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Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]

Objective: To determine impact of undertaking an international educational program during a nurse's or midwife's pre-registration program on subsequent practice, focusing on how nurses and midwives were transformed personally through participation in such programs. Background: Participation in international educational programs has been reported to enhance nursing and midwifery students' personal and professional development, however long-term impacts remain unclear. This paper presents findings drawn from a larger grounded theory study. Study design and Methods: Charmaz's grounded theory methodology was used to elicit experiences from 13 general nurses, two mental health nurses, three midwives and four dual qualified nurse/midwives across eight different countries. Data analysis led to the creation of three categories, with this paper reporting on the category of Developing as a Person. Findings: Participation in international educational programs can be transformative for nurses and midwives with long-lasting impacts, contributing positively to their personal growth and development. Discussion: The study findings underscore significant long-term impacts of international educational programs for nurses and midwives. These outcomes highlight the importance of incorporating international experiences into healthcare education. Conclusion: By providing opportunities for healthcare professionals to engage with diverse settings and populations, organisations and educational institutions can foster the development of well-rounded and globally competent practitioners. Implications for research, policy, and practice: The study's findings hold significant implications for research, policy, and practice in healthcare education. To deepen our understandings, additional longitudinal research across diverse countries is warranted. Policymakers have an opportunity to acknowledge the positive impact of these programs on the personal growth and development of nurses and midwives, potentially leading to the integration of global competency requirements into licensure programs. In order to provide comprehensive education, educational institutions should consider the inclusion of study abroad opportunities, cultural exchanges, and global clinical placements within nursing and midwifery curricula. What is already known about the topic? • International educational programs are widely used as a way of developing nursing and midwifery students' cultural understandings. • Previous studies have reported on short-term impacts of international educational programs. What this paper adds: • Long-term impacts of participation in an international educational program on nurses and midwives are described. • Personal development and subsequent transformations occur for nurses and midwives as a result of participation in international educational programs. [ABSTRACT FROM AUTHOR]

Introduction: Drug reimbursement decisions are often made based on a price set by the manufacturer. In some cases, this price leads to public and scientific debates about whether its level can be justified in relation to its costs, including those related to research and development (R&D) and manufacturing. Such considerations could enter the decision process in collectively financed health care systems. This paper investigates whether manufacturers' costs in relation to drug prices, or profit margins, are explicitly mentioned and considered by health technology assessment (HTA) organisations. Method: An analysis of reimbursement reports for cancer drugs was performed. All relevant Dutch HTA-reports, published between 2017 and 2019, were selected and matched with HTA-reports from three other jurisdictions (England, Canada, Australia). Information was extracted. Additionally, reimbursement reports for three cases of expensive non-oncolytic orphan drugs prominent in pricing debates in the Netherlands were investigated in depth to examine consideration of profit margins. Results: A total of 66 HTA-reports concerning 15 cancer drugs were included. None of these reports contained information on manufacturer's costs or profit margins. Some reports contained general considerations of the HTA organisation which related prices to manufacturers' costs: six contained a statement on the lack of price setting transparency, one mentioned recouping R&D costs as a potential argument to justify a high price. For the case studies, 21 HTA-reports were selected. One contained a cost-based price justification provided by the manufacturer. None of the other reports contained information on manufacturer's costs or profit margins. Six reports contained a discussion about lack of transparency. Reports from two jurisdictions contained invitations to justify high prices by demonstrating high costs. Conclusion: Despite the attention given to manufacturers' costs in relation to price in public debates and in the literature, this issue does not seem to get explicit systematic consideration in the reimbursement reports of expensive drugs. [ABSTRACT FROM AUTHOR]

In this paper, we study the mathematical Heat and Mass transfer model, Apple shipments from Australia to England began to decline several decades ago. Due to a disorder known as "brown heart," which developed due to insufficient cooling. When placed on deck, the apples are normally warm and must be refrigerated to keep them fresh. Storing in the cold Breathing generates heat as well. This heat was thought to be the cause. The generation successfully counteracted the apple's cooling, resulting in dark fruit. "Brown Heart ".This was the issue that resulted in the Awberry. To investigate how heat is distributed within a room. The location where heat is produced. At first, Awberry assumed the apple was in the beginning.at a constant temperature In the suitable value, we can assume that this temperature is zero. Select a temperature scale from the drop-down menu. = 0 is the current time. It must be concluded that the generation of heat inside the apple is not "Brown Heart "cause. We now know that the brown core is caused by an excessive concentration of carbon dioxide and an insufficient amount of oxygen in the stockpile. It affects the metabolic activities that occur in apples and leads to a decrease in temperature separation. We have solved the heat equation for cooling apples using the method of separating variables in addition to numerical methods and clarification of the results obtained, including comparing the exact solution with the numerical solution. In terms of discovering analytical and numerical solutions, the approach is quite effective and useful. [ABSTRACT FROM AUTHOR]

Background: Large-scale partnerships between universities and health services are widely seen as vehicles for bridging the evidence-practice gap and for accelerating the adoption of new evidence in healthcare. Recently, different versions of these partnerships - often called academic health science centres - have been established across the globe. Although they differ in structure and processes, all aim to improve the integration of research and education with health services. Collectively, these entities are often referred to as Research Translation Centres (RTCs) and both England and Australia have developed relatively new and funded examples of these collaborative centres.Methods: This paper presents findings from a rapid review of RTCs in Australia and England that aimed to identify their structures, leadership, workforce development and strategies for involving communities and service users. The review included published academic and grey literature with a customised search of the Google search engine and RTC websites.Results: RTCs are complex system-level interventions that will need to disrupt the current paradigms and silos inherent in healthcare, education and research in order to meet their aims. This will require vision, leadership, collaborations and shared learnings, alongside structures, processes and strategies to deliver impact in the face of complexity. The impact of RTCs in overcoming the deeply entrenched silos across organisations, disciplines and sectors needs to be captured at the systems, organisation and individual levels. This includes workforce capacity and public and patient involvement that are vital to understanding the evolution of RTCs. In addition, new models of leadership are needed to support the brokering and mobilisation of knowledge in complex organisations.Conclusions: The development and funding of RTCs represents one of the most significant shifts in the health research landscape and it is imperative that we continue to explore how we can progress the integration of research and healthcare and ensure research meets stakeholder needs and is translated via the collaborations supported by these organisations. Because RTCs are a recent addition to the healthcare landscape in Australia, it is instructive to review the processes and infrastructure needed to support their implementation and applied health research in England. [ABSTRACT FROM AUTHOR]

