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A recent Registered Replication Report (RRR) of the development of verbal rehearsal during serial recall revealed that children verbalized at younger ages than previously thought, but did not identify sources of individual differences. Here, we use mediation analysis to reanalyze data from the 934 children ranging from 5 to 10 years old from the RRR for that purpose. From ages 5 to 7, the time taken for a child to label pictures (i.e. isolated naming speed) predicted the child's spontaneous use of labels during a visually presented serial reconstruction task, despite no need for spoken responses. For 6- and 7-year-olds, isolated naming speed also predicted recall. The degree to which verbalization mediated the relation between isolated naming speed and recall changed across development. All relations dissipated by age 10. The same general pattern was observed in an exploratory analysis of delayed recall for which greater demands are placed on rehearsal for item maintenance. Overall, our findings suggest that spontaneous phonological recoding during a standard short-term memory task emerges around age 5, increases in efficiency during the early elementary school years, and is sufficiently automatic by age 10 to support immediate serial recall in most children. Moreover, the findings highlight the need to distinguish between phonological recoding and rehearsal in developmental studies of short-term memory.

Purpose: Amyotrophic lateral sclerosis (ALS) is a progressive, ultimately fatal disease causing progressive muscular weakness. Most people living with ALS (plwALS) experience dysarthria, eventually becoming unable to communicate using natural speech. Many wish to use speech for as long as possible. Personalized automated speech recognition (ASR) model technology, such as Google's Project Relate, is argued to better recognize speech with dysarthria, supporting maintenance of understanding through real-time captioning. The objectives of this study are how plwALS and communication partners use Relate in everyday conversation over a period of up to 12 months and how it may change with any decline in speech over time. Method: This study videoed interactions between three plwALS and communication partners. We assessed ASR caption accuracy and how well they preserved meaning. Conversation analysis was used to identify participants' own organizational practices in the accomplishment of interaction. Thematic analysis was used to understand better the participants' experiences of using ASR captions. Results: All plwALS reported lower-than-expected ASR accuracy when used in conversation and felt ASR captioning was only useful in certain contexts. All participants liked the concept of live captioning and were hopeful that future improvements to ASR accuracy may support their communication in everyday life. Conclusions: Training is needed on best practices for customization and practical use of ASR technology and for the limitations of ASR in conversational settings. Support is needed for those less confident with technology and to reduce misplaced allocation of ownership of captioning errors, risking negative effects on psychological well-being. [ABSTRACT FROM AUTHOR]

Purpose: This study examines the effectiveness of automatic speech recognition (ASR) for individuals with speech disorders, addressing the gap in performance between read and conversational ASR. We analyze the factors influencing this disparity and the effect of speech mode-specific training on ASR accuracy. Method: Recordings of read and conversational speech from 27 individuals with various speech disorders were analyzed using both (a) one speaker-independent ASR system trained and optimized for typical speech and (b) multiple ASR models that were personalized to the speech of the participants with disordered speech. Word error rates were calculated for each speech model, read versus conversational, and subject. Linear mixed-effects models were used to assess the impact of speech mode and disorder severity on ASR accuracy. We investigated nine variables, classified as technical, linguistic, or speech impairment factors, for their potential influence on the performance gap. Results: We found a significant performance gap between read and conversational speech in both personalized and unadapted ASR models. Speech impairment severity notably impacted recognition accuracy in unadapted models for both speech modes and in personalized models for read speech. Linguistic attributes of utterances were the most influential on accuracy, though atypical speech characteristics also played a role. Including conversational speech samples in model training notably improved recognition accuracy. Conclusions: We observed a significant performance gap in ASR accuracy between read and conversational speech for individuals with speech disorders. This gap was largely due to the linguistic complexity and unique characteristics of speech disorders in conversational speech. Training personalized ASR models using conversational speech significantly improved recognition accuracy, demonstrating the importance of domain-specific training and highlighting the need for further research into ASR systems capable of handling disordered conversational speech effectively. [ABSTRACT FROM AUTHOR]

A number of UK universities prioritize economic development or regeneration activities and for some of these universities such activities are the main focus of their knowledge transfer work. This study compares two regions of the UK--the North West and the South East of England--which have very different levels of economic performance. Quantitative data from the UK government's Higher Education Business and Community Interaction Survey are used to track economic development funding and activity from universities in these two regions. Strategy documents prepared for the fourth round of the government's Higher Education Innovation Fund are analysed to aid interpretations. Elements of evolutionary theory are used to explore the reasons for the differences and a case study of one university programme, Leading Enterprise and Development, is provided as an illustrative example. (Contains 5 notes, 3 tables and 14 figures.)

