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Background: A responsive and innovative postgraduate programme curriculum that produces an effective and competent multi professional healthcare leader whom can lead within the United Kingdom (UK) and international healthcare context offers a promising approach to contributing towards the challenging global healthcare agenda. Aims: The aim of the study is to evaluate the impact of utilising constructive alignment curricular methodology incorporating the Patchwork Text Assessment on the healthcare leadership development of UK and international postgraduate students. Design: Case study design, incorporating Kirkpatrick's Five Levels of Evaluation Model. Settings and Participants: 12 post graduate students (multi-professional, UK and international) studying on a healthcare leadership and management programme at one UK University in the North West of England. Methods: Retrieval of the critical commentary produced and submitted by students as part of the Patchwork Text Assessment process Data Analysis: Thematic content analysis approach. Results: Four key themes emerged demonstrating how the success of constructive alignment and the Patchwork Text Assessment in promoting deep learning for UK and international postgraduate healthcare leadership students is underpinned by principles of good practice and these include: a) Curriculum planners incorporating work based learning activities into the generated learning activities; b) Curriculum planners creating the best learning environment so the student can achieve the learning activities; c) Providing the learning activities that reflect the real world of healthcare leadership; d) Providing students with opportunities to contextualise theory and practice through relevant patchwork activity and learning activities; e) Equipping students with the transferable postgraduate skills (through learning activities and patch working) to embark on a journey of lifelong learning and continuous professional development; f) Targeting the postgraduate programme /module intended learning outcomes and assessment patches against contemporary leadership qualities frameworks; g) Providing students with opportunities to reflect in multi- professional groups that remain constant in terms of facilitator and supervisor; and h) Creating the learning opportunities for students to apply their learning to their own healthcare organisation.

Globally, terrestrial invertebrates are in decline, in part due to habitat fragmentation. Footpaths provide nature-based recreation to the public but can present small-scale spatially continuous changes in forest dynamics. However, their effects on terrestrial invertebrate communities are unknown. Pitfall trapping was undertaken to identify whether terrestrial invertebrate communities were disrupted by a popular recreational footpath in Blean Woods, an ancient UK woodland. The study identified 720 invertebrates across 36 taxa from 20 footpath edge and forest interior traps. It was found that footpaths did not significantly affect terrestrial invertebrate communities. There was no difference in the taxonomic abundance, richness, and diversity; invertebrate trait abundance and richness; or invertebrate community composition between the footpath edge and woodland interior traps. Thus, footpaths in Blean Woods do not disturb the terrestrial invertebrate community, and therefore present a sustainable mechanism for facilitating public engagement with conservation in a nationally important protected ancient woodland. [ABSTRACT FROM AUTHOR]

Court ethnographies have commonly relied on the physical presence of the ethnographers. This paper explores the opportunities and the challenges of conducting court ethnographies without this physical presence. Specifically, it examines what it means to conduct remote ethnographies of legal processes where neither the ethnographer nor the other hearing participants are physically co‐present. The sudden shift towards remote hearings in fieldwork conducted during the COVID‐19 pandemic presented an opportunity to compare in‐person and remote ethnographic methods. Through a case study of bail hearings in the immigration tribunal in the UK, this paper explores the value and challenges associated with conducting remote ethnographies and asks how they can help to shed light on the impact of absences in legal events. Court ethnographies have commonly relied on the physical presence of the ethnographers. This paper explores the opportunities and the challenges of conducting court ethnographies without this physical presence. Specifically, it examines what it means to conduct remote ethnographies of legal processes where neither the ethnographer nor the other hearing participants are physically co‐present. [ABSTRACT FROM AUTHOR]

