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The core of Beverton and Holt's seminal work of the 1950s had been anticipated by Baranov 30 years earlier, but his contributions, published in Russian, remained poorly known to Anglophone scientists until after 1945. By that time, Russell and Graham had presented parallel ideas, though without Baranov's mathematics. Limited subsequent acknowledgement of the Russian's contributions has left an impression that each of his advances was achieved independently in England, hence that they contributed little to the Beverton–Holt model. I here construct a timeline of events linking and separating the Russian and English studies. From it, I argue that both Russell's presentation of the underlying concepts and Graham's decision to pursue a mathematical realization of his "Modern Theory" may have been influenced by translations of Baranov's papers. Moreover, when Holt developed the "simple" Beverton–Holt model during 1946–1947, he certainly drew on Baranov's exponential model of mortality, though perhaps only via Ricker. [ABSTRACT FROM AUTHOR]

Objectives There are few papers concerning ethnic differences in disease expression in PsA, which may be influenced by a number of genetic, lifestyle and cultural factors. This article aims to compare clinical and radiographic phenotypes in people of South Asian (SA) and North European (NE) origin with a diagnosis of PsA. Methods This was a cross-sectional observational study recruiting patients of SA and NE origin from two hospitals in a well-defined area in the North of England. Results A total of 58 SA and 48 NE patients were recruited. SA patients had a more severe clinical phenotype with more tender (median 5 vs 2) and swollen (median 1 vs 0) joints, more severe enthesitis (median 3 vs 1.5), more patients with dactylitis (24% vs 8%), more severe skin disease (median PASI 2.2 vs 1) and worse disease activity as measured by the composite Psoriatic Arthritis Disease Activity Score (mean 4.5 vs 3.6). With regards to patient-completed measures, SA patients had worse impact with poorer quality of life and function (mean HAQ 0.9 vs 0.6; mean PsAQoL 10.8 vs 6.2; mean 36-item short form physical component score 33.5 vs 38.9). No significant differences in current MTX and biologics use were found. Conclusions SA patients had a worse clinical phenotype and worse impact of disease than NE patients. Further studies are needed to confirm and explore the reasons behind these differences. [ABSTRACT FROM AUTHOR]

Background: Induced abortion is a common procedure. However, there is marked variation in accessibility of services across England. Accessing abortion services may be difficult, particularly for women who live in remote areas, are in the second trimester of pregnancy, have complex pre-existing conditions or have difficult social circumstances.Objective and Rationale: This article presents a two-part review undertaken for a new National Institute of Health and Care Excellence guideline on abortion care, and aiming to determine: the factors that help or hinder accessibility and sustainability of abortion services in England (qualitative review), and strategies that improve these factors, and/or other factors identified by stakeholders (quantitative review). Economic modelling was undertaken to estimate cost savings associated with reducing waiting times.Search Methods: Ovid Embase Classic and Embase, Ovid MEDLINE(R) Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid MEDLINE(R), PsycINFO, Cochrane Library via Wiley Online, Cinahl Plus and Web of Science Core Collection were searched for articles published up to November 2018. Studies were included if they were published in English after 2001, conducted in Organization for Economic Co-operation and Development (OECD) countries and were: qualitative studies reporting views of patients and/or staff on factors that help or hinder the accessibility and sustainability of a safe abortion service, or randomized or non-randomized studies that compared strategies to improve factors identified by the qualitative review and/or stakeholders. Studies were excluded if they were conducted in OECD countries where abortion is prohibited altogether or only performed to save the woman's life. One author assessed risk of bias of included studies using the following checklists: Critical Appraisal Skills Programme checklist for qualitative studies, Cochrane Collaboration quality checklist for randomized controlled trials, Newcastle-Ottawa scale for cohort studies, and Effective Practice and Organization of Care risk of bias tool for before-and-after studies.Qualitative evidence was combined using thematic analysis and overall quality of the evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE) Confidence in the Evidence from Reviews of Qualitative Research (CERQual). Quantitative evidence was analysed in Review Manager 5.3 and overall quality of evidence was assessed using GRADE.Outcomes: Eight themes (service level barriers; financial barriers; logistical barriers; personal barriers; legal and policy barriers; privacy and confidentiality concerns; training and education; community prescribing and telemedicine introduce greater flexibility) and 18 subthemes were identified from 23 papers (n = 1016) included in the qualitative review. The quality of evidence ranged from very low to high, with evidence for one theme and seven subthemes rated as high quality. Nine studies (n = 7061) were included in the quantitative review which showed that satisfaction was better (low to high quality evidence) and women were seen sooner (very low quality evidence) when care was led by nurses or midwives compared with physician-led services, women were seen sooner when they could self-refer (very low quality evidence), and clinicians were more likely to provide abortions if training used an opt-out model (very low quality evidence). Economic modelling showed that even small reductions in waiting times could result in large cost savings for services.Wider Implications: Self-referral, funding for travel and accommodation, reducing waiting times, remote assessment, community services, maximizing the role of nurses and midwives and including practical experience of performing abortion in core curriculums, unless the trainee opts out, should improve access to and sustainability of abortion services. [ABSTRACT FROM AUTHOR]

The article focuses on the quarto editions (Q4) of William Shakespeare's plays, which were issued without title page dates in England. It was hypothesized that Q4 of "Romeo and Juliet" and Q4 of "Hamlet" dated 1622 and 1625, had influenced the text of the First Folio on its attempt to adduce hypothesized evidence. The author explains how and why the paper be useful for dating and the prescribed method for collecting and analyzing paper data. In addition, the comparative analysis of paper stocks is being made, including the watermarks, which can be a powerful forensic tool for dating imprints decisively.

