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Social identity theory (SIT) was used to investigate effects of social categorization on adolescents' intergroup behaviour. Participants displayed consistent ingroup-favouring behaviour in their ratings: the ingroup was associated to a greater extent than the outgroup with positively valued dimensions, and to a lesser extent with negatively valued dimensions. (Author)

Investigates whether social loafing (the tendency for individuals to reduce their input when performing as part of a group) existed in a collaborative educational task employing groups of three and eight participants. Indicates that individuals working in smaller groups were more productive than those working in larger groups. (CMK)

Background Variation in the approach, radicality, and quality of gastroesophageal surgery impacts patient outcomes. Pathological outcomes such as lymph node yield are routinely used as surrogate markers of surgical quality, but are subject to significant variations in histopathological evaluation and reporting. A multi-society consensus group was convened to develop evidence-based recommendations for the standardized assessment of gastroesophageal cancer specimens. Methods A consensus group comprised of surgeons, pathologists, and oncologists was convened on behalf of the Association of Upper Gastrointestinal Surgery of Great Britain & Ireland. Literature was reviewed for 17 key questions. Draft recommendations were voted upon via an anonymous Delphi process. Consensus was considered achieved where >70% of participants were in agreement. Results Consensus was achieved on 18 statements for all 17 questions. Twelve strong recommendations regarding preparation and assessment of lymph nodes, margins, and reporting methods were made. Importantly, there was 100% agreement that the all specimens should be reported using the Royal College of Pathologists Guidelines as the minimum acceptable dataset. In addition, two weak recommendations regarding method and duration of specimen fixation were made. Four topics lacked sufficient evidence and no recommendation was made. Conclusions These consensus recommendations provide explicit guidance for gastroesophageal cancer specimen preparation and assessment, to provide maximum benefit for patient care and standardize reporting to allow benchmarking and improvement of surgical quality. [ABSTRACT FROM AUTHOR]

Barley 'Scald' is an economically damaging fungal disease that is a global problem, causing significant yield and economical losses in the UK barley feed and malting industries. Presently, a limited number of Rhynchosporium resistance genes exist, but selective pressures on the fungi cause the demand for new sources of resistance. Landraces, such as the Scottish Bere barley, hold potential sources of resistance that can be utilised, with farmers providing anecdotal evidence of resistance in field populations of Bere. This study analysed 131 heritage cultivars and landrace lines, including 37 Bere lines, to screen for resistance using both detached leaf assays (DLAs) and field experiments. Results showed that Bere lines produced smaller, but more necrotic, lesions for the majority of isolates in the DLAs, as well as smaller scores when visually assessed in field conditions. Whilst the infection patterns of the lines differed between isolates and experimental conditions, three Bere lines were identified as consistently showing reduced levels of infection (45 A 23, 58 A 36 Eday, and 8-125). Using genome-wide association analysis, we were able to identify a number of genomic regions associated with reduced infection symptoms, four in regions associated with known resistance genes, but another four associated with new regions that contain promising candidate genes. Further analysis of these new regions and candidate genes should be undertaken to identify targets for future disease-resistance breeding. [ABSTRACT FROM AUTHOR]

This research investigated associations between the lyrics of every song to have reached the weekly U.K. Top 5 singles chart from 1960 to 2015 and the number of people responsible for recording each song. Following computerized content analysis of the lyrics of the 4,534 unique songs, the results showed that the number of musicians involved was negatively related to use of cognitive terms, consistent with previous research on social loafing, and was also negatively related to instances of self-reference and use of language concerning social interaction, arguably in reflection of the inherent constraints on such that arise from collaborating with others. [ABSTRACT FROM AUTHOR]

Summary: This document aims to provide practical guidance for the assessment and management of patients with thrombocytopenia, with a particular focus on immune thrombocytopenia (ITP), during the COVID‐19 pandemic. The intention is to support clinicians and, although recommendations have been provided, it is not a formal guideline. Nor is there sufficient evidence base to conclude that alternative approaches to treatment are incorrect. Instead, it is a consensus written by clinicians with an interest in ITP or coagulation disorders and reviewed by members of the UK ITP forum. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Understanding UV exposure is essential for the assessment of its contribution to the occupational risk of pilots developing ocular and skin pathologies. The objective of this observational study was to measure the UV exposure of pilots flying between the United Kingdom and a range of destinations at three different seasons. METHODS: The in-flight UV exposure of pilots was measured on 322 Monarch Airlines short-haul flights on the Airbus A321-231 and Airbus A320-214 to 31 destinations, mostly in Europe, from 4 UK airports in September 2016–August 2017. The erythema effective and UV-A doses were compared with the ICNIRP guidance and typical recreational weekend exposure of UK office workers. RESULTS: The erythema effective radiant doses did not exceed 0.1 SED. For most of the flights, the UV-A exposure was also low. On 27 single sector flights, UV-A exposure could have exceeded the ICNIRP guidance if eye protection was not used. DISCUSSION: The UV exposure in a cockpit is mostly governed by the presence of direct sunlight and the duration of a flight. The average monthly exposures were low and significantly below weekend recreational exposures of UK office workers over a similar period. To assess the contribution of occupational UV exposure to the risk of developing sun-related ocular and cutaneous pathologies, it is important to consider the accumulative flight time, destinations, and UV attenuation of aircraft windshields. Additionally, leisure and recreational outdoor time needs to be considered before meaningful overall risk analysis can be undertaken. [ABSTRACT FROM AUTHOR]