Background: The life expectancy of people with severe mental illness (SMI) is shorter than those without SMI, with multimorbidity and poorer physical health contributing to health inequality. Screening tools could potentially assist the optimisation of medicines to protect the physical health of people with SMI. The aim of our research was to design and validate a medicines optimisation tool (OPTIMISE) to help clinicians to optimise physical health in people with SMI. Methods: A review of existing published guidelines, PubMed and Medline was carried out. Literature was examined for medicines optimisation recommendations and also for reference to the management of physical illness in people with mental illness. Potential indicators were grouped according to physiological system. A multidisciplinary team with expertise in mental health and the development of screening tools agreed that 83 indicators should be included in the first draft of OPTIMISE. The Delphi consensus technique was used to develop and validate the contents. A 17-member multidisciplinary panel of experts from the UK and Ireland completed 2 rounds of Delphi consensus, rating their level of agreement to 83 prescribing indicators using a 5-point Likert scale. Indicators were accepted for inclusion in the OPTIMISE tool after achieving a median score of 1 or 2, where 1 indicated strongly agree and 2 indicated agree, and 75th centile value of ≤ 2. Interrater reliability was assessed among 4 clinicians across 20 datasets and the chance corrected level of agreement (kappa) was calculated. The kappa statistic was interpreted as poor if 0.2 or less, fair if 0.21–0.4, moderate if 0.41–0.6, substantial if 0.61–0.8, and good if 0.81–1.0. Results: Consensus was achieved after 2 rounds of Delphi for 62 prescribing indicators where 53 indicators were accepted after round 1 and a further 9 indicators were accepted after round 2. Interrater reliability of OPTIMISE between physicians and pharmacists indicated a substantial level of agreement with a kappa statistic of 0.75. Conclusions: OPTIMISE is a 62 indicator medicines optimisation tool designed to assist decision making in those treating adults with SMI. It was developed using a Delphi consensus methodology and interrater reliability is substantial. OPTIMISE has the potential to improve medicines optimisation by ensuring preventative medicines are considered when clinically indicated. Further research involving the implementation of OPTIMISE is required to demonstrate its true benefit. Trial registration: This article does not report the results of a health care intervention on human participants. [ABSTRACT FROM AUTHOR]

While the drivers and processes of forced migration may overlap for people seeking refuge or experiencing human trafficking, responses are invariably rooted in legislation and policy rather than empirical enquiry. In the UK, tightening of legislation around asylum has, for the past three decades, resulted in a 'hostile environment'. During this time, a discourse around human trafficking (also referred to as 'modern slavery' in the UK) has emerged. This paper looks at asylum and human trafficking in the UK to consider a fractioning of protection and resulting fractioning of support for basic needs and welfare provision, provided through the establishment of parallel systems of support for both populations. This paper explores the distinctions, interface, key points of contact, and disconnects between asylum and trafficking in the UK. It details the trajectory of asylum policy, provides an overview of the pre-history to the hostile environment, the impacts of fractioning refugee protection, and what this means for trust as a result. It is argued that trust is an essential component of UK government policies but that the trajectory of asylum policy from a focus on integration to a culture of hostility runs directly counter to efforts to identify 'victims' of 'modern slavery'. [ABSTRACT FROM AUTHOR]