Background: The Public Health Responsibility Deal (RD) is a public--private partnership in England involving voluntary pledges between government, and business and other public organizations to improve public health. One such voluntary pledge refers to the reduction of trans fatty acids (TFAs) in the food supply in England by either pledging not to use artificial TFAs or pledging artificial TFA removal. This paper evaluates the RD's effectiveness at encouraging signatory organizations to remove artificially produced TFAs from their products. Methods: We analysed publically available data submitted by RD signatory organizations. We analysed their plans and progress towards achieving the TFAs pledge, comparing 2015 progress reports against their delivery plans. We also assessed the extent to which TFAs reductions beyond pre-2011 levels could be attributed to the RD. Results: Voluntary reformulation via the RD has had limited added value, because the first part of the trans fat pledge simply requires organizations to confirm that they do not use TFAs and the second part, that has the potential to reduce use, has failed to attract the participation of food producers, particularly those producing fast foods and takeaways, where most remaining use of artificial TFAs is located. Conclusions: The contribution of the RD TFAs pledges in reducing artificial TFAs from England's food supply beyond pre-2011 levels appears to be negligible. This research has wider implications for the growing international evidence base voluntary food policy, and offers insights for other countries currently undertaking work to remove TFAs from their food supply. [ABSTRACT FROM AUTHOR]

Background: This paper proposes that Population Impact Measures (PIMs), the Population Impact Number of Eliminating a Risk Factor over a time period (PIN-ER-t) and the number of events prevented in your population (NEPP), can assist in policy making as they include relevant information which describes the impact or benefits to the population of risk factors and interventions. In this study, we explore the utilization of the indicators from European System of Urban Health Indicators System to produce the two PIMs. Methods: We identified from the indicators list the health determinants, health status and health interventions which can be linked, and searched Medline for evidence of association. We then investigated whether the type of frequency measure available for the indicator match with the measure used in PIMs, and explored data availability for the City of Manchester (UK) as an urban area. Results: Of the 39 indicators relevant to socio-economic factors, health determinants and health status, it was possible to calculate the population impact of a risk factor, i.e. the PIN-ER-t, for only six associations, and the population impact of health interventions, i.e. NEPP, for only one out of the three listed indicators, as the relevant health conditions were not included. Conclusions: The results of this study suggest that if an indicator system is intended to play a part in the policy making process, then the method of presentation to policy-makers should be decided before setting up the system, as it is likely that some indicators which would be essential might not be available. [ABSTRACT FROM AUTHOR]

Quality Issue: Approximately 10% of patients are harmed by healthcare, and of this harm 15% is thought to be medication related. Despite this, medication safety data used for improvement purposes are not often routinely collected by healthcare organizations over time.Initial Assessment: A need for a prospective medication safety measurement tool was identified.Choice Of Solution: The aim was to develop a tool to allow measurement and aid improvement of medication safety over time. The methodology used for the National Health Service (NHS) Safety Thermometer was identified as an approach. The resulting tool was named the 'Medication Safety Thermometer'.Implementation: The development of the Medication Safety Thermometer was facilitated by a multidisciplinary steering group using a Plan, Do, Study, Act (PDSA) method. Alpha and beta testing occurred over a period of 9 months. The tool was officially launched in October 2013 and continued to be improved until May 2016 using ongoing user feedback.Evaluation: Feedback was gained through paper and online forms, and was discussed at regular steering group meetings. This resulted in 16 versions of the tool. The tool is now used nationally, with over 230 000 patients surveyed in over 100 NHS organizations. Data from these organizations are openly accessible on a dedicated website.Lessons Learned: Measuring harm from medication errors is complex and requires steps to measure individual errors, triggers of harm and actual harm. PDSA methodology can be effectively used to develop measurement systems. Measurement at the point of care is beneficial and a multidisciplinary approach is vital. [ABSTRACT FROM AUTHOR]

Background Sustaining public health programmes in the long-term is key to ensuring full manifestation of their intended benefits. Although an increasing interest in sustainability is apparent within the global literature, empirical studies from within the European setting are few. The factors that influence sustainability are generally conceptualized at three levels: programme level, the immediate context and the wider environment. To-date attention has focused primarily on the former two. Using a community-based child injury prevention programme in England as an exemplar, this paper explores the concept of sustainability within the wider policy environment, and considers the impact of this on local programmes. Methods A content review of global and UK national public health policies (1981-2014) relevant to child safety was undertaken. Interviews were held with senior representatives of global and UK agencies involved in developing child safety policy. Results Forty-nine policies were reviewed. The term 'sustain', or its derivatives, featured in 36 (73%) of these. Its' use however, related primarily to conservation of resources rather than continued programme operation. Potential mechanisms for supporting programme sustainability featured within some documents; however, the approach to sustainability was inconsistent between policies and over time. Policy stakeholders identified programme sustainability as relevant to their core business, but its' conceptualization varied according to individual interpretation. Conclusions Programme sustainability is poorly addressed within global and UK-based public health policy. Strengthening a national and international policy focus on sustainability and incorporating sustainability into public health planning frameworks may create a more supportive environment for local programmes. [ABSTRACT FROM AUTHOR]

The relationship between the police and the news media is an integral part of how police forces communicate into the public sphere. Using, as a benchmark, Chibnall's influential account of English crime reporting, Law-and-Order News, and drawing on Habermas's concept of the public sphere, this paper examines the contemporary police–media relationship. It analyses the rise of police corporate communications against the apparent decline of specialist crime reporting drawing on interviews with crime reporters, police communications managers and a survey of police forces in England, Wales and Scotland. The paper concludes that ‘law-and-order news’ currently remains contested but the relationship is increasingly asymmetrical in favour of the police. [ABSTRACT FROM PUBLISHER]

This paper presents a selection of the findings of a larger empirical research study into the mode of trial decisions in two English magistrates' courts (Cammiss 2005). While the interests of victims within the criminal justice process have recently risen up the political agenda, researchers and policy makers have said little on the place of the victim within the mode of trial hearing. This paper addresses the treatment of domestic violence victims in the mode of trial hearing and shows how, when compared with similar offences, cases of domestic violence are more likely to be disposed of in the magistrates' court rather than the Crown Court. The role of the prosecutor in managing information placed before the court is examined and the consequences for the airing of victims' stories are explored. [ABSTRACT FROM AUTHOR]

This paper examines the rich possibilities for social history opened up by the cultural turn. Focusing on the interplay of myth, memory, and place, it begins with the Kymin, a hillside site outside the Welsh border town of Monmouth. In about 1800 this site was carefully remodelled to invest it with a series of meanings—urban/rural, enlightened/romantic, Welsh/English/British—through which those who visited it were able to explore and express their ambivalent identities. The eighteenth-century spa of Bath was also "symbolic territory," and in one of its iconic structures, the Circus, myth, memory, and place combined to allow the elite to examine similar issues of identity to those at the Kymin. Central to the mythical element in both sites was the notion of the hero. It was an idea that was to resurface on a grand scale in late Victorian and Edwardian Bath, as the city's historic fabric was reconfigured as a "mausoleum" to Britain's Georgian imperial heroes. The paper concludes by arguing that the identities examined in the paper were closely tied to ones of social class, and that the way forward for social history is a fusion of the cultural and the structural that emphasizes the interaction between the two. [ABSTRACT FROM AUTHOR]

