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Soil organic carbon (SOC) is a soil health indicator and understanding dynamics changing SOC stocks will help achieving net zero goals. Here we present four datasets featuring 11,750 data points covering co-located aboveground and below-ground metrics for exploring ecosystem SOC dynamics. Five sites across England with an established land use contrast, grassland and woodland next to each other, were rigorously sampled for aboveground (n = 109), surface (n = 33 soil water release curves), topsoil, and subsoil metrics. Commonly measured soil metrics were analysed in five soil increments for 0–1 metre (n = 4550). Less commonly measured soil metrics which were assumed to change across the soil profile were measured on a subset of samples only (n = 3762). Additionally, we developed a simple method for soil organic matter fractionation using density fractionation which is part of the less common metrics. Finally, soil metrics which may impact SOC dynamics, but with less confidence as to their importance across the soil profile were only measured on topsoil (~5–15 cm = mineral soil) and subsoil (below 50 cm) samples (n = 2567). [ABSTRACT FROM AUTHOR]

The translocation of non-indigenous fishes into lowland rives can result in invasive populations establishing and dispersing. Because non-indigenous fishes can cause ecological harm, it is important to understand their trophic relationships and the effects they may have on native fishes. We assessed the trophic ecology of a translocated chub Squalius cephalus population in the River Frome, a lowland chalk stream in Southern England, using bulk stable isotope (δ13C, δ15N) metrics, and compared the results with those derived from indigenous chub populations. The isotopic niche sizes of all fishes in the River Frome were substantially larger in the tidal versus non-tidal site, with the δ13C values suggesting some fish were foraging further downstream of their sampling point in areas that had greater tidal and salinity influences. Inter-specific comparisons of isotopic niches revealed a consistent pattern of similar niche size and overlap between chub and the trophically analogous dace Leuciscus leuciscus. These isotopic relationships between chub and dace were then also apparent in the indigenous populations of these fishes. These results suggest that the colonisation of this lowland river by translocated chub is being facilitated by their isotopic relationships with other fishes that are similar to those observed in their native range. [ABSTRACT FROM AUTHOR]

Evidence-based clinical guidelines are essential to maximize patient benefit and to reduce clinical uncertainty and inconsistency in clinical practice. Gaps in the evidence base can be addressed by data acquired in routine practice. At present, there is no international consensus on management of women diagnosed with atypical lesions in breast screening programmes. Here, we describe how routine NHS breast screening data collected by the Sloane atypia project was used to inform a management pathway that maximizes early detection of cancer and minimizes over-investigation of lesions with uncertain malignant potential. A half-day consensus meeting with 11 clinical experts, 1 representative from Independent Cancer Patients' Voice, 6 representatives from NHS England (NHSE) including from Commissioning, and 2 researchers was held to facilitate discussions of findings from an analysis of the Sloane atypia project. Key considerations of the expert group in terms of the management of women with screen detected atypia were: (1) frequency and purpose of follow-up; (2) communication to patients; (3) generalizability of study results; and (4) workforce challenges. The group concurred that the new evidence does not support annual surveillance mammography for women with atypia, irrespective of type of lesion, or woman's age. Continued data collection is paramount to monitor and audit the change in recommendations. [ABSTRACT FROM AUTHOR]

Objectives To build a data set capturing the whole breast cancer screening journey from individual breast cancer screening records to outcomes and assess data quality. Methods Routine screening records (invitation, attendance, test results) from all 79 English NHS breast screening centres between January 1, 1988 and March 31, 2018 were linked to cancer registry (cancer characteristics and treatment) and national mortality data. Data quality was assessed using comparability, validity, timeliness, and completeness. Results Screening records were extracted from 76/79 English breast screening centres, 3/79 were not possible due to software issues. Data linkage was successful from 1997 after introduction of a universal identifier for women (NHS number). Prior to 1997 outcome data are incomplete due to linkage issues, reducing validity. Between January 1, 1997 and March 31, 2018, a total of 11 262 730 women were offered screening of whom 9 371 973 attended at least one appointment, with 139 million person-years of follow-up (a median of 12.4 person years for each woman included) with 73 810 breast cancer deaths and 1 111 139 any-cause deaths. Comparability to reference data sets and internal validity were demonstrated. Data completeness was high for core screening variables (>99%) and main cancer outcomes (>95%). Conclusions The ATHENA-M project has created a large high-quality and representative data set of individual women's screening trajectories and outcomes in England from 1997 to 2018, data before 1997 are lower quality. Advances in knowledge This is the most complete data set of English breast screening records and outcomes constructed to date, which can be used to evaluate and optimize screening. [ABSTRACT FROM AUTHOR]

