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This study examined cancer research stories on the BBC web archive (July 1998-June 2006). There were about 260 BBC stories per year, of which about 170 were classed as relevant to reports of cancer research. The stories focused heavily on breast cancer, and over one-third of them mentioned this (compared with a cancer disease burden of 13%); the next most covered sites were lung and prostate cancers, although the former was much less mentioned than its cancer disease burden of almost 20% would have suggested. The focus of the stories was often on new or improved drugs or vaccines (20% of stories), with lifestyle choices (12%), genetic developments (9%), and food and drink (8%) also featuring fairly prominently. The BBC stories cited about 1380 research papers that could be identified as journal articles. About three-quarters of the cited papers were in the field of cancer. The papers of these authors came from over 60 countries, and 40% were from the United Kingdom and 36% from the United States. UK cancer research was heavily overcited, by about 6:1, relative to its presence in world oncology research and US research was cited about in proportion. That of most other countries, especially Japan, Germany, and Austria, was relatively undercited. These cited papers also acknowledged more funding bodies. Most of the BBC stories were put in context by external commentators, of whom the large majority was from the UK's cancer research charities. [ABSTRACT FROM AUTHOR]

The article presents information on European Control Conferences that took place during 1991-2001. First European Control Conference was held in Grenoble, France in July 1991. Noteworthy is a high percentage of screened papers, which seems to be due to the fact that this was the first conference and a substantial part of papers were preplanned to some extent because they were presented at the 28 so-called invited sessions. The Seventh European Control Conference took place in Cambridge, Great Britain on September 14, 2003. The European Union recently pays much attention to increasing the standing of the European researchers in the international science and engineering. This was the main goal of organizing in 1990 the European Union Control Association.

There has been a substantially increased interest in biomedical research impact assessment over the past 5 years. This can be studied by a number of methods, but its influence on clinical guidelines must rank as one of the most important. In cancer, there are 43 UK guidelines (and associated Health Technology Assessments) published (up to October 2006) across three series, each of which has an evidence base in the form of references, many of which are papers in peer-reviewed journals. These have all been identified and analysed to determine their geographical provenance and type of research, in comparison with overall oncology research published in the peak years of guideline references (1999-2001). The UK papers were cited nearly three times as frequently as would have been expected from their presence in world oncology research (6.5%). Within the United Kingdom, Edinburgh and Glasgow stood out for their unexpectedly high contributions to the guidelines' scientific base. The cited papers from the United Kingdom acknowledged much more explicit funding from all sectors than did the UK cancer research papers at the same research level. [ABSTRACT FROM AUTHOR]

Reports on Great Britain's 1993 white paper `Realizing Our Potential.' Research reforms proposed in the white paper; Threat on the medical Research Council's institutes; Particle Physics and Astronomy Research Council's funding of basic research; Privatization of public research laboratories.

Discusses reaction to the British government's White Paper (policy statement) on the organization of science and technology, `Realising our Potential,' published last week in London, England. The lack of radical change; Additional information. INSETS: Waldegrave gets help, by D.D.;A global search, by D.D..

Focuses on the work of Alison Smith, a plant scientist at the University of Cambridge in Great Britain, in exploring the idea that seaweed make Vitamin B12. Collaboration made with her constant collaborator Martin Warren to initiate the experiment; Inquiry made on the genomic sequences of the three types of algae; Examination on the mechanism by which the algae get the vitamin from the bacteria and also what the bacteria get from the transaction.

This paper reports on a multi-phased, mixed-method consensus-based study conducted with young carers in the UK aged 11–18, and health, social care and education professionals from the UK, USA and Canada, to identify priority items for inclusion in a short screening tool for use with young carers of a family member with a progressive or long-term illness or disability. Following ethical approval from University and local Research Ethics Committees, qualitative and quantitative data were collected between 2017 and 2019 from 267 people (107 young carers; 160 professionals), through interviews, a focus group, a Delphi survey, consensus group meetings and consultations. Qualitative data were analysed thematically, and quantitative data were analysed using measures of central tendency, frequency and levels of dispersion. The resulting Carers' Alert Thermometer (CAT-YC) contains an identification question followed by ten areas of need across two themes of 'current caring situation' and 'carer's health and wellbeing,' along with guidance for possible next steps and space for an action plan to be jointly agreed between the screener and young carer. Preliminary piloting of the CAT-YC provides evidence of identifying and monitoring needs, and is expected to be useful for young carers, a wide range of professionals, and organisations that support young carers. [ABSTRACT FROM AUTHOR]

This paper discusses the methodological issues involved in assessing the impact of organizational structure upon the innovative capacity of voluntary organizations. It reports the use of a specific methodological tool—the Aston measures—as an approach to these issues. In addition to the empirical findings reported, this paper argues for these measures as a useful addition to the methodological tool kit of voluntary sector researchers. [ABSTRACT FROM AUTHOR]

This paper describes how a simple transcription error ‘created’ what appeared to be the earliest recorded mosque in Britain. Research in 2008/9 for a project about the history of Muslim settlement in Cardiff included a check of mosque registration data that revealed the origin of the factual inaccuracy. However, the paper does not simply concern itself with debunking the myth that has evolved concerning a mosque, said to have been registered in the Cathays district of Cardiff in 1860 (which in fact was not registered until 1991). Rather, it seeks to explore its contemporary resonances. The broadcast of the ‘first mosque in the UK’ story and its multiple repetition and embellishment has satisfied a growing need to articulate ideas about the longevity and legitimacy of Muslim settlement. As such it has created an important symbolic ‘space’ for framing contemporary Muslim experience in Britain. The paper contemplates the independent life that this myth has taken on, and the way in which its promotion has been useful for politicians, academics, tourism promoters, and indeed British Muslims themselves. However, there is an important contrast between the promotion of a story about a supposed historic mosque, and the lived reality of actual Muslim community building. The latter has much more substance—and ultimately more relevance—than the ascription of dates to buildings. It is the story of community struggle and achievement that the current Cardiff research is uncovering, and this paper argues that the debunking of the myth has provided an opportunity (and a responsibility) to disseminate awareness of the historic settlement of Muslims in the city. [ABSTRACT FROM AUTHOR]