The 1990 Victim's Charter created an obligation for the Probation Service in England and Wales to contact the victims, or their families, of life sentence prisoners prior to any consideration of the offender's release to enquire whether they have anxieties about the release. In 1996 this was broadened to include the victims of ‘serious violent or sexual offences’. The implementation of the Victim's Charter requirements has been both hesitant and variable across different Probation Services. This paper considers some of the findings of a study of victim contact work in the Probation Service and their implications, particularly with regard to the views and experiences of victims. The research fieldwork focused on the practice response to the Victim's Charter requirements of two Probation Services, both of which had in place nationally recognized, coherent and yet different models of victim contact service delivery. This paper examines the impact of victim contact work upon victims, the management of offenders and the Probation Service. It explores some of the ambiguities and tensions in translating policy initiatives concerning the needs of victims into the delicate balance of criminal justice. [ABSTRACT FROM AUTHOR]

Background: concern over the sustainability of the National Health Service (NHS) is often focussed on rising numbers of hospital admissions, particularly among older people. Hospital admissions are enumerated routinely by the Hospital Episode Statistics (HES) Service, but published data do not allow individual-level service use to be explored. This study linked information on Hertfordshire Cohort Study (HCS) participants with HES inpatient data, with the objective of describing patterns and predictors of admissions among individuals.Methods: 2,997 community-dwelling men and women aged 59–73 years completed a baseline HCS assessment between 1998 and 2004; HES and mortality data to 31 March 2010 were linked with the HCS database. This paper describes patterns of hospital use among the cohort at both the admission and individual person level.Results: the cohort experienced 8,741 admissions; rates were 391 per 1,000 person-years among men (95% CI: 380, 402) and 327 among women (95% CI: 316, 338), P < 0.0001 for gender difference. A total of 1,187 men (75%) and 981 women (69%) were admitted to hospital at least once; among these, median numbers of admissions were 3 in men (inter-quartile range, (IQR): 1, 6) and 2 in women (IQR: 1, 5). Forty-eight percent of those ever admitted had experienced an emergency admission and 70% had been admitted overnight.Discussion: It is possible to link routinely collected HES data with detailed information from a cohort study. Hospital admission is common among community-dwelling ‘young-old’ men and women. These linked datasets will facilitate research into lifecourse determinants of hospital admission and inform strategies to manage demand on the NHS. [ABSTRACT FROM AUTHOR]

Introduction: Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. PA interventions for community-dwelling older adults are often delivered by healthcare professionals, fitness instructors or trained members of a research team. Innovative approaches are needed to ensure that these interventions are practical and sustainable.This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods: Following PRISMA recommendations, five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched until May 2019, for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years, reporting on participant outcomes. Meta-analysis was not conducted due to included study heterogeneity. Results: Twelve papers (eight studies including three randomised controlled trials (RCTs)) were included in the review; five papers reported different outcomes from the same RCT. Intervention settings included community exercise groups (n=4), home (n=2) and care homes (n=2). All eight studies included strength and balance exercises and frequency of PA ranged from once daily to weekly sessions. The three RCTs showed improvement in grip strength, nutritional and frailty status, and reduction in fear of falling, among 39 older adults (mean age 83 years) who received a physical training and nutritional intervention; improvement in grip strength and activity of daily living scores among 56 nursing home older adults (mean age 78 years) who received resistance exercise training; and a significantly higher proportion of older adults (n = 193, 9% improvement vs 0.5% in the control group) achieved the recommended target of 150 minutes of moderate vigorous PA per week using the Falls Management Exercise intervention. Two studies compared volunteer and health professional-delivered PA interventions and reported that both interventions were equally effective in reducing fear of falls and improving quality of life. Two quasi-experimental studies reported improvement in functional outcomes including functional reach, timed up and go test, and chair stand. A large prospective cohort study (n = 1620) reported a reduction in disability among older adults who received volunteer-led exercise compared to control, with a hazard ratio of 0.73 (95% CI 0.62-0.86) for development of disability. Conclusions: Trained volunteers can lead PA interventions among community-dwelling older adults with some evidence of improved health outcomes including nutritional, functional and frailty status. [ABSTRACT FROM AUTHOR]

Introduction: In contrast to other medical specialties, trainees in Geriatrics have historically provided an increased contribution to clinical workload in General Internal Medicine and a reduced output of academic achievements. More recently, development of non-clinical skills has been recognised to have similar importance to clinical skills and the South East (SE) London Geriatrics Training Programme has thus supported trainees in applications for Out of Programme (OOP) opportunities to optimise career progression. Methods: Doctors who had undertaken specialist registrar training in the SE London Geriatrics Training Programme at any time between 2011 and 2019 were sent a questionnaire to assess whether they had completed time OOP and whether they had been awarded research grants, published papers in peer-reviewed journals, had abstracts accepted for presentation at conferences, and/or published book chapters during their training programme. Chisquared and Wilcoxon rank-sum tests were used to compare data between registrars who had completed time OOP and those who had not taken time OOP. Results: 77 (24 male; 53 female) registrars completed training in the SE London Geriatrics Training Programme between 2011 and 2019. 71 registrars (92%) completed the questionnaire, of whom 31 (44%) completed time OOP. In total, registrars were awarded 15 research grants, published 86 papers in peer-reviewed journals, had abstracts accepted for 184 conference presentations and published 20 book chapters. A notably increased proportion of registrars who took time OOP had an output of research grants, papers published in peer reviewed journals, abstracts accepted for presentation at conferences and/or book chapters respectively compared with registrars who had not taken time OOP (23% vs 5% ; 61% vs 23%; 84% vs 33%; 45% vs 5%). This equated to a combined academic output in 94% of registrars who completed time OOP compared with 48% who did not (p <0.001). Conclusions: A very strong association existed between registrars in Geriatrics taking time OOP and academic achievement substantiating the training programme’s aspiration to support development of non-clinical skills that may be helpful to trainees in their future careers. It would be worthwhile further work being undertaken in this area in other regions. [ABSTRACT FROM AUTHOR]

