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As part of "The Blue Marble" project, the Universities of Leicester and Nottingham, UK, have developed day-long, interdisciplinary, hands-on workshops for primary schools to introduce space technology and the role of the research scientist. The workshop activities introduce 5-11 year olds to the role of the UK space industry, show the importance of satellite technology for observing and monitoring the Earth and highlight a range of environmental issues. There are links to "how science works," environmental and geoscience topics, as well as a range of science, technology, engineering and mathematics subjects. These interactive workshops provide an opportunity for learners to meet "real" scientists--one of the take-home messages from the day is that anyone can become involved in science, whatever their ability or subject of interest. The methodology introduces the role of the scientist using space technology themes, but could easily be adapted for use with any inspirational topic. The workshops--attended by 349 learners aged 6-11--were fully and independently evaluated, with very positive changes to learners' views of science and scientists. This paper provides an overview of the activities, the methodology, the evaluation process and results, noting the potential for adaptation to Key Stage 3. (Contains 3 figures.)

In order to combat the COVID-19 pandemic, policymakers around the globe have increasingly invested in digital health technologies to support the 'test, track and trace' approach of containing the spread of the novel coronavirus. These technologies include mobile 'contact tracing' applications (apps), which can trace individuals likely to have come into contact with those who have reported symptoms or tested positive for the virus and request that they self-isolate. This paper takes a critical public health perspective that advocates for 'genuine participation' in public health interventions and emphasises the need to take citizen's knowledge into account during public health decision-making. In doing so, it presents and discusses the findings of a UK interview study that explored public views on the possibility of using a COVID-19 contact-tracing app public health intervention at the time the United Kingdom (UK) Government announced their decision to develop such a technology. Findings illustrated interviewees' range and degree of understandings, misconceptions, and concerns about the possibility of using an app. In particular, concerns about privacy and surveillance predominated. Interviewees associated these concerns much more broadly than health by identifying with pre-existent British national narratives associated with individual liberty and autonomy. In extending and contributing to ongoing sociological research with public health, we argue that understanding and responding to these matters is vital, and that our findings demonstrate the need for a forward-looking, anticipatory strategy for public engagement as part of the responsible innovation of the COVID-19 contact-tracing app in the UK. [ABSTRACT FROM AUTHOR]

Background Little has been reported on mortality following admissions at weekends for many gastrointestinal (GI) disorders. The aim was to establish whether GI disorders are susceptible to increased mortality following unscheduled admission on weekends compared with weekdays. Methods Record linkage was undertaken of national administrative inpatient and mortality data for people in England and Wales who were hospitalized as an emergency for one of 19 major GI disorders. Results The study included 2 254 701 people in England and 155 464 in Wales. For 11 general surgical and medical GI disorders there were little, or no, significant weekend effects on mortality at 30 days in either country. There were large consistent weekend effects in both countries for severe liver disease (England: 26·2 (95 per cent c.i. 21·1 to 31·6) per cent; Wales: 32·0 (12·4 to 55·1 per cent) and GI cancer (England: 21·8 (19·1 to 24·5) per cent; Wales: 25·0 (15·0 to 35·9) per cent), which were lower in patients managed by surgeons. Admission rates were lower at weekends than on weekdays, most strongly for severe liver disease (by 43·3 per cent in England and 51·4 per cent in Wales) and GI cancer (by 44·6 and 52·8 per cent respectively). Both mortality and the weekend mortality effect for GI cancer were lower for patients managed by surgeons. Discussion There is little, or no, evidence of a weekend mortality effect for most major general surgical or medical GI disorders, but large weekend effects for GI cancer and severe liver disease. Lower admission rates at weekends indicate more severe cases. The findings for severe liver disease may suggest a lack of specialist hepatological resources. For cancers, reduced availability of end-of-life care in the community at weekends may be the cause. [ABSTRACT FROM AUTHOR]

Abstract: Little is known about individual differences in the pattern of university adjustment. This study explored longitudinal associations between emotional self-efficacy, emotion management, university adjustment, and academic achievement in a sample of first year undergraduates in the United Kingdom (N=331). Students completed measures of adjustment to university at three points during their first year at university. Latent growth mixture modeling identified four trajectories of adjustment: (1) low, stable adjustment, (2) medium, stable adjustment, (3) high, stable adjustment, and (4) low, increasing adjustment. Membership of the low, stable adjustment group was predicted by low emotional self-efficacy and low emotion management scores, measured at entry into university. This group also had increased odds of poor academic achievement, even when grade at entry to university was controlled. Students who increased in adjustment had high levels of emotion management and emotional self-efficacy, which helped adaptation. These findings have implications for intervention. [Copyright &y& Elsevier]