A comparison of Australian and United Kingdom faculty salaries takes into account academic rank, salary scales, relative prices and purchasing power, and tax rates. Although Australian academics at the bottom lecturer ranks have a real salary 64 percent higher than their counterparts in the U.K., professors have the same real salary. (MSE)

The broad area of psychotherapy research is sometimes subdivided into that which focuses on outcome and that which focuses on process. Research into the active processes of psychotherapy can sometimes be occupied with debates around common versus specific factors. At the same time, within the process literature there has been increasing focus on the qualitative accounts of the service user in therapy and what they found to be significant or useful to them. The aim of this mixed methods study was twofold: first, to identify what elements of a relatively brief CBT intervention contributed to a successful outcome from the point of view of the service user. Participants were recruited at a low‐intensity Improving Access to Psychological Therapy (IAPT) service in the UK; and second, to attempt to frame those results within the common versus specific factor framework. Eight participants (5 males and 3 females) took part in this mixed methods research, which used semi‐structured interviews analysed using thematic analysis and brief quantitative questionnaire completion. Five overarching qualitative themes were identified in the data: three relating to common factors ('Insight', 'Talking' and 'Therapist qualities'); and two relating to specific factors ('Responding differently to thoughts and feelings' and 'Tasks/activities'). Importantly, all participants spoke about the importance of both common and specific factors. The discussion relates the findings back to existing research, highlighting the relative importance of insight within the data set and the participant led focus on talking. Future directions are discussed. [ABSTRACT FROM AUTHOR]

In the United Kingdom, the question of how much information is required to be given to patients about the benefits and risks of proposed treatment remains extant. Issues about whether healthcare resources can accommodate extended shared decision-making processes are yet to be resolved. COVID-19 has now stepped into this arena of uncertainty, adding more complexity. U.K. public health responses to the pandemic raise important questions about professional standards regarding how the obtaining and recording of consent might change or be maintained in such emergency conditions, particularly in settings where equipment, medicines, and appropriately trained or specialized staff are in short supply. Such conditions have important implications for the professional capacity and knowledge available to discuss the risks and benefits of and alternatives to proposed treatment with patients. The government's drive to expedite the recruitment to wards of medical students nearing the end of their studies, as well as inviting retired practitioners back into practice, raises questions about the ability of such healthcare providers to engage fully in shared decision-making. This article explores whether the legal duty on healthcare practitioners to disclose the material risks of a proposed medical treatment to a patient should be upheld during pandemic conditions or whether the pre-eminence of patient autonomy should be partly sacrificed in such exceptional circumstances. We argue that measures to protect public health and to respect autonomous decision-making are not mutually exclusive and that there are good reasons to maintain professional standards in obtaining consent to treatment even during acute pressures on public health systems. [ABSTRACT FROM AUTHOR]

Exploring and combining results from more than one real‐world data (RWD) source might be necessary in order to explore variability and demonstrate generalizability of the results or for regulatory requirements. However, the heterogeneous nature of RWD poses challenges when working with more than one source, some of which can be solved by analyzing databases converted into a common data model (CDM). The main objective of the study was to evaluate the implementation of the Observational Medical Outcome Partnership (OMOP) CDM on IQVIA Medical Research Data (IMRD)‐UK data. A drug utilization study describing the prescribing of codeine for pain in children was used as a case study to be replicated in IMRD‐UK and its corresponding OMOP CDM transformation. Differences between IMRD‐UK source and OMOP CDM were identified and investigated. In IMRD‐UK updated to May 2017, results were similar between source and transformed data with few discrepancies. These were the result of different conventions applied during the transformation regarding the date of birth for children younger than 15 years and the start of the observation period, and of a misclassification of two drug treatments. After the initial analysis and feedback provided, a rerun of the analysis in IMRD‐UK updated to September 2018 showed almost identical results for all the measures analyzed. For this study, the conversion to OMOP CDM was adequate. Although some decisions and mapping could be improved, these impacted on the absolute results but not on the study inferences. This validation study supports six recommendations for good practice in transforming to CDMs. [ABSTRACT FROM AUTHOR]

Copyright of British Journal of Surgery is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The authors set out and estimate a dynamic logit model of viewing behavior, which relates a channel's share ratings and audience composition to the programme types that it and competing channels are offering. Using the model on U.K. data, they evaluate the likely effects of changes in the programme types offered by current channels on the socioeconomic composition of channel audiences. They also show the impact of a new channel on audience composition, and how the model can be used in strategic programme scheduling. [ABSTRACT FROM AUTHOR]

Compression therapy is the main method used within the treatment and management of lymphoedema and chronic oedema. The increasing prevalence of the condition, which has multiple causes, such as genetic factors, age and external factors, require the effective management of the condition, and to enhance the management methods used to contain the condition. The use of exercise alongside the mainstay method of treatment (compression therapy) has been an underutilised area. The application of a structured exercise programme in conjunction with multi-layer lymphoedema bandaging combined with an adjustable velcro wrap based systems led to a decrease in limb volume in one case study. The results of the programme indicate that the approach is beneficial and requires embedding further within Walsall lymphoedema service, due to improved patient outcomes, and cost effectiveness in terms of resources. [ABSTRACT FROM AUTHOR]

