Search

This study aimed to determine whether caffeine gum influenced perceptual-cognitive and physical performance during the extra-time period of simulated soccer match-play. Semiprofessional male soccer players (n = 12, age: 22 ± 3 years, stature: 1.78 ± 0.06 m, mass: 75 ± 9 kg) performed 120-min soccer-specific exercise on two occasions. In a triple-blind, randomized, crossover design, players chewed caffeinated (200 mg; caffeine) or control (0 mg; placebo) gum for 5 min following 90 min of soccer-specific exercise. Perceptual-cognitive skills (i.e., passing accuracy, reaction time, composure, and adaptability) were assessed using a soccer-specific virtual reality simulator, collected pre- and posttrial. Neuromuscular performance (reactive-strength index, vertical jump height, absolute and relative peak power output, and negative vertical displacement) and sprint performance (15 and 30 m) were measured at pretrial, half-time, 90 min, and posttrial. Caffeine gum attenuated declines in reaction time (pre: 90.8 ± 0.8 AU to post: 90.7 ± 0.8 AU) by a further 4.2% than placebo (pre: 92.1 ± 0.8 AU to post: 88.2 ± 0.8 AU; p <.01). Caffeine gum reduced composure by 4.7% (pre: 69.1 ± 0.8 AU to post: 65.9 ± 0.8 AU) versus placebo (pre: 68.8 ± 0.8 AU to post: 68.3 ± 0.8 AU; p <.01). Caffeine gum did not influence any other variables (p >.05). Where caffeine gum is consumed by players prior to extra-time, reaction time increases but composure may be compromised, and neuromuscular and sprint performance remain unchanged. Future work should assess caffeine gum mixes with substances like L-theanine that promote a relaxed state under stressful conditions. [ABSTRACT FROM AUTHOR]

Three of the most prevalent developmental disorders (DDs) are autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and fetal alcohol spectrum disorder (FASD). As part of a study screening for DDs in Greater Manchester, UK, a unique opportunity was taken to explore parents' experiences of receiving reports about their child's previously unrecognised DD. Six parents out of a possible 16 took part in interviews, which were analysed thematically. Findings drawn from parental responses revealed a number of barriers to accessing support for their child's additional needs, including perceived resistance from schools, particularly for quiet, well-behaved girls, and difficulty in accessing assessment or referrals. There needs to be greater awareness of additional needs in children without externalising behaviours, the presence of gender-specific differences in the presentation of DDs, and FASD as a commonly occurring DD. Ultimately, better support for children with DDs would reduce the burden of unmet needs for the children and their families, and for wider services.

The findings of "Face your elephant," a peer led youth engagement project, are presented. It has been operating for over 10 years and has engaged with over 10,000 festival-goers at 15 festivals, trained over 100 peer educators in science communication and public engagement skills and helped to change power supply practices of festival organizers in the United Kingdom. This long-term approach has delivered multiple benefits in terms of raising festival-goers awareness of actions needed to address climate change, empowering young volunteers as peer educators and informing festival organizers about the opportunities for greenhouse gas emission reductions.

Across the globe, students with disabilities have been increasing in prevalence in higher education settings. In the twenty-first century the struggle to include individuals with disabilities into nursing schools and workplaces continues in different parts of the world. Historically, entry criteria in nursing schools have been based on essential functions, which were primarily designed to be used in the workforce, rather than technical standards for education. In other health professions, such as medicine, this is not necessarily the case. For example, the American Association of Medical Colleges has worked over the past two decades to develop appreciation among medical schools for the need to admit and accommodate students with disabilities. We argue that nursing has not followed suit. This paper presents an integrative literature review, consisting of material from the United States, Ireland, United Kingdom, and Australia, investigating compelling stories, legal mandates, websites, and extant literature looking at essential functions or technical standards as entry criteria for nursing schools. The results show that, when essential functions for employment are used in nursing education, they may be a barrier to entry into that program. The paper concludes with recommendations for well-defined technical standards for nursing schools to be used primarily as entry criteria.

This article describes how a homework task on climate change is being developed as part of a larger project on sustainability issues -- Urban Science. The ultimate aim of this European project is to improve the teaching of scientific enquiry so that students develop the competences to actively contribute to creating sustainable cities, to understand how cities consist of linked systems that affect each other and to gain scientific skills for employment, thereby becoming more motivated to study science. It was found that students can research and present information in spider diagrams and relate this to everyday life. Although this was at a relatively high level, they were not linking different aspects of climate change. The idea of creating a 'messy wall' from the students' work during stage 1 of the Urban Science project is discussed.

Historical pageants were important sites of popular engagement with the past in twentieth-century Britain. They took place in many places and sometimes on a large scale, in settings ranging from small villages to industrial cities. They were staged by schools, churches, professional organisations, women's groups and political parties, among others. This article draws on contemporary studies of heritage and performance to explore the blend of history, myth and fiction that characterised pageants, and the ways in which they both shaped and reflected the self-image of local communities. Pageants were important channels of popular education as well as entertainment and, although they are sometimes seen as backward-looking and conservative spectacles, this article argues that pageants could be an effective means of enlisting the past in the service of the present and future.

Introduction: Potatoes are one of the world's most important agricultural crops, with potential for making a major contribution to global food security. This study shows how a biostimulant derived from a plant extract can improve potato crop yield and global food supply. Successful potato production currently requires significant levels of inputs including fertiliser, pesticides and irrigation, however non-microbial plant biostimulants or mixtures of biostimulants with synergistic actions, have the capacity to reduce inputs and improve the sustainability of intensive agriculture. Methods: A complex biostimulant containing a number of flavonoids including protocatechuic acid, quercetin, chlorogenic acid, coumaroyl quinic acid and gentistic acid was tested against three potato varieties for its efficacy in improving plant growth characteristics and tuber production in controlled and field environments. Results: In containers, complex biostimulant treatment enhanced photosynthetic ability, with elevated levels of chlorophyll, higher specific leaf areas and significantly larger leaf assimilation areas. Treatment also significantly increased tuber yield by an average of 33% in tuber weight across three potato varieties and shifted tuber production toward larger sized tubers. The biostimulant derived from flavonoids was also assessed in 6 commercial potato crops and consistently increased total yield (average 5.2%) and marketable yield, representing an increase in margins of UK£700 per hectare across the 6 crops. Similar increases in yield were seen when comparing chitted and unchitted seed potatoes and both types of seed responded positively to biostimulant application. Biostimulant treatment had no significant effects on tuber specific gravity, dry matter percentage and starch content, except at one location where these quality characteristics were higher in the control plants. Conclusion: The flavonoid based complex biostimulant produced significant effects on potato yield and quality in both container experiments and in field trials indicating its potential for contributing to sustainable potato production. [ABSTRACT FROM AUTHOR]