The microplastic loads in elvers of the critically endangered European eel Anguilla anguilla, sampled in the lower reaches of three English rivers, were very low (incidence: 3.3%, mean ± s.d.: 0.03 ± 0.18 particles) and did not vary with body length or between rivers. Particles were mostly black, polyolefins, fibres and fragments of size 101–200 μm. Current levels indicate a low contamination pressure locally and, consequently, management efforts might prioritise mitigating the effects of other stressors affecting the species. [ABSTRACT FROM AUTHOR]

Introduced fishes into lowland rivers can result in invasive populations establishing and then dispersing, where knowledge of their life history traits contributes to understandings of their invasion ecology. Here, the age and growth rates of a translocated chub Squalius cephalus population were assessed in the River Frome, a lowland chalk-stream in Southern England, where chub was introduced approximately 15 years ago. The results were assessed in relation to 35 riverine indigenous chub populations in England. Across these populations, individual chub were present to lengths over 550 mm and aged to at least 19 years old. In samples collected from the River Frome, however, no fish were present over 300 mm and age 4+years. Growth rate analyses of both the annual length increment produced between age 1 and 2 years (juvenile growth rate) and length at the last annulus (adult growth rate) revealed that both of these were relatively high in the River Frome population, being among the fastest of all sampled populations. It is suggested these fast growth rates were the response of the fish to their new environment, facilitating their establishment and colonisation through, for example, enabling reproduction at relatively young ages. [ABSTRACT FROM AUTHOR]

Background: The risk of iatrogenic harm from the use and misuse of prescription drugs such as gabapentin, pregabalin, and oxycodone is substantial. In recent years, deaths associated with these drugs in England have increased. Aim: To characterise general practice prescribing trends for gabapentin, pregabalin, and oxycodone -- termed dependence forming medicines (DFM) -- in England and describe potential drivers of unwarranted variation (that is, very high prescribing). Design & setting: This study is a retrospective secondary analysis of open source, publicly available government data from various sources pertaining to primary care demographics and prescriptions. Method: This study used 5 consecutive years (April 2013-March 2018) of aggregate data to investigate longitudinal trends of prescribing and variation in prescribing trends at practice and clinical commissioning group (CCG) level. Results: Annual prescriptions of gabapentin, pregabalin, and oxycodone increased each year over the period. Variation in prescribing trends was associated with GP practice deprivation quintile, where the most deprived GP practices prescribed 313% (P<0.001) and 238% (P<0.001) greater volumes of gabapentin and pregabalin per person respectively, than practices in the least deprived quintile. The highest prescribing CCGs of each of these drugs were predominantly in northern and eastern regions of England. Conclusion: Substantial increases in gabapentin, pregabalin, and oxycodone prescriptions are concerning and will increase iatrogenic harm from drug-related morbidity and mortality. More research is needed to understand the large variation in prescribing between general practices, and to develop and implement interventions to reduce unwarranted variation and increase the appropriateness of prescribing of these drugs. [ABSTRACT FROM AUTHOR]

Background Cumulative impact zones (CIZs) are a discretionary policy lever available to local government, used to restrict the availability of alcohol in areas deemed already saturated. Despite little evidence of their effect, over 200 such zones have been introduced. This study explores the impact of three CIZs on the licensing of venues in the London Borough of Southwark. Methods Using 10 years of licensing data, we examined changes in the issuing of licences on the introduction of three CIZs within Southwark, relative to control areas. The number of licence applications made (N = 1110), the number issued, and the proportion objected to, were analysed using negative binomial regression. Results In one area tested, CIZ implementation was associated with 119% more licence applications than control areas (incidence rate ratios (IRR) = 2.19, 95% confidence intervals (CI): 1.29–3.73, P = 0.004) and 133% more licences granted (IRR = 2.33, 95% CI: 1.31–4.16, P = 0.004). No significant effect was found for the other two areas. CIZs were found to have no discernible effect on the relative proportion of licence applications receiving objections. Conclusions CIZs are proposed as a key lever to limit alcohol availability in areas of high outlet density. We found no evidence that CIZ establishment reduced the number of successful applications in Southwark. [ABSTRACT FROM AUTHOR]

