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Although the relationship between religion and football has gained considerable interest during the last twenty years, scant attention has been paid to the relationship between pilgrimage and football. This paper seeks to advance the study of this relationship through an exploration of collective memory about football disasters that throws fresh light on central themes within pilgrimage studies—pilgrimage as both a journey to a sacred place and the performance of diverse rituals at such places. The paper explores, in particular, the ways in which three different tragedies involving English football clubs have been commemorated through journeys to and ritual performance at places seen as sacred to those involved in commemoration—football stadiums and urban spaces, and cathedrals and pilgrimage shrines in England, Germany and Italy. Through this analysis, we seek to show how the commemoration of football disaster is linked to pilgrimage as a process where people seek healing and reconciliation through the public performance of rituals that link the local to the global. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to gain consensus among young people with a stoma due to inflammatory bowel disease (IBD) on the priorities for the content of an intervention for the self‐management of stoma‐related distress. The current identification and management of distress in young people with a stoma is often suboptimal in clinical settings and there is a need for improved support resources. Methods: Two consensus group meetings were carried out via online video conferencing, using nominal group technique. Participants generated, rated on a Likert scale and discussed, topics for inclusion in a future self‐management intervention. Results: Nineteen young people, aged 19–33, with a stoma due to IBD took part in one of two group meetings. Participants were located across England, Scotland, and Northern Ireland. Twenty‐nine topics were generated by participants, seven of which reached consensus of ≥80%, that is, a mean of ≥5.6 on a 7‐point Likert scale. These were: receiving advice from young people with lived experience of stoma surgery; advice on/addressing concerns about romantic relationships, sex and intimacy; information about fertility and pregnancy related to stoma surgery; stoma 'hacks', for example, useful everyday tips regarding clothing, making bag changes easier and so forth; reflecting on and recognising own emotional response to surgery; tips on managing the stoma during the night; and processing trauma related to the illness and surgery journey. Conclusions: Findings extend previous research on young people's experiences of stoma surgery, by generating consensus on young people's priorities for managing distress related to surgery and living with a stoma. These priorities include topics not previously reported in the literature, including the need for information about fertility and pregnancy. Findings will inform the development of a self‐management resource for young people with an IBD stoma and have relevance for the clinical management of stoma‐related distress in this population. Patient or Public Contribution: Three patient contributors are co‐authors on this paper, having contributed to the study design, interpretation of results and writing of the manuscript. The study's Patient and Public Involvement and Engagement advisory group also had an integral role in the study. They met with the research team for four 2‐h virtual meetings, giving input on the aims and purpose of the study, recruitment methods, and interpretation of findings. The group also advised on the age range for participants. The views of young people with a stoma are the central component of the study reported in this paper, which aims to gain consensus among young people with an IBD stoma on their priorities for the content of a resource to self‐manage distress related to stoma surgery. [ABSTRACT FROM AUTHOR]

Introduction: Developments in information and communication technologies have enabled electronic health and seen a huge expansion over the last decade. This has increased the possibility of self-management of health issues. Purpose: To assess the effectiveness of the Baby Buddy app on maternal self-efficacy and mental well-being three months post-birth in a sample of mothers recruited antenatally. In addition, to explore when, why and how mothers use the app and consider any benefits the app may offer them in relation to their parenting, health, relationships or communication with their child, friends, family members or health professionals. Methods: We will use a mixed-methods approach, a cohort study, a qualitative element and analysis of in-app data. Participants will be first-time pregnant women, aged 16 years and over, between 12 and 16 weeks of gestation and recruited from five English study sites. Evaluation plan: We will compare maternal self-efficacy and mental health at three months post-delivery in mothers who have downloaded the Baby Buddy app compared with those that have not downloaded the app, controlling for confounding factors. Women will be recruited antenatally between 12 and 16 weeks of gestation. Further follow-ups will take place at 35 weeks of gestation and three months post-birth. Data from the cohort study will be supplemented by in-app data that will include, for example, patterns of usage. Qualitative data will assess the impact of the app on the lives of pregnant women and health professionals using both focus groups and interviews. Ethics: Approval from the West Midlands-South Birmingham Research Ethics Committee (NRES) (16/WM/0029) and the University of the West of England, Bristol, Research Ethics Committee (HAS.16.08.001). Dissemination: Findings of the study will be published in peer reviewed and professional journals, presented locally, nationally and at international conferences. Participants will receive a summary of the findings and the results will be published on Best Beginnings' website. [ABSTRACT FROM AUTHOR]

The critique of planning and new proposals to reform the English planning system and "rethink planning from first principles" have led to the introduction of rules-based principles into what is regarded as the paradigm of a discretionary planning system, culminating in a recent White Paper, which it is claimed will create a faster and better planning system than the existing discretionary approach. But are these proposals based on an oversimplified understanding of the differences between discretionary and regulatory models, neglecting, for example, the negotiation between stakeholders and the flexibility which also exists in regulatory planning systems? Our contribution will review some of the recent changes of the English planning system and reflect on experiences with zoning in European countries to bust the myth that the planning reform claims to address: the possibility to combine faster decision making with better place making and less interference from local planning authorities. [ABSTRACT FROM AUTHOR]

Background: Childhood, adolescent and young adult (CAYA) cancer survivors are vulnerable to adverse late-effects. For CAYA cancer survivors, tobacco smoking is the most important preventable cause of ill-health and early death. Yet, effective strategies to support smoking cessation in this group are lacking. The PRISM study aims to undertake multi-method formative research to explore the need for, and if appropriate, inform the future development of an evidence-based and theory-informed tobacco smoking cessation intervention for CAYA cancer survivors. Materials and methods: PRISM involves three phases of: 1) an environmental scan using multiple strategies to identify and examine a) smoking cessation interventions for CAYA cancer survivors that are published in the international literature and b) current smoking cessation services in England that may be available to, or tailorable to, CAYA cancer survivors; 2) a qualitative study involving semi-structured interviews with CAYA cancer survivors (aged 16–29 years and who are current or recent ex-smokers and/or current vapers) to explore their views and experiences of smoking, smoking cessation and vaping; and 3) stakeholder workshops with survivors, healthcare professionals and other stakeholders to consider the potential for a smoking cessation intervention for CAYA cancer survivors and what such an intervention would need to target and change. Findings will be disseminated to patient groups, healthcare professionals and researchers, through conference presentations, journal papers, plain English summaries and social media. Discussion: PRISM will explore current delivery of, perceived need for, and barriers and facilitators to, smoking cessation advice and support to CAYA cancer survivors from the perspective of both survivors and healthcare professionals. A key strength of PRISM is the user involvement throughout the study and the additional exploration of survivors' views on vaping, a behaviour which often co-occurs with smoking. PRISM is the first step in the development of a person-centred, evidence- and theory-based smoking cessation intervention for CAYA cancer survivors who smoke, which if effective, will reduce morbidity and mortality in the CAYA cancer survivor population. [ABSTRACT FROM AUTHOR]

Background: The Brief Educational Workshops in Secondary Schools Trial (BESST) is an England-wide school-based cluster randomised controlled trial assessing the clinical and cost-effectiveness of an open-access psychological workshop programme (DISCOVER) for 16–18-year-olds. This baseline paper describes the self-referral and other recruitment processes used in this study and the baseline characteristics of the enrolled schools and participants. Method: We enrolled 900 participants from 57 Secondary schools across England from 4th October 2021 to 10th November 2022. Schools were randomised to receive either the DISCOVER day-long Stress workshop or treatment as usual which included signposting information. Participants will be followed up for 6 months with outcome data collection at baseline, 3-month, and 6-month post randomisation. Results: Schools were recruited from a geographically and ethnically diverse sample across England. To reduce stigma, students were invited to self-refer into the study if they wanted help for stress. Their mean age was 17.2 (SD = 0.6), 641 (71%) were female and 411 (45.6%) were from ethnic minority groups. The general wellbeing of our sample measured using the Mood and Feelings Questionnaire (MFQ) found 314 (35%) of students exhibited symptoms of depression at baseline. Eighty percent of students reported low wellbeing on the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) suggesting that although the overall sample mean is below the cut-off for depression, the self-referral approach used in this study supports distressed students in coming forward. Conclusion: The BESST study will continue to follow up participants to collect outcome data and results will be analysed once all the data have been collected. Trial registration: ISRCTN registry ISRCTN90912799. Registered on 28 May 2020. [ABSTRACT FROM AUTHOR]

