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Introduction and aims: The clinical indication for a prescribed medicine in secondary care is not always clear, accurate or easy to locate within patients' medical notes, making it difficult to assess the appropriateness of the medicine. This study sought to determine the impact of including clinical indications for prescribed medicines in paper and electronic prescribing systems in acute hospitals in England. Methods: This mixed-methods study involved semi-structured telephone interviews with 64 chief pharmacists, 11 focus groups with multidisciplinary healthcare teams (MDTs) from three NHS trusts and a review of medical documentation of 89 patients (who were under the care of MDTs participating in the focus groups). Results: Participants described the inclusion of a clinical indication as "helpful" or "useful". However, from a prescriber's perspective, providing an indication for all medicines would be time consuming and unrealistic, especially with pre-admission medicines where it is more of a transcribing process than a prescribing process and where accuracy may be an issue. Mandatory input of indications in electronic systems was considered impractical unless the systems assisted the prescriber. Only 4 of the 64 trusts (6%) required an indication for all medicines, while 15 trusts (23%) did not require an indication for any medicines because of governance and patient confidentiality issues. Discussion: The inclusion of clinical indications on inpatient prescriptions varies across a range of trusts, which affects clinical workflow, regulation and patient safety. Adding clinical indications to prescriptions impacted negatively on healthcare professionals' clinical workflow, but was viewed favourably in certain circumstances (e.g. for a newly initiated medicine). Conclusion: Current requirements for clinical indications on inpatient prescriptions is variable and the role of electronic systems in enforcing standards is unclear. Management and frontline practitioners recognise both the positives and negatives, but systems that force prescribers through mandatory fields to document clinical indications may be counterproductive. If incorporation of clinical indications on hospital prescriptions is to be successful, health IT systems must embrace user-centred design. [ABSTRACT FROM AUTHOR]

Background: Admission of infants to hospital with bronchiolitis consumes considerable healthcare resources each winter. We report an analysis of hospital admissions in England over five decades.Methods: Data were analysed from the Hospital In-Patient Enquiry (HIPE, 1968-1985), Hospital Episode Statistics (HES, 1989-2011), Oxford Record Linkage Study (ORLS, 1963-2011) and Paediatric Intensive Care Audit Network (PICANet, 2003-2012). Cases were identified using International Classification of Diseases (ICD) codes in discharge records. Bronchiolitis was given a separate code in ICD9 (used in England from 1979). Geographical variation was analysed using Local Authority area boundaries. Maternal and perinatal risk factors associated with bronchiolitis and subsequent admissions for asthma were analysed using record-linkage.Results: All-England HIPE and HES data recorded 468 138 episodes of admission for bronchiolitis in infants aged <1 year between 1979 and 2011. In 2011 the estimated annual hospital admission rate was 46.1 (95% CI 45.6 to 46.6) per 1000 infants aged <1 year. Between 2004 and 2011 the rates rose by an average of 1.8% per year in the all-England HES data, whereas admission rates to paediatric intensive care changed little (1.3 to 1.6 per 1000 infants aged <1 year). A fivefold geographical variation in hospital admission rates was observed. Young maternal age, low social class, low birth weight and maternal smoking were among factors associated with an increased risk of hospital admission with bronchiolitis.Conclusions: Hospital admissions for infants with bronchiolitis have increased substantially in recent years. However, cases requiring intensive care have changed little since 2004. [ABSTRACT FROM AUTHOR]

The article offers information on the need of a serogroup C meningococcal vaccine booster for adolescents to protect them from the disease meningococcal (MenC) caused by the bacterium Neisseria meningitidis. It mentions that a clone of Neisseria meningitidis with a serogroup C polysaccharide capsule swept through England that caused a serious public health problem. It also presents graphs depicting peaks of diseased cases among young children and adolescents in England.

A radiocarbon-dated multiproxy palaeoenvironmental record from the Lower Thames Valley at Hornchurch Marshes has provided a reconstruction of the timing and nature of vegetation succession against a background of Holocene climate change, relative sea level movement and human activities. The investigation recorded widespread peat formation between c. 6300 and 3900 cal. yr BP (marine ‘regression’), succeeded by evidence for marine incursion. The multiproxy analyses of these sediments, comprising pollen, Coleoptera, diatoms, and plant and wood macrofossils, have indicated significant changes in both the wetland and dryland environment, including the establishment of Alnus (Alder) carr woodland, and the decline of both Ulmus (Elm; c. 5740 cal. yr BP) and Tilia (Lime; c. 5600 cal. yr BP, and 4160–3710 cal. yr BP). The beetle faunas from the peat also suggest a thermal climate similar to that of the present day. At c. 4900 cal. yr BP, Taxus (L.; Yew) woodland colonised the peatland forming a plant community that has no known modern analogue in the UK. The precise reason, or reasons, for this event remain unclear, although changes in peatland hydrology seem most likely. The growth of Taxus on peatland not only has considerable importance for our knowledge of the vegetation history of southeast England, and NW Europe generally, but also has wider implications for the interpretation of Holocene palaeobotanical records. At c. 3900 cal. yr BP, Taxus declined on the peatland surface during a period of major hydrological change (marine incursion), an event also strongly associated with the decline of dryland woodland taxa, including Tilia and Quercus, and the appearance of anthropogenic indicators. [ABSTRACT FROM PUBLISHER]

The article provides an overview on the topic of nanocomposites with emphasis on their use in electrical applications. It examines composite systems which illustrate the dielectric response of nanocomposites and the mechanical and electrical properties of nanocomposites. It tackles the nanodielectrics research at the University of Southampton in England which aims to understand why nanocomposites in general and nanodielectrics in particular behave the way they do. Several salient features of nanocomposite research which are related to the development and application of dielectrics are presented.

Abstract: Middle Pleistocene deposits at Hackney, north London comprise a thick unit of organic sands and silts occupying a channel near the confluence of the River Thames in south-eastern England and its left-bank tributary the River Lea. They represent a short time interval, perhaps no more than a few years, within a late Middle Pleistocene interglacial. The organic sediments are overlain by unfossiliferous sands and gravels indicating deposition on the floodplain of a braided river under cool or cold climatic conditions. The fossil plant, insect, mollusc and vertebrate remains from the interglacial deposits all indicate climatic conditions with summers warmer than the present in SE England, and winters with a similar thermal climate. The biostratigraphic evidence suggests that the time period represented by the organic unit is part of MIS 9, although the geochronological evidence for such an age is inconclusive. The palaeontological evidence strongly suggests that this temperate stage was warmer than the succeeding temperate stage MIS 7 or the Holocene, and approaching the Ipswichian (MISs 5e) in its warmth. The multidisciplinary description of the Hackney deposits is one of the first to reconstruct terrestrial conditions in Marine Isotope Stage 9 in Western Europe. [Copyright &y& Elsevier]

In the 1830s, Charles Babbage worked on a mechanical computer he dubbed the Analytical Engine. Although some people around Babbage described his invention as though it had authentic mental powers, Babbage refrained from making such claims. He does not, however, seem to have discouraged those he worked with from mooting the idea publicly. This article investigates whether (1) the Analytical Engine was the focus of a covert research program into the mechanism of mentality; (2) Babbage opposed the idea that the Analytical Engine had mental powers but allowed his colleagues to speculate as they saw fit; or (3) Babbage believed such claims to be fanciful, but cleverly used the publicity they engendered to draw public and political attention to his project.