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Regulation of the aesthetic sector is long overdue. Aesthetic nurses are standing on the threshold of a new era for aesthetic practice — they have been handed a 'golden egg' of opportunity, but many remain fearful that they may drop it [ABSTRACT FROM AUTHOR]

Aims: Family intervention (FI) is recommended in national guidance to be offered to all service users accessing an early intervention in psychosis (EIP) team, due to the consistent evidence base in reducing relapse and rehospitalisation rates. However, FI implementation is poor nationally. Although barriers have been identified at the level of staff member and the organisation, there is a paucity of research identifying service user perspectives. Methods: A qualitative questionnaire design was used to explore service user perspectives of behavioural family therapy (BFT) within a specialist EIP service in northwest England. Results: Most participants contacted reported they lacked knowledge and understanding of BFT, with 54% reporting that this intervention had not been offered to them. This finding was unexpected and is inconsistent with the offer of BFT documentation in their clinical notes. Reasons for accepting BFT included to increase understanding of family members and for them to also be supported. Reasons for declining BFT included a preference for one‐to‐one interventions and not wanting family involved in their care. Conclusions: National guidance on FI for psychosis is not reliably being translated to clinical practice, with many participants reporting that they were not offered this intervention. A key factor in accepting or declining an offer of BFT appeared to be whether participants wanted family members to be involved in their care. A lack of understanding of the BFT approach was evident, it is recommended that the offer of FI in psychosis is improved for service users to make an informed decision. [ABSTRACT FROM AUTHOR]

Background: Mastoiditis is the most common intra-temporal complication of acute otitis media. Despite potentially lethal sequelae, optimal management remains poorly defined. Method: A retrospective case review was conducted of children diagnosed with mastoiditis at a tertiary referral centre, in North East England, between 2010 and 2017. Results: Fifty-one cases were identified, 49 without cholesteatoma. Median patient age was 42 months (2 months to 18 years) and median hospital stay was 4 days (range, 0–27 days). There was no incidence trend over time. Imaging was conducted in 15 out of 49 cases. Surgery was performed in 29 out of 49 cases, most commonly mastoidectomy with (9 out of 29) or without (9 out of 29) grommets. Complications included sigmoid sinus thrombosis (3 out of 49) and extradural abscess (2 out of 51), amongst others; no fatalities occurred. Conclusion: A detailed contemporary description of paediatric mastoiditis presentation and management is presented. The findings broadly mirror those published by other UK centres, but suggest a higher rate of identified disease complications and surgical interventions. [ABSTRACT FROM AUTHOR]

Poor quality medical information adds to the risks associated with intercountry adoption. Other receiving countries acknowledge this more readily than the UK. All have to tackle the problems posed by inadequate reports and most insist on further assessment of the child on arrival. This article comprises a retrospective review of 120 medical reports from 23 countries written about children matched with adopters from IAC-the Centre for Adoption (registered as the Intercountry Adoption Centre) between April 2010 and November 2014. The quality and quantity of medical information varied widely but was generally inadequate. Most reports consisted of an isolated, single physical examination. There was incomplete screening for important medical conditions, inadequate medical histories and virtually no assessment of development. The reports for special needs children and adolescents were particularly concerning. In almost all cases, there was a lack of the essential information needed by adopters in order to make an informed decision about the suitability of the match. All intercountry adopted children, regardless of their country of origin, need the involvement of an experienced medical adviser in the matching process and should have a comprehensive paediatric health assessment after placement. This should be carried out on the NHS and be free to parents, as it is in Northern Ireland. The number of children concerned is small but their needs are important, particularly as they are disadvantaged compared to domestic adoptees. [ABSTRACT FROM AUTHOR]

The article offers information on the topics discussed in the annual conference of the journal, that was held at London School of Economics in England on February 26, 2011. The participants presented their views on the subject of the meeting, the nature of Stalinism. Several issues that were discussed in the conference include Russian leader Joseph Stalin, the purges, and the political economy of the phenomenon.

The article reports on the identification of a juvenile Pacific Diver Gavia pacifica at Farnham Gravel-pit in Yorkshire, England on January 13, 2007. It discusses the circumstances of the bird's discovery in January 12 in Farnham where it remained until February 4. The bird's identification, taxonomy, distribution and subsequent records of Pacific Diver in Europe are also noted. The addition of Pacific Diver to the Category A of the British List represents the first record of the species for Great Britain and the Western Palearctic.