Coronavirus disease-19 (COVID-19) has disproportionately affected certain demographics in England, exacerbating existing health disparities. Effective therapeutics are a critical line of defence against COVID-19, particularly for patients at elevated risk for severe disease. Surveillance systems were established to monitor the usage of COVID-19 therapeutics in hospital and community settings and to inform stewardship. Three antiviral therapies—nirmatrelvir plus ritonavir (Paxlovid®), remdesivir (Veklury®), and molnupiravir (Lagevrio®)—and two neutralising monoclonal antibody therapies (nMAbs)—sotrovimab (Xevudy®) and casirivimab with imdevimab (Ronapreve®)—were in use in England between July 2020 and April 2023. This paper aims to illuminate trends in the utilisation of COVID-19 therapeutics treatment in both hospital and community settings, stratified by the Index of Multiple Deprivation (IMD) in England. Chapter 3 of the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) Report 2022 to 2023 also discusses the epidemiological surveillance of these five directly acting antiviral COVID-19 therapeutics' use in England between 2022 and 2023. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this paper is to investigate what factors are associated to cardiovascular disease and what differences exists between Asians living in the UK (from the English Longitudinal Study of Ageing) and the Asians living in India (from the Longitudinal Ageing Study in India). Methods: Logistic regression was used to investigate how demographic and physical performance factors were associated with cardiovascular disease using data from Wave 6 of the English Longitudinal Study of Ageing and Wave 1 of the Longitudinal Study of Ageing in India, with the main variable of interest being country of residence, Asians in England or Asians in India. Results: A total of 83,997 participants were included in the analyses. In the primary analysis, 73,396 participants from LASI were compared to 171 Asians in ELSA. After adjusting for age, blood pressure, resting heart rate, sex, waist circumference, gait, handgrip strength and standing balance, there was a statistically significant difference for the outcome of CVD between Whites ELSA (reference) and the participants of LASI (odds ratio = 0.77; 95% confidence interval = 0.60 to 0.99). There were no significant differences in CVD between the LASI participants, Asian ELSA, and the Non-White but not Asian ELSA groups. Discussion: No difference was found between Asians that live in India compared to ethnic minorities living in England, including Asians, after adjusting for confounders, but was found between Whites in ELSA compared to LASI participants. A key limitation was the massive disparity in sample sizes between the ELSA subgroups and LASI. Further work is required where comparable sample sizes and longitudinal analyses allow trends to be identified and to investigate the factors associated with the difference in CVD between two similar ethnicities living in distinct locations. Conclusion: After adjusting for risk factors, there was no difference in CVD between localised Asians and the ethnic minorities in the UK, but there was a difference between the majority ethnicities in the respective countries. [ABSTRACT FROM AUTHOR]

It seems probable that some form of medically-assisted dying will become legal in England and Wales in the foreseeable future. Assisted dying Bills are at various stages of preparation in surrounding jurisdictions (Scotland, Republic of Ireland, Isle of Man, Jersey), and activists campaign unceasingly for a change in the law in England and Wales. There is generally uncritical supportive media coverage, and individual autonomy is seen as the unassailable trump card: 'my life, my death'. However, devising a law which is 'fit for purpose' is not an easy matter. The challenge is to achieve an appropriate balance between compassion and patient autonomy on the one hand, and respect for human life generally and medical autonomy on the other. More people should benefit from a change in the law than be harmed. In relation to medically-assisted dying, this may not be possible. Protecting the vulnerable is a key issue. Likewise, not impacting negatively on societal attitudes towards the disabled and frail elderly, particularly those with dementia. This paper compares three existing models of physician-assisted suicide: Switzerland, Oregon (USA), and Victoria (Australia). Vulnerability and autonomy are discussed, and concern expressed about the biased nature of much of the advocacy for assisted dying, tantamount to disinformation. A 'hidden' danger of assisted dying is noted, namely, increased suffering as more patients decline referral to palliative-hospice care because they fear they will be 'drugged to death'. Finally, suggestions are made for a possible 'least worse' way forward. One solution would seem to be for physician-assisted suicide to be the responsibility of a stand-alone Department for Assisted Dying overseen by lawyers or judges and operated by technicians. Doctors would be required only to confirm a patient's medical eligibility. Palliative-hospice care should definitely not be involved, and healthcare professionals must have an inviolable right to opt out of involvement. There is also an urgent need to improve the provision of care for all terminally ill patients. [ABSTRACT FROM AUTHOR]

Background: Globally, it is estimated that one in three adults live with two or more long‐term conditions (multiple long‐term conditions, MLTCs), that require self‐management. People who experience socioeconomic deprivation face significant health inequalities due to a range of interrelated characteristics that lead to a lack of resources and opportunities. Previous research with underserved populations indicate low levels of trust towards primary care providers and potential barriers for developing patient‐healthcare professional relationships. The purpose of this paper is to explore the barriers and facilitators to self‐managing MLTCs, amongst people who experience socioeconomic deprivation. Methods: Semistructured one‐to‐one interviews with adults (n = 28) living in London and Sheffield, United Kingdom with MLTCs who are experiencing socioeconomic deprivation. Participants were recruited through general practices, community channels and social media. Data were analysed in NVivo using reflexive thematic analysis methods. Findings: Four analytical themes were developed: (1) challenges in accessing healthcare services, financial assistance, and cultural awareness; (2) empowerment and disempowerment through technology, including digital exclusion, and use of technology; (3) impact and causes of exclusion on self‐management, including social isolation, area‐based and economic exclusion, and health‐related stigma and (4) adapting self‐management strategies, including cost‐effective, and culturally/lifestyle appropriate strategies. Conclusions: Future health interventions and services need to be developed with consideration of the combined complexities of managing MLTCs while experiencing socioeconomic deprivation. Increased awareness in practitioners and commissioners of the complexities surrounding the lives of people experiencing socioeconomic deprivation, and the need for targeted strategies to promote self‐management of MLTCs are of great importance. Patient or Public Contribution: A patient advisory group contributed to all stages of the study, including providing important feedback on study documents (topic guides and recruitment materials), as well as providing critical insights surrounding the interpretation of interview data. [ABSTRACT FROM AUTHOR]

Introduction: In England, primary care networks (PCNs) offer opportunities to improve access to and sustainability of general practice through collaboration between groups of practices to provide care with a broader range of practitioner roles. However, there are concerns that these changes may undermine continuity of care. Our study investigates what the organisational shift to PCNs means for continuity of care. Methods: The paper uses thematic analysis of qualitative data from interviews with general practitioners and other healthcare professionals (HCPs, n = 33) in 19 practices in five PCNs, and their patients (n = 35). Three patient cohorts within each participating practice were recruited, based on anticipated higher or lower needs for continuity of care: patients over 65 years with polypharmacy, patients with anxiety or depression and 'working age' adults aged between 18 and 45 years. Findings: Patients and clinicians perceived changes to continuity in PCNs in our study. Larger‐scale care provision in PCNs required better care coordination and information‐sharing processes, aimed at improving care for 'vulnerable' patients in target groups. However, new working arrangements and ways of delivering care in PCNs undermine HCPs' ability to maintain continuity through ongoing relationships with patients. Patients experience this in terms of reduced availability of their preferred clinician, inefficiencies in care and unfamiliarity of new staff, roles and processes. Conclusions: New practitioners need to be effectively integrated to support effective team‐based care. However, for patients, especially those not deemed 'vulnerable', this may not be sufficient to counter the loss of relationship with their practice. Therefore, caution is required in relation to designating patients as in need of, or not in need of continuity. Rather, continuity for all patients could be maintained through a dynamic understanding of the need for it as fluctuating and situational and by supporting clinicians to provide follow‐up care. Patient and Public Involvement (PPI): A PPI group was recruited and consulted during the study for feedback on the study design, recruitment materials and interpretation of findings. [ABSTRACT FROM AUTHOR]