BackgroundHigh occupational suicide rates are often linked to easy occupational access to a method of suicide. This study aimed to compare suicide rates across all occupations in Britain, how they have changed over the past 30 years, and how they may vary by occupational socio-economic group.MethodWe used national occupational mortality statistics, census-based occupational populations and death inquiry files (for the years 1979–1980, 1982–1983 and 2001–2005). The main outcome measures were suicide rates per 100 000 population, percentage changes over time in suicide rates, standardized mortality ratios (SMRs) and proportional mortality ratios (PMRs).ResultsSeveral occupations with the highest suicide rates (per 100 000 population) during 1979–1980 and 1982–1983, including veterinarians (ranked first), pharmacists (fourth), dentists (sixth), doctors (tenth) and farmers (thirteenth), have easy occupational access to a method of suicide (pharmaceuticals or guns). By 2001–2005, there had been large significant reductions in suicide rates for each of these occupations, so that none ranked in the top 30 occupations. Occupations with significant increases over time in suicide rates were all manual occupations whereas occupations with suicide rates that decreased were mainly professional or non-manual. Variation in suicide rates that was explained by socio-economic group almost doubled over time from 11.4% in 1979–1980 and 1982–1983 to 20.7% in 2001–2005.ConclusionsSocio-economic forces now seem to be a major determinant of high occupational suicide rates in Britain. As the increases in suicide rates among manual occupations occurred during a period of economic prosperity, carefully targeted suicide prevention initiatives could be beneficial. [ABSTRACT FROM PUBLISHER]

Summary: Changes and gender differences in the muscle bone unit at different skeletal sites were investigated during pubertal development. Females accrued greater BMC in relation to muscle compared to males; these gender differences were greater after adjustment for height and regional fat mass. Purpose: To describe changes and gender differences in the muscle-bone unit at different skeletal sites during pubertal development. Methods: Four hundred forty-two children aged 5-18 years were studied. Measurements of bone mineral content (BMC), lean mass (LM) and fat mass of the whole body (WB), legs, arms and lumbar spine were obtained from dual-energy X-ray absorptiometry. Peripheral quantitative computed tomography was used to measure BMC of the radius diaphysis and cross-sectional muscle area (CSMA) of the mid-forearm. These measurements were used to describe differences between, and within, genders at each pubertal stage in BMC accrual relative to muscle, both before and after adjustment for height, regional fat and muscle at central and peripheral skeletal sites. Results: In males, there were significant increases in adjusted WB and leg BMC at the end of pubertal development. Unadjusted and adjusted lumbar spine BMC increased at the onset of, and at the end, of puberty. Radius BMC increased at most pubertal stages. In females, there were increases in unadjusted and adjusted whole body BMC at late puberty, in leg BMC at the onset of puberty and at pubertal stage four. Unadjusted arm BMC increased at most pubertal stages; however, after adjustment, an increase occurred at pubertal stage four. Both adjusted and unadjusted lumbar spine BMC increased at pubertal stage four. Unadjusted radius BMC increased at most pubertal stages. Females had greater BMC at all skeletal sites, compared to males, except at the radius, where adjusted BMC was greater in males at pubertal stage four. Conclusions: Males and females accrue more BMC in relation to lean mass at multiple skeletal sites as puberty proceeds. Females accrue more BMC in relation to lean mass, in comparison to males, at most skeletal sites. [ABSTRACT FROM AUTHOR]

