chronically by COVID-19, this work has implications for how governments and organizations support target populations in other complex challenges facing us today, such as in sustainability, and healthy lifestyle behaviors. An individual's intentions are not always matched by their actions, and so the findings support a balanced liberal paternalistic approach where system-level changes support appropriate individual-level decisions to engender collective responsibility and action. [ABSTRACT FROM AUTHOR]

Rates of Multimorbidity (also called Multiple Long Term Conditions, MLTC) are increasing in many developed nations. People with multimorbidity experience poorer outcomes and require more healthcare intervention. Grouping of conditions by health service utilisation is poorly researched. The study population consisted of a cohort of people living in Wales, UK aged 20 years or older in 2000 who were followed up until the end of 2017. Multimorbidity clusters by prevalence and healthcare resource use (HRU) were modelled using hypergraphs, mathematical objects relating diseases via links which can connect any number of diseases, thus capturing information about sets of diseases of any size. The cohort included 2,178,938 people. The most prevalent diseases were hypertension (13.3%), diabetes (6.9%), depression (6.7%) and chronic obstructive pulmonary disease (5.9%). The most important sets of diseases when considering prevalence generally contained a small number of diseases, while the most important sets of diseases when considering HRU were sets containing many diseases. The most important set of diseases taking prevalence and HRU into account was diabetes & hypertension and this combined measure of importance featured hypertension most often in the most important sets of diseases. We have used a single approach to find the most important sets of diseases based on co-occurrence and HRU measures, demonstrating the flexibility of the hypergraph approach. Hypertension, the most important single disease, is silent, underdiagnosed and increases the risk of life threatening co-morbidities. Co-occurrence of endocrine and cardiovascular diseases was common in the most important sets. Combining measures of prevalence with HRU provides insights which would be helpful for those planning and delivering services. [ABSTRACT FROM AUTHOR]

Background: Addressing violence related harm is a global public health priority. While violence is primarily managed in the criminal justice system, healthcare supports and manages those injured by violence. Emergency Departments (EDs), the primary destination for those seriously injured, have emerged as a candidate location for violence prevention initiatives. There is limited evaluation of ED-based violence prevention, and a lack of guidance for the implementation and delivery of them. Nurse-led Violence Prevention Teams (VPTs) have been developed and implemented in two EDs in Wales, UK. This protocol describes methods used in the process evaluation of these VPTs. Aim: To understand how VPTs function, how they were implemented, and mechanisms of impact, as well as the exploration of wider contextual factors influencing their function. Methods: Adopting a critical realist approach and informed by the Medical Research Council (MRC) guidance for process evaluations, the process evaluation will employ qualitative methods to collect and analyse data: a scoping review of evidence of effectiveness that considers the causal mechanisms underpinning violence; a documentary analysis to determine operational considerations concerning the development, implementation and delivery of the VPTs; a descriptive analysis of routine ED data to characterise the prevalence of violence-related attendances in each ED; interviews with professional stakeholders (N = 60) from the violence prevention ecologies in which the VPTs are embedded. Discussion: This protocol outlines a process evaluation of a novel, nurse led violence prevention intervention. Findings will be used to inform policy makers' decision making on whether and how VPTs should be used in practice in other EDs across the UK, and the extent that a single operational model should be adjusted to address the local characteristic of violence. To the authors knowledge, this is the first process evaluation of a UK-based, nurse led Emergency Department Violence Prevention Team. Trial registration: Protocol registration ISRCTN: 15286575. Registered 13th March, 2023. [ABSTRACT FROM AUTHOR]

Echiurans (spoonworms) are a very distinctive group of polychaete annelids that had long been considered to constitute a separate phylum. Their fossil record is extremely limited, although trace fossils that have been suggested to be attributable to them date back as far as the Cambrian Period. The oldest body fossils are from the Carboniferous Mazon Creek Biota, and preserve only limited morphological detail. New material from the Middle Ordovician (Darrivilian, Didymograptus murchisoni Biozone) Castle Bank Biota of Wales shows fine detail of the morphology of a new taxon, Llwygarua suzannae gen. et sp. nov., including several details that indicate an assignment to the derived family Thalassematidae, allied to the speciose genus Ochetostoma. These details include proboscis morphology, anterior setae, and muscle organisation within the trunk. An additional specimen is described in open nomenclature, as it may be either a distinct species, or a juvenile of Llwygarua suzannae gen. et sp. nov. with a relatively elongated proboscis. These worms demonstrate a very early and previously unrecognised diversification of the echiuran grown group, further supporting an early diversification of Annelida as a whole. [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]

In August 2020, the UK government and regulation body Ofqual replaced school examinations with automatically computed A Level grades in England and Wales. This algorithm factored in school attainment in each subject over the previous three years. Government officials initially stated that the algorithm was used to combat grade inflation. After public outcry, teacher assessment grades used instead. Views concerning who was to blame for this scandal were expressed on the social media website Twitter. While previous work used NLP-based opinion mining computational linguistic tools to analyse this discourse, shortcomings included accuracy issues, difficulties in interpretation and limited conclusions on who authors blamed. Thus, we chose to complement this research by analysing 18,239 tweets relating to the A Level algorithm using Corpus Linguistics (CL) and Critical Discourse Analysis (CDA), underpinned by social actor representation. We examined how blame was attributed to different entities who were presented as social actors or having social agency. Through analysing transitivity in this discourse, we found the algorithm itself, the UK government and Ofqual were all implicated as potentially responsible as social actors through active agency, agency metaphor possession and instances of passive constructions. According to our results, students were found to have limited blame through the same analysis. We discuss how this builds upon existing research where the algorithm is implicated and how such a wide range of constructions obscure blame. Methodologically, we demonstrated that CL and CDA complement existing NLP-based computational linguistic tools in researching the 2020 A Level algorithm; however, there is further scope for how these approaches can be used in an iterative manner. [ABSTRACT FROM AUTHOR]

