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Background: The under-representation of women and other minority group members in STEM (Science, Technology, Engineering, and Mathematics) academia is a problem internationally and is attributed in part to hostile workplace cultures. We draw on the social identity perspective to examine the dynamic inter and intragroup processes entailed in these experiences. In this paper, we report a reflexive thematic analysis of 219 responses to a free-text question on bullying and harassment embedded in a national survey of 40 STEM departments from across the United Kingdom. Most were women (53%) at an early, pre-lectureship career stage. Main findings: Our analysis shows who is the perpetrator and who is the victim is not arbitrary, and neither is the form that it takes; majority group members draw on discourses that warrant the exclusion of minority group members (e.g., women are not smart; incompatibility with religious identity). In this 'othering', minority group members learn that one is not regarded as a bona fide STEM academic ingroup member and accordingly are constrained in being able to claim and act on that identity. Thus, it is not just the acts themselves that are problematic, but the ways in which being denied a shared STEM academic identity is consequential for a range of putative benefits and leads to a range of strategies that all confer costs. Conclusions/potential implications: The solution must rest with senior STEM academics and with institutions. First, we need to challenge discourses and practices that narrowly define the boundaries and content of STEM academic identity. Second, all members of a community need to perceive an alignment between the purported values of an organisation for diversity, inclusion, and respect and how that organisation responds when those principles are violated. Formal processes of remedy need to recognise the dynamics entailed in status differences and remove the onus of complaint from isolated, low status individuals. In addition, there is a need to recognise the ways in which perpetrators are embedded in networks of support both within and without the university; and the importance, therefore, of widening the scope of evidence gathering and intervention.

Background: Veterinary professionals experience higher psychological distress and lower wellbeing compared with the general population. Identifying workplace stressors is key to understanding and alleviating these difficulties. Objective: Identify the severity of workplace stressors in veterinary professions across different levels of professional experience. Method: A cross‐sectional quantitative design was utilised via administration of a veterinary stressor questionnaire that measured the severity of 93 generic and veterinary‐specific workplace stressors. Results: A total of 658 participants reported stressor severity score. Factor analysis revealed four main stressor categories: workload and job demands, client relations stress, performance and accountability, patient care challenges. An inverse relationship was found between experience level and stressor severity scores. Furthermore, the most severe stressors varied as a function of career stage. Findings and implications: Stressor severity tends to decrease with increasing experience levels. Stressors can be categorised by theme and unique stressor profiles can be derived for practitioners according to experience level. This knowledge can assist in the design and delivery of workplace support initiatives. Conclusions: Identify key stressors across different levels of experience is important in focusing efforts to support people in the workplace. [ABSTRACT FROM AUTHOR]

Electronic travel devices are used to transform information about the environment that would normally be perceived through the visual sense into a form that can be perceived by people who are blind or have low vision through another sense (Blasch, Long, & Griffin-Shirley, 1989). They are divided into two broad categories: primary devices and secondary devices. A primary device is one that a person who is blind may use safely and efficiently by itself, independent of a cane or a dog guide. A secondary device is one that must be used in conjunction with a cane or a dog guide to ensure safe and efficient travel (Farmer, 1980). The UltraCane, developed by Sound Foresight, uses ultrasonic waves to detect objects to the front and above the wrist, while relying on the cane to detect drop-offs, stairs, and curbs using the traditional touch technique of the constant-contact technique (Hill & Ponder, 1976). This article reports on an UltraCane master trainer class for 16 Orientation and Mobility (O&M) instructors from Australia, New Zealand, the United Kingdom, and the United States, all of whom were level tenure-track or adjunct faculty or others who were responsible for training direct service providers. The article also details the curriculum for the course that was developed by two of the authors (Corbett and Blasch). (Contains 1 figure and 1 table.)

Background The link between poor cardiovascular health (CVH), lifestyle and mild cognitive impairment (MCI) has been well established in the general population. However, there is limited research exploring these associations in ageing UK veterans. Aims This study explored the risk of MCI and its association with nine CVH and lifestyle risk factors (including diabetes, heart disease, high cholesterol, high blood pressure, obesity, stroke, physical inactivity, the frequency of alcohol consumption and smoking) in UK veterans and non-veterans. Methods This prospective cohort study comprised data from the PROTECT study between 2014 and 2022. Participants comprised of UK military veterans and non-veterans aged ≥50 years at baseline. Veteran status was defined using the Military Service History Questionnaire. CVH and lifestyle risk factors were defined using a combination of self-report measures, medication history or physical measurements. MCI was defined as the presence of subjective and objective cognitive impairment. Results Based on a sample of 9378 veterans (n  = 488) and non-veterans (n  = 8890), the findings showed the risk of MCI significantly reduced in veterans with obesity, those who frequently consumed alcohol and were physically inactive compared to non-veterans. The risk of MCI significantly increased in veterans with diabetes (hazards ratio [HR] = 2.22, 95% confidence interval [CI] 1.04–4.75, P  ≤ 0.05) or high cholesterol (HR = 3.11, 95% CI 1.64–5.87, P  ≤ 0.05) compared to veterans without. Conclusions This study identified CVH and lifestyle factors of MCI in UK veterans and non-veterans. Further work is needed to understand these associations and the underpinning mechanisms which could determine intervention strategies to reduce the risk of MCI. [ABSTRACT FROM AUTHOR]