A lot of clay has fl owed through the kilns since the 1989 Newcastle earthquake. Several signifi cant changes have occurred to make masonry veneer construction safer and stronger over this period, both in the methods of construction of the veneer and the understanding of the behaviour of the veneer panels. These changes have lead to the conclusion that masonry veneer construction can be reliably considered to provide some bracing resistance to a light timber-framed structure, even if only to resist its own inertial loads. Recent research undertaken at BRANZ has investigated the behaviour of full-scale brick veneer single- and two-storey buildings under slow static and dynamic cyclic loading. This paper describes the developments that have occurred since 1989 and this recent research that has provided the new confi dence in the seismic performance of clay brick veneer. [ABSTRACT FROM AUTHOR]

There is wide agreement that the US student loan system faces significant problems. Seven million borrowers are in default and many more are not repaying for reasons such as returning to school, or economic hardship. The stress of repayments faced by many students results at least in part from the design of US student loans. Specifically, loans are organised like a mortgage, with fixed monthly repayments over a fixed period of time, creating a high repayment burden on borrowers with low income. This paper draws on the experience of the income-contingent loan (ICL) systems operating in England and Australia, in which monthly or two-weekly repayments are related to the borrower's income in that period, thus building in automatic insurance against inability to repay during periods of low income. We discuss the design of this type of loan in detail since such an exercise seems to be largely absent in the US literature. Drawing on data from the US Current Population Survey (CPS) we provide two main empirical contributions: a stylised illustration of the revenue and distributional implications of different hypothetical ICL arrangements for the USA; and an illustration of repayment problems faced by low-earning borrowers in the US loan system, including a plausible example of adverse outcomes with respect to Stafford loans. Importantly, we compare repayment burdens under the existing and alternative systems. Our illustrations show how US mortgage-type loans can create financial difficulties for a significant minority of US borrowers, difficulties which an ICL is designed to address. We note also that the current small and ineffective income-based repayment system in the US has few of the characteristics of an ideal ICL. [ABSTRACT FROM AUTHOR]

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Aim To determine which characteristics of academic leadership are perceived to be necessary for nursing deans to be successful. Background Effective leadership is essential for the continued growth of the discipline. Method A qualitative study using semi-structured interviews with 30 deans (academics in universities who headed a nursing faculty and degree programmes) was conducted in three countries - Canada, England and Australia. The conversations were analysed for leadership attributes. Result Sixty personal and positional attributes were nominated by the participants. Of these, the most frequent attribute was 'having vision'. Personal attributes included: passion, patience, courage, facilitating, sharing and being supportive. Positional attributes included: communication, faculty development, role modelling, good management and promoting nursing. Conclusion Both positional and personal aspects of academic leadership are important to assist in developing a succession plan and education for new deans. Implications for nursing management It is important that talented people are recognised as potential leaders of the future. These future leaders should be given every chance to grow and develop through exposure to opportunities to develop skills and the attributes necessary for effective deanship. Strategic mentoring could prove to be useful in developing and supporting the growth of future deans of nursing. [ABSTRACT FROM AUTHOR]

Objective: A high prevalence of hearing loss in older adults contrasts with a small proportion of people who seek help. Emerging developments in hearing healthcare (HHC) could reduce costs but may not increase access. This study evaluated older adults' perceptions of current and future HHC services in Australia, England, US and Canada to explore potential levers and system improvements. Methods: Semi-structured focus groups (n = 47) were conducted, and data were analysed using a directed content analysis. Participants were adults 60 years and older with a) no hearing problems; b) hearing problems and hearing aid use; and c) hearing problems and no hearing aid use. Results: Perceived barriers, facilitators and preferences were largely consistent across countries, with stigma and trust in HHC being the barriers most often discussed. Conclusion: Although cost and access were consistently deemed important, there may be limited change in help-seeking and HHC uptake unless the key barriers of trust and stigma are addressed. When seeking to undertake transformative change to healthcare it is important to engage recipients of care to understand existing barriers and coproduce a user-centered solution. [ABSTRACT FROM AUTHOR]

Background: There is a scarcity of research published on clinical scholarship. Much of the conceptualisation has been conducted in the academy. Nurse academics espouse that the practice of nursing must be built within a framework of clinical scholarship. A key concept of clinical scholarship emerging from discussions in the literature is that it is an essential component of enabling evidence-based nursing and the development of best practice standards to provide for the needs of patients/clients. However, there is no comprehensive definition of clinical scholarship from the practicing nurses. The aim of this study was to contribute to this definitional discussion on the nature of clinical scholarship in nursing. Methods: Naturalistic inquiry informed the method. Using an interpretative approach 18 practicing nurses from Australia, Canada and England were interviewed using a semi-structured format. The audio-taped interviews were transcribed and the text coded for emerging themes. The themes were sorted into categories and the components of clinical scholarship described by the participants compared to the scholarship framework of Boyer [JHEOE 7:5-18, 2010]. Results: Clinical scholarship is difficult to conceptualise. Two of the essential elements of clinical scholarship are vision and passion. The other components of clinical scholarship were building and disseminating nursing knowledge, sharing knowledge, linking academic research to practice and doing practice-based research. Conclusion: Academic scholarship dominated the discourse in nursing. However, in order for nursing to develop and to impact on health care, clinical scholarship needs to be explored and theorised. Nurse educators, hospital-based researchers and health organisations need to work together with academics to achieve this goal. Frameworks of scholarship conceptualised by nurse academics are reflected in the findings of this study with their emphasis on reading and doing research and translating it into nursing practice. This needs to be done in a nonthreatening environment. [ABSTRACT FROM AUTHOR]