The economic landscape of the United Kingdom has been significantly shaped by the intertwined issues of Brexit, COVID-19, and their interconnected impacts. Despite the country's robust and diverse economy, the disruptions caused by Brexit and the COVID-19 pandemic have created uncertainty and upheaval for both businesses and individuals. Recognizing the magnitude of these challenges, academic literature has directed its attention toward conducting immediate research in this crucial area. This study sets out to investigate key economic factors that have influenced various sectors of the UK economy and have broader economic implications within the context of Brexit and COVID-19. The factors under scrutiny include the unemployment rate, GDP index, earnings, and trade. To accomplish this, a range of data analysis tools and techniques were employed, including the Box-Jenkins method, neural network modeling, Google Trend analysis, and Twitter-sentiment analysis. The analysis encompassed different periods: pre-Brexit (2011-2016), Brexit (2016-2020), the COVID-19 period, and post-Brexit (2020-2021). The findings of the analysis offer intriguing insights spanning the past decade. For instance, the unemployment rate displayed a downward trend until 2020 but experienced a spike in 2021, persisting for a six-month period. Meanwhile, total earnings per week exhibited a gradual increase over time, and the GDP index demonstrated an upward trajectory until 2020 but declined during the COVID-19 period. Notably, trade experienced the most significant decline following both Brexit and the COVID-19 pandemic. Furthermore, the impact of these events exhibited variations across the UK's four regions and twelve industries. Wales and Northern Ireland emerged as the regions most affected by Brexit and COVID-19, with industries such as accommodation, construction, and wholesale trade particularly impacted in terms of earnings and employment levels. Conversely, industries such as finance, science, and health demonstrated an increased contribution to the UK's total GDP in the post-Brexit period, indicating some positive outcomes. It is worth highlighting that the impact of these economic factors was more pronounced on men than on women. Among all the variables analyzed, trade suffered the most severe consequences in the UK. By early 2021, the macroeconomic situation in the country was characterized by a simple dynamic: economic demand rebounded at a faster pace than supply, leading to shortages, bottlenecks, and inflation. The findings of this research carry significant value for the UK government and businesses, empowering them to adapt and innovate based on forecasts to navigate the challenges posed by Brexit and COVID-19. By doing so, they can promote long-term economic growth and effectively address the disruptions caused by these interrelated issues. [ABSTRACT FROM AUTHOR]

This study presents a comprehensive review of building materials, construction methods, and building regulations on the U.K. mainland. This provides valuable insights into the historical progression and transformation of the construction industry through a comprehensive analysis of both traditional and modern building construction materials and methods and categorising their evolutionary trajectory. Current building regulations in England, Wales, and Scotland are compared, highlighting differences in fire safety, noise safety, energy conservation, and sustainability. For example, fire safety regulations are analysed in detail, including fire resistance duration, wall cladding combustibility, and limitations on unprotected areas. Advances in knowledge and technology have led to increasingly sophisticated and energy-dependent methods, materials, and regulations. This study showcases the vast array of building construction materials spanning centuries, each possessing unique properties and performances. The selected methods and materials represent those currently employed or widely utilised in the U.K. construction industry, affirming their relevance and applicability in modern construction practices. Limitations in construction practices primarily stem from a lack of knowledge and tools rather than material scarcity. Enhancing knowledge and access to advanced tools is crucial to overcoming these limitations and driving advancements in the field. This study provides insights into the evolution of building materials, construction methods, and building regulations that can inform future developments in sustainable building practices. The findings have significant implications for policymakers, building designers, and constructors, particularly in terms of adopting sustainable materials and construction methods that comply with building regulations while reducing the environmental impact of the built environment. [ABSTRACT FROM AUTHOR]

Wireworm, the larval stages of click beetles, are a serious pest of tubers, brassicas and other important commercial crops throughout the northern hemisphere. No effective control agent has been developed specifically for them, and many of the pesticides marketed as having secondary application against them have been withdrawn from EU and Asian markets. Metarhizium brunneum, an effective entomopathogenic fungus, and its derived volatile metabolites are known to be effective plant biostimulants and plant protectants, although field efficacy has yet to be validated. Field validation of a combined M. brunneum and derived VOC treatments was conducted in Wales, UK, to assess the effects of each as a wireworm control agent and biostimulant. Plots were treated with Tri-Soil (Trichoderma atroviridae), M. brunneum, 1-octen-3-ol or 3-octanone, or combinations thereof. Treatments were applied subsurface during potato seeding (n = 52), and potatoes were harvested at the end of the growing season. Each potato was weighed individually and scored for levels of wireworm damage. Applications of both the VOCs and the M. brunneum individually were found to significantly decrease wireworm burden (p < 0.001). Combinations of M. brunneum and 3-octanone were also found to significantly decrease wireworm damage (p < 0.001), while no effect on yield was reported, resulting in an increased saleable mass over controls (p < 0.001). Herein, we present a novel 'stimulate and deter' wireworm control strategy that can be used to significantly enhance saleable potato yields and control wireworm populations, even under high pest pressure densities. [ABSTRACT FROM AUTHOR]