A project to investigate the use of art and design images in higher education courses was undertaken as part of a Knowledge Transfer Partnership between the Bridgeman Art Library Limited and the London College of Communication, University of the Arts London. The principal objective of the project was the exploration of how art and design images complement the educational experience and how they inform the creative process of graphic design. The project consisted of various stages: meeting with employees at The Bridgeman Art Library to document their experiences with image requests from graphic design clients; creating sets of suitable images; licensing images to students and their instructor at the university; surveying the students about their experiences; and obtaining the instructor's feedback. The goals were to explore the ways in which art and design images can be used in teaching and in student coursework and to investigate whether the licensing of carefully selected sets of images, rather than the entire database, to educational institutions could work as a business model. [ABSTRACT FROM AUTHOR]

Background: Guidelines on COPD diagnosis and management encourage primary care physicians to detect the disease at an early stage and to treat patients according to their condition and needs. Problems in guideline implementation include difficulties in diagnosis, using spirometry and the disputed role of reversibility testing. These lead to inaccurate diagnostic registers and inadequacy of administered treatments. This study represents an audit of COPD diagnosis and management in primary care practices in Devon. Methods: Six hundred and thirty two patients on COPD registers in primary care practices were seen by a visiting Respiratory Specialist Nurse. Diagnoses were made according to the NICE guidelines. Reversibility testing was carried out either routinely or based on clinical indication in two sub-samples. Dyspnoea was assessed. Data were entered into a novel IT-based software which computed guideline-based treatment recommendations. Current and recommended treatments were compared. Results: Five hundred and eighty patients had spirometry. Diagnoses of COPD were confirmed in 422 patients (73%). Thirty nine patients were identified as asthma only, 94 had normal spirometry, 23 were restrictive and 2 had a cardiac disorder. Reversibility testing changed diagnosis of 11% of patients with airflow obstruction, and severity grading in 18%. Three quarters of patients with COPD had been offered practical help with smoking cessation. Short and long-acting anticholinergics and long acting beta-2 agonists had been under-prescribed; in 15-18% of patients they were indicated but not received. Inhaled steroids had been over-prescribed (recommended in 17%; taken by 60%), whereas only 4% of patients with a chronic productive cough were receiving mucolytics. Pulmonary rehabilitation was not available in some areas and was under-used in other areas. Conclusion: Diagnostic registers of COPD in primary care contain mistakes leading to inaccurate prevalence estimates and inappropriate treatment decisions. Use of pre-bronchodilator readings for diagnosis overestimates the prevalence and severity in a significant minority, thus post bronchodilator readings should be used. Management of stable COPD does often not correspond to guidelines. The IT system used in this study has the potential to improve diagnosis and management of COPD in primary care. [ABSTRACT FROM AUTHOR]

The use of three techniques for pruning artificial neural networks (magnitude-based pruning, optimum brain damage and optimal brain surgeon) is investigated, using microwave SAR and optical SPOT data to classify land cover in a test area located in eastern England. Results show that it is possible to reduce network size significantly without compromising overall classification accuracy; indeed, accuracy may rise as the number of links decreases. However, individual class accuracies and the spatial distribution of the pixels forming the individual classes may change significantly. If the network is pruned too severely some classes may be eliminated altogether. In terms of maintaining overall classification accuracy the optimal brain surgeon algorithm gave the best results, and magnitude-based pruning also gave good results despite its simplicity. The optimum brain damage algorithm performed least well of the three methods tested. [ABSTRACT FROM AUTHOR]