European Union (EU) Clinical Trials Regulation 536/2014, expected to come into force in 2019, provides for a streamlined single EU application for cross-border clinical trials and enhanced transparency of results. The status of the Regulation in post-Brexit UK is uncertain. Matters of regulatory alignment will be covered by agreements on the future EU-UK relationship. In the short term, implementation of the Regulation in the United Kingdom depends on the Brexit model and timing of the Regulation's implementation. The EU (Withdrawal) Act will convert EU law into UK law, including the vast array of EU life sciences regulation. However, the Regulation is likely to be implemented after the United Kingdom leaves the EU, but within the transition period. If the United Kingdom is not part of the legal framework governing clinical trials in the EU, then the United Kingdom will still need to comply with the global framework set out in the International Council on Harmonisation if it wants to be part of trials of medicinal products for which marketing authorization will be sought for licensing in the European Economic Area. This article extols the virtues of harmonization with the EU and attempts to counter some of the media focus on the advantages of a deregulated bespoke approach. [ABSTRACT FROM AUTHOR]

Patients have a right to autonomy that encompasses making medical decisions that others consider 'bad'. The ambits of this right in law and clinical practice are explored in this article, which describes an expansion of welfare protections across different aspects of medical law and explores their justifications and implications. In England and Wales, the Mental Capacity Act 2005 sets out protections for those who fall within its definition of incapacity. Those who retain capacity are ostensibly free to make decisions others consider unwise. But the decisions of those with borderline capacity; those whose decisions conflict with the public interest in protecting the patient from harm; and those considered 'vulnerable' are, in circumstances explored in this article, susceptible to override. The article explores the effects of these developments on the relationship between patients' autonomy rights and clinicians' responsibilities. [ABSTRACT FROM AUTHOR]

Affirming the doctrine of informed consent, the UK Supreme Court in Montgomery v Lanarkshire HB belatedly followed the Australian decision of Rogers v Whitaker, decoupling the duty to inform patients about the material risks of medical treatment from Bolam. The underlying commitment to patient autonomy coincides with a wider body of medical law that protects the right of capacitous adult patients to make treatment decisions, even if others consider those decisions bizarre and even if they will cause the patient serious harm. It is seemingly anomalous, therefore, that the Supreme Court in Montgomery referred to a ‘therapeutic exception’ (TE), as this suggests an underlying paternalistic approach. Contrary to this view, international examples suggest that a TE does not necessarily conflict with commitment to patient autonomy. In some countries, the exception mitigates the effects of a broadly objective test of materiality by enabling clinicians in exceptional circumstances to protect the autonomy interests of the particular patient. In others, it protects those incapable of an autonomous decision from harm. In England and Wales, however, alternative mechanisms can be interpreted to protect such patients from harm. On this basis, it is argued that the TE is obfuscatory, unnecessary and unjustified. [ABSTRACT FROM AUTHOR]

Purpose -- Workplace stress is a particular issue in the fire service. Research suggests this is related to excessive demands, relationships with senior managers, changing roles and exposure to traumatic events. The purpose of this paper is to evaluate the impact on managers of three mental health promotion interventions. First, a locally developed course entitled "Looking after Wellbeing at Work" (LWW), second, an internationally developed training course: Mental Health First Aid (MHFA). Third, an hour-long leaflet session (LS). Design/methodology/approach -- This study used a random allocation design. In total, 176 fire service line managers were randomly allocated to one of the three training conditions: LWW, MHFA, or a control condition (LS). Participants completed The Attitudes to Mental Illness Scale (Luty et al., 2006) and a locally developed "Mental Health Stigma Questionnaire" pre- and post-intervention. Results were analysed using a MANOVA. Participants were also asked to complete a general evaluation, rating all aspects of the courses from poor to excellent. In total, 30 participants were also chosen at random to conduct telephone interviews about their experience of the course. Results were analysed using thematic analysis. Findings -- The LWW and MHFA courses were associated with statistically significant improvements in attitudes to mental illness and knowledge/self-efficacy around mental health, comparing pre- and post-scores, and comparing post-scores of the two training courses with a LS. The general evaluations of the LWW and MHFA courses indicated the mean rating for all aspects of both training conditions was good to excellent. Two themes were identified across the qualitative interviews: participants described they were more able to recognise and respond to mental health problems; and participants described changing attitudes towards mental health. Research limitations/implications -- The strengths of this study are the number of participants, random allocation, and multiple facets of evaluation. The quantitative evaluation is limited, as one of the questionnaires has untested psychometric properties. The control condition was limited as it was only offered for one hour, making comparison with two-day training problematic. The qualitative evaluation was useful in gaining descriptive data, however, it may have been possible to conduct a more in-depth analysis with a smaller number of participants. Originality/value -- The results from this study indicate that providing training in mental health awareness and promotion was considered helpful, by managers in the Fire Service and had positive outcomes for attitudes and understanding about mental health. While there are limitations, initial results of training in mental health promotion are promising. Such training has the potential to promote the public's mental health and wellbeing, and improve the quality of life for people with mental health problems. [ABSTRACT FROM AUTHOR]