Background: The accumulation of age‐associated cognitive deficits can lead to Mild Cognitive Impairment (MCI) and dementia. This is a major public health issue for the modern ageing population, as it impairs health, independence and overall quality of life. Keeping the brain active during life has been associated with an increased cognitive reserve, therefore reducing the risk of cognitive impairment in older age. Previous research has identified a potential relationship between musicality and cognition. Objectives: Explore the relationship between musicality and cognitive function in a large cohort of older adults. Methods: This was a nested study within the PROTECT‐UK cohort, which collects longitudinal computerised assessments of cognitive function in adults over 40. Participants were invited to complete the validated Edinburgh Lifetime Musical Experience Questionnaire (ELMEQ) to assess their musical experience and lifetime exposure to music. Linear regression analysis was performed using cognitive data from PROTECT‐UK. Results: Analysis identified an association between musicality and cognition in this cohort. Playing a musical instrument was associated with significantly better performance in working memory and executive function. Significant associations were also found between singing and executive function, and between overall musical ability and working memory. Conclusions: Our findings confirm previous literature, highlighting the potential value of education and engagement in musical activities throughout life as a means of harnessing cognitive reserve as part of a protective lifestyle for brain health. Key points: Playing a musical instrument was associated with significantly better working memory and executive function.Singing and overall musical ability was associated with more favourable cognition.Engagement with musical activities should be considered as part of public health initiatives to promote a protective lifestyle for brain health. [ABSTRACT FROM AUTHOR]

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This article on post-Brexit policies for higher education and research suggests that these public policy domains are characterised by their intellectual independence from the state or market. The authors see a legacy of the UK's historical relationship with the EU in its treatment of the two epistemically linked domains, reflecting institutional differences. UK governments have generally been wary of EU involvement in higher education and supportive of research collaboration. Post-Brexit evidence suggests that the UK has been purposively 'de-Europeanising' higher education for the supposed gains of marketised international policy. But the UK is also a victim of its overarching Brexit policy, which risked failing to secure associate status for the UK in the EU's world famous Horizon Europe science programme. The article explores the question of whether Brexit caused divergence in these sectors or whether it provided the opportunity for the UK government to solidify an already semi-autonomous policy trajectory. [ABSTRACT FROM AUTHOR]

Background: We investigated whether aspects of subjective cognitive aging, including awareness of age-related gains and losses in cognition (AARC-gains, AARC-losses) and subjective cognitive decline (SCD), predict change in objective cognitive function as measured by verbal reasoning (VR) and working memory (WM). Methods: We used longitudinal data for 3,299 cognitively healthy UK residents aged 65+. We used data on AARC and SCD assessed in 2019, and cognitive tasks assessed in 2019, 2020, and 2021. We used latent growth curve modeling, latent class growth analysis, and growth mixture modeling. Results: For VR, multiple growth trajectories were not evident. Mean VR at baseline was 37.45; this remained stable over time. Higher AARC-gains in cognition (mean intercept = -0.23; 95%CI: -0.31; -0.16), higher AARC-losses in cognition (mean intercept = -0.37; 95%CI: -0.46; -0.28), and lower SCD (mean intercept = 2.92; 95%CI: 2.58; 3.58) were associated with poorer VR at baseline. A three-class growth mixture model--class varying best represented trajectories of WM. In Class 1 (N = 182) mean WM at baseline was 31.20; this decreased by 2.48 points each year. In Class 2 (N = 119) mean WM at baseline was 23.12; this increased by 3.28 points each year. In Class 3 (N = 2,998) mean WM at baseline was 30.11; and it remained stable. Higher AARC-gains (Odds Ratio = 1.08; 95%CI: 1.03; 1.14) and AARC-losses (Odds Ratio = 1.10; 95%CI: 1.04; 1.16) in cognition predicted greater likelihood of being in Class 2 than Class 3. Conclusion: Although both higher AARC-gains and AARC-losses indicate poorer concurrent cognition, higher AARC-gains may be a resource that facilitates future cognitive improvement. [ABSTRACT FROM AUTHOR]

People with learning disabilities are more likely to experience sexual things happening to them when they do not want them to. This is called sexual abuse. A group was started to help women who have been sexually abused. The group met once a week and lasted for 20 weeks. Women who were interested in attending this group were given information about it and asked on three separate occasions if they wanted to attend. Seven women with learning disabilities took part in the group and their carers helped them travel to the group and then went into a separate carers' group upstairs. After the groups had finished the carers helped the women get home again. Some of the women found it very difficult to talk about the sexual abuse that had happened to them. At first they felt very upset and two women hurt themselves. Everybody felt angry about what had happened and it was good to hear they were not alone. After several months the group helped the women feel less scared and depressed and helped the women's carers understand them better. This research matters because it helped the women move on with their lives and will help others who want to start a survivors' of sexual abuse group.

Background: When people with chronic kidney disease reach kidney failure, renal replacement therapy is usually required to improve symptoms and maintain life. Although in‐centre haemodialysis is most commonly used for this purpose, other forms of dialysis are available, including home haemodialysis and peritoneal dialysis. Objectives: We aimed to explore the experiences of adults living with chronic kidney disease who were either approaching the need for dialysis or had reached kidney failure and were receiving a form of dialysis. In particular, we explored how different forms of dialysis affect their quality of life, wellbeing, and physical activity. Methods: Individual semistructured interviews were conducted with 40 adults with kidney failure, comprising four groups (n = 10 each): those receiving in‐centre haemodialysis, home haemodialysis or peritoneal dialysis, or predialysis. Interviews were transcribed verbatim, thematically analysed, and then composite vignettes were subsequently developed to present a rich narrative of the collective experiences of each group. Findings: Compared with adults who were predialysis, quality of life and wellbeing improved upon initiation of their home haemodialysis or peritoneal dialysis. Conversely, minimal improvement was perceived by those receiving in‐centre haemodialysis. Low physical activity was reported across all four groups, although those receiving home haemodialysis and peritoneal dialysis reported a greater desire and ability to be physically active than those in‐centre. Conclusion: These findings highlight that dialysis modalities not requiring regular hospital attendance (i.e., home haemodialysis and peritoneal dialysis) improve independence, quality of life, wellbeing, and can facilitate a more physically active lifestyle. [ABSTRACT FROM AUTHOR]

Discusses the development and implementation of the United Kingdom's National Internet Accessibility Database (NIAD), how the design of the database was based on ease of use by both its target audience in higher education and those working on the database, and the approaches taken to ensure the successful implementation of the NIAD. (Author/LRW)