Background: Carbapenemase-producing Enterobacterales (CPE) are a group of Gram-negative bacteria causing global concern due to their resistance to carbapenems. In this report, we detail the learning points from a CPE outbreak in a tertiary neonatal unit (NU) in the UK. Methods: Routine surveillance screening (rectal swabs) of babies on the NU identified a potential cluster of CPE carriage. Samples were sent to a reference laboratory for confirmatory testing. Environmental screening and cot mapping were undertaken to determine movements of babies within the unit. Regular audits of cleaning standards, hand hygiene, and maternal hygiene when expressing breast milk were carried out. Results: The outbreak lasted 19 weeks. During the outbreak, there were 360 admissions, with 11 babies being colonised with the outbreak strain. Once the outbreak was declared, there were enhanced Infection Prevention and Control (IPC) precautions (including increased environmental and equipment cleaning frequency). CPE screening frequency was increased and cot capacity was reduced. Hand hygiene compliance improved from 92% at the start of the outbreak to 100% by its close. Cleaning standards remained compliant. Maternal hygiene standards varied from 78% to 100%, but no cross-infection links were identified. Environmental screening was negative. No route of cross-infection was identified. Notably, no babies developed invasive CPE infection. Conclusion: This is the first report of a CPE outbreak in a UK NU. Although no specific mode of cross-transmission was identified and the outbreak's end cannot be attributed to any single intervention, the bundle of interventions proved successful after a 5-month period. [ABSTRACT FROM AUTHOR]

How does protest affect political speech? Protest is an important form of political claim-making, yet our understanding of its influence on how individual legislators communicate remains limited. Our paper thus extends a theoretical framework on protests as information about voter preferences, and evaluates it using crowd-sourced protest data from the 2017–2019 Fridays for Future protests in the UK. We combine these data with ~2.4m tweets from 553 legislators over this period and text data from ~150k parliamentary speech records. We find that local protests prompted MPs to speak more about the climate, but only online. These results demonstrate that protest can shape the timing and substance of political communication by individual elected representatives. They also highlight an important difference between legislators' offline and online speech, suggesting that more work is needed to understand how political strategies differ across these arenas. [ABSTRACT FROM AUTHOR]

Initiatives that promote mental well‐being are formally recommended for all British workers, with many practices targeting change in individual workers' resources. While the existing evidence is generally positive about these interventions, disagreement is increasing because of concerns that individual‐level interventions do not engage with working conditions. Contributing to the debate, this article uses survey data (N = 46,336 workers in 233 organisations) to compare participants and nonparticipants in a range of common individual‐level well‐being interventions, including resilience training, mindfulness and well‐being apps. Across multiple subjective well‐being indicators, participants appear no better off. Results are interpreted through the job demands–resources theory and selection bias in cross‐sectional results is interrogated. Overall, results suggest interventions are not providing additional or appropriate resources in response to job demands. [ABSTRACT FROM AUTHOR]

The United Kingdom's Abortion Act 1967 has attracted substantial controversy, which has centred not only on the regulation of abortion itself, but also on the extent to which conscientious objection should be permitted. The aim of this study was to examine a range of healthcare professionals' views on conscientious objection and identify the appropriate parameters of conscientious objection to abortion. Gadamer's hermeneutic was utilised to frame this study. We conducted semi-structured interviews in two UK locations with 18 pharmacists, 17 midwives, 12 nurses and nine doctors, encompassing a mix of conscientious objectors and non-objectors to abortion. A multi-faceted in-depth data analysis led to the development of a hermeneutic of "respecting self and others". Four major themes of "doing the job", "entrusting to others", "acknowledging institutional power" and "being selective" and 18 subthemes contributed to this overarching theme. The complexity of the responses indicates that there is little consistency within and between each profession. They show that participants who were conscientious objectors were accepted by their colleagues and accommodated without detriment to the service, and that in larger hospitals, such as those where our work was carried out, it is possible to be employed in the service areas that include abortion while still being a conscientious objector. Finally, our results indicate that, by respecting of self and others, each profession should be able to accommodate conscience-based objections where individual practitioners seek to exercise them. Conscientious objectors as well as non-objectors have something to contribute to the ongoing development of the maternity and gynaecological services as abortion is only a small part of the work of these services. [ABSTRACT FROM AUTHOR]

The UK parliament's role in the Brexit process has been closely scrutinised and fiercely contested. Despite this, we still have relatively little systematic evidence about parliament's role in shaping Brexit legislation. This article therefore analyses the extent and nature of parliamentary influence on Brexit-related legislation between 2017 and 2019. Using new data on the legislative passage of 13 different bills, including over 3000 proposed amendments, we measure the prominence of three different kinds of parliamentary influence, and compare this to findings from earlier periods. We show that some Brexit bills had a fairly typical parliamentary experience, with very few successful non-government amendments but numerous government concessions. However, a dramatic change from earlier periods was the large number of Brexit-related bills that were simply paused once the government encountered parliamentary difficulties. Parliament's influence over Brexit legislation in this period therefore showed elements of both continuity and change. This finding contributes to our understanding of the Brexit process, and of parliament's role in recent British politics. [ABSTRACT FROM AUTHOR]

An insight into fellowship pathways for surgical trainees in Australia and how they compare to the UK. [ABSTRACT FROM AUTHOR]

We aimed to determine if a programme change to 12 hourly injections of FSH (150 IU per injection) for the first 2 days of stimulation in women with high ovarian reserve (AMH ≥ 30 pmol/L), followed by 24 hourly injections, would elicit increased earlier follicular recruitment, higher egg yields and blastocyst embryos for cryopreservation, leading to potential higher cumulative pregnancy rates, than conventional daily injections throughout. For safety reasons, the approach required mandatory cryopreservation of all blastocysts (mFET group; n = 74), after ovulation trigger with GnRH-agonist, in GnRH-antagonist controlled cycles. The 'Comparator group' (n = 91) comprised women with the same high AMH levels treated with the same base dose of FSH, with the aim of fresh blastocyst transfer and cryopreservation of supernumerary embryos, treated over the preceding 2 years. There was no difference in age, AMH, weight or BMI between the groups. The mFET group achieved higher egg (17.7 versus 11.7; p < 0.001) and embryo (10.9 versus 7.2; p < 0.001) yields and fewer cases with sub-optimal embryo yields (7% versus 22%; p = 0.018). The cumulative live birth rate was superior in the mFET group (73% versus 43%), as was the safety profile, and negligible rate of treatment plan modification. [ABSTRACT FROM AUTHOR]