This paper is based on a study carried out in Great Britain on a national sample of 11,804 ten-year olds. The first section describes an at- tempt to pick out cases of "specific developmental dyslexia" (Critchley 1970), a constellation or syndrome of difficulties which some believe to be recognizable clinically. When specified criteria for dyslexia were used, 269 children qualified as dyslexic (2.28 percent of the sample). These included 223 boys and 46 girls,for a ratio of 4.51 to 1. Two possible difficulties in interpreting these data are discussed, and a defense is offered of the criteria used. Since some recent research papers report a gender ratio much nearer 1:1 (Shaywitz et al. 1990; Wadsworth et al. 1992; Lubs et al. 1993), those papers were examined for possible differences in procedure; it was found that the definition of dyslexia they used was "poor reading in relation to intelligence. We carried out a further analysis on our own data using the same criterion. Of the 494 children who qualified as dyslexic on the basis of discrepancy criteria alone (4.19 percent of the sample), 314 were boys and 180 were girls for a ratio of 1.69 to 1. It seems, therefore, that the apparent differences in gender ratio reported in the literature have arisen because different criteria for dyslexia have been used. We argue that the definition based on clinical criteria leads to a more powerful taxonomy and that the widespread equation of dyslexia with poor reading is a hindrance to progress. [ABSTRACT FROM AUTHOR]

Purpose: Measure Yourself Concerns and Wellbeing (MYCaW) is a validated person-centred measure of the concerns and wellbeing of people affected by cancer. Research suggests that the concerns of informal caregivers (ICs) are as complex and severely rated as people with cancer, yet MYCaW has only been used to represent cancer patients' concerns and wellbeing. This paper reports on the development of a new qualitative coding framework for MYCaW to capture the concerns of ICs, to better understand the needs of this group.Methods: This multicentred study involved collection of data from ICs receiving support from two UK cancer support charities (Penny Brohn UK and Cavendish Cancer Care). Qualitative codes were developed through a detailed thematic analysis of ICs' stated concerns.Results: Thematic analysis of IC questionnaire data identified key themes which were translated into a coding framework with two overarching sections; (1) 'informal caregiver concerns for self' and (2) 'informal caregiver concerns for the person with cancer'. Supercategories with specific accompanying codes were developed for each section. Two further rounds of framework testing across different cohorts allowed for iterative development and refinement of the framework content.Conclusions: This is the first person-centred tool specifically designed for capturing IC's concerns through their own words. This coding framework will allow for IC data to be analysed using a rigorous and reproducible method, and therefore reported in a standardised way. This may also be of interest to those exploring the needs of ICs of people in other situations. [ABSTRACT FROM AUTHOR]

Purpose: Shared decision-making (SDM) and the wider elements of intersecting professional and lay practices are seen as necessary components in the implementation of mental health interventions. A randomised controlled trial of a user- and carer-informed training package in the United Kingdom to enhance SDM in care planning in secondary mental health care settings showed no effect on patient-level outcomes. This paper reports on the parallel process evaluation to establish the influences on implementation at service user, carer, mental health professional and organisational levels.Methods: A longitudinal, qualitative process evaluation incorporating 134 semi-structured interviews with 54 mental health service users, carers and professionals was conducted. Interviews were undertaken at baseline and repeated at 6 and 12 months post-intervention. Interviews were digitally audio-recorded, transcribed verbatim and analysed thematically.Results: The process evaluation demonstrated that despite buy-in from those delivering care planning in mental health services, there was a failure of training to become embedded and normalised in local provision. This was due to a lack of organisational readiness to accept change combined with an underestimation and lack of investment in the amount and range of relational work required to successfully enact the intervention.Conclusions: Future aspirations of SDM enactment need to place the circumstances and everyday practices of stakeholders at the centre of implementation. Such studies should consider the historical and current context of health care relationships and include elements which seek to address these directly. [ABSTRACT FROM AUTHOR]

Spirituality as a dimension of quality of life and well-being has recently begun to be more valued within person-centred treatment approaches to mental health in the UK. The aim of this paper is to provide indicators of the extent to which accessing a spiritual support group may be useful within mental health recovery from the view point of those in receipt of it. The study design was a small-scale exploratory study utilising mixed methods. Quantitative methods were used to map the mental health, general well-being and social networks of the group. These were complimented by a semi-structured open-ended interview which allowed for Interpretative Phenomenological Analysis (IPA) of the life-history accounts of nine individuals with mental health problems who attended a 'spirituality support group'. Data from unstructured open-ended interviews with five faith chaplains and a mental health day centre manager were also analysed using thematic analysis. The views of 15 participants are therefore recounted. Participants reported that the group offered them: an alternative to more formal religious organisations, and an opportunity to settle spiritual confusions/fears. The 'group' was also reported to generally help individual's subjective feelings of mental wellness through social support. Whilst the merits of spiritual care are appealing, convincing services to include it within treatment may still be difficult. [ABSTRACT FROM AUTHOR]

The use of the phrase 'basic research' as a term used in science policy discussion dates only to about 1920. At the time the phrase referred to what we today commonly refer to as applied research in support of specific missions or goals, especially agriculture. Upon the publication of Vannevar Bush's well-known report, Science - The Endless Frontier, the phrase 'basic research' became a key political symbol, representing various identifications, expectations and demands related to science policy among scientists and politicians. This paper tracks and evaluates the evolution of 'basic research' as a political symbol from early in the 20th century to the present. With considerable attention having been paid to the on-going evolution of post-Cold War science policy, much less attention has focused on the factors which have shaped the dominant narrative of contemporary science policies. [ABSTRACT FROM AUTHOR]