Background: Mood disorders are characterised by pronounced symptom heterogeneity, which presents a substantial challenge both to clinical practice and research. Identification of subgroups of individuals with homogeneous symptom profiles that cut across current diagnostic categories could provide insights in to the transdiagnostic relevance of individual symptoms, which current categorical diagnostic systems cannot impart.Aims: To identify groups of people with homogeneous clinical characteristics, using symptoms of manic and/or irritable mood, and explore differences between groups in diagnoses, functional outcomes and genetic liability.Method: We used latent class analysis on eight binary self-reported symptoms of manic and irritable mood in the UK Biobank and PROTECT studies, to investigate how individuals formed latent subgroups. We tested associations between the latent classes and diagnoses of psychiatric disorders, sociodemographic characteristics and polygenic risk scores.Results: Five latent classes were derived in UK Biobank (N = 42 183) and were replicated in the independent PROTECT cohort (N = 4445), including 'minimally affected', 'inactive restless', active restless', 'focused creative' and 'extensively affected' individuals. These classes differed in disorder risk, polygenic risk score and functional outcomes. One class that experienced disruptive episodes of mostly irritable mood largely comprised cases of depression/anxiety, and a class of individuals with increased confidence/creativity reported comparatively lower disruptiveness and functional impairment.Conclusions: Findings suggest that data-driven investigations of psychopathological symptoms that include sub-diagnostic threshold conditions can complement research of clinical diagnoses. Improved classification systems of psychopathology could investigate a weighted approach to symptoms, toward a more dimensional classification of mood disorders. [ABSTRACT FROM AUTHOR]

This article explores the development of disability charities in the United Kingdom, especially Mencap, a charity to help people with learning disabilities and their families. Tensions between the need to sell an image that attracts financial support and the campaign for equal rights and dignity are explored. (DB)

Background: A quality improvement project in a secondary care centre was initiated to investigate and evaluate the impact of staff education and the use of the British Society of Gastroenterology/British Association for the Study of the Liver cirrhosis care bundle in improving care of patients admitted to hospital with decompensated liver cirrhosis. Method: A staff training programme was implemented, involving around 30 health professionals consisting of consultants, junior doctors, physician associates and nurses from the acute medical unit. A review of electronic documentation and analysis of key clinical parameters, pre- and post-intervention, was carried out. Results: The data show that the intervention has led to an improvement in patient management and clinical outcomes. Conclusion: This project illustrates that collaboration between hepatology and medical teams, with emphasis on education and training, benefits patients who present to hospital with decompensated liver cirrhosis. [ABSTRACT FROM AUTHOR]

Background: Only one study has explored the associations of subjective sleep difficulties with self-perceptions of aging. It focused on a global indicator of self-perceptions of aging (subjective age) despite individuals reporting different experiences of aging in relation to different life domains. The concept of awareness of negative age-related change, capturing perceived losses across five domains (e.g., physical health, cognition), may be more appropriate when relating subjective sleep difficulties to self-perceptions of aging. We examined whether nine different indicators of subjective sleep difficulties predict levels of awareness of negative age-related change and subjective age, measured concurrently and one year later, while controlling for covariates (mood and daily function). Participants/Methods: We used data from the PROTECT cohort study; 4,482 UK residents (mean age = 66.1; SD = 6.9) completed measures of awareness of age-related change, subjective age, mood, daily function, and subjective sleep difficulties. Results: Based on linear regression analyses, poorer quality of sleep, lower alertness after awakening, satisfaction with sleep, depth of sleep, more frequent early awakening, difficulty falling asleep, more times awake during a night, fewer hours of sleep during the night and more hours of sleep during the day predicted higher awareness of negative age-related change at baseline and follow-up (p<.001). Associations were small in size. Associations between subjective sleep difficulties and subjective age were either negligible or statistically non-significant. Conclusions: Although subjective sleep difficulties are one of the many factors associated with awareness of negative age-related change, addressing sleep difficulties, alongside negative mood, and poor daily functioning, may promote a small additional increase in positive self-perceptions of aging. [ABSTRACT FROM AUTHOR]

Background: Fully covered intraductal self-expanding metal stents (IDSEMS) have been well described in the management of post-liver transplant (LT) anastomotic strictures (ASs). Their antimigration waists and intraductal nature make them suited for deployment across the biliary anastomosis. Objectives: We conducted a multicentre study to analyse their use and efficacy in the management of AS. Design: This was a retrospective, multicentre observational study across nine tertiary centres in the United Kingdom. Methods: Consecutive patients who underwent endoscopic retrograde cholangiopancreatography with IDSEMS insertion were analysed retrospectively. Recorded variables included patient demographics, procedural characteristics, response to therapy and follow-up data. Results: In all, 162 patients (100 males, 62%) underwent 176 episodes of IDSEMS insertion for AS. Aetiology of liver disease in this cohort included hepatocellular carcinoma (n = 35, 22%), followed by alcohol-related liver disease (n = 29, 18%), non-alcoholic steatohepatitis (n = 20, 12%), primary biliary cholangitis (n = 15, 9%), acute liver failure (n = 13, 8%), viral hepatitis (n = 13, 8%) and autoimmune hepatitis (n = 12, 7%). Early AS occurred in 25 (15%) cases, delayed in 32 (20%) cases and late in 95 (59%) cases. Age at transplant was 54 years (range, 12–74), and stent duration was 15 weeks (range, 3 days–78 weeks). In total, 131 (81%) had complete resolution of stricture at endoscopic re-evaluation. Stricture recurrence was observed in 13 (10%) cases, with a median of 19 weeks (range, 4–88 weeks) after stent removal. At removal, there were 21 (12%) adverse events, 5 (3%) episodes of cholangitis and 2 (1%) of pancreatitis. In 11 (6%) cases, the removal wires unravelled, and 3 (2%) stents migrated. All were removed endoscopically. Conclusion: IDSEMS appears to be safe and highly efficacious in the management of post-LT AS, with low rates of AS recurrence. [ABSTRACT FROM AUTHOR]