This paper addresses the effects of recent political and economic trends on the construction of forensic science in England and Wales. Using documentary sources and fieldwork, I show how neo-liberal initiatives have differentially reconstructed relationships between forensic scientists and the police. I argue that this stems from contested interpretations of scientific integration that have selectively appropriated elements of neo-liberalism. Neo-liberal reform of forensic science has, however, exposed actors to new risks, culminating in the UK Government's announcement to close the Forensic Science Service. Yet, rather than representing the end of ‘marketization’, debates concerning the organization of forensic science have entered a new phase. These hold significant implications for understanding the relationship between crime, science and advanced liberal governance. [ABSTRACT FROM PUBLISHER]

This paper presents a new definition of fear of crime that integrates two conceptual developments in this enduring field of criminological enquiry. Our measurement strategy differentiates first between specific worries and diffuse anxieties in emotional responses to crime, and second between productive and counterproductive effects on subjective well-being and precautionary activities. Drawing on data from a representative survey of seven London neighbourhoods, these distinctions are combined into an ordinal scale that moves from the ‘unworried’, to low-level motivating emotions, to frequent and dysfunctional worry about crime. We demonstrate that different categories of ‘fear’ have different correlates and explain different levels of variation in public confidence in policing. We conclude with a call for more longitudinal research to uncover the dynamic nature of fear of crime over the life course. [ABSTRACT FROM PUBLISHER]

In April 2009, at the Association of Physicians of Great Britain and Ireland (APGBI) Annual Meeting in Birmingham, a workshop was held to consider the changing demographics of the medical profession, its potential effects on the Association’s stated aims of promoting academic excellence and ways of ensuring that medical academia is attractive to everyone with the ability and drive it needs. This paper reports the discussions of the workshop participants and also summarises recommendations for actions by both the Association and its membership, which will encourage interest, equal opportunities and personal development for all in academic medicine. [ABSTRACT FROM PUBLISHER]

It is 21 years since the publication of the author's Flashpoints: Studies in Public Disorder. In this book, and in subsequent publications, David Waddington and his colleagues have outlined and refined the so-called Flashpoints Model of Public Disorder, which has underpinned separate analyses of orderly and disorderly crowd events in Britain, Europe, Asia, Australasia, and North and South America. The model has had its critics and detractors—the most recent being Paul Bagguley and Yasmin Hussain, who level several criticisms at the model in their book, Riotous Citizens: Ethnic Conflict in Multicultural Britain, an analysis of the 2001 Bradford riot. This paper not only addresses these criticisms, but uses Bagguley and Hussain's own account as the basis of a re-analysis of the Bradford riot in terms of the flashpoints model. [ABSTRACT FROM PUBLISHER]

Abstract: This essay is a personal reflection on John Long’s keynote address at the BCS People and Computers meeting in Nottingham in the summer of 1989. I try to locate the paper’s purpose and significance within the history of human-computer interaction (HCI), both prior to 1989 and subsequently, and particularly with respect to the abiding questions of what sort of enterprise HCI is, and of what sorts of knowledge it uses and produces. [Copyright &y& Elsevier]

The article presents the author's comment with regard to the concern of English naturalist Charles Darwin on first cousin marriage in England. According to the author, Darwin was worried about heredity and the consequences of cousin marriage. A paper published by Darwin's son George, which recommends to avoid cousin marriage should be avoided is mentioned. Charles Darwin endorsed George's conclusion that cousin marriage might be quite all right for the reach but bad for the poor.

We have performed a detailed population study of patients with genetic muscle disease in the northern region of England. Our current clinic population comprises over 1100 patients in whom we have molecularly characterized 31 separate muscle disease entities. Diagnostic clarity achieved through careful delineation of clinical features supported by histological, immunological and genetic analysis has allowed us to reach a definitive diagnosis in 75.7% of our patients. We have compared our case profile with that from Walton and Nattrass’ seminal study from 1954, also of the northern region, together with data from other more recent studies from around the world. Point prevalence figures for each of the five major disease categories are comparable with those from other recent studies. Myotonic dystrophies are the most common, comprising 28.6% of our clinic population with a point prevalence of 10.6/100 000. Next most frequent are the dystrophinopathies and facioscapulohumeral muscular dystrophy making up 22.9% (8.46/100 000) and 10.7% (3.95/100 000) of the clinic population, respectively. Spinal muscular atrophy patients account for 5.1% or 1.87/100 000 patients. Limb girdle muscular dystrophy, which was described for the first time in the paper by Walton and Nattrass (1954) and comprised 17% of their clinic population, comprises 6.2% of our clinic population at a combined prevalence of 2.27/100 000. The clinic population included patients with 12 other muscle disorders. These disorders ranged from a point prevalence of 0.89/100 000 for the group of congenital muscular dystrophies to conditions with only two affected individuals in a population of three million. For the first time our study provides epidemiological information for X-linked Emery–Dreifuss muscular dystrophy and the collagen VI disorders. Each of the X-linked form of Emery–Dreifuss muscular dystrophy and Ullrich muscular dystrophy has a prevalence of 0.13/100 000, making both very rare. Bethlem myopathy was relatively more common with a prevalence of 0.77/100 000. Overall our study provides comprehensive epidemiological information on individually rare inherited neuromuscular conditions in Northern England. Despite the deliberate exclusion of relatively common groups such as hereditary motor and sensory neuropathy (40/100 000) and mitochondrial disorders (9.2/100 000), the combined prevalence is 37.0/100 000, demonstrating that these disorders, taken as a group, encompass a significant proportion of patients with chronic disease. The study also illustrates the immense diagnostic progress since the first regional survey over 50 years ago by Walton and Nattrass. [ABSTRACT FROM PUBLISHER]

This paper reviews two key initiatives undertaken in the historical city of Oxford to bring about reductions in energy-related CO2 emissions on a dwelling-level as well as city-wide scale, using both bottom-up and top-down carbon-counting approaches. The development and application of a bottom-up carbon-counting approach called DECoRuM is described. DECoRuM is a Geographical Information System-based software model which estimates and maps baseline energy use and CO2 emissions on a house-by-house level, identifies ‘pollution’ hotspots, predicts the potential for reductions in CO2 emissions and monitors reductions achieved as a result of deploying energy efficiency measures and renewable energy systems. The application of DECoRuM model to a case study in Oxford shows that CO2 emission reductions above 60% are possible, at a cost of between £6 and £77 per tonne of CO2 emissions saved, depending upon the package of measures used and the scenario of capital costs (low or high) employed. Alongside DECoRuM, the author has led the development of an action-oriented Oxford Climate Change Action Plan (OCCAP) which uses top-down approaches to construct an accurate CO2 emissions inventory for Oxford city for a baseline year, establish CO2 reduction targets and propose action for each of the energy-related sectors to meet those targets. These two different, but complimentary, approaches provide a useful example for other cities in their endeavour for emission reductions. [ABSTRACT FROM PUBLISHER]