Background: The potential of the electronic health record to support safety netting has been recognised and a number of electronic safety-netting (E-SN) tools developed. Aim: To establish the most important features of E-SN tools. Design & setting: User-experience interviews followed by a Delphi study in a primary care setting in the UK. Method: The user-experience interviews were carried out remotely with primary care staff who had trialled the EMIS E-SN toolkit for suspected cancer. An electronic modified Delphi approach was used, with primary care staff involved in safety netting in any capacity, to measure consensus on tool features. Results: Thirteen user-experience interviews were carried out and features of E-SN tools seen as important formed the majority of the features included in the Delphi study. Three rounds of Delphi survey were administered. Sixteen responders (64%) completed all three rounds, and 28 out of 44 (64%) features reached consensus. Primary care staff preferred tools that were general in scope. Conclusion: Primary care staff indicated that tools that were not specific to cancer or any other disease, and had features that promoted their flexible, efficient, and integrated use, were important. However, when the important features were discussed with the patient and public involvement (PPI) group, they expressed disappointment that features they believed would make E-SN tools robust and provide a safety net that is difficult to fall through did not reach consensus. The successful adoption of E-SN tools will rely on an evidence base of their effectiveness. Efforts should be made to assess the impact of these tools on patient outcomes. [ABSTRACT FROM AUTHOR]

Background: The fourth section of the 1967 Abortion Act states that individuals (including health care practitioners) do not have to participate in an abortion if they have a conscientious objection. A conscientious objection is a refusal to participate in abortion on the grounds of conscience. This may be informed by religious, moral, philosophical, ethical, or personal beliefs. Currently, there is very little investigation into the impact of conscientious objection on service users in Britain. The perspectives of service users are imperative in understanding the real-world consequences and potential impact of conscientious objection and should be considered when creating and reviewing policies and guidelines. This research provided a platform for women and those who can become pregnant to share their experiences and opinions at a time when these voices are largely excluded in the great tradition of Western political philosophy and law-making processes. Method: Five service users were interviewed using a narrative interview approach to uncover their abortion journeys and experiences of conscientious objection. Findings: The findings were presented as found poems and uncovered that doctors are not always: informing service users that they have a conscientious objection to abortion, giving service users enough information to access abortion (indirect referral), treating them non-judgmentally, and providing medically correct information. Service users did not experience burdens such as long waiting times and were still able to access legal abortion. However, service users did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred and/or were mistreated. Conclusions: Findings indicate that conscientious objection could work in practice. However, it is currently failing some individuals on an emotional level, as not all doctors are adhering to guidelines. Conscientious objection in Britain needs to be addressed, to ensure service users receive fair, impartial, non-judgmental care. [ABSTRACT FROM AUTHOR]

Recent years have seen an increase in the use of delegated legislation to implement major policy decisions in the UK. This has exacerbated the longstanding criticism that Westminster lacks sufficiently robust procedures for parliamentary scrutiny of delegated legislation. However, the UK is not the only country to use delegated legislation, or to face the challenge of ensuring it receives adequate parliamentary scrutiny. This article therefore places the UK system in wider context by comparing it to six other national parliaments. We highlight one comparative strength of the UK system, two weaknesses it shares with the other six cases, and one way in which the UK might learn lessons from elsewhere. Overall, our evidence suggests that no one country offers a clear template for more rigorous parliamentary scrutiny of delegated legislation. Successful reform of the UK's system is likely to require creative procedural innovation. [ABSTRACT FROM AUTHOR]

The Centre for Social Action was commissioned by the Leicester City Council to evaluate its Teenage Pregnancy Prevention Strategy. This was a multi-stage project with a central element of consulting with young people. This article outlines the process that was followed in order to recruit, train and support young people through the process of being peer researchers. Issues covered include retention of interested young people, experiences of training peer evaluators and supporting them throughout the project. The added value of using peer evaluators will be discussed and recommendations given for those wanting to work with young people as researchers in future.

As contact between cultures continues to increase, the impact that this has on cultural identity and belonging is unclear. Cross-cultural or bicultural identification remains a relatively unexplored phenomenon. Is it possible, natural or potentially good to have an identity rooted in more than one culture? If so, how is cross-cultural identity negotiated? Semi-structured interviews were undertaken with nine women who have lived as immigrants in the UK or the USA for at least 20 years. The focus was on the experience of cross-cultural identification, including its benefits and drawbacks. The variety of experience does not permit generalisation at this stage, but the main characteristics of being bicultural in their experience include heightened self-awareness and understanding of difference, and a potential for critical, objective perspective on their environment. It is argued that emphasising the benefits of bicultural identity can be an important step toward improving cross-cultural interaction. (Contains 1 table.)

Toward the end of the of the twentieth century, the idea that young people are social actors gained increasing predominance. Since then, there has been a growing recognition of young people's ability to understand and contribute to forming their environments. In this article, the authors discuss the state of youth participation in the United Kingdom and United States and then describe two projects--one in each country--that represent efforts to stimulate young people's initiative in working for community change. The principles of social action, as developed by the Centre for Social Action, informed both of these projects. The projects demonstrate how social action practice can be a valuable framework for youth engagement. It emphasizes youth voice, participatory practice, and community building. Older youth consistently point to these components as necessary and desirable features of youth organizations and projects. Project examples help educators to understand the challenges and tasks of using the social action framework to inspire youth leadership and healthy development. (Contains 9 notes.)

There is a taken-for-granted acceptance that sports stars have responsibilities as "role models", yet the concept of a "role model" is unclear. The present study addressed the choice of "role models" amongst elite young British rugby league players, and the reasons for their choices. During the summer of 2002 under-13 and under-14 participants of regional training camps (N = 291) completed a questionnaire survey. Almost all indicated that they had a "favourite player"--though some were not current rugby league players. The most frequently cited were all senior international players, and many had on-field leadership experience. Analysis of the reasons for the choices revealed important general dimensions of technical competence, decision-making, physical characteristics, (explicit reference to) "role models" and temperament. These provided the basis for a preliminary explanatory model. This particular cohort of young players demonstrated broad consensus and were able to make clear judgements through nuanced understandings of the game. (Contains 7 notes, 1 table, and 3 figures.)