SummaryAims To examine the scope for cardiovascular disease risk factor intervention among diabetic patients in England was examined using data from the Health Surveys for England 1991–94. This evaluation included calculating the proportion who require lipid lowering therapy according to the Standing Medical Advisory Committee (SMAC) guidelines. Methods The Health Survey for England is an annual, nationwide household-based in which anthropomorphic data, blood pressure, lipids and details of cardiovascular risk factors are collected from households after random stratification for geographical and socio-economic factors within a population sample of 39 639 adults, 970 (2.3%) diabetic subjects were identified. Results Overall, 51% of those with diabetes had hypertension (systolic blood pressure ≥ 160 mmHg or a diastolic BP ≥ 95 mmHg or being on antihypertensive therapy), 27% were obese (body mass index ≥ 30 kg/m2) and 19% were current smokers. One-third of those with hypertension were untreated and less than one-half of those on treatment had their hypertension controlled to below 160/95 mmHg. More than one-quarter had poor glycaemic control (glycated Hb > 11% or an HbA1c > 7.5%). Of those aged < 70 years, 29% required lipid lowering therapy according to the SMAC guidelines and almost all (94%) of these were not on treatment. An analysis showed that, because the SMAC guidelines do not require high density lipoprotein (HDL) cholesterol to be measured, their use is likely to result in substantial underestimation of the need for lipid lowering, particularly in diabetic women. Conclusion In England, among those with diabetes there is considerable unmet need for cardiovascular risk factor intervention, particularly for hypertension and raised cholesterol. With this baseline established, future improvements can be monitored. Diabet. Med. 16, 35–40 (1999). [ABSTRACT FROM AUTHOR]

Focuses on the Southall Diabetes Survey on the prevalence of diabetes in Asians and Europeans in London, England. Tabular data on the age specific prevalence of diabetes in subjects; Information of the age at diagnosis and duration of diabetes in respondents; Importance of the data in planning for the care of diabetic patients in Asian communities.

Comparison of the results of home and hospital treatment in men aged 70 years suffering from myocardial infarction in England. Examination of hypotension incidence among the patients; Percentage of mortality rate for 28 days of the study; Preference of home care treatment for older patients.

The article describes the designs and plans for several buildings at the University of East Anglia in England by Rick Mather Associates. Areas on one side of the campus were utilized to construct college buildings. One of the many features of the buildings include glass, cylinders and roofings. Entrances are emphasized as well as the shapes. Given importance are the technical aspects of the structure.

Examines the variability of variation perception threshold among sites in diabetic patients in London, England. Variation of perception between contralateral sites and ipsilateral sites; Factors behind such variation; Use of electromechanical devices such as biothesiometer in measuring the vibration.

Abstract: An investigation of atmospheric trace metals was conducted in Oxford, UK, a small city ∼60 miles northwest of London, in 2007 and 2008. Concentrations of Sr, Mo, Cd, Pb, V, Cr, Mn, Fe, Co, Ni, Cu and Zn in aerosol were measured in bulk and size segregated samples. In addition, total gaseous mercury (TGM) concentrations were monitored semi-continuously by cold vapour-atomic fluorescence spectroscopy. Metal concentrations in Oxford were intermediate between previously reported levels of UK rural and urban areas for most metals studied and levels of Cd, Ni and Pb were within European guidelines. Metal concentrations appeared to be influenced by higher traffic volume on a timescale of hours. The influence of traffic on the aerosols was also suggested by the observation of carbonaceous particles via scanning electron microscopy (SEM). Air mass back trajectories suggest air masses arriving in Oxford from London and mainland Europe contained the highest metal concentrations. Aerosol samples collected over Bonfire Weekend, a period of intense firework use and lighting of bonfires in the UK, showed metal concentrations 6–46 times higher than at other times. Strontium, a tracer of firework release, was present at higher concentrations and showed a change in its size distribution from the coarse to fine mode over Bonfire Weekend. The presence of an abundance of spherical Sr particles was also confirmed in SEM images. The average TGM concentration in Oxford was 3.17 ng m−3 (st. dev. 1.59) with values recorded between 1.32 and 23.2 ng m−3. This is a higher average value than reported from nearby rural locations, although during periods when air was arriving from the west, similar concentrations to these rural areas were seen in Oxford. Comparison to meteorological data suggests that TGM in Oxford''s air is highest when wind is arriving from the east/southeast. This may be due to emissions from London/mainland Europe with a possible contribution from emissions from a local crematorium situated 4 miles east of the sampling site. A diurnal pattern was also observed in the TGM data with a minimum concentration during the day when mercury may have been diluted by thermal mixing of the atmospheric boundary layer. Additionally, this diurnal pattern may reflect variations in a local source of TGM. [Copyright &y& Elsevier]

Focuses on a study comparing the effectiveness of three rapid bioassays and a Daphnia magna (D. magna) 48-hour immobilization test that were used to assess groundwater quality in London, England. Comparison of bioassay result to groundwater chemistry; Correlation between bioassay and D. magna test results; Role of iron, ammonia and chloride in controlling water quality and toxicity.