A major concern with COVID‐19 was the impact it would have on individual health, the routine use of healthcare services, and physical activities, especially for older adults with comorbidities. To address this, we studied the association between these variables for older adults during the pandemic. To explore what policy instruments might be effective in mitigating the negative impacts, we investigated the effects of a shielding notice for those identified as vulnerable by the government and social media given it has been an important source for disseminating information of COVID‐19. We employed a UK sample with 3,807 participants aged ≥50 from an online survey administered during May and June 2020. Based on numbers of comorbidities, we separated the sample into a higher comorbidity group with those in the upper quartile of the sample (n = 829) and a lower comorbidity group with the remainder (n = 2,978). Statistical methods include chi‐squared analyses and cross‐sectional regressions. We found that individuals with higher comorbidities were more likely to have poorer self‐reported health and mental health and to receive a shielding notice from the government compared to those without (p < 0.05). Decreases in physical activities were associated with poorer self‐reported health and the increases were associated with better self‐reported health; on the other hand, the decreases were associated with poorer mental health, but the increases did not link to better mental health. Examination of the effects of policy instruments shows that a shielding notice was positively associated with primary care use. The notice generated greater reliance on telephone/video consultations compared to in‐person consultations, but the impacts were less strong for people with higher comorbidities. Frequent use of social media raised the probability of increasing physical activities and reduced that of decreasing physical activities, implying social media being an effective tool in promoting physical activities during the lockdown and subsequent restrictions. [ABSTRACT FROM AUTHOR]

Home dialysis therapies offer a significant benefit to patients in respect of quality of life and autonomy, as compared with in-centre haemodialysis. There is significant unwarranted variation across the world in the availability of both peritoneal dialysis (PD) and home haemodialysis, which has led in the UK to a recommendation of a minimum 20% prevalent rate of dialysis patients at home. Key advances in PD have included changes in the approach to prescribing PD and the use of assisted dialysis. Peritonitis remains a significant complication which may present to general physicians and needs prompt recognition and treatment. The development of novel small dialysis machines has led to a resurgence of interest in home haemodialysis. [ABSTRACT FROM AUTHOR]

Background Coping mechanisms are cognitive and behavioural actions to overcome health problems and their consequences. To understand how patients with blow-out fractures of the orbit cope with the outcome of this injury, it is imperative to recognise the sequence of physical and emotional stress they go through. Patients with blow-out fractures have been found to experience different degrees of negative feelings related to fear and uncertainty. Fear in this case is essentially related to fear of losing vision, inability to work and inability to drive. Uncertainty about the outcome of trauma is an additional fear factor. Objectives to explore coping strategies adapted by patients sustaining orbital blow-out fractures. Materials and Methods a purposive sample with maximum variation (n=21) was taken from patients who were treated for blow-out fractures of the orbit in the Oral and Maxillofacial Department in a secondary care hospital in the United Kingdom. Semistructured interviews were the preferred method for data selection for a logistic reason. Line-by-line coding was employed to generate data, which was organized using the Framework Approach. Data were organized theme by theme and case by case. Principles of Constant Comparative Method were followed for inductive iterative analysis of data. Results both coping strategies; physical (problemfocused) and psychological (emotionally focused) have been identified within our data as being reportedly adopted by patients with blow-out fractures. Knowledge about the injury, treatment of the injury, restoring the sense of life normality helped patients to regain their confidence. Conclusion psychological coping with the consequences of orbital blow-out fractures seems to be achieved through patients' regaining their confidence. The passage of time after treatment plays a positive role in this respect. [ABSTRACT FROM AUTHOR]

This article looks at the way in which the language used in relation to special education needs has changed and evolved since the 1960s, based on articles published in the British special education literature. Vocabulary, images, and attitudes are discussed in the context of political correctness and its impact on behavior. (DB)

Introduction: Hip fractures are the most common traumatic injury in the UK's elderly population. Patients are often extremely frail with multiple comorbidities and so are at high risk of death should they contract COVID-19. This study aims to quantify the effects of COVID-19 on patients presenting with hip fractures to the Norfolk and Norwich University Hospital (NNUH). Methods: This is a single centre, prospective, observational cohort study of patients over the age of sixty admitted with a hip fracture to NNUH between March 24th and April 22nd, 2020 and comparing them retrospectively with controls in April 2019. Patients were followed up for 30 days; data collected includes demographics, COVID-19 PCR results, date/cause of death and other prognostic indicators. Results: 66 consecutive patients managed for hip fractures were included in the study. 30-day mortality increased from 8.5% in April 2019 to 18.2% in April 2020. The 30-day mortality rate was 80% for those patients who test positive for COVID-19 as an inpatient, and was 13.8% for patients COVID-19 negative and for those who were untested. Those admitted from a healthcare institution were more likely to test positive for COVID-19 and had a higher 30-day mortality (p = 0.04 & p = 0.006, respectively). Suspected COVID-19-positive patients at time of admission had a delayed time to theatre, 46.7 h versus 27.1 h (p = 0.007), however this had no significant effect on mortality (p = 0.7). Conclusions: The combination of fragility hip fracture and COVID-19 is associated with poor outcomes. COVID-19 has also indirectly increased mortality in this patient group. [ABSTRACT FROM AUTHOR]

Purpose: This paper represents a personal view of a newly appointed consultant practitioner trainee in frailty. This role was created as a result of a rapid workforce review of a Frailty Support Team (FST) in response to the COVID-19 pandemic. Design/methodology/approach: The FST traditionally worked alongside other community services. A "One Team" approach was developed whereby prior silos of community nursing, therapy and frailty teams became a single, locality based and mutually supportive integrated community service. This significantly increased capacity for an urgent community response for older people with complex needs and improved clinical management and coordination of care. As a workforce review identified the need for skills development, new roles for trainee advanced frailty practitioners (AFPs) and a consultant practitioner trainee in frailty were established. Findings: Staff experience of the "One Team" model was positive. The changes were thought to encourage closer and more efficient working between primary care and a range of community health services. The improved communication between professionals enabled more personalised care at home, reducing pressure on emergency hospital services. A rapid review of the workforce model has enabled the enhanced team capacity to cover a wider geographical area and improved recruitment and retention of staff by introducing a new pathway for career progression within the expanding specialism of frailty. Originality/value: The challenge of COVID-19 has prompted rapid service redesign to create an enhanced "One Team in the community." The innovative workforce model looks beyond traditional roles, values the experience and capabilities of staff and develops the skills and confidence required to provide a more integrated and person-centred specialist community pathway for people living with frailty. [ABSTRACT FROM AUTHOR]