Background: We aimed to estimate the clinical effectiveness of Community Occupational Therapy for people with dementia and family carers-UK version (Community Occupational Therapy in Dementia-UK version [COTiD-UK]) relative to treatment as usual (TAU). We hypothesised that COTiD-UK would improve the ability of people with dementia to perform activities of daily living (ADL), and family carers' sense of competence, compared with TAU.Methods and Findings: The study design was a multicentre, 2-arm, parallel-group, assessor-masked, individually randomised controlled trial (RCT) with internal pilot. It was conducted in 15 sites across England from September 2014 to January 2018. People with a diagnosis of mild to moderate dementia living in their own home were recruited in pairs with a family carer who provided domestic or personal support for at least 4 hours per week. Pairs were randomised to either receive COTiD-UK, which comprised 10 hours of occupational therapy delivered over 10 weeks in the person with dementia's home or TAU, which comprised the usual local service provision that may or may not include standard occupational therapy. The primary outcome was the Bristol Activities of Daily Living Scale (BADLS) score at 26 weeks. Secondary outcomes for the person with dementia included the following: the BADLS scores at 52 and 78 weeks, cognition, quality of life, and mood; and for the family carer: sense of competence and mood; plus the number of social contacts and leisure activities for both partners. Participants were analysed by treatment allocated. A total of 468 pairs were recruited: people with dementia ranged from 55 to 97 years with a mean age of 78.6 and family carers ranged from 29 to 94 with a mean of 69.1 years. Of the people with dementia, 74.8% were married and 19.2% lived alone. Of the family carers, 72.6% were spouses, and 22.2% were adult children. On randomisation, 249 pairs were assigned to COTiD-UK (62% people with dementia and 23% carers were male) and 219 to TAU (52% people with dementia and 32% carers were male). At the 26 weeks follow-up, data were available for 364 pairs (77.8%). The BADLS score at 26 weeks did not differ significantly between groups (adjusted mean difference estimate 0.35, 95% CI -0.81 to 1.51; p = 0.55). Secondary outcomes did not differ between the groups. In total, 91% of the activity-based goals set by the pairs taking part in the COTiD-UK intervention were fully or partially achieved by the final COTiD-UK session. Study limitations include the following: Intervention fidelity was moderate but varied across and within sites, and the reliance on primarily proxy data focused on measuring the level of functional or cognitive impairment which may not truly reflect the actual performance and views of the person living with dementia.Conclusions: Providing community occupational therapy as delivered in this study did not improve ADL performance, cognition, quality of life, or mood in people with dementia nor sense of competence or mood in family carers. Future research should consider measuring person-centred outcomes that are more meaningful and closely aligned to participants' priorities, such as goal achievement or the quantity and quality of activity engagement and participation.Trial Registration: Current Controlled Trials ISRCTN10748953. [ABSTRACT FROM AUTHOR]

Background: Studies indicate there is a need to improve the delivery of unexpected news via obstetric ultrasound, but there have been few advances in this area. One factor preventing improvement has been a lack of consensus regarding the appropriate phrases and behaviours which sonographers and ultrasound practitioners should use in these situations. Aims: To develop consensus guidelines for unexpected news delivery in Early Pregnancy Unit and Fetal Anomaly Screening Programme NHS settings. Methods: A workshop was conducted to identify priorities and reach consensus on areas of contention. Contributors included interdisciplinary healthcare professionals, policy experts, representatives from third-sector organisations, lay experts and academic researchers (n = 28). Written and verbal feedback was used to draft initial guidance which was then circulated amongst the wider writing group (n = 39). Revisions were undertaken until consensus was reached. Results: Consensus guidelines were developed outlining the behaviours and phrases which should be used during scans where unexpected findings are identified. Specific recommendations included that: honest and clear communication should be prioritised, even with uncertain findings; technical terms should be used, but these should be written down together with their lay interpretations; unless expectant parents use other terminology (e.g. 'foetus'), the term 'baby' should be used as a default, even in early pregnancy; at the initial news disclosure, communication should focus on information provision. Expectant parents should not be asked to make decisions during the scan. Conclusions: These recommendations can be used to develop and improve news delivery interventions in obstetric ultrasound settings. The full guidelines can be accessed online as supplemental material and at https://doi.org/10.5518/100/24. [ABSTRACT FROM AUTHOR]

It is now common practice for preceptorship programmes to be offered to newly qualified nurses within the NHS. The Nursing and Midwifery Council expects newly qualified nurses to be given protected time for learning in their first year of qualified practice and to access support from a preceptor. This article discusses a preceptorship programme that has been implemented in a large integrated NHS Trust in north-west London and shares reflections and learning to date, which can benefit others wanting to roll out a similar programme in the UK. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to describe the use of videoconferencing to deliver a post-graduate education programme in forensic mental services by video-conference across three sites in a large urban centre and develop a forensic community of practice.Design/methodology/approach This paper describes the setting up of the programme, equipment used, the challenges and evaluation of a teaching programme delivered using technology-enhanced education.Findings This forward thinking mechanism of delivery of education has propelled multi-disciplinary and multi-site discussion with the formation of a community of practice.Research limitations/implications Additional skills are demanded of clinicians including familiarisation with the equipment and an awareness of the restrictions in communication using videoconferencing.Practical implications The use of technology has facilitated delivery of a learning programme within our services. Practical benefits are readily evident with increased accessibility, cost and travel savings.Social implications The greatest benefit has been the development of a virtual community allowing peer support, an extended peer review and network development.Originality/value The paper describes use of technology to support delivery of a post-graduate forensic mental health training programme. [ABSTRACT FROM AUTHOR]