This paper reviews the results of the literature on the ranking of centers of excellence in economics. There are two objectives: (1) to examine the evolution during the 1990s of certain features of economics research—such as the gap that exists between the US and the rest of the world, the dominant position of the UK within Europe, and the low productivity of economic scholars everywhere—and (2) to document the significant progress that Spanish research institutions have experienced during this period. Results by several broad fields of specialization are summarized here for the first time. [ABSTRACT FROM AUTHOR]

The paper explores the dynamics of competition in higher education. National competition and global competition are distinct, but feed into each other. Higher education produces ‘positional goods’ (Hirsch 1976) that provide access to social prestige and income-earning. Research universities aim to maximise their status as producers of positional goods. This status is a function of student selectivity plus research performance. At system-level competition bifurcates between exclusivist elite institutions that produce highly value positional goods, where demand always exceeds supply and expansion is constrained to maximise status; and mass institutions (profit and non-profit) characterised by place-filling and expansion. Intermediate universities are differentiated between these poles. In global competition, the networked open information environment has facilitated (1) the emergence of a world-wide positional market of elite US/UK universities; and (2) the rapid development of a commercial mass market led by UK and Australian universities. Global competition is vectored by research capacity. This is dominated by English language, especially US universities, contributing to the pattern of asymmetrical resources and one-way global flows. The paper uses Australia as its example of system segmentation and global/national interface. It closes by reflecting on a more balanced global distribution of capacity. [ABSTRACT FROM AUTHOR]

Discusses the transformations that have taken place in the naturalist tradition as illustrated by the contents of "The Ibis," the journal of the British Ornithologists' Union. Study of living birds in their natural environment; Effects of professionalization on the discipline; Focus on biology increased by the Journal; Importance of methodological and institutional context in determining and reinforcing appropriate research programs for ornithologists.

There has been increasing interest in the ability of different methods to rank efficient hospitals over their inefficient counterparts. The UK Department of Health has used three cost indices to benchmark NHS hospitals (Trusts). This study uses the same dataset and compares the efficiency rankings from the cost indices with those obtained using Data Envelopment Analysis (DEA) and Stochastic Frontier Analysis (SFA). The paper concludes that the methods each have particular strengths and weaknesses and potentially measure different aspects of efficiency. Several specifications should be used to develop ranges of inefficiency to act as signalling devices rather than point estimates. It is argued that differences in efficiency scores across different methods may be due to random "noise" and reflect data deficiencies. The conclusions concur with previous findings that there are not truly large efficiency differences between Trusts and savings from bringing up poorer performers would in fact be quite modest. [ABSTRACT FROM AUTHOR]

The allocation of funding for new anticancer treatments within the UK has not kept pace with demand. Clinicians find themselves restricted in the use of licensed drugs which they feel are in the best interests of individual patients. Against this, health authorities have a duty to ensure that scarce resources are used equitably to meet the needs of the local population as a whole. Differential levels of funding for new treatments across the country have led to concerns about rationing by postcode. This paper outlines an approach to the prioritization of new treatment for advanced cancer developed jointly by clinicians and health authorities in South London. The approach involves evidence reviews and consensus meetings. Existing and new treatments are rated on a four-point 'relative effectiveness scale', which takes account of the impact of the treatment on quality of life and on survival. The strength of evidence supporting each effectiveness rating is also classified. Health Authorities have used these ratings to determine overall funding levels, while leaving decisions on individual patients to the relevant Trusts. [ABSTRACT FROM AUTHOR]

Background: Muscle weakness is associated with adverse clinical outcomes including disability and mortality. We report demographic, anthropometric and lifestyle correlates of grip strength in UK and Japanese population-based cohorts. Aim: To report prevalence of low grip strength according to 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) and 2019 Asian Working Group for Sarcopenia (AWGS 2019) thresholds and to consider correlates of grip strength in Eastern and Western populations. Methods: UK (1572 men; 1415 women) and Japanese (519 men; 1027 women) participants were recruited from two cohorts harmonised by consensus. Muscle strength was measured by grip strength dynamometry. Potential correlates of grip strength were examined using sex-stratified linear regression; univariate correlates (p < 0.05) were included in mutually adjusted models. Results: Mean (SD) age was 66.2 (2.8) and 65.8 (12.3) in UK and Japanese cohorts, respectively. Prevalence of low grip strength was higher in Japanese participants (EWGSOP2 5.4% versus 2.4%, AWGS 2019 9.0% versus 3.7%). In both cohorts and sexes, univariate correlates of lower grip strength were older age, shorter height, not consuming alcohol, leaving education earlier and greater comorbidity. Apart from older age and shorter height, the only factors related to lower grip strength in mutually adjusted analyses were greater comorbidity among UK participants (kg difference in grip strength (95%CI) per additional comorbidity − 0.60(− 0.98, − 0.21) among men and − 0.50(− 0.86, − 0.13) among women) and not consuming alcohol among Japanese men (− 1.33(− 2.51, − 0.15)). Discussion: Correlates of muscle strength were similar in both cohorts. Conclusions: A global approach to age-related muscle weakness prevention may be appropriate. [ABSTRACT FROM AUTHOR]

The article comments on the increase in number of publication of fraud research papers in Great Britain. It presents methods developed to improve the screening process of research papers. It mentions the case of a researcher who published two fraudulent papers that reported the efficient generation of human stem-cell lines from cloned embryos. The author pointed out the need to improve the detection of illicit data manipulation and that fraud papers deserve the attention of all biosciences.