Background: Clinical scholarship has been conceptualised and theorised in the nursing literature for over 30 years but no research has captured nurses' clinicians' views on how it differs or is the same as clinical expertise and clinical leadership. The aim of this study was to determine clinical nurses' understanding of the differences and similarities between the clinical expert, clinical leader and clinical scholar. Methods: A descriptive interpretative qualitative approach using semi-structured interviews with 18 practising nurses from Australia, Canada and England. The audio-taped interviews were transcribed and the text coded for emerging themes. The themes were sorted into categories of clinical expert, clinical leader and clinical scholarship as described by the participants. These themes were then compared and contrasted and the essential elements that characterise the nursing roles of the clinical expert, clinical leader and clinical scholar were identified. Results: Clinical experts were seen as linking knowledge to practice with some displaying clinical leadership and scholarship. Clinical leadership is seen as a positional construct with a management emphasis. For the clinical scholar they linked theory and practice and encouraged research and dissemination of knowledge. Conclusion: There are distinct markers for the roles of clinical expert, clinical leader and clinical scholar. Nurses working in one or more of these roles need to work together to improve patient care. An 'ideal nurse' may be a blending of all three constructs. As nursing is a practice discipline its scholarship should be predominantly based on clinical scholarship. Nurses need to be encouraged to go beyond their roles as clinical leaders and experts to use their position to challenge and change through the propagation of knowledge to their community. [ABSTRACT FROM AUTHOR]

Background: There appears to be considerable variation between different national jurisdictions and between different sectors of public policy in the use of evidence and particularly the use of randomised controlled trials (RCTs) to evaluate non-healthcare sector programmes. Methods: As part of a wider study attempting to identify RCTs of public policy sector programmes and the reasons for variation between countries and sectors in their use, we carried out a pilot study which interviewed 10 policy makers and researchers in six countries to elicit views on barriers to and facilitators of the use of RCTs for social programmes. Results: While in common with earlier studies, those interviewed expressed a need for unambiguous findings, timely results and significant effect sizes, users could, in fact, be ambivalent about robust methods and robust answers about what works, does not work or makes no difference, particularly where investment or a policy announcement was planned. Different national and policy sector cultures varied in their use of and support for RCTs. Conclusions: In order to maximise the use of robust evaluations of public programmes across the world it would be useful to examine, systematically, cross-national and cross-sectoral variations in the use of different methods including RCTs and barriers to and facilitators of their use. Sound research methods, whatever their scientific value, are no guarantee that findings will be useful or used. 'Stories' have been shown to influence policy; those advocating the use of RCTs may need to provide convincing narratives to avoid repetition about their value. [ABSTRACT FROM AUTHOR]

Objective: General dentist orthodontic practice is a controversial issue and this paper aims to analyze it comparing foreign laws to Brazilian Legal System. Methods: Regulations and scientific texts concerning orthodontic practice by general dentists, in Portuguese or English language, were sought. Results and Conclusion: Portugal clearly forbids general dentist orthodontic practice; United States of America do not clearly forbid general dentist orthodontic practice, but do regulate and promote campaigns to encourage public to seek specialist service; in Australia and England, corrective orthodontics are offered both by orthodontists and general dentists; it was not possible to evaluate how orthodontic services are provided in Eastern Europe; and the fact that general dentists are forbidden to practice corrective orthodontics in Brazilian Legal System is compatible to other countries policy. [ABSTRACT FROM AUTHOR]

One of the things we are constantly told about the internet is that the world becomes a smaller place. Communication with like-minded individuals is easier through virtual communication. For radio practitioners this connectivity should allow people with common interests and skills to collaborate more effectively on radio-like productions. Shared Stories is about this type of collaborative production of documentaries and features. The first version of this project involved university students in Australia and England. This paper describes the processes and challenges encountered in this collaboration, identifying the ways in which this form of production can be developed. [ABSTRACT FROM AUTHOR]

Seeking ethics committee approval for research can be challenging even for relatively simple studies occurring in single settings. Complicating factors such as multicentre studies and/or contentious research issues can challenge review processes, and conducting such studies internationally adds a further layer of complexity. This paper draws on the experiences of the LINNAEUS Collaboration, an international group of primary care researchers, in obtaining ethics approval to conduct an international study investigating medical error in general practice in six countries. It describes the ethics review processes applied to exactly the same research protocol for a study run in Australia, Canada, England, the Netherlands, New Zealand, and the US. Wide variation in ethics review responses to the research proposal occurred, from no approval being deemed necessary to the study plan narrowly avoiding rejection. The authors' experiences demonstrated that ethics committees operate in their own historical and cultural context, which can lead to radically different subjective interpretations of commonly-held ethical principles, and raised further issues such as 'what is research?'. This first LINNAEUS study started when patient safety was a particularly sensitive subject. Although it is now a respectable area of inquiry, patient safety is still a topic that can excite emotions and prejudices. The LINNAEUS Collaboration now extends to more countries and continues to pursue an international research agenda, so reflection on the influences of history, social context, and structure of each country's ethical review processes is timely. [ABSTRACT FROM AUTHOR]

One of the things we are constantly told about the internet is that the world becomes a smaller place. Communication with like-minded individuals is easier through virtual communication. For radio practitioners this connectivity should allow people with common interests and skills to collaborate more effectively on radio-like productions. Shared Stories is about this type of collaborative production of documentaries and features. The first version of this project involved university students in Australia and England. This paper describes the processes and challenges encountered in this collaboration, identifying the ways in which this form of production can be developed. [ABSTRACT FROM AUTHOR]

