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Introduction: Complications following mandibular fractures occur in 9–23% of patients. Identifying those at risk is key to prevention. Previous studies highlighted smoking, age and time from injury to presentation as risk factors but rarely recorded other possible confounders. In this paper, we use a collaborative snapshot audit to document novel risk factors and confirm established risks for complications following the treatment of mandibular fractures. Methods: The audit was carried out by 122 OMFS trainees across the UK and Ireland (49 centres) over 6 months, coordinated by the Maxillofacial Surgery Trainees Research Collaborative. Variables recorded included basic demography, medical and social history, injury mechanism and type, management and 30-day outcome. Results: Nine hundred and forty-seven (947) patients with fractured mandibles were recorded. Surgical management was carried out in 76.3%. Complications at 30 days occurred 65 (9%) of those who were managed surgically. Risk factors for complications included male sex, increasing age, any medical history, increasing number of cigarettes smoked per week, increasing alcohol use per week, worse oral hygiene and increased time from injury to presentation. Discussion: We have used a large prospective snapshot audit to confirm established risk factors and identify novel risk factors. We demonstrate that time from injury to presentation is confounded by other indicators of poor health behaviour. These results are important in designing trial protocols for management of mandibular fractures and in targeting health interventions to patients at highest risk of complications. [ABSTRACT FROM AUTHOR]

Landslides involving peat are relatively common in Ireland, upland areas of Great Britain and subantarctic islands. Bogflows and bog slides are less common types of peat failure and almost unknown outside Ireland. Unusually, three of these occurred in 2020 including one bogflow at a windfarm that gained much adverse media attention, and a small but damaging peat slide was also reported. The aim of this paper is to determine the extent to which the new bog slide and bogflows are consistent with previous examples in terms of their contexts, characteristics and possible causes, particularly relating to commercial forestry operations. Aerial video footage of all three landslides obtained by local people using drones, and ground-based footage of one of them in progress, allowed a detailed examination of their characteristics and contexts to be made despite the global travel and activity restrictions caused by the coronavirus pandemic. The windfarm bogflow appears to have resulted from removal of toe support by an earlier peat flow that was itself probably caused by construction of an access road; the other two landslides were most likely triggered by rainfall. All three are consistent with previous examples of their respective types in their general characteristics and appear to be associated with well-known causal factors including hydrological, topographic and/or forestry influences. Forestry operations probably contributed to the occurrence of two of the landslides and restricted the expansion of two of them. [ABSTRACT FROM AUTHOR]

Background: Radio-frequency ablation (RFA) for Barrett's oesophagus (BE)-related neoplasia is currently used after endoscopic resection of visible neoplasia. The HALO 360 balloon has been used to ablate long segment BE. The Barrx™ 360 Express RFA self-sizing catheter ('RFA Express') may potentially allow quicker ablation times and improved treatment outcomes. The aim of this paper is to present real world data on the use of the 360 Express Device. Methods: Centres in the UK and Ireland submitted cases where the RFA Express was used. The primary outcome was regression of BE at 3 months. Secondary outcomes were the rate of symptomatic stricture formation and resolution of intestinal metaplasia (CR-IM) and dysplasia (CR-D) at End of Treatment (EoT). Results: 11 centres submitted 123 consecutive patients. 112 had a follow up endoscopy. The median age was 67 years (IQR 62–75). 3 dosimetries were used. The mean reduction in Circumferential (C) length was 78% ± 36 and mean reduction in Maximal length (M) was 55% ± 36. 17 patients (15%) developed strictures requiring dilation. There was a higher rate of stricture formation when the 12 J energy was used (p < 0.05). 47 patients had EoT biopsies, 40 (85%) had CR-D and 34(76%) had CR-IM. Conclusions: The RFA 360 Express catheter shows reduction in length of baseline BE at 3 months after index treatment, and eradication of intestinal metaplasia and dysplasia at 12 months similar to other studies with earlier devices. It appears that the symptomatic stricture rate is slightly higher than previous series with the HALO 360 catheter. This study was performed as part of the HALO registry and has been approved by the Research Ethics Committee - MREC Number 08/H0714/27 Local project reference 08/0104 Project ID 15,033 IRAS Number 54678 EudraCT 2009-015980-1. Registered on ISRCTN as below: ISRCTN93069556. https://doi.org/10.1186/ISRCTN93069556 [ABSTRACT FROM AUTHOR]

This paper looks at the initiatives by the Associated Booksellers of Great Britain and Ireland between 1920 and 1930 to formalise training for booksellers, reflecting on the current moves to reinstate some kind of bookselling qualification through the partnership of Waterstones with the University of Derby. It uses as primary sources the trade papers of The Publishers' Circular and Booksellers' Record and The Bookseller, both key narrative repositories for histories of this nature. [ABSTRACT FROM AUTHOR]

Acceptance of ritual as a valid interpretation of Mesolithic behaviour has slowly emerged over the past decade; the ‘silly season’ heralded by Mellars (Antiquity 83:502-517, 2009) has not materialised, though in Ireland and Britain difficulties persist in defining what might constitute ‘ritual’ away from the graveside. New discoveries from both the development-led and academic sectors enable Mesolithic archaeologists to better establish which elements of the archaeological record can be interpreted as ritual. This paper seeks to identify further strands of ritual behaviour, incorporating evidence from sites without organic remains. We consider the evidence for ritual at the site and feature scales, and in the special treatment of objects—an often overlooked body of data in understanding ritual. Thus the material signature of ritual will be questioned, and ways in which Mesolithic ritual can be rehabilitated and expanded will be explored. [ABSTRACT FROM AUTHOR]

In this paper, it is argued that the industrial revolution in eighteenth century Great Britain had its origins in the arrival of 100,000–140,000 Protestant refugees in England and Ireland in the sixteenth, seventeenth and eighteenth centuries. Specifically, it is argued that their arrival prompted both Schmooklerian pull and push factors. The pull factor was the thousands of refugee merchants and ship owners/captains to England and Ireland resulting in the creation of the Protestant International (1550-1750). This increased the demand for tradables which in turn spurred invention and innovation among refugees (push factor) and their descendants as well as in the local population. These factors were self-reinforcing, leading in time to the industrial revolution. The result is a novel account of the origins of the industrial revolution, one that is consistent with competing explanations. [ABSTRACT FROM AUTHOR]

This paper presents a framework for studying international differences in the distribution of household income. Integrating micro-econometric and micro-simulation approaches in a decomposition analysis, it quantifies the role of tax-benefit systems, employment and occupational structures, labour and financial market returns, and demographic composition in accounting for differences in income inequality across countries. Building upon EUROMOD (the European tax-benefit calculator) and its harmonised datasets, the model is portable and can be implemented for cross-country comparisons between any participating country. An application to the UK and Ireland—two countries that have much in common while displaying different levels of inequality—shows that differences in tax-benefit rules between the two countries account for over one third of the observed difference in disposable household income inequality. Demographic differences play negligible roles. The Irish tax-benefit system is more redistributive than UK's due to a higher tax progressivity and higher average transfer rates. These are largely attributable to policy parameter differences, but also to differences in pre-tax, pre-transfer income distributions. [ABSTRACT FROM AUTHOR]