Abstract: Predictive linear regression (LR) modelling indicates that total Pb is the only highly significant independent variable for estimating Pb bioaccessibility in “mineralisation domains” located in limestone (high pH) and partly peat covered (low pH) shale-sandstone terrains in England. Manganese is a significant minor predictor in the limestone terrain, whilst organic matter and sulphur explain 0.5% and 2% of the variance of bioaccessible Pb in the peat-shale-sandstone terrain, compared with 93% explained by total Pb. Bootstrap resampling shows that LR confidence limits overlap for the two mineralised terrains but the limestone terrain has a significantly lower bioaccessible Pb to total Pb slope than the urban domain. A comparison of the absolute values of stomach and combined stomach-intestine bioaccessibility provides some insight into the geochemical controls on bioaccessibility in the contrasting soil types. [Copyright &y& Elsevier]

Abstract: The authors review recent scholarly and policy initiatives in respect of media pluralism and argue that contradictions between policy objectives, in analytical approaches and deficiencies in some established methodologies mean that robust conclusions have been hard to secure. They argue that concerns about diminishing pluralism are likely to grow in consequence of changes in a dominant legacy media funding model as advertising revenues move online. Examining UK data, they argue that a contemporary focus of concern, growing concentration in privately owned media, is overshadowed by the striking dominance of the publicly owned BBC and suggest established analytical methodologies used to analyse market power may offer a valuable analogy in the definition and measurement of pluralism issues. They consider possible alternatives to regulation as means of enhancing pluralism and propose the use of subsidised entry. [Copyright &y& Elsevier]

The human ingestion bioaccessibility of As was measured on 50 representative samples of soils selected from a 281-soil-sample geochemical survey of Northampton. The major and trace element content, pH and near infrared (NIR) spectra of the 281 soils were determined. A multiple linear regression (MLR) model using total As, major element composition and pH identified total As, pH and P to be the significant predictor variables for bioaccessible As (R2 = 0.72, median standard error of prediction = 1.5 mg kg−1bioaccessible As). When spectral components (SC) derived from chemometric analysis of the NIR spectra were also included in the MLR, total As, pH, Mg and two NIR spectral components were found to be significant predictor variables (R2 = 0.84, median standard error of prediction = 1.2 mg kg−1bioaccessible As). Correlation analysis of the SC with major element data suggested that the two NIR SC in the second model were related to different forms of Fe oxides in the soil. When plotted over a geological map of Northampton interpolated predictions of bioaccessible As showed clear geological control. The median total As concentration of the soils in Northampton was 30.2 mg kg−1and the median bioaccessible As was 3.0 mg kg−1. [ABSTRACT FROM AUTHOR]

Abstract: Predictive linear regression (LR) modelling between bioaccessible arsenic (B-As) and a range of total elemental compositions and soil properties was executed in order to assess the potential for developing a national B-As dataset for the UK. LR indicates that total arsenic (As) is the only highly significant independent variable for estimating B-As in urban areas where it explains 75–92% of the variance. The broad compatibility of the London, Glasgow and Swansea regression models suggests that application of these models to estimate bioaccessible As in UK soils impacted by diffuse anthropogenic urban contamination and non-ferrous metal processing should be relatively accurate. In areas dominated by Jurassic ironstones and associated clays and limestones, total As, P and pH are significant, accounting for 53, 14 and 5%, respectively, of the B-As variance. Models based on total As as the sole predictor in the combined Jurassic and Cretaceous sedimentary ironstones datasets explain about 40% of the B-As variance. The median As bioaccessible fraction (%As-BAF) is 19 to 28% in the anthropogenic contamination impacted urban domains, but much lower (5–9%) in geogenic terrains dominated by ironstones. Results of this study can be used as part of a lines of evidence approach to localised risk assessment but should not be used to replace bioaccessibility testing at individual sites where local conditions may vary considerably from the broad overview presented in this study. [Copyright &y& Elsevier]

Re R and Re W allow a parent to consent to treatment a competent minor refuses, but the cases have not been tested post-Human Rights Act 1998. Gilmore and Herring offer a means by which they might be distinguished or sidelined. They interpret Gillick to say that in order to consent a minor need only have a full understanding of the particular treatment. They argue that the minors in Re R and Re W were refusing all treatment which requires a separate assessment of capacity—an assessment which was not made. We fear that this distinction would not be workable in clinical practice and argue that their interpretation of Gillick is flawed. From a clinician's point of view, competence cannot always be judged in relation to a specific treatment, but instead must relate to the decision. We show that a decision can incorporate more than one treatment, and more than one decision might be made about one treatment. A minor's understanding of a specific treatment is not always sufficient to demonstrate competence to make a decision. The result is that whilst there might be situations when a parent and a minor both have the power to consent to a particular treatment, they will not share concurrent powers in relation to the same decision. Consequently, a challenge to Re R and Re W, if forthcoming, would need to take a different form. We emphasise the necessity to minimise the dichotomy between legal consent and how consent works in medical practice. [ABSTRACT FROM PUBLISHER]

Mortality rates from liver disease in the UK are increasing and alcohol is a major contributor to this trend. Over the last decade, there has been a 5-fold increase in young patients aged 35–55 years developing alcoholic cirrhosis. Patients drinking harmful levels of alcohol, with evidence of organ damage, are known to consult their GPs twice as often as the average patient; however, only 2–5% are known to primary care as harmful drinkers. This article aims to describe the epidemiology of alcoholic liver disease and its management within primary care including indications for referral to secondary care. [ABSTRACT FROM AUTHOR]