This paper provides an estimate of the impact of educational attainment on juvenile conviction rates using information at the Local Education Authority in England. The empirical analysis uses aggregate conviction rates over time for three cohorts of young people, born between 1981 and 1983, and their corresponding educational attainments, poverty indicators, time away from school and school resources. Results using mixed-effects models show that the increase in educational attainment between cohorts is associated with reductions in conviction rates for most offences (burglary, theft, criminal damage and drug-related offences) but not for violent crime. Reductions in poverty are associated with decreasing conviction rates for violent crime, criminal damage and drug-related offences, whereas increasing unauthorized time away from school is associated with higher convictions rates for theft. The results are important, as they complement current empirical studies by looking at the impact of education on cohort-specific conviction rates over time and at the impact of education on different types of offences. [ABSTRACT FROM AUTHOR]

In this paper, we draw on our experience as evaluators of three restorative justice schemes in England and Wales which were funded under the auspices of the Home Office's 'Grime Reduction Programme' to reflect upon the theoretical and empirical potential of restorative justice (in particular, conferencing) to bring about reductions in reoffending on the part of participating offenders. We propose that there is a case to be made for a subtle shift in ways of thinking about the recidivism reduction potential of restorative justice: that is, as an opportunity to facilitate a desire, or consolidate a decision, to desist. [ABSTRACT FROM AUTHOR]

Aims: This paper describes prevalences, time-trends and characteristics of self-reported never-drinkers, during the period 1994-2003, focussing particularly on white adults aged 18-54. Methods: Data on 122,809 adults (18+) were obtained from the Health Survey for England (HSfE). Logistic regressions were used to estimate time trends in self-reported never-drinking, and associations between never-drinking and living alone, and educational qualification. Analyses were stratified by gender, age group and period. Results: The overall proportion of white, female never-drinkers was 5.5%, rising monotonically with age. Proportions among men were much lower, with the lowest proportion (1.1%) in the 30-54 age group. Odds of never-drinking increased by 3% per year in those aged 30-54, a trend not explained by any covariates. Smaller increases were seen among those aged 18-29. Never-drinking was strongly associated with living with another adult and with lower qualification. The association with qualification increased over time among young women, and the association with living with another adult increased among men aged 30-54. Conclusions: : Never-drinkers are a significant minority in England, whose prevalence rose, between 1994 and 2003, among adults aged under 55 years. The prevalence varies considerably by age, sex, and social characteristics, and the social discrepancies in never-drinking appear to be widening. [ABSTRACT FROM AUTHOR]

In order to reduce the level of youth offending in England and Wales, the Association of Chief Police Officers and the Youth Justice Board have emphasized the importance of multi-agency work. Recent years have witnessed the introduction of `robust' community interventions for young offenders, including the Intensive Supervision and Surveillance Programme (ISSP). This paper assesses the involvement of the police in ISSP, as well as the wider contribution of police officers to youth offending teams (YOTs). Whilst the study identified ‘good practice’ in relation to intelligence-led policing and joined-up youth justice intervention, there was some variability amongst ISSP schemes and YOTs. In some contrast to the findings of Burnett and Appleton (2004), the specific contribution of police officers to youth justice work was regarded by civilian practitioners and police officers themselves as unique and specialized. Following de Lint (2003), it was found that the police are key in terms of ‘brokering access’ to young offenders. [ABSTRACT FROM AUTHOR]

Most American and English cancer patients prefer to die at home. Factors associated with greater likelihood of dying at home have been contradictory in many studies and no studies have compared the effects of factors in different countries. The objective of this paper is to compare the factors affecting place of cancer death in two major cities, New York and London. Methods: We use data on all individuals aged ≥40 dying of cancer in London (59604) and New York City (51 668) in the years 1995 through 1998. The probability of death at home is examined in each city as a function of gender, age group (40-55, 56-64, 65-74, 75+), year, type of cancer, and area socioeconomic status, using multiple logistic regression. Results: Although the probability of death at home is the same in the two cities (∼1 in 5), being female lowers the odds of death at home by ∼7% in London, and raises it by ∼22% in New York. Older age is associated with increased odds of dying at home in New York but decreased odds of dying at home in London. Being in the lowest tercile of socioeconomic status (relative to the highest) lowers the odds of death at home by 22% in London and 39% in New York. Conclusion: Site of death varies significantly by patient and area characteristics in both cities, an understanding, which should be taken account of in future planning of end-of-life care. [ABSTRACT FROM AUTHOR]

This paper considers the extent to which the Government's declared intentions to unite youth justice practice cultures around a common emphasis on preventing offending through early criminal justice intervention have been realized in practice. Based on interviews with a range of practitioners in Wales in 2003/04, it examines their priorities and underlying objectives. It outlines a complex pattern of change in which concern for the welfare of young offenders has been not so much marginalized as reconstituted in more conditional terms. The article questions whether this complexity can be adequately captured by suggestions of a 'punitive turn' in youth justice. [ABSTRACT FROM AUTHOR]

Pawson, M. G., Kupschus, S., and Pickett, G. D. 2007. The status of sea bass (Dicentrarchus labrax) stocks around England and Wales, derived using a separable catch-at-age model, and implications for fisheries management. – ICES Journal of Marine Science, 64: 346–356. The commercial fishery for sea bass (Dicentrarchus labrax) around the coasts of England and Wales developed rapidly in the late 1970s and 1980s and, by 1986, involved some 3000 fishers using more than 2000 boats to make landings worth £3–4 million. The estimated annual catch of sea bass by sport-anglers was similar to the level recorded from the commercial fishery. Sampling of landings showed strong evidence of growth-overfishing in many areas, and a package of technical measures was introduced in 1990 aimed at improving the exploitation pattern and yield per recruit. This paper describes how data collected through a fishery and biological sampling programme around England and Wales over the period 1985–2004 have been utilized in a separable catch numbers-at-age model to assess the dynamics of sea bass stocks in English and Welsh coastal waters. The model output shows that recruitment improved during the 1990s and that moderate levels of fishing mortality allied to an exploitation pattern that largely avoids juvenile fish have enabled the bass population and its fishery to develop sustainably. Results are discussed in relation to model development and management of the bass fishery. [ABSTRACT FROM PUBLISHER]