Abstract The ongoing loss of global biodiversity suggests that established conservation practices have not been fully successful at halting species decline. Rewilding, a restoration strategy focused on restoring ecological processes, has become increasingly prominent as a potential means of addressing this problem. Rewilding has been described as a versatile approach that is applicable even in areas with dense human populations and productive agricultural landscapes such as the lowlands of Western Europe. Yet little is known about the options that might exist for rewilding such landscapes, or about their relative suitability. The present study addresses this knowledge gap by assessing the relative popularity and suitability of different rewilding scenarios in the county of Dorset, south-west England, involving the consultation of local stakeholders. Survey results showed strong support for rewilding among stakeholders, with the reintroduction of beavers (Castor fiber) and pine martens (Martes martes) being especially popular. Yet stakeholder perceptions also differed regarding how rewilding should be defined, and what it comprises. The suitability of the proposed rewilding approaches was measured through a spatial multi-criteria analysis using the following variables: popularity among stakeholders, suitability within relevant land cover types, and suitability at the landscape-scale. Naturalistic grazing and farmland abandonment emerged as the most suitable rewilding options overall, although these were not the most popular choices. Overall, these results suggest that land managers in lowland agricultural landscapes could consider rewilding as one of the land management options available to them, provided that the options being considered are ecologically appropriate and local stakeholders have been consulted. In the UK, such rewilding options might be supported by new national agricultural land use policies currently under development. In areas of continental Europe where agricultural land abandonment is more widespread, policy-makers seeking to address the issue could look towards the EU's wilderness guidelines for potential solutions that promote rewilding while offsetting the costs incurred by local stakeholders. In either context, integrated exploration of stakeholder values and ecological data as presented here can potentially be used to evaluate the relative suitability and popularity of different rewilding approaches, and thereby establish priorities. [ABSTRACT FROM AUTHOR]

Research on musical preference has been dominated by two approaches emphasizing, respectively, the arousal-evoking qualities of a piece or its typicality of the individual’s overall musical experience. There is a dearth of evidence concerning whether either can explain preference in conditions of high ecological validity. To address this, the present research investigated the association between sales of 143,353 pieces of music, representing all the music that has enjoyed any degree of commercial success in the United Kingdom, and measures of both the energy of each piece (as a proxy for arousal) and the extent to which each piece was typical of the corpus. The relationship concerning popularity and energy was U-shaped, which can be reconciled with earlier findings, and there was a positive relationship between the typicality of the pieces and the amount of time they featured on sales charts. The population-level popularity of an entire corpus of music across several decades can be predicted by existing aesthetic theories, albeit with modifications to account for market conditions. [ABSTRACT FROM AUTHOR]

Functional diversity (FD) is increasingly used as a metric to evaluate the impact of forest management strategies on ecosystem functioning. Management interventions that aim to maximise FD require knowledge of multiple environmental drivers of FD, which have not been studied to date in temperate coniferous production forests. We quantified the relative importance of abiotic (forest management) and biotic (ground vegetation community) drivers of carabid FD and trait distribution in 44 coniferous plantation forest stands across the UK. Carabid FD declined with canopy cover and carabid body length correlated negatively with the percentage of open semi-natural area surrounding a plot. We conclude that forest management could enhance carabid FD through initiatives that emulate natural disturbance regimes through gap creation. We found that neither functional nor taxonomic metrics of vegetation diversity correlated with carabid FD, suggesting that restoration of plant communities, a major goal of forest restoration efforts, will not necessarily enhance carabid FD in coniferous plantations. [ABSTRACT FROM AUTHOR]

Background: Most research on the influence of psychosocial job characteristics on health status has been conducted within affluent Western economies. This research addresses the same topic in a middle-income Southeast Asian country, enabling comparison with a Western benchmark. Methods: We analysed and compared the Health Survey for England conducted in 2010 and the Thai Cohort Study data at 2005 baseline for workers aged 35-45 years. Multivariate logistic regression was used to assess relationships between psychosocial job characteristics and health, measured as Adjusted Odd Ratios (AOR), controlling for potential covariates in final analyses. Results: In both UK and Thai working adults, psychological distress was associated with job insecurity (AOR 2.58 and 2.32, respectively), inadequate coping with job demands (AOR 2.57 and 2.42), and low support by employers (AOR 1.93 and 1.84). Job autonomy was associated with psychological distress in the UK samples (AOR 2.61) but no relationship was found among Thais after adjusting for covariates (AOR 0.99). Low job security, inability to cope with job demands, and low employer support were associated with psychological distress both among Thai and UK workers. Conclusions: Job autonomy was an important part of a healthy work environment in Western cultures, but not in Thailand. This finding could reflect cultural differences with Thais less troubled by individualistic expression at work. Our study also highlights the implications for relevant workplace laws and regulations to minimise the adverse job effects. These public health strategies would promote mental health and wellbeing in the population. [ABSTRACT FROM AUTHOR]