Ann Gillmore Rees was a designer and teacher who used three different names over the course of a career, which began in England in the 1920s and concluded in Australia in the 1970s. Rees illustrated books, designed textiles and exhibited work in a variety of genres. As a teacher she influenced notable Australian women including Marion Hall Best and Joan Law-Smith. It is surprising then that since her death in 1982, Ann Rees has largely been forgotten. In this paper, I reconstruct the story of Ann Rees' career and discuss reasons for her omission from British and Australian art, craft and design histories, concluding that the telling of stories like hers would provide us with a more complete view of our cultural history. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 is primarily a respiratory illness, and smoking adversely impacts the respiratory and immune systems; this confluence may therefore incentivize smokers to quit. The present study, conducted in four high-income countries during the first global wave of COVID-19, examined the association between COVID-19 and: (1) thoughts about quitting smoking; (2) changes in smoking (quit attempt, reduced or increased smoking, or no change); and (3) factors related to a positive change (making a quit attempt or reducing smoking) based on an adapted framework of the Health Belief Model. Methods: This cross-sectional study included 6870 adult smokers participating in the Wave 3 (2020) ITC Four Country Smoking and Vaping Survey conducted in Australia, Canada, England, and United States (US). These four countries had varying responses to the pandemic by governments and public health, ranging from advising voluntary social distancing to implementing national and subnational staged lockdowns. Considering these varying responses, and the differences in the number of confirmed cases and deaths (greatest in England and the US and lowest in Australia), smoking behaviours related to COVID-19 may have differed between countries. Other factors that may be related to changes in smoking because of COVID-19 were also explored (e.g., sociodemographics, nicotine dependence, perceptions about personal and general risks of smoking on COVID-19). Regression analyses were conducted on weighted data. Results: Overall, 46.7% of smokers reported thinking about quitting because of COVID-19, which differed by country (p<0.001): England highest (50.9%) and Australia lowest (37.6%). Thinking about quitting smoking because of COVID-19 was more frequent among: females, ethnic minorities, those with financial stress, current vapers, less dependent smokers (non-daily and fewer cigarettes smoked/day), those with greater concern about personal susceptibility of infection, and those who believe COVID-19 is more severe for smokers. Smoking behaviour changes due to COVID-19 were: 1.1% attempted to quit, 14.2% reduced smoking, and 14.6% increased smoking (70.2% reported no change). Positive behaviour change (tried to quit/reduced smoking) was reported by 15.5% of smokers, which differed by country (p = 0.02), where Australia had significantly lower rates than the other three countries. A positive behavioural smoking change was more likely among smokers with: lower dependence, greater concern about personal susceptibility to infection, and believing that COVID-19 is more severe for smokers. Conclusions: Though nearly half of smokers reported thinking about quitting because of COVID-19, the vast majority did not change their smoking behaviour. Smokers were more likely to try and quit or reduce their smoking if they had greater concern about susceptibility and severity of COVID-19 related to smoking. Smokers in Australia were least likely to reduce or try to quit smoking, which could be related to the significantly lower impact of COVID-19 during the early phase of the pandemic relative to the other countries. [ABSTRACT FROM AUTHOR]

The use of sunscreens is recommended to limit the impact of sun exposure on the skin. The objective of this study was to examine the relationship between sunscreen sales and melanoma in 4 different countries with diverse sunscreen regulations. Data from publicly available databases were examined for Sweden, England, Australia, and the USA from 1999 to 2018. The association between incidence of melanoma and sunscreen sales was estimated using a generalized estimating equation, and modelling was used to predict melanoma cases. Incidence of melanoma was positively associated with sunscreen sales in England, Australia, and the USA, and negatively associated with sunscreen sales in Sweden. Growth rates in melanoma cases of 0.42%, 16.7%, 19.1% and 12.2% were predicted for Sweden, England, Australia, and the USA, respectively. The differences observed between England, Australia, and the USA, on the one hand, and Sweden, on the other hand, are consistent with the adoption of strong regulations requiring the use of ultraviolet A blocking agents in sunscreens. [ABSTRACT FROM AUTHOR]

Background: In the regulation of healthcare, the subject of patient and family involvement figures increasingly prominently on the agenda. However, the literature on involving patients and families in regulation is still in its infancy. A systematic analysis of how patient and family involvement in regulation is accomplished across different health systems is lacking. We provide such an overview by mapping and classifying methods of patient and family involvement in regulatory practice in four countries; Norway, England, the Netherlands, and Australia. We thus provide a knowledge base that enables discussions about possible types of involvement, and advantages and difficulties of involvement encountered in practice.Methods: The research design was a multiple case study of patient and family involvement in regulation in four countries. The authors collected 1) academic literature if available and 2) documents of regulators that describe user involvement. Based on the data collected, the authors from each country completed a pre-agreed template to describe the involvement methods. The following information was extracted and included where available: 1) Method of involvement, 2) Type of regulatory activity, 3) Purpose of involvement, 4) Who is involved and 5) Lessons learnt.Results: Our mapping of involvement strategies showed a range of methods being used in regulation, which we classified into four categories: individual proactive, individual reactive, collective proactive, and collective reactive methods. Reported advantages included: increased quality of regulation, increased legitimacy, perceived justice for those affected, and empowerment. Difficulties were also reported concerning: how to incorporate the input of users in decisions, the fact that not all users want to be involved, time and costs required, organizational procedures standing in the way of involvement, and dealing with emotions.Conclusions: Our mapping of user involvement strategies establishes a broad variety of ways to involve patients and families. The four categories can serve as inspiration to regulators in healthcare. The paper shows that stimulating involvement in regulation is a challenging and complex task. The fact that regulators are experimenting with different methods can be viewed positively in this regard. [ABSTRACT FROM AUTHOR]