The question of how to price access to the copper network during the period of transition to fibre has attracted much attention, both from regulators and in reports prepared by consultants (notably Plum Consulting and WIK Consult) acting for different groups of operators. Our paper considers three regulatory objectives - the two familiar ones of efficient cost recovery and efficient entry, and an additional one of efficient migration to fibre. It examines a range of possible pricing principles including the LRIC, HCA and CCA approaches, and mixed HCA/CCA approaches observed in France and the UK. These are simulated using a data set for the copper local loop in France, prepared by the regulator, ARCEP. Recognising that the number of instruments available to the regulator is less than the number of objectives, the paper proposes an approach which ensures nearly exact cost recovery, and which takes separate account of the obsolescent copper and of the continuing value of the trenches and ducts which contain it. Where full cost recovery allows it, the price of access to the physical works should be lowered to encourage the transition to fibre. The simulations show that the access prices associated with the proposed approach are lower than those derived from CCA and LRIC methods for pricing copper. [ABSTRACT FROM AUTHOR]

Infusion of lipid emulsion has been demonstrated to facilitate return of spontaneous circulation in animal models and human cases of local anaesthetic induced cardiac arrest. Guidelines for lipid application exist; however, experimental evidence of efficacy at recommended dosing is lacking. In 20 sedated, mechanically ventilated, and invasively monitored New Zealand White rabbits, asystole was induced via bolus bupivacaine injection. Animals were randomised to receive either 20% Intralipid administered according to Association of Anaesthetists of Great Britain and Ireland guidelines, or identical volumes of 0.9% saline solution, in addition to standard Advanced Cardiac Life Support resuscitative measures. Seven lipid treated rabbits developed return of spontaneous circulation vs four saline treated animals (p = 0.370). A trend toward sooner return of spontaneous circulation in the lipid treated group was observed (2.4 (0.53) vs 3.8 (1.7) min; p = 0.082). Five animals in the lipid treated group survived to protocol termination vs nil animals from the saline treated group (p = 0.033). The current Association of Anaesthestists of Great Britain and Ireland lipid infusion protocol provides a useful beginning for lipid emulsion administration. [ABSTRACT FROM AUTHOR]

Background: In 2000/1, a survey found that 42% of newly qualified UK doctors felt their medical training had not prepared them well for starting work. Aim: To determine factors associated with preparedness. Methods: A questionnaire to all 5143 newly qualified doctors in May 2005. Results: The response rate was 2062/4784 = 43.1%. 15% of respondents felt poorly prepared by medical school for starting work. There were no associations between gender or graduate entry status and preparedness. The personality traits of conscientiousness (r = 0.14; p < 0.001) and extraversion (r = 0.15; p < 0.001) were associated with high preparedness. Neuroticism was associated with low preparedness (r = -0.16; p < 0.001). Respondents who had done shadowing attachments were more likely to feel prepared (58.6% vs 48.5% felt prepared; χ2 = 4.0; p = 0.05), as were graduates of problem based learning courses (61.3% vs 56.1%; χ2 = 5.0; p = 0.03). Preparedness correlated with agreement with the statements 'My teaching was relevant to real life as a doctor' (rho = 0.36; p < 0.001), and 'As a house officer I found it easy to get help when I needed it' (rho = 0.29; p < 0.001). Conclusions: Improvements in the preparedness of UK medical school graduates may be due to increased relevance of undergraduate teaching to life as a junior doctor and increased support in the workplace. [ABSTRACT FROM AUTHOR]

Parents' educational attainment is one of the strongest predictors of children's cognitive development, which in turn exerts a pivotal influence on children's educational outcomes. However, no prior study has explored change and stability in the relative association of mothers' and fathers' education with children's intelligence (IQ) that may occur across generations. Here, we identified 5 population cohort studies with children born in 1946, 1958, 1970, 1994–1996, and 2000-2002 that were representative of the UK's population at their inception, and that assessed parents' educational attainment and children's IQ (total N in analyses = 48,175). Associations of mothers' and fathers' education with children's IQ ranged from r = 0.38 (CI 95% 0.36–0.41) to r = 0.19 (CI 95% 0.17–0.20) across generations. Fathers' education was more strongly related to children's IQ in the earlier cohorts but in later years, mothers' education emerged as more dominant. However, these differences in the strength of the associations were small and might be chance findings. Negative interactions between mothers' and fathers' education in the prediction of children's intelligence that may reflect compensatory effects were observed in all cohorts, but only reached significance before 1970. We conclude that parents' educational attainment has been continuously associated with children's intelligence across generations with medium to large effect sizes. While our results are based on analyses of large population cohort studies that span across six decades, the limitations of the data and study design warrant a cautious interpretation of our findings. Preregistration & data: https://osf.io/ep3jz/ • Data came from 5 British population cohort studies born between 1946 and 2000. • Parents' education predicted children's IQ differences across generations. • The influence of mothers' education has gained strength since 1946. • In recent generations, mothers' and fathers' education equally influence children's IQ. • Assortative mating has slightly declined across generations. [ABSTRACT FROM AUTHOR]

The article presents an audit and pilot study on increasing the impact of continuing professional development (CPD) on physicians in Great Britain. It includes an in-depth analysis of the key features of CPD for doctors, as well as a discussion on its desired effects in terms of improvements in doctors' performance and changes in their working practices.