Objectives The objective of this paper is to describe the contemporary teaching of dental implantology to dental undergraduates in the United Kingdom and Ireland. The paper also aims to assess the attitudes of dental school educators in relation to future trends in dental implant training for dental undergraduates.Methods An online questionnaire relating to current and future possible trends in dental implantology education was developed and distributed to Heads of Division/Departments of Restorative Dentistry, or equivalent, in each of the 15 dental schools with undergraduate dental programmes in the United Kingdom and Ireland. The questionnaire included both 'open' and 'closed' style questions.Results All 15 dental schools invited to participate in this survey responded. Of the 15 schools, two do not provide any training for their undergraduate dental students in relation to implant dentistry. The teaching is mainly delivered in lecture-based or phantom head room settings (eight of the 13 implant-teaching schools). Only four schools allow their students to interact clinically with implant patients. All schools anticipate an increase in dental implant teaching in the next five years, however, there is much variation in the scope and nature of this increase.Conclusions The teaching of dental implants in the UK and Ireland has increased since the time of previous surveys. It would seem prudent for this theme of teaching to further increase in order to best prepare graduating students for independent clinical practice. [ABSTRACT FROM AUTHOR]

Cross-country comparisons of average loan interest rates, often carried out using statistics provided by national and international authorities, should be accompanied by strong caveats. If underlying compositional differences in loans, borrowers or lenders are unaccounted for, claims of over/under-pricing may be unfounded. In this paper, we propose a simple methodology that compares interest rates between countries after controlling for such differences. We apply our method to loan-level data from three Irish banks lending to Small and Medium Enterprises (SMEs) in both Ireland and the UK. We find that controlling for such factors reduces the the cross-country interest rate premium significantly. We attribute any remaining interest rate "gap" to overall lending market conditions – for example, to differences in the recoverability of collateral, the level of competition among banks, the aggregate perception of risk, or banks' expectations on the relative movements in policy rates and exchange rates between the UK and the euro area. [ABSTRACT FROM AUTHOR]

This paper provides an introduction to the articles and report excerpt submitted to the special issue of Trends in Organized Crime on ‘Organised crime and illegal markets in the UK and Ireland’. The aim of the special issue is to draw together empirical research findings and theoretical accounts on various manifestations of organised crime in the particular geographic context(s), the evolution of organised crime, the links between organised crime, the legal sphere and paramilitary groups, as well as an account of the demographic profile and attitudes of citizens in areas in which organised crime groups thrive. [ABSTRACT FROM AUTHOR]

Recent surveys from general dental practice have found increased placement of direct composite resin restorations in occlusal (Class I) and occlusoproximal (Class II) cavities in permanent teeth by general dental practitioners. This has been matched, and possibly driven, at least in part, by the development of new composite resin materials and bonding technologies. Recent studies by the authors have found an increase in the teaching of Class I and Class II composite resin restorations in the UK, Ireland, the US, and Canada. The increased teaching in the UK and Ireland, however, was not as great as in North America, and several worrying trends were observed. The aim of this paper is to discuss these trends and related factors considered important to the necessary further development of the teaching of Class I and Class II direct composite resin restorations, let alone modern operative dentistry in general, in the UK and Ireland. [ABSTRACT FROM AUTHOR]

Background: PROs are valuable tools in clinical care to capture patients' perspectives of their health, symptoms and quality of life. However the COVID-19 pandemic has had profound impacts on all aspects of life, in particular healthcare and research. This study explores the views of UK and Irish health professionals, third sector and pharmaceutical industry representatives and academic researchers on the impact of COVID-19 on PRO collection, use and development in clinical practice. Methods: A volunteer sample took part in a 10 question cross sectional qualitative survey, on the impact of COVID-19, administered online via Qualtrics. Demographic data was descriptively analysed, and the qualitative free text response data was subject to thematic analysis and summarised within the Strengths, Weaknesses, Opportunities and Threats (SWOT) framework. Results: Forty nine participants took part located in a range of UK settings and professions. Participants highlighted staff strengths during the pandemic including colleagues' flexibility and ability to work collaboratively and the adoption of novel communication tools. Weaknesses were a lack of staff capacity to continue or start PRO projects and insufficient digital infrastructure to continue studies online. Opportunities included the added interest in PROs as useful outcomes, the value of electronic PROs for staff and patients particularly in relation to integration into systems and the electronic patient records. However, these opportunities came with an understanding that digital exclusion may be an issue for patient groups. Threats identified included that the majority of PRO research was stopped or delayed and funding streams were cut. Conclusions: Although most PRO research was on hold during the pandemic, the consensus from participants was that PROs as meaningful outcomes were valued more than ever. From the opportunities afforded by the pandemic the development of electronic PROs and their integration into electronic patient record systems and clinical practice could be a lasting legacy from the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

AimThe aim of this paper is to investigate methods employed for teaching removable partial dentures in dental schools in Ireland and the United Kingdom.Materials and methodsA questionnaire was distributed by email in May 2005 to each of the 15 dental schools with undergraduate dental degree programmes in Ireland and the UK. The questionnaire sought information relating to the preclinical and clinical teaching of removable partial dentures (both acrylic and cobalt-chromium based dentures).ResultsEleven completed questionnaires were returned. The average duration of a preclinical course in removable partial dentures was 67 hours (range = 24-200 hours). This course was directed by a senior clinical academic alone in eight schools, by a senior clinical academic in collaboration with a dental technician in two schools, and solely by a dental instructor technician in one school. The median number of cobalt-chromium and acrylic removable partial dentures provided by undergraduate dental students was 3 (range = 2-5) and 2 (range = 0-3), respectively. Four schools reported that their patient pool is not entirely satisfactory for clinical teaching of undergraduate dental students.ConclusionVariations were noted between dental schools in both the amount and content of teaching programmes. Experience gained by undergraduate students in dental schools is limited, and appears to be hampered by limited access to patients suitable for undergraduate teaching. [ABSTRACT FROM AUTHOR]

This article discusses a Leverhulme residency undertaken by the author Julie Brixey-Williams in 2003–4 at the Association of Anaesthetists of Great Britain and Ireland. Notions of medical visibility were explored through practice-led investigations under the umbrella title, Traces of the Invisible, that concentrated on making concrete, visible responses to the hidden or intangible elements of the anesthetist's working life in areas such as sleep, breath, pain and genetic markers. Rosebud is a unique nine-foot concertina bookwork created after reading the entire story of The Sleeping Beauty into an anesthetic machine. This essay expands upon the concepts and material responses that led to the making of the book with particular reference to how the book's structure forms a relationship to language and the body-as-site, whilst operating as a sculptural object that raises the visibility of the anesthetic profession. Fairy tales and their telling, including stories of enchanted sleep, transformational qualities, magical languages and shaman healers, will be examined alongside. [ABSTRACT FROM AUTHOR]

Since the 1950s, large areas of upland peat have been afforested in northern European countries. Due to the poor phosphorus (P) adsorption capacity and low hydraulic permeability in blanket peat soil and increased labile P sources, harvesting these blanket peat forests can significantly increase P concentrations in the receiving aquatic systems. This paper briefly reviews the current management practices on the control of P releases from forestry in Ireland and the UK, and proposes a possible novel practice-grass seeding clearfelled areas immediately after harvesting, which should reduce P release from blanket peat forest harvesting. The study was conducted in the Burrishoole Catchment in the west of Ireland. A field trial was carried out to identify the successful native grass species that could grow quickly in the blanket peat forest. The two successful grass species- Holcus lanatus and Agrostis capillaris-were sown in three blanket peat forest study plots with areas of 100, 360, and 660 m immediately after harvesting. Areas without grass seeding were used as controls. One year later, the P content in the aboveground vegetation biomass of the three study plots were 2.83, 0.65, and 3.07 kg P ha, respectively, which were significantly higher than the value of 0.02 kg P ha in the control areas. The water extractable phosphorus in the three study plots were 8.44, 9.83, and 6.04 mg (kg dry soil), respectively, which were lower than the value of 25.72 mg (kg dry soil) in the control sites. The results indicate that grass seeding of the peatland immediately after harvesting can quickly immobilize significant amounts of P and warrants additional research as a new Best Management Practice following harvesting in the blanket peatland forest to mitigate P release. [ABSTRACT FROM AUTHOR]