Purpose Training in the prison settings is a mandatory part of higher training in forensic psychiatry. Violence in prisons is a recognised issue, which can impact on trainee safety and overall training experience. The Royal College of Psychiatrists have produced guidelines regarding the safety of the environment in inpatient mental health settings, but there is currently no such guidance regarding the prison setting. The purpose of this paper is to report on a survey of UK-based ST4-6 trainees in forensic psychiatry regarding their training experience in prisons, focusing on supervision and safety.Design/methodology/approach The authors constructed an electronic survey which comprised of 18 items. This was sent to each UK training programme director in forensic psychiatry, who were asked to distribute the survey to trainees in their region.Findings There were 36 unique responses, out of an approximate total of 100 trainees. The questions fell into two broad categories: trainee safety and trainee supervision. The main themes that arose were that the majority of trainees (59 per cent) reported that they had not received a formal induction at their prison and had not received training in using the Assessment, Care in Custody and Teamwork framework (58 per cent) and serious incident review protocol (83 per cent). The vast majority (76 per cent) reported not being allocated a personal safety alarm, and 27 per cent reported having received a direct threat from a patient in prison. Responses with regards to consultant supervision were varied. The majority indicated that they received weekly supervision (62 per cent).Originality/value The findings indicate that there are a number of areas where both safety and supervision within the prison environment may be improved. This is concerning given the standards outlined by Promoting Excellence (General Medical Council), which highlights the importance of a safe and supported learning environment, and suggests the need for further analysis locally of training opportunities within prisons. [ABSTRACT FROM AUTHOR]

Introduction A national survey was conducted with United Kingdom (UK) occupational therapists to scope occupational therapy service provision for people with dementia and their family carers in the community. Method This was an online questionnaire with topics on occupational therapists’ roles, service provision, referral, assistive technology and assessment tools. Recruitment was through direct invitation, and promotion via occupational therapy networks, websites and newsletters. Results A total of 197 responded. Occupational therapy referrals most commonly came from the multidisciplinary team. Over half primarily undertook profession-specific work, with occupational therapy assessments the most common profession-specific task. Two-thirds of referrals for initial assessments were for people with mild-to-moderate dementia. A median of 2.5 hours for assessment/intervention was spent for each person with dementia. Almost two-thirds used the Model of Human Occupation Screening Tool. Most could prescribe personal activities of daily living equipment and Telecare, with few able to prescribe equipment for reminiscence or leisure. Conclusion This national survey increases knowledge of UK community occupational therapy practice and service provision for people with dementia and their family carers. It informs occupational therapists about national trends within this practice area, and development of the community occupational therapy intervention (COTiD-UK) as part of the Valuing Active Life in Dementia research programme. [ABSTRACT FROM AUTHOR]

Objective: The authors developed and validated a clozapine-specific side-effects scale capable of eliciting the subjectively unpleasant side-effects of clozapine.Methods: Questions from the original Glasgow Antipsychotic Side-effects Scale (GASS) were compared to a list of the most commonly reported clozapine side-effects and those with a significant subjective burden were included in the GASS for Clozapine (GASS-C). The original authors of the GASS and a group of mental health professionals from the UK and Ireland were enlisted to comment on the questions in the GASS-C based on their clinical experience. 110 clozapine outpatients from two sites completed the GASS-C, the original GASS and a repeat GASS-C. Statistical analyses were performed using SPSS for Windows version 19.Results: The GASS-C was shown to have construct validity, in that Spearman's correlation coefficient was 0.816 (p<0.001) with the original GASS, whilst Cohen's kappa coefficient was >0.77 (p<0.001) for one question and >0.81 (p<0.001) for remaining relevant questions. GASS-C was also shown to have strong test-retest reliability, in that Cronbach's alpha coefficient was >0.907 (p<0.001), whilst Cohen's kappa coefficient was >0.81 (p<0.001) for 12 questions and >0.61 (p<0.001) for the remaining four questions.Conclusion: The GASS-C is a valid and reliable clinical tool to enable a systematic assessment of the subjectively unpleasant side-effects of clozapine. Future research should focus on how the scale can be utilised as a clinical tool to improve real-world outcomes such as adherence to clozapine therapy and quality of life. [ABSTRACT FROM AUTHOR]