The environmental impact of the UK building stock has increased the pressure on architects, engineers and building operators to reduce the use of air conditioning in favour of more passive cooling solutions. Good progress has been made in this direction but many passive solutions are limited to new-build projects. For existing buildings, and those for which mechanical air conditioning cannot be avoided, low energy cooling capability can be incorporated to improve significantly overall efficiency. This paper focuses on one such example – cooling using groundwater, which has gained popularity in recent years in the London area. Among the reasons for this are the excellent energy efficiency and the increasing viability of water abstraction systems. [ABSTRACT FROM AUTHOR]

Drawing on surveys of 4,860 prisoners 'perceptions of the quality of prison life in 49 establishments in England and Wales, this paper examines the extent to which prisoners viewed race relations in prison as problematic. Emphasis was placed upon how aspects of race relations were rated by different ethnic groups, and in individual prisons. Significant differences were found between prisons of the same security category. The findings support those of previous studies in that they raise concerns about the treatment of ethnic minority prisoners, particularly in some prisons. Attention was also paid to the role of gender, age and the security category of the prison. Ethnic minority prisoners tended to rate the quality of race relations in prison more poorly than their White counterparts. Large proportions amongst all ethnic minority groups felt that they were subject to unfair treatment compared to the White majority. On the whole, female prisoners were more likely than males to rate the quality of race relations more favourably, as were adult prisoners in comparison to their young counterparts. Gender and age had a considerable impact on the views of ethnic minority prisoners on the quality of race relations in the establishment. Perceived quality of race relations was significantly associated with prisoners' views on more general aspects of their treatment in prison, such as respect, humanity, fairness, relationships with staff and safety. Neither the ethnic composition of each prison's population nor the respective ratio of White to ethnic minority staff had a significant impact on how prisoners viewed the quality of race relations. These results suggest, amongst other things, that perceptions of the legitimacy of penal practices differ significantly between age and ethnic groups, and that attempts to reduce discrimination work more effectively in relation to distributive practices than in relation to attitudes and general treatment. [ABSTRACT FROM AUTHOR]

Book reviewed:Julian Go and Anne L. Foster, eds.The American Colonial State in the Philippines, Global Perspectives. Durham, NC and London: Duke University Press, 2003. 312 pp. Index. $79.95 (cloth), $22.95 (paper). [ABSTRACT FROM AUTHOR]

British drugs legislation has recently been changed to reclassify cannabis from a Class B drug to a Class C one. The reclassification is intended to reflect more accurately the risks posed by cannabis relative to other drugs. The debate about reform of the British laws in regulating cannabis possession has tended to ignore the fact that even before cannabis was reclassified as a Class C drug, police officers often turned a 'blind eye' to cannabis offences, or else gave informal warnings. This paper examines the political background to reclassification. It then examines the factors that guide officers to use their discretion and informally dispose of cannabis offences. It goes on to consider the impact that reclassification may have on informal action. The data are drawn from a detailed study of the policing of cannabis prior to reclassification, conducted by the Institute for Criminal Policy Research. We demonstrate that a multiplicity of police, offender and situational factors, either alone or in combination, influence an officer's decision to take informal action on the street. We outline the potential for reclassification to generate a reduction in the use of informal disposals, which may create a `net-widening' effect, or an increase in use, which might lead to the offence being selectively decriminalized. The implications for both scenarios are considered. [ABSTRACT FROM AUTHOR]

Harold Shipman was an English general practitioner who murdered at least 215 of his patients between 1974 and 1998. A public inquiry is underway, but general practitioners and all doctors also need to consider the implications for their profession. The aim of this paper is to stimulate debate. Issues identified as important to consider include: trust between doctors; attitudes towards failing systems such as cremation certification; acceptance of the duty of accountability; ensuring patients can have reasonable confidence in their doctors; commitment to preventing such a case occurring again; and relationships with patients. It is argued that restricting debate to methods to detect doctors who murder would limit the opportunity to improve medical practice and would constitute a failure to fulfil the duty owed by doctors to Shipman's victims and their families. [ABSTRACT FROM AUTHOR]

The ubiquitous theme of 'joined-up' services in UK government thinking is exemplified by recent reforms to the youth justice system in England and Wales. Previous research on multi-agency approaches has distinguished between 'benevolent' and 'conspiratorial' interpretations of joined-up criminal justice and has identified complexities in turning the rhetoric into reality. In line with conspiratorial perspectives, New Labour's changes to the youth justice system have been seen as evidence of further departure from welfare-based work, towards increased punitiveness and managerialism. This paper reports findings from an in-depth case-study of one youth offending team and its partnerships, exploring the realities of collaboration on three levels: core practice; specialist projects; and strategic management. It was found that the social ethic has survival this overhaul of the youth justice system. [ABSTRACT FROM AUTHOR]

Background This paper evaluates claims in a recent study that inequalities in small area mortality rates have lessened. We examine the effect of differently estimated populations on time trends in age‐specific mortality rates for Yorkshire and the Humber and East of England. [ABSTRACT FROM PUBLISHER]

Background The continuing identification, assessment and management of risks are key themes for clinical governance. These themes are being integrated into both primary and secondary care practice; however, integration into public health practice appears much slower. This paper describes the recent approach that we have taken in Sheffield, and proposes a model for public health departments to identify, assess and manage risks, which complements other risk management processes and is transferable to other settings. It assumes that public health practice is not a risk‐free activity and holds that the process of identifying, assessing and managing risks is a key component to raising standards. [ABSTRACT FROM PUBLISHER]