Butterfly Conservation, in partnership with the Centre for Ecology and Hydrology and Dublin Naturalists' Field Club, has been coordinating the collation of detailed geographical records of butterfly sightings across Britain and Ireland, mainly made by volunteers, for a continuous period of 15 years since 1995. This has generated a dataset of over 7.5 million records, supplemented by collated historical records. Results at the end of the first five-year period (1995-9) and at the end of the second five-year period (2000-4) indicated significant range declines in many species over a 30-year period (since baseline distributions recorded in the 1970s); for other species, there has been a significant extension of range, principally towards more northerly latitudes. This paper shows the results of a preliminary analysis for the end of the third five-year period (2005-9), to assess progress towards the EU target of halting biodiversity loss by 2010. The findings indicate that populations are continuing to be lost at a similar rate to previous periods, contrary to the 2010 target. In contrast, major northward extensions of range are reported for some mobile generalist species. Conservation successes are also reported for a few species whose declines have been halted and in some cases, reversed. Changes in range and species diversity remain consistent with the primary hypotheses for the causes of change: decreases caused by destruction, deterioration and fragmentation of biotopes and range increases in response to climate warming. [ABSTRACT FROM AUTHOR]

This paper investigates the two-way relationship between R&D and export activity. In particular, we concern ourselves with the question whether R&D stimulates exports and, perhaps more importantly, whether export activity leads to increasing innovative activity in terms of R&D (learning-by-exporting). We use two unique firm level databases for Great Britain and the Republic of Ireland and compare the results for these two countries. We find that previous exporting experience enhances the innovative capability of Irish firms. Conversely, no strong learning-by-exporting effects are found for British firms. Arguably part of the differences between Ireland and Britain are attributable to different, cross-country exporting patterns where Irish firms have a greater interface with OECD markets. [ABSTRACT FROM AUTHOR]

Historic sandstone structures carry an inheritance, or a ‘memory’, of past stresses that the stone has undergone since its placement in a façade. This inheritance, which conditions present day performance, may be made up of long-term exposure to a combination of low magnitude background environmental factors (for example, salt weathering, temperature and moisture cycling) and, superimposed upon these, less frequent but potentially high magnitude events or ‘exceptional’ factors (for example, lime rendering, severe frost events, fire). The impact of complex histories on the decay pathways of historic sandstone is not clearly understood, but this paper seeks to improve that understanding through the use of a laboratory ‘process combination’ study. Blocks of quartz sandstone (Peakmoor, from NW England) were divided into subsets that experienced different histories (lime rendering and removal, fire and freeze–thaw cycles in isolation and combination) that reflected the event timeline of a real medieval sandstone monument in NE Ireland, Bonamargy Friary (McCabe et al. ). These subsets were then subject to salt weathering cycles using a 10% salt solution of NaCl and MgSO4 that represents the ‘every-day’ stress environment of, for example, sandstone structures in coastal, or polluted urban, location. Block response to salt weathering was monitored by collecting, drying and weighing the debris that was released as blocks were immersed in the salt solution at the beginning of each cycle. The results illustrate the complexity of the stone decay system, showing that seemingly small variations in stress history can produce divergent response to salt weathering cycles. Applied to real-world historic sandstone structures, this concept may help to explain the spatial and temporal variability of sandstone response to background environmental factors on a single façade, and encourage conservators to include the role of stress inheritance when selecting and implementing conservation strategies. [ABSTRACT FROM AUTHOR]

At the beginning of the nineteenth century, the medical concept of “necessaries of life”—i.e., food, heat, clothing, and shelter—became controversial in Britain. The new domain of political economy, in both its Smithian and its Malthusian modes, challenged the view that necessity was either a measurable concept or a deliverable right. For the political economists, “necessity” was relative, a standard erected by class and culture. Many doctors and surgeons resisted that relativism, insisting that the fever epidemics they were responding to could be directly or indirectly attributed to the absence of such “necessaries.” The first half of the article reviews the distinct debates between doctors and economists on these issues in England, Scotland, and Ireland during the first half of the nineteenth century. By mid-century these so-called “necessaries” had largely been de-medicalized and transformed into the status of consumer commodities. The second half of the paper describes the quite different list of necessities that replaced them in public health campaigning and administration during the second half of the century. [ABSTRACT FROM AUTHOR]

This paper examines the work ethic characteristics of particular practising Protestant, Catholic and Muslim managers in Britain, Ireland and Turkey. Max Weber, argued that Protestant societies had a particular work ethic which was quite distinct from non-Protestant societies. The Protestant work ethic (PWE) thesis of Weber was reviewed. Previous empirical and analytical research results showed that the number of research results which support Weberian ideas were more than those which did not support. Methodological issues were also discussed. Results revealed that there was a considerable difference between Muslim and other groups in terms of PWE characteristics. The Muslim group showed the highest PWE level, while the Protestant group was placed second and the Catholic group third. The Protestant group showed a slightly higher of PWE level than the Catholic group. The possible reasons for the higher level of the PWE values of Muslim managers are discussed in the light of historical, political, social and economic developments in Turkey. [ABSTRACT FROM AUTHOR]

Background: For some adults with Attention-Deficit/Hyperactivity Disorder (ADHD), nonstimulants need to be considered either as a monotherapy or as an adjunct to stimulants. Objectives: The objectives of this systematic review and meta-analysis were to assess the efficacy, acceptability, and tolerability of nonstimulants in adults with ADHD. Methods: Data sources, searches, and study selection were based on a previously published network meta-analysis of randomized clinical trials (RCTs) by Cortese at al. (Lancet Psychiatry 5(9):727–738, 2018), which we updated in March 2022. Specifically, we searched PubMed, BIOSIS Previews, CINAHL, the Cochrane Central Register of Controlled Trials, EMBASE, ERIC, MEDLINE, PsycINFO, OpenGrey, Web of Science Core Collection, ProQuest Dissertations and Theses (UK and Ireland), ProQuest Dissertations and Theses (abstracts and international), and the WHO International Trials Registry Platform, including ClinicalTrials.gov for double-blind RCTs with a placebo arm, lasting at least one week, including adults with a diagnosis of ADHD based on DSM-III, DSM-III-R, DSM-IV(TR), DSM-5 or ICD-9- or 10, and reporting data on efficacy, tolerability (drop-out due to side effects) and acceptability (drop-out due to any cause) of guanfacine, clonidine, or atomoxetine. Additionally, we searched for RCTs of viloxazine extended release (ER), approved for ADHD in 2021. Random-effects meta-analyses were conducted, and the risk of bias for individual RCTs was assessed using the Cochrane Risk of Bias tool. Results: We included 18 studies in the meta-analyses (4308 participants) plus one additional study in the narrative synthesis (374 participants). The meta-analysis showed that atomoxetine (15 RCTs) (Hedge's g = − 0.48, 95% CI [− 0.64; − 0.33]), guanfacine (two RCTs) (Hedge's g = − 0.66, 95% CI [− 0.94; − 0.38]) and viloxazine ER (one RCT) were significantly more efficacious than placebo. Atomoxetine was less well tolerated than placebo, while tolerability of guanfacine and viloxazine ER could not be meta-analysed, since only one study, for each medication, reported on it. Conclusions: All investigated nonstimulants were more efficacious in the treatment of ADHD in adults, than placebo, while the placebo had better acceptability and tolerability. Protocol: https://osf.io/5vnmt/?view_only=2bf87ed12ba94645babedceeee4c0120. [ABSTRACT FROM AUTHOR]