Metal-mining exploitation has caused ecosystem degradation worldwide. Legacy wastes are often concentrated around former mines where monitoring and research works are mostly focused. Geochemical and physical weathering can affect metal-enriched sediment locations and their capacity to release metals at a catchment scale. This study investigated how fluvial geomorphology and soil geochemistry drive zinc and lead dispersion along the Nant Cwmnewyddion (Wales, UK). Sediments from different locations were sampled for geochemical and mineralogical investigations (portable X-ray fluorescence, scanning electron microscope, X-ray diffraction, and electron microprobe analysis). The suspended sediment fluxes in the streamwater were estimated at different streamflows to quantify the metal dispersion. Topographical and slope analysis allowed us to link sediment erosion with the exposure of primary sulphide minerals in the headwater. Zinc and lead entered the streamwater as aqueous phases or as suspended sediments. Secondary sources were localised in depositional stream areas due to topographical obstruction and a decrease in stream gradient. Sediment zinc and lead concentrations were lower in depositional areas and associated with Fe-oxide or phyllosilicates. Streamwater zinc and lead fluxes highlighted their mobility under high-flow conditions. This multi-disciplinary approach stressed the impact of the headwater mining work on the downstream catchment and provided a low-cost strategy to target sediment sampling via geomorphological observations. [ABSTRACT FROM AUTHOR]

Introduction: At the start of the COVID-19 pandemic there was an urgent need to identify individuals at highest risk of severe outcomes, such as hospitalisation and death following infection. The QCOVID risk prediction algorithms emerged as key tools in facilitating this which were further developed during the second wave of the COVID-19 pandemic to identify groups of people at highest risk of severe COVID-19 related outcomes following one or two doses of vaccine. Objectives: To externally validate the QCOVID3 algorithm based on primary and secondary care records for Wales, UK. Methods: We conducted an observational, prospective cohort based on electronic health care records for 1.66m vaccinated adults living in Wales on 8th December 2020, with follow-up until 15th June 2021. Follow-up started from day 14 post vaccination to allow the full effect of the vaccine. Results: The scores produced by the QCOVID3 risk algorithm showed high levels of discrimination for both COVID-19 related deaths and hospital admissions and good calibration (Harrell C statistic: ≥ 0.828). Conclusion: This validation of the updated QCOVID3 risk algorithms in the adult vaccinated Welsh population has shown that the algorithms are valid for use in the Welsh population, and applicable on a population independent of the original study, which has not been previously reported. This study provides further evidence that the QCOVID algorithms can help inform public health risk management on the ongoing surveillance and intervention to manage COVID-19 related risks. [ABSTRACT FROM AUTHOR]

A study of chemical runoff following the use of acetamiprid as a pre-treatment and top-up spray to prevent damage from the large pine weevil (Hylobius abietis L.) to young trees was undertaken at a restock site in mid-Wales. The site was specifically selected to pose a high risk of chemical runoff, being a high elevation, headwater catchment with stagnopodzol soils, subject to high rainfall. Water samples were collected before, during and after each treatment from six points around the site, as well as from a nearby stream that acted as a control. Only 1 of the 90 water samples collected detected acetamiprid at levels above the limit of quantification of 0.005 μg l−1 (i.e. 0.000000005 g in 1 l of water) and this appeared to be due to wash-off of residues from the plastic bags the trees had been delivered to the site in, which had been temporarily placed within a dry road drain. The recorded concentration of 0.1022 μg l−1 of acetamiprid was low, being only 20 per cent of the Predicted No Effect Concentration (PNEC) of 0.5 μg l−1. Neither of the top-up spray applications resulted in water contamination at any of the sampling points. The results show that the good forestry practice measures employed were effective in preventing contamination of stream waters by acetamiprid. The use of 10-m buffers between forest drains and receiving streams, as per standard good forestry practice in the UK, should be more than adequate to prevent any chemical runoff contaminating watercourses. However, it is recommended that forest practice is further tightened in relation to the placement and handling of planting bags on site. Bags should not be placed within or near road or forest drains, and they should be removed from the site at the end of each day. [ABSTRACT FROM AUTHOR]