Multisystemic therapy (MST) is an empirically supported intervention for young people presenting with antisocial behaviour. This study explored the process of sustaining positive outcomes following MST from caregiver perspectives. Semi-structured interviews were carried out 5-21 months post-MST with 12 caregivers. A grounded theory methodology was used to analyse the data. Caregivers in this study identified the following themes as contributing to sustaining change; improvements in their relationship with their child, shifting how they viewed difficulties and solutions and feeling personally strengthened and resilient. The therapeutic alliance in MST was described as important in initiating these changes. Clinical implications and how the themes from this study fit into the existing model of change in MST are discussed. Practitioner points Caregivers validated the therapeutic alliance as key to the MST approach., Experiencing a positive therapeutic alliance was also identified as important in improving relationships within the family even after therapy was completed., Positive experiences of MST developed caregivers' experiences of feeling more resilient in the face of later difficulties helping sustain positive outcomes. [ABSTRACT FROM AUTHOR]

Multisystemic therapy (MST) is an empirically validated, family and community‐based intervention for young people presenting with antisocial and offending behaviour. This qualitative study aimed to explore young people's experiences of MST and learn what had helped them to sustain positive outcomes over time. Semi‐structured interviews were conducted with eight young people at an average of 14 months after MST (range: 5–21 months). A constructivist version of grounded theory was employed to analyse the data, leading to the development of a model of sustained change in MST. Themes from the model included therapeutic alliance, increases in systemic awareness, recognizing responsibility, positive peer relationships, acknowledging and celebrating success, continued use of specific strategies (for example, worry boxes) and the identification and creation of a preferred future. This research presents an understanding of how change may be sustained after MST, highlighting systemic, developmental and individual factors in relation to this. Clinical implications and a proposed model of sustained change in MST are discussed. Practitioner points: The therapeutic alliance was perceived by young people as central to the process of change and sustained change following MSTYoung people's contribution to sustaining therapeutic gains at follow up, alongside caregivers, highlighted the importance of actively engaging them in therapyPeer relationships were identified as relevant to sustaining change, particularly in relation to shared values and goals for the future [ABSTRACT FROM AUTHOR]

Background There is some evidence to suggest that higher job satisfaction among healthcare staff in specific settings may be linked to improved patient outcomes. This study aimed to assess the potential of staff satisfaction to be used as an indicator of institutional performance across all acute National Health Service (NHS) hospitals in England. Methods Using staff responses from the NHS Staff Survey 2009, and correlating these with hospital standardised mortality ratios (HSMR), correlation analyses were conducted at institutional level with further analyses of staff subgroups. Results Over 60 000 respondents from 147 NHS trusts were included in the analysis. There was a weak negative correlation with HSMR where staff agreed that patient care was their trust's top priority (Kendall τ = -0.22, p<0.001), and where they would be happy with the care for a friend or relative (Kendall τ = -0.30, p<0.001). These correlations were identified across clinical and non-clinical groups, with nursing staff demonstrating the most robust correlation. There was no correlation between satisfaction with the quality of care delivered by oneself and institutional HSMR. Conclusions In the context of the continued debate about the relationship of HSMR to hospital performance, these findings of a weak correlation between staff satisfaction and HSMR are intriguing and warrant further investigation. Such measures in the future have the advantage of being intuitive for lay and specialist audiences alike, and may be useful in facilitating patient choice. Whether higher staff satisfaction drives quality or merely reflects it remains unclear. [ABSTRACT FROM AUTHOR]

The article describes how the changes in architectural landscapes in Croydon, London, England have helped remember and overcome social, urban, and economic traumas. Topics cited include the definition of trauma, history of Croydon, notable examples of modernist architecture's illustration of historical contexts and traumas, and architectural features of the Croydon Tower.

