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Background: In recent years, a significant proportion of inpatient facilities for people with intellectual disabilities and/or autism has been de-commissioned in England, This has resulted in individuals with intellectual disabilities being sent to distant hospitals far away from their families and carers leading to challenges in follow-up, community care and interventions. The impact of de-institutionalisation, has often caused patient trauma, family distress and subsequent discharge difficulties. Not every individual with intellectual disabilities and/or autism requires inpatient care but inpatient care when needed has to be local, adequate and appropriate. Aims: To evaluate current evidence of utility of inpatient models for people with intellectual disabilities and outline best clinical practice. Method: PubMed, CINAHL, EMBASE, Cochrane Library, Scopus, Web of Science were searched with key search terms. The search was conducted by the information specialist and identified abstracts screened further for inclusion criteria, methodological issues, and other appropriate characteristics. Twenty-three papers were included in the rapid review. Papers shortlisted had the inclusion criteria applied against the full text version independently by two reviewers. Disagreements regarding eligibility of studies was resolved by discussion and consensus within the project team. Key data related to in-patient models of care was extracted from the included papers, which included year of study, design, study objectives, target population, method/s tested, outcomes reported, country of study/studies, and results. Data extraction was performed by two reviewers and reviewed by the project team. Results: From the review of services for people with intellectual disabilities, we came across four broad models/frameworks/approaches. Evidence on what worked for inpatient service provision tended to be based on models developed and implemented locally. Conclusions: We make recommendations for the best clinical practice and standards. Both clinical service providers and policymakers need to be aware of specific needs of individuals with intellectual disability and/or autism. [ABSTRACT FROM AUTHOR]

This research looked at the management of identity change within Physical Education and School Sport (PESS) at one of the first Free schools in England. Opened as a new institution within an unfamiliar setting, the school had to contend with limited resources for an ambitious programme based upon a full complement of examination courses and an emphasis on prestigious team sports using a traditional public-school model. A single case study methodology revealed that subsequent changes in identity stemmed from staffing issues, alongside a shift in personal philosophies towards a more inclusive ideology. Both senior management and middle management agreed that PESS needed to offer more sports to more pupils while still contributing towards the school's "knowledge rich" achievement-based ethos. Using Goffman's concept of "impression management", changes are explained by the analysis of a team "performance" communication to parents, identified by interviewees as key policy actors in the life of the school. This approach has been successful in justifying change, a finding that will help to understand the extent to which parental expectations are managed at Free schools. However, elements of traditionalism remain within the school's games-based PESS programme and possibilities for innovation are interpreted by policy actors as necessitating changes in content rather than within pedagogy or curriculum design. Recommendations for future study include the need to fully understand the freedoms associated with Free schools, particularly expectations for curriculum innovation. [ABSTRACT FROM AUTHOR]

Introduction: Varicose veins (VV) negatively impact quality of life (QoL) and have risks of major complications including bleeding, ulceration and phlebitis. During the COVID-19 pandemic, the VSGBI (Vascular Society of Great Britain and Ireland) and GIRFT (Get It Right First Time) classified VVs as lowest priority for intervention. Objective: This study aims to determine harm caused and the impact on the QoL on patients waiting for their VVs procedures for more than 1 year. Methods: This was a prospective study conducted at the Norfolk and Norwich University Hospital (NNUH). Patients with VVs awaiting intervention for >1 year were included in the study. Patients with CEAP C6 disease were considered to be too high risk to be invited for treatment during the Covid-19 pandemic. Patients were sent QoL questionnaires and underwent a telephone consultation to assess harm. Both generic (EQ-VAS and EQ-5D) and disease-specific (AVVQ and CIVIQ-14) instruments were utilised. There were no control groups available for comparison. Results: 275 patients were identified (37.1% male) with median time on waiting list of 60 weeks (IQR 56–65). 19 patients (6.9%) came to major harm, including phlebitis (3.6%), bleeding (1.8%) and ulceration (1.8%). Fifty-two patients (18.9%) had minor harm, including worsening pain (12.7%) and swelling (6.2%). 6.9% reported psychological harm. Rising CEAP stage was also associated with worsening level of harm in patients with C5-6 disease (p < 0.0001). Only 8.7% stated they would decline surgery during the pandemic. 104 QoL questionnaires were returned. Median EQ-VAS and EQ-5D was 75 (IQR: 60–85) and 0.685 (0.566–0.761), respectively. Median AVVQ score was 23.2 (14.9–31.0) and CIVIQ-14 score was 33 (21–44). ConclusionsThis study highlights the impact of delaying VVs surgery during a pandemic. A significant rate of both major and minor as well as psychological harm was reported. In addition, VVs had a significant detriment to quality of life. [ABSTRACT FROM AUTHOR]