Trafficking of children and young people has become an increasingly debated issue in the UK, with official statistics often considered to reflect only the 'tip of the iceberg' of cases. Identification of a child as 'trafficked' relies upon referral to designated 'first responders' and 'competent authorities' within a National Referral Mechanism ( NRM). This article explores the complex undertaking of identifying a child as 'trafficked'. It is suggested that, like any other form of child protection, in cases of 'trafficking' there are unlikely to be 'magic bullets' providing immediate answers to why children are not always seen as being exploited and/or abused and consequently identified as 'trafficked'. Drawing on findings from two qualitative studies into understandings of trafficking amongst agencies working with children, it is suggested that identifying 'trafficking' of children could be enhanced if a broader range of agencies had roles in the process, particularly those working within community engagement frameworks in positions to form crucial relationships of trust with children. [ABSTRACT FROM AUTHOR]

The article focuses on the retrospective accounts of the experiences of childhood sexual abuse survivors on therapeutic support received before the age of 18 in Great Britain. It notes that the survey has formed part of a broad programme of research on therapeutic interventions for children who are affected by sexual abuse. It mentions the National Society for the Prevention of Cruelty to Children (NSPCC) under the Rebuilding Childhoods programme.

Aims and objectives To evaluate the application of a Multidimensional Model of Clinical Leadership on the community healthcare leader and on transforming community services. Background Healthcare policy advocates clinical leadership as the vehicle to transform community and healthcare services. Few studies have identified the key components of an effective clinical leadership development model. Design The first two stages of Kirkpatrick's ( Personnel Administrator 28, 1983, 62) Four/Five Levels of Evaluation were used to evaluate the application of the multidimensional model of clinical leadership. Methods Eighty community healthcare leaders were exposed to this multidimensional clinical leadership development model through attendance of a community clinical leadership development programme. Twenty five leaders participated in focus group interviews. Data from the interviews were analysed utilising thematic content analysis. Results Three key themes emerged that influenced the development of best practice principles for clinical leadership development: Personal leadership development, Organisational leadership, The importance of multiprofessional action learning/reflective groups, Conclusions Emergent best practice principles for clinical leadership development include adopting a multidimensional development approach. This approach encompasses: preparing the individual leader in the role and seeking organisational leadership development that promotes the vision and corporate values of the organisation and delivers on service improvement and innovation. Moreover, application of the Multidimensional Model of Clinical Leadership could offer the best platform for embedding the Six C's of Nursing ( Compassion in Practice - Our Culture of Compassionate Care, Department of Health, Crown Copyright, 2012) within the culture of the healthcare organisation: care, compassion, courage, commitment, communication, and competency. This is achieved in part through the application of emotional intelligence to understand self and to develop the personal integrity of the healthcare leader and through supporting a culture of lifelong leadership learning. Relevance to clinical practice Embedding the best practice principles of clinical leadership development within a multidimensional model of clinical leadership provides a promising approach to: equipping the healthcare leader with those transferable leadership skills required to help them embark on a journey of lifelong leadership learning; and producing the healthcare leader who is caring, compassionate and can confidently and effectively transform community services. [ABSTRACT FROM AUTHOR]

