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Background: Talking therapy for people with intellectual disabilities is often specifically adapted. One adaptation is the involvement of significant others in therapy, however, there is no systematic description of the use of this adaptation in routine clinical practice. Method: An online survey of UK psychologists regarding the inclusion of significant others in individual therapy with people with intellectual disabilities. Data were analysed using qualitative content analysis. Results: Ninety‐five psychologists who work with people with intellectual disabilities provided responses to questions regarding the decision to include significant others in therapy, factors that make including significant others more or less likely and how the role of significant others is explained to them. Conclusions: Psychologists consider a range of factors in deciding the involvement of significant others. We discuss implications for training of therapists working with people with intellectual disabilities, issues of consent and how the roles of significant others are understood. [ABSTRACT FROM AUTHOR]

Aims Adapting interventions with an existing evidence base offers a more efficient approach than developing a new intervention. The aim of this study was to describe the process of adapting a home-based cardiac rehabilitation (CR) programme (REACH-HF) intervention originally developed in the UK for people with heart failure (HF) to the Danish health system—the 'DK:REACH-HF' programme. Methods and results We followed methodological framework for the conduct and reporting of studies adapting interventions, utilizing documentary analysis, qualitative interviews, stakeholder consultations, and mapping of the Danish policy context. Our study found broad support for the REACH-HF intervention as an alternative to existing centre-based CR. We also identified three key areas of adaptation for the Danish context. First, reduce the word count of the intervention's resources by linking to existing publicly available CR materials. Second, while retaining REACH-HF core components, adapt its content and delivery to reflect differences between Denmark and UK. Third, develop a digital version of the intervention. Conclusion Using an evidence-based approach, we successfully adapted the REACH-HF intervention to the context of the Danish healthcare setting, maintaining core components of the original intervention and developing both a paper-based and digital version of the programme material. To inform scaled national implementation of the DK:REACH-HF programme, we seek to undertake a pilot study to test the adapted intervention materials feasibility and acceptability to healthcare practitioners, patients, and their caregivers and confirm the positive impact on the outcomes of HF patients and caregivers. [ABSTRACT FROM AUTHOR]

In order to slow the spread of COVID-19, on March 23, 2020, a strict lockdown was implemented in the UK. This was followed by alternating periods of less restrictive lockdowns until most public health restrictions were lifted in the summer of 2021. While these measures were necessary, they significantly affected people's daily activities, lifestyles, and mental well-being. This paper presents a longitudinal research study that focused on females aged 55 + in the UK, aiming to understand how COVID-19 and the subsequent 15-month period of lockdowns affected their lifestyles and emotions. The study collected data through online surveys, where respondents reported the frequency and mode of access to activities, and their positive and negative emotional experiences during distinct study phases that encompassed both lockdown and less strict periods. In contrast to previous studies highlighting vulnerabilities for females and the elderly during lockdowns, this research found that the studied group maintained an overall positive outlook throughout the study period and successfully adapted to the lockdowns by increasing their engagement in certain activities, in particular, activities like 'getting active'. In addition, our findings indicate rapid adaptive behaviour change towards many online activities, such as cultural activities. However, the study also revealed negative emotions and a decrease in some activities during the second lockdown in 2020 and the subsequent lockdowns in 2021, underscoring the challenges inherent in prolonged periods of confinement. In addition, the study found negative affect associated with some activities, including working and studying from home. The findings provide valuable insights into how females aged over 55 coped with stressful circumstances, which can inform the development of resilient and mental health-conscious public health policies and responses in preparation for future pandemics or other hazards. [ABSTRACT FROM AUTHOR]

Introduction: The Pathway for Eating disorders and Autism developed from Clinical Experience (PEACE pathway) is a clinical pathway of adapted treatment for individuals with eating disorders and autism in the UK. This study aims to investigate multidisciplinary clinicians' views of the strengths and challenges of PEACE pathway adaptations, while identifying areas where further improvement is needed. Method: Semi-structured interviews were conducted with 16 clinicians who worked on the PEACE pathway. Themes relevant to the benefits, challenges and areas of improvement were identified, and a thematic map was produced. Results: PEACE Pathway brought clinical benefits such as improved understanding of patients' perspective, improved flexibility and individualisation in clinicians' approach, increased patient engagement, and provision of resources that are helpful to all patients with or without autism. Benefits to the service included increase in autism awareness, clinicians' confidence, and team collaboration. Challenges were also identified, including difficulties in incorporating autism adaptations into existing treatment protocol, implementing PEACE at different levels of care, staff schedule conflicts, and increased pressure to meet patients' needs. Overall, there is a need for systemic improvement in aftercare and community support for autism, more suitable autism screening tool, and more structured guidelines for making adaptations. Conclusions and implications: PEACE Pathway has brought clinical and service benefits, while also bringing practical challenges rooted in the difficulty in distinguishing between autism and eating disorder in comorbid population. Future areas of improvement are highlighted for PEACE resources as well as in the national support system for autistic individuals. [ABSTRACT FROM AUTHOR]