Background: Since the 2009 A/H1N1 pandemic, Public Health England have developed a suite of real-time statistical models utilising enhanced pandemic surveillance data to nowcast and forecast a future pandemic. Their ability to track seasonal influenza and predict heightened winter healthcare burden in the light of high activity in Australia in 2017 was untested.Methods: Four transmission models were used in forecasting the 2017/2018 seasonal influenza epidemic in England: a stratified primary care model using daily, region-specific, counts and virological swab positivity of influenza-like illness consultations in general practice (GP); a strain-specific (SS) model using weekly, national GP ILI and virological data; an intensive care model (ICU) using reports of ICU influenza admissions; and a synthesis model that included all data sources. For the first 12 weeks of 2018, each model was applied to the latest data to provide estimates of epidemic parameters and short-term influenza forecasts. The added value of pre-season population susceptibility data was explored.Results: The combined results provided valuable nowcasts of the state of the epidemic. Short-term predictions of burden on primary and secondary health services were initially highly variable before reaching consensus beyond the observed peaks in activity between weeks 3-4 of 2018. Estimates for R0 were consistent over time for three of the four models until week 12 of 2018, and there was consistency in the estimation of R0 across the SPC and SS models, and in the ICU attack rates estimated by the ICU and the synthesis model. Estimation and predictions varied according to the assumed levels of pre-season immunity.Conclusions: This exercise successfully applied a range of pandemic models to seasonal influenza. Forecasting early in the season remains challenging but represents a crucially important activity to inform planning. Improved knowledge of pre-existing levels of immunity would be valuable. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to benchmark roles that veterinary librarians at universities and colleges play in systematic reviews (SRs) and scoping reviews that are conducted by faculty and students at their institutions, to benchmark the level of training that veterinary librarians have in conducting SRs, to identify barriers to their participation in SRs, and to identify other types of literature reviews that veterinary librarians participate in. Methods: Sixty veterinary librarians in universities and colleges in Canada, the United States, England, Scotland, Ireland, Australia, and New Zealand were surveyed online about their roles and training in conducting SRs, barriers to participation in SRs, and participation in other types of literature reviews. Results: Veterinary librarians' highest participation was at an advising level in traditional librarian roles as question formulator, database selector, search strategy developer, and reference manager. Most respondents reported pretty good to extensive training in traditional roles and no or some training in less traditional roles. Sixty percent of respondents received few or no requests to participate in SRs, and only half of respondents had participated in SRs as a review team member. Sixty percent of respondents stated that their libraries had no policies regarding librarian roles and participation in SRs. Conclusions: The surveyed veterinary librarians participated in SRs to a lesser degree than human health sciences librarians, experienced low demand from veterinary faculty and students to participate in SRs, and participated as review team members at significantly lower rates than human health sciences librarians. The main barriers to participation in SRs were lack of library policies, insufficient training, and lack of time. [ABSTRACT FROM AUTHOR]

Objective: To undertake the first detailed genomic analysis of methicillin-resistant Staphylococcus aureus (MRSA) isolated in Sri Lanka. Methods: A prospective observational study was performed on 94 MRSA isolates collected over a 4 months period from the Anuradhapura Teaching Hospital, Sri Lanka. Screening for mec A, mec C, and the Panton-Valentine leucocidin (PVL)-associated lukS-PV/lukF-PV genes and molecular characterization by spa typing was undertaken. Whole genome sequencing (WGS) and phylogenetic analysis was performed on selected multilocus sequence type (MLST) clonal complex 5 (CC5) isolates from Sri Lanka, England, Australia, and Argentina. Results: All 94 MRSA harbored the mecA gene. Nineteen spa types belonging to nine MLST clonal complexes were identified. Where origin of the sample was recorded, most isolates were from skin and soft tissue infections (70/91; 76.9%), with fewer causing bacteremia (16/91; 17.6%), empyema (3/91; 3.3%) and osteomyelitis (2/91; 2.2%). Sixty two (65.9%) isolates were PVL positive with the majority (56 isolates; 90.3%) belonging to a dominant CC5 lineage. This lineage, PVL-positive ST5-MRSA-IVc, was associated with both community and hospital-onset infections. Based on WGS, representative PVL-positive ST5-MRSA-IVc isolates from Sri Lanka, England and Australia formed a single phylogenetic clade, suggesting wide geographical circulation. Conclusions: We present the most detailed genomic analysis of MRSA isolated in Sri Lanka to date. The analysis identified a PVL-positive ST5-MRSA-IVc that is prevalent among MRSA causing clinical infections in Sri Lanka. Furthermore, this clone was also found among isolates from the United Kingdom and Australia. [ABSTRACT FROM AUTHOR]

Background Late diagnosis is a considered to be a major factor contributing to poorer cancer survival rates in the UK. Interventions have focussed on the promotion of earlier diagnosis in patients with potential cancer symptoms. However, to assess the effectiveness of these interventions, the time from symptom onset to presentation needs to be reliably and accurately measured. This qualitative study explored the use of calendar landmarking instruments in cancer symptom research. Methods We performed a secondary analysis of transcripts of interviews using the calendar landmarking instrument, undertaken with patients who had either been diagnosed with cancer (n = 40, IRCO study, Western Australia), or who had symptoms suggestive of cancer (n = 38, SYMPTOM study, North East and Eastern England). We used constant comparison methods to identify use of the calendar landmarking instruments and the impact of their application. Results The calendar landmarking instrument appeared to help many patients, either by acting as a prompt or helping to refine recall of events. A combination of personal (e.g. birthday) and national (e.g. Christmas) landmarks seemed to be the most effective. Calendar landmarking instruments appeared more useful where the time period between onset of symptoms and date of first consultation was less than three months. The interviewee's age, gender and cancer type did not appear to influence whether or not the instrument facilitated recall, and there were no instances where the use of the instrument resulted in the disclosure of a new first symptom. Symptoms of similar chronic conditions could create difficulties when applying the instrument; it was difficult for these participants to characterise and disentangle their symptoms which prompted their decisions to seek help. Some participants tended to prefer to use their own, already personalised, diaries to assist in their recall of events. Conclusions This study is the first to describe the potential role of calendar landmarking instruments to support research interviews which explore symptoms and events along the cancer diagnostic pathway. The major challenge remains as to whether they actually improve accuracy of recall. [ABSTRACT FROM AUTHOR]