PURPOSE: Unpleasant physical sensations during maximal exercise may manifest themselves as negative cognitions that impair performance, alter pacing, and are linked to increased rating of perceived exertion (RPE). This study examined whether motivational self-talk (M-ST) could reduce RPE and change pacing strategy, thereby enhancing 10-km time-trial (TT) cycling performance in contrast to neutral self-talk (N-ST). METHODS: Fourteen men undertook 4 TTs, TT1-TT4. After TT2, participants were matched into groups based on TT2 completion time and underwent M-ST (n = 7) or N-ST (n = 7) after TT3. Performance, power output, RPE, and oxygen uptake (VO2) were compared across 1-km segments using ANOVA. Confidence intervals (95%CI) were calculated for performance data. RESULTS: After TT3 (ie, before intervention), completion times were not different between groups (M-ST, 1120 ± 113 s; N-ST, 1150 ± 110 s). After M-ST, TT4 completion time was faster (1078 ± 96 s); the N-ST remained similar (1165 ± 111 s). The M-ST group achieved this through a higher power output and VO2 in TT4 (6th-10th km). RPE was unchanged. CI data indicated the likely true performance effect lay between 13- and 71-s improvement (TT4 vs TT3). CONCLUSION: M-ST improved endurance performance and enabled a higher power output, whereas N-ST induced no change. The VO2 response matched the increase in power output, yet RPE was unchanged, thereby inferring a perceptual benefit through M-ST. The valence and content of self-talk are important determinants of the efficacy of this intervention. These findings are primarily discussed in the context of the psychobiological model of pacing. [ABSTRACT FROM AUTHOR]

Background: Awareness of positive and negative age-related changes (AARC gains and losses) captures the perceived changes that older individuals experience in several domains of their lives including physical, cognitive and social functioning; interpersonal relationships; and lifestyle. Exploring antecedents of AARC is important to identify those individuals that could benefit the most from interventions promoting positive experiences of ageing and/or adaptation to age-related changes. This study investigates the experience of pain as a predictor of lower AARC gains and higher AARC losses. Methods: Analyses are based on cross-sectional data from the PROTECT cohort (2019); 1013 UK residents (mean (SD; range) age: 65.3 (7.1; 51.4–92) years, 84.4% women) completed measures of AARC and pain and provided demographic information. Linear regression models were fitted to examine pain as a predictor of AARC gains and AARC losses. Results: Higher levels of pain predicted more AARC losses both before (regression coefficient, B = 0.36; 95% confidence interval (CI): 0.29 to 0.42, p -value < 0.001; R 2 = 0.11) and after adjusting for demographic covariates (B = 0.34; 95% CI: 0.27 to 0.40; p -value < 0.001; Partial R 2 = 0.11). Pain was not significantly associated with AARC gains (unadjusted B = 0.05; 95% CI: −0.03 to 0.12, p -value = 0.21; Partial R 2 = 0.01). Conclusion: Individuals experiencing pain may perceive more AARC losses. Interventions aiming to decrease levels of pain could include a component targeting self-perceptions of ageing and/or promoting acceptance of the negative changes that can happen with ageing. Statement of significance: The predictive role of greater levels of pain for more negative perceptions of age-related changes extends the literature on the negative psychological outcomes of pain and on predictors of perceived awareness of age-related changes (AARC). As individuals experiencing pain may be more at risk of perceiving their own ageing in a more negative way, they may benefit from interventions that combine strategies to reduce levels of pain and the interference that pain exerts on their daily activities with an educational component enhancing positive self-perceptions of ageing and promoting acceptance of negative age-related changes. [ABSTRACT FROM AUTHOR]

Understanding which factors influence the ability of individuals to respond to changing temperatures is fundamental to species conservation under climate change.We investigated how a community of butterflies responded to fine‐scale changes in air temperature, and whether species‐specific responses were predicted by ecological or morphological traits.Using data collected across a UK reserve network, we investigated the ability of 29 butterfly species to buffer thoracic temperature against changes in air temperature. First, we tested whether differences were attributable to taxonomic family, morphology or habitat association. We then investigated the relative importance of two buffering mechanisms: behavioural thermoregulation versus fine‐scale microclimate selection. Finally, we tested whether species' responses to changing temperatures predicted their population trends from a UK‐wide dataset.We found significant interspecific variation in buffering ability, which varied between families and increased with wing length. We also found interspecific differences in the relative importance of the two buffering mechanisms, with species relying on microclimate selection suffering larger population declines over the last 40 years than those that could alter their temperature behaviourally.Our results highlight the importance of understanding how different species respond to fine‐scale temperature variation, and the value of taking microclimate into account in conservation management to ensure favourable conditions are maintained for temperature‐sensitive species. [ABSTRACT FROM AUTHOR]

The Dementias Platform UK Data Portal is a data repository facilitating access to data for 3 370 929 individuals in 42 cohorts. The Data Portal is an end-to-end data management solution providing a secure, fully auditable, remote access environment for the analysis of cohort data. All projects utilising the data are by default collaborations with the cohort research teams generating the data. The Data Portal uses UK Secure eResearch Platform infrastructure to provide three core utilities: data discovery, access, and analysis. These are delivered using a 7 layered architecture comprising: data ingestion, data curation, platform interoperability, data discovery, access brokerage, data analysis and knowledge preservation. Automated, streamlined, and standardised procedures reduce the administrative burden for all stakeholders, particularly for requests involving multiple independent datasets, where a single request may be forwarded to multiple data controllers. Researchers are provided with their own secure 'lab' using VMware which is accessed using two factor authentication. Over the last 2 years, 160 project proposals involving 579 individual cohort data access requests were received. These were received from 268 applicants spanning 72 institutions (56 academic, 13 commercial, 3 government) in 16 countries with 84 requests involving multiple cohorts. Projects are varied including multi-modal, machine learning, and Mendelian randomisation analyses. Data access is usually free at point of use although a small number of cohorts require a data access fee. [ABSTRACT FROM AUTHOR]