In this paper, we seek to understand feminization of the dentist workforce moving beyond previous research that has looked at gender in isolation. We contend that little consideration has been given to how gender interacts with other important social identities such as race/ethnicity to influence the opportunities and barriers that female dentists encounter during their dental career. We argue that the scholarly debate about the feminization of the dentistry has not acknowledged the intersectionality of women's lives. Intersectionality describes how multiple social identities (such as race/ethnicity, gender, and class) overlap and interact to inform outcomes, creating disadvantages and/or privileges. Our thesis is that the increasing feminization of the dentist workforce is complicated and paradoxical, creating both opportunities for women and gender imbalances and blockages within the profession. To support our thesis, we critically reviewed the literature on feminization and analysed UK and US workforce data. While the female dentist workforce in both the UK and the US has increased significantly over the past decade, the growth in the number of female dentists was not equal across all racial/ethnic groups. The largest increase in the number of female dentists was among White and Asian women. Viewing the feminization of the dentist workforce through an intersectionality lens exposes the multiple and complex experiences of women, as well as the power dynamics in dentistry. Feminization in dentistry demonstrates the importance of presence, privilege, and power. Based on our assessment of the dentist workforce, dentistry may be less inclusive, despite being perceived as more diverse. Further research should explore how power and privilege may operate in dentistry. Dentistry should embrace intersectionality to provide an inclusive evaluation of equity in the workforce. [ABSTRACT FROM AUTHOR]

Deaf students at two institutions of higher education and hearing students taking the same degree programmes completed the Course Experience Questionnaire and a short version of the Approaches to Studying Inventory. The deaf students were just as likely as the hearing students to adopt a meaning orientation to their studies but were more likely to adopt a reproducing orientation. This was particularly true of those deaf students who preferred to communicate through sign language. However, the deaf students evaluated their programmes just as positively as did the hearing students. It is concluded that deafness per se has no impact on students' perceptions of academic quality, and that deafness and perceptions of academic quality are mutually independent determinants of approaches to studying in higher education. (Contains 9 tables.)

To assess the impact of nasal deviation on the perception of the maxillary dental centreline position as judged by orthodontists, dentists and laypersons. Cross-sectional study. Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK. Three groups of raters comprising 30 orthodontists, 30 dentists and 30 laypersons. A frontal photograph of a smiling white woman was captured and digitally manipulated with varying degrees of nasal deviation and dental centreline (DC) position in increments of 1.5 mm and 3 mm to the right and left. Three rater groups assessed the attractiveness of images using a visual analogue scale (VAS). Multiple regression analysis was undertaken, and images were compared using the Tukey HSD method. Using a mixed linear model, the intraclass correlation coefficient (ICC) was estimated in the range of 69%–86%, indicating good inter-rater reliability. The interaction between image rating and nasal position (P < 0.001), DC position (P < 0.001) and the relationship between nose and DC position (P < 0.001) were found to be statistically significant with symmetrical upper midline and nasal tip position, both considered to be most aesthetically pleasing. Image rating was not influenced by rater group type (P = 0.995), age (P = 0.983) or sex (P = 0.476). There was a preference for a central and coincident nose and maxillary DC position uniformly across the rater groups. Deviations of the nose, DC and their interactions negatively impacted on perceived smile aesthetics with increasing extent and opposing direction of deviations rated progressively more unaesthetic. No differences were observed between orthodontists, general dental practitioners and lay people with respect to perceived impact on smile aesthetics. [ABSTRACT FROM AUTHOR]

In its 2019 manifesto, Boris Johnson's Conservative Party pledged a Constitution, Democracy and Rights Commission, to consider far-reaching constitutional change. This appeared to signal a radical departure from UK precedent in approaching constitutional reform. In this paper, we examine the Johnson government's initial proposals and subsequent actions, placing them in comparative context and contrasting them with UK precedent. We show that the government's explicit pledge to appoint a single Commission to develop the reforms along with its emphasis on restoring public trust in politics through the constitutional reform process, reflected several internationally recognized principles and models for constitutional reform. In practice, however, the government abandoned these potentially radical procedural ambitions, and instead appointed several issue-specific elite-led reviews. We argue that the government's procedural approach has so far closely followed recent UK precedent, and that the Commission turned out to be an opportunity not taken rather than the radical departure that initially seemed possible. [ABSTRACT FROM AUTHOR]

Fluxes of oxygen (O 2) and carbon dioxide (CO 2) in and out of the atmosphere are strongly coupled for terrestrial biospheric exchange processes and fossil fuel combustion but are uncoupled for oceanic air–sea gas exchange. High-precision measurements of both species can therefore provide constraints on the carbon cycle and can be used to quantify fossil fuel CO 2 (ffCO 2) emission estimates. In the case of O 2 , however, due to its large atmospheric mole fraction (∼20.9 %) it is very challenging to measure small variations to the degree of precision and accuracy required for these applications. We have tested an atmospheric O 2 analyser based on the principle of cavity ring-down spectroscopy (Picarro Inc., model G2207- i), both in the laboratory and at the Weybourne Atmospheric Observatory (WAO) field station in the UK, in comparison to well-established, pre-existing atmospheric O 2 and CO 2 measurement systems. In laboratory tests analysing dry air in high-pressure cylinders, we found that the best precision was achieved with 30 min averaging and was ±0.5 ppm (∼±2.4 per meg). Also from continuous measurements from a cylinder of dry air, we found the 24 h peak-to-peak range of hourly averaged values to be 1.2 ppm (∼5.8 per meg). These results are close to atmospheric O 2 compatibility goals as set by the UN World Meteorological Organization. However, from measurements of ambient air conducted at WAO we found that the built-in water correction of the G2207- i does not sufficiently correct for the influence of water vapour on the O 2 mole fraction. When sample air was dried and a 5-hourly baseline correction with a reference gas cylinder was employed, the G2207- i 's results showed an average difference from the established O 2 analyser of 13.6±7.5 per meg (over 2 weeks of continuous measurements). Over the same period, based on measurements of a so-called "target tank", analysed for 12 min every 7 h, we calculated a repeatability of ±5.7±5.6 per meg and a compatibility of ±10.0±6.7 per meg for the G2207- i. To further examine the G2207- i 's performance in real-world applications we used ambient air measurements of O 2 together with concurrent CO 2 measurements to calculate ffCO 2. Due to the imprecision of the G2207- i , the ffCO 2 calculated showed large differences from that calculated from the established measurement system and had a large uncertainty of ±13.0 ppm, which was roughly double that from the established system (±5.8 ppm). [ABSTRACT FROM AUTHOR]