Objective: To examine the effectiveness of targeted surveillance for the identification of moderate-profound PCHI in babies who pass the newborn hearing screen in England and have risk factors. Design: Retrospective analysis. Study sample: 2 307 880 children born 01/04/06-30/09/09 in England. Results: Overall the prevalence for all PCHI in children with risk factors who pass newborn hearing screening is 1.49/1000. The risk factors with the highest prevalence are (1) Syndrome (other than Down's) associated with a hearing loss; (2) NICU with refer in both ears at OAE and pass in both ears at AABR; (3) Craniofacial anomaly; (4) Down's syndrome; (5) Congenital infection. Conclusion: Targeted surveillance for children who pass the screen and have the risk factors 1-5 listed above will be retained within the English NHSP; targeted surveillance for children who pass the screen and have other risk factors is not effective and has been discontinued. [ABSTRACT FROM AUTHOR]

Fitness cost associated with pathogens carrying unnecessary virulence alleles is the fundamental assumption for preventing the emergence of complex races in plant pathogen populations but this hypothesis has rarely been tested empirically on a temporal and spatial scale which is sufficient to distinguish evolutionary signals from experimental error. We analyzed virulence characteristics of ∼1000 isolates of the barley pathogen Rhynchosporium secalis collected from different parts of the United Kingdom between 1984 and 2005. We found a gradual increase in race complexity over time with a significant correlation between sampling date and race complexity of the pathogen (r20 = 0.71, p = 0.0002) and an average loss of 0.1 avirulence alleles (corresponding to an average gain of 0.1 virulence alleles) each year. We also found a positive and significant correlation between barley cultivar diversity and R. secalis virulence variation. The conditions assumed to favour complex races were not present in the United Kingdom and we hypothesize that the increase in race complexity is attributable to the combination of natural selection and genetic drift. Host resistance selects for corresponding virulence alleles to fixation or dominant frequency. Because of the weak fitness penalty of carrying the unnecessary virulence alleles, genetic drift associated with other evolutionary forces such as hitch-hiking maintains the frequency of the dominant virulence alleles even after the corresponding resistance factors cease to be used. [ABSTRACT FROM AUTHOR]

Genetic associations of TNFR2, VDR ( Bsm I and Fok I), A2M, GSTT, GSTM and ACE in South Asian and Caucasian patients with rheumatoid arthritis (RA) were assessed in this study. DNA samples from South Asians (134 cases, 149 controls) and Caucasians (137 cases, 150 controls) from the East Midlands of the United Kingdom were genotyped for seven polymorphisms. All cases were rheumatoid-factor positive. Significant genetic associations were observed with TNFR2 R-R (OR = 3.16, CI 1.20-9.26, P < 0.05), A2M 1-1 (OR = 2.09, CI 1.21-3.64, P < 0.05) and GST Tnull (OR = 1.97, CI 1.07-3.68, P < 0.05) among Caucasian patients. In South Asians, VDR Bsm I B-B genotype (OR = 2.08, CI 1.23-3.52, P < 0.05), A2M 2-2 genotype (OR = 3.99, CI 1.19-17.18, P < 0.05), and GST Tnull genotype (OR = 2.81, CI 1.40-5.77, P < 0.002) genotypes were associated with RA. In the majority of cases, recessive and multiplicative modes of inheritance explained the observed associations. This study demonstrates that ethnicity affects the genetic associations in RA. [ABSTRACT FROM AUTHOR]

Abstract: In order to explore the impact of land-use change on carbon (C) stocks in South West England, three scenarios were explored based on current UK national- and regional-scale policies and plans. The scenarios assessed were: (i) Rebuilding Biodiversity (RB), involving habitat restoration of 824,244ha of strategic nature areas; (ii) Forest Strategy (FS), involving establishment of 16,000ha of new woodlands; and (iii) Biomass Strategy (BS), involving conversion of 65,513ha of arable land into bioenergy crops. It was assumed that each of these targets would be implemented by the year 2020, with carbon build-up times of 100, 100 and 30 years, respectively. Estimates of C-stock changes were produced by compiling vegetation and soil organic C-density data for 11 land-use types from a systematic literature review. Results indicated that FS would lead to the highest yearly potential carbon sequestration (up to 3.63MgCha−1 yr−1). However, the total C-stocks would be the highest under RB (up to 20% increase), owing to the greater area of pastures and arable land being converted into broadleaved forest when compared to FS. BS would have the least effect on C (C-stock increase of up to 0.3% and up to 0.41MgCha−1 yr−1 sequestered). The spatially explicit analytical approach adopted here provides an indication of which land-use changes would contribute most to C-sequestration within the South West region, and could contribute to achieving national emission reduction targets post-2012. [Copyright &y& Elsevier]