A number of studies have identified problems with undergraduate oncology teaching. We have investigated how well prepared newly qualified doctors (first foundation year, or FY1 doctors) are for treating patients with cancer. Twenty-five FY1 doctors and 15 senior doctors participated in interviews. We turned the emergent themes into a questionnaire for all 5143 UK FY1 doctors in 2005. The response rate was 43% (2062 responses). Sixty-one percent of FY1 doctors had received oncology teaching at medical school, but 31% recalled seeing fewer than 10 patients with cancer. Forty percent of FY1 doctors felt prepared for looking after patients with cancer. Sixty-five percent felt prepared for diagnosing cancer, 15% felt they knew enough about chemotherapy and radiotherapy, and 11% felt prepared for dealing with oncological emergencies. Respondents believed medical students should learn about symptom control (71%) and communication skills (41%). Respondents who had received oncology teaching were more likely to feel prepared for looking after patients with cancer (OR 1.52; 95% CI 1.14-2.04). Preparedness also correlated with exposure to patients with cancer (OR 1.48; 95% CI 1.22-1.79). We have found worryingly low levels of exposure of medical students to patients with cancer. First foundation year doctors lack knowledge about cancer care and symptom control. Oncologists should maintain involvement in undergraduate teaching, and encourage greater involvement of patients in this teaching. [ABSTRACT FROM AUTHOR]

The article provides information on a guidance published by the British National Institute for Health and Clinical Excellence (NICE) for the assessment and management of fevers in children. A chart of the guidance and a chart suggesting the use of thermometer in assessing fever are presented. Also, a table summarizing signs and symptoms of specific diseases, with fever as one of the manifestations, is provided.

Background: Newly qualified doctors should be competent in advanced life support (ALS) and critical care. The Resuscitation Council has published a course about ALS for undergraduate medical students (the intermediate life support (ILS) course). However, there is no undergraduate-level course on assessing and treating critically ill patients, despite the fact that postgraduate courses on this topic are extremely popular. We hove developed a new course called Direct Response Workshop for House Officer Preparation (DR WHO), which teaches both ALS and critical care at an undergraduate level. Methods: We taught the Resuscitation Council ILS course to our 2003-4 cohort of final year medical students (n = 350), and the new course (DR WHO) to our 2004-5 cohort (n = 338). Students filled in feedback forms immediately after the courses, and a subset repeated the feedback forms 4 months after they had started work as house officers. Course evaluation: Student and house officer feedback was positive. The DR WHO cohort was more confident in coring for critically ill patients (18/26 (69%) were confident after ILS, and 40/45 (89%) were confident after DR WHO (χ² = 4.3; df = 1; p = 0.06)). Both cohorts were competent in ALS, each with a mean score of 18.6/20 in a finals level practical examination on this topic. Conclusions: The DR WHO course is popular with the students and practical to run. The course needs to be reevaluated to determine the long-term competency of graduates. [ABSTRACT FROM AUTHOR]

Background: A survey of newly qualified doctors in the UK in 2000/2001 found that 42% of them felt unprepared for their first year of employment in clinical posts. We report on how UK qualifiers' preparedness has changed since then, and on the impact of course changes upon preparedness. Methods: Postal questionnaires were sent to all doctors who qualified from UK medical schools, in their first year of clinical work, in 2003 (n = 4257) and 2005 (n = 4784); and findings were compared with those in 2000/2001 (n = 5330). The response rates were 67% in 2000/2001, 65% in 2003, and 43% in 2005. The outcome measure was the percentage of doctors agreeing with the statement "My experience at medical school has prepared me well for the jobs I have undertaken so far". Results: In the 2000/2001 survey 36.3% strongly agreed or agreed with the statement, as did 50.3% in the 2003 survey and 58.5% in 2005 (chi-squared test for linear trend: ?2 = 259.5; df = 1; p < 0.001). Substantial variation in preparedness between doctors from different medical schools, reported in the first survey, was still present in 2003 and 2005. Between 1998 and 2006 all UK medical schools updated their courses. Within each cohort a significantly higher percentage of the respondents from schools with updated courses felt well prepared. Conclusion: UK medical schools are now training doctors who feel better prepared for work than in the past. Some of the improvement may be attributable to curricular change. [ABSTRACT FROM AUTHOR]

Purpose - To analyse the application of competition law and regulation in The value chain for television broadcasting in the UK, and to evaluate The need for intervention Through the financing of public service broadcasting. Design/methodology/approach - Arguments relating to public service broadcasting are deployed and UK competition laws and regulatory interventions are analysed. Findings - In the digital age, the need for public intervention in broadcasting is weakened, but further development of competition law is required to prevent abuse of the market power Originality/value - A broad debate about the role of public intervention in the broadcasting market place is now taking place, and the paper proposes That such interventions be largely con fined to competition policy and regulation directed to The goal of competitive markets. [ABSTRACT FROM AUTHOR]