Background: The UK Department for Work and Pensions (DWP) administers Universal Credit (UC) – the main UK benefit for people in- and out-of-work. UC is being rolled out nationally from 2013 to 2024. Citizens Advice (CA) is an independent charity that provides advice and support to people making a claim for UC. The aim of this study is to understand who is seeking advice from CA when making a UC claim and how the types of people seeking advice are changing as the rollout of UC continues. Methods: Co-developed with Citizens Advice Newcastle and Citizens Advice Northumberland we performed longitudinal analysis of national data from Citizens Advice for England and Wales on the health (mental health and limiting long term conditions) and socio-demographic of 1,003,411 observations for people seeking advice with claiming UC over four financial years (2017/18 to 2020/21). We summarised population characteristics and estimated the differences between the four financial years using population-weighted t-tests. Findings were discussed with three people with lived experience of seeking advice to claim UC to help frame our interpretation and policy recommendations. Results: When comparing 2017/18 to 2018/19, there was a significantly higher proportion of people with limiting long term conditions seeking advice with claiming UC than those without (+ 2.40%, 95%CI: 1.31-3.50%). However, as the rollout continued between 2018/29 and 2019/20 (-6.75%, 95%CI: -9.62%--3.88%) and between 2019/20 and 2020/21 (-2.09%, 95%CI: -2.54%--1.64%), there were significantly higher proportions of those without a limiting long term condition seeking advice than with. When comparing 2018/19 to 2019/20 and 2019/20 to 2020/21, there was a significant increase in the proportion of self-employed compared to unemployed people seeking advice with claiming UC (5.64%, 95%CI: 3.79-7.49%) and (2.26%, 95%CI: 1.29-3.23%) respectively. Conclusion: As the rollout for UC continues, it is important to understand how changes in eligibility for UC may impact on those who need help with applying for UC. Ensuring that the advice process and application process is responsive to a range of people with different needs can help to reduce the likelihood that the process of claiming UC will exacerbate health inequalities. [ABSTRACT FROM AUTHOR]

Background: Individuals from minority ethnic groups in the UK are thought to be at higher risk of developing dementia while facing additional barriers to receiving timely care. However, few studies in the UK have examined if there are ethnic disparities in survival once individuals receive a dementia diagnosis. Methods: We conducted a retrospective cohort study using electronic health record data of individuals diagnosed with dementia from a large secondary mental healthcare provider in London. Patients from Black African, Black Caribbean, South Asian, White British, and White Irish ethnic backgrounds were followed up for a 10-year period between 01 January 2008 and 31 December 2017. Data were linked to death certificate data from the Office of National Statistics to determine survival from dementia diagnosis. Standardised mortality ratios were calculated to estimate excess deaths in each ethnicity group as compared to the gender- and age-standardised population of England and Wales. We used Cox regression models to compare survival after dementia diagnosis across each ethnicity group. Results: Mortality was elevated at least twofold across all ethnicity groups with dementia compared to the general population in England and Wales. Risk of death was lower in Black Caribbean, Black African, White Irish, and South Asian groups as compared to the White British population, even after adjusting for age, gender, neighbourhood-level deprivation, indicators of mental and physical comorbidities. Risk of death remained lower after additionally accounting for those who emigrated out of the cohort. Conclusions: While mortality in dementia is elevated across all ethnic groups as compared to the general population, reasons for longer survival in minority ethnic groups in the UK as compared to the White British group are unclear and merit further exploration. Implications of longer survival, including carer burden and costs, should be considered in policy and planning to ensure adequate support for families and carers of individuals with dementia. [ABSTRACT FROM AUTHOR]

Background: One of the many challenges faced by mental health services during the COVID-19 pandemic was how to deliver care during lockdown. In community and crisis services, this often meant rapidly adopting or expanding the use of telemental health technologies, including phone and video calls. The aim of this study is to explore variations in use and report staff views of such technologies during the early stages of the pandemic. The primary analysis compared rates of use between professions, demographic groups, genders, regions, and crisis and community services. Methods: We used data from an online survey conducted by the Mental Health Policy Research Unit in Spring 2020 regarding the impact of the pandemic on mental healthcare in the United Kingdom. We included quantitative data from all professional groups working in community or crisis services providing care to working age adults, including general and specialist services. Our outcome of interest was the percentage of clients whom clinicians primarily interacted with via videocall. We also collected demographics and professional characteristics such as the type of mental health service respondents worked in. In addition, we explored respondents' views and experiences of telemental health as a medium for providing care. Results: 978 participants were included in the primary analysis (834 provided outcome data for community services, 193 for crisis services). In community services, virtually all staff reported stopping some or all face-to-face appointments following the onset of the pandemic, with a large majority using video or phone call appointments where possible instead. Telemental health use was higher in community than in crisis services, and amongst professionals who mainly provided psychotherapy or peer support than in other groups. There was also evidence of use being lower in regions in Northern England, Scotland, and Wales than elsewhere. There was no evidence of an association with staff gender, age, or ethnicity. Staff were generally positive about telemental health and intended to make more use of technologies following the pandemic. However, significant barriers to its use were also reported, often involving skills and available infrastructure. Conclusions: Despite its rapid implementation, telemental health was viewed positively by clinicians who saw it as an effective alternative to face-to-face appointments in some contexts, including during the pandemic. However, adoption of the technology also has the potential to exacerbate existing or create new inequalities without effective management of training and infrastructure needs. [ABSTRACT FROM AUTHOR]