Objective: To determine impact of undertaking an international educational program during a nurse's or midwife's pre-registration program on subsequent practice, focusing on how nurses and midwives were transformed personally through participation in such programs. Background: Participation in international educational programs has been reported to enhance nursing and midwifery students' personal and professional development, however long-term impacts remain unclear. This paper presents findings drawn from a larger grounded theory study. Study design and Methods: Charmaz's grounded theory methodology was used to elicit experiences from 13 general nurses, two mental health nurses, three midwives and four dual qualified nurse/midwives across eight different countries. Data analysis led to the creation of three categories, with this paper reporting on the category of Developing as a Person. Findings: Participation in international educational programs can be transformative for nurses and midwives with long-lasting impacts, contributing positively to their personal growth and development. Discussion: The study findings underscore significant long-term impacts of international educational programs for nurses and midwives. These outcomes highlight the importance of incorporating international experiences into healthcare education. Conclusion: By providing opportunities for healthcare professionals to engage with diverse settings and populations, organisations and educational institutions can foster the development of well-rounded and globally competent practitioners. Implications for research, policy, and practice: The study's findings hold significant implications for research, policy, and practice in healthcare education. To deepen our understandings, additional longitudinal research across diverse countries is warranted. Policymakers have an opportunity to acknowledge the positive impact of these programs on the personal growth and development of nurses and midwives, potentially leading to the integration of global competency requirements into licensure programs. In order to provide comprehensive education, educational institutions should consider the inclusion of study abroad opportunities, cultural exchanges, and global clinical placements within nursing and midwifery curricula. What is already known about the topic? • International educational programs are widely used as a way of developing nursing and midwifery students' cultural understandings. • Previous studies have reported on short-term impacts of international educational programs. What this paper adds: • Long-term impacts of participation in an international educational program on nurses and midwives are described. • Personal development and subsequent transformations occur for nurses and midwives as a result of participation in international educational programs. [ABSTRACT FROM AUTHOR]

The present paper deals with the short history of the English jury in the modern age. The main goal of the author is completing a historical research and finding the most important features concerning legal institutions of the Anglo-Saxon type of lay jurisdiction in England and Ireland. The historical perspective gives a chance to examine the institutions of the jury as a court of citizens integrated into the jurisdiction of the state for a brief period of time. The author takes the view in several periods from the early 19th century up to the end of the 20th century. It is not the procedure but the organisational rules which are under discussion here with special attention to the conditions which determined the role of the jury as a part of county courts and sessions as well as the central tribunals in London. The literature was collected in the British Library during research intervals to have the opportunity to work from special sources not cited by Central-European scholars yet. [ABSTRACT FROM AUTHOR]

The research discussed in this paper was prompted by the writer's interest in the roles of England's small country ("market") towns. It has two aims: first, to discover the extent to which the work programmes announced in the British government's Rural White Paper (RWP 2000) (DETR-MAFF 2000) are recognised by town clerks, and second, to find out what town councils are doing, either on their own, or with others, and to gauge the potential and desire that they have for a greater degree of autonomy. In both cases the data was gathered from an online questionnaire sent to town clerks. [ABSTRACT FROM AUTHOR]

Estimating loss reserves is a crucial activity for non-life insurance companies. It involves adjusting the expected evolution of claims over different periods of active policies and their fluctuations. The chain-ladder (CL) technique is recognized as one of the most effective methods for calculating claim reserves in this context. It has become a benchmark within the insurance sector for predicting loss reserves and has been adapted to estimate variability margins. This variability has been addressed through both stochastic and possibilistic analyses. This study adopts the latter approach, proposing the use of the CL framework combined with intuitionistic fuzzy numbers (IFNs). While modeling with fuzzy numbers (FNs) introduces only epistemic uncertainty, employing IFNs allows for the representation of bipolar data regarding the feasible and infeasible values of loss reserves. In short, this paper presents an extension of the chain-ladder technique that estimates the parameters governing claim development through intuitionistic fuzzy regression, such as symmetric triangular IFNs. Additionally, it compares the results obtained with this method with those derived from the stochastic chain ladder by England and Verrall. [ABSTRACT FROM AUTHOR]

Background: Equitable access to healthcare is a priority of many healthcare systems, aiming to ensure access is driven by need and not minority groups such as those defined by sexual orientation. However, there are healthcare areas where inequity in access across sexual orientation groups is found that are not justified based on need. Mandated LGBTQ+-specific training of the healthcare workforce may help address some barriers of access for these groups. The study aims to understand the potential economic implications for mandated LGBTQ+-specific healthcare training on the healthcare system in England, UK to inform commissioning of training provision. Methods: Cervical cancer screening was used as an exemplar case where there appears to be inequity in access for different sexual orientation groups. A decision model was developed and analysed that considered the impacts of greater uptake of screening for lesbian and bisexual women due to LGBTQ+ training. Costs took the perspective of the healthcare system and outcomes modelled were cancer cases averted in a timeframe of 5 years. Results: Based on cervical cancer screening alone, where training costs are fully attributed to this service, training would likely result in fewer cancer cases detected in the lesbian and bisexual populations, though this comes at a modest increase in healthcare sector costs, with this increase largely reflecting a greater volume of screens. Training costs do not appear to be a major component of the cost implications. Conclusions: In resource-constrained systems with increasing pressures for efficiency savings, the opportunity cost of delivering training is a realistic component of the commissioning decision. The findings in this paper provide a signal that mandated LGBTQ+ training in healthcare could lead to potentially greater outcomes and in breaking down barriers of access and could also enable the healthcare system to provide more equitable access to healthcare. [ABSTRACT FROM AUTHOR]

Non-stationary methods of flood frequency analysis are widespread in research but rarely implemented by practitioners. One reason may be that research papers on non-stationary statistical models tend to focus on model fitting rather than extracting the sort of results needed by designers and decision makers. It can be difficult to extract useful results from non-stationary models that include stochastic covariates for which the value in any future year is unknown. We explore the motivation for including such covariates, whether on their own or in addition to a covariate based on time. We set out a method for expressing the results of non-stationary models as an integrated flow estimate, which removes the dependence on the covariates. This can be defined either for a particular year or over a longer period of time. The methods are illustrated by application to a set of 375 river gauges across England and Wales. We find annual rainfall to be a useful covariate at many gauges, sometimes in conjunction with a time-based covariate. For estimating flood frequency in future conditions, we advocate exploring hybrid approaches that combine the best attributes of non-stationary statistical models and simulation models that can represent changes in climate and river catchments. [ABSTRACT FROM AUTHOR]