We conducted a systematic review to answer the following: (a) Is there any evidence to support increased prevalence of suicidality and self-harm (i.e. self-harm or suicidality) in urban versus rural environments? (b) What aspects of the urban environment pose risk for suicidality and self-harm? Thirty-five studies met our criteria. Our findings reflect a mixed picture, but with a tendency for urban living to be associated with an increased risk of suicidality and self-harm over rural living, particularly for those living in deprived areas. Further research should focus on the clustering and additive effects of risk and protective factors for suicidality and self-harm in urban environments. [ABSTRACT FROM AUTHOR]

A detailed map of the available UV across the UK from 2003 to 2012 is provided. A suite of data derived from climatologies and satellite observations are used to calculate spectral UV irradiance and related weighted doses (erythema, DNA damage, vitamin D). The result is a well-validated tool that has two advantages: (i) the output is simulated spectral UV irradiance that can be weighted with any action spectrum for use in any research studies that require ambient UV data, (ii) reliance on instruments with planned operational lives of at least several years that ensures data and method homogeneity for extension to future studies. The model-derived doses are satisfactory validated against spectral ground-based measurements at two sites. According to the calculated climatology, the southern part of the UK receives 1.5–2 times more UV than the north during spring, summer and autumn. During wintertime, the UV doses in the far north are an order of magnitude lower than southern values. Even for the same latitude, regional variations of cloudiness result in doses at coastal sites being up to 25% higher than inland areas. [ABSTRACT FROM AUTHOR]

Collaboration and successful teamworking are important components of clinical practise, and these skills should be cultivated early in medical school. The breadth of current medical school curricula means that students often have limited exposure to clinical neurosciences. Since its inception in 2009, the Neurology and Neurosurgery Interest Group (NANSIG) has become a national (UK and Republic of Ireland) example of student and junior doctor synergistic collaboration to deliver educational materials, research, conferences, seminars and workshops, as well as advocating for diversity in this field. Recently, it has expanded to incorporate an international audience and cater for a larger group of young medical professionals. The organisation has overcome numerous challenges and is constantly innovating new approaches to harness the necessary knowledge, skills and network to succeed in a career in neurosciences, neurology and neurosurgery. This article summarises the initiatives undertaken by the group over its first 10 years of existence and its organisational structure, as well as its future plans. [ABSTRACT FROM AUTHOR]

Organic food fraud is a significant challenge in the food testing sector—high price premiums, ease of access to produce to be relabelled and difficulties in developing testing strategies that can detect such frauds make organic foods particularly attractive and thus highly vulnerable to fraud. Samples of conventional and organic cattle taken across meat plants in Ireland and the United Kingdom, consisting of the neck (supraspinatus), rump (gluteus), and shin (flexor carpi radialis) regions of the carcass were analysed using a high resolution time-of-flight based rapid evaporative ionisation mass spectrometry (REIMS) system. The resulting untargeted lipidomic data (m/z 600–1000) was used to generate PCA-LDA models for production system and for muscle type, for these models, it was found that the production system model could differentiate organic from conventional beef with an accuracy of 84%, whilst the muscle type model could identify the cut of meat with a 98% accuracy; additionally, samples can be assessed against multiple models simultaneously, reducing analysis time and sample numbers. The use of REIMS showed considerable promise in its ability to detect different forms of meat fraud; its accuracy in differentiating organic from conventional beef is superior to stable isotope ratio mass spectrometry, with the added advantages of substantially shorter analysis times and lower sample analysis costs. The ability to rapidly confirm the cut of meat also demonstrates the potential of REIMS to concurrently determine multiple aspects of beef authenticity in a close to real time analysis. [ABSTRACT FROM AUTHOR]

In our recent reassessment we explored the risk of MS by age at immigration in 258 migrants from United Kingdom and Ireland (UKI) to four states of Australia (New South Wales, Queensland, South Australia, and Western Australia) in the period 1947-1981 (Group II). In the present report we have compared their characteristics with 44 cases who migrated before 1947 (Group I), divided into two subsets: Group Ia (15 cases) was rather similar to Group II in age at immigration (means of 20 and 23 years), age at onset (39 and 33 years), and duration from immigration to onset (19 and 10 years). Group Ib (29 cases) was significantly different from Group II, with mean ages of 4 years at immigration and 40 years at onset, for a mean interval of some 35 years between immigration and onset. All onsets in Group Ib occurred after 1947. We concluded that the Group Ib cases had most probably acquired their MS in Australia. Immigrants from high MS risk countries, including UKI, were modest in number before 1947, but some 770,000 entered from 1947-1981. They may have been the source of MS for the Group Ib migrants. [ABSTRACT FROM AUTHOR]

We downscale the results of a global tourism simulation model at a national resolution to a regional resolution. We use this to investigate the impact of climate change on the regions of Germany, Ireland and the UK. Because of climate change, tourists from all three countries would spend more holidays in the home country. In all three countries, climate change would first reduce the number of international arrivals—as Western European international tourist demand falls—but later increase numbers—as tourism demand from increasingly rich tropical countries grows. In Ireland and the UK, the regional pattern of demand shifts is similar to the international one: tourism shifts north. In Germany, the opposite pattern is observed as the continental interior warms faster than the coast: tourism shifts south. [ABSTRACT FROM AUTHOR]

Introduction: Burnout is becoming an increasingly recognised phenomenon within the medical profession. This study aims to investigate the presence of burnout amongst neurosurgical trainees in the UK and Ireland as well as investigating potential exacerbating and protective factors. Method: An online survey was sent to all neurosurgical trainees in the UK and Ireland via the British Neurosurgical Trainees' Association (BNTA) mailing list. Responding participants anonymously completed the Copenhagen Burnout Inventory (CBI) and answered questions about known risk factors for burnout including workplace environment, workplace bullying, time spent on leisure activities and sleep and reported likelihood of leaving neurosurgery. We also collated data on responders' demographics. We compared CBI scores for participants with and without risk factors to determine correlation with CBI. Results: There were 75 respondents (response rate 42%) from a range of ages and all training grades, 72% of whom were male. The median CBI score was 38.85 (IQR 17.76). Participants showed a higher degree of personal and workplace burnout (median CBIs of 47.02, IQR 25.00; and 49.14, IQR 19.64, respectively) compared with patient-related burnout (median CBI 18.67, IQR 25.00). Participants with the following self-reported risk factors were significantly more likely to have higher CBIs: workplace bullying (p = 0.01), getting on less well with colleagues (p < 0.05), working longer hours (p < 0.05) and insufficient sleep, exercise and leisure time (all p < 0.01). Those with higher CBI scores were more likely to consider leaving neurosurgical training (p = 0.01). Conclusion: We identified a high burnout incidence in a cohort representative of UK neurosurgical trainees, although our results may have been skewed somewhat by selection bias. We determined potential risk factors for burnout related to specific workplace stressors and time for non-work activities. In the future, changes to training curricula should address these issues, aiming to improve training, enhance patient care and reduce attrition rates. [ABSTRACT FROM AUTHOR]