Background: Inequalities between different areas in the United Kingdom (UK) according to health and employment outcomes are well-documented. Yet it is unclear which health indicator is most closely linked to labour market outcomes, and whether associations are restricted to the older population.Methods: We used the Office for National Statistics (ONS) Longitudinal Study (LS) to analyse which measures of health-in-a-place were cross-sectionally associated with three employment outcomes in 2011: not being in paid work, working hours (part-time, full-time), and economic inactivity (unemployed, retired, sick/disabled, other). Seven health indicators from local-authority census and vital records data were chosen to represent the older working age population (self-rated health 50-74y, long-term illness 50-74y, Age-specific mortality rate 50-74y, avoidable mortality, life expectancy at birth and 65 years, disability-free life expectancy at 50 years, and healthy life expectancy at 50 years). An additional two health indicators (life expectancy at birth and infant mortality rate) were included as test indicators to determine if associations were limited to the health of older people in a place. These nine health indicators were then linked with the LS sample aged 16-74y with data on employment outcomes and pertinent demographic and individual health information. Interactions by gender and age category (16-49y vs. 50-74y) were also tested.Findings: For all health-in-a-place measures, LS members aged 16-74 who resided in the tertile of local authorities with the 'unhealthiest' older population, had higher odds of not being in paid work, including all four types of economic inactivity. The strongest associations were seen for the health-in-a-place measures that were self-reported, long-term illness (Odds Ratio 1.60 [95% Confidence Intervals 1.52, 1.67]) and self-rated health (1.60 [1.52, 1.68]). Within each measure, associations were slightly stronger for men than women and for the 16-49y versus 50-74y LS sample. In models adjusted for individual self-rated health and gender and age category interactions, health-in-a-place gradients were apparent across all economic inactivity's. However, these same gradients were only apparent for women in part-time work and men in full-time work.Conclusion: Improving health of older populations may lead to wider economic benefits for all. [ABSTRACT FROM AUTHOR]

Silvopastoral agroforestry and the strategic placement of trees and hedgerows offers potential to improve livestock welfare and production efficiency through the provision of shelter in livestock farming systems. The aim of this study was to investigate the relationship between shelter-seeking behaviour of ewes during the lambing period and the microclimate influenced by landscape shelter features. Artificial and natural shelter was provided to Aberfield ewes (n = 15) on an upland sheep farm in Wales, UK, which were then continuously monitored for 14 days using global positioning system tracking devices. Modelling of microclimate influenced by topographical shelter features at the test site was used to generate a 1 m resolution wind field for geospatial statistical analysis of localised wind speed. Ewes demonstrated an increased preference for natural (3.4-fold; p < 0.01) and artificial (3.0-fold; p < 0.05) shelter zones five times the height of the shelter, compared to the exposed area of the trial site. Wind-chill and modelled local-scale wind speeds were found to have the greatest influence on shelter-seeking behaviour, with temperature and field-scale wind speed significantly influencing livestock behaviour. Mean wind-chill temperature during the trial was 3.7 °C (min −5.3 °C; max 13.1 °C), which is within the cold stress temperature threshold (−3 and 8 °C) that requires thermoregulatory strategies such as shelter-seeking behaviour. An improved understanding of the relationship between microclimate and shelter-seeking behaviour in sheep, demonstrated through the agent-based model developed in this project, shall better inform the economic incentives (e.g., reduction in lamb mortality and forage requirements) behind silvopastoral practices that benefit farm productivity, livestock welfare and the environment. [ABSTRACT FROM AUTHOR]

A crucial step in the evolution of Euarthropoda (chelicerates, myriapods, pancrustaceans) was the transition between fossil groups that possessed frontal appendages innervated by the first segment of the brain (protocerebrum), and living groups with a protocerebral labrum and paired appendages innervated by the second brain segment (deutocerebrum). Appendage homologies between the groups are controversial. Here we describe two specimens of opabiniid-like euarthropods, each bearing an anterior proboscis (a fused protocerebral appendage), from the Middle Ordovician Castle Bank Biota, Wales, UK. Phylogenetic analyses support a paraphyletic grade of stem-group euarthropods with fused protocerebral appendages and a posterior-facing mouth, as in the iconic Cambrian panarthropod Opabinia. These results suggest that the labrum may have reduced from an already-fused proboscis, rather than a pair of arthropodized appendages. If some shared features between the Castle Bank specimens and radiodonts are considered convergent rather than homologous, phylogenetic analyses retrieve them as opabiniids, substantially extending the geographic and temporal range of Opabiniidae. Here, the authors describe two opabiniid-like euarthropods with anterior proboscises from the Middle Ordovician Castle Bank Biota, Wales, UK. Phylogenetic analysis suggests that these specimens may be sister to radiodonts and deuteropods. [ABSTRACT FROM AUTHOR]

In this article, we present the use of the coupled land surface model and groundwater flow model SWAT-MODFLOW with the decision support tool WEAP (Water Evaluation and Planning software) to predict future surface-water abstraction scenarios in a complex river basin under conditions of climate change. The modelling framework is applied to the Dee River catchment in Wales, United Kingdom. Regarding hydrology, the coupled model improves overall water balance and low-streamflow conditions compared with a stand-alone SWAT model. The calibrated SWAT-MODFLOW is employed with high-resolution climate model data from the UKCP18 project with the future scenario of RCP85 from 2020 to 2040. Then, water supply results from SWAT-MODFLOW are fed into WEAP as input for the river reach in the downstream region of the river basin. This system is utilized to create various future scenarios of the surface-water abstraction of public water supply in the downstream region—maximum licensed withdraw, 50% authorized abstractions, monthly time series with 1% increases in water use, and maximum water withdraw per year based on historical records repeated every year with 1% increases in water use—to estimate the unmet demands and streamflow requirement. This modelling approach can be used in other river basins to manage scenarios of supply and demand. [ABSTRACT FROM AUTHOR]