The impact of British rule casts a long shadow over Irish history. While nationalist historians tended to blame Union with Britain for all the economic ills of the 19th century (O’Brien, 1921), recent re-evaluations of both historical and recent Irish economic performance have been cause for a reappraisal of the economic relations between Ireland and Britain (Cullen, 1969; Kennedy and Johnson, 1996). The extent to which economic factors were important in Ireland’s withdrawal from the United Kingdom will be examined in this paper. A secondary aim is to assess the economic consequences of independence in the interwar period. There were many economic reasons up to 1913 as to why Ireland should separate. UK policy was determined by majority voting and policies were suited to the needs of industrial workers in Britain, rather than agricultural workers in Ireland. This led to increased spending beyond the means of Ireland which caused transition difficulties on independence. Finally the consequences of separation in the north and south of Ireland are examined. Evidence suggests that separation led to short term economic difficulty. In the longer run the south benefited from independence due to weakness in British institutions and the incentive structures created during the interwar period. [ABSTRACT FROM PUBLISHER]

This article examines the simple police cautioning disposal and argues that at present the theory and practice of the procedure do not coincide, resulting in unfairness, dissatisfaction and grounds for potential challenge. It is suggested that the process should be amended so that a police caution can be offered, with appropriate safeguards in place, prior to an admission being made. [ABSTRACT FROM AUTHOR]

Within the UK, trafficking of children and young people into, within and out of the country has become an increasingly important and debated issue over the past decade. Although not a new phenomenon, human trafficking has risen up the policy agendas of many countries since the end of the Cold War. This type of forced migration is inextricably linked to the promotion and protection of human rights - be they civil, political, social, economic or cultural rights - and as such it is important that the broader social processes involved are understood and researched by sociologists. This contribution draws upon qualitative research into practitioner responses to trafficking of children conducted by the University of Bedfordshire and the National Society for the Prevention of Cruelty to Children (NSPCC) in the UK. A key finding of this study was that trafficking of children is often viewed as a one-off 'event' by those who have a duty to care for children and young people. It is argued that viewing trafficking as a broader sociological process rather than an event enables a greater understanding of the environmental backgrounds of individual children and the human rights contexts within countries of origin as well as subsequent migration trajectories. It is suggested that this may lead to an enhanced ability to identify children as having been trafficked by those with a duty to care for children. The literature from the multidisciplinary fields of refugee studies and forced migration is drawn upon where applicable. [ABSTRACT FROM AUTHOR]

The phylogeographical structure of brown trout Salmo trutta in Britain and Ireland was studied using polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) analysis of four mitochondrial DNA segments (16S/ND1, ND5/6, COXIII/ND5 and ND5/12S). Analysis of 3636 individuals from 83 sites–morphotypes revealed a total of 25 haplotypes. These haplotypes were nested in seven two-step clades. Although there was a clear geographical patterning to the occurrence of derived clades, admixture among ancestral clades was extensive throughout the studied area. A relevant feature of the data was that some populations contained mixtures of highly divergent clades. This type II phylogeographic pattern is uncommon in nature. Clade intermixing is likely to have taken place during earlier interglacials as well as since the Last Glacial Maximum. The anadromous life history of many S. trutta populations has probably also contributed to clade mixing. Based on the data presented here and published data, postglacial colonization of Britain and Ireland most likely involved S. trutta from at least five potential glacial refuges. Probable locations for such refugia were: south of England–western France, east of the Baltic Sea, western Ireland, Celtic Sea and North Sea. Ferox S. trutta, as defined by their longevity, late maturation and piscivory, exhibited a strong association with a particular clade indicating that they share a common ancestor. Current evidence indicates that the Lough Melvin gillaroo S. trutta and sonaghen S. trutta sympatric types diverged prior to colonization of Lough Melvin and, although limited gene flow has occurred since secondary contact, they have remained largely reproductively isolated due to inlet and outlet river spawning segregation. Gillaroo S. trutta may reflect descendents of a previously more widespread lineage that has declined due to habitat alterations particularly affecting outlet rivers. The mosaic-like distribution of mtDNA lineages means that conservation prioritization in Britain and Ireland should be based on the biological characteristics of local populations rather than solely on evolutionary lineages. [ABSTRACT FROM AUTHOR]