Legal problems can be cause and consequence of ill‐health and homelessness, necessitating efforts to integrate responses to these challenges. How to respond to legal issues within the context of health services for people who are homeless is though unclear. Groundswell piloted providing legal support to peer advocates (who have current or past experience of homelessness) and clients currently homeless in addition to their health‐focused work. A participatory action‐research design evaluated the emerging programme. Groundswell staff, both researchers and those involved in service delivery, co‐led the research alongside an external researcher. Qualitative methods were used to understand the experiences of legal support. We interviewed peer advocates and volunteers (n = 8), Groundswell clients (n = 3) and sector stakeholders (n = 3). Interviews were linked to regular reflective recorded meetings (n = 7) where Groundswell staff and researchers discussed the programme and the evaluation. Data were analysed thematically. The findings focus on three themes. First, peer advocates' and clients' legal needs involve an experience of being overwhelmed by system complexity. Second, the legal support to peer advocates aided in brokering and signposting to other legal support, in the context of a supportive organisational culture. Third, support to clients can be effective, although the complexity of legal need undermines potential for sustainable responses. In conclusion, legal support for peer advocates should be developed by Groundswell and considered by other similar agencies. Legal support to people who are currently street homeless requires significant resources and so health‐focused third‐sector organisations maybe unable to offer effective support. Other modes of integration should be pursued. Findings also have implications for how the third sector relates to the government agencies implicated in the legal challenges facing people who are homeless. [ABSTRACT FROM AUTHOR]

Background: Tooth decay has a significant impact on children, their families and wider society. The dental consultation provides an opportunity to prevent tooth decay by engaging in an effective oral health conversation with parents and children. However, there is limited literature which explores how these oral health conversations are delivered, received, and understood. Aim: To explore the common facilitators of delivering oral health advice from dental teams, parents' and children's experiences, to identify and inform practical recommendations for clinical practice. Method: The current paper used a qualitative supplementary analysis to reanalyse data of existing published studies by applying a different research question. Qualitative focus groups were undertaken following a semi-structured interview guide with 27 dental team members (dentists, dental nurses, practice managers and receptionists), 37 parents and 120 children (aged 7–10 years old) in the northern region of England. Thematic analysis informed the identification of themes and aggregation of findings. Results: Three overarching themes were developed: (1) An engaging and personalised dental visit for parents and children; (2) Dental teams, parents and children working collaboratively to improve oral health habits; and (3) Recommending appropriate oral health products. Many parents and children had little recollection of any preventive oral health conversations when visiting the dentist. Practical solutions were identified by different stakeholders to facilitate three-way, personalised, non-judgemental and supportive oral health conversations. Adopting these innovative approaches will help to enable parents and their children to adopt and maintain appropriate oral health behaviours. Conclusion: Understanding the context and triangulating the experiences of stakeholders involved in preventive oral health conversations for young children is an essential step in co-designing a complex oral health intervention. This study has provided recommendations for dental practices and wider paediatric health care services. Furthermore, the findings have informed the design of a complex oral health intervention called "Strong Teeth". [ABSTRACT FROM AUTHOR]

Background: Amidst increased pressures on General Practice across England, the receptionist continues to fulfil key administrative and clinically related tasks. The need for more robust support for these key personnel to ensure they stay focussed and motivated is apparent, however, to be effective a more systematic understanding of the parameters of their work is required. Here we present a valuable insight into the tasks they fulfil, their relationship with colleagues and their organisation and their attitudes and behaviour at work collectively defined as their 'work design'. Methods: Our aim was to quantitatively assess the various characteristics of receptionists in primary care in England using the validated Work Design Questionnaire (WDQ) a 21 point validated questionnaire, divided into four categories: task, knowledge and social characteristics and work context with a series of sub-categories within each, disseminated online and as a postal questionnaire to 100 practices nationally. Results: Seventy participants completed the WDQ, 54 online and 16 using the postal questionnaire with the response rate for the latter being 3.1%. The WDQ suggested receptionists experience high levels of task variety, task significance and of information processing and knowledge demands, confirming the high cognitive load placed on receptionists by performing numerous yet significant tasks. Perhaps in relation to these substantial responsibilities a reliance on colleagues for support and feedback to help negotiate this workload was reported. Conclusion: The evidence of our survey suggests that the role of modern GP receptionists requires an array of skills to accommodate various administrative, communicative, problem solving, and decision-making duties. There are ways in which the role might be better supported for example devising ways to separate complex tasks to avoid the errors involved with high cognitive load, providing informal feedback, and perhaps most importantly developing training programmes. [ABSTRACT FROM AUTHOR]

Background: Equitable access to mental healthcare is a priority for many countries. The National Health Service in England uses a weighted capitation formula to ensure that the geographical distribution of resources reflects need.Aims: To produce a revised formula for estimating local need for secondary mental health, learning disability (intellectual disability) and psychological therapies services for adults in England.Method: We used demographic records for 43 751 535 adults registered with a primary care practitioner in England linked with service use, ethnicity, physical health diagnoses and type of household, from multiple data-sets. Using linear regression, we estimated the individual cost of care in 2015 as a function of individual- and area-level need and supply variables in 2013 and 2014. We sterilised the effects of the supply variables to obtain individual-need estimates. We aggregated these by general practitioner practice, age and gender to derive weights for the national capitation formula.Results: Higher costs were associated with: being 30-50 years old, compared with 20-24; being Irish, Black African, Black Caribbean or of mixed ethnicity, compared with White British; having been admitted for specific physical health conditions, including drug poisoning; living alone, in a care home or in a communal environment; and living in areas with a higher percentage of out-of-work benefit recipients and higher prevalence of severe mental illness. Longer distance from a provider was associated with lower cost.Conclusions: The resulting needs weights were higher in more deprived areas and informed the distribution of some 12% (£9 bn in 2019/20) of the health budget allocated to local organisations for 2019/20 to 2023/24. [ABSTRACT FROM AUTHOR]

The following sociologically orientated study explores how two physical education (PE) teachers at two secondary schools in North West England construct the notion of 'healthiness', and how this informs their health-based PE practice. The research process was influenced by figurational sociology [Elias, N. (1978). What is sociology? New York, NY: Columbia University Press], and the use of in-depth, reflexive interviews allowed emergent beliefs of the teachers in relation to 'healthiness' to be made evident, as contextual elements of their lived-in world surfaced. Within health-based PE, the teachers embodied a 'healthy role model' to match dominant PE discourses, whereby teachers must work on their capacity to help pupils learn, and work on their own 'healthy bodies' simultaneously. It is suggested that notions of 'healthiness' constructed by PE teachers develop within the social contexts of their personal and professional lives as complex spaces that provide dilemmas, opportunities and possibilities within which the teacher constructs, adapts and embodies a 'healthy role model' to enhance both long and short term (self) interests. [ABSTRACT FROM AUTHOR]

Summary: Background: Recessive forms of congenital ichthyosis encompass a group of rare inherited disorders of keratinization leading to dry, scaly skin. So far, 13 genes have been implicated, but there is a paucity of data on genotype–phenotype correlation in some populations. Objectives: We compiled an English cohort of 146 individuals with recessive ichthyosis and assessed genotype–phenotype correlation. Methods: Deep phenotyping was undertaken by history‐taking and clinical examination. DNA was screened for mutations using a next‐generation sequencing ichthyosis gene panel and Sanger sequencing. Results: Cases were recruited from 13 National Health Service sites in England, with 65% of patients aged < 16 years at enrolment. Pathogenic biallelic mutations were found in 83% of cases, with the candidate gene spread as follows: TGM1 29%, NIPAL4 12%, ABCA12 12%, ALOX12B 9%, ALOXE3 7%, SLC27A4 5%, CERS3 3%, CYP4F22 3%, PNPLA1 2%, SDR9C7 1%. Clinically, a new sign, an anteriorly overfolded ear at birth, was noted in 43% of patients with ALOX12B mutations. The need for intensive care stay (P = 0·004), and hand deformities (P < 0·001), were associated with ABCA12 mutations. Self‐improving collodion ichthyosis occurred in 8% of the cases (mostly TGM1 and ALOX12B mutations) but could not be predicted precisely from neonatal phenotype or genotype. Conclusions: These data refine genotype–phenotype correlation for recessive forms of ichthyosis in England, demonstrating the spectrum of disease features and comorbidities, as well as the gene pathologies therein. Collectively, the data from these patients provide a valuable resource for further clinical assessment, improving clinical care and the possibility of future stratified management. What's already known about this topic? Recessive forms of ichthyosis are rare but often difficult to diagnose.Mutations in 13 genes are known to cause recessive forms of ichthyosis: ABCA12, ALOX12B, ALOXE3, CERS3, CYP4F22, LIPN, NIPAL4, PNPLA1, SDR9C7, SLC27A4, SULT2B1, ST14 and TGM1.Some phenotypic features may associate with certain gene mutations, but paradigms for genotype–phenotype correlation need refining. What does this study add? The genotypic spectrum of recessive ichthyosis in England (based on 146 cases) comprises TGM1 (29%), NIPAL4 (12%), ABCA12 (12%), ALOX12B (9%), ALOXE3 (7%), SLC27A4 (5%), CERS3 (3%), CYP4F22 (3%), PNPLA1 (2%) and SDR9C7 (1%).New or particular phenotypic clues were defined for mutations in ALOX12B, ABCA12, CYP4F22, NIPAL4, SDR9C7 and TGM1, either in neonates or in later life, which allow for greater diagnostic precision.In around 17% of cases, the molecular basis of recessive ichthyosis remains unknown. Linked Editorial:Steele and O'Toole. Br J Dermatol 2020; 182:521–522. Plain language summary available online [ABSTRACT FROM AUTHOR]

This study presents findings from a longitudinal study of the Mulberry Bush School (MBS), a therapeutic residential special school in England which provides an integrated approach to education and care for children aged between 5 and 13 years. Four cohorts were followed (23 = boys; 13 = girls), each for a consecutive 3-year period, approximating children’s time at the MBS. Children showed significant improvements in their socio-emotional, behavioural and academic development. The picture is more mixed for children’s attachment representations, which might be expected of the vulnerable and severely traumatised children who make up the MBS population. The importance of these improvements stem from the fact that they were achieved in the face of the exceptional disadvantages and challenges that characterise the lives of all children who attend the MBS. This is testimony to their achievement, and to the potential of the residential special school as a therapeutic learning environment. [ABSTRACT FROM AUTHOR]

The author reflects on the future of sample survey in a world where increasing numbers of organizations have data flows and analytical capabilities that enable them to make decisions without recourse to traditional surveys. As social researchers, the authors look at the developments of this type of surveys and ponder on its implications. Results of a survey concerning the prepayment card system used for travel around London, England is then discussed.

In an era of global environmental deterioration and income inequity, public health faces many challenges, including the growing number of individuals, especially older people, with chronic diseases. Dementia is increasingly being seen not just as a biomedical problem to solve but as a public and community challenge to address more broadly. Concepts like prevention, brain health, and quality of life/well-being are receiving more attention. The engagement of community in addressing these challenges is being seen as critical to successful social adaptation. Arts programs are reinvigorating cultural responses to the growing number of older people with cognitive challenges. The humanities offer ways of understanding the power of words and stories in public discourse and a critical lens though which to view political and economic influences. In this paper, we report on a panel held in London on the occasion of the conference at the Royal Society for Public Health in March, 2017, in which the authors presented. Key issues discussed included problem framing, the nature of evidence, the politics of power and influence, and the development of effective interventions. In this paper, we review the rejection of two policies, one on dementia and one on the arts and humanities in public health, by the American Public Health Association; the emergence of policies in the UK; and some of the state of the art practices, particularly in training, again focusing on the UK. [ABSTRACT FROM AUTHOR]

For many new academics, coming to a decision about which research methodology to employ for their doctoral studies can be daunting. Faced with numerous options, sometimes contradictory advice from experienced scholars and a desire to find the perfect match for a research question, one can find the decision to opt for a particular methodological path a huge step, and it can be hindered by nagging concerns and a lack of academic experience. This article draws together two short pieces of writing from PhD students at Lancaster University, who attended and were inspired by a workshop on narrative methods, led by Professor Catherine Kohler Riessman. The first piece is a reflective account of why the author was drawn to narrative methods for her research. It explores the impact of charities and how this is articulated qualitatively, within the context of a mixed market approach to welfare and health service provision in the UK. It discusses what she observes to be the parallels between a narrative research approach and her practice as a social worker and details her experience of completing her first narrative interview. The second is about how the author was inspired by the workshop to produce a pilot study on attitudes of male offenders towards violence against women using the narrative approach and including excerpts from his research data. Finally, it draws together their thoughts about the workshop and how they intend to continue working with narratives in their future. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this study is to evaluate the efficacy of providing health and well-being checks and six months support to unpaid carers. Changes in carer stress will be measured between baseline and final assessment. Design/methodology/approach -- This is a cross-sectional, correlational study of the 394 carers recruited and the sub-group of 348 carers who received support for six months. A T-test measured change in the carers' GHQ-12 scores between baseline and final assessment. A chi-squared test was used to measure movement in the GHQ-12 scoring quartiles between baseline and final assessment. Findings -- The 348 carets receiving support for six months reported a statistically significant small reduction in their baseline and final assessment scores. The carets identified by the GHQ as having less severe stress scores did better than those with more severe stress levels. Research limitations/implications -- As there was no control group, it was not possible to compare the outcomes of the intervention group with the outcomes of a group of carers receiving care as usual. It is therefore possible that there may be some other factors at play for the intervention group over the six-month period of support, other than the intervention itself, which have influenced the change in carer stress. Social implications -- Financial pressures on health and social care budgets can lead to carers' support services being under-resourced in some areas. However, the draft Care and Support Bill (July 2012) and the introduction of new mandatory duties may help to ensure that local authorities and health and wellbeing boards meet their obligations to provide services for carers. Originality/value -- There is limited research available on the outcomes of carers' interventions, particularly those which involve holisfic interventions, such as health and well-being checks being delivered by a multi-agency partnership. [ABSTRACT FROM AUTHOR]

Beginning in 1750, Handel gave annual performances of Messiah in the Chapel of the Foundling Hospital in London, and the series was continued by others after his death, until 1777. The Hospital's archives include complete itemised lists of performers for many of these events, and provide information about income and expenditure relating to all of the performances. The performers' lists from 1754, 1758 and 1759 are well known, since they provide the only detailed contemporary record of singers and players for Handel's oratorio performances. However, the complete run of surviving lists enables us to track individual performers in London over a longer period, as well as revealing changes in the management, composition and remuneration of the ensembles. Transcriptions of the lists are here accompanied by an index of names and a summary analysis of the financial accounts for each performance. [ABSTRACT FROM AUTHOR]

This article demonstrates that the film presentations of British public hall showmen in the 1900s were often more elaborate and oriented towards middle-class audiences, but much less well-travelled, than is typically realized. It attempts to explain how one such show, West's Pictures at the Shaftesbury Hall, Bournemouth, established itself as a semi-permanent attraction, and argues that T.J. West's activities reveal the need for a revised morphology of the emergence and evolution of the permanent picture theatre that acknowledges the complexity of both the cinema's journey towards 'gentrification' and the relationships between provincial and metropolitan screen entertainment practices. [ABSTRACT FROM AUTHOR]

The article focuses on the contracts, accounts, and reflections of performance art as masochistic practice of the exhibition "The Chymical Wedding" held at Tate Britain in London, England on January 1, 2008. It notes that the exhibition was performed to act out a masochistic pact to relate desiring bodies and laws on their association. It also engages a state of abjection to get involved the masochistic reversal of paternal law.

The article reports on Sir Edward Elgar who was appointed as Master of the King's Musick, Ceremonial Department, St. James's Palace in London, England. It states that Elgar wrote to William Barclay Squire, Honorary Curator of the King's Music Library, expressing pleasure in his appointment. It notes that Lancelot Percival, Precentor and Sub-Dean of the Chapel Royal, also wrote to Squire regarding the disposal of obsolete music in the Chapel Royal and an enclosure of Percival's letter to Elgar.

The article presents representations of "Chinatown" in Limehouse cinema. The entry discusses various policies practiced by the British Board of Film Censors and local councils in regulating film content. It analyzes shifts in the status of film as an art form during the postwar period. It examines Limehouse fiction in cinema from 1914 onwards, including "A Chinese Vengeance," "London's Yellow Peril" and "Broken Blossoms" and explains the analogies of these films to the social realities of that era.

This paper uses both survey and qualitative panel data collected from five different case-study areas in England in order to offer a conceptualisation of the contemporary role that housing is playing in the transition to adult life. The data suggest that the types of housing pathway that young people follow are a function of differences in the combination and intensity of three main factors: the ability of young people to plan for and control their entry to independent living; the extent and form of constraints that characterise their access to housing; and the degree of family support available to them. Based around these three dimensions (each of which is a continuum), the following ideal typical pathways can be identified: a chaotic pathway, an unplanned pathway, a constrained pathway, a planned (non-student) pathway and a student pathway. [ABSTRACT FROM AUTHOR]

This article argues that lawyers are not doing enough to eradicate the needless differences in terminology used, and the substantive inconsistencies, between common law and equity. In developing this argument, three categories within English private law are recognized. First, where common law and equity co‐exist coherently, and where the historical labels of common law and equity remain useful terminology. Second, where common law and equity co‐exist coherently but there is nothing to be gained by adherence to those labels which could, and should, be excised at a stroke. And third, where common law and equity do not co‐exist coherently and a change in the law, albeit often only a small change, is needed to produce a principled product. As a general illustration of what the third category comprises, and what fusion requires, one wide‐ranging and practically very important area within the third category is focused on, namely monetary remedies for civil wrongs. [ABSTRACT FROM PUBLISHER]

Discusses the process of making an installation for the exhibition 'Rites of Passage' at the Whitworth Gallery in Manchester, England. Background on the exhibition; Aims of the project; Materials and space used in the development of the documentary video installation.

Focuses on the ethical dilemma in England of having to kill one of Siamese twins so that the other may live. Operation performed to separate them; Presence of children's welfare advocates in a country which allows abortion; Injection of ethical discussion in public life.

This paper contributes to current debates on the psycho-social determinants of health by offering a qualitative analysis of the health consequences of the experience of mortgage possession. Previous research has shown that it is possible to decipher a statistical relationship between the onset of mortgage indebtedness and health. This paper extends this work by examining how this statistical patterning is generated at the level of the ‘lived experiences’ of families experiencing the loss of their mortgaged home. The narratives of 44 adults and 10 children from a sample of 30 households who have experienced mortgage possession are analysed. The results of this qualitative analysis are related to current debates in both the sociology of health inequalities and the sociology of the emotions concerned with the specification of what Elstad has called “the psychological stress, relative deprivation and psycho-social injuries of inequality structures”. [ABSTRACT FROM AUTHOR]

Focuses on the French emigre literary journalism in London from 1793 to 1841. Arguments on the literary culture of the French Revolution; Origin and articulation of counter-revolutionary discourse in the press of the revolutionary emigres; Discourse assumptions; Relationship between the discourse and the perception of the journalist.

The article investigates patterns of residential mobility in relation to social housing in Great Britain by using the data from the "Survey of English Housing 1993/4." In 1993/4 there were a total of some 2.1 million separate household moves in England. The increased rate of mobility is due to a number of factors, but is primarily a result of the demographic profile of tenants in the social rented sector. The demographic profile of the population housed in the social rented sector has been fundamentally altered by the operation of Right to Buy (RTB). As the rate of mobility within the social rented sector increases, the stability in tenant populations necessary for sustainable community development is potentially undermined. The majority of moves, some 222,000, were movements within the local authority stock. Some 50,000 moves were movements within the housing association sector. Households headed by someone aged between 16 and 29 are the most likely to have been mobile. Households headed by someone over 65 are significantly less likely to be have been mobile.

Investigates the social distribution of mortgage arrears in England using the 1993-1994 Survey of English Housing. Data on the survey; Conceptual and methodological issues in the modelling of mortgage arrears; Odds of households being three months or more in mortgage arrears.

Focuses on the Countryside March which took place on March 1, 1998 in London, England. Delegations who joined the march; Objectives of demonstrators in joining the nationwide march; Moral implication of the event to Great Britain.

This paper presents a pilot study evaluating a smoking cessation programme, implemented by a nurse, in surgical pre-admission clinics at The Chesterfield and North Derbyshire Royal Hospital NHS Trust, Chesterfield, England. Using a quasi-experimental design, a convenience sample of 60 subjects who smoked were randomized, 30 to a control and 30 to a treatment group. Those in the treatment group received a variety of educational interventions and self-assessment questionnaires relating to smoking cessation, when attending the clinic. The control group received routine information. Data were collected using the combined interview and questionnaire method. There was a significant increase in positive behaviour on admission to hospital in the treatment group (80% stopped or reduced smoking), compared to a control group (50% stopped or reduced smoking), particularly in subjects who did not intend to reduce or stop before admission. The level of satisfaction with the service and information relating to smoking cessation was also significantly higher in the treatment group. Subjects described the approach of the nurse and a leaflet devised for the study, as the most helpful aspects of the programme. The study highlights how the nurse, using appropriate theory to underpin such a programme, can facilitate smokers' intention to stop or reduce tobacco consumption prior to hospital admission, and help them to prepare for their surgery, anaesthesia, and the hospital's no smoking policy. [ABSTRACT FROM AUTHOR]

Examines the contemporary housing circumstances of young people in England between the ages of 16 and 24 who live in rural areas. Household and housing circumstances in the late 1990s; Relationship between young people's preferences and housing conditions; Implications on the prevailing socioeconomic structures.

This paper is a direct response to Wilkinson's (1996) call for more research into housing insecurity and health. It explores the consequences of mortgage arrears for both the health of indebted home owners and their use of primary health care services. It is based on the results of a secondary analysis of the British Household Panel Survey. It demonstrates that the experience of mortgage indebtedness has an independent effect on the subjective well being of men and women, and that it increases the likelihood that men will visit their general practitioners. The paper draws upon the sociological notions of 'ontological security' and 'individualisation' to make sense of these empirical findings. It suggests that policies which have encouraged the growth of home ownership are premised on the idea of individual responsibility, a notion which underpins other spheres of contemporary welfare policies. Within this context, the consequences of mortgage indebtedness are likely to have profound psychosocial consequences for those who have direct experience of it. The spectre of mortgage debt may also contribute to the insecurity which has come to form a feature of our contemporary social and cultural life. [ABSTRACT FROM AUTHOR]

The reforms of the National Health Service in England have given an emphasis to “strategic” approaches to health and health care, in that, ideally, purchasing decisions will be made on the basis of evidence from various forms of “needs assessment”. Alongside these reforms a strategic approach to the promotion of health has been set out in the “Health of the Nation” (DoH 1992). However, although the promotion of health is high on the policy agenda, the occupational group of health promotion specialists, whose prime function it is to devise, develop and implement health promotion strategies, have been ignored. Drawing on qualitative interview data with these specialists in both provider and purchasing settings in England this paper argues that thus far the reforms have actually hindered the development of a strategic approach to the promotion of health by health promotion specialists. Three main reasons for this are suggested; a confusion over the most appropriate institutional location for health promotion specialists; a lack of clarity by key actors as to the role and function of health promotion specialists; and the emergence of a model of effectiveness and efficiency which is largely antithetical to the philosophy and practice of health promotion. [ABSTRACT FROM AUTHOR]

Presents proceedings of the Seventy-second annual meeting of the British Association of Dermatologists in Bournemouth, England in 1992.