This paper—which appears in two separate parts—traces the advent since 1945 of chief constables as significant commentators on both 'law and order' in particular and 'the state of the nation' more generally. Drawing upon autobiographies (and other writings), force annual reports, and interviews with serving and retired chiefs, we set out to understand how police elites have come to acquire the power to legitimately 'name', diagnose and classify social problems. We set out—in Part I—to chart the transformation of chief officers from powerful (but essentially) local figures in the 1950s and 1960s, through the rise of maverick, culturally prominent police heroes' in the 1970s, to the establishment of a more corporate (and generally liberal) police voice since the late 1980s; and document the themes, imagery and preoccupations that have characterized the senior police outlook during what we distinguish as three distinct periods of mobilization—1945-72, 1973-86 and 1987-present. In Part II (Loader and Mulcahy 2001), we proceed to develop a sociological interpretation of the emergence and subsequent transformation of the elite police voice. [ABSTRACT FROM AUTHOR]

Background: This paper presents an analysis of the English experience of setting and monitoring targets during the 1990s. It draws on two studies of the former national public health strategy, ‘Health of the Nation’ (HOTN). Methods: the two evaluations conducted 16 case studies between them, two in each health region in England. Over 250 individual and group interviews were conducted and over 400 documents were analysed. In eight health authorities, an analysis of expenditure was also carried out to determine what impact, if any, HOTN had on resource allocation. Results: Full results are published elsewhere. Lessons for the new strategy are as follows: i) the role of central government is key in ensuring that there is a consistent message across government in support of the health strategy and in fostering the development and dissemination of an evidence-base for public health, ii) The new strategy needs to address the underlying social and structural determinants of health and health inequalities directly, iii) Both studies found widespread support for targets as a helpful way to prioritise and focus efforts. However, national targets must be credible i.e. based on sound and convincing evidence. The development of local targets needs to be encouraged, and process targets should supplement outcomes locally and nationally, iv) The new strategy needs to be communicated widely – to broaden ownership outside the National Health Service, and include the public, v) To sustain momentum and ensure effective implementation, the strategy must be embedded in the performance management framework for health and local authorities, vi) Partnerships between key local agencies to work together for health need to be encouraged, either via a statutory framework or with other incentives. Discussion: The new English strategy, ‘Saving Lives’, is outlined in relation to the development of targets. The wider issues of a target-based approach to health policy include: i) Importance of distinguishing between the objective to ensure that policy is directed towards the achievement of health outcomes, and monitoring progress to ensure that health policy objectives are being achieved, ii) The role of targets as an inspiration as well as or instead of a management tool, iii) A target-based health policy should: set targets which are realistic, achievable and challenging; involve stakeholders; link targets to implementation; consider technical issues e.g. small numbers, availability of data; be based on evidence; express targets in terms of health improvement, iv) Target-based health policies should avoid: perverse incentives; distortion of data; too many targets; target setting without resources, v) The experience from England provides lessons for other European countries introducing a target-based approach to health policy. [ABSTRACT FROM AUTHOR]

Survey data indicate a substantial minority of westerners who have no attachment to Eastern or New Age religion but who nevertheless believe in reincarnation. This paper summarizes the findings of a small intensive interview study of group of English people who take seriously the possibility of reincarnation: 1) Many of them hold reincarnation alongside Christian belief; 2) Most are less than dogmatic about their belief; 3) Some entertain the possibility of reincarnation because of experience (first or second hand), for others reincarnation solves intellectual problems, e.g., concerning theodicy ; 4) They see bodily incarnations in the context of long-term spiritual Progress, and they value spirit over body; 5) Their belief in reincarnation has rather little effect on the rest of their lives. It is concluded that rising belief in reincarnation heralds neither a spiritual nor a moral revolution, but fits easily into the privatized religion that characterizes western social, and England in particular. [ABSTRACT FROM AUTHOR]

Discusses the factors that influence female theft in England from 1779-1789. Information on the social condition of women during the period; Difficulties encountered by women; Examination on the Old Bailey Sessions Papers; Data on the thefts in the 1780s.

Examines the inner thoughts of Chamberlain in the days prior to war in 1939 found in the National Liberal Club Library papers which were bought by Bristol University Library in England. Details on the contents of these documents; Evidence found in the documents on what Chamberlain understood by the British guarantee to Poland.

Introduction: Older women are increasingly undergoing surgery for gynaecological malignancies. Although survival data is available other outcomes such as functional recovery are less well described. However older people are both more vulnerable to changes in function and often prioritise function over survival. There is limited published research examining function outside of context of sexual or urodynamic function following gynaeoncology surgery but a large body or research exists examining health-related quality of life (HrQOL) both as a pre-operative risk factor for survival and as a post-treatment outcome measure in its own right. HRQOL tools may report on physical function as a subcomponent within composite tools. This systematic review and narrative synthesis describes functional recovery after gynaeoncology surgery with respect to baseline characteristics which - if identified – could enable pre- or post-operative risk reduction. Methods: Systematic search of MEDLINE and EMBASE databases and Cochrane Library between 1974-2018. Two reviewers independently reviewed abstracts/papers for inclusion against the following criteria: • Mean/median age >60 • Gynaeoncological treatment includes surgery (RCTs, observational or mixed methods studies). • Any measure of functional ability as defined by WHOICF classification section D1–D7 inclusive, D855, D860-79 and D9 using validated tool. • Minimum pre-operative and one post-operative measure. Results analysed and presented using narrative synthesis. Results: Sixteen studies identified (7 Endometrial, 2 Ovarian, 2 Vulval, 6 mixed cancer types). 1/16 used a standalone functional assessment tool, 15/16 used Health-Related Quality of Life tools (EORTC QLQ C30 (10), FACT-G (3), SF-36 (3)) comprising items describing function. More studies showed full recovery to baseline (n=11) than incomplete recovery (n=5 including 2 reporting age as a negative association). Recovery was more likely and occurred faster in minimally-invasive surgery. 1 study demonstrated failure to recover baseline functional independence by 12 months. [ABSTRACT FROM AUTHOR]