This paper focusses on coping strategies employed by children and adolescents with diagnosed short stature, assesses the impact of socio-demographic and clinical characteristics on coping, examines the relationship between coping and health related quality of life (QoL) and investigates the role of coping strategies in mediating the relationship between height and QoL. Coping with a disease (CODI) and quality of life in short stature youth (QoLISSY-QoL) questionnaires were completed by 137 short-statured children and adolescents between 8 and 18 years, participating in the crosssectional European QoLISSY study. Clinical and socio-demographic data were collected to examine differences in coping via variance and regression analyses, associations between CODI and QoLISSY were inspected using correlation and mediation analyses. Most frequently employed coping strategies in the CODI were 'Acceptance' and 'Wishful Thinking', with 'Emotional Reaction' used least. Significant effects of age, diagnosis and treatment status on coping strategies were detected. CODI scales 'Acceptance' and 'Distance' were associated with higher QoLISSY-QoL scores, 'Emotional Reaction' and 'Wishful Thinking' with lower scores. Coping strategies predicted 60 % of the QoLISSY-QoL variance. Relationships between height deviation and QoLISSY-QoL were mediated by the coping strategies of 'Wishful Thinking' and 'Distance'. Findings suggest that coping efforts vary with socio-demographic and clinical characteristics, that protective coping strategies in terms of QoL can be identified and that coping mediates the relationship between short stature and QoL. Future longitudinal research should focus on the adaptive function of coping in relation to QoL over time. [ABSTRACT FROM AUTHOR]

Millions of people cross political borders yearly without having the proper documents. This has led to increased detention and deportation practices in destination countries for reasons related to security and sovereignty. The objective of the current study was to analyze and visualize research publications on the detention and deportation of migrants to identify current research hotspots, research gaps, and potential future research in the field. Relevant research articles were obtained from the Scopus database for the study period from 1900 to December 31, 2022. The analysis included presentations of key contributors to the field and visualization of topics, themes, and international collaboration. In total, 906 articles were found. The earliest was in 1982. The majority of articles were published in journals within the subject areas of social sciences and humanities. The number of publications showed a steep rise from 2011 to 2022. The Journal of Ethnic and Migration Studies was the most prolific, but publications in the Citizenship Studies journal received the highest number of citations per article. Researchers from the United States contributed the most. Mexico ranked fifth in the number of publications. Oxford University was the most prolific institution, followed by three universities in Australia. The majority of articles were single-authored, indicative of limited author-author collaboration. Research hotspots in the field were "human rights" and "mental health". The detention and deportation of Mexican and other Latino migrants in the United States constituted a distinct research theme in the field. International research collaboration was limited by geographical proximity (e.g., the United States and Mexico) or common language (e.g., the United Kingdom and Australia). Future research topics should focus on alternatives to detention, family separation, and healthcare services for detained migrants. Research activity on detention and deportation is required from all world regions, including the source countries of migrants. Future research should promote alternatives to traditional detentions. The contribution of countries in Africa, the Middle East, and South-Eastern Asian regions needs to be encouraged. Future research on the detention and deportation of non-Latino migrants is highly required. [ABSTRACT FROM AUTHOR]

Purpose: Worldwide, many people who would benefit from osteoporosis drugs are not offered or receiving them, resulting in an osteoporosis care gap. Adherence with bisphosphonates is particularly low. This study aimed to identify stakeholder research priorities relating to bisphosphonate treatment regimens for prevention of osteoporotic fractures. Methods: A three-step approach based on the James Lind Alliance methodology for identification and prioritisation of research questions was used. Research uncertainties were gathered from a large programme of related research studies about bisphosphonate regimens and from recent published international clinical guidelines. Clinical and public stakeholders refined the list of uncertainties into research questions. The third step prioritised the questions using a modified nominal group technique. Results: In total, 34 draft uncertainties were finalised into 33 research questions by stakeholders. The top 10 includes questions relating to which people should be offered intravenous bisphosphonates first line (1); optimal duration of treatment (2); the role of bone turnover markers in treatment breaks (3); support patient need for medicine optimisation (4); support primary care practitioner need regarding bisphosphonates (5); comparing zoledronate given in community vs hospital settings (6); ensuring quality standards are met (7); the long-term model of care (8); best bisphosphonate for people aged under 50 (9); and supporting patient decision-making about bisphosphonates (10). Conclusion: This study reports, for the first time, topics of importance to stakeholders in the research of bisphosphonate osteoporosis treatment regimens. These findings have implications for research into implementation to address the care gap and education of healthcare professionals. Summary: Using James Lind Alliance methodology, this study reports prioritised topics of importance to stakeholders in the research of bisphosphonate treatment in osteoporosis. The priorities address how to better implement guidelines to address the care gap, understanding patient factors influencing treatment selection and effectiveness, and how to optimise long-term care. [ABSTRACT FROM AUTHOR]

Loch Leven is a large, shallow lake in lowland Scotland, UK. Scientific research began here almost 200 years ago. Early research characterised the biodiversity and physical characteristics of the loch, providing an important historical background for future research. In the mid-1960s, this ad hoc approach was superseded by a more structured research programme under the umbrella of the International Biological Programme. This was the beginning of the Loch Leven long-term monitoring programme. Today, the results of these studies form one of the longest and most comprehensive limnological datasets for shallow freshwater lakes in the world, comprising more than 500 physical, chemical and biological variables collected at two-weekly intervals. To celebrate the 40th anniversary of the start of the long term monitoring programme, and to highlight the scientific investigations still being conducted at Loch Leven, the NERC Centre for Ecology & Hydrology (CEH) organised a symposium entitled "Loch Leven: 40 years of scientific research" in Kinross, Scotland, UK, on 11 December 2008. This examined the role of long-term monitoring in developing our understanding of the links between pollution, climate change and ecological responses in shallow lakes. This article introduces a series of papers summarising the scientific results presented at this meeting. [ABSTRACT FROM AUTHOR]