Introduction: Associations between structural inequalities and health are well established. However, there is limited work examining this link in relation to mental health, or that centres public perspectives. This study explores people's experience and sense‐making of inequality in their daily lives, with particular consideration of impacts on mental health. Methods: We conducted a peer research study. Participants had to live in one of two London Boroughs and have an interest in inequalities and mental health. Using social media, newsletters, local organisations and our peer researchers' contacts, we recruited 30 participants who took photos representing their experience of inequality and discussed them during semi‐structured interviews. Data were analysed using reflexive thematic analysis. Results: Three themes were identified in this study: (1) inequalities are unjust, multilayered and intertwined with mental health. Accounts demonstrated a deep understanding of inequalities and their link to mental health outcomes, describing inequalities as 'suffering' and 'not good for anyone'. Financial, housing, immigration and healthcare problems exacerbated poor mental health, with racism, gender‐based violence and job loss also contributing factors for both poor mental health and experiences of inequality; (2) inequalities exclude and have far‐reaching mental health consequences, impacting personal sense of belonging and perceived societal value and (3) moving forwards—addressing long‐standing inequality and poor public mental health necessitated coping and resilience strategies that are often unacknowledged and undervalued by support systems. Conclusion: Lived experience expertise was central in this study, creating an innovative methodological approach. To improve public mental health, we must address the everyday, painful structural inequalities experienced by many as commonplace and unfair. New policies and strategies must be found that involve communities, redistributing resources and power, building on a collective knowledge base, to coproduce actions combatting inequalities and improving population mental health. Patient or Public Contribution: This study was peer‐led, designed and carried out by researchers who had experiences of poor mental health. Six authors of the paper worked as peer researchers on this study. [ABSTRACT FROM AUTHOR]

Background: A lifelong gluten-free diet is the only treatment for coeliac disease. The cost and availability of gluten-free substitute food (GFSF) remain challenging. Some local areas in England have stopped gluten-free prescriptions for coeliac disease. The aim of this paper is to present the quantitative findings of the financial impact of prescription withdrawal on people with coeliac disease. Methods: A cross-sectional survey with adults in England who reported having been diagnosed with coeliac disease by a health professional. The postal survey was distributed by Coeliac UK to their members in 13 prescribing and 13 non-prescribing local areas that were matched for geographical location and level of deprivation. Additionally, an advertisement for the survey was placed on social media. The questionnaire contained items on the availability and use of prescriptions; the weekly amount spent on GFSF; amount of specific GFSF bought; affordability of GFSF; demographics and health-related variables. Data were analysed by descriptive statistics, analysis of variance and regression analysis. Results: Of the 1697 participants, 809 resided in areas that provided prescriptions and 888 in non-prescribing areas. Participants self-report of their prescription did not always match the local area prescription policy. There was no statistically significant difference between prescribing and non-prescribing areas in how easy or difficult participants found it to obtain GFSF (p = 0.644) and its availability in various locations. Participants in non-prescribing areas purchased most types of GFSF items in statistically significantly higher quantities and thereby spent an additional £11.32/month on GFSF items than participants in prescribing areas (p < 0.001). While taking into account the self-reported prescription status, the amount increased to £14.09/month (p < 0.001). Although affordability to buy GFSF did not differ based on local area prescription policy or self-reported prescription status, it was dependent on equivalised annual income. However, affordability did not influence spending on GFSF. Regression analysis indicated that males and households with additional members with coeliac disease spent more on GFSF. Conclusions: The study has highlighted that gluten-free prescription withdrawal can have financial implications for people with coeliac disease. Any future changes to the prescription policy of GFSF should consider the impact on the population, especially lower income households. [ABSTRACT FROM AUTHOR]

Background: Little is known about the effectiveness of, and implementation complexities associated with, service delivery models for children and young people (CYP) experiencing 'common' mental health problems such as anxiety, depression, behavioural difficulties and self-harm. This paper outlines how a model for high-quality service design for this population group was developed by identifying available services, their effectiveness, cost-effectiveness and acceptability, and the barriers and enablers to access. Methods: Sequential, mixed-methods design, combining evidence syntheses (scoping and integrative reviews of the international literature) with primary research (a collective case study in England and Wales). Data from these two elements were collaboratively synthesised in a subsequent model-building phase. Results: The scoping review yielded a service model typology. The integrative review found effectiveness evidence only for four models: collaborative care (the only service model to also have cost-effectiveness evidence), outreach approaches, brief intervention services and an organisational framework called 'Availability, Responsiveness and Continuity'. No service model seemed more acceptable than others. Three case study themes were identified: pathways to support; service engagement; and learning and understanding. The model-building phase identified rapid access, learning self-care skills, individualised support, clear information, compassionate and competent staff and aftercare planning as core characteristics of high-quality services. These characteristics were underpinned by four organisational qualities: values that respect confidentiality; engagement and involvement; collaborative relationships; and a learning culture. Conclusions: A consistent organisational evidence-base for service design and delivery in CYP's mental health spanning many years appears to have had little impact on service provision in England and Wales. Rather than impose – often inflexible and untested – specific local or national models or frameworks, those commissioning, designing and delivering mental health services for CYP should (re)focus on already known, fundamental components necessary for high-quality services. These fundamental components have been integrated into a collaboratively produced general model of service design for CYP with common mental health problems. While this general model is primarily focused on British service provision, it is broad enough to have utility for international audiences. [ABSTRACT FROM AUTHOR]

Background: Over 180,000 people use crack cocaine in England, yet provision of smoking equipment to support safer crack use is prohibited under UK law. Pipes used for crack cocaine smoking are often homemade and/or in short supply, leading to pipe sharing and injuries from use of unsafe materials. This increases risk of viral infection and respiratory harm among a marginalised underserved population. International evaluations suggest crack pipe supply leads to sustained reductions in pipe sharing and use of homemade equipment; increased health risk awareness; improved service access; reduction in injecting and crack-related health problems. In this paper, we introduce the protocol for the NIHR-funded SIPP (Safe inhalation pipe provision) project and discuss implications for impact. Methods: The SIPP study will develop, implement and evaluate a crack smoking equipment and training intervention to be distributed through peer networks and specialist drug services in England. Study components comprise: (1) peer-network capacity building and co-production; (2) a pre- and post-intervention survey at intervention and non-equivalent control sites; (3) a mixed-method process evaluation; and (4) an economic evaluation. Participant eligibility criteria are use of crack within the past 28 days, with a survey sample of ~ 740 for each impact evaluation survey point and ~ 40 for qualitative process evaluation interviews. Our primary outcome measure is pipe sharing within the past 28 days, with secondary outcomes pertaining to use of homemade pipes, service engagement, injecting practice and acute health harms. Anticipated impact: SIPP aims to reduce crack use risk practices and associated health harms; including through increasing crack harm reduction awareness among service providers and peers. Implementation has only been possible with local police approvals. Our goal is to generate an evidence base to inform review of the legislation prohibiting crack pipe supply in the UK. This holds potential to transform harm reduction service provision and engagement nationally. Conclusion: People who smoke crack cocaine in England currently have little reason to engage with harm reduction and drug services. Little is known about this growing population. This study will provide insight into population characteristics, unmet need and the case for legislative reform. Trial registration: ISRCTN12541454 https://doi.org/10.1186/ISRCTN12541454 [ABSTRACT FROM AUTHOR]

Introduction: This study characterized the extent to which (1) financial barriers and (2) abortion care-seeking within a person's country of residence were associated with delays in abortion access among those travelling to England and the Netherlands for abortion care from European countries where abortion is legal on broad grounds in the first trimester but where access past the first trimester is limited to specific circumstances. Methodology: We drew on cross-sectional survey data collected at five abortion clinics in England and the Netherlands from 2017 to 2019 (n = 164). We assessed the relationship between difficulty paying for the abortion/travel, acute financial insecurity, and in-country care seeking on delays to abortion using multivariable discrete-time hazards models. Results: Participants who reported facing both difficulty paying for the abortion procedure and/or travel and difficulty covering basic living costs in the last month reported longer delays in accessing care than those who had no financial difficulty (adjusted hazard odds ratio: 0.39 95% CI 0.21–0.74). This group delayed paying other expenses (39%) or sold something of value (13%) to fund their abortion, resulting in ~ 60% of those with financial difficulty reporting it took them over a week to raise the funds needed for their abortion. Having contacted or visited an abortion provider in the country of residence was associated with delays in presenting abroad for an abortion. Discussion: These findings point to inequities in access to timely abortion care based on socioeconomic status. Legal time limits on abortion may intersect with individuals' interactions with the health care system to delay care. Plain Language Summary: This paper explores delays in accessing abortion care associated with financial and medical system barriers. We focus on residents of countries in Europe where abortion is available on broad grounds in the first trimester seeking abortion care outside of their country of residence. This study demonstrates an association between difficulty covering abortion costs for people facing financial insecurity and in-country care seeking and delays in accessing abortion abroad. Policy barriers, medical system barriers, as well as financial barriers may interact to delay access to care for people in European countries with broad grounds for abortion access in the first trimester but restrictions thereafter, especially for people later in pregnancy. [ABSTRACT FROM AUTHOR]