People living with HIV are ageing with a combination of physical, mental and social health challenges, known as disability. Although rehabilitation can address disability, the field is still emerging. Our aim was to identify similar disability experiences across complex chronic conditions and establish recommendations for future rehabilitation research and practice to advance healthy ageing with HIV. We conducted a consultation with 77 stakeholders from the United Kingdom, Canada, and Ireland with expertise in the fields of rehabilitation and HIV, cancer, cardiovascular disease, renal disease, or chronic obstructive pulmonary disease who attended a one-day symposium. We used facilitated discussions to identify how rehabilitation issues in complex chronic disease translate to people ageing with HIV, and prioritised recommendations for future practice and research. Disability issues experienced across HIV and other complex chronic diseases included: (i) frailty, (ii) uncertainty and worrying about the future ageing with complex chronic disease, (iii) mental health, (iv) pain, and (v) stigma. We highlight six recommendations for clinical practice and research to advance healthy ageing with HIV. Opportunities for cross-collaboration exist with other more established areas of chronic disease management and rehabilitation. Recommendations can be used to inform future HIV clinical practice and research in this emerging field. [ABSTRACT FROM AUTHOR]

Abstract: Background and purpose: Physiotherapy “standard care” for the acute post lung transplant recipient has not yet been documented. We aimed to analyse how soon patients commence exercise and how much time is dedicated to this during physiotherapy sessions acutely post lung transplantation. Methods: Prospective observational study of bilateral sequential and single lung transplant recipients for any indication, ≥18 years. Participants were observed during 6 physiotherapy sessions: 3 initial and 3 prior to acute inpatient discharge. Duration and content of each session was recorded, consisting of physical exercise and non‐exercise tasks. Results: Thirty participants, 20 male, median age 58.5 (interquartile range 54.5–65.0) were observed over 173 sessions. Chronic obstructive pulmonary disease was the most common transplant indication (n = 12, 40%). Bilateral lung transplant was performed in 90% (n = 27) of participants. First time to mobilise was 2 (2–3) days. Participants received 14 (12.8–23.8) sessions over 18 (17–31) days. The mean duration of physiotherapy in the initial phase was 107.8 (standard deviation 21.8) min, with 22.9 (7.5) min spent exercising. In the final phase, exercise time increased to 28.1 (11.4) min out of 84.1 (24.6) min. Assessment was the most common non‐exercise component, at 26.6 (7.9) and 22.1 (12.5) min across the three initial and final sessions. Implications for physiotherapy practice: Lung transplant recipients spent 21–34% of observed sessions performing physical exercise beginning 48 hr following surgery. Remaining physiotherapist time was spent on assessment, respiratory interventions, education, and patient‐specific duties. The use of physiotherapy assistants, structured, progressive exercise programs, and continued workplace innovation may enable a higher percentage of physiotherapist supervised physical exercise in the future. [ABSTRACT FROM AUTHOR]

This study aimed to investigate whether special education teachers shared similar difficulties in their understanding of reward and punishment as their mainstream peers. Thirty-five teachers working in six special education needs schools took part in a mixed methods study to explore their use and understanding of reinforcement principles. The purpose of the mixed methods approach was to triangulate the teachers use and perceived use of different reinforcement strategies within the classroom. Teachers' had a good grasp of positive reward-based strategies, but their understanding of the other three types of reinforcement (negative reward, punishment and penalty) was less accurate. There was a clear aversion amongst the sample to discuss punishment with many stating that they do not use it, which contrasted with the observations. Structured continued professional development interventions are required to rectify the discrepancies between belief and evidence. [ABSTRACT FROM AUTHOR]

Background: There is no single definition of a community hospital in the UK, despite its long history. We sought to understand the nature and scope of service provision in community hospitals, within the UK and other high-income countries. Methods: We undertook a scoping review of literature on community hospitals published from 2005 to 2014. Data were extracted on features of the hospital model and the services provided, with results presented as a narrative synthesis. Results: 75 studies were included from ten countries. Community hospitals provide a wide range of services, with wide diversity of provision appearing to reflect local needs. Community hospitals are staffed by a mixture of general practitioners (GPs), nurses, allied health professionals and healthcare assistants. We found many examples of collaborative working arrangements between community hospitals and other health care organisations, including colocation of services, shared workforce with primary care and close collaboration with acute specialists. Conclusions: Community hospitals are able to provide a diverse range of services, responding to geographical and health system contexts. Their collaborative nature may be particularly important in the design of future models of care delivery, where emphasis is placed on integration of care with a key focus on patient-centred care. [ABSTRACT FROM AUTHOR]

The article focuses on the implications of European referendum or Brexit which is the withdrawal of Great Britain from its membership with the European Union. Topics discussed divisions of British society including divisions between England and Scotland, the rise of modern democracy such as membership in the European Economic Community (EEC), and ratification of Lisbon and Maastricht Treaties.

The article focuses on the admissibility of expert evidence in British design litigation. Topics include design freedom in Great Britain, the admissibility of witness statements as evidence, and intellectual property (IP) law litigation. Information is provided on the Intellectual Property Enterprise Court's (IPEC) interpretation of IP law.

The article discusses the approaches that Great Britain and the European Patent Office (EPO) reportedly take regarding excluded subject-matter and inventive steps, focusing on the British Court of Appeal's rulings in cases involving the Aerotel Ltd. telemedicine firm and the Pozzoli SpA packaging company which deal with patentable subject-matter. Comparative law, computer software patents, and the harmonisation of European patent law are also examined.