Purpose: Lockdown measures to combat the COVID-19 pandemic restricted social interactions and travel. This retrospective, observational study was conducted to evaluate the effect of lockdown restrictions on Oswestry Disability Index (ODI) scores in patients with spinal conditions. Methods: Prospectively collected data from the British Spine Registry were retrospectively analysed in two groups. The study group included patients' baseline pre-operative ODI scores collected during the first national lockdown in the UK between March and May 2020. The reference group included ODI scores recorded during the same period in 2019, before the pandemic. Scores were compared between groups using the Mann–Whitney U test. We also calculated modified scores that omitted responses to questions related to travel and social life. These were compared using Wilcoxon matched-pairs signed-rank test and Bland–Altman analyses. Results: The median ODI scores for the reference and lockdown groups were 49 and 45, respectively, with no significant differences in the mean ranks (p = 0.068). Comparisons of original and modified ODI scores showed different outcomes for each study group. No significant differences were observed in the lockdown group (p = 0.06). However, for the pre-COVID-19 reference group, there was a significant difference (p < 0.01). Bland–Altman analyses showed reasonable agreement between the methods for calculating ODI in both groups. Conclusion: We found no clinically important differences in ODI scores between the two groups. The findings suggest that the ODI is reliable during lockdown situations and can be used with confidence in the future research using both retrospective and prospective data. Level of evidence: Level 3. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has profoundly affected UK primary care, and as a result the route to cancer diagnosis for many patients. Aim: To explore how the pandemic affected primary care practice, in particular cancer suspicion, referral, and diagnosis, and how this experience evolved as the pandemic progressed. Design and setting: Seventeen qualitative interviews were carried out remotely with primary care staff. Method: Staff from practices in England that expressed an interest in trialling an electronic safety-netting tool were invited to participate. Remote, semi-structured interviews were conducted from September 2020 to March 2021. Data analysis followed a thematic analysis and mind-mapping approach. Results: The first lockdown was described as providing time to make adjustments to allow remote and minimal-contact consultations but caused concerns over undetected cancers. These concerns were realised in summer and autumn 2020 as the participants began to see higher rates of late-stage cancer presentation. During the second and third lockdowns patients seemed more willing to consult. This combined with usual winter pressures, demands of the vaccine programme, and surging levels of COVID-19 meant that the third lockdown was the most difficult. New ways of working were seen as positive when they streamlined services but also unsafe if they prevented GPs from accessing all relevant information and resulted in delayed cancer diagnoses. Conclusion: The post-pandemic recovery of cancer care is dependent on the recovery of primary care. The COVID-19 pandemic has highlighted and exacerbated vulnerabilities in primary care but has also provided new ways of working that may help the recovery. [ABSTRACT FROM AUTHOR]

The article discusses the urgent need for healthcare professionals in the UK to take childhood asthma seriously, following the tragic death of a 10-year-old boy from asthma. The boy had been sent home from the hospital without proper treatment and subsequently died. The article highlights the high number of asthma deaths in children in the UK, the failure to implement recommendations to prevent these deaths, and the recurring preventable risk factors. It emphasizes the need for national action, improved medical management, and education to prevent asthma attacks and deaths in children. [Extracted from the article]

Background: Around one million individuals in the UK have heart failure (HF), a chronic disease that causes significant morbidity and mortality. N-terminal pro-B-type natriuretic peptide (NT-proBNP) monitoring could help improve the care of patients with HF in the community. Aim: The aim of this study is to provide evidence to support the routine use of point-of-care (POC) NT-proBNP monitoring in primary care. Design & setting: In this observational cohort study, the Roche Cobas h 232 POC device was used to measure NT-proBNP in 27 patients with HF at 0, 6, and 12 months, with a subset reanalysed in the laboratory for comparison. Method: Data were analysed for within-person and between-person variability and concordance with laboratory readings using Passing-Bablok regression. GPs reported whether POC results impacted clinical decisionmaking, and patients indicated their willingness to participate in long-term cohort studies using the Likert acceptability scale. Results: Within-person variability in POC NT-proBNP over 12 months was 881 pg/mL (95% confidence interval [CI] = 380 to 1382 pg/mL). Between-person variability was 1972 pg/mL (95% CI = 1,525 to 2791 pg/mL). Passing-Bablok regression showed no significant systematic difference between POC and laboratory measurements. Patients indicated a high level of acceptability, and GP decisionmaking was affected for at least one visit in a third of patients. Conclusion: Within-person variability in POC NT-proBNP is around half of between-person variability, so detecting changes could be of use in HF management. High patient acceptability and impact on clinical decisionmaking warrant further investigation in a larger long-term cohort study. [ABSTRACT FROM AUTHOR]

Fluxes of oxygen (O2) and carbon dioxide (CO2) in and out of the atmosphere are strongly coupled for terrestrial biospheric exchange processes and fossil fuel combustion but are uncoupled for oceanic air-sea gas exchange. High-precision measurements of both species can therefore provide constraints on the carbon cycle and can be used to quantify fossil fuel CO2 (ffCO2) emission estimates. In the case of O2, however, due to its large atmospheric mole fraction of O2 (~20.9 %) it is very challenging to measure small variations to the degree of precision and accuracy required for these applications. We have tested an atmospheric O2 analyser based on the principle of cavity ring-down spectroscopy (Picarro Inc., model G2207- i), both in the laboratory and at the Weybourne Atmospheric Observatory (WAO) field station in the UK, in comparisons to well-established, pre-existing atmospheric O2 and CO2 measurement systems. In laboratory tests analysing air in high-pressure cylinders, from the Allan deviation we calculated a precision of ± 1 ppm (1σ standard deviation of 300 seconds mean), and a 24-hour peak-to-peak range of hourly averaged values of 1.2 ppm. These results are close to atmospheric O2 compatibility goals as set by the UN World Meteorological Organization. From measurements of ambient air conducted at WAO we found that the built-in water correction of the G2207-i does not sufficiently correct for the influence of water vapour on the O2 mole fraction. When sample air was pre-dried and employing a 5-hourly baseline correction with a reference gas cylinder, the G2207-i’s results showed an average difference from the established O2 analyser of 13.6 ± 7.5 per meg (over two weeks of continuous measurements). Over the same period, based on measurements of a so-called “target tank” (sometimes known as a “surveillance tank”), analysed for 12 minutes every 7 hours, we calculated a repeatability of ± 5.7 ± 5.6 per meg and a compatibility of ± 10.0 ± 6.7 per meg for the G2207-i . To further examine the G2207-i’s performance in real-world applications we used ambient air measurements of O2 together with concurrent CO2 measurements to calculate ffCO2. Due to the imprecision of the G2207-i, the ffCO2 calculated showed large differences from that calculated from the established system, and had a large uncertainty of ± 13.0 ppm, which was roughly double that from the established system (± 5.8 ppm). [ABSTRACT FROM AUTHOR]