Background: The National Health Service (NHS) and general practice are increasingly adopting digital services. These services can impact both positively and negatively upon patient experiences, and access to digital services is not equal amongst all groups. Within a wider project examining digital facilitation (the Di-Facto study) our team conducted a patient survey amongst English primary care practices aiming to investigate patient views of what supports uptake and use of web-based services. This paper reports on the analysis of the free-text responses from the patient survey. Methods: The Di-Facto patient survey was distributed to practices in eight clinical commissioning groups (CCGs) in England between 2021–2022. We examined free-text responses to two questions relating to access to primary care web-based and support for web-based services. We used qualitative reflexive thematic analysis based on a six-stage process to analyse responses. Results: Of the 3051 patients who responded to the Di-Facto survey, 2246 provided a free-text response. We present our findings in two major themes: systems and structures and their impact on use of web-based services, and 'what works for me', a description of how respondents described what worked, or did not work in terms of their interactions with web-based services. Respondents described how the technology, such as poor practice website design, confusion over multiple digital apps, data security and concerns about eConsultation offerings impacted on use of web-based services. Respondents described practice level barriers, such as a lack of or inconsistent provision, which prevented optimal use of web-based services. Respondents described personal and technical barriers that impacted on their use of digital services, and described which web-based services worked well for them. Respondents felt that web-based services were not a replacement for face-to-face interactions with a doctor. Conclusions: This analysis of free-text responses from a large patient survey highlights the system, practice, and person level barriers and facilitators to use of digital services in primary care. With an increasing push towards digital solutions in NHS primary care, practices should consider the design, rollout and communication of their web-based services to support patient access. [ABSTRACT FROM AUTHOR]

Background: Community-based volunteering supports outbreak management by extending reach into at-risk communities. This paper examines the application of a 'community champions' model in England, UK, during the COVID-19 pandemic. Evidence pre-pandemic shows that community champion interventions tap into social networks to strengthen connections with disadvantaged communities. During the pandemic, the UK government set up a COVID community champions funding award scheme for local authorities to develop local programmes that addressed emerging inequalities. The study aim was to identify transferable learning on community engagement in the pandemic by undertaking a secondary qualitative synthesis of practice-based case studies of local COVID community champion programmes. Methods: A systematic staged approach for synthesis of practice-based case studies was used. In total, 16 COVID community champion case studies, which were written by practitioners involved in local programme implementation and published by the Local Government Association, were included. Case studies covered aims, programme development and delivery, examples of activities and a discussion of learning. Framework qualitative analysis methods were used to code and organise data prior to cross case analysis. The final stage produced an overarching thematic framework that best represented descriptive and interpretive themes. Results: The results provide an overview of common features of COVID community champion programmes and emergent learning. All local programmes aimed to reduce health inequalities by involving at-risk communities in local prevention efforts, adapting the approach to local priorities. Two levels of community engagement were volunteer mobilisation and subsequent community-based outreach activities. Elements of capacity building, such as training and creation of networks, were common. The synthesis of practice-based learning found that stronger relationships with communities were regarded as a key mechanism to support more equitable prevention strategies. Other learning themes related to champion roles, community engagement strategies and programme implementation. Conclusions: By focusing on how community champion approaches were applied by local authorities in England during the COVID-19 pandemic, this study contributes to knowledge on volunteer mobilisation as a mechanism to improve public health communication and outreach. Notwithstanding the limitations of experiential evidence, the synthesis of practice-based learning highlights potentially transferable community engagement strategies for health protection and health improvement. [ABSTRACT FROM AUTHOR]

Background: The National Health Service Diabetes Prevention Programme (NHS DPP) was commissioned by NHS England in 2016 and rolled out in three 'waves' across the whole of England. It aims to help people with raised blood glucose levels reduce their risk of developing type 2 diabetes through behaviour change techniques (e.g., weight loss, dietary changes and exercise). An independent, longitudinal, mixed methods evaluation of the NHS DPP was undertaken. We report the findings from the implementation work package: a qualitative interview study with designated local leads, responsible for the local commissioning and implementation of the programme. The aim of the study was to explore how local implementation processes were enacted and adapted over time. Methods: We conducted a telephone interview study across two time-points. Twenty-four semi-structured interviews with local leads across 19 sampled case sites were undertaken between October 2019 and January 2020 and 13 interviews with local leads across 13 sampled case sites were conducted between July 2020 and August 2020. Interviews aimed to reflect on the experience of implementation and explore how things changed over time. Results: We identified four overarching themes to show how implementation was locally enacted and adapted across the sampled case sites: 1. Adapting to provider change; 2. Identification and referral; 3. Enhancing uptake in underserved populations; and 4. Digital and remote service options. Conclusion: This paper reports how designated local leads, responsible for local implementation of the NHS DPP, adapted implementation efforts over the course of a changing national diabetes prevention programme, including how local leads adapted implementation during the COVID-19 pandemic. This paper highlights three main factors that influence implementation: the importance of facilitation, the ability (or not) to tailor interventions to local needs and the role of context in implementation. [ABSTRACT FROM AUTHOR]

This article explores the effect on assessment of ‘translating’ paper and pencil test items into their computer equivalents. Computer versions of a set of mathematics questions derived from the paper-based end of key stage 2 and 3 assessments in England were administered to age appropriate pupil samples, and the outcomes compared. Although in most cases the change to the different medium seems to make little difference, for some items the affordances of the computer profoundly affect how the question is attempted, and therefore what is being assessed when the item is used in a test. These differences are considered in terms of validity and legitimacy, that is whether the means used to answer a question in a particular medium are appropriate to the assessment intention. The conclusion is not only that translating paper and pencil items into the computer format sometimes undermines their validity as assessments, it is also that some paper and pencil items are less valid as assessments than their computer equivalents would be. [ABSTRACT FROM AUTHOR]

This paper is a reflection upon the research findings of Rebecca Allen and Anne West in relation to religious schools in London. While welcoming this contribution to the systematic study of faith schools (a neglected area of empirical inquiry), the paper argues that the use of 'religious schools' as a unitary category is problematic for the analysis. It also suggests that certain historical and cultural contextual knowledge is required when analysing the characteristics of different categories of religious schools. This response is intended to be helpful for future researchers into the different types of faith school. [ABSTRACT FROM AUTHOR]

In 1998, a review for the Ministry of Agriculture Fisheries and Food (the predecessor of the Food Standards Agency) was published evaluating the relative merits of different dietary assessment methods against a series of factors likely to affect compliance or accuracy in low-income households. The review informed the design of a method comparison study carried out in London, UK, in 2001, in which the validity and acceptability of 4 d dietary assessment methods based on 24 h recalls, food checklists and a semi-weighed method were compared with 4 d weighed inventories and other reference measures. Results were based on observations in 384 respondents (159 males, 225 females) aged 2-90 years in 240 households. Outcomes of the comparison study included evaluations of each method made by respondents, interviewers and researchers. These findings were used in the present paper to update and extend the 1998 review. Additional factors not included in the 1998 review have been considered. This updated and extended review provides the basis for discussion of the relative merits of approaches to dietary assessment in low-income households in developed economies. The evidence presented here and elsewhere suggests that the 24 h recall is the method best suited for dietary assessment in low-income households, followed by the weighed inventory, food checklist and lastly the semi-weighed method. [ABSTRACT FROM AUTHOR]