Introduction: There are multiple drivers to move healthcare into community settings, including people’s own homes. Traditional healthcare training, particularly medical training, is largely hospital-based, and hospital-based models of care. Few professions have explicit training in how best to assess an individual at home, and the additional elements to examine when visiting an induvial in their own home. To meet this training need Croydon Health Services were successful in a bid for funding to develop training to meet this gap. With this funding, a programme was developed and after attempts at simulation home visits in the simulation centre, a virtual reality (VR) home visit scenario was devised and filmed in the community using a professional actor to simulate a housebound individual. The recording was then professionally edited by a specialist VR team tomaximise its effectiveness including interactive educational elements. Methods: A pilot study examining the acceptability of the virtual reality home visit scenario was designed. A user group of medical staff with limited community experience participated in undertaking the virtual reality scenarios, delivered via SamsungNote 8 devices combined with Samsung Gear VR headsets. Feedback was received from participants by standardised paper-based surveys. Results: 7 responses were obtained. 100% of respondents described the scenario as easy to use, as well as agreeing that the same experience could not be gained from watching a standard video of the same scenario. 100% of respondents felt that the on-screen information was helpful. Feedback on areas for improvement suggested a desire for greater interactivity of other aspects of home assessment, and a desire to improve interactivity with the simulated patient, including history taking. Conclusions: Virtual reality home visit simulations are an acceptable and effective tool to introduce new concepts to staff. Further development should aim to maximise interactivity in the scenario and explore options for greater interaction with the simulated patient. Further role out of the virtual reality is planned for local and regional training sessions. [ABSTRACT FROM AUTHOR]

Introduction: Care home residents often have multiple, chronic conditions and are receiving complex treatment regimes, yet 30–50% of prescribed medicines are not taken as recommended [1]. Polypharmacy and medication errors are common. Evidence suggests that there is a linear increase in medication errors with the number of medications a patient is prescribed. This paper describes an approach to identity and address inappropriate polypharmacy and safety concerns in Buckinghamshire care homes. The workforce used was: primary care and care home pharmacists, technicians and geriatricians. Methods: A successful business proposal enabled a new interdisciplinary model of care to be established. This was delivered in 2768 Buckinghamshire care home beds (63% of Bucks ICS bed capacity). The CCG pharmacists, GPs and pharmacy technicians reviewed medication for all residents followed by a medication and clinical review by a geriatrician for the most complex individuals. Other community specialist teams were included as part of a Multidisciplinary team as needed. Data on reviews, medicines stopped and safety were collected from 2013–2018. Results: Overall 2134 medications were stopped for 1268 residents of 2102 reviewed, with 505 interventions to reduce falls risk. 942 safety issues were identified and resolved. Total savings on medicines optimisation, waste and non-elective admission prevented was £619,000. System wide safety included: community psychiatric nurse to support dementia diagnosis, specialist enteral feeding nurse reinstated and a new website to share and disseminate good practice standards. Conclusions: Future direction of this work focuses on system wide improvements to promote multi-organisational interdisciplinary healthcare and social services professionals work in care homes. NHSE Pharmacy integrated funding has provided extra pharmacists and technicians to support the 37% of the care home beds not yet covered by March 2020. [ABSTRACT FROM AUTHOR]

Introduction: Constipation has a high prevalence of 30-40% in those aged over 65. It can lead to complications including delirium, faecal impaction, stercoral ulceration, and bowel obstruction. Although stool charts are used in geriatric wards to monitor bowel movements to guide management of constipation, they are often inconsistently recorded. Similarly, regular laxatives are often not prescribed for constipated patients due to ward pressures or unawareness regarding their importance. Aims: Our aims were to audit the rates of recording on stool charts and laxative prescription in a geriatrics department, and to assess whether amultifactorial intervention aimed at both doctors and nursing staff improved these rates. Methods: Two independent assessors audited the recording of stool charts, and rates of constipating medications and laxative prescription in two geriatrics wards in a tertiary UK hospital. A multifactorial intervention was implemented, consisting of didactic sessions for doctors and nurses, healthcare assistant champions to promote the recording of stool charts, and consolidation of bowel movement recording onto a single paper stool chart by the bedside rather than multiple charts. After the intervention, the data was re-audited on the same wards. Descriptive statistics and frequency tabulation were used for data analysis. Results: Data was collected from 33 patients. Pre-intervention, stool charts were recorded daily in 13 patients, 10 patients had no stool chart record, 20 patients were on at least one constipating medication, 12 patients were prescribed at least one laxative, and 5 out of 7 patients with opiates had laxatives co-prescribed. Post-intervention, stool charts were recorded daily in 21 patients, all patients had a stool chart record, 20 patients were on at least one constipating medication, 23 patients were prescribed at least one laxative, and 2 out of 4 patients with opiates had laxatives co-prescribed. Our intervention improved daily recording on stool charts by 24%, resulted in all patients having a current stool chart and improved prescription of regular laxatives by 34%. Conclusions: A multifactorial intervention based on educational sessions, healthcare assistants acting as champions, and consolidation of recording of bowel movements into a single chart, improved stool chart recording and prescription of regular laxatives in a tertiary geriatrics department. Future auditing will extend the sample size and generalise the intervention to other hospital departments. [ABSTRACT FROM AUTHOR]

This paper describes the successful implementation of universal antenatal screening for HIV and hepatitis B in Southampton and South West Hampshire Health Authority. This was achieved through formation of a multi‐disciplinary planning group of clinicians and managers from local trusts. The approach taken in implementing screening is described, key elements of this being the appointment of screening co‐ordinators and consultation with local midwives to ensure their training needs were addressed. Lessons for future work are discussed. [ABSTRACT FROM PUBLISHER]

The article offers information on the subscription of the periodical "Musical Quarterly." The periodical is published by the Oxford University Press in England every quarter in March, June, September and December. The periodical also has an Advance Access which bears papers that have currently accepted but have not yet been included within the issue. The institutional subscription rate for print and online access is 187 U.S. dollars or 125 pounds.

Multiparameter evidence synthesis is becoming widely used as a way of combining evidence from multiple and often disparate sources of information concerning a number of parameters. Synthesizing data in one encompassing model allows propagation of evidence and learning. We demonstrate the use of such an approach in estimating the number of people infected with the hepatitis C virus (HCV) in England and Wales. Data are obtained from seroprevalence studies conducted in different subpopulations. Each subpopulation is modeled as a composition of 3 main HCV risk groups (current injecting drug users (IDUs), ex-IDUs, and non-IDUs). Further, data obtained on the prevalence (size) of each risk group provide an estimate of the prevalence of HCV in the whole population. We simultaneously estimate all model parameters through the use of Bayesian Markov chain Monte Carlo techniques. The main emphasis of this paper is the assessment of evidence consistency and investigation of the main drivers for model inferences. We consider a cross-validation technique to reveal data conflict and leverage when each data source is in turn removed from the model. [ABSTRACT FROM AUTHOR]