This prophylactic regimen has been previously described in solid organ lung transplant patients.[7] Based on this evidence, the prolonged turnaround times of fungal diagnostic tests and voriconazole supply issues, the decision was made to initiate antifungal prophylaxis on all mechanically ventilated COVID-19 patients. A further three patients did not meet the ECMM/ISHAM criteria; two patients had radiological findings consistent with CAPA, with BAL GM levels detectable below the ECMM/ISHAM threshold, and a single patient had low-level BAL GM positivity, which did not clinically correlate. A literature review identified a single publication describing antifungal prophylaxis in CAPA patients[6] using nebulized liposomal amphotericin B (AmBisome SP ® sp ) in mechanically ventilated patients. [Extracted from the article]

Little is known about bottle refusal by breastfed babies; however, an informal review of global online forums and social media suggested large numbers of mothers experiencing the scenario. This study aimed to explore UK mothers' experiences of bottle refusal by their breastfed baby in order to provide understanding of the scenario and enhance support for mothers experiencing it. A 22‐point online questionnaire was developed and completed by 841 UK mothers. Findings suggest that mothers introduced a bottle to their breastfed baby due to physical, psychological and socio‐cultural factors. Advice and support for mothers experiencing bottle refusal was not always helpful, and 27% of mothers reported bottle refusal as having a negative impact on their breastfeeding experience. When compared with eventual bottle acceptance, bottle refusal was significantly associated with previous experience of bottle refusal (p <.001), how frequently mothers intended to feed their baby by bottle and babies being younger at the first attempt to introduce a bottle (p <.001). This study provides a unique insight into the complexities of bottle refusal by breastfed babies and the impact it can have upon mothers' breastfeeding experiences. It generates knowledge and understanding that can help to inform practice and policies. In addition, a 'normalising' of the scenario could enable mothers, and those supporting them, to view and manage it more positively. [ABSTRACT FROM AUTHOR]

Objective: Domestic Cat Hepadnavirus (DCH) is a novel virus recently identified in the domestic cat. Currently, little is known regarding its clinical significance. The hepadnaviridae family includes the Hepatitis B Virus (HBV). Co‐infection of HBV and Hepatitis C in humans increases the risk of uveitis. We aimed to determine whether DCH is present in the United Kingdom (UK) and whether DCH warrants investigation as a potential cause of uveitis in cats. Procedures: Clinical records from the Royal Veterinary College (RVC) and the Animal Health Trust (AHT) were reviewed for feline cases diagnosed with endogenous uveitis. A healthy control group was identified from cats presented to the RVC as blood donors. DNA was extracted from stored blood samples using commercially available kits. Polymerase chain reaction assays were performed to confirm the presence of feline DNA and to detect the presence of DCH DNA using previously described protocols. Results: Blood samples were available from 65 cats with endogenous uveitis and 43 healthy control cats. Two blood samples from cats with endogenous uveitis tested positive for the presence of DCH DNA. DCH DNA was not detected in the control group. There was no statistically significant difference between the prevalence of DCH between the groups. Conclusions: Domestic Cat Hepadnavirus is present in the UK. This study failed to demonstrate a conclusive link between DCH and uveitis in cats, although further studies to investigate an association with other feline diseases are warranted. [ABSTRACT FROM AUTHOR]

An online survey (N = 2063) of women working either as police officers or non-sworn/warranted police staff addressed personal well-being and work-related factors during the first COVID lockdown in the United Kingdom from March to August 2020. Overall, 59% of all respondents reported being more stressed during the lockdown than they had been previously. A key factor in stress levels was the respondents' organisational support measured by a computed index of trust, communication, and support (TCS). Those respondents having a positive orientation towards TCS were less stressed than those whose orientation was more negative. Findings differentiated the experience of respondents typed as front-line police officers, front-line police staff, police officers serving in support functions and police staff in support functions. Innovative COVID-19 working arrangements are highlighted as beneficial new practices worth retaining. [ABSTRACT FROM AUTHOR]

Voluntary and community sector organisations are increasing their role in supporting primary care services through 'social prescribing'. parkrun is a charity that delivers free, weekly 5 km events, on a Saturday morning in areas of open space across the UK and globally. In June 2018, parkrun and the Royal College of General Practitioners launched an initiative to encourage the linking of general practitioner practices and local parkrun events. This study investigates the interaction between parkrun events and practices in order to understand why and how parkrun events' promote such linkage, and their experiences of doing so. Its purpose was to provide practical recommendations for developing the parkrun practice initiative and similar collaborations between primary care and voluntary and community sector organisations. An online survey, which included both tick box questions and free text comments was sent to Event Directors for all UK parkrun events and completed by half (322/634, 50.8%). Over two‐thirds (225/322; 69.6%) of the event teams were knowingly linked with one or more general practices; and this was generally viewed as having been a positive experience and was motivated by wanting to positively impact on the health and well‐being of their community. Challenges centred on the process of initiating contact between parkrun events and practices; the lack of time among parkrun event volunteers to promote the scheme; and the difficulty of clarifying parkrun event and practice responsibilities, including who takes the lead. Practical recommendations include: ensuring clear pathways of communication between event teams and practices (e.g. via a Link Worker or designated person within the practice and/or parkrun event); minimising resource implications and ensuring mutual understanding from practices and parkrun event teams as to expected roles and involvement. Our findings, while focused on the parkrun practice initiative, are likely to have relevance to other collaborations between primary care and voluntary and community sector organisations. [ABSTRACT FROM AUTHOR]

Summary: Bleeding and thrombosis are major complications in patients supported with extracorporeal membrane oxygenation (ECMO). In this multicentre observational study of 152 consecutive patients (≥18 years) with severe COVID‐19 supported by veno‐venous (VV) ECMO in four UK commissioned centres during the first wave of the COVID‐19 pandemic (1 March to 31 May 2020), we assessed the incidence of major bleeding and thrombosis and their association with 180‐day mortality. Median age (range) was 47 years (23–65) and 75% were male. Overall, the 180‐day survival was 70·4% (107/152). The rate of major bleeding was 30·9% (47/152), of which intracranial bleeding (ICH) was 34% (16/47). There were 96 thrombotic events (63·1%) consisting of venous 44·7% [68/152 of which 66·2% were pulmonary embolism (PE)], arterial 18·6% (13/152) and ECMO circuit thrombosis 9·9% (15/152). In multivariate analysis, only raised lactate dehydrogenase (LDH) at the initiation of VV ECMO was associated with an increased risk of thrombosis [hazard ratio (HR) 1·92, 95% CI 1·21‐3·03]. Major bleeding and ICH were associated with 3·87‐fold (95% CI 2·10–7·23) and 5·97‐fold [95% confidence interval (CI) 2·36–15·04] increased risk of mortality and PE with a 2·00‐fold (95% CI1·09–3·56) risk of mortality. This highlights the difficult balancing act often encountered when managing coagulopathy in COVID‐19 patients supported with ECMO. [ABSTRACT FROM AUTHOR]