This paper investigates the issue of trust, or mistrust, specifically in relation to single adult asylum seekers and asylum seeker families compulsorily dispersed across England. It draws upon doctoral research on the social exclusion of asylum seekers as a result of dispersal and their separation from mainstream welfare provision due to the creation of the National Asylum Support Service (NASS) following the Immigration and Asylum Act 1999. Trust is an ambiguous term and four forms of trust are delineated to assist conceptualizing the experience of forced migration: social, political, institutional and restorative trust. This paper provides an overview of the aims and each phase of the implementation of dispersal. It is argued that the dispersal system leaves little room for political or institutional trust to be restored and hinders the restoration of social trust. It is suggested that this lack of space for the restoration of trust has negative implications for the longer term resettlement process of asylum seekers who obtain refugee status. It is also suggested that trust is an essential component of UK government policies promoting social or community cohesion, community engagement and initiatives to combat trafficking, forced marriage and `honour' based violence and that mistrust of asylum seekers as a group directly contradicts such policies and initiatives. [ABSTRACT FROM AUTHOR]

The article discusses a study of the impact of the film "The Day After Tomorrow" on people's perception of climate change in Great Britain. The analysis focuses on the likelihood of extreme impacts, concern over climate change versus other global problems, motivation to take action and responsibility for the problem of climate change. The study finds that the film increased anxiety about environmental risks.

Aim: This study looks at changes in the knowledge of and attitudes towards substance misuse in medical students in two UK medical schools between years 1 and 4 of undergraduate training.Method: The instrument used comprised 20 questions regarding knowledge, attitudes to training, clinical practice, and stigma. Questionnaires were distributed to 1st and 4th year students. Data was entered onto Microsoft Excel worksheets and analysed using the Excel program.Results: There was an overall response rate of 75%. Knowledge was poor amongst the students, with little improvement seen between 1st and 4th years. Responses to attitudes to training were encouraging from both years of students at both schools. Attitudes to clinical practice demonstrate improvement between the 1st and 4th years. Negative attitudes to substance misuse greatly diminish from the 1st year to the 4th.Conclusions: Education and training in substance misuse are vital in the personal and professional development of medical students, who will become tomorrow's doctors. This study indicates that, while there is a degree of improvement in their knowledge about prevalence and complications related to substance misuse, there is a more clear cut change in attitudes to substance misusers and the value of treatment, as students progress through their years of training. However, an unacceptably high proportion of students still feel negatively about the patient population and about treatment prospects and prognosis. [ABSTRACT FROM AUTHOR]

Focuses on the use of methods to help midwives acquire the necessary information to enhance the skills in dealing patients with HIV infection and Hepatitis B in Great Britain. Issuance of legislation to all health authorities by the Department of Health; Reduction of mother-to-baby transmission of HIV; Recommendation for an HIV anti-body test.

Action Levels (ALs) are thresholds which are used to determine whether dredged material is suitable for disposal at sea by providing a proxy risk assessment for potential impacts to biological features such as fish and benthos. This project tested proposed scenarios for changes to the UK Action Levels to determine the likely implications for navigational dredge licensing in England and Wales. Approximately 3000 sample data records from 2009 to 2018 were collated with varying numbers of concentrations for contaminant parameters including trace metals, organotins, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) and polybrominated diphenyl ethers (PBDEs). Initially, these data were assessed using current ALs to determine the percentages of the samples with levels below AL1 (generally acceptable for disposal), between AL1 and AL2 and those showing levels above AL2 (generally unacceptable for disposal). These results were then used to compare with the results of the proposed new AL scenarios for each contaminant type derived from literature reviews and historic data. The results indicate that there are changes to the ALs which could be made such as updating the current ALs with the revised ALs, as well as the introduction of ALs where there are currently none set. The benefits of changing the ALs include reducing contaminant disposal to the marine environment and increased transparency in decision making. Any proposed scenarios will need to be phased in carefully in full liaison with stakeholders. [ABSTRACT FROM AUTHOR]

The article reports on difficulties faced by refugees from refugee camps on the Thai-Burma border who have been resettled in Sheffield, England between May 2005 and September 2007, and offers recommendations to overcome those difficulties. The refugees were selected under the Gateway Protection Programme that has been run by Great Britain since March 2004. It is reported that the lack of confidence among refugees and their fear of authority of any kind have become a barrier to accessing other services necessary for settlement. It is recommended that refugees should be provided better information about countries where they are supposed to resettle. It is further recommended that refugees should be provided accessible skills training for employment.