Widespread spatially coherent flood events can cause severe damage and disruption. Climate change has the potential to change the severity and frequency of such events. Despite this, assessment of future fluvial flood risk typically gives little to no consideration to potential changes in the spatial structure of future events. To understand the significance of this gap, climate model simulations are coupled with a national hydrological model to identify event spatially coherent present and future flood events. A statistical Empirical Copula is used to generate a large number of unseen events and linked to a national flood risk simulation model. The research finds that including changes in the spatial structure of flood events materially increases projected changes in risk when compared to conventional approaches based on local uplifts alone; increasing the projected change in Expected Annual Damage across Great Britain by a factor of ~ 1.5. The event-based approach is also shown to provide new insights into the extreme distribution fluvial risk including single event damage, damage seasons, and damage years. The results suggest the 1-in-100-year winter flood may increase from £1.3b to £2.1b, and the 1-in-100 year single event damage may rise from £1.1b today to £1.7b by the 2080s given a 4 °C rise in Global Mean Surface Temperature (assuming current adaptation policies continue and no population growth). Consequently, the findings suggest a much greater emphasis is needed on spatial 'flood events' if future risk is to be understood and adaptation responses appropriately framed. [ABSTRACT FROM AUTHOR]

Background: Healthcare systems are operating under substantial pressures, and often simply cannot provide the standard of care they aspire to within the available resources. Organisations, managers, and individual clinicians make constant adaptations in response to these pressures, which are typically improvised, highly variable and not coordinated across clinical teams. The purpose of this study was to identify and describe the types of everyday pressures experienced by surgical teams and the adaptive strategies they use to respond to these pressures. Methods: We conducted interviews with 20 senior multidisciplinary healthcare professionals from surgical teams in four major hospitals in the United Kingdom. The interviews explored the types of everyday pressures staff were experiencing, the strategies they use to adapt, and how these strategies might be taught to others. Results: The primary pressures described by senior clinicians in surgery were increased numbers and complexity of patients alongside shortages in staff, theatre space and post-surgical beds. These pressures led to more difficult working conditions (e.g. high workloads) and problems with system functioning such as patient flow and cancellation of lists. Strategies for responding to these pressures were categorised into increasing or flexing resources, controlling and prioritising patient demand and strategies for managing the workload (scheduling for efficiency, communication and coordination, leadership, and teamwork strategies). Conclusions: Teams are deploying a range of strategies and making adaptations to the way care is delivered. These findings could be used as the basis for training programmes for surgical teams to develop coordinated strategies for adapting under pressure and to assess the impact of different combinations of strategies on patient safety and surgical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: We report results in relation to returning to driving in the UK under the exceptional cases rule for visual field loss. Methods: The Hemianopia Adaptation Study is a prospective clinical study recruiting adult stroke survivors with new onset homonymous hemianopia. The mobility assessment course (MAC) was used to measure navigational scanning. Car drivers were offered a 1-year post-stroke assessment to consider referral for driving assessment. Results: Of 144 participants, 51 were eligible for driving assessment, with 13 (25.4%) accepting appointment for UK Driving and Vehicle Licensing Agency (DVLA) referral. A statistically significant difference in gender and baseline Barthel (stroke severity) scores was found between those requesting referral and those declining (p＝0.046; p<0.001). MAC outcomes were significantly different, with those referred having a lower percentage of target omissions (9.0%) and faster mean course completion time (46.0 s), than those not referred (28.3%/72.5 s) (p＝0.006/p<0.001). Twelve of the 13 referred were offered a driving assessment by the DVLA. All 12 passed and returned to driving. Conclusions: It is possible for individuals with post-stroke homonymous hemianopia to return to driving, where exceptional cases criteria are met. There is evidence to support use of the MAC as a clinical measurement of adaptation. [ABSTRACT FROM AUTHOR]