Background: In order to optimize IVF strategies, particularly with the use of single embryo transfer, good predictive models are required. Here, we develop a model to allow such prediction, and the structure of the models point to more general conclusions about the mode of action of prognostic factors.Methods: Anonymized data from consecutive embryo transfers in five IVF centres in the UK for the 2000-2005 period were extracted and the morphological grade based on common scoring criteria was included. There were 16 096 (12 487 fresh and 3609 frozen) transfers, for 8775 couples, available for analysis. Live birth data were fitted to a model with separate sub-models for embryo and recipient effects [the 'Embryo-Uterus' (EU) model]. All covariates were included, with sub-model selection using Akaike's information criterion.Results: Age, number of embryos created, attempt number, previous history of pregnancy, duration of infertility, day of transfer and tubal diagnosis were all identified as significant prognostic factors, along with embryo grade and growth rate. Frozen transfers were substantially less likely to lead to a live birth with odds ratios of 1/3 to 1/2 compared with fresh transfers, with no evidence of differential loss for any particular patient group. Age acts predominantly through the embryo component with only a weak effect on the uterus. The embryo number, attempt number, previous pregnancies and duration of infertility act predominantly through the uterine environment. Both sub-models show significant heterogeneity between centres.Conclusions: The EU modelling framework has generated a model for predicting outcomes of embryo-transfer procedures, subject to the limitations of routinely collected data. With this large data set, the model allows identification of factors that act specifically on embryo viability or maternal receptivity. Variability in the two components between centres with similar overall outcomes suggests scope for further optimization of IVF treatment. [ABSTRACT FROM AUTHOR]

The article focuses on the service provision available for the effective management of gastrointestinal (GI) and hepatic disorders in Great Britain, and discusses their economic and personal burden. As stated, there is a lack of evidence related to service delivery for GI disorders due to lack of high technology assessment and evaluation. The burden of this ailment on the patient's quality of life is mentioned, and the role of National Health Service in its management is discussed.

Despite widespread concern about declines in pollination services, little is known about the patterns of change in most pollinator assemblages. By studying bee and hoverfly assemblages in Britain and the Netherlands, we found evidence of declines (pre- versus post-1980) in local bee diversity in both countries; however, divergent trends were observed in hoverflies. Depending on the assemblage and Location, pollinator declines were most frequent in habitat and flower specialists, in univoltine species, and/or in nonmigrants. In conjunction with this evidence, outcrossing plant species that are reliant on the declining pollinators have themselves declined relative to other plant species. Taken together, these findings strongly suggest a causal connection between Local extinctions of functionally linked plant and pollinator species. [ABSTRACT FROM AUTHOR]

We aim to compare the outcomes of patients undergoing R0 esophagectomy by a multidisciplinary team (MDT) with outcomes after surgery alone performed by surgeons working independently in a UK cancer unit. An historical control group of 77 consecutive patients diagnosed with esophageal cancer and undergoing surgery with curative intent by six general surgeons between 1991 and 1997 (54 R0 esophagectomies) were compared with a group of 67 consecutive patients managed by the MDT between 1998 and 2003 (53 R0 esophagectomies, 26 patients received multimodal therapy). The proportion of patients undergoing open and closed laparotomy and thoracotomy decreased from 21% and 5%, respectively, in control patients, to 13% and 0% in MDT patients (χ2 = 11.90, DF = 1, P = 0.001; χ2 = 5.45, DF = 1, P = 0.02 respectively). MDT patients had lower operative mortality (5.7% vs. 26%; χ2 = 8.22, DF = 1, P = 0.004) than control patients, and were more likely to survive 5 years (52% vs. 10%, χ2 = 15.05, P = 0.0001). In a multivariate analysis, MDT management (HR = 0.337, 95% CI = 0.201–0.564, P < 0.001), lymph node metastases (HR = 1.728, 95% CI = 1.070–2.792, P = 0.025), and American Society of Anesthesiologists grade (HR = 2.207, 95% CI = 1.412–3.450, P = 0.001) were independently associated with duration of survival. Multidisciplinary team management and surgical subspecialization improved outcomes after surgery significantly for patients diagnosed with esophageal cancer. [ABSTRACT FROM AUTHOR]

Alongside a rising prevalence of known diabetes, patterns of care for diabetes have been changing in the United Kingdom. The aim of this study is to describe the changes in the prevalence of known diabetes and shift in site of care of patients in a single health district over a 10-year period. Repeat cross-sectional study over 10 years of patients with diabetes resident in North Tyneside district. The crude prevalence of known diabetes in North Tyneside rose from 1.1 to 3.0% between 1991 and 2001. The proportion of patients receiving their diabetes care wholly in primary care rose significantly from 608/2236 (27%) in 1991 to 3995/5809 (69%) in 2001 (χ2 = 968, 1 d.f., P < 0.001). The number of patients attending secondary care also rose by 14% over this period of time from 1508 to 1712 patients. Most of the extra workload of the rising prevalence of diabetes has been met in primary care. However, hospital care has not seen a drop in workload. This has important implications for health care planning, as an increase in resources will be required within both primary and secondary care to meet the needs of the diabetic population. Diabet. Med. (2004) [ABSTRACT FROM AUTHOR]