Two recent papers that examined the association between oral bisphosphonates and the risk of esophageal cancer reported seemingly discrepant findings, despite both studies using data from the UK General Practice Research Database, from similar time periods. Each paper set out brief conclusions within their abstracts, generating two opposing impressions: that the risk of incident esophageal cancer is not significantly increased with bisphosphonate use, or that the risk is increased when bisphosphonates have been prescribed ten or more times, or for longer than 5 years. Of course, the latter conclusion was more widely reported in the popular press, and with patients arriving at the clinic wanting to discuss the reports, clinicians must be able to interpret the existing evidence correctly. In this article we discuss important methodological issues regarding the two observational studies, define areas of consensus and discrepancy, examine possible bias and confounding, and condense the results into a clinically useful summary. [ABSTRACT FROM AUTHOR]

Those who have worked in the Royal Institution of Great Britain have, since its foundation in 1799, made significant contributions to scientific knowledge, to its practical application, and to its communication to a wide variety of audiences. Such work cannot be carried out in an architectural vacuum, and in this paper we examine how the buildings of the Royal Institution, 20 and 21 Albemarle Street in central London, have shaped the work undertaken within its walls and how, on a number of occasions, the buildings have been reconfigured to take account of the evolving needs of scientific research and communication. [ABSTRACT FROM AUTHOR]

Members of the public are increasingly consulted over health care and research priorities. Patient involvement in determining cancer research priorities, however, has remained underdeveloped. This paper presents the findings of the first consultation to be conducted with UK cancer patients concerning research priorities. The study adopted a participatory approach using a collaborative model that sought joint ownership of the study with people affected by cancer. An exploratory, qualitative approach was used. Consultation groups were the main method, combining focus group and nominal group techniques. Seventeen groups were held with a total of 105 patients broadly representative of the UK cancer population. Fifteen areas for research were identified. Top priority areas included the impact cancer has on life, how to live with cancer and related support issues; risk factors and causes of cancer; early detection and prevention. Although biological and treatment related aspects of science were identified as important, patients rated the management of practical, social and emotional issues as a higher priority. There is a mismatch between the research priorities identified by participants and the current UK research portfolio. Current research activity should be broadened to reflect the priorities of people affected by the disease. [ABSTRACT FROM AUTHOR]

This paper presents the first full micro costing of a commonly used cancer genetic counselling and testing protocol used in the UK. Costs were estimated for the Cardiff clinic of the Cancer Genetics Service in Wales by issuing a questionnaire to all staff, conducting an audit of clinic rooms and equipment and obtaining gross unit costs from the finance department. A total of 22 distinct event pathways were identified for patients at risk of developing breast, ovarian, breast and ovarian or colorectal cancer. The mean cost per patient were pound sterling 97- pound sterling 151 for patients at moderate risk, pound sterling 975- pound sterling 3072 for patients at high risk of developing colorectal cancer and pound sterling 675- pound sterling 2909 for patients at high risk of developing breast or ovarian cancer. The most expensive element of cancer genetic services was labour. Labour costs were dependent upon the amount of labour, staff grade, number of counsellors used and the proportion of staff time devoted to indirect patient contact. With the growing demand for cancer genetic services and the growing number of national and regional cancer genetic centers, there is a need for the different protocols being used to be thoroughly evaluated in terms of costs and outcomes. [ABSTRACT FROM AUTHOR]

Former iron and steel works sites are significant in terms of their size, number, degree of contamination, and their wide distribution in the United Kingdom. They are likely to have become chemically contaminated with a wide range of substances from the manufacture of iron and steel, and the many associated processes. Associated processes include coke-production, metal refining and finishing. Contamination by metals, inorganic and organic compounds, acids/alkalis and asbestos is common on such sites. The aim of this research was to draw together information on the contamination of former iron and steel works through a review of current literature and by the use of examples and case studies from the UK. The style of the paper is loosely based on an Inter-departmental Committee for Research in Contaminated Land (ICRCL) style guidance note, with case studies and examples. [ABSTRACT FROM AUTHOR]

In this paper, queuing theory is tested through an examination of the occupational attainment of six groups of non-whites in London and New York. Workers in the dominant economy are distinguished from those in the niche economy and emphasis is placed on the former. Black male immigrants in New York and black female immigrants in London hold more favorable occupational status. These results reflect differences in (1) the presence of indigenous minorities--African Americans and Puerto Ricans--in New York but not London, and (2) the relatively low position of indigenous minority males compared to the relatively middling position of indigenous minority females in New York's labor queue. [ABSTRACT FROM AUTHOR]

Two important sets of performance indicators have become established in the United Kingdom: research quality ratings and teaching quality ratings. The research quality ratings and, to a lesser extent, the teaching quality ratings, influence the level of government funding provided to higher education institutions. This paper considers the correlation between the two ratings and the possible consequences of policies that reshape the higher education sector by concentrating research resources in a limited number of institutions. Comparisons are made between quality assurance/assessment approaches in the United Kingdom and those in the United States. [ABSTRACT FROM AUTHOR]

Aim: Understanding COVID-19 risk perceptions and their impact on behaviour can improve the effectiveness of public health strategies. Prior evidence suggests that, when people perceive uncontrollable risks to their health, they are less likely to engage in healthful behaviour. This article aims to understand the extent to which COVID-19 is perceived as an uncontrollable risk, and to assess whether this perceived risk is associated with health behaviour. Subject and methods: We surveyed a nationally representative sample of 496 participants during the first UK lockdown. We assessed perceptions of COVID-19-related risk, self-reported adherence to infection control measures recommended by the UK Government, and general health behaviours. We predicted that increased perceived extrinsic mortality risk (the portion of mortality risk perceived to be uncontrollable) would disincentivise healthy behaviour. Results: Perceived threat to life was the most consistent predictor of reported adherence to infection control measures. Perceived extrinsic mortality risk was found to have increased due to the pandemic, and was associated with lower reported adherence to Government advice on diet, physical activity, and smoking. Conclusions: Our findings suggest that health messages that highlight threat to life may be effective in increasing adherence to infection control, but may also lead to a reduction in health-promoting behaviours. We suggest that messages that highlight threat to life should be accompanied by statements of efficacy. Further, messages evoking feelings of concern for others may be effective in promoting compliance with anti-infection measures, without the potential for the unwelcome side-effect of discouraging healthy behaviour. [ABSTRACT FROM AUTHOR]