The paper referred to is ‘The Future of Data Analysis,’ published in 1962. Many authors have discussed it, notably Peter Huber, who in 1995 reviewed the period starting with Hotelling's 1940 article ‘The Teaching of Statistics.’ I extend the scope of Huber's remarks by considering also the period before 1940 and developments since 1995. I ask whether statistics is a science and suggest that to attract bright students to our subject, we need to show them the excitement and rewards of applied work. [ABSTRACT FROM AUTHOR]

The Mawgridge's case in 1707 set the precedent where adultery was recognised as a justified trigger for the husband's killing of his wife's lover; this crystallised a partial defence for provocation. However, in an 1810 case, the killing of the unfaithful wife followed a manslaughter conviction rather than murder for the first time. This study aims to investigate the shaping of a legally permissible violence, that is, the mitigation of the husband's culpability in killing his adulterous wife. This provides the opportunity to question the (ir)rationality behind the judiciary's discourse in the case of R v Clinton 2012; here, despite infidelity being abolished in 2009 in England and Wales as a defence for murder, the judges still insisted on its relevance in our culture and hence on legal culpability. The theoretical framework in this paper draws upon the scholarship of masculinity, the family, and the law. This paper discusses the contribution of the hegemonic male identity in creating this legal violence and fortifying social-hierarchical structure. [ABSTRACT FROM AUTHOR]

Although both the analysis of regional culture and urbanisation are long-standing preoccupations in geography, few studies have considered the relationship between the two, the former traditionally being a topic in cultural geography, while the latter is usually interpreted and analysed as a process in economic geography. Taking evidence from the 1851–1911 censuses of England and Wales, this article analyses individual migration paths to identify stable regions of human interaction by applying a sophisticated community-detection algorithm. By accurately mapping the regions within which the majority of migration occurred between 1851 and 1911 and arguing that the stability of these geographies is evidence of more than just mutable communities but rather of persistent regional cultures, this article responds to previous studies that have sought to identify the cultural provinces of England and Wales. Indeed, by demonstrating that the regions bear a striking resemblance to those that have long been hypothesised as being distinct cultural provinces of England and Wales, this article empirically corroborates their existence. In order to further demonstrate that the regions constitute cultural provinces, this paper incorporates these boundaries into a spatial interaction model (SIM). The results of the SIM not only shows that the boundaries between the regions limited the number of migrants that crossed them–over and above that explained by control variables–and therefore represented the boundaries of cultural provinces, demarcating discrete regions of human interaction–but that such boundaries disproportionately restricted rural-urban migrants, thereby slowing the pace at which England and Wales urbanised. This paper therefore demonstrates that urbanisation should not only be interpreted as only an economic phenomenon, but a cultural one also, and that if urbanisation is to be fully understood, individuals' attachment to place as a component of their identity, ought to be formally incorporated into models of migration. [ABSTRACT FROM AUTHOR]

Background: Heroin-Assisted Treatment (HAT) is well evidenced internationally to improve health and social outcomes for people dependent on opioids who have not been helped by traditional treatment options. Despite this evidence base, England has been slow to implement HAT. The first service outside of a trial setting opened in 2019, providing twice-daily supervised injections of medical-grade heroin (diamorphine) to a select sample of high-risk heroin users in Middlesbrough. This paper explores their experiences, including the negotiation of the strict regularly controls required of a novel intervention in the UK context. Methods: We conducted in-depth interviews with service providers and users of the Middlesbrough HAT service between September and November 2021. Data from each group were thematically analysed and reported separately. This paper details the experiences of the twelve heroin dependent men and women accessing HAT. Results: Participants' accounts of HAT treatment evidenced a tension between the regulatory constraints and uncertainty of treatment provision, and the positive outcomes experienced through supportive service provision and an injectable treatment option. Limited confidence was held in treatment efficacy, longevity of funding, and personal capacity for treatment success. This was counteracted by a strong motivation to cease engagement with the illicit drug market. While attendance requirements placed restrictions on daily activities, participants also experienced benefits from strong, supportive bonds built with the service providers through their continued engagement. Conclusions: The Middlesbrough HAT programme provided benefits to a high-risk population of opioid dependent people who were unable or disinclined to participate in conventional opioid substitution treatments. The findings in this paper highlight the potential for service modifications to further enhance engagement. The closure of this programme in 2022 prohibits this opportunity for the Middlesbrough community, but holds potential to inform advocacy and innovation for future HAT interventions in England. [ABSTRACT FROM AUTHOR]

Introduction: Co‐production with communities is increasingly seen as best practice that can improve the quality, relevance and effectiveness of research and service delivery. Despite this promising position, there remains uncertainty around definitions of co‐production and how to operationalize it. The current paper describes the development of a co‐production strategy to guide the work of the ActEarly multistakeholder preventative research programme to improve children's health in Bradford and Tower Hamlets, UK. Methods: The strategy used Appreciative Inquiry (AI), an approach following a five‐step iterative process: to define (Step 1) scope and guide progress; to discover (Step 2) key issues through seven focus groups (N = 36) and eight in‐depth interviews with key stakeholders representing community groups, and the voluntary and statutory sectors; to dream (Step 3) best practice through two workshops with AI participants to review findings; to design (Step 4) a co‐production strategy building on AI findings and to deliver (Step 5) the practical guidance in the strategy. Results: Nine principles for how to do co‐production well were identified: power should be shared; embrace a wide range of perspectives and skills; respect and value the lived experience; benefits should be for all involved parties; go to communities and do not expect them to come to you; work flexibly; avoid jargon and ensure availability of the right information; relationships should be built for the long‐term; co‐production activities should be adequately resourced. These principles were based on three underlying values of equality, reciprocity and agency. Conclusion: The empirical insights of the paper highlight the crucial importance of adequate resources and infrastructure to deliver effective co‐production. This documentation of one approach to operationalizing co‐production serves to avert any misappropriations of the term 'co‐production' by listening to service users, stakeholders and other relevant groups, to develop trust and long‐term relationships, and build on the learning that already exists amongst such groups. Patient or Public Contribution: The work was overseen by a steering group (N = 17) of individuals, both professional and members of the public with experience in undertaking co‐production, and/or with some knowledge of the context of the two ActEarly field sites, who provided regular oversight and feedback on the AI process. [ABSTRACT FROM AUTHOR]

Granger causality provides a framework that uses predictability to identify causation between time series variables. This is important to policymakers for effective policy management and recommendations. Granger causality is recognized as the primary advance on the causation problem. The objective of this paper is to conduct a bibliometric analysis of Granger causality publications indexed in the Web of Science database. Harzing's Publish or Perish and VOSviewer were used for performance analysis and science mapping. The first paper indexed was published in 1981 and there has been an upward trend in the annual publication of Granger causality studies which are shifting towards the areas of environmental science, energy, and economics. Most of the publications are articles and proceeding papers under the areas of business economics, environmental science ecology, and neurosciences/neurology. China has the highest number of publications while the United States has the highest number of citations. England has the highest citation impact. This paper also constructed country co-authorship, co-analysis of cited references, cited sources, and cited authors, keyword co-occurrence, and keyword overlay visualization maps. [ABSTRACT FROM AUTHOR]