Walking has moved into increasing visibility in social, cultural, and geographical studies as well as art and cultural practice in recent times. Walking practices are often mobitised as a means for sensing and learning about spaces, for enabling reflection on the mutual constitution of bodies and landscapes, and for finding meaning within and potentially re-enchanting environments. Through the influence of Michel de Certeau in particular, the idea that walking 'encunciates' spaces and is a creative, elusive, and resistive everyday practice, counterpoised to the 'solar eye', has become com- monplace. This paper focuses on projects by the artist Francis Alys that are based on walking in London and other cities, to consider their engagements with the politics of urban space. Attention is paid to walking as his method of unfolding stories, and to its potential to unsettle and bring into question current realities, especially in the context of the regulated, fortified, and surveilled zones of London. Addressing the poetics and politics of his spatial practices, however, reveals the inadequacy of undifferentiated models of creative resistance, nomadism, and subversion beloved of much recent theory, and often endorsed through a partial reading of Certeau. Instead, the openness and ambivalence of these practices suggest a need for a more nuanced approach to the multiple rhythms, trajectories, and narratives that constitute urban spaces as well as to their contested (in)visibilities. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate the potential of employing unconventional facility/facilities management (FM) performance indicators in healthcare settings to enable more strategic conversations between FM and business users concerning asset performance. Background: The theoretical background for a Lean asset approach and a high-level analysis of data from hospital trusts in England have been published elsewhere. This paper reports on the fi rst uses of that approach in operational settings. Method: Observations are drawn primarily from three case studies. Results: The individual studies support the premise that the conventional emphasis on cost per square meter (m2) as a preeminent measure of FM disguises a portfolio of too much underutilized space. They provide a means of putting a healthcare estates strategy in terms that will engage business users. Conclusions: Despite a growing interest in Lean approaches in healthcare, the philosophy has not yet been extended to the estate. This study demonstrates that alternative benchmarks are possible. [ABSTRACT FROM AUTHOR]

1. About 25 % of juvenile Atlantic salmon ( Salmo salar) migrating downstream in the River Frome in southern England do so in the autumn rather than in the spring. Here, we examine the physiological status of these fish with regard to those features that adapt them to sea water during the parr–smolt transformation (i.e. gill Na+K+ ATPase activity; the number, size and type of chloride cells on the gill lamellae; salinity tolerance and relative plasma thyroid levels). 2. Autumn migrants, and those fish which subsequently reside in the tidal reaches during the winter, are not sufficiently physiologically adapted to permit permanent or early, entry into the marine environment. 3. It is not known what proportion of autumn migrating fish survive and return to spawn as adults. If significant numbers do return, however, the production from tidal reach habitats must be taken into account in the development of salmon stock management strategies, especially monitoring and assessment programmes, and in the evaluation of factors affecting stocks. [ABSTRACT FROM AUTHOR]

The use of passive integrated transponder technology facilitated the first observations of the autumn migration of 0+ year Atlantic salmon Salmo salar parr into tidal rearing habitats in the U.K. The quality of these habitats in relation to smolt production and the ecological significance of this alternative life-history strategy are presently not understood. [ABSTRACT FROM AUTHOR]

The article describes the rapid colonization of new water bodies by the invasive topmouth gudgeon, Pseudorasbora parva, which is a small cyprinid, in England and Wales. The dispersal and known distribution of the topmouth gudgeon are also discussed. The report provides an important basis for agencies responsible for protecting aquatic ecosystems in Great Britain. It also identifies sites from which there is an imminent risk of downstream dispersal of Pseudorasbora parva into river networks, an occurrence that would significantly reduce options for controlling the future spread and subsequent impact of the invasive species.

The grade of recurrent in situ and invasive carcinoma occurring after treatment of pure ductal carcinoma in situ (DCIS) has been compared with the grade of the original DCIS in 122 patients from four different centres (The Royal Marsden Hospitals, London and Sutton, 57 patients; Guy's Hospital, London, 19 patients; Nottingham City Hospital, 31 patients and The Royal Liverpool Hospital, 15 patients). The recurrent carcinoma was pure DCIS in 70 women (57%) and in 52 women (43%) invasive carcinoma was present, which was associated with an in situ element in 43. In all, 19 patients developed a second recurrence (pure DCIS in 11 and invasive with or without an in situ element in eight). The majority of invasive carcinomas followed high-grade DCIS. There was strong agreement between the grade of the original DCIS and that of the recurrent DCIS (?=0.679), which was the same in 95 of 113 patients (84%). The grade of the original DCIS showed only fair agreement with the grade of recurrent invasive carcinoma (?=0.241), although agreement was stronger with the pleomorphism score of the recurrent carcinoma (?=0.396). There was moderate agreement, in recurrent invasive lesions, between the grade of the DCIS and that of the associated invasive element (?=0.515). Other features that showed moderate or strong agreement between the original and recurrent DCIS were necrosis and periductal inflammation. The similarity between the histological findings of the original and subsequent DCIS is consistent with the concept that recurrent lesions represent regrowth of residual carcinoma. In addition, although agreement between the grade of the original DCIS and that of any subsequent invasive carcinoma was only fair, there is no suggestion that low-grade DCIS lesions progress to higher grade lesions or to the development of higher grade invasive carcinoma. This is in agreement with immunohistochemical and molecular data indicating that low-grade and high-grade mammary carcinomas are quite different lesions.British Journal of Cancer (2004) 90, 1538-1542. doi:10.1038/sj.bjc.6601704 www.bjcancer.com Published online 30 March 2004 [ABSTRACT FROM AUTHOR]