Aims To determine the cost-effectiveness of a structured treatment and teaching programme (STTP) combining dietary freedom with insulin adjustment for Type 1 diabetes. Methods Incremental cost-effectiveness analysis based on effectiveness data from three RCTs in Germany, Austria, and Dose Adjustment for Normal Eating (DAFNE) in the UK, to model the long-term microvascular complications of Type 1 diabetes. Results The STTP approach yields effectiveness gains at a lower cost compared with current standard practice for treatment of Type 1 diabetes. STTPs are likely to save 0.05 life years, yield 0.12 EuroQol 5 dimensions (EQ-SD) and 0.09 visual analogue scale (VAS) incremental quality-adjusted life years, and save approximately £2200 per patient treated discounted over 10 years. Conclusions Introducing STTPs as standard treatment for people with Type 1 diabetes in the UK may help to achieve the primary goal of the National Service Framework (NSF) for Diabetes by enabling individuals to manage their own lifestyle and condition. In doing so it could save valuable resources for the NHS and yield important morbidity and mortality gains. [ABSTRACT FROM AUTHOR]

This study was designed to establish the manner and causes of all fatalities among seafarers who were serving in British merchant shipping between 1 January 1986 and 31 December 1995. Other main aims were to compare mortality rates with workers in other industries and with seafarers in other merchant fleets, and to discuss recommendations for the prevention of occupational mortality. This study was based upon official mortality files with a population of 253 919 seafarer–years at risk. There was a total of 252 fatalities in British merchant shipping during the study period. One hundred and seven of the 252 deaths were due to natural causes, of which 93 (87%) were caused by cardiovascular disease. The relative risk of mortality due to accidents at work (96 fatalities) was 23.9 times higher than for all workers in Great Britain during the same time period (95% confidence interval = 14.0–40.7). The risk of a fatal accident in merchant shipping was also much higher than in other British industrial sectors, such as agriculture, forestry and fishing (relative risk = 4.5), construction (5.5), and manufacturing (22.0). Seafaring was identified as a dangerous occupation compared with shore–based employment. Many of the fatal accidents at work were caused by hazardous working practices and were often preventable, as were the many off–duty accidents and drowning that were caused by seafarers falling into docks when encountering hazardous access to their ships from the shore. Seafarers are also at special risk from acute illnesses since they lack direct access to specialist medical care. [ABSTRACT FROM PUBLISHER]

The article focuses on the records of textiles and leather business and industry in Great Britain from 1760 to 1914. The information about manuscript sources for British history is kept by the Royal Commission on Historical Manuscripts at the National Register of Archives. To disseminate the accumulated information more widely, the Commission embarked in 1982 on a series of "Guides to Sources for British History," published for it by Her Majesty's Stationery Office. The first of the eight volume in the series covers the textile, clothing and leather industries between 1760 and 1914.

Interactive services on tree-and-branch cable TV systems in the U.K. have been rather slow to emerge. This has been partly due to the high cost of the customers terminals but is also due to the difficulty of passing keyboard data, from the customers, hack over the cable network to the head-end. This paper describes a new approach to these problems and shows that Videotex and other interactive services can be provided without major engineering changes to tile network. [ABSTRACT FROM AUTHOR]

This series is designed to assist care professionals and assistants in updating of learning new skills. This month, Cheryl Holman, Sally Roberts and Maggie Nicol consider age-related changes to hearing and how they can be ameliorated. [ABSTRACT FROM AUTHOR]

Comments on the role of in-patient diabetes specialist nursing service in the reduction of patient length of stay in hospitals in Great Britain. Use of the Diabetes Care Service Questionnaire to study patient satisfaction; Effects of organizational change on patient length of stay; Susceptibility of specialist teams in palliative care to influences.