El artículo enfoca en los problemas que ha enfrentado un grupo de refugiados birmanos reasentados en Sheffield, Reino Unido. Cita como fueron seleccionados los refugiados para participar del Programa de Acceso de Protección (GPP, por sus siglas en inglés), menciona algunas de las dificultades que encontraron en adaptarse al nuevo contexto y ofrece algunas recomendaciones para que futuras experiencias de adaptación sean más favorables.

Review of the e-learning course "Trafficking, Exploitation and Modern Slavery" offered by Virtual College, Guiseley, West Yorkshire is presented.

Military service has often been a basis for civilian welfare entitlements. If mass wartime service justified collective provision, it is now suggested professional militaries have been co-opted to support reformed welfare models in which entitlement is increasingly conditional on individuals’ commitment, discipline, and responsibility. “Forces Covenants” which explicitly connect the dedication and contribution of service to state assistance, symbolically re-enforce this shift. The U.K. state operates a highly conditional civilian social security system, and an active Armed Forces Covenant agenda. This article assesses the extent to which U.K. veterans who also claimed social security benefits support or reject the principles of conditionality. It contends military service continues to inform values they believe civilian services should follow. Although some align with conditional ideas of entitlement, others are at odds. This analysis adds to the understandings of contemporary welfare and the role of military identities after service. [ABSTRACT FROM AUTHOR]

Abstract: The deep-sea includes over 90% of the world's oceans and is thought to be one of the most diverse ecosystems in the world. It supplies society with valuable ecosystem services, including the provision of food, the regeneration of nutrients and the sequestration of carbon. Technological advancements in the second half of the 20th century made large-scale exploitation of mineral, hydrocarbon and fish resources possible. These economic activities, combined with climate change impacts, constitute a considerable threat to deep-sea biodiversity. Many governments, including that of the UK, have therefore decided to implement additional protected areas in their waters of national jurisdiction. To support the decision process and to improve our understanding for the acceptance of marine conservation plans across the general public, a choice experiment survey asked Scottish households for their willingness-to-pay for additional marine protected areas in the Scottish deep-sea. This study is one of the first to use valuation methodologies to investigate public preferences for the protection of deep-sea ecosystems. The experiment focused on the elicitation of economic values for two aspects of marine biodiversity: (i) the existence value for deep-sea species and (ii) the option value of deep-sea organisms as a source for future medicinal products. [ABSTRACT FROM AUTHOR]

• A non-human primate protective head cap that promotes wound healing after cranial implants. • Use of the head cap reduced wound dehiscence and the need to re-suture surgical wounds. • The head cap is easily adjustable to cover most primate cranial implants. • The head cap facilitates primate cranial implant wound management in neuroscience. Neuroscience studies with macaque monkeys may require cranial implants to stabilize the head or gain access to the brain for scientific purposes. Wound management that promotes healing after the cranial implant surgery in non-human primates can be difficult as it is not necessarily possible to cover the wound margins. Here, we developed an easily modifiable head cap that protects the sutured skin margins after cranial implant surgery and contributes to wound healing. The protective head cap was developed in response to monkeys picking at sutured skin margins around an implant, complicating healing. The user-friendly protective cap, made from Klarity- R™ Sheet (3.2 mm thick with 36 % or 42 % perforation) is affixed to the implant post-surgically. Once secured and while the monkey is still anesthetized, the plastic sheeting is molded around the implant. The protective head cap restricts the monkey's finger access to its' wound margins while allowing air to circulate to promote wound healing. Across two UK primate facilities, the protective head cap promoted wound healing. In monkeys that did not wear the head cap, re-suturing was necessary in ∼30 % of cases. In contrast, none of the monkeys that wore the head cap required re-suturing. The monkeys wearing the head cap also had reduced numbers of days of prescribed antibiotics and analgesia. This bespoken, easily adaptable, protective head cap supports postoperative wound healing, and enhances the welfare of monkeys involved in neuroscience research. [ABSTRACT FROM AUTHOR]