The European polecat (Mustela putorius) is a mammalian predator which occurs across much of Europe east to the Ural Mountains. In Great Britain, following years of persecution the range of the European polecat contracted and by the early 1900s was restricted to unmanaged forests of central Wales. The European polecat has recently undergone a population increase due to legal protection and its range now overlaps that of feral domestic ferrets (Mustela putorius furo). During this range expansion, European polecats hybridized with feral domestic ferrets producing viable offspring. Here, we carry out population-level whole-genome sequencing on 8 domestic ferrets, 19 British European polecats, and 15 European polecats from the European mainland. We used a range of population genomics methods to examine the data, including phylogenetics, phylogenetic graphs, model-based clustering, phylogenetic invariants, ABBA-BABA tests, topology weighting, and Fst. We found high degrees of genome introgression in British polecats outside their previous stronghold, even in those individuals phenotyped as "pure" polecats. These polecats ranged from presumed F1 hybrids (gamma = 0.53) to individuals that were much less introgressed (gamma = 0.2). We quantify this introgression and find introgressed genes containing Fst outliers associated with cognitive function and sight. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES We sought to evaluate the impact of different national clinical guidelines (with consistent and conflicting recommendations) on clinician's practice in the UK. METHODS In this cohort study, we analysed data from National Lung Cancer Audit comprising all patients diagnosed with lung cancer between 2008 and 2013 within England and Wales for consistent (British Thoracic Society and National Institute of Clinical Excellence) recommendations for lower/more permissive lung function but opposing stage (N2) selection parameters for surgery. RESULTS From 2008 to 2013, data from 167 192 patients with primary lung cancers were included. The proportion of patients undergoing surgery for lung cancer increased from 9.5% to 20.5% in 2013 (P  < 0.001) as the number of general thoracic surgeons in the UK increased from 40 to 81 in the corresponding timeframe. Mean forced expiratory volume in 1 s of surgical patients increased from 76% (22) to 81% (22) in 2013 (P  < 0.001). Of the patients undergoing surgery, the proportion of patients with N2 disease across the 6-year interval was broadly consistent between 8% and 11% without any evidence of trend (P  = 0.125). CONCLUSIONS Within 3 years of new clinical guideline recommendations, we did not observe any overall change suggesting greater selection for surgery on lower levels of lung function. When presented with conflicting recommendation, no observable change in selection was noted on surgery for N2 disease. The observed increase in surgical resection rates is more likely due to greater access to surgery (by increasing number of surgeons) rather than any impact of guideline recommendations. [ABSTRACT FROM AUTHOR]

Wales is one of the world leaders in household waste recycling with a steady recent recycling rate of ~65%. The Welsh Assembly Government (WAG) set a statutory target of achieving a 70% recycling rate by 2024/25. We reviewed historical trends in waste management in Wales from 2006 to 2020, with a focus on recycling. Authoritative, official data were obtained from WasteDataFlow, an Internet system for municipal waste data reporting by UK local authorities to government. Data are collected quarterly allowing the generation of time series plots, trendlines and like-for-like comparisons between groupings of various characteristics, such as number of separate kerbside collections, income, political preference, and impact of policy changes. Results showed that the approach taken by the WAG to politically prioritise and encourage participation in household recycling has achieved impressive results that contrast starkly with the recycling performance of other UK countries. In Wales, household waste disposed annually per person via landfill decreased from ~410 kg to <50 kg and household waste recycled increased from to ~150 kg to ~310 kg, with a recent increase in incineration with energy recovery to ~135 kg as infrastructure has come online. Recycling rates show a seasonal variation due to increases in garden waste sent for composting in the summer. There are variations in local authority performance across Wales, mainly caused by variations in the number of separate collections. Co-mingled collections tend to lead to higher contamination of recyclates that are then not able to be sold for recycling. Deprivation, as indicated by differences in income, also influences total waste arisings and recycling rates. A plateau of ~65% recycling rate was reached in 2020, with incineration reaching a rate of >25%. The recycling rate plateaus at exactly the same time as incineration comes on stream. Evidence demonstrates that improvements to recycling rates can become more difficult when incineration becomes available. Whilst further reductions and improvements to recycling in Wales will be more challenging, the WAG's track record of focused proactive political and policy support shows what can be achieved when there is suitable political will. The WAG has demonstrated that it tends to deliver on its waste-related plans, and it clearly has the best chance of any of the UK's four countries of achieving its aims. [ABSTRACT FROM AUTHOR]

Debate around Wales' place in the United Kingdom has intensified over recent years, with radically differing visions for the union of the Welsh and UK governments emerging alongside growing (though still minority) support for Welsh independence. This article argues that these constitutional debates must be considered alongside Wales' current fiscal position. Wales' estimated fiscal deficit is reflective of long-standing economic underperformance as part of the UK, which we argue is unlikely to be addressed under current economic, fiscal and constitutional arrangements. On the other hand, it also suggests a difficult economic outlook for an independent Wales, which would require tough fiscal and economic choices to address Wales' apparent balance of payments deficit. [ABSTRACT FROM AUTHOR]

The British forestry sector lacks reliable dynamic growth models for stands of improved Sitka spruce, the most important commercial forest type in Great Britain. The aim of this study is to fill this gap by trialling a new modelling framework and to lay the foundations of a future dynamic growth simulator for that forest type. First, we present single tree diameter and height increment models that are climate sensitive and include explicit competition effects. The predictions from the increment models are pooled to project diameter and height at a given age. These projections are then used as inputs to an integrated taper model from which stochastic tree volume predictions are obtained. Retrospective data from over 1400 trees collected in two extensive genetic trials in Scotland and Wales were used for the purposes of this study. Diameter increment and height increment predictions were highly accurate and diameter and height projections proved consistent. The predicted volume at the time of harvesting also exhibited a high degree of accuracy, which shows the robustness of our approach. Further data will be needed in the future to recalibrate the present models and extend their range of validity to the whole of Great Britain. [ABSTRACT FROM AUTHOR]

The thin layer of soil at the earth's surface supports life, storing water and nutrients for plant uptake. These processes occur in the soil pore space, often half the soil volume, but our understanding of how this volume responds to environmental change is poor. Convention, has been to predict soil porosity, or its reciprocal bulk density (BD), from soil texture using pedotransfer functions (PTFs). A texture based approach, invariant to environmental change, prevents feedback from land use or climate change to soil porosity. Moreover, PTFs are often limited to mineral soils with < 20% soil organic matter (SOM) content. Here, we develop an analytical model to predict soil porosity, or BD, as a function of SOM. We test it on two comprehensive, methodologically consistent, temperate national-scale topsoil data sets (0–15 cm) (Wales, n = 1385; Great Britain, n = 2570). The purpose of the approach is to generate an analytical function suitable for predicting soil porosity change with SOM content, while providing insight into the main grain-scale factors determining the porosity emergence. The newly developed function covering the entire SOM gradient allows for impacts of land use, management or climate change to feedback on soil porosity or bulk density through decadal dynamic changes in SOM. [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]

Background: Chronic kidney disease (CKD) typically co-exists with multimorbidity (presence of 2 or more long-term conditions: LTCs). The associations between CKD, multimorbidity and hospitalisation rates are not known. The aim of this study was to examine hospitalisation rates in people with multimorbidity with and without CKD. Amongst people with CKD, the aim was to identify risk factors for hospitalisation.Methods: Two cohorts were studied in parallel: UK Biobank (a prospective research study: 2006-2020) and Secure Anonymised Information Linkage Databank (SAIL: a routine care database, Wales, UK: 2011-2018). Adults were included if their kidney function was measured at baseline. Nine categories of participants were used: zero LTCs; one, two, three and four or more LTCs excluding CKD; and one, two, three and four or more LTCs including CKD. Emergency hospitalisation events were obtained from linked hospital records.Results: Amongst 469,339 UK Biobank participants, those without CKD had a median of 1 LTC and those with CKD had a median of 3 LTCs. Amongst 1,620,490 SAIL participants, those without CKD had a median of 1 LTC and those with CKD had a median of 5 LTCs. Compared to those with zero LTCs, participants with four or more LTCs (excluding CKD) had high event rates (rate ratios UK Biobank 4.95 (95% confidence interval 4.82-5.08)/SAIL 3.77 (3.71-3.82)) with higher rates if CKD was one of the LTCs (rate ratios UK Biobank 7.83 (7.42-8.25)/SAIL 9.92 (9.75-10.09)). Amongst people with CKD, risk factors for hospitalisation were advanced CKD, age over 60, multiple cardiometabolic LTCs, combined physical and mental LTCs and complex patterns of multimorbidity (LTCs in three or more body systems).Conclusions: People with multimorbidity have high rates of hospitalisation. Importantly, the rates are two to three times higher when CKD is one of the multimorbid conditions. Further research is needed into the mechanism underpinning this to inform strategies to prevent hospitalisation in this very high-risk group. [ABSTRACT FROM AUTHOR]

Background: Drones are increasingly used in healthcare, and feasibility studies of deployment of Automated External Defibrillators (AED) in Out-of-hospital cardiac arrest (OHCA) have been conducted. Despite the potential contribution of drones to healthcare, regulatory barriers exist, including limits on flights beyond visual line-of-sight (BVLOS). The aim of this project was to deliver an AED BVLOS in Wales. Methods: We developed of a Concept of Operations (CONOPS) to identify requirements, constraints, organisation and roles and responsibilities associated with deploying a drone to deliver an AED BVLOS. We equipped a Penguin B drone with satellite-enabled technology to enhance situational awareness and safety for the remote pilot. A BVLOS Operating Safety Case and three-week flight test programme was conducted with an AED attached directly to parachute for deployment to simulated OHCA. Results: We completed six flights totalling 92km, 1:02.5 hours of flight time and four successful parachute payload drops. We conducted a successful end-to-end flight demonstration of an AED delivered via BVLOS by drone to a simulated OHCA and resuscitation by lay responder's in a remote location; the final delivery of 4.5km was completed in 2:50 minutes. Conclusion: We have delivered an AED by parachute, from fixed wing drone BVLOS in the UK in simulated OHCA. This project adds to the body of knowledge required for regulatory assurance on drone use BVLOS. Further research is needed before routine use of this technology. [ABSTRACT FROM AUTHOR]

Background: Over ten years on from a randomised controlled trial and subsequent national roll-out, the National Exercise Referral Scheme (NERS) continues to be routinely delivered in primary care across Wales, UK. Few studies have revisited effective interventions years into their delivery in routine practice to understand how implementation, and perceived effects, have been maintained over time. This study explores perceptions and experiences of referral to NERS among referrers, scheme deliverers and patients.Methods: Individual, semi-structured interviews were conducted with 50 stakeholders: scheme referrers (n = 9); scheme deliverers (n = 22); and referred patients (n = 19). Convenience sampling techniques were used to recruit scheme referrers and purposive sampling to recruit scheme deliverers and patients. Thematic analysis was employed.Results: Analyses resulted in five key themes; referrer characteristics, geographical disparities in referral and scheme access, reinforcements for awareness of the scheme, patient characteristics and processes and context underpinning a referral. Overall there was a high concordance of views between all three stakeholder groups and barriers and facilitators were found to be entwined within and across themes. Referral barriers persisting since the earlier trial included a lack of consultation time and a lack of referral feedback. Newly identified barriers included a lack of scheme awareness and a referral system perceived to be time intensive and disjointed. Key referral facilitators included patient self-referrals, a growing scheme reputation and promotional activities of scheme deliverers.Conclusions: Findings provide evidence that could inform the further development of NERS and wider exercise referral schemes to ensure the referral process is timely, efficient and equitable. [ABSTRACT FROM AUTHOR]

Public perceptions of pandemic viral threats and government policies can influence adherence to containment, delay, and mitigation policies such as physical distancing, hygienic practices, use of physical barriers, uptake of testing, contact tracing, and vaccination programs. The UK COVID-19 Public Experiences (COPE) study aims to identify determinants of health behaviour using the Capability, Opportunity, Motivation (COM-B) model using a longitudinal mixed-methods approach. Here, we provide a detailed description of the demographic and self-reported health characteristics of the COPE cohort at baseline assessment, an overview of data collected, and plans for follow-up of the cohort. The COPE baseline survey was completed by 11,113 UK adult residents (18+ years of age). Baseline data collection started on the 13th of March 2020 (10-days before the introduction of the first national COVID-19 lockdown in the UK) and finished on the 13th of April 2020. Participants were recruited via the HealthWise Wales (HWW) research registry and through social media snowballing and advertising (Facebook®, Twitter®, Instagram®). Participants were predominantly female (69%), over 50 years of age (68%), identified as white (98%), and were living with their partner (68%). A large proportion (67%) had a college/university level education, and half reported a pre-existing health condition (50%). Initial follow-up plans for the cohort included in-depth surveys at 3-months and 12-months after the first UK national lockdown to assess short and medium-term effects of the pandemic on health behaviour and subjective health and well-being. Additional consent will be sought from participants at follow-up for data linkage and surveys at 18 and 24-months after the initial UK national lockdown. A large non-random sample was recruited to the COPE cohort during the early stages of the COVID-19 pandemic, which will enable longitudinal analysis of the determinants of health behaviour and changes in subjective health and well-being over the course of the pandemic. [ABSTRACT FROM AUTHOR]

The use of regulation of sex work is undergoing sweeping changes across Europe and client criminalization is becoming very widespread, with conflicting claims about the intended and actual consequences of this policy. We discuss changes in demand for paid sex accompanying the criminalization of prostitution in the United Kingdom, which moved from a relatively permissive regime under the Wolfenden Report of 1960, to a much harder line of aiming to crack down on prostitution with the Prostitution (Public Places) Scotland Act 2007 and the Policing and Crime Act of 2009 in England and Wales. We make use of two waves of the British National Survey of Sexual Attitudes and Lifestyles (NATSAL2, conducted in 2000–2001 and NATSAL3, conducted in 2010–2012) to document the changes in both the amount of demand for paid sex and in the type of clients that have taken place across the two waves, and their possible implications for policies that frame prostitution as a form of crime. [ABSTRACT FROM AUTHOR]

Action Levels (ALs) are thresholds which are used to determine whether dredged material is suitable for disposal at sea by providing a proxy risk assessment for potential impacts to biological features such as fish and benthos. This project tested proposed scenarios for changes to the UK Action Levels to determine the likely implications for navigational dredge licensing in England and Wales. Approximately 3000 sample data records from 2009 to 2018 were collated with varying numbers of concentrations for contaminant parameters including trace metals, organotins, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) and polybrominated diphenyl ethers (PBDEs). Initially, these data were assessed using current ALs to determine the percentages of the samples with levels below AL1 (generally acceptable for disposal), between AL1 and AL2 and those showing levels above AL2 (generally unacceptable for disposal). These results were then used to compare with the results of the proposed new AL scenarios for each contaminant type derived from literature reviews and historic data. The results indicate that there are changes to the ALs which could be made such as updating the current ALs with the revised ALs, as well as the introduction of ALs where there are currently none set. The benefits of changing the ALs include reducing contaminant disposal to the marine environment and increased transparency in decision making. Any proposed scenarios will need to be phased in carefully in full liaison with stakeholders. [ABSTRACT FROM AUTHOR]