As organisations, museums are responsible for conserving, protecting, and displaying artwork and artefacts. Museum buildings must deliver an environment that will continue to provide this facility for both current and future generations. This research focused on presenting a museum with quantifiable and measurable data to help with climate adaptation planning. A methodology was developed using monitored data. Subhourly data for both indoor and outdoor temperature and humidity spanning the years 2012–2021 was used to produce a daily maximum, daily minimum, and daily average dataset. A sensitivity analysis determined which years to use to derive the indoor-outdoor relationships used in climate modelling. Future impacts were calculated using UK Climate Projections 2018 (UKCP18) data (12 models on a 2.2 km scale), as published by the Met Office Hadley Centre. The data contained within the 12 models was overlayed with the relationships derived to calculate the projected indoor temperature and humidity conditions within the museum. The results presented indicate that temperature and humidity conditions are projected to exceed design conditions more frequently in the coming decades. Consequently, adaptation plans must consider the potential impacts that include indoor environmental deterioration, leading to discomfort and health implications, increased energy costs, and system upgrade costs, as well as the potential for accelerated degradation of artwork and artefacts. [ABSTRACT FROM AUTHOR]

Background: Evidence is needed to support local action to reduce the adverse health impacts of climate change and maximise the health co-benefits of climate action. Focused on England, the study identifies priority areas for research to inform local decision making. Methods: Firstly, potential priority areas for research were identified from a brief review of UK policy documents, and feedback invited from public and policy stakeholders. This included a survey of Directors of Public Health (DsPH) in England, the local government officers responsible for public health. Secondly, rapid reviews of research evidence examined whether there was UK evidence relating to the priorities identified in the survey. Results: The brief policy review pointed to the importance of evidence in two broad areas: (i) community engagement in local level action on the health impacts of climate change and (ii) the economic (cost) implications of such action. The DsPH survey (n = 57) confirmed these priorities. With respect to community engagement, public understanding of climate change's health impacts and the public acceptability of local climate actions were identified as key evidence gaps. With respect to economic implications, the gaps related to evidence on the health and non-health-related costs and benefits of climate action and the short, medium and longer-term budgetary implications of such action, particularly with respect to investments in the built environment. Across both areas, the need for evidence relating to impacts across income groups was highlighted, a point also emphasised by the public involvement panel. The rapid reviews confirmed these evidence gaps (relating to public understanding, public acceptability, economic evaluation and social inequalities). In addition, public and policy stakeholders pointed to other barriers to action, including financial pressures, noting that better evidence is insufficient to enable effective local action. Conclusions: There is limited evidence to inform health-centred local action on climate change. More evidence is required on public perspectives on, and the economic dimensions of, local climate action. Investment in locally focused research is urgently needed if local governments are to develop and implement evidence-based policies to protect public health from climate change and maximise the health co-benefits of local action. [ABSTRACT FROM AUTHOR]

Insect pollination is fundamental for natural ecosystems and agricultural crops. The bumblebee species Bombus terrestris has become a popular choice for commercial crop pollination worldwide due to its effectiveness and ease of mass rearing. Bumblebee colonies are mass produced for the pollination of more than 20 crops and imported into over 50 countries including countries outside their native ranges, and the risk of invasion by commercial non‐native bumblebees is considered an emerging issue for global conservation and biological diversity. Here, we use genome‐wide data from seven wild populations close to and far from farms using commercial colonies, as well as commercial populations, to investigate the implications of utilizing commercial bumblebee subspecies in the UK. We find evidence for generally low levels of introgression between commercial and wild bees, with higher admixture proportions in the bees occurring close to farms. We identify genomic regions putatively involved in local and global adaptation, and genes in locally adaptive regions were found to be enriched for functions related to taste receptor activity, oxidoreductase activity, fatty acid and lipid biosynthetic processes. Despite more than 30 years of bumblebee colony importation into the UK, we observe low impact on the genetic integrity of local B. terrestris populations, but we highlight that even limited introgression might negatively affect locally adapted populations. [ABSTRACT FROM AUTHOR]

Understanding the rate and extent to which populations can adapt to novel environments at their ecological margins is fundamental to predicting the persistence of biological communities during ongoing and rapid global change. Recent range expansion in response to climate change in the UK butterfly Aricia agestis is associated with the evolution of novel interactions with a larval food plant, and the loss of its ability to use an ancestral host species. Using ddRAD analysis of 61,210 variable SNPs from 261 females from throughout the UK range of this species, we identify genomic regions at multiple chromosomes that are associated with evolutionary responses, and their association with demographic history and ecological variation. Gene flow appears widespread throughout the range, despite the apparently fