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Aims: In 2017, two distinct interventions were implemented in Ireland and England to reduce prescribing of lidocaine medicated plasters. In Ireland, restrictions on reimbursement were introduced through implementation of an application system for reimbursement. In England, updated guidance on items which should not be routinely prescribed in primary care, including lidocaine plasters, was published. This study aims to compare how the interventions impacted prescribing of lidocaine plasters in these countries. Methods: We conducted an interrupted time‐series study using general practice data. For Ireland, monthly dispensing data (2015–2019) from the means‐tested General Medical Services (GMS) scheme was used. For England, data covered all patients. Outcomes were the rate of dispensings, quantity and costs of lidocaine plasters, and we modelled level and trend changes from the first full month of the policy/guidance change. Results: Ireland had higher rates of lidocaine dispensings compared to England throughout the study period; this was 15.22/1000 population immediately pre‐intervention, and there was equivalent to a 97.2% immediate reduction following the intervention. In England, the immediate pre‐intervention dispensing rate was 0.36/1000, with an immediate reduction of 0.0251/1000 (a 5.8% decrease), followed by a small but significant decrease in the monthly trend relative to the pre‐intervention trend of 0.0057 per month. Conclusions: Among two different interventions aiming to decrease low‐value lidocaine plaster prescribing, there was a substantially larger impact in Ireland of reimbursement restriction compared to issuing guidance in England. However, this is in the context of much higher baseline rates of use in Ireland compared to England. [ABSTRACT FROM AUTHOR]

This article focuses on the planning–technology nexus. Recent work explores the potential of digital technology in overcoming the longstanding limitations of a lack of public engagement and citizen empowerment in the planning process. In August 2020, the Government published a White Paper to democratize, digitize, and digitalize the planning system. We interrogate whether these radical reforms constitute a 'planning revolution' or an 'attack on planning'; we focus on two important issues: democratic deficit and digital divide. The article examines how statements about digitization and digitalization may meet the Government's desire to make the planning process more inclusive (i.e. equitable, fair, just) by empowering greater numbers of people to influence planning decisions for their local communities. In this agenda-setting article, we reflect on the English planning landscape; more broadly, we critically reflect on the values and political rhetoric involved in embracing technological innovations, and how these intersect with societal concerns. [ABSTRACT FROM AUTHOR]

Summary: Social workers have been members of community mental health teams (CMHTs) for many years. However, a combination of factors has resulted in their removal from CMHTs in some areas in recent years. This study presents findings from a 2018 national survey of CMHT team managers (44% response rate), to ascertain the current position of the social worker within CMHTs in England. Analyses focussed on membership, roles and tasks, and change within the previous 12 months. Descriptive statistics were used to analyse the quantitative data and content analysis to interpret free text comments. Findings: Social workers were found to undertake a variety of generic roles and tasks but were reported to do so proportionally less often than nurses. A large minority were involved in non-traditional social work tasks such as monitoring medication. In one-fifth of teams, managers thought they had too few social workers. Free text comments suggested that managers valued social workers for their social perspective and expressed concern regarding their removal or the curtailment of their role, perceiving this as having a negative effect on overall CMHT service delivery. Applications: The findings provide evidence of some instability in the position of social workers within CMHTs in relation to both their membership and their involvement in traditional and non-traditional roles and tasks. Free text comments suggest that if a biopsychosocial model of mental health support, now recognised as essential to long-term wellbeing, is to be achieved, a social work presence in CMHTs is required. [ABSTRACT FROM AUTHOR]

This paper traces the historical roots of farmland ownership, showing how English, and ultimately American, property law has developed through centuries of exchanges among English monarchs, their subjects, and the courts. It was these interplays that gave us concepts such as inheritance taxes, trusts, and limits to corporate ownership. Beginning in England's feudal period, farmland was held largely by a wealthy few with incentives to keep the land in the family to preserve their dynasties. A few key court decisions were able to chip away at the dynasty-friendly protections, particularly the Duke of Norfolk's Case in 1682. The result was the Rule Against Perpetuities (RAP), which limited the time an owner could control land after death. Adopting much, but not all, of these English traditions, U.S. property laws have taken steps toward reviving the possibility of an enduring dynasty as evidenced by the generation-skipping trust (GST) and the repeal of the RAP by several U.S. states. From these policies, the dynasty trust was born: a tool whose impact has yet to be fully understood and may merit further study. [ABSTRACT FROM AUTHOR]

Purpose: High suicide rates among men presents a global challenge for commissioners and clinicians. Innovative approaches towards suicide prevention interventions designed for men are needed. The James' Place (JP) service opened in 2018, and its model of practice is a clinical, community-based intervention for men experiencing suicidal crisis. This paper aims to describe the implementation framework within which the JP model is applied. Design/methodology/approach: Fostering a public health case study approach, this paper provides a description of how the JP service operates, including the referral pathways, key components of this innovative model and its impact upon the men who receive the intervention. Illustrative case studies derived from semi-structured interviews from men and therapists are reported. Findings: The JP model is dynamic and flexible, allowing the tailoring of a suicidal crisis intervention to suit the needs and priorities of the individual and the wider local community. Clinical and practical implications, such as reduction in suicidality, are discussed. Originality/value: Rapidly accessible, effective community-based interventions for men experiencing suicidal crisis are required. Yet, while widely advocated in policy, there remains a dearth of evidence illustrating the real-world application and value of such services within a community-setting. To the best of the authors' knowledge, the JP model is the first of its kind in the UK and an example of an innovative clinical, community-based suicide prevention intervention offering support for men experiencing suicidal crisis. [ABSTRACT FROM AUTHOR]

Despite being a profession dedicated to the empowerment of service users, empirical study of mental health social work appears dominated by the perspectives of social workers themselves. What service users value is less often reported. This study, authored by a mix of academics and service users/carers, reports a Best–Worst Scaling analysis of ten social worker 'qualities', representing both those highly specialist to social work and those generic to other mental health professionals. Fieldwork was undertaken during 2018 with 144 working-age service users, living at home, in five regions of England. Of specialist social work qualities, service users rated '[the social worker] thinks about my whole life, not just my illness' particularly highly, indicating that person-centred approaches drawing on the social model of mental health are crucial to defining social work. However, service users did not value help accessing other community resources, particularly those who had spent the longest time within mental health services. Continuity of care was the most highly valued of all, although this is arguably a system-level feature of support. The research can assist the profession to promote the added value of their work, focusing on their expertise in person-centred care and the social model of mental health. [ABSTRACT FROM AUTHOR]

Background: The NHS Health Check Programme is a risk-reduction programme offered to all adults in England aged 40-74 years. Previous studies mainly focused on patient perspectives and programme delivery; however, delivery varies, and costs are substantial. We were therefore working with key stakeholders to develop and co-produce an NHS Health Check Programme modelling tool (workHORSE) for commissioners to quantify local effectiveness, cost-effectiveness, and equity. Here we report on Workshop 1, which specifically aimed to facilitate engagement with stakeholders; develop a shared understanding of current Health Check implementation; identify what is working well, less well, and future hopes; and explore features to include in the tool.Methods: This qualitative study identified key stakeholders across the UK via networking and snowball techniques. The stakeholders spanned local organisations (NHS commissioners, GPs, and academics), third sector and national organisations (Public Health England and The National Institute for Health and Care Excellence). We used the validated Hovmand "group model building" approach to engage stakeholders in a series of pre-piloted, structured, small group exercises. We then used Framework Analysis to analyse responses.Results: Fifteen stakeholders participated in workshop 1. Stakeholders identified continued financial and political support for the NHS Health Check Programme. However, many stakeholders highlighted issues concerning lack of data on processes and outcomes, variability in quality of delivery, and suboptimal public engagement. Stakeholders' hopes included maximising coverage, uptake, and referrals, and producing additional evidence on population health, equity, and economic impacts. Key model suggestions focused on developing good-practice template scenarios, analysis of broader prevention activities at local level, accessible local data, broader economic perspectives, and fit-for-purpose outputs.Conclusions: A shared understanding of current implementations of the NHS Health Check Programme was developed. Stakeholders demonstrated their commitment to the NHS Health Check Programme whilst highlighting the perceived requirements for enhancing the service and discussed how the modelling tool could be instrumental in this process. These suggestions for improvement informed subsequent workshops and model development. [ABSTRACT FROM AUTHOR]

Major cultural events are increasingly seen by local stakeholders as important opportunities to stimulate urban regeneration, city branding and economic development. The European Capital of Culture programme is a prominent example. Since 1985 over thirty cities have hosted the title and today it remains a highly sought-after prize. This paper analyses competing interpretations of the success of Liverpool's hosting of the European Capital of Culture in 2008. It unpacks contrasting views of Liverpool08, from the official triumphant message of urban regeneration and economic renaissance to more critical analyses that problematise important elements of the event and its social and spatial impacts. In so doing, it challenges the hyperbole of culture-led transformation to reveal different geographies of culture, different cultural experiences and different socio-economic realities; it also offers an additional cultural reading of Liverpool in 2008. Through the example of Liverpool this paper shows how local culture is politicised, manipulated and sanitised in order to stimulate urban regeneration and construct a spatial re-branding of the city. [ABSTRACT FROM AUTHOR]

The concept of identity has attracted significant academic attention. This article unpacks what constitutes the Scouse identity, how it is constructed and its different dimensions, with particular reference to place, phonology and race. Its novelty lies in developing the underused concept of “sonic geography” to examine the extent to which sound, for example a distinctive accent and/or dialect, affects the construction of local identity. Empirically this is conducted through a detailed analysis of the Scouse, or Liverpudlian, identity. The article also deploys the concept of “sonic exclusion” to examine the role a distinguishing vernacular plays in shaping local identity and the extent to which it determines “who is in” and “who is out” as a Scouser. The conclusion is that an effective understanding of a Scouser is not only spatial – someone born in Liverpool – because the sonoric landscape of spoken Scouse, and thereby Scouse identity, extends beyond the contemporary political and geographic boundaries of the City of Liverpool. [ABSTRACT FROM AUTHOR]

The article discusses the homily during Ryan Columba's funeral held at St. Dominic's Priory in London, England on August 18, 2009. It notes the first reading taken from Job which speaks on the power of words relative to the dishonest answers on God's suffering and justice. It mentions that Ryan was one of the philosophers of the English Dominican province along with Job as one of the Bible's philosopher.

On 28th August 1207, King John created the Borough of Liverpool by granting its first charter. During the ensuing 800 years Liverpool has experienced a complex and changing social, economic and political history resulting in powerful images of the city and its people. This paper examines the labelling of Liverpool and stereotypes of Scousers. It explains how historical and contemporary events, and their coverage in various arms of the media, construct social and spatial imaginations of the city. This involves a more systematic contribution to the how and why dimensions of negative place imagery and social stereotypes, and enhances our understanding of the processes and issues affecting our interpretations of people and place. The analysis is both historical and contemporaneous in teasing out how previous and current events shape the perceptions of insiders and outsiders. This paper reveals that despite concerted efforts to re-brand Liverpool the city continues to face difficult challenges with ongoing bad publicity and negative place imagery. [Copyright &y& Elsevier]

The challenges facing local government in the 21st century are complex and rapidly changing. This article examines issues ranging from adaptive behaviour in citizens (as governments struggle to create cognitive shifts around areas such as waste minimization and obesity) to the co-production of services. It offers examples of action being developed in the London Borough of Barnet to enable public managers to move from being place managers to place shapers. [ABSTRACT FROM AUTHOR]

Assesses Objective One, a policy designated by the European Commission in 1993 to provide economic aid to Merseyside, England. European structural funds in Great Britain; Critique of Objective One through urban governance and economic development; Implications for Merseyside's next Objective One program; Aim of Objective One.

Examines the rhetoric of the Pathways literature, a policy of the European Union for the unemployment and social exclusion problems in Merseyside, England. Promotion of community economic development and capacity building; Comparison between the rhetoric and the reality of its local delivery; Economic and political objectives of the policy.

Outlines the implementation of a formal team working package using a facilitator provided by England-based Southern Derbyshire Speech and Language Therapy (SLT) Department's team of SLT specialists who support children with Specific Language Impairment in their mainstream schools. Possibility of addressing team instability and insecurity within a framework of group rules; Process of group development and effective team working.

Profiles William Sealy Gosset as a professor of Genetics at Cambridge University in England. Family background; Career achievements; Contribution to the development of modern statistics.

A randomized controlled trial of home telecare for the management of acute exacerbations of chronic obstructive pulmonary disease has been undertaken in the north-west of England. A videophone was used that communicates via the ordinary telephone network. The intervention period for each participant was two weeks. Participants in the telecare arm of the trial were asked to complete logbooks to record their experiences of each telecare encounter. A simple, self-completed, 10-item questionnaire was used that consisted of a Likert scale, ranging from 1 (totally disagree) to 5 (totally agree). Fourteen nurses completed 150 logbooks and 22 patients completed 145 logbooks. These results demonstrate significant differences in perception between patients and their health-care providers with regard to telecare encounters across all the domains addressed. Participating patients consistently demonstrated more positive views of the telecare encounters than their healthcare providers. [ABSTRACT FROM AUTHOR]

Cluster headache (CH), a severe primary headache, is often misdiagnosed and mismanaged. The aim of this study was to develop and evaluate a screening tool to aid the diagnosis of CH. We developed a novel 12-item screening tool. This was comprised of four components: (1) images depicting headache pain; (2) pain descriptors; (3) key questions that could differentiate between CH and migraine; and (4) a visual analogue pain scale. The total possible questionnaire score ranged from 3-32. Patients with CH and migraines (control group) were recruited prospectively from a headache centre in the North of England, UK. Two-hundred and ninety-six patients were included in the study: 81 CH patients, 36 of which suffer with episodic CH and 45 with chronic CH; 215 migraine patients, 92 of which suffer with episodic migraine and 123 with chronic migraine. The mean questionnaire score was higher in CH patients versus migraine patients (28.4 versus 19.5). At a cut-off score of >25 out of 32, the screening tool had a sensitivity of 86.4% and a specificity of 92.0% in differentiating between CH and migraine. The screening tool could be a useful instrument to aid the diagnosis of a CH. The images depicting headache pain do not clearly discriminate between CH and migraine. [ABSTRACT FROM AUTHOR]

This article reports on the Third Interdisciplinary Perspectives on Accounting Conference that was held at the University of Manchester, Manchester, England, on July 8 to 10, 1991. The participants are composed of 180 grown-ups with a half-dozen or so of children. The conference was held in a cozy walled compound of dormitories and class buildings in the southern part of Manchester, within easy walk of several pubs and about a hundred Indian restaurants. Careful planning was evident in all aspects of the conference, from the pre-mailing of conference papers to the efficient room registration and fine meals.

Background: The National Institute for Health and Clinical Excellence (NICE) single technology appraisal (STA) process was set up as a rapid way to appraise new technologies for use within the NHS in England and Wales and has been in place since 2005., Objectives: This study had five primary objectives: (1) to provide a map of the STA process to date; (2) to identify current approaches to the critical appraisal of manufacturers' submissions (MSs) by Evidence Review Groups (ERGs); (3) to identify recurring themes in clarification letters sent to manufacturers; (4) to provide recommendations for possible alternative approaches to be used in the critical appraisal process; and (5) to revise the current ERG report template., Data Sources: Data for the mapping of the STA process were obtained from the NICE website (www.nice.org.uk). Data for the analyses of the ERG reports and clarification letters were taken from the reports and letters themselves., Review Methods: For the mapping, a spreadsheet was developed to collect data on 22 predefined variables related to timings and outcomes. Simple descriptive statistics were used to analyse the data. For the thematic analysis, a documentary analysis of 30 ERG reports was undertaken. Data on key elements of the MSs, the processes undertaken by ERGs and the strengths and weaknesses of MSs were extracted. A framework of a priori themes was developed. Data were extracted, coded and analysed according to a framework approach. Twenty-one clarification letters were examined and data were extracted using a set of codes to cover report quality, systematic review methods and clinical/economic issues. The current ERG report template was modified and sent to the current ERG teams for comment. All comments were considered and formed the basis for further revisions to the template., Results: Ninety-five STAs were included in the mapping exercise. Many STAs were subject to delay or cancellation for a variety of reasons. The ERG reports highlighted the strengths and weaknesses of MSs to the STA process. Thematic analysis of these data offered a means of clarifying and describing these aspects of the submissions. This analysis generated five themes: process, reporting, satisfaction of objectives, reliability and validity of findings, and content. Points from clarification letters were analysed and presented in four main categories: report quality, systematic review methods, clinical data analysis and economic data analysis., Limitations: Nearly all data were obtained from the NICE website; therefore, any errors in the data on the website will be reflected in the mapping analysis presented in this report. Missing data for the mapping exercise limit the generalisability of the findings. Analyses were limited to what was reported in the ERG reports and the clarification letters., Conclusions: Guidance suggested for manufacturers will help to ensure that more appropriate submissions are received in the future while recommendations provided for ERG teams will help to guide teams to ensure that reporting methods are transparent., Funding: The National Institute for Health Research Health Technology Assessment programme.

This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of pemetrexed for the maintenance treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC), in accordance with the licensed indication, based upon the evidence submission from the manufacturer (Eli Lilly) to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal (STA) process. The primary clinical outcome measure was progression free survival (PFS). Secondary outcomes included overall survival (OS), time to worsening of symptoms, objective tumour response rate, adverse events and changes in lung cancer symptom scale. Data for two populations were presented: patients with non-squamous NSCLC histology and patients with adenocarcinoma histology. The clinical evidence was derived from a double-blind, placebo-controlled randomised controlled trial (RCT), the JMEN trial. The trial compared the use of pemetrexed + best supportive care (BSC ) as maintenance therapy, with placebo + BSC in patients with NSCLC (n = 663) who had received four cycles of platinum-based chemotherapy (CTX) and whose disease had not progressed. In the licensed population (patients with non-squamous histology), the trial demonstrated greater median PFS for patients treated with pemetrexed than for patients in the placebo arm [4.5 vs 2.6 months; hazard ratio (HR) 0.44; 95% confidence interval (CI) 0.36 to 0.55, p < 0.00001]. Median OS was also greater for the pemetrexed- treated patients (15.5 vs 10.3 months; HR 0.70; 95% CI 0.56 to 0.88, p = 0.002). In addition, tumour response and disease control rates were statistically significantly greater for patients who received pemetrexed. Patient survival rates at 1 year and 2 years were higher in the pemetrexed arm. The incremental cost-effectiveness ratios (ICERs) estimated by the manufacturer's model were 33,732 pounds per quality adjusted life-year (QALY) for the licensed nonsquamous population, and 39,364 pounds per QALY for the adenocarcinoma subgroup. Both of these ICERs were above the standard NICE willingness-to-pay range (20,000 pounds-30,000 pounds per QALY). The manufacturer also presented a case for pemetrexed to be considered as an end of life treatment. The ERG identified a number of problems in the economic model presented by the manufacturer; after correction, the base case ICER was re-estimated as 51,192 pounds per QALY gained and likely to exceed NICE's willingness-to-pay thresholds. Following a revised economic analysis submitted by the manufacturer, the AC accepted that an ICER of 47,000 pounds per QALY gained was most plausible. The AC also considered that maintenance treatment with pemetrexed fulfilled the end of life criteria.The guidance issued by NICE, on 20 June 20 2010, in TA190 as a result of the STA states that: People who have received pemetrexed in combination with cisplatin as first-line chemotherapy cannot receive pemetrexed maintenance treatment. 1.1 Pemetrexed is recommended as an option for the maintenance treatment of people with locally advanced or metastatic non-small-cell lung cancer other than predominantly squamous cell histology if disease has not progressed immediately following platinum-based chemotherapy in combination with gemcitabine, paclitaxel or docetaxel.