We examine the work of icap, a clinic for Irish people in Britain, to describe an (Irish) idea of ‘home’ within a psychoanalytic/group‐analytic discourse, and some aspects of its clinical significance in providing culturally‐sensitive psychotherapy. Our work weaves through four axes of trauma: the dislocation embedded in all migration, irrespective of the social or economic circumstances of the migrant; the long domination of Ireland by England, and some of the resulting complexities in Irish migration to Britain; childhood abuse, within the ‘home’ and within the Church‐run institutions sanctioned by the Irish state; and childhood neglect and deprivation. In clinical practice these levels interpenetrate and interact with each other. Early trauma followed by migration impacts on the patient's internalized ‘home’; culturally‐specific loss and yearning are then central to the creation and maintenance of identity, and linked to narratives of ‘home’. In trauma ‘home’ can become frozen in an idealized and/or terrorized state, whereas the creation of a healthy internalized ‘home’ depends on a creative fluidity, a need intensified when actual departure from the home country requires identity adjustment. We touch on the significance of the physical body and external ‘home’. Composite case studies illustrate these clinical themes. [ABSTRACT FROM AUTHOR]

Background People with long-term conditions need to be signposted to high quality information and advice to understand and manage their condition. Information seeking tools combined with third sector information could help address their information needs. Objective To describe the development and implementation of an information service for people living with long-term conditions at one NHS acute trust in the Northeast of England. Methods An information service was trialled using bespoke information models for three long-term conditions in collaboration with third sector organisations. These guided people to relevant, timely and reliable information. Both clinician and service user questionnaires were used to evaluate satisfaction with the service. Results Appropriately designed information models can be used interchangeably across all services. Between 75% and 91% of users agreed that they were satisfied with various aspects of the service. Generally, users received relevant, understandable and high quality information at the right time. Nearly all health professionals (94-100%) felt the service was accessible, provided high quality information and did not significantly impact on their consultation time. Conclusion The developed information service was well received by service users and health professionals. Specifically, the use of information prescriptions and menus facilitated access to information for people with long-term conditions. [ABSTRACT FROM AUTHOR]

This paper examines the determinants of U.S. FDI in the United Kingdom from 1986 through 2010 using stepwise and OLS multiple regression techniques. The paper confirms that Eurozone membership may have significantly influenced U.S. investment decisions on where to enter or expand within the European Union, by testing empirically our model for Belgium and comparing the regression outcomes. The results confirm that U.S. FDI in the United Kingdom has been influenced by market growth, and statutory corporate tax rates, but also that the country's attractiveness to U.S. investors may have been negatively impacted by the creation of the Eurozone. For Belgium, the results suggest that membership in the Eurozone and E U enlargement had a positive impact on U S FDI. [ABSTRACT FROM AUTHOR]

This paper subjects to critical scrutiny the idea of the ‘big society’ which, at present, is the UK Coalition government’s big idea and the personal mission of the Prime Minister David Cameron. First of all the concept is explained, with reference to some of the rhetoric surrounding it. Then the philosophical foundations of the ‘big society’ are unpacked, with particular reference to Red Toryism and libertarian paternalism. This is followed by an assessment of the big society and reference to the other major plank in the government’s social policy agenda, large cuts in public expenditure, that reflects the neo-liberal engine driving the strategy – the hollowing-out of the state – which has implications for the community initiatives and NGOs favoured by the big society’s promoters but which are entirely unacknowledged by them. Then a comparison is made between the present big society idea and Margaret Thatcher’s denial of the existence of society, which reveals many similarities in substance despite the rhetorical distancing. The final part of the paper examines the parallel Blue Labour analysis and suggests an alternative participatory democratic approach. [ABSTRACT FROM PUBLISHER]

Carabid beetles are important functional components of many terrestrial ecosystems. Here, we describe the first long-term, wide-scale and quantitative assessment of temporal changes in UK carabid communities, to inform nationwide management aimed at their conservation., Multivariate and mixed models were used to assess temporal trends over a 15-year period, across eleven sites in the UK Environmental Change Network. Sites covered pasture, field margins, chalk downland, woodland and hedgerows in the lowlands, moorland and pasture in the uplands, and grassland, heaths and bogs in montane locations., We found substantial overall declines in carabid biodiversity. Three-quarters of the species studied declined, half of which were estimated to be undergoing population reductions of > 30%, when averaged over 10-year periods. Declines of this magnitude are recognized to be of conservation concern. They are comparable to those reported for butterflies and moths and increase the evidence base showing that insects are undergoing serious and widespread biodiversity losses., Overall trends masked differences between regions and habitats. Carabid population declines (10-year trend, averaged across species) were estimated to be 52% in montane sites, 31% in northern moorland sites and 28% in western pasture sites (with at least 80% of species declining in each case). Conversely, populations in our southern downland site had 10-year increases of 48% on average. Overall, biodiversity was maintained in upland pasture, and populations were mostly stable in woodland and hedgerow sites., Synthesis and applications. Our results highlight the need to assess trends for carabids, and probably other widespread and ubiquitous taxa, across regions and habitats to fully understand losses in biodiversity. Land management should be underpinned by a consideration of how wide-scale environmental drivers interact with habitat structure. The stability of population trends in woodlands and hedgerows of species that are declining elsewhere puts these habitats at the fore-front of integrated landscape management aimed at preserving their ecosystem services. [ABSTRACT FROM AUTHOR]

This article contributes to the steady flow of critiques of the big society idea contained in The Political Quarterly. It focuses chiefly on two sets of parallels. The first is between the big society and the policies pursued by the Thatcher government which, despite their obvious rhetorical differences, contain many striking similarities, including their neoliberal origins, application of the 'crowding out' thesis and uncritically idealised notions of community. The second is between the big society and a policy with the same name pursued doggedly by the Chinese Communist Party for nearly 20 years until being abandoned as a failure. Lessons for the Prime Minister's flagship policy are drawn from the Chinese experience. The article concludes with a welcome for the rediscovery of the social by public policy and some suggestions as to how a more participative and democratic state could follow from this breakthrough. [ABSTRACT FROM AUTHOR]

The article discusses a study conducted to investigate the danger posed to dialysis patients by travel and ways to minimize the risk. The results of the study revealed that temporary haemodialysis away from base (TDAFB) exposes patients to heightened risk of infection due to contact with different pathogens. It refers to a document "Minimising the risk of transmission of blood borne viruses among adults with chronic or end-stage kidney disease" which describes the tests and precautions that are needed before and after episodes of TDAFB. It highlights that nurses who provide patients with haemodialysis via a central venous catheter (CVC) are responsible for risk management and to assess effectiveness of relevant practices and policies.