Sinonasal malignancy is a rare and heterogenous disease, with limited evidence to guide management. This report summarises the findings of a UK survey and expert workshop discussion which took place to inform design of a proposed UK trial to assess proton beam therapy versus intensity-modulated radiation therapy. A multidisciplinary working group constructed an online survey to assess current approaches within the UK to surgical and non-surgical practice. Head and neck clinical oncologists, ear nose and throat (ENT) and oral-maxillofacial (OMF) surgeons were invited to participate in the 42-question survey in September 2020. The Royal College of Radiologists Consensus model was adopted in establishing categories to indicate strength of response. An expert panel conducted a virtual workshop in November 2020 to discuss areas of disagreement. A survey was sent to 140 UK-based clinicians with 63 responses (45% response rate) from 30 centres, representing a broad geographical spread. Participants comprised 35 clinical oncologists (56%) and 29 surgeons (44%; 20 ENT and 9 OMF surgeons). There were variations in preferred sequence and combination of treatment modalities for locally advanced maxillary squamous cell carcinoma and sinonasal undifferentiated carcinoma. There was discordant surgical management of the orbit, dura, and neck. There was lack of consensus for radiotherapy in post-operative dose fractionation, target volume delineation, use of multiple dose levels and treatment planning approach to organs-at-risk. There was wide variation across UK centres in the management of sinonasal carcinomas. There is need to standardise UK practice and develop an evidence base for treatment. • Limited evidence base to guide management of sinonasal cancers. • A national survey was carried out to capture current UK practice in management of sinonasal cancers and a virtual expert workshop was held to discuss revealed areas of controversy. • Wide variation across UK centres. There is a need to standardise UK practice and to develop an evidence base for treatment. • The national survey and subsequent workshop informed design of a proposed UK multi-center trial PROTIS (PROTon beam therapy Vs IMRT in Sinonasal malignancy). [ABSTRACT FROM AUTHOR]

Rationale, Aims and Objectives: Sharing aspects of the traditional medical record with patients has been successful in primary and antenatal care, but has not been investigated in the UK inpatient setting. Our aim was to evaluate the impact on patient and clinician experience of providing patients with a written lay summary of their care‐plan in the acute care setting. Method: We carried out a qualitative interview study on two acute medicine wards in an NHS University Teaching Hospital for a 4‐week period in 2019. A summary record, designed in response to suggestions from doctors and patients from a previous study, was distributed to patients on the first ward round after admission. Eligible participants included all doctors and nurses working on and all patients and their families attending the acute medical units; patients were excluded if they lacked capacity to consent or were under 18. We interviewed 20 patients, 10 relatives, 10 doctors and 7 nurses. Results: Patients felt that the summary improved their ability to remember details about their care so they could more accurately and easily update their relatives. They did not feel that the summary induced anxiety. Patient‐doctor communication was improved: patients felt empowered to ask more questions and doctors felt that it solidified their plan and encouraged them to avoid medical jargon. Most patients felt the summary included the 'right' amount of information. Healthcare professionals were more concerned about the risk of breaching confidentiality than patients. Doctors felt that providing summaries was time‐consuming; there were differing opinions about whether this was a worthwhile investment of time. Clinicians recognized that the traditional medical record has many roles. Conclusions: A summary record could empower patients and improve patient‐doctor communication but would require additional clinician and administrative time. [ABSTRACT FROM AUTHOR]

Background: Looked after children are defined as children who are in the care of their local authority. Previous studies have reported that looked after children have poorer mental and physical health, increased behavioural problems, and increased self-harm and mortality compared to peers. They also experience poorer educational outcomes, yet population-wide research into the latter is lacking, particularly in the United Kingdom. Education and health share a bidirectional relationship; therefore, it is important to dually investigate both outcomes. Our study aimed to compare educational and health outcomes for looked after children with peers, adjusting for sociodemographic, maternity, and comorbidity confounders. Methods and findings: Linkage of 9 Scotland-wide databases, covering dispensed prescriptions, hospital admissions, maternity records, death certificates, annual pupil census, examinations, school absences/exclusions, unemployment, and looked after children provided retrospective data on 715,111 children attending Scottish schools between 2009 and 2012 (13,898 [1.9%] looked after). Compared to peers, 13,898 (1.9%) looked after children were more likely to be absent (adjusted incidence rate ratio [AIRR] 1.27, 95% confidence interval [CI] 1.24 to 1.30) and excluded (AIRR 4.09, 95% CI 3.86 to 4.33) from school, have special educational need (SEN; adjusted odds ratio [AOR] 3.48, 95% CI 3.35 to 3.62) and neurodevelopmental multimorbidity (AOR 2.45, 95% CI 2.34 to 2.57), achieve the lowest level of academic attainment (AOR 5.92, 95% CI 5.17 to 6.78), and be unemployed after leaving school (AOR 2.12, 95% CI 1.96 to 2.29). They were more likely to require treatment for epilepsy (AOR 1.50, 95% CI 1.27 to 1.78), attention deficit hyperactivity disorder (ADHD; AOR 3.01, 95% CI 2.76 to 3.27), and depression (AOR 1.90, 95% CI 1.62 to 2.22), be hospitalised overall (adjusted hazard ratio [AHR] 1.23, 95% CI 1.19 to 1.28) for injury (AHR 1.80, 95% CI 1.69 to 1.91) and self-harm (AHR 5.19, 95% CI 4.66 to 5.78), and die prematurely (AHR 3.21, 95% CI 2.16 to 4.77). Compared to children looked after at home, children looked after away from home had less absenteeism (AIRR 0.35, 95% CI 0.33 to 0.36), less exclusion (AIRR 0.63, 95% CI 0.56 to 0.71), less unemployment (AOR 0.53, 95% CI 0.46 to 0.62), and better attainment (AIRR 0.31, 95% CI 0.23 to 0.40). Therefore, among those in care, being cared for away from home appeared to be a protective factor resulting in better educational outcomes. The main limitations of this study were lack of data on local authority care preschool or before 2009, total time spent in care, and age of first contact with social care. Conclusions: Looked after children had poorer health and educational outcomes than peers independent of increased neurodevelopmental conditions and SEN. Further work is required to understand whether poorer outcomes relate to reasons for entering care, including maltreatment and adverse childhood events, neurodevelopmental vulnerabilities, or characteristics of the care system. In this record-linkage study in Scotland, Michael Fleming and colleagues compare educational and health outcomes for children who are in the care of their local authority with the outcomes of their peers. Author summary: Why was this study done?: Looked after children, defined as children placed in the care of their local authority, comprise a vulnerable cohort exhibiting poorer educational and health outcomes compared to peers. Only a few small sample studies have been conducted in the UK, and a recent systematic review reported an urgent need for more population-wide research into the educational outcomes of children placed in social care services. To our knowledge, no previous UK studies have dually investigated educational and health outcomes of looked after children compared to peers using an unselected, nationwide cohort. What did the researchers do and find?: We linked together 9 Scotland-wide databases to compare educational and health outcomes of looked after children against peers, adjusting for sociodemographic, maternity, and comorbidity confounders. Looked after children had increased risk of school absenteeism and exclusion; special educational need (SEN); poor academic attainment; unemployment; hospitalisation and mortality; and treatment for epilepsy, attention deficit hyperactivity disorder (ADHD), depression, and neurodevelopmental multimorbidity. Among children in care, those looked after away from home had less absenteeism, less exclusion, less unemployment, and better attainment. What do these findings mean?: Looked after children had poorer health and educational outcomes than peers independent of increased neurodevelopmental conditions and SEN. Among those in care, being cared for away from home appeared to be a protective factor resulting in better educational outcomes. Further work is required to understand whether poorer outcomes relate to reasons for entering care, including maltreatment and adverse childhood events, neurodevelopmental vulnerabilities, or characteristics of the care system. [ABSTRACT FROM AUTHOR]