New mothers in Western societies report being influenced by ideologies which suggest mothering comes naturally to women and is joyful and fulfilling. However, research reveals motherhood-related negative thoughts are common even among non-depressed new mothers, and it has been suggested experiencing such thoughts may be related to guilt and shame. This study updates and extends Hall and Wittkowski's (2006) prevalence survey of motherhood-related negative thoughts by assessing new mothers' perceptions of the social acceptability of negative thoughts, and by exploring relationships with guilt, shame and psychological distress. A cross-sectional survey design was used. A self-selected sample of non-clinical new mothers (N = 395) from the United Kingdom and Ireland completed online questionnaires including measures of the frequency and social acceptability of motherhood-related negative thoughts, shame and guilt proneness, depression and motherhood experience. Hierarchical regression analyses were used to explore relationships between variables. The frequency of negative thoughts was much higher than reported by Hall and Wittkowski. After controlling for demographic variables and social support, frequency of negative thoughts significantly predicted shame and guilt, whereas social acceptability of negative thoughts significantly predicted guilt. Negative thoughts, shame, guilt and motherhood experience relative to expectations significantly predicted depression score. These results suggest that negative thoughts are more common in early motherhood than previously reported, are considered socially unacceptable, and are related to guilt, shame and depression scores. The findings increase our understanding of postnatal distress in non-clinical populations. Future research should explore information and/or interventions aimed at "normalising" negative thoughts in early motherhood. Highlights: Negative thoughts were more frequent in non-clinical new mothers than previously reported. New mothers found negative thoughts related to motherhood difficult to share with others. Frequency of negative thoughts in new mothers was related to guilt and shame. Frequency of negative thoughts, guilt and shame were related to depression score. Interventions for mothers that "normalise" negative thoughts should be considered. [ABSTRACT FROM AUTHOR]

There has been a drive towards increased digitalisation in healthcare. The aim was to provide a snapshot of current apps, instant messaging, and smartphone photography use in paediatric emergency care. A web-based self-report questionnaire was performed. Individual physicians working in paediatric emergency care recorded their personal practice. One hundred ninety-eight medical doctors completed the survey. Eight percent of respondents had access to institutional mobile devices to run medical apps. Eighty-six percent of respondents used medical apps on their personal mobile device, with 78% using Apple iOS devices. Forty-seven percent of respondents used formulary apps daily. Forty-nine percent of respondents had between 1–5 medical apps on their personal mobile device. Respondents who used medical apps had a total of 845 medical apps installed on their personal device, accounted for by 56 specific apps. The British National Formulary (BNF/BNFc) app was installed on the personal mobile device of 96% of respondents that use medical apps. Forty percent of respondents had patient confidentiality concerns when using medical apps. Thirty-eight percent of respondents have used consumer instant messaging services, 6% secure specialist messaging services, and 29% smartphone photography when seeking patient management advice. Conclusion: App use on the personal mobile devices, in the absence of access to institutional devices, was widespread, especially the use of a national formulary app. Instant messaging and smartphone photography were less common. A strategic decision has to be made to either provide staff with institutional devices or use software solutions to address data governance concerns when using personal devices. What is Known: • mHealth use by junior doctors and medical students is widespread. • Clinicians' use of instant messaging apps such as WhatsApp is the widespread in the UK and Ireland, in the absence of alternatives. What is New: • Personal mobile device use was widespread in the absence of alternatives, with the British National Formulary nearly universally downloaded to physicians' personal mobile devices. • A third of respondents used instant messaging and smartphone photography on their personal mobile device when seeking patient management advice from other teams in the absence of alternatives. [ABSTRACT FROM AUTHOR]

Perinatal autopsy rates have declined significantly in recent decades. There is a lack of consensus concerning the potential religious influences for bereaved parents in their decision making process for post-mortem. This online study of British and Irish maternity healthcare chaplains explored their understanding of general and local perinatal post-mortem procedures and their experiences in the support of parents. Participants included Christian, Muslim and non-faith chaplains. No chaplain identified any religious prohibition to perinatal post-mortem. A majority of chaplains reported that they had been asked about post-mortem by parents; only a minority felt adequately prepared. A key recommendation is that following appropriate training chaplains may be well placed to support colleagues and parents during the decision making process. [ABSTRACT FROM AUTHOR]

There is increasing focus on the frequency of jellyfish blooms in the Northeast Atlantic because of negative interactions with humans. However, uncertainty exists as to whether perceptions of increasing bloom frequencies reflect reality due to limitations within long-term population trend data. This study, therefore, developed and applied a semi-quantitative mapping approach to visualise bloom suitability based on the physiological tolerances of seven jellyfish to ocean temperature, salinity and a prey index across the Northeast Atlantic. A 10% increase and a 10% decrease in the environmental parameters was then applied to the maps to assess model sensitivity and the potential influence of environmental change on bloom suitability. The study found that optimal physiological temperatures and salinities combined with peaks in prey abundance drove higher bloom suitability and determined distribution. Several locations predicted to be at high risk of bloom occurrence off British and Irish coasts were found to coincide with areas of high anthropogenic activity that could be impacted by blooms. In the absence of long-term datasets on jellyfish population dynamics, the results and methods developed in this study allow an understanding of historic bloom events and predictions of future populations that will be useful in informing monitoring and management. [ABSTRACT FROM AUTHOR]

Identifying and understanding COVID-19 vaccine hesitancy within distinct populations may aid future public health messaging. Using nationally representative data from the general adult populations of Ireland (N = 1041) and the United Kingdom (UK; N = 2025), we found that vaccine hesitancy/resistance was evident for 35% and 31% of these populations respectively. Vaccine hesitant/resistant respondents in Ireland and the UK differed on a number of sociodemographic and health-related variables but were similar across a broad array of psychological constructs. In both populations, those resistant to a COVID-19 vaccine were less likely to obtain information about the pandemic from traditional and authoritative sources and had similar levels of mistrust in these sources compared to vaccine accepting respondents. Given the geographical proximity and socio-economic similarity of the populations studied, it is not possible to generalize findings to other populations, however, the methodology employed here may be useful to those wishing to understand COVID-19 vaccine hesitancy elsewhere. Hesitancy and resistance towards vaccination is a challenge for public health. Here the authors determine psychological characteristics associated with COVID-19 vaccine hesitancy or resistance attitudes in the UK and Ireland. [ABSTRACT FROM AUTHOR]

Summary: We identified demographic, health and lifestyle factors associated with falls in adults aged 50–64 years from Australia, The Netherlands, Great Britain and Ireland. Nearly all factors were associated with falls, but there were differences between countries and between men and women. Existing falls prevention programs may also benefit middle-aged adults. Introduction: Between ages 40–44 and 60–64 years, the annual prevalence of falls triples suggesting that middle age may be a critical life stage for preventive interventions. We aimed to identify demographic, health and lifestyle factors associated with falls in adults aged 50–64 years. Methods: Harmonised data were used from four population-based cohort studies based in Australia (Australian Longitudinal Study on Women's Health, n = 10,641, 51–58 years in 2004), Ireland (The Irish Longitudinal Study on Ageing, n = 4663, 40–64 years in 2010), the Netherlands (Longitudinal Ageing Study Amsterdam, n = 862, 55–64 years in 2012–13) and Great Britain (MRC National Survey of Health and Development, n = 2987, 53 years in 1999). Cross-sectional and prospective associations of 42 potential risk factors with self-reported falls in the past year were examined separately by cohort and gender using logistic regression. In the absence of differences between cohorts, estimates were pooled using meta-analysis. Results: In cross-sectional models, nearly all risk factors were associated with fall risk in at least one cohort. Poor mobility (pooled OR = 1.71, CI = 1.34–2.07) and urinary incontinence (OR range = 1.53–2.09) were consistently associated with falls in all cohorts. Findings from prospective models were consistent. Statistically significant interactions with cohort and sex were found for some of the risk factors. Conclusion: Risk factors known to be associated with falls in older adults were also associated with falls in middle age. Compared with findings from previous studies of older adults, there is a suggestion that specific risk factors, for example musculoskeletal conditions, may be more important in middle age. These findings suggest that available preventive interventions for falls in older adults may also benefit middle-aged adults, but tailoring by age, sex and country is required. [ABSTRACT FROM AUTHOR]