Germline anomalies of the INK4a-ARF and Cdk4 genes were sought in a series of 89 patients suspected of having a genetic predisposition to melanoma. Patients were selected based on the following criteria: (a) familial melanoma (23 cases), (b) multiple primary melanoma (MPM; 18 cases), (c) melanoma and additional unrelated cancers (13 cases), (d) age at diagnosis less than 25 years (21 cases), and (e) nonphoto-induced melanoma (NPIM; 14 cases). Mutations of INK4a-ARF and Cdk4 were characterised by automated sequencing, and germline deletions of INK4a-ARF were also examined by real-time quantitative PCR. Seven germline changes of INK4a-ARF, five of which were novel, were found in seven patients (8%). Four were very likely to be pathogenic mutations and were found in three high-risk melanoma families and in a patient who had a pancreatic carcinoma in addition to melanoma. Three variants of uncertain significance were detected in one MPM patient, one patient <25 years, and one NPIM patient. No germline deletion of INK4a-ARF was found in 71 patients, and no Cdk4 mutation was observed in the 89 patients. This study confirms that INK4a-ARF mutations are infrequent outside stringent familial criteria, and that germline INK4a-ARF deletions are rarely involved in genetic predisposition to melanoma.British Journal of Cancer (2004) 90, 503-509. doi:10.1038/sj.bjc.6601503 www.bjcancer.com [ABSTRACT FROM AUTHOR]

This paper examines the UK's response to a recent European Clinical Trials Directive, namely the Department of Health, Central Office for Research Ethics Committee guidance, Governance Arrangements for NHS Research Ethics Committees. The revisions have been long awaited by researchers and research ethics committee members alike. They substantially reform the ethical review system in the UK. We examine the new arrangements and argue that though they go a long way toward addressing the uncertainty surrounding ethics committee function, the system favours the facilitation of research over the protection of the dignity and welfare of research participants. [ABSTRACT FROM AUTHOR]

Examines the health implications of urban regeneration in Great Britain. Government's attempts to incorporate consideration of health impact into urban planning and development; Effect of urban development on housing and employment.

Presents letter to the editor concerning medical issues. Criticism of an editorial discussing changes in Great Britain's health care system; Blood pressure measurement; Prevention of suicides; Public opinion of tobacco control policy in Japan; Others.

Analyzes the competition patterns in mobile telecommunications in the United Kingdom (U.K.). Decision to introduce mobile telecommunications by the U.K. government in 1983; Identification of the first operators and share market which each held; Regulation of mobile telephone services by the U.K. Telecommunications Act of 1984; Details on the market competition in the U.K.; Conclusions drawn from the analysis.

The development of performance indicators (PIs) in higher education in the UK since 1990 is reviewed. The period has witnessed a huge expansion in student numbers, brought to a halt in 1994. The expected development of quantitative indicators has not fully materialized. Instead the focus has shifted to qualitative assessments of teaching and research, which draw in varying degrees upon quantitative data. PIs are likely, however, to continue to play a variety of roles. Their usefulness will also be affected if evolving funding mechanisms give an increasing role to market forces. [ABSTRACT FROM AUTHOR]

Do we need to create market relationships in order to enfranchise the consumers of education? The power of the professionals is blamed for the unresponsiveness of the education service to the wishes of parents. Best professional practice, however, involves teachers in building partnerships with the families they serve. [ABSTRACT FROM AUTHOR]

From the late 1920s, :all radio broadcasting in the United Kingdom was undertaken by a public sector broadcaster--the British Broadcasting Corporation (BBC). Television was also the exclusive preserve of the BBC until the mid-1950s, when advertiser-supported commercial stations came into existence. This form of competition for audiences, but not for finance, between two broadcasting sectors---called by some a 'comfortable duopoty'--persisted until the late 1980s when the government permitted competitive entry by cable and satellite operators, introduced competition for advertising revenue between terrestrial stations, and placed commercial television broadcasting on a more competitive footing by introducing tendering for franchises. As these changes have occurred, the BBC has maintained its traditional system of regulation and has continued to operate under a Royal Charter. Although the expiry of the current Charter at the end of 1996 has provoked a debate about the role of the BBC, the government has stated its intention to renew the Charter for another 10 years. It seems likely that, until the year 2002 at least, the current system of regulating and financing public Service broadcasting in the United Kingdom will remain intact. However, the proliferation of channels represents a threat to the BBC's audience base. There may also be difficulties in combining within the same organization a public service mission and highly commercial activities, undertaken in a very competitive world market. [ABSTRACT FROM AUTHOR]