Background Several clinical pharmacy activities are common to UK hospitals. It is not clear whether these are provided at similar levels, and whether they take similar amounts of time to carry out. Objective To quantify and compare clinical pharmacist ward activities between different UK hospitals. Setting Seven acute hospitals in the Greater London area (UK). Methods A list of common ward activities was developed. On five consecutive days, pharmacists visiting hospital wards documented total time spent and how many of each activity they undertook. Results were analysed by hospital. The range and number of activities per 100 occupied bed days, and per 24 beds were compared. Main outcome measure Time spent on wards and numbers of each activity undertaken. Results Pharmacists logged a total of 2291 h carrying out 40,000 activities. 4250 changes to prescriptions were made or recommended. 5901 individual medication orders were annotated for clarity or safety. For every 24 beds visited, mean time spent was 230 min-seeing 6.2 new patients, carrying out 3.9 calculations and 1.3 patient consultations, checking and authorising 1.8 discharge prescriptions, and providing staff with information twice. Other activities varied significantly, not all could be explained by differences in hospital specialties or Information Technology systems. Conclusion This is the first detailed comparison of clinical pharmacy ward activities between different hospitals. There are some typical levels of activities carried out. Wide variations in other activities could not always be explained. Despite a large number of contacts, pharmacists reported very few consultation sessions with patients. [ABSTRACT FROM AUTHOR]

Background: The UK Medical Research Council approach to evaluating complex interventions moves through development, feasibility, piloting, evaluation and implementation in an iterative manner. This approach might be useful as a conceptual process underlying complex valuation tasks.Objective: The objective of the study was to explore the applicability of such a framework using a single case study (valuing the ICECAP-Supportive Care Measure) and considering three key uncertainties: the number of response categories for the measure; experimental design; and the potential for using slightly different variants of the measure with the same value set.Methods: Three on-line pilot studies (n = 204, n = 100, n = 102) were undertaken during 2012 and 2013 with adults from the UK general population. Each used variants of discrete choice and best-worst scaling tasks; respondents were randomly allocated to different groups to allow exploration of the number of levels for the instrument (four or five), optimal experimental design and the values for alternative wording around prognosis. Conditional logit regression models were used in the analysis and variance scale factors were explored.Results: The five-level version of the measure seemed to result in simplifying heuristics. Plotting the variance scale factors suggested that best-worst scaling answers were approximately four times more consistent than the discrete choice answers. The likelihood ratio test indicated there was virtually no difference in values between the differently worded versions.Conclusion: Rigorous piloting can improve the design of valuation studies. Thinking in terms of a 'complex valuation framework' may emphasise the importance of conducting and funding such rigorous pilots. [ABSTRACT FROM AUTHOR]

Background: Using continuing professional development (CPD) as part of the revalidation of pharmacy professionals has been proposed in the UK but not implemented. We developed a CPD outcomes framework ('the framework') for scoring CPD records, where the score range was -100 to +150 based on demonstrable relevance and impact of the CPD on practice.Objective: This exploratory study aimed to test the outcome of training people to use the framework, through distance-learning material (active intervention), by comparing CPD scores before and after training.Setting: Pharmacy professionals were recruited in the UK in Reading, Banbury, Southampton, Kingston-upon-Thames and Guildford in 2009.Method: We conducted a randomised, double-blinded, parallel-group, before and after study. The control group simply received information on new CPD requirements through the post; the active intervention group also received the framework and associated training. Altogether 48 participants (25 control, 23 active) completed the study. All participants submitted CPD records to the research team before and after receiving the posted resources. The records (n = 226) were scored blindly by the researchers using the framework. A subgroup of CPD records (n = 96) submitted first (before-stage) and rewritten (after-stage) were analysed separately.Main Outcome Measure: Scores for CPD records received before and after distributing group-dependent material through the post.Results: Using a linear-regression model both analyses found an increase in CPD scores in favour of the active intervention group. For the complete set of records, the effect was a mean difference of 9.9 (95 % CI 0.4-19.3), p value = 0.04. For the subgroup of rewritten records, the effect was a mean difference of 17.3 (95 % CI 5.6-28.9), p value = 0.0048.Conclusion: The intervention improved participants' CPD behaviour. Training pharmacy professionals to use the framework resulted in better CPD activities and CPD records, potentially helpful for revalidation of pharmacy professionals. [ABSTRACT FROM AUTHOR]

As patient health information is highly regulated due to privacy concerns, most machine learning (ML)-based healthcare studies are unable to test on external patient cohorts, resulting in a gap between locally reported model performance and cross-site generalizability. Different approaches have been introduced for developing models across multiple clinical sites, however less attention has been given to adopting ready-made models in new settings. We introduce three methods to do this—(1) applying a ready-made model "as-is" (2); readjusting the decision threshold on the model's output using site-specific data and (3); finetuning the model using site-specific data via transfer learning. Using a case study of COVID-19 diagnosis across four NHS Hospital Trusts, we show that all methods achieve clinically-effective performances (NPV > 0.959), with transfer learning achieving the best results (mean AUROCs between 0.870 and 0.925). Our models demonstrate that site-specific customization improves predictive performance when compared to other ready-made approaches. [ABSTRACT FROM AUTHOR]