Background: Several regions in the UK and Ireland have delivered home-based laparoscopic simulation programmes in an attempt to progress surgical trainees' skills through deliberate practice. However, engagement with these programmes has been poor. This study aims to uncover the barriers to engagement with home-based simulation, with a view to developing an improved programme.Methods: This was a qualitative study using focus groups with key stakeholders including junior surgical trainees, consultants/attendings and simulation faculty. Data were collected across four regions in three countries. Data were audio-recorded, transcribed and a thematic analysis was performed using NVivo software.Results: Sixty-three individuals were interviewed in 12 focus groups (43 trainees, 20 trainers). Trainees cited competing commitments as a barrier to engaging with home-based simulation. They tended to focus on scoring 'points' towards career progression rather than viewing tasks as interesting, or associated with personal development. Their view was that this approach is perpetuated by the training system, which rewards trainees for publications and exams, but not for operative skill. Trainees were unsatisfied with metric feedback and wanted individual feedback from consultants (attendings). Trainees perceived consultants as lacking interest in the programmes and training in general. However, some consultants were unaware of the programmes being delivered and others felt lacking in confidence to deliver the necessary training.Conclusions: Scheduled simulation sessions which provide trainees with the opportunity for consultant feedback may improve engagement. Tackling the 'point-scoring' culture is more challenging. This could be addressed by modified assessment structures, greater recognition and accountability for trainers, and recognition and funding of simulation strategies including in-house skills sessions. [ABSTRACT FROM AUTHOR]

Background: Patient selection for seizure prophylaxis after traumatic brain injury (TBI) and duration of anti-epileptic drug treatment for patients with early post-traumatic seizures (PTS), remain plagued with uncertainty. In early 2017, a collaborative group of neurosurgeons, neurologists, neurointensive care and rehabilitation medicine physicians was formed in the UK with the aim of assessing variability in current practice and gauging the degree of uncertainty to inform the design of future studies. Here we present the results of a survey of clinicians managing patients with TBI in the UK and Ireland.Materials and methods: An online survey was developed and piloted. Following approval by the Academic Committee of the Society of British Neurological Surgeons, it was distributed via appropriate electronic mailing lists.Results: One hundred and seventeen respondents answered the questionnaire, predominantly neurosurgeons (76%) from 30 (of 32) trauma-receiving hospitals in the UK and Ireland. Fifty-three percent of respondents do not routinely use seizure prophylaxis, but 38% prescribe prophylaxis for one week. Sixty percent feel there is uncertainty regarding the use of seizure prophylaxis, and 71% would participate in further research to address this question. Sixty-two percent of respondents use levetiracetam for treatment of seizures during the acute phase, and 42% continued for a total of 3 months. Overall, 90% were uncertain about the duration of treatment for seizures, and 78% would participate in further research to address this question.Conclusion: The survey results demonstrate the variation in practice and uncertainty in both described aspects of management of patients who have suffered a TBI. The majority of respondents would want to participate in future research to help try and address this critical issue, and this shows the importance and relevance of these two clinical questions. [ABSTRACT FROM AUTHOR]

Background: Non-medical use of benzodiazepines and Z-drugs is common; however, there is limited information available on the extent of harm related to this in Europe, as well as the relationship between misuse and availability.Aim: To describe presentations to the emergency department in Europe related to the recreational use of benzodiazepines and Z-drugs and compare regional differences in these presentations with legal drug sales of benzodiazepines and Z-drugs within each country.Methods: Emergency department presentations with recreational misuse of benzodiazepines and Z-drugs were obtained from the Euro-DEN dataset for the period from October 2013 to September 2015; data extracted included demographics, clinical features, reported coused drugs, and outcome data. Sales figures obtained by QuintilesIMS™ (Atlanta, Georgia) were used to compare regional differences in the proportion of benzodiazepines and Z-drugs in the emergency department presentations and legal drug sales across Europe.Results: Over the 2 years, there were 2119 presentations to the Euro-DEN project associated with recreational use of benzodiazepines and/or Z-drugs (19.3% of all Euro-DEN presentations). Presentations with 25 different benzodiazepines and Z-drugs were registered in all countries, most (1809/2340 registered benzodiazepines and Z-drugs, 77.3%) of which were prescription drugs. In 24.9%, the benzodiazepine was not specified. Where the benzodiazepine/Z-drug was known, the most frequently used benzodiazepines and Z-drugs were respectively clonazepam (29.5% of presentations), diazepam (19.9%), alprazolam (11.7%), and zopiclone (9.4%). The proportions of types of benzodiazepines/Z-drugs related to ED-presentations varied between countries. There was a moderate (Spain, UK, Switzerland) to high (France, Ireland, Norway) positive correlation between ED presentations and sales data (Spearman Row's correlation 0.66-0.80, p < 0.005), with higher correlation in countries with higher ED presentation rates.Conclusion: Presentations to the emergency department associated with the non-medical use of benzodiazepines and/or Z-drugs are common, with variation in the benzodiazepines and/or Z-drugs between countries. There was a moderate to high correlation with sales data, with higher correlation in countries with higher ED presentation rates. However, this is not the only explanation for the variation in non-medical use and in the harm associated with the non-medical use of benzodiazepines/Z-drugs. [ABSTRACT FROM AUTHOR]

Background: Cystic Fibrosis (CF) management requires complex treatment regimens but adherence to treatment is poor and has negative health implications. There are various methods of measuring adherence, but little is known regarding the extent of adherence measurement in CF centres throughout the UK and Ireland.Objective: To determine the adherence monitoring practices in CF centres throughout the UK and Ireland, and to establish CF pharmacists' views on these practices.Setting: UK and Ireland Cystic Fibrosis Pharmacists' Group's annual meeting (2014).Methods: A questionnaire was designed, piloted and distributed to pharmacists attending the UK and Ireland Cystic Fibrosis Pharmacists' Group's annual meeting (2014). The main outcome measures were the methods of inhaled/nebulised antibiotic supply and the methods used to measure treatment adherence in CF centres. The questionnaire also ascertained the demographic information of participating pharmacists. Closed question responses were analysed using descriptive statistics. Open questions were analysed using content analysis.Results: Twenty-one respondents (84 % response) were included in the analysis and were mostly from English centres (66.7 %). Detailed records of patients receiving their inhaled/nebulised antibiotics were lacking. Adherence was most commonly described to be measured at 'every clinic visit' (28.6 %) and 'occasionally' (28.6 %). Patient self-reported adherence was the most commonly used method of measuring adherence in practice (90.5 %). The availability of electronic adherence monitoring in CF centres did not guarantee its use. Pharmacists attributed an equal professional responsibility for adherence monitoring in CF to Consultants, Nurses and Pharmacists. Seventy-six percent of pharmacists felt that the current adherence monitoring practices within their own unit were inadequate and associated with the absence of sufficient specialist CF pharmacist involvement. Many suggested that greater specialist pharmacist involvement could facilitate improved adherence monitoring.Conclusion: Current adherence knowledge is largely based on self-report. Further work is required to establish the most appropriate method of adherence monitoring in CF centres, to improve the recording of adherence and to understand the impact of increased specialist pharmacist involvement on that adherence. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this review is to report on recent developments in youth mental health incorporating all levels of severity of mental disorders encouraged by progress in the field of early intervention in psychotic disorders, research in deficiencies in the current system and social advocacy.Methods: The authors have briefly reviewed the relevant current state of knowledge, challenges and the service and research response across four countries (Australia, Ireland, the UK and Canada) currently active in the youth mental health field.Results: Here we present information on response to principal challenges associated with improving youth mental services in each country. Australia has developed a model comprised of a distinct front-line youth mental health service (Headspace) to be implemented across the country and initially stimulated by success in early intervention in psychosis; in Ireland, Headstrong has been driven primarily through advocacy and philanthropy resulting in front-line services (Jigsaw) which are being implemented across different jurisdictions; in the UK, a limited regional response has addressed mostly problems with transition from child-adolescent to adult mental health services; and in Canada, a national multi-site research initiative involving transformation of youth mental health services has been launched with public and philanthropic funding, with the expectation that results of this study will inform implementation of a transformed model of service across the country including indigenous peoples.Conclusions: There is evidence that several countries are now engaged in transformation of youth mental health services and in evaluation of these initiatives. [ABSTRACT FROM AUTHOR]

Objective:To (1) examine the opinions of medical staff working in spinal cord injury (SCI) centres (SCICs); (2) evaluate their knowledge, attitudes and practices towards obesity prevention and management; (3) report the number of beds and dietitians available at each SCIC.Methods:A 37-item questionnaire was sent to 23 SCICs in the UK, the Netherlands, Belgium and the Republic of Ireland between September 2012 and January 2013.Results:Eighteen SCICs returned the questionnaires for analysis. All respondents stated that they had an interest in obesity treatment but only 2.3% of the respondents received training in obesity management. Sixty-one percent of staff did not consider body mass index (BMI) to be appropriate for use in SCI patients and subsequently less than half of the respondents use BMI routinely. The majority of respondents reported that they are confident in dealing with overweight (74.5%) and obese (66.1%) SCI adults, less than half (44.1%) are confident in treating overweight and obese SCI children. Respondents also indicated the need for nationally adopted guidelines and a lack of physical activity provision. There were 17.5 whole-time equivalent (WTE) dietitians recorded in 22 SCICs, equivalent to 47.8 beds per WTE dietitians (range 10-420). Non-UK SCIC dietitians are significantly better resourced than in UK SCICs (beds per WTE dietitian: 36 vs 124, P=0.035).Conclusion:Medical staff expressed the need to participate in obesity prevention and management. Appropriate training should be considered for all medical staff and the development of specific weight management guidelines and dietetic provision should be considered. [ABSTRACT FROM AUTHOR]

Aims:The majority of patients with spinal cord injury (SCI) will develop neurogenic lower urinary tract dysfunction (NLUTD). These patients require a long-term urological follow-up. The follow-up protocol has varied across SCI units in the United Kingdom and Eire. We reviewed the long-term management in the SCI units to identify changes in practice over a decade and compared them to current guidelines.Methods:We present results of a review of all SCI centres in the United Kingdom and Eire on their long-term urological management before and after the current guidelines and compared the results with European Association of Urology (EAU) Guidelines on NLUTD and the proposed British guidelines for the urological management of patients with SCI. Data were collected through questionnaires posted to SCI units.Results:SCI patients are followed up in outpatients annually in the SCI centres and the frequency of follow-up remains largely unchanged. More SCI units perform renal tract imaging annually as a part of SCI follow-up. Most units follow the proposed British guideline indications for urodynamics and do not perform 'routine urodynamics'.Conclusions:We conclude that the long-term management of SCI patients in SCI units in the United Kingdom and Eire has changed overtime to follow the proposed British guidelines. EAU guidelines offer a more extensive follow-up regime. Last, there is a continued lack of high-quality evidence to support an optimal long-term follow-up protocol. Importantly, there is a lack of evidence on clinical outcomes when these guidelines have been followed. [ABSTRACT FROM AUTHOR]

Volcanic ash layers show that the products of Icelandic volcanism reached Britain and Ireland many times during the Holocene. Historical records suggest that at least one eruption, that of Laki in a. d. 1783, was associated with impacts on vegetation. These results raise the question: did Icelandic volcanism affect the Holocene vegetation history of Britain and Ireland? Several studies have used pollen data to address this issue but no clear consensus has been reached. We re-analyse the palynological data using constrained ordination with various representations of potential volcanic impacts. We find that the palynological evidence for volcanic impacts on vegetation is weak but suggest that this is a case of absence of evidence and is not necessarily evidence of absence of impact. To increase the chances of identifying volcanic impacts, future studies need to maximise temporal resolution, replicate results, and investigate a greater number of tephras in a broader range of locations, including more studies from lake sediments. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the usefulness of daptomycin, tigecycline, and linezolid for the treatment of MRSA infection compared with vancomycin in Belgium, the United Kingdom/Ireland, and Spain. Methods: The methodology included the following steps: acquisition of microbiological and pharmacokinetic data, Monte Carlo simulation, estimation of the probability of target attainment (PTA), and calculation of the cumulative fraction of response (CFR). Results: We showed that differences in the susceptibility of MRSA strains among countries may justify differences in the antibiotic dose selection. Two, 3, and 4 g daily of vancomycin seem be adequate in Belgium, Spain, and United Kingdom/Ireland respectively. The CFR obtained with 50 mg tigecycline every 12 h was higher in Spain than in Belgium and the United Kingdom/Ireland, but with the highest dose (100 mg q12h) the CFR was always 100%. At least 8 mg/kg daptomycin is necessary in United Kingdom/Ireland, but 4 mg/kg may be sufficient in Spain, and probably in Belgium. Six hundred mg q12h linezolid may be adequate in the four countries. Conclusion: Our study reinforces the idea that the local MIC distribution must be considered in order to increase the probability of success of empirical treatment and must be periodically updated. [ABSTRACT FROM AUTHOR]

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The wood warbler ( Phylloscopus sibilatrix) is a migratory species in the western Mediterranean wintering in the Gulf of Guinea region, West Africa. In autumn and spring, this species, along with the populations breeding in Ireland and Britain, uses the Italian peninsula as its main axis of migration. From the data of captured birds at several ringing stations in the western Mediterranean (Balearic Islands and coastal Iberian Peninsula), we analyzed capture rates of the species during spring migration from 1993 to 2007. Based on the selection of days with a significant number of captures and those without captures, we analyzed the effect of wind direction over the western Mediterranean to determine a relationship between winds and the number of captures. From a total of 663 wood warblers captured between 1993 and 2007, a total of 31 days have been selected as significant days with a high number of captures, and 31 days have been selected as no-capture days. On days of maximum captures, winds coming from an easterly direction, i.e. Algeria and Tunisia, were dominant, indicating days with a clear eastern component. Contrary to expected results, captures were also made on days when the wind direction was predominantly from a northerly direction. Analysis of the origin of the winds in north eastern Spain (western Mediterranean) revealed that the majority of northerly winds originated from Africa and not from Europe as is usual for this region. Days or periods selected as no-capture days were characterized by winds coming from a northerly (European origin) or westerly direction. [ABSTRACT FROM AUTHOR]