The family is an important setting for the transmission of values and traditions, and parents have a significant influence on the religious involvement of their children. The family typically provides an initial religious identity and introduces children to religious beliefs, practices and a network of adherents. For both scholars and practitioners, the question of how religion does or does not come to be passed on in families is of crucial importance. In this study we use data from the 2001 International Congregational Life Survey to examine church attendance across three generations in England and Australia. In both England and Australia there is a strong tendency for couples to attend church together; they are making joint decisions and, when churchgoing is favored, encouraging each other in religious practice. The impact of two churchgoing parents on their children is considerably stronger than that of one alone. Our analysis shows that not only parental but also grandparental religious activity has a significant effect. While much of their influence simply results from the upbringing they gave their own children, a substantial proportion of it seems likely to be a direct, unmediated effect on grandchildren. [ABSTRACT FROM AUTHOR]

The article presents information on the biographies and biographers with reference to the history of law. It discusses the emergence of legal biographies and also discusses the written lives of lawyers practicing law in England, Australia and the U.S. Information on the works of Professor Jeremy Black and a quote from poet E. C. Bentley regarding the biographies is also presented.

This volume on the archaeology of urban poverty arises from a three-day symposium hosted by York Archaeological Trust and the University of York in July 2009 to establish the wider intellectual framework for the investigation of the nineteenth- and twentieth-century archaeology of the Hungate neighborhood of York. In this opening article, the trajectory of medieval and post-medieval archaeology in Britain is contrasted with historical archaeology in the United States and Australia, and the influence of the pre-modern history of the Hungate neighborhood on its development since 1800 is explored. [ABSTRACT FROM AUTHOR]

This reflective piece draws together the themes and issues presented within the volume, exploring historic and contemporary definitions and attitudes towards poverty and their implications of the archaeological study of 'slum' neighborhoods. It compares and contrasts the individual case studies from York and Manchester with investigations in America and Australia, drawing attention to the differences between them. Suggestions are made for future investigations, particularly in the potential for further comparative work at an international level. [ABSTRACT FROM AUTHOR]

The UK has long experienced a shortage of social workers and has recruited internationally to meet demand. There have been few specific data quantifying the scale of social work mobility to the UK through which such experiences can be set in context. The analysis reported in this article uses data from October 2008, relating to registered social workers working in England. As part of a wider study of migrant social care workers in England, the article reports analysis of data records of over 7,000 non-UK social workers registered to work in England and compares their characteristics to UK-qualified social workers. These analyses are supplemented by analysis of more recent application and registration data from the General Social Care Council pertaining to social workers qualified within and outside the European Union during 2008 and 2009. The findings highlight several important observations in terms of non-UK-qualified social workers' profile as well as some possible trends in migration and variations in rates of qualification verification. Over half of all international social workers in England were trained in four countries: Australia, South Africa, India and the USA. Findings are contextualised with qualitative data obtained from the wider study and policy debates. [ABSTRACT FROM PUBLISHER]

It is often asserted that, between 1865 and 1914, economic dependence on British capital subjected settler societies to an unofficial imperialism wielded by the City of London. This article argues that both advocates and critics of such models, particularly in the recent controversy over 'gentlemanly capitalism', pay insufficient attention to the City itself. Using the Edwardian City's connections with Australia and Canada, it illustrates the range of financial intermediaries involved and explores their perceptions of political economy in these countries. It concludes that the City's influence (or 'structural power') was limited by its internal divisions and hazy conceptions of political economy. [ABSTRACT FROM AUTHOR]

Background: Although primary health care, and in particular, general practice will be at the frontline in the response to pandemic influenza, there are no frameworks to guide systematic planning for this task or to appraise available plans for their relevance to general practice. We aimed to develop a framework that will facilitate planning for general practice, and used it to appraise pandemic plans from Australia, England, USA, New Zealand and Canada. Methodology/Principal Findings: We adapted the Haddon matrix to develop the framework, populating its cells through a multi-method study that incorporated the peer-reviewed and grey literature, interviews with general practitioners, practice nurses and senior decision-makers, and desktop simulation exercises. We used the framework to analyse 89 publiclyavailable jurisdictional plans at similar managerial levels in the five countries. The framework identifies four functional domains: clinical care for influenza and other needs, public health responsibilities, the internal environment and the macroenvironment of general practice. No plan addressed all four domains. Most plans either ignored or were sketchy about noninfluenza clinical needs, and about the contribution of general practice to public health beyond surveillance. Collaborations between general practices were addressed in few plans, and inter-relationships with the broader health system, even less frequently. Conclusions: This is the first study to provide a framework to guide general practice planning for pandemic influenza. The framework helped identify critical shortcomings in available plans. Engaging general practice effectively in planning is challenging, particularly where governance structures for primary health care are weak. We identify implications for practice and for research. [ABSTRACT FROM AUTHOR]

Although high-stakes tests play an increasing role in students' schooling experiences, scholars have not examined these tests as sites for socialisation. Drawing on qualitative data collected at an American urban primary school, this study explores what educators teach students about motivation and effort through high-stakes testing, how students interpret and internalise these messages, and how student hierarchies develop as a result. I found that teachers located boys' failure in their poor behavior and attitudes, while arguing that girls simply needed more self-esteem to pass the test. Most boys accepted their teachers' diagnosis of the problem. However, the boys who felt that they were already 'doing their best' and 'working hard' began to doubt that educational success is a function of merit and effort. I conclude that students learn about much more than the three Rs through their experiences with high-stakes testing, and argue that future research should attend to the social dimensions of these experiences. [ABSTRACT FROM AUTHOR]