One hundred patients with chronic airway obstruction, 50 in Chicago and 50 in London, were studied by standardized techniques in 1961. The results of the initial studies, previously reported, showed that the patients in the two cities were similar; using clinical and physiological criteria based on pathological studies, the patients were divided into three types—emphysematous type A, bronchial type B, and an indeterminate type X. The patients were studied again in succeeding years, 1962-65. During this time 26 died, 19 due to their respiratory disease; these 19 patients were initially more breathless, had a higher incidence of cor pulmonale, and had more severe airway obstruction and higher carbon dioxide pressures than the remainder. Type B patients (mortality 36%) had a worse prognosis than either type A (15%) or type X (12%). Of the measurements made, high carbon dioxide pressures were most closely related (<0·001) to mortality. During the period of follow-up about one-third of the patients who did not die became more short of breath and developed more severe airway obstruction and carbon dioxide retention: about 10% showed definite improvement in symptoms and pulmonary function. The F.E.V. declined on average by 46 ml./year, 4·8% of the initial value; V.C. declined by 120 ml./year, 4·0% of the initial value; mixed venous increased 1 mm. Hg/year. The changes that occurred during this time confirmed the previously reported similarity between the patients attending the two clinics. Although the incidence of bronchitic exacerbations was similar in the two cities, such illnesses in the London patients led to more frequent and more prolonged incapacity. [ABSTRACT FROM PUBLISHER]

The article reports on the spread of Spartina in the Chesire estuary of Dee, Wales. The spread of Spartina in Chesire shore started since 1945 due to its open sand banks, channel edges, and pans with integrated salt marshes. It came from Connah's Quay, Flintshire in 1928 and 1929. It is influenced by the formation of sward at the marsh front and consolidated marsh. It depends on the specie's annual seed set and on the survival rate and germination rate of seedlings from upper and lower marshes of the estuary.

AbstractObjectiveMethodResultsConclusion\nHIGHLIGHTSThere is a growing body of evidence on suicide risk in family carers, but minimal research on parents caring for children with disabilities and long-term illnesses. The aim of this study was to conduct the first dedicated research on suicide risk in parent carers and identify: (1) the number of parent carers experiencing suicidal thoughts and behaviors, and (2) the risk and protective factors for suicidality in this population.A cross-sectional survey of parent carers in England (n = 750), co-produced with parent carers. Suicidal thoughts and behaviors were measured with questions from the Adult Psychiatric Morbidity Survey. Frequencies summarized the proportion of carers experiencing suicidal thoughts and behaviors. Logistic regressions identified risk and protective factors.42% of parents had experienced suicidal thoughts and behaviors while caring for a disabled or chronically ill child. Only half had sought help for these experiences. Depression, entrapment, dysfunctional coping, and having a mental health diagnosis prior to caring, were significant risk factors.Parent carers contemplate suicide at levels that exceed those of other family carers and the general public. There is an urgent need, in policy and practice, to recognize parent carers as a priority group for prevention and intervention.This is the first dedicated study of suicide risk in parent carers.More than 40% of parents had considered suicide while caring for a disabled or chronically ill child.The risk factors for suicidal ideation in parent carers were depression, entrapment, dysfunctional coping strategies, and having a mental health diagnosis prior to becoming a carer.Parent carers may be a high-risk group for suicide and need urgent support. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of the Unite/Community Practitioners and Health Visitors Association Student Health Visiting Question Time event held at the University of Central Lancashire in England in May 2014. Highlights include funds raised by a cake sale for Cash4Kids charity that supports disadvantaged children, a reflection by Karen Whittaker on her time as a health visitor practitioner, and an issue raised by fellow students about job security.

Focuses on the vulnerability of labor in a low wage economy in Nottinghamshire, England and the activities of the local government association to contain it. Role assumed by the Nottingham County Council in relation to learning, skills and employment; List of good practice models adopted by the Nottingham County Council to support local unemployed people; Information on the code of practice adopted by the construction industry in Nottinghamshire.

The article presents a study that determines the effectiveness of adding MoleMate system to appropriately manage referrals of pigmented lesions from primary to secondary care settings. It cites the randomized controlled trial in general practices in England on adults with pigmented skin lesions. The result of the study indicates that adding MoleMate approach to the systematic applications of the best practice guidelines did not increase the proportion of appropriately referred lesions.

The measurement of flows and recording of storm events at combined sewer overflows are a key requirement in effective urban pollution management. Staff of Thames Water Utilities have developed a low-cost system based on monitoring the behaviour of flap valves on numerous major river outfalls. The paper presents the development of a modelling approach based on the principle of conservation of angular momentum and its application to experimental data for circular gates. Flow-prediction accuracies, based on the measurement of gate inclination and water depths, in the range 120-30%, are found to be achievable for wider gate openings (>20 deg.) -- the recommended calibration offering conservative flow predictions at lower angles. [ABSTRACT FROM AUTHOR]