Purpose: Non-contrast CT head scans provide rapid and accurate diagnosis of acute head injury; however, increased utilisation of CT head scans makes it difficult to prioritise acutely unwell patients and places pressure on busy emergency departments (EDs). This study validates an AI algorithm to triage patients presenting with Intracranial Haemorrhage (ICH) or Acute Infarct whilst also identifying a subset of patients as Normal, with the potential to function as a rule-out test. Methods: In total, 390 CT head scans were collected from 3 institutions in the UK, US and India. Ground-truth labels were assigned by 3 FRCR consultant radiologists. AI performance, as well as the performance of 3 independent radiologists, was measured against ground-truth labels. Results: The algorithm showed AUC values of 0.988 (0.978–0.994), 0.933 (0.901–0.961) and 0.939 (0.919–0.958) for ICH, Acute Infarct and Normal, respectively. Sensitivity/specificity for ICH and Acute Infarct were 0.988/0.925 and 0.833/0.927, respectively, compared to 0.907/0.991 and 0.618/0.977 for radiologists. AI rule-out of Normal scans achieved 0.93% negative predictive value (NPV) for the removal of 54.3% of Normal cases, compared to 86.8% NPV for radiologists. Conclusion: We show our algorithm can provide effective triage of ICH and Acute Infarct to prioritise acutely unwell patients. AI can also benefit clinical accuracy, with the algorithm identifying 91.3% of radiologist false negatives for ICH and 69.1% for Acute Infarct. Rule-out of Normal scans has huge potential for workload management in busy EDs, in this case removing 27.4% of all scans with no acute findings missed. [ABSTRACT FROM AUTHOR]

Summary: We estimated and characterized the imminent fracture risk (1–2 years) of high-risk fracture patients through a multinational (UK, Spain, Denmark) cohort study. Older individuals with newly diagnosed osteoporosis and individuals who had a fracture while on treatment with a bisphosphonate were at a high risk of imminent fracture. Purpose: To characterize and estimate 1- to 2-year fracture risk in high-risk fracture patients. Methods: Multi-cohort study in (database/study period) UK (CPRD/1995–2017), Spain (SIDIAP/2006–2016) and Denmark (DHR/1995–2016) including individuals ≥ 50 years old in NDO (newly diagnosed osteoporosis), OFx (incident osteoporotic fracture), BP (incident oral bisphosphonates use) or FWOT (fracture while on treatment with bisphosphonates). Outcomes (ICD-10/READ): hip, clinical spine, non-hip, non-spine and hip/humerus/distal forearm fracture. Follow-up: from cohort entry until death, migration/transfer or end of the study. Statistics: baseline characteristics and incidence rate (IR per 1000 persons). Results (1-year IR): NDO included 69,899 (UK), 37,901 (Spain) and 158,191 (Denmark) individuals. Spanish-IR was lowest for hip (4.7), clinical spine (2.5) and major osteoporotic fracture (MOF) (17.3) and highest in Denmark (74.2, 26.0 and 120.1, respectively). OFx included 83,514 (UK), 51,044 (Spain) and 509,551 (Denmark) individuals. IR in Denmark was highest for hip (24.1) and MOF (47.2), in Spain was highest for the clinical spine (9.4) and lowest for hip (9.5) and in the UK was lowest for the clinical spine (2.8) and MOF (20.7). BP included 148,507 (UK), 52,037 (Spain) and 204,010 (Denmark) individuals. Spanish-IR was lowest for hip (5.0) and MOF (21.1) and highest in Denmark (20.3 and 48.6, respectively). FWOT included 28,930 (UK), 1,865 (Spain) and 31,882 (Denmark) individuals. Clinical spine-IR was highest for Spain (12.0). Hip-IR was lowest for Spain (7.6) and highest for Denmark (33.6). Comparing young subjects, those who have FWOT started with an increased fracture rate. Conclusion: OFx and FWOT individuals experience higher re-fracture incidence rates than those with osteoporosis with or without treatment. [ABSTRACT FROM AUTHOR]

Background: Long-term cancer survivors in the United Kingdom are mostly followed up in a primary care setting by their general practitioner; however, there is little research on the use of services. This study examines whether cancer survivors receive adequate screening and preventative care in UK primary care.Patients and Methods: We identified a cohort of long-term survivors of breast, colorectal and prostate cancer with at least a 5-year survival using the General Practice Research Database, with controls matched for age, gender and practice. We compared adherence with cancer screening and the use of preventative care between cancer survivors and controls.Results: The cancer survivors' cohort consisted of 18 612 breast, 5764 colorectal and 4868 prostate cancer survivors. Most cancer survivors receive cancer screening at the same levels as controls, except for breast cancer survivors who were less likely to receive a mammogram than controls (OR=0.78, 95% CI: 0.66-0.92). Long-term cancer survivors received comparable levels of influenza vaccinations and cholesterol tests, but breast (OR 0.81, 95% CI: 0.74-0.87) and prostate cancer survivors (OR=0.70, 95% CI: 0.57-0.87) were less likely to receive a blood pressure test. All survivors were more likely to receive bone densitometry.Conclusion: The provision and uptake of preventive care in a primary care setting in the United Kingdom is comparable between the survivors of three common cancers and those who have not had cancer. However, long-term breast cancer survivors in this cohort were less likely to receive a mammogram. [ABSTRACT FROM AUTHOR]

Background: Analysis of the Psychiatric Morbidity Survey of Great Britain showed that the prevalence of common mental disorders was lower amongst men at or above Britain's state pension age of 65, relative to younger men. Retirees below this age had consistently higher rates of mental disorders than working men. In contrast, the low prevalence of mental disorders amongst retirees aged 65 and older was similar to that of their working peers. The aim of this analysis was to investigate this pattern of results in a national sample of Australian men, and the mediating role of socio-demographic factors.Method: Data were from the Household, Income and Labour Dynamics (HILDA) in Australia survey (2003). The analyses included men aged 45-74 years who were active in the labour force (n = 1309), or retired (n = 635). Mental health was assessed using the mental health scale from the Short-Form 36 Health Questionnaire.Results: Retirees were more likely to have mental health problems than their working peers, however this difference was progressively smaller across age groups. For retirees above, though not below, the age of 55 this difference was explained by poorer physical functioning. When age at retirement was considered it was found that early retirees who were now at or approaching the conventional retirement age did not display the substantially elevated rates of mental health problems seen in their younger counterparts. Further, men who had retired at age 60 or older did not display an initially elevated rate of mental health problems.Conclusions: The association between retirement and mental health varies across older adulthood. Retired British and Australian men below the conventional retirement age of 65 are more likely to have mental health problems relative to their working peers, and retirees above this age. However, poor mental health appears to be linked to being retired below this age rather than an enduring characteristic of those who retire early. [ABSTRACT FROM AUTHOR]