AusRivAS is an Australia-wide program that measures river condition using predictive models to compare the macroinvertebrate families occurring at a river site with those expected if the site were in natural condition. Results of assessment of 685 sites across all major rivers in Western Australia are presented. Most rivers were in relatively natural condition in the northern half of the state where the human population is low and pastoralism is the major land use. In the south, where the human population is higher and agriculture is more intensive, rivers were mostly more disturbed. AusRivAS assessment produced some erroneous results in rivers of the south-west cropping zone because of the lack of appropriate reference site groups and biased distribution of sampling sites. Collecting low numbers of animals from many forested streams, because of low stream productivity and samples that were difficult to sort, also affected assessments. Overall, however, AusRivAs assessment identified catchment processes that were inimical to river health. These processes included salinisation, high nutrient and organic loads, erosion and loss of riparian vegetation. River regulation, channel modification and fire were also associated with river degradation. As is the case with other assessment methods, one-off sampling at individual sites using AusRivAS may be misleading. Seasonal drought, in particular, may make it difficult to relate conditions at the time of sampling to longer-term river health. AusRivAS has shown river condition in Western Australia is not markedly different from other parts of Australia which, as a whole, lacks the substantial segments of severely degraded river systems reported in England. [ABSTRACT FROM AUTHOR]

In this article we describe the background to the recent development of citizenship education in Australia, Canada and England and then, following an account of our methods, discuss issues arising from an analysis of a sample of textbooks from these countries. We suggest that the current policies to introduce versions of citizenship education have emerged in these countries in the context of diverse challenges to the legitimacy of the nation state. We argue, generally, that all three countries tend, in the textbooks we have examined, to emphasize forms of citizenship education that may submerge citizen empowerment under essentially orthodox agendas. We see differences in textbooks between and within the three countries but argue that, despite many exceptions, we are able to characterize textbooks in Ontario, Canada as education in civics (provision of information about formal public institutions), those in England as education for citizenship (a broad‐based promotion of socially useful qualities) and those in Australia as social studies (societal understanding that emerges from the development of critical thinking skills related to existing academic subjects such as history and English). [ABSTRACT FROM AUTHOR]

English and Australian judges have, over the past few decades, severely questioned the juridical distinctiveness and utility of the rule in Rylands v Fletcher. The popular assertion in this country has been that the rule is really only a subspecies of the law of private nuisance. By contrast, the Australian judiciary has abandoned the rule altogether, preferring to expand the law of negligence to capture the rule's former territory. This article seeks to defend the rule in Rylands v Fletcher. In particular it asserts that, by reference to their historical origins, the rule in Rylands v Fletcher and the law of private nuisance can be seen to be quite different creatures. It also argues that there is strong case for the rule's continued vitality, and that it would be a grave mistake to abandon it in favour of a yet more expansive law of negligence. [ABSTRACT FROM AUTHOR]

This article contends that researchers have made two false assumptions about the history of violence and violent crime in the nineteenth and early twentieth centuries. First, that judicial statistics appearing to show an accelerating decline in violent crime towards the fin de siècle actually mirror a real fall, and that violence was becoming less prevalent in society. Second, that the prosecution figures evidence a changing public attitudes towards violence in the 1880-1920 period. These assumptions have helped to shape rather inadequate and schematic theoretical paradigms which link changing public sensibilities towards violence with the reformation of aggressive masculinity, and the 'civilization 'of society. This article suggests that transcribed life histories can offer the researcher a greater understanding of public attitudes towards violence; and it therefore presents archival evidence from England, Australia and New Zealand to illustrate collective attitudes towards nonlethal violence/violent crime at the turn of the twentieth century. [ABSTRACT FROM AUTHOR]

From the earliest British colonization of Australia, draughtsmen and watercolourists were eager to depict their new home. A demand for paintings in the more permanent and prestigious medium of oil was met by many of these first artists, even though most were not trained in this medium. In the first 40 years, artists often depended on personal patrons and friends in Britain for the supply of painting materials. The problems of shortages led to some improvisation and substitution of materials. By the 1830s the number of professionally trained British artists who had emigrated to Australia had increased, and the supply of artists' materials had also become more reliable. This early period, greatly dependent on irregular supplies from England, was followed by rapid commercial development of the colonies and faster shipping which ensured that new materials and techniques from England quickly appeared in the Australian colonies. [ABSTRACT FROM AUTHOR]

By applying a renewal theory model to data from the Australian Prisons Census, we estimate the number of remand receptions at prisons and the mean and median remand times served by prisoners during the period 1982-1990. We conclude that despite the general increases in court delays, and despite a large increase in the remand reception rate between 1982 and 1990, remand times have been largely unaffected, with the median remand time for 1990 being 1.7 weeks. Comparisons are made with official figures for various states and with figures for Canada and England/Wales. [ABSTRACT FROM AUTHOR]

Background: Over the past decade, Research Translation Centres (RTCs) have been established in many countries. These centres (sometimes referred to as Academic Health Science Centres) are designed to bring universities and healthcare providers together in order to accelerate the generation and translation of new evidence that is responsive to health service and community priorities. This has the potential to effectively 'flip' the traditional research and education paradigms because it requires active participation and continuous engagement with stakeholders (especially service users, the community and frontline clinicians). Although investment and expectations of RTCs are high, the literature confirms a need to better understand the processes that RTCs use to mobilise knowledge, build workforce capacity, and co-produce research with patients and the public to ensure population impact and drive healthcare improvement.Methods: Semi-structured interviews were conducted with selected leaders and members from select RTCs in England and Australia. Convenience sampling was utilised to identify RTCs, based on their geography, accessibility and availability. Purposive sampling and a snowballing approach were employed to recruit individual participants for interviews, which were conducted face to face or via videoconferencing. Interviews were recorded, transcribed verbatim and analysed using a reflexive and inductive approach. This involved two researchers comparing codes and interrogating themes that were analysed inductively against the study aims and through meetings with the research team.Results: A total of 41 participants, 22 from England and 19 from Australia were interviewed. Five major themes emerged, including (1) dissonant metrics, (2) different models of leadership, (3) public and patient involvement and research co-production, (4) workforce development and (5) barriers to collaboration.Conclusions: Participants identified the need for performance measures that capture community impact. Better aligned success metrics, enhanced leadership, strategies to partner with patients and the public, enhanced workforce development and strategies to enhance collaboration were all identified as crucial for RTCs to succeed. [ABSTRACT FROM AUTHOR]

The article offers news briefs related to medical ethics. In Victoria, Australia, the Law Reform Committee has recommended that all donor-conceived individuals should be able to receive identifying information about donors. The High Court in England has ruled that Tony Nicklinson would be allowed to proceed with his challenge to the law of murder and assisted suicide. In England, an adult can be assessed as lacking capacity to make medical decision on the basis of certain diagnostic criteria.