In the UK and Ireland, research on the control of bovine tuberculosis in badgers includes the development of a palatable bait for oral delivery of a vaccine and a means of its deployment in the field. In the present study, we carried out field deployment of bait according to the established method of bait marking in early spring and early summer to compare the effects of seasonality on bait uptake rates. All baits contained rhodamine B (RhB) which was subsequently detected in the hair and whiskers of captured badgers. During the 8 days of bait feeding at 14 badger setts, 99% of baits deployed in spring, and 100% of those deployed in summer were removed. The presence of RhB in captured badgers indicated high rates of uptake amongst adult badgers in spring (93%) and summer (98%). Only cubs captured in summer showed evidence of having taken bait (91%). Between 67% and 100% of each social group was estimated to have taken bait. The detection of RhB in 96% of badgers captured at outlier setts, where bait was not fed, suggested that deployment at main setts alone may be sufficient to target a relatively high proportion of the badger population. The number of baits deployed per marked badger suggested that a similar level of uptake might be achievable using fewer baits. The results clearly demonstrate the potential value of the bait-marking methodology for delivering vaccine baits to badgers during spring and summer, but that deployment in early summer is necessary to target cubs. [ABSTRACT FROM AUTHOR]

Located off the northwestern coast of the European mainland, Britain and Ireland were among the last regions of Europe to be colonized by modern humans after the last glacial maximum. Further, the geographical location of Britain, and in particular of Ireland, is such that the impact of historical migration has been minimal. Genetic diversity studies applying the Y chromosome and mitochondrial systems have indicated reduced diversity and an increased population structure across Britain and Ireland relative to the European mainland. Such characteristics would have implications for genetic mapping studies of complex disease. We set out to further our understanding of the genetic architecture of the region from the perspective of (i) population structure, (ii) linkage disequilibrium (LD), (iii) homozygosity and (iv) haplotype diversity (HD). Analysis was conducted on 3654 individuals from Ireland, Britain (with regional sampling in Scotland), Bulgaria, Portugal, Sweden and the Utah HapMap collection. Our results indicate a subtle but clear genetic structure across Britain and Ireland, although levels of structure were reduced in comparison with average cross-European structure. We observed slightly elevated levels of LD and homozygosity in the Irish population compared with neighbouring European populations. We also report on a cline of HD across Europe with greatest levels in southern populations and lowest levels in Ireland and Scotland. These results are consistent with our understanding of the population history of Europe and promote Ireland and Scotland as relatively homogenous resources for genetic mapping of rare variants. [ABSTRACT FROM AUTHOR]

Aim Advances of composite systems and their application have revolutionised the management of posterior teeth affected by caries, facilitating a minimally invasive approach. Previous surveys have indicated that the teaching of posterior composites within dental schools was developing, albeit not keeping pace with clinical evidence and the development of increasingly predictable techniques and materials. Concurrently, surveys of dental practice indicate that dental amalgam still predominates as the 'material of choice' for the restoration of posterior teeth within UK general dental practice. In light of such considerations, the aim of this study was to investigate current teaching of posterior composites in Irish and UK dental schools.Methods An online questionnaire which sought information in relation to the current teaching of posterior composites was developed and distributed to the 17 established Irish and UK dental schools with undergraduate teaching programmes in late 2009.Results Completed responses were received from all 17 schools (response rate = 100%). All 17 schools taught the placement of occlusal and two-surface occlusoproximal composites in premolar and permanent molar teeth. Two schools did not teach placement of three-surface occlusoproximal composites in either premolars or molars. In their preclinical courses, ten schools taught posterior composites before teaching dental amalgams. Fifty-five percent of posterior restorations placed by dental students were of composite (range = 10-90%) and 44% amalgam (range = 10-90%), indicating an increase of 180% in the numbers of posterior composites placed over the past five years. Diversity was noted in the teaching of clinical techniques and students at different schools are trained with different composites and bonding systems. Some cause for concern was noted in the teaching of certain techniques that were not in keeping with existing best evidence, such as the teaching of transparent matrix bands and light-transmitting wedges for occluso-proximal composites (eight schools) and the teaching of bevels on the cavosurface enamel margins of both the occlusal and proximal box margins (three schools).Conclusion The teaching of posterior composites in the Irish and UK dental schools has substantially increased over the last five years. Dental students in these schools often gain more experience in the placement of posterior composites than amalgam. However, practice trends indicate that a majority of GDPs continue to place amalgam in preference to composite, thereby suggesting a source of tension as current dental students emerge into the dental workforce over the coming years. There is, as a consequence, a challenge to the dental profession and its funding agencies in the UK to encourage more of a shift towards the minimally interventive use of composite systems in the restoration of posterior teeth, in particular among established practitioners. [ABSTRACT FROM AUTHOR]

Lymph node examination in colorectal cancer is of vital importance for accurate staging. Patients who have fewer nodes examined may be understaged and not offered adjuvant chemotherapy. The national institute of clinical excellence and the association of coloproctology of Great Britain and Ireland both recommend that 12 nodes should be examined for accurate staging. The aim of this study was to assess lymph node harvest at five hospitals in the northwest of England in respect to these guidelines. This study is a retrospective review of all colorectal cancer resections over a 1-year period at five hospitals. Two hospitals met the national guidelines of a median of 12 or more nodes. Overall, over 50% of colorectal cancers contained fewer than 12 nodes. Fifty-three point seven percent (53.7%) of Dukes B patients did not have 12 nodes in their specimens and may therefore be understaged. There was a significant variation between hospitals in terms of the number of cancers with 12 or more nodes ( P < 0.0001) and the number of Dukes B cancers with 12 or more nodes ( P < 0.008). Over 50% of all colorectal cancer specimens contain fewer than 12 lymph nodes despite clear national guidelines. This is of particular importance to Dukes B cancers where over 53% of cases may be understaged and not offered adjuvant therapy. Significant variation exists between hospitals within the same region. [ABSTRACT FROM AUTHOR]

Ethical dilemmas involving tax issues were identified by members of the American Institute of Certified Public Accountants as posing the most difficult ethical problem for them (Finn et al., Journal of Business Ethics 7(8), pp. 607–609, 1988). The KPMG tax shelter fraud case proves that the tax profession has not gone untainted in the age of numerous accounting and corporate scandals, such as the Enron débâcle (Sikka and Hampton, Accounting Forum 29(3), 325–343, 2005). High-profile scandals serve to highlight the problems caused by differences in ethical judgement among accountants and tax practitioners and the issue of ethics has been brought publicly to the forefront of the profession. Nevertheless, the nature and dimension of ethical issues in tax practice have been largely unexplored (Erard, Journal of Public Economics 52(2), 163–197, 1993; Marshall et al., Journal of Business Ethics 17(12), 1265–1279, 1998; Frecknall Hughes, Unpublished PhD Thesis, The University of Leeds, 2002). This research aims to contribute to the debate on ethics in tax practice by reporting interview data on tax practitioners’ perceptions of ethics in the jurisdictions of Ireland and the United Kingdom and exploring the link or equation of ethics with risk management. [ABSTRACT FROM AUTHOR]