Authors from the UK review their experience of lower urinary tract injuries in association with fractures of the pelvic ring. They found that the pattern of pelvic fracture did not help with the prediction of the presence of lower urinary injury, but that the type of injury was related to the fracture mechanism. This study represents a large review of such injuries in both men and women, and the authors present their own theories on mechanisms of injury. OBJECTIVE To investigate whether the observation of particular pelvic fracture patterns enables the clinician to predict the presence and type of injuries to the lower urinary tract, as the mechanisms of injury to the lower urinary tract in association with fractures of the pelvic ring are unclear. PATIENTS AND METHODS The case-notes and radiographs of 168 patients with either pelvic ring or acetabular fractures were reviewed; 108 pelvic ring fractures (81 men, 27 women) and 60 acetabular fractures (46 men, 14 women). The pelvic fractures were classified according to the system described by Tile and were correlated with the incidence and type of lower urinary tract injury (LUTI). RESULTS Overall, of the 108 men and women with pelvic ring fractures, 27 (25%) had a LUTI documented either radiologically or as an intraoperative finding. Of the 81 men with pelvic ring fractures, 24 (30%) had a LUTI, of whom six (7%) had an isolated bladder laceration, 14 (17%) a partial urethral injury (PUI) and four (5%) a complete urethral disruption (CUD). Five of the 18 men with urethral injuries also had bladder injuries and in three of these, the bladder neck was also injured. Three of 27 women (11%) had a LUTI, all of whom had isolated bladder lacerations. Of the 46 men with an acetabular fracture, one (2%) had a CUD, and three (7%) had a PUI. One of 14 of women with an acetabular fracture sustained a bladder laceration. None of the three men with a Tile Type-A pelvic ring fracture sustained a LUTI. Of the 28 men with ‘open-book’ (Tile Type-B1) fractures, 21 (75%) had no associated LUTI and seven (25%) had a LUTI (five partial urethral injuries and two bladder lacerations). Of the 10 men with ‘lateral compression’ (Tile Type-B2) fractures, six had no LUTI and four had a LUTI (two partial urethral injuries and two bladder lacerations). Of the 40 men with ‘vertical shear’ (Tile Type-C) fractures, 27 (68%) had no LUTI and 13 (32%) a LUTI (four complete urethral disruptions, seven partial urethral injuries, and two bladder lacerations) including all of the combined bladder and urethral injuries and all of the bladder neck injuries. CONCLUSION The pelvic fracture pattern alone does not predict the presence of a LUTI. When it occurs, the type of LUTI appears to be related to the fracture mechanism. The pattern of injury to the soft tissue envelope and specifically to the ligaments supporting the lower urinary tract offers the best correlation with the observed LUTI. We propose a mechanism for this. [ABSTRACT FROM AUTHOR]

It has often been observed that the early years of the 20th century witnessed a significant and noticeable rise in both the quantity and quality of British analysis. Invariably in these accounts, the name of G.H. Hardy (1877–1947) features most prominently as the driving force behind this development. But how accurate is this interpretation? This paper attempts to reevaluate Hardy''s influence on the British mathematical research community and its analysis during the early 20th century, with particular reference to his relationship with the London Mathematical Society. [Copyright &y& Elsevier]

The aim of this paper is to describe the provision of hearing aid services in Denmark, Finland and the United Kingdom (UK). A cross-sectional survey of adult hearing aid centres in Denmark, Finland and the UK was undertaken. Information requested included annual expenditure, staff levels, types of hearing aids provided, and patient characteristics. Data for the calendar year 2000 was requested in Denmark and Finland and for the financial year 2000/1 in the UK. Costs were converted into euros (€), at the following rates: 1€ = £0.62 = 7.45 Danish Krone = 5.95 Finnish Markka. The population covered by responding centres was equivalent to 80% in Denmark, 90% in Finland and 78% in the UK. Denmark spent the most per capita (€7.31), spent €670 per person fitted and provided the most aids (10.9 per thousand people). Finland spent €2.48 per capita, spent the most per person fitted (€924), but provided the fewest aids (2.7 per thousand people). The UK spent the least per capita (€1.76), spent €296 per person fitted and provided 6.0 aids per thousand people. The price of similar types of hearing aids differed across countries and was at least 10% lower for all aid types in the UK. Between countries, there were variations in the proportion of people who received bilateral (Denmark 68%, Finland 5%, UK 18%), in the ear (Denmark 43%, Finland 25%, UK 7%) and digital signal processing (Denmark 52%, Finland 17%, UK 1%) hearing aids. We conclude that there are major differences in hearing aid services provided in Denmark, Finland and the UK. These international differences arise from both differences in expenditure levels and different choices made about the number and types of aids provided. [ABSTRACT FROM AUTHOR]