This report is of a study of small group work in general practice vocational training schemes (GPVTS) in the London area, by a group of Baling-orientated general practitioner (GP) educators. It is part of a larger study which examines the educational processes of small group work. In this report, we focus on the `insider research' contribution of the Baling GP educators who identify the prevalence of small group teaching of different styles (established by a postal questionnaire) describe visits to some schemes offering Balint groups and some that used case discussion groups with other aims consider what was found and discuss the place of case discussion groups within a GPVTS for encouraging work based reflection. [ABSTRACT FROM AUTHOR]

This article presents abstracts of proffered papers of meeting held by Society for the Study of Human Biology which was held at the University of Cambridge on May 8, 2003. Some of the papers discussed here are: "What the "Body-Beautiful" Might Be Telling Us About the "Body-Healthy"" by S. Lewis of Chester College from Chester, England. "The Cognitive Abilities of Cebus Apella Libidinosus: Tool Use and Survival in a Harsh Environment" by A.C. De Moura and P.C. Lee from University of Cambridge, located in England. "A Review of Neanderthal and Selk'nam Long Bone Trauma Frequency" by S. UnderDown, University of Cambridge, located in England.

Studies the spawning behavior of male nest guarding sunbleak Leucaspius delineatus, an invasive species in southern England. Reproductive behavior of territorial males; Initial cue in female mate choice; Decisive behavioral trait in influencing mate choice; Rates of sired egg predation by dilution among unrelated eggs.

Theoretical ideas of sustainability of heritage are applied to a practical case study. The south western peninsula of England has a rich variety of coastal heritage, analysis of which is undertaken via the ‘fields’ of nature, landscape, buildings, sites, artefacts, activities and people. The value of treating the cultural heritage apart from the natural heritage is seriously questioned, particularly in a coastal context. Disputes relating to the preference for one type of heritage over another are identified. While major successes are demonstrated in landscape and urban conservation, numerous failures and challenges are also recognised. It is argued that, reflecting institutional dominance of the conservation agenda, the heritage most at risk is often that which carries most meaning for local people and traditional visitors. Relating the study to the sustainability dimensions of economic development and environmental protection, the paper questions whether these wider definitions of sustainability can be applied to coastal heritage, especially in a remote region. [Copyright &y& Elsevier]

The response of micro-businesses to sustainability issues, and their use of environmental management tools and systems, are often presented as simply scaled-down versions of those of larger businesses in the small and medium-sized enterprise (SME) sector as a whole. This paper presents the findings of a series of focus groups with the owners of tourism micro-businesses in South East Cornwall about their awareness, understanding and adoption of sustainable tourism practices. The results reveal a complex and diverse response to the concept that resists such generalizations. A genuine need for measures to increase awareness and integrate sustainability issues within business practice is highlighted. Initiatives that do not account for the heterogeneity of the sector are likely to have only limited success. [ABSTRACT FROM AUTHOR]

Reports that seven pike Esox lucius L., implanted with radio-transmitters, were tracked throughout autumn and winter in the River Frome, a southern English chalk river. Description of the study in which it was seen that during the first flood events of the year, pike remained within the main river channel but during subsequent flood events, pike could also be found in flooded fields, in drainage ditches or in a millstream; Evidence that eighty percent of the fixes over flooded land occurred near the riverbank, although distances of up to 89 meters from the bank were recorded; Finding that for pike in ditches and flooded fields, distance from the main river channel was positively correlated with discharge; Appearance of individual variation amongst pike for the habitat types selected, with some pike utilizing flooded field or ditch habitat more often than others; Study of the correlation between the proportion of time spent out of the main river channel the size of the pike; Suggestion that pike are leaving the main river channel to exploit feeding opportunities in the flooded fields and drainage ditches, rather than using these areas as refugia from high flow conditions.

Examines development management practices in English cities based on a study of Sheffield, England. Account on the closure of the Sheffield Users Network health project; Contradictions in the development management practices in the cities; Issues on power, framework on language and culture, patterns of domination and deprivation in the cities.

The author suggests the implementation of the Inspire program of England in Scotland since cross-sectoral library collaboration is flourishing in the region. It is a national two-year programme aimed at improving access for all learners to resources held in national, higher education and public libraries. The funding of Inspire comes from Regional Libraries Advisory Group.