• Soil-to-sebum partition coefficients were derived for 8 high molecular weight polycyclic aromatic hydrocarbons (HMW-PAH). • Soil type influences the amount of HMW-PAH released from soil into sebum. • HMW-PAH molecular weight and octanol-carbon partition coefficients influence the amount released from soil into sebum. In vitro high molecular weight polycyclic aromatic hydrocarbons (HMW-PAH) soil-sebum partition coefficients (K SS) were measured for twelve soils collected from former UK gasworks. Concentrations of ∑16 USEPA PAH in the soils ranged from 51 to 1440 mg/kg. Time series extractions (0.5, 1, 2, 4, 8 and 24 h) at skin temperature (32 °C) of HMW-PAH from sebum to soil for two samples were conducted to determine the maximum release time-step. The maximum HMW-PAH release time-step was determined as 4 h, which was subsequently used as the extraction time for the remaining samples. The 4 h extraction for all samples showed HMW-PAH K SS ranging from 0.06 to 1.4 (median = 0.59; mean = 0.59; standard deviation = 0.27; median absolute deviation = 0.29). Evaluation of K SS data for the 4 h extractions showed that soil type and selected HMW-PAH properties (literature based molecular weight and octanol-carbon partition coefficients) affect the amount of HMW-PAH released from soil into sebum. [ABSTRACT FROM AUTHOR]

The solid-phase speciation of contaminants in soil plays a major role in regulating both the environmental mobility of contaminants and their bioavailability in biological receptors such as humans. With the increasing prevalence of urban agriculture, in tandem with growing evidence of the negative health impacts of even low levels of exposure to Pb, there is a pressing need to provide regulators with a relevant evidence base on which to build human health risk assessments and construct sustainable site management plans. We detail how the solid-phase fractionation of Pb from selected urban agricultural soil samples, using sequential extraction, can be utilised to interpret the bioaccessible fraction of Pb and ultimately inform sustainable site management plans. Our sequential extraction data shows that the Pb in our urban soils is primarily associated with Al oxide phases, with the second most important phase associated with either Fe oxyhydroxide or crystalline FeO, and only to a limited extent with Ca carbonates. We interpret the co-presence of a P component with the Al oxide cluster to indicate the soils contain Pb phosphate type minerals, such as plumbogummite (PbAl3(PO4)2(OH)5·H2O), as a consequence of natural "soil aging" processes. The presence of Pb phosphates, in conjunction with our biomonitoring data, which indicates the lack of elevated blood Pb levels in our gardeners compared to their non-gardening neighbours, suggests the (legacy) Pb in these soils has been rendered relatively immobile. This study has given confidence to the local authority regulators, and the gardeners, that these urban gardens can be safe to use, even where soil Pb levels are up to ten times above the UK's recommended lead screening level. The advice to our urban gardeners, based on our findings, is to carry on gardening but follow recommended good land management and hygiene practices. [ABSTRACT FROM AUTHOR]

Simple Summary: Nanotechnology is becoming widely accepted and being adapted for use in different fields. In the animal feed sector, there is potential for delivery of minerals using a nano format to increase bioavailability and digestibility. Broiler chickens and zinc were chosen as a model for examining nano mineral delivery. The trial showed that amino acid coated zinc improved bird growth and feed consumption and also improved digestibility of zinc. A further benefit was an improvement in leg strength of the supplemented birds. This suggests that coated nano delivery of minerals can improve their bioavailability with implications for production of mineral supplements in the animal feed industry. Recently, nanotechnology has been widely adopted in many fields. The goal of this study was to evaluate the potential for amino acid coated nano minerals as a supplement in broiler feed. Zinc was selected as a model mineral for this test and supplementation of nano zinc, both coated and uncoated was compared with organic and inorganic commercial forms of zinc. A total of 48 pens (8 birds each) were assigned to one of the following dietary treatments: Control, methionine-Zinc chelate (M-Zn), nano zinc oxide (Nano-ZnO), and methionine coated nano zinc oxide (M-Nano-ZnO). All experimental diets were formulated with the same total zinc, methionine, protein, and energy content with just the zinc source as a variable. Bird weight, feed intake and feed conversion ratios were recorded weekly, with three birds culled (sacrificed) at day 21 and day 35 for sampling measures. Ileal digestibility of zinc was determined at day 21 and day 35 using titanium dioxide as an inert marker. Blood serum, liver and spleen samples were collected at day 21 and day 35 and analysed for zinc content via inductively coupled plasma mass spectrometry (ICP-MS). Tibia strength and morphometrics were measured from both legs of three birds per pen at day 21 and day 35. The study was conducted at Nottingham Trent University Poultry Unit, UK. The novel method of producing nano minerals coated with amino acids was successfully tested with zinc and material produced to test in the feeding study. Methionine coated nano zinc oxide supplementation significantly improved bird weight gain and the increased feed intake of broilers compared to an inorganic zinc form. Ileal digestibility was also improved with this methionine-nano zinc. Moreover, this supplementation improved the tibia strength of broilers at the age of 21 days, though this was not observed at day 35. Therefore, M-Nano-ZnO could be used to supplement broilers to improve both performance and digestibility with a limited positive impact on bone strength. The results of the current study suggest that the amino acid coating of nano minerals can improve the digestibility of minerals which may have further implications for the field of mineral nutrition in animal feeds. [ABSTRACT FROM AUTHOR]

Presents letters to the editor referencing articles and topics about British military history discussed in previous issues. Information on veteran companies which were formed in England in 1825; Role of military officer Michael Frederick Rimington in World War I; Deportation of Boers to Sri Lanka during the Boer War.