Senecio squalidus (Oxford Ragwort) is being used as a model species to study the genetics and molecular genetics of self‐incompatibility (SI) in the Asteraceae. S. squalidus has a strong system of sporophytic SI (SSI) and populations within the UK contain very few S alleles probably due to a population bottleneck experienced on its introduction to the UK. The genetic control of SSI in S. squalidus is complex and may involve a second locus epistatic to S. Progress towards identifying the female determinant of SSI in S. squalidus is reviewed here. Research is focused on plants carrying two defined S alleles, S1 and S2. S2 is dominant to S1 in pollen and stigma. RT‐PCR was used to amplify three SRK‐like cDNAs from stigmas of S1S2 heterozygotes, but the expression patterns of these cDNAs suggest that they are unlikely to be directly involved in SI or pollen–stigma interactions in contrast to SSI in the Brassicaceae. Stigma‐specific proteins associated with the S1 allele and the S2 allele have been identified using isoelectric focusing and these proteins have been designated SSP1 (Stigma S‐associated Protein 1) and SSP2. SSP1 and SSP2 cDNAs have been cloned by 3′ and 5′ RACE and shown to be allelic forms of the same gene, SSP. The expression of SSP and its linkage to the S locus are currently being investigated. Initial results show SSP to be expressed exclusively in stigmas and developmentally regulated, with maximal expression occurring at and just before anthesis when SI is fully functional, SSP expression being undetectable in immature buds. Together these data suggest that SSP is a strong candidate for a Senecio S‐gene. [ABSTRACT FROM PUBLISHER]

Despite an increase in the number of food handlers receiving food hygiene training, a high proportion of food poisoning outbreaks still occur as a result of poor food handling practices. This paper uses elements of social cognitive theory to examine the beliefs of food handlers towards food safety and to determine food handlers' self-reported practices. Questionnaires were completed by 137 food handlers from 52 small to medium-sized food businesses in Wales. Generally, food handlers were aware of the food safety actions they should be carrying out but identified a number of barriers which would prevent them from implementing these practices. These barriers included lack of time, lack of staff and a lack of resources. Despite 95% of respondents receiving food hygiene training, 63% admitted to sometimes not carrying out food safety behaviours. All the food handlers also perceived their business to be of relatively low risk and yet all businesses prepared high risk foods. This research highlights the need for training to be based around a risk-based approach and demonstrates that behavioural change will not occur merely as a result of training. Food safety practices will only be implemented given adequate resources and an appropriate management culture. [ABSTRACT FROM AUTHOR]

Conclusions: Prevalence of confirmed permanent childhood hearing impairment increases until the age of 9 years to a level higher than previously estimated. Relative to current yields of universal neonatal hearing screening in the United Kingdom, which are close to 1/1000 live births, 50-90% more children are diagnosed with permanent childhood hearing impairment by the age of 9 years. Paediatric audiology services must have the capacity to achieve early identification and confirmation of these additional cases. [ABSTRACT FROM AUTHOR]

Examines the evolution of manuscript versions of a text in Great Britain. Relationships between different manuscript version of a text; Similarities between the evolution of DNA and the evolution of texts; Mistakes frequently made by scribes in copying a text.

The food hygiene training received and qualifications held by four different grades of food handlers were compared by means of a postal survey of 1650 businesses in the manufacturing, retail and catering sectors of the UK food industry. Significant differences (p < 0.05) were identified between the methods of training delivery to, and qualifications held by different grades of food handlers across the three industry sectors. Business status, personnel characteristics and risk perceptions of managers all had significant effects on the methods of training used and qualification levels achieved within each industry sector. Positive attitudes towards training were expressed by most managers although follow-up face-to-face interviews revealed their concerns about the cost, time and relevancy of the training their staff received. Whilst both the uptake of training and level of food hygiene qualifications may have improved in recent years, this study highlighted the need to develop training methods that are proven to change workplace behaviour as well as imparting knowledge. This may be best achieved by consolidating food hygiene training as a fundamental part of a wider approach to food safety control based on HACCP. [ABSTRACT FROM AUTHOR]

Presents research which examined the relationship between individuals' responses to pop music in Great Britain and overt statements made by pop music critics. Examination of the media coverage given to pop music, by arts media; Description of research methods utilized; Analysis of data compiled in this research.