The article presents information on the issue of the disqualification of the drivers from driving under the criminal justice administration by the traffic courts of London, England. The focus of the revision in the criminal justice administration is to reduce cost and increase efficiency in the roads of London. Information on the court sanctions regarding the revision in the justice to drivers with respect to the role of the police of Great Britain is also presented.

Abstract: Purpose: Management of neonatal testicular torsion (NTT) is controversial, with varied opinion regarding the merit(s) and role of “emergent” testicular exploration and/or contralateral orchidopexy of the healthy testis. Methods: A survey of consultant paediatric surgeons and urologists working in the United Kingdom and Ireland was conducted to ascertain views to guide best practice. Results: A total of 148 questionnaires were mailed, of which 110 were returned (74% response rate). Of these, 60 (54.5%) surgeons considered NTT secondary to torsion of the spermatic cord and 8 (7.2%) thought primary vascular infarction of the testis responsible. Twelve (10.9%) use Doppler ultrasound to guide management and exclude tumour. Eighty-two surgeons (74.5%) explore the scrotum, and 59 (71.9%) perform ipsilateral orchidectomy and contralateral orchidopexy of the “healthy” testis. Few surgeons undertake emergent exploration. Only 11 (10%) surgeons have ever found a viable testis. Seven (6.4%) cases of synchronous NTT were reported. Twenty-four (21.8%) surgeons do not perform contralateral orchidopexy with concerns of damaging a healthy testis. Orchidopexy is favoured by 89 surgeons, with 46 (52%) using nonabsorbable suture fixation and 28 (31.4%) creating a sutureless extradartos pouch. In boys later found to have a “solitary scrotal testis” and a contralateral testicular remnant, 38 (36.5%) of 104 would always “pex” the testis to avert anorchia. Conclusions: Surgeons'' opinions with NTT in the United Kingdom and Ireland remain diverse. Strong argument can be made for scrotal exploration with/without contralateral orchidopexy. Parents should be counselled on the merits of varied strategies to gain better understanding of the long-term outcomes for their male child. [Copyright &y& Elsevier]

The article presents a study on the ecosystem services delivered by long-term monitoring sites in the environmental change network (ECN) in Great Britain. The researchers highlighted the challenges involved in characterizing the ecosystem services delivered by several terrestrial non-urban environments. They also showed the commonalities in the ecosystem service provision provided by the biogeographic types of site in the ECN. They found that ECN sites contribute well to the scientific assessment of the tradeoffs and synergies in ecosystem services.

Background: Reviewing litigation brought against health institutions is a clinical governance issue and can help to prevent further cases. While large-scale databases are rare, the British National Health Service Litigation Authority deals with claims brought against all public health trusts in England. Methods: We reviewed all 2312 successful cases pertaining to adult orthopaedic claims between 2000 and 2006 in an effort to establish trends of litigation and highlight specific areas of concern such that orthopaedic health care could be potentially improved. A total of 1473 entries had sufficient detail to be considered in our study. Results: There were 4,847,841 elective and trauma-related orthopaedic procedures performed between 2000 and 2006 in the United Kingdom. Compared with the number of cases performed, the frequency of successful litigation is relatively low but financially costly to the National Health Service. From 2000 to 2006, a total of more than US$321,695,072 was paid in adult orthopaedic surgery-related settlements. The most common reason for successful litigation was due to the presence and sequelae of infection (123 cases). In the remaining cases, successful litigation appeared to be related to two common themes: the consent process and the mismanagement of orthopaedic conditions, particularly fractures, cauda equina syndrome, and compartment syndrome. Conclusions: These findings highlight the fact that education and vigilance remain important components of orthopaedic training as many of the cases of successful litigation had a preventable cause. [ABSTRACT FROM AUTHOR]

The article presents a study which investigates the workplace stressor and how the stress affected the doctors in Great Britain. It states that knowing how the doctors handle a stressful situation is crucial in their own well-being and for their patient's safety. The study found out that the work-related stressors among physicians include long working hours, lack of senior support, and organizational pressures.

Childhood obesity and diet-related disease in the UK is rising dramatically. Which?, the UK's largest consumer organisation, has carried out extensive research into the promotion of less healthy foods to children including a recent analysis of the practices of leading UK food companies. In this article, Clare Corbett and Colin Walker identify the range of promotions used to promote less healthy foods to children, evaluate Government and industry action to date and discuss the need for action on a UK, European and global level. [ABSTRACT FROM AUTHOR]

Aims: There is a paucity of research on the lived experience of mental health service users in community rehabilitation services. This exploratory study researched this phenomenon within one UK community rehabilitation scheme. Methods: A non-experimental phenomenological design and analysis of semi-structured interviews enabled an exploratory description of the phenomenon. Use of this design was based on policy recommendations and gaps in the literature on the lived experience of users. Findings: Interpretative phenomenological analysis of data yielded five overarching themes not previously reported: belief about mental illness; the value of independence; community rehabilitation scheme accommodation/peer relationships; adjusting to a community setting; and feeling involved in care; all of which emerged from 64 sub-themes related to the phenomenon. Conclusions: The study revealed shared and unique experiences and highlighted how being cared for within a community mental health rehabilitation service involved users carefully/logically weighing up gains/disadvantages; such as being provided with accommodation/financial benefits together with feeling 'labelled'/coping with a potentially stigmatising diagnosis. The study yielded rich and varied data as individual experiences are posited as differing according to users' own perceptions, experiences and social context. Implications are discussed for professionals working in community mental health rehabilitation settings. [ABSTRACT FROM AUTHOR]

This article focuses on a study which explored patients' responses to the care they receive from minor/major injury/illness nurse treatment service (MINTS) nurses in Great Britain. It presents background on the MINTS scheme. The sample analysed was 1,000 patients who attended see-and-treat services and who were seen by different types of practitioner. The key findings of the study are described.