Introduction: People with spinal cord injury receive physical rehabilitation to promote neurological recovery. Physical rehabilitation commences as soon as possible when a person is medically stable. One key component of physical rehabilitation is motor training. There is initial evidence to suggest that motor training can enhance neurological recovery if it is provided soon after injury and in a high dosage. The Early and Intensive Motor Training Trial is a pragmatic randomised controlled trial to determine whether 10 weeks of intensive motor training enhances neurological recovery for people with spinal cord injury. This pragmatic randomised controlled trial will recruit 220 participants from 15 spinal injury units in Australia, Scotland, Italy, Norway, England, Belgium and the Netherlands. This protocol paper describes the process evaluation that will run alongside the Early and Intensive Motor Training Trial. This process evaluation will help to explain the trial results and explore the potential facilitators and barriers to the possible future rollout of the trial intervention., Methods and Analysis: The UK Medical Research Council process evaluation framework and the Implementation Research Logic Model will be used to explain the trial outcomes and inform future implementation. Key components of the context, implementation and mechanism of impact, as well as the essential elements of the intervention and outcomes, will be identified and analysed. Qualitative and quantitative data will be collected and triangulated with the results of the Early and Intensive Motor Training Trial to strengthen the findings of this process evaluation., Ethics and Dissemination: Ethical approval for the Early and Intensive Motor Training Trial and process evaluation has been obtained from the Human Research Ethics Committee at the Northern Sydney Local Health District (New South Wales) in Australia (project identifier: 2020/ETH02540). All participants are required to provide written consent after being informed about the trial and the process evaluation. The results of this process evaluation will be published in peer-reviewed journals., Trial Registration Number: Australian New Zealand Clinical Trial Registry (ACTRN12621000091808); Universal Trial Number (U1111-1264-1689)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Using a knowledge-attitudes-behavior practice (KABP) paradigm, professionals have focused on educating the public in biomedical explanations of mental illness. Especially in high-income countries, it is now common for education-based campaigns to also include some form of social contact and to be tailored to key groups. However, and despite over 20 years of high-profile national campaigns (e.g., Time to Change in England; Beyond Blue in Australia), examinations suggest that the public continue to Other those with experiences of mental ill-health. Furthermore, evaluations of anti-stigma programs are found to have weak- to no significant long-term effects, and serious concerns have been raised over their possible unintended consequences. Accordingly, this article critically re-engages with the literature. We evidence that there have been systematic issues in problem conceptualization. Namely, the KABP paradigm does not respond to the multiple forms of knowledge embodied in every life, often outside conscious awareness. Furthermore, we highlight how a singular focus on addressing the public's perceived deficits in professionalized forms of knowledge has sustained public practices which divide between "us" and "them." In addition, we show that practitioners have not fully appreciated the social processes which Other individuals with experiences of mental illness, nor how these processes motivate the public to maintain distance from those perceived to embody this devalued form of social identity. Lastly, we suggest methodological tools which would allow public health professionals to fully explore these identity-related social processes. Whilst some readers may be frustrated by the lack of clear solutions provided in this paper, given the serious unintended consequences of anti-stigma campaigns, we caution against making simplified statements on how to correct public health campaigns. Instead, this review should be seen as a call to action. We hope that by fully exploring these processes, we can develop new interventions rooted in the ways the public make sense of mental health and illness., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Walsh and Foster.)

Background: Understanding the resilience of healthcare is critically important. A resilient healthcare system might be expected to consistently deliver high quality care, withstand disruptive events and continually adapt, learn and improve. However, there are many different theories, models and definitions of resilience and most are contested and debated in the literature. Clear and unambiguous conceptual definitions are important for both theoretical and practical considerations of any phenomenon, and resilience is no exception. A large international research programme on Resilience in Healthcare (RiH) is seeking to address these issues in a 5-year study across Norway, England, the Netherlands, Australia, Japan, and Switzerland (2018-2023). The aims of this debate paper are: 1) to identify and select core operational concepts of resilience from the literature in order to consider their contributions, implications, and boundaries for researching resilience in healthcare; and 2) to propose a working definition of healthcare resilience that underpins the international RiH research programme., Main Text: To fulfil these aims, first an overview of three core perspectives or metaphors that underpin theories of resilience are introduced from ecology, engineering and psychology. Second, we present a brief overview of key definitions and approaches to resilience applicable in healthcare. We position our research program with collaborative learning and user involvement as vital prerequisite pillars in our conceptualisation and operationalisation of resilience for maintaining quality of healthcare services. Third, our analysis addresses four core questions that studies of resilience in healthcare need to consider when defining and operationalising resilience. These are: resilience 'for what', 'to what', 'of what', and 'through what'? Finally, we present our operational definition of resilience., Conclusion: The RiH research program is exploring resilience as a multi-level phenomenon and considers adaptive capacity to change as a foundation for high quality care. We, therefore, define healthcare resilience as: the capacity to adapt to challenges and changes at different system levels, to maintain high quality care. This working definition of resilience is intended to be comprehensible and applicable regardless of the level of analysis or type of system component under investigation.