Over the last decade, our knowledge of the demand for money has become more fragile. Widely accepted short-run estimating equations which relate real balances to the level of real income, the cost of holding money and lagged real balances are variously said to have broken down in the 1970s. This has been found in evidence generated in several countries and has prompted many attempts to explain why this previously satisfactory formulation should now display instability. Some of these took to changes in the institutional framework and/or policy regime, others to the modelling of the short-run adjustment process for explanations. But yet another approach has been to suggest that the conventional equation is itself misspecified: measures of both the 'scale' variable and the 'cost' variable have been questioned.[1] This paper re-examines the cost of holding money and derives theoretically an appropriate measure of this cost which is then employed in an examination of the UK demand for money.
Section II sets out the appropriate specification of the cost variable, Section III specifies the estimating equation and in Sections IV and V the empirical performance of the cost variable supports its specification. [ABSTRACT FROM AUTHOR]

Presents several correspondence related to medical issues in Great Britain. Demonstration of circulating immune complexes in schistosomiasis; Efficacy of penicillamine in treating myasthenia gravis; Tendencies of television to depict care for mentally handicapped problems.

The article focuses on the questionnaire-based survey of health-related lifestyle of adults and children with primary immune thrombocytopenia (ITP) in Great Britain conducted by the ITP Support Association. It says that the questionnaires were mailed to ITP Support Association members and results were separated by age and platelet count at the last follow-up. Results of the survey support recurrent reports of fatigue in patients with primary ITP.

A number of studies suggest that pilots are at twice the risk of melanoma and keratinocyte skin cancers than the general population, and that they have a raised mortality from melanoma. No conclusive links with in-flight exposure to ionising radiationor circadian rhythm disruption due to the pilots' shift work were found. Possible over-exposure to ultraviolet radiation (UVR) may be implicated as pilots may be exposed to higher UV-A levels at cruise altitude compared with those at ground levels. The direct method of making in-flight spectral measurements has been carried out on a limited number of flights, but this technique is challenging; the use of small wearable sensors may be more appropriate but there are a few issues that should be addressed for their use in cockpit measurements. While the spectral response of sensors for erythema effective values usually closely matches the corresponding weighting function, the response of UV-A sensors may not be spectrally flat, which, if not corrected to account for the transmission of the aircraft windshield, could potentially result in large errors. In this paper, the spectral correction method was applied to the UV-A sensor of the Genesis-UV unit to measure UVR exposure of commercial pilots on 312 flights to a range of destinations from four UK airports from September 2016 to August 2017. [ABSTRACT FROM AUTHOR]

The 1011-page book, Hearing in Adults, published in 1995, contains the fullest report of the United Kingdom's Medical Research Council National Study of Hearing. It was designed to determine the prevalence and distribution in Great Britain of audiometrically measured hearing loss as a function of age, gender, occupation, and noise exposure. The study's size, quality, and breadth made it unique when it was done in the 1980s. These qualities remain, and its data are still the primary U.K. source for the prevalence of auditory problems. However, only 550 copies were printed, and the book is essentially unobtainable today. We describe here a fully searchable, open-access, digital (PDF) "reprinting" of Hearing in Adults, summarizing the study's design and the book's contents, together with a brief commentary in the light of subsequent developments. [ABSTRACT FROM AUTHOR]

• 102 woodland variables assessed, including structure, composition, and function. • 35 ecological variables differed significantly between at least two stages. • Easy to assess structural measures had the most consistent trends. • Decrease in richness of ectomycorrhizal fungi (67%) and epiphytic lichen (32%). Forests globally are facing an increasing number of threats from modified disturbance regimes, novel stressors and changing environmental conditions. This has ultimately resulted in declines in the ecological condition of many forest and woodland ecosystems, leading to widespread tree mortality and stand dieback. Effective indicators of overall woodland ecological condition are therefore needed for environmental monitoring and to support management responses. To test the effectiveness of different variables that could potentially be used as indicators of woodland condition, 102 variables that describe woodland structure, composition, functioning, edaphic conditions and disturbance regimes were assessed along 12 replicate gradients of beech stand dieback. Results indicated that 35 variables differed significantly between at least two stages of the dieback gradient, indicating their sensitivity to stand dieback. Seven of these indicators related to woodland species composition, two to functional processes, 20 to structural features, four to edaphic conditions, and two to disturbance regimes. These results demonstrate that effective indicators can potentially be identified for each of the ecological categories. Effective composition indicators included species richness of ectomycorrhizal fungi, ground flora and epiphytic lichens; functional indicators were soil respiration rate and net nitrification rate; edaphic conditions included soil Na:Ca ratio, exchangeable sodium, total carbon, Ca:Al ratio; structural indicators included canopy openness, litter cover, sward height, and volume of deadwood, and for disturbance the indicator was Equus dung density. Other measures, such as shrub cover and species richness of carabid beetles and spiders, were not found to vary significantly along the dieback gradients, and were therefore not identified as effective indicators. These results demonstrate the value of gradient analysis for evaluating indicators of woodland condition, but also highlight the need for multi-site studies to identify indicators with widescale applicability. [ABSTRACT FROM AUTHOR]

This paper examines the influence of exchange rate variability on UK exports in the period of 'floating' sterling 1973Q2-1990Q3. Using the most recently developed bounds tests (appropriate when the cointegrating vector incorporates both I(1) or I(0) variables) the long-run demand for UK exports invariant to exchange rate variability is found. [ABSTRACT FROM AUTHOR]

The article focuses on the modernization program for hearing aid services in Great Britain. The program has introduced patient centered pathways and protocols, modern technology for selecting, analyzing and fitting hearing aids, and stressed an evaluative culture including formal outcome measures that inform rehabilitation or follow-up programs. The program is aimed at providing the best possible hearing health care and hearing aid service through the most cost effective model.