Multiple-cause-coded mortality rates for thromboembolism in the Oxford region of the UK showed a steady decline fom 1975 to 1998. The trend for admission rates was less clear-cut, but recent changes were not specific to women of ages associated with use of oral contraceptives or hormone-replacement therapy. [ABSTRACT FROM AUTHOR]

Background: Propensity score (PS) regression analysis can be used to minimize differences between cohorts in order to perform comparisons The aim of this study was to use PS analysis to examine the outcomes of oesophageal adenocarcinoma (OAC) treatment with surgery alone or neoadjuvant chemotherapy (NAC) followed by surgery (NACS), to see whether the benefits seen in a randomized trial (MRC OE02) were reproducible in a UK cancer network clinical practice., Methods: Consecutive patients undergoing potentially curative treatment for OAC in a regional cancer network were studied. Multiple regression models, including PS analysis, were developed to account for confounding factors. Primary outcome measures were disease-free (DFS) and overall (OS) survival., Results: A cohort of 440 patients was included in a regression analysis controlling for confounders (176 surgery alone, 264 NACS). NACS was associated with a higher positive margin status rate compared with surgery alone (42·4 versus 26·7 per cent respectively; P < 0·001), an inferior 5-year DFS rate (32·1 versus 56·9 per cent; P < 0·001) and a worse 5-year OS rate (27·5 versus 47·3 per cent; P < 0·001). On regression adjustment based on propensity scores, NACS was not associated with DFS (P = 0·220) or OS (P = 0·431). The Mandard tumour regression grade (TRG) score was significantly associated with DFS (hazard ratio (HR) 0·21, 95 per cent c.i. 0·07 to 0·70) and OS (HR 0·27, 0·13 to 0·59). Five-year DFS and OS rates related to TRG were 64 and 62 per cent respectively for 25 good responders versus 8·0 and 8·6 per cent for 127 poor responders (P < 0·001)., Conclusion: The prescription of NAC to all patients with OAC risks delay in effective treatment of patients who are relatively chemoresistant, given the variability in pathological response. Identification of patients with OAC who may derive the most benefit from NAC should be the focus., (© 2020 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of British Journal of Surgery Society.)

Background: Surgeon-level operative mortality is widely seen as a measure of quality after gastric and oesophageal resection. This study aimed to evaluate this alongside a compound-level outcome analysis., Methods: Consecutive patients who underwent treatment including surgery delivered by a multidisciplinary team, which included seven specialist surgeons, were studied. The primary outcome was death within 30 days of surgery; secondary outcomes were anastomotic leak, Clavien-Dindo morbidity score, lymph node harvest, circumferential resection margin (CRM) status, disease-free (DFS), and overall (OS) survival., Results: The median number of annual resections per surgeon was 10 (range 5-25), compared with 14 (5-25) for joint consultant teams (P = 0·855). The median annual surgeon-level mortality rate was 0 (0-9) per cent versus an overall network annual operative mortality rate of 1·8 (0-3·7) per cent. Joint consultant team procedures were associated with fewer operative deaths (0·5 per cent versus 3·4 per cent at surgeon level; P = 0·027). The median surgeon anastomotic leak rate was 12·4 (range 9-20) per cent (P = 0·625 versus the whole surgical range), overall morbidity 46·5 (31-60) per cent (P = 0·066), lymph node harvest 16 (9-29) (P < 0·001), CRM positivity 32·0 (16-46) per cent (P = 0·003), 5-year DFS rate 44·8 (29-60) per cent and OS rate 46·5 (35-53) per cent. No designated metrics were independently associated with DFS or OS in multivariable analysis., Conclusion: Annual surgeon-level metrics demonstrated wide variations (fivefold), but these performance metrics were not associated with survival., (© 2019 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.)

We investigated the effect of social inequalities on the uptake of human papillomavirus (HPV) vaccination, combining data from a feasibility study conducted in 2007-2008 in 2817 secondary schoolgirls in two UK primary-care trusts, with census and child health records. Uptake was significantly lower in more deprived areas (P<0·001) and in ethnic minority girls (P=0·013). The relatively small proportion of parents who actively refused vaccination by returning a negative consent form were more likely to come from more advantaged areas (P<0·001). Non-responding parents were from more deprived (P<0·001) and ethnic minority (P=0·001) backgrounds. Girls who did not receive HPV vaccination were less likely to have received all their childhood immunizations particularly measles, mumps and rubella (MMR). Different approaches may be needed to maximize HPV vaccine uptake in engaged and non-responding parents, including ethnic-specific approaches for non-responders.