The UK700 trial failed to demonstrate an overall benefit of intensive case management (ICM) in patients with severe psychotic illness. This does not discount a benefit for particular subgroups, and evidence of a benefit of ICM for patients of borderline intelligence has been presented. The aim of this study is to investigate whether this effect is part of a general benefit for patients with severe psychosis complicated by additional needs. In the UK700 trial patients with severe psychosis were randomly allocated to ICM or standard case management. For each patient group with complex needs the effect of ICM is compared with that in the rest of the study cohort. Outcome measures are days spent in psychiatric hospital and the admission and discharge rates. ICM may be of benefit to patients with severe psychosis complicated by borderline intelligence or depression, but may cause patients using illicit drugs to spend more time in hospital. There was no convincing evidence of an effect of ICM in a further seven patient groups. ICM is not of general benefit to patients with severe psychosis complicated by additional needs. The benefit of ICM for patients with borderline intelligence is an isolated effect which should be interpreted cautiously until further data are available. [ABSTRACT FROM AUTHOR]

In the UK, approaches to developing, encouraging and extending children’s’ thinking are of considerable professional interest. Teachers and researchers have explored a number of different strategies. These are categorized in recent Department for Education and Skills (DFES) guidance into three broad areas: philosophical, cognitive intervention, and brain-based learning approaches. Within all these approaches, spoken language has been identified as essential for collaborative learning of any kind and in some, information technology is also seen as a potentially supportive collaborative medium (McGuiness, 1999). This paper takes the form of a case study of children aged 10–11, from two Primary schools and considers the place of diagrammatic software in supporting children’s’ exploration and representation of ideas. The case study provides some concrete examples of ways in which the children made links between their discussion of ideas and their visual record. Children were recorded as they worked together to produce their map and as they reported to their peers on its completion. Data were collected over a six week period using observational schedules, field notes, and pupil feedback. The analysis of maps themselves was a central concern as this as techniques for this are not yet fully established, although some significant work is available (e.g. Mavers et al., 2002) The study showed the ease with which all pupils adapted to the use of the software. [ABSTRACT FROM AUTHOR]

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Copyright of Anaesthesist is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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

Describes a Web-based pre-prints project in Great Britain's Electronic Libraries Programme in order to raise issues about the forms of scholarship that are best suited to online working. Processes at work in academic research; Degrees of formality involved in different kinds of online communication; Use of established groupware tools to accommodate academic working practices.

The study evaluated the implementation fidelity and effectiveness of KiVa, an evidence-based program that aims to prevent and address bullying in schools, with a particular emphasis on changing the role of bystanders. The study was a two-arm waitlist control cluster randomized controlled trial in which 22 primary schools (clusters) (N = 3214 students aged 7-11) were allocated using a 1:1 ratio to intervention (KiVa; 11 clusters, n = 1588 students) and a waitlist control (usual school provision; 11 clusters, n = 1892 children)). The trial statistician (but not schools or researchers) remained blind to allocation status. The outcomes were as follows: student-reported victimization (primary outcome) and bullying perpetration; teacher-reported child behavior and emotional well-being; and school absenteeism (administrative records). Implementation fidelity was measured using teacher-completed online records (for class lessons) and independent researcher observations (for school-wide elements). Outcome analyses involved 11 intervention schools (n = 1578 children) and 10 control schools (n = 1636 children). There was no statistically significant effect on the primary outcome of child-reported victimization (adjusted intervention/control OR 0.76; 95% CI 0.55 to 1.06; p = 0.11) or on the secondary outcomes. The impact on victimization was not moderated by child gender, age, or victimization status at baseline. Lesson adherence was good but exposure (lesson length) was lower than the recommended amount, and there was considerable variability in the implementation of whole school elements. The trial found insufficient evidence to conclude that KiVa had an effect on the primary outcome. A larger trial of KiVa in the UK is warranted, however, with attention to issues regarding implementation fidelity. Trial registration: Current Controlled Trials ISRCTN23999021 Date 10-6-13. [ABSTRACT FROM AUTHOR]

Background: An increasing number of technologies are obtaining marketing authorisation based on sparse evidence, which causes growing uncertainty and risk within health technology reimbursement decision making. To ensure that uncertainty is considered and addressed within health technology assessment (HTA) recommendations, uncertainties need to be identified, included in health economic models, and reported.Objective: Our objective was to develop the TRansparent Uncertainty ASsessmenT (TRUST) tool for systematically identifying, assessing, and reporting uncertainties in decision models, with the aim of making uncertainties and their impact on cost effectiveness more explicit and transparent.Methods: TRUST was developed by drawing on the uncertainty and risk assessment literature. To develop and validate this tool, we conducted HTA stakeholder discussion meetings and interviews and applied it in six real-world HTA case studies in the Netherlands and the UK.Results: The TRUST tool enables the identification and categorisation of uncertainty according to its source (transparency issues, methodology issues, and issues with evidence: imprecision, bias and indirectness, and unavailability) in each model aspect. The source of uncertainty determines the appropriate analysis. The impact of uncertainties on cost effectiveness is also assessed. Stakeholders found using the tool to be feasible and of value for transparent uncertainty assessment. TRUST can be used during model development and/or model review.Conclusion: The TRUST tool enables systematic identification, assessment, and reporting of uncertainties in health economic models and may contribute to more informed and transparent decision making in the face of uncertainty. [ABSTRACT FROM AUTHOR]