Cases of de novo immune thrombocytopenia (ITP), including a fatality, following SARS-CoV-2 vaccination in previously healthy recipients led to studying its impact in preexisting ITP. In this study, 4 data sources were analyzed: the Vaccine Adverse Events Reporting System (VAERS) for cases of de novo ITP; a 10-center retrospective study of adults with preexisting ITP receiving SARS-CoV-2 vaccination; and surveys distributed by the Platelet Disorder Support Association (PDSA) and the United Kingdom (UK) ITP Support Association. Seventy-seven de novo ITP cases were identified in VAERS, presenting with median platelet count of 3 [1-9] ×109/L approximately 1 week postvaccination. Of 28 patients with available data, 26 responded to treatment with corticosteroids and/or intravenous immunoglobulin (IVIG), and/or platelet transfusions. Among 117 patients with preexisting ITP who received a SARS-CoV-2 vaccine, 19 experienced an ITP exacerbation (any of: ≥50% decline in platelet count, nadir platelet count <30 × 109/L with >20% decrease from baseline, and/or use of rescue therapy) following the first dose and 14 of 70 after a second dose. Splenectomized persons and those who received 5 or more prior lines of therapy were at highest risk of ITP exacerbation. Fifteen patients received and responded to rescue treatment. In surveys of both 57 PDSA and 43 UK patients with ITP, prior splenectomy was associated with worsened thrombocytopenia. ITP may worsen in preexisting ITP or be identified de novo post-SARS-CoV2 vaccination; both situations responded well to treatment. Proactive monitoring of patients with known ITP, especially those postsplenectomy and with more refractory disease, is indicated., (© 2022 by The American Society of Hematology.)

Background: During the COVID-19 pandemic, many intensive care units have been overwhelmed by unprecedented levels of demand. Notwithstanding ethical considerations, the prioritization of patients with better prognoses may support a more effective use of available capacity in maximizing aggregate outcomes. This has prompted various proposed triage criteria, although in none of these has an objective assessment been made in terms of impact on number of lives and life-years saved., Design: An open-source computer simulation model was constructed for approximating the intensive care admission and discharge dynamics under triage. The model was calibrated from observational data for 9505 patient admissions to UK intensive care units. To explore triage efficacy under various conditions, scenario analysis was performed using a range of demand trajectories corresponding to differing nonpharmaceutical interventions., Results: Triaging patients at the point of expressed demand had negligible effect on deaths but reduces life-years lost by up to 8.4% (95% confidence interval: 2.6% to 18.7%). Greater value may be possible through "reverse triage", that is, promptly discharging any patient not meeting the criteria if admission cannot otherwise be guaranteed for one who does. Under such policy, life-years lost can be reduced by 11.7% (2.8% to 25.8%), which represents 23.0% (5.4% to 50.1%) of what is operationally feasible with no limit on capacity and in the absence of improved clinical treatments., Conclusions: The effect of simple triage is limited by a tradeoff between reduced deaths within intensive care (due to improved outcomes) and increased deaths resulting from declined admission (due to lower throughput given the longer lengths of stay of survivors). Improvements can be found through reverse triage, at the expense of potentially complex ethical considerations.