Objective: To test the extent to which initial walking speed influences dual-task performance after walking intervention, hypothesising that slow walking speed affects automatic gait control, limiting executive resource availability. Design: A secondary analysis of a trial of dual-task (DT) and single-task (ST) walking interventions comparing those with good (walking speed ⩾0.8 m s−1, n = 21) and limited (walking speed <0.79 m s−1, n = 24) capacity at baseline. Setting: Community. Subjects: Adults six-months post stroke with walking impairment. Interventions: Twenty sessions of 30 minutes treadmill walking over 10 weeks with (DT) or without (ST) cognitive distraction. Good and limited groups were formed regardless of intervention received. Main measures: A two-minute walk with (DT) and without (ST) a cognitive distraction assessed walking. f NIRS measured prefrontal cortex activation during treadmill walking with (DT) and without (ST) Stroop and planning tasks and an f MRI sub-study used ankle-dorsiflexion to simulate walking. Results: ST walking improved in both groups (∆baseline: Good = 8.9 ± 13.4 m, limited = 5.3±8.9 m, Group × time = P < 0.151) but only the good walkers improved DT walking (∆baseline: Good = 10.4 ± 13.9 m, limited = 1.3 ± 7.7 m, Group × time = P < 0.025). f NIRS indicated increased ispilesional prefrontal cortex activation during DT walking following intervention (P = 0.021). f MRI revealed greater DT cost activation for limited walkers, and increased resting state connectivity of contralesional M1 with cortical areas associated with conscious gait control at baseline. After the intervention, resting state connectivity between ipsilesional M1 and bilateral superior parietal lobe, involved in integrating sensory and motor signals, increased in the good walkers compared with limited walkers. Conclusion: In individual who walk slowly it may be difficult to improve dual-task walking ability. Registration: ISRCTN50586966 [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the most common causes of endogenous feline uveitis in a UK referral population and to investigate associations based on signalment. Methods: Retrospective multicenter cross‐sectional study from 2010 to 2019 including cats presented to the Animal Health Trust and the Royal Veterinary College with clinical signs consistent with uveitis. Cats were included in analyzes if they had a full physical examination including an ophthalmic examination, complete blood count, serum biochemistry, and infectious disease testing for at least two diseases unless the diagnosis was found on clinical examination (eg, neoplasia). Results: A total of 92 cats were included in the study. The majority of cats presenting with uveitis were male (66.3%). The most common causes of endogenous uveitis were idiopathic uveitis (42/92 45.7%), feline infectious peritonitis (FIP) 15/92 16.3%), and lymphoma (10/92 10.9%). Fisher's exact test showed differences in breed across diagnosis groups (p =.002) with purebred cats being overrepresented in the lymphoma and FIP groups. Kruskal‐Wallis test showed differences in median age across diagnosis groups (p <.001) with cats in the FIP group having the youngest age (median 1.4 years, interquartile range (IQR) 0.4–1.8 years) and cats in the neoplasia (primary or paraneoplastic) group having the oldest age (median 12.8 IQR 10.8–13.8). Idiopathic uveitis was unilateral in 56.1% of cases, and infectious causes were unilateral in 47.8% of cases. Conclusions: The most common cause of endogenous uveitis in a population of cats in the UK was idiopathic uveitis, followed by FIP and lymphoma. [ABSTRACT FROM AUTHOR]

Background: Despite high levels of prenatal alcohol exposure in the UK, evidence on the prevalence of fetal alcohol spectrum disorders (FASD) is lacking. This paper reports on FASD prevalence in a small sample of children in primary school. Methods: A 2‐phase active case ascertainment study was conducted in 3 mainstream primary schools in Greater Manchester, UK. Schools were located in areas that ranged from relatively deprived to relatively affluent. Initial screening of children aged 8–9 years used prespecified criteria for elevated FASD risk (small for age; special educational needs; currently/previously in care; significant social/emotional/mental health symptoms). Screen‐positive children were invited for detailed ascertainment of FASD using gold standard measures that included medical history, facial dysmorphology, neurological impairment, executive function, and behavioral difficulties. Results: Of 220 eligible children, 50 (23%) screened positive and 12% (26/220) proceeded to Phase 2 assessment. Twenty had a developmental disorder, of whom 4 had FASD and 4 were assessed as possible FASD. The crude prevalence rate of FASD in these schools was 1.8% (95% CI: 1.0%, 3.4%) and when including possible cases was 3.6% (2.1%, 6.3%). None of these children had previously been identified with a developmental diagnosis. Conclusions: FASD was found to be common in these schools and most of these children's needs had not previously been identified. A larger, more definitive study that uses a random sampling technique stratified by deprivation level to select schools is needed to make inferences regarding the population prevalence of FASD. [ABSTRACT FROM AUTHOR]

In August 2019, the UK government's attempt to prorogue parliament for five weeks raised the question whether the UK's prorogation rules ought to be reformed. We place this discussion in comparative perspective by contrasting the UK's prorogation rules with (i) equivalent procedures in 26 European democracies and (ii) recent changes in other areas of UK executive–legislative relations. These comparisons suggest that the UK's current prorogation rules are increasingly anomalous. They give governments significantly more power to suspend parliament than comparable European democracies, and are at variance with recent efforts to counterbalance the executive's wide ranging discretion in the UK. [ABSTRACT FROM AUTHOR]