Since at least 2012, UK housing providers (and policy makers) have introduced policies aimed at developing autonomy and independence among service users, through an agenda sometimes referred to as 'responsibilisation'. This paper considers the role that technologies play in this agenda, through an analysis of how wellbeing and independence are facilitated amongst older social housing tenants. Based on case studies of four supported housing schemes in England, the research considers the capacity to exercise agency amongst older persons, through their willingness and ability to accept technological interventions, and the role of support networks to facilitate independent living. Using the concept of modalities of agency, the research examines the impact of implementing 'low-level' assistive technologies in the home, based on the perspectives of residents and staff. The interventions studied were designed to improve social relationships, promote self-sufficiency and support self-managed care (based on the principle that the most effective projects facilitate individual agency). The research findings identified that residents responded differentially to technology, based on their levels of capability, motivation, reluctance and resistance. Whilst the study demonstrated that small technological innovations could have disproportionately positive impacts in improving wellbeing, the research demonstrates the complex nature of agency and limits of responsibility. The paper argues that responsibilisation is part of a wider neoliberal project, where choice and agency are manufactured to create an idealised notion of the autonomous actor (in this case through technology-enabled care). The article argues that a collaborative approach to service provision in which responsibility is shared, via co-managed care, is a more effective means of enhancing agency, than one which advocates a withdrawal of support (in the guise of autonomy). [ABSTRACT FROM AUTHOR]

Background: The Live Well with Parkinson's Self-Management Toolkit is designed for use in the NHS to support people with Parkinson's, their carers and health professionals in managing motor and non-motor symptoms and promoting well-being. The Toolkit was developed based on theory-based behaviour change and self-management techniques in consultation with people living with Parkinson's and health and social care practitioners. There are digital (e-Toolkit) and paper (manual) versions. Methods: Single-blind two-arm randomised controlled trial RCT of clinical effectiveness and cost-effectiveness of the Toolkit, facilitated by up to six sessions with a trained non-specialist supporter, in improving quality of life. People with Parkinson's will be assessed at baseline, 6 and 12 months. Assessors will be blind to the treatment group. The primary outcome measure is the Parkinson's Disease Questionnaire (PDQ-39, Parkinson's related quality of life) score at 12 months. Secondary outcome measures include the MDS Unified Parkinson's Disease Rating Scale (Part I, II, III, IV), EQ-5D, and a Client Service Receipt Inventory shortened, adapted for Parkinson's. Carer outcomes include the Zarit Carer Burden Inventory and Carer Quality of Life Questionnaire for Parkinsonism. A total of 338 people with Parkinson's, and their carers if appropriate, will be recruited from diverse settings across England. Those with advanced dementia, at end-of-life or with atypical Parkinsonism will be excluded. A parallel mixed methods process evaluation will explore the factors promoting or inhibiting implementation, uptake, use, effectiveness and cost-effectiveness of the Toolkit and sessions. Discussion: If successful, the Live Well with Parkinson's Toolkit could be used as a model for other complex long-term disorders, including dementia. This would bridge existing gaps in the NHS (as shown by the national Parkinson's audit data), by enabling patients and carers to access personalised information, advice and support on symptom management and 'living well' with Parkinson's. Trial registration: ISRCTN92831552. Registered on 26th Oct 2021. [ABSTRACT FROM AUTHOR]

The article examines the problem of ensuring the political stability of a democratic social system with a shortage of a vital commodity (like vaccine against COVID-19). In such a system, members of society citizens assess the authorities. Thus, actions by the authorities to increase the supply of this commodity can contribute to citizens' approval and hence political stability. However, this supply is influenced by random factors, the actions of competitors, etc. Therefore, citizens do not have sufficient information about all the possibilities of supplying, and it is difficult for them to make the right decisions. Such citizen unawareness can be exploited by unscrupulous politicians to achieve personal targets. Therefore, it is necessary to organize public control to motivate politicians to use all available opportunities in supplying. The goal of the paper is to build such a digital mechanism of public control of the politicians by citizens, which would best assess and stimulate the activities of the authorities to improve the supply of a vital commodity. In the age of artificial intelligence, such digital public control in the face of uncertainty can be based on digital machine learning. In addition, it is necessary to take into account and model the activities of politicians associated with the presence of their own targets that do not coincide with public ones. Such politicians can use the learning of citizens for their own targets. The objective of the article is to build an optimal digital mechanism of public control in a two-level model of a democratic social system—a digital society. At its top level, there is the Citizen, who gives an assessment for the Politico located at the lower level. In turn, the Politico can influence the supplying of a vital commodity. Political stability is guaranteed if the Citizen regularly approves of the Politico's actions to increase this supply. However, the Politico may not use the opportunities available to him to offer a commodity to achieve a personal target. To avoid this, the Politico's control mechanism is proposed. It includes the procedure for digital learning of the Citizen, as well as a procedure for assessing the Politico activity. Sufficient conditions have been found for the synthesis of such the Politico's control mechanism, at which stochastic possibilities of increasing the supply of a vital commodity are used. The example of such the Politico's control mechanism is considered on the case of supply of the COVID-19 vaccine in England. [ABSTRACT FROM AUTHOR]

The case of naturalization of the zebra mussel, Dreissena polymorpha (Pallas, 1771), in countries lying beyond its native Ponto–Caspian range is remarkable as one of the first instances when the scientific community as early as the mid-19th century was fully aware of the non-indigenous status of a particular species as well as of the need for the study and monitoring of this process. Based on a study of contemporary sources, I reconstruct the early response of European naturalists (including those who today would be called "citizen scientist") to the invasion of Dreissena and describe their attitudes to the problem, including the divergence in opinion about the origin and the means of dispersal of this bivalve species. An analysis of papers published in English, French, German, and Russian between 1774 and 1920 showed that the invasion of D. polymorpha was by no means "silent"; quite the opposite, it provoked an immediate reaction from naturalists. The scientific agenda for the study of the new invader was proposed in England as early as 1838. [ABSTRACT FROM AUTHOR]

The pressure on mental health services has not gone unremarked and is of widespread concern in England and Wales. This can have implications when a bed is being sought for a patient who has undergone a Mental Health Act assessment and is deemed to meet the criteria for being formally admitted to hospital. Once the 24 h period for assessment under section 136 of the Act has lapsed, the ongoing detention of the patient can lead to a legal grey area. Through a fictional example this paper examines the relevant case law and statute that may be used to continue the detention and explores the ethical problems that this may cause. [ABSTRACT FROM AUTHOR]

The mechanism, temperature, and timescale of granite intrusion remain controversial, with wide-ranging implications for understanding continental growth, differentiation, rheology, and deformation dynamics. In this paper we present a method for determining intrusion emplacement temperature and timescale using the characteristics of the surrounding metamorphic aureole, and apply it to the Skiddaw granite in northern England. The estimated emplacement timescale (0.1–2 Myr) implies magma transport velocities of 1–100 mm/year. At the absent or low melt fractions relevant to our estimated emplacement temperature (580–650 ∘ C), such velocities are incompatible with pluton formation by successive injections through dykes. Instead, our results indicate the intrusion of a diapir of crystal-rich slurry, solidifying before emplacement, with a rheology governed by the solid crystals. The emplacement depth is likely to be governed by the depth-dependent rheology of the surrounding rocks, occurring close to the brittle-ductile transition. The wider implications of our results relate to (1) the appreciation that much of the chemical and textural characteristics of plutons may relate to pre-emplacement crystallisation at depth, passively transported to higher crustal levels, and (2) an explanation of the difficulty of seismically imaging active plutonism. [ABSTRACT FROM AUTHOR]

Recent work in early modern English collecting and bookbinding has shown the extent to which readers viewed books as malleable collections rather than unified totalities. This essay expands our understanding of these practices by examining a series of volumes collected and bound during the second half of the seventeenth century. These volumes show texts transformed by their proximity to other, often incongruous imprints, as well as readers registering their own presence amidst the chaotic print world of Civd War England. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various articles within the issue on topics including methodology and innovation in the mixed jurisdictions, traditional African concept of ubuntu, and development of English common law.

An essay is presented on the poem "Ode on the Death of a Favourite Cat, Drowned in a Tub of Gold Fishes," by Thomas Gray, and a china tub owned by intellectual Horace Walpole. It comments on Walpole's home, Strawberry Hill, in Twickenham, London, England. The author examines Walpole's collecting and his Glass Closet, a section in his library. She also considers the book "Designs by Mr. R. Bentley, for Six Poems by Mr. T. Gray," by artist Richard Bentley.

Assesses the validated outcome instrument quality of life in hip revision with impacted morselized allograft bone and cemented Exeter prosthesis compared to primary hip replacement in England. Outcomes of hip revision; Indication of the Nottingham Health Profile scores after revision; Duration of the primary cemented hip replacement.

Background: The MODEM project (A comprehensive approach to MODelling outcome and costs impacts of interventions for DEMentia) explores how changes in arrangements for the future treatment and care of people living with dementia, and support for family and other unpaid carers, could result in better outcomes and more efficient use of resources.Methods: MODEM starts with a systematic mapping of the literature on effective and (potentially) cost-effective interventions in dementia care. Those findings, as well as data from a cohort, will then be used to model the quality of life and cost impacts of making these evidence-based interventions more widely available in England over the period from now to 2040. Modelling will use a suite of models, combining microsimulation and macrosimulation methods, modelling the costs and outcomes of care, both for an individual over the life-course from the point of dementia diagnosis, and for individuals and England as a whole in a particular year. Project outputs will include an online Dementia Evidence Toolkit, making evidence summaries and a literature database available free to anyone, papers in academic journals and other written outputs, and a MODEM Legacy Model, which will enable local commissioners of services to apply the model to their own populations.Discussion: Modelling the effects of evidence-based cost-effective interventions and making this information widely available has the potential to improve the health and quality of life both of people with dementia and their carers, while ensuring that resources are used efficiently. [ABSTRACT FROM AUTHOR]

The Becoming Breastfeeding Friendly (BBF) in Great Britain study was conducted during 2017–2019 comprising three country studies: BBF England, Wales and Scotland. It was part of an international project being coordinated during the same period by the Yale School of Public Health across five world regions to inform countries and guide policies to improve the environment for the promotion, protection and support of breastfeeding. This paper reports on the application of the BBF process that is based on an implementation science approach, across the countries that constitute Great Britain (England, Wales and Scotland). The process involves assessing 54 benchmarks across eight interlocking gears that drive a country's 'engine' towards a sustainable policy approach to supporting, promoting and protecting breastfeeding. It takes a consensus‐oriented approach to the evaluation of benchmarks and the development of recommendations. This paper provides a critical overview of how the process was conducted, the findings and recommendations that emerged and how these were managed. We draw on critical theory as a theoretical framework for explaining the different outcomes for each country and some considerations for future action. Key messages: Undertaking an international, comparable approach to develop evidence‐based policy recommendations for scaling up the breastfeeding environment can provide useful data on which to draw explanations and conclusions on national variation.The findings from the BBF process across England, Scotland and Wales suggest that improving breastfeeding in Great Britain is dependent on the degree of political will and having a coordinated national breastfeeding strategy in place or not, along with access to robust breastfeeding data.A critical theory lens helps to bring to light some differences in the research and policy process that can explain differences between countries in the United Kingdom. [ABSTRACT FROM AUTHOR]

King Arthur and Robin Hood, as two main folkloric figures, play an important role in British national identity especially in the nineteenth century. Throughout centuries, these mythical stories became well-known in the cultural heritage of other countries besides Britain. The lore and depictions of these two characters were not limited to the written and oral literature but came into existence through different mediums such as television, cinema, and computer games. Both the stories of King Arthur and Robin Hood have topical themes reflecting the political, social, and cultural issues and conflicts in societies and shape the future as timeless artefacts. In this sense, the major aim of this paper is to present and analyze the evolution of these two folk legends by using various historical and cultural sources to demonstrate the validity of the two characters across time, place, and medium. King Arthur and Robin Hood: The History and Folklore of England's Most Famous Folk Legends by Jesse Harasta (2009) is used as the basis of the evolution of the lore of the two folkloric characters. The stories and the characters, the subjects of various myths and legends throughout centuries, have also been adapted and used in a variety of works and products transmitting local history of the lore of King Arthur and Robin Hood into global folklore. The political, social, and cultural use, adaptation, and evolution of King Arthur and Robin Hood will be traced starting from their emergence in the medieval ages through the twentieth century when the lore of King Arthur and Robin Hood is transformed through story-telling and added to different structures by using different media. As will be exemplified per the aim of the study though some changes in the presentation of the folkloric characters are present; the major dichotomic human characteristics are preserved. The article follows the trajectory of evolution of two legends into myths, literature, and finally products of popular culture. The work questions whether the divisive line between what is local and authentic versus that which is globalized and thus international is as clear as is presupposed. [ABSTRACT FROM AUTHOR]

The mechanism, temperature, and timescale of granite intrusion remain controversial, with wide-ranging implications for understanding continental growth, differentiation, rheology, and deformation dynamics. In this paper we present a method for determining intrusion emplacement temperature and timescale using the characteristics of the surrounding metamorphic aureole, and apply it to the Skiddaw granite in northern England. The estimated emplacement timescale (0.1–2 Myr) implies magma transport velocities of 1–100 mm/year. At the absent or low melt fractions relevant to our estimated emplacement temperature (580–650 ∘ C), such velocities are incompatible with pluton formation by successive injections through dykes. Instead, our results indicate the intrusion of a diapir of crystal-rich slurry, solidifying before emplacement, with a rheology governed by the solid crystals. The emplacement depth is likely to be governed by the depth-dependent rheology of the surrounding rocks, occurring close to the brittle-ductile transition. The wider implications of our results relate to (1) the appreciation that much of the chemical and textural characteristics of plutons may relate to pre-emplacement crystallisation at depth, passively transported to higher crustal levels, and (2) an explanation of the difficulty of seismically imaging active plutonism. [ABSTRACT FROM AUTHOR]

During Cook's 1772–75 Antarctic circumnavigation on the HMS Resolution , he recorded the positions of hundreds of icebergs. This paper compares Cook's observations and those of Halley in 1700, Bouvet in 1739 and Riou in 1789, with the Brigham Young University/National Ice Center (BYU/NIC) and the Alfred Wegener Institute datasets. Cook's description of the iceberg plume east of the Amery Ice Shelf and the iceberg distributions in the Weddell, Ross and Amundsen Seas agree with modern data. In January 1774, Cook reached his farthest south on the shelf of the Amundsen Sea Embayment, the site of the current International Thwaites Glacier Collaboration field study. Cook's largest iceberg had a 2.5 km diameter, where power-law models show that icebergs of this size or smaller comprise 92% of their total number. In the eastern Weddell, Cook's observation of a sea-ice tongue with a much greater extent than in satellite imagery remains unexplained. Although Riou's icebergs lie 1000 km east of the BYU/NIC trajectories, application of the England and others (2020) fracture and drift model to the trajectories removes the discrepancy and means that all the ship observations are consistent with modern observations and theory. [ABSTRACT FROM AUTHOR]

In this article, we examine education policymaking in England during the Covid-19 pandemic, focusing on the period from 2020 to 2022. We argue that the pandemic, while obviously damaging materially, economically and psychologically, seemed to have provided a rare opportunity for a step change, a chance to recalibrate and reconsider values assumed as 'truths'. However, policymaking in England appears to have been driven by a desire to return to normal as soon as possible or to double down on control. Through a rigorous policy analysis of two specific areas of policy - initial teacher education and inspection - we review policy and ministerial speeches, as well as academic papers, media articles and social media blogs published from the start of the pandemic in England, to analyse the extent to which policy formation was reactive in an attempt to maintain a steady state and return as quickly as possible to pre-pandemic normality and to previously stated intransigent policy positions. We suggest that this policy formation reflects a broader trend in policymaking, which seeks to use power and sustain privilege, underpinned by a constructed evidence base, to present a particular 'truth' about what needs to be done to improve education outcomes. [ABSTRACT FROM AUTHOR]