Background: Previous studies have reported national and regional Global Burden of Disease (GBD) estimates for the UK. Because of substantial variation in health within the UK, action to improve it requires comparable estimates of disease burden and risks at country and local levels. The slowdown in the rate of improvement in life expectancy requires further investigation. We use GBD 2016 data on mortality, causes of death, and disability to analyse the burden of disease in the countries of the UK and within local authorities in England by deprivation quintile., Methods: We extracted data from the GBD 2016 to estimate years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and attributable risks from 1990 to 2016 for England, Scotland, Wales, Northern Ireland, the UK, and 150 English Upper-Tier Local Authorities. We estimated the burden of disease by cause of death, condition, year, and sex. We analysed the association between burden of disease and socioeconomic deprivation using the Index of Multiple Deprivation. We present results for all 264 GBD causes of death combined and the leading 20 specific causes, and all 84 GBD risks or risk clusters combined and 17 specific risks or risk clusters., Findings: The leading causes of age-adjusted YLLs in all UK countries in 2016 were ischaemic heart disease, lung cancers, cerebrovascular disease, and chronic obstructive pulmonary disease. Age-standardised rates of YLLs for all causes varied by two times between local areas in England according to levels of socioeconomic deprivation (from 14 274 per 100 000 population [95% uncertainty interval 12 791-15 875] in Blackpool to 6888 [6145-7739] in Wokingham). Some Upper-Tier Local Authorities, particularly those in London, did better than expected for their level of deprivation. Allowing for differences in age structure, more deprived Upper-Tier Local Authorities had higher attributable YLLs for most major risk factors in the GBD. The population attributable fractions for all-cause YLLs for individual major risk factors varied across Upper-Tier Local Authorities. Life expectancy and YLLs have improved more slowly since 2010 in all UK countries compared with 1990-2010. In nine of 150 Upper-Tier Local Authorities, YLLs increased after 2010. For attributable YLLs, the rate of improvement slowed most substantially for cardiovascular disease and breast, colorectal, and lung cancers, and showed little change for Alzheimer's disease and other dementias. Morbidity makes an increasing contribution to overall burden in the UK compared with mortality. The age-standardised UK DALY rate for low back and neck pain (1795 [1258-2356]) was higher than for ischaemic heart disease (1200 [1155-1246]) or lung cancer (660 [642-679]). The leading causes of ill health (measured through YLDs) in the UK in 2016 were low back and neck pain, skin and subcutaneous diseases, migraine, depressive disorders, and sense organ disease. Age-standardised YLD rates varied much less than equivalent YLL rates across the UK, which reflects the relative scarcity of local data on causes of ill health., Interpretation: These estimates at local, regional, and national level will allow policy makers to match resources and priorities to levels of burden and risk factors. Improvement in YLLs and life expectancy slowed notably after 2010, particularly in cardiovascular disease and cancer, and targeted actions are needed if the rate of improvement is to recover. A targeted policy response is also required to address the increasing proportion of burden due to morbidity, such as musculoskeletal problems and depression. Improving the quality and completeness of available data on these causes is an essential component of this response., Funding: Bill & Melinda Gates Foundation and Public Health England., (Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: UK Biobank will be collecting blood samples from a cohort of 500 000 volunteers and it is expected that the rate of collection will peak at approximately 3000 blood collection tubes per day. These samples need to be prepared for long-term storage. It is not considered practical to manually process this quantity of samples so an automated blood fractionation system is required., Methods: Principles of industrial automation were applied to the blood fractionation process leading to the requirement of developing a vision system to identify the blood fractions within the blood collection tube so that the fractions can be accurately aspirated and dispensed into micro-tubes. A prototype was manufactured and tested on a range of human blood samples collected in different tube types., Results: A specially designed vision system was capable of accurately measuring the position of the plasma meniscus, plasma/buffy coat interface and the red cells/buffy coat interface within a vacutainer. A rack of 24 vacutainers could be processed in <5 min., Conclusion: An automated, high throughput blood fractionation system offers a solution to the problem of processing human blood samples collected in vacutainers in a consistent manner and provides a means of ensuring data and sample integrity.

Utility scores were estimated for 609 hearing-impaired adults who completed EQ-5D, Health Utilities Index Mark III (HUI3) and SF-6D survey instruments both before and after being provided with a hearing aid. Pre-intervention, the mean utility scores for EQ-5D (0.80) and SF-6D (0.78) were significantly higher than the mean HUI3 utility score (0.58). Post-intervention, the mean improvement in the HUI3 (0.06 change) was significantly higher than the mean improvement according to the EQ-5D (0.01 change) or SF-6D (0.01 change). The estimated cost effectiveness of hearing-aid provision is therefore likely to be dependent on which instrument is used to measure utility.

Objective: To design and validate a statistical method for evaluating the performance of surgical units that adjusts for case volume and case mix., Design: Validation study using routinely collected data on in-hospital mortality., Data Sources: Two UK databases, the ASCOT prospective database and the risk scoring collaborative (RISC) database, covering 1042 patients undergoing surgery in 29 hospitals for gastro-oesophageal cancer between 1995 and 2000., Statistical Analysis: A two level hierarchical logistic regression model was used to adjust each unit's operative mortality for case mix. Crude or adjusted operative mortality was plotted on mortality control charts (a graphical representation of surgical performance) as a function of number of operations. Control limits defined as 90%, 95%, and 99% confidence intervals identified units whose performance diverged significantly from the mean., Results: The mean in-hospital mortality was 12% (range 0% to 50%). The case volume of the units ranged from one to 55 cases a year. When crude figures were plotted on the mortality control chart, four units lay outside the 90% control limit, including two outside the 95% limit. When operative mortality was adjusted for risk, three units lay outside the 90% limit and one outside the 95% limit. The model fitted the data well and had adequate discrimination (area under the receiver operating characteristics curve 0.78)., Conclusions: The mortality control chart is an accurate, risk adjusted means of identifying units whose surgical performance, in terms of operative mortality, diverges significantly from the population mean. It gives an early warning of divergent performance. It could be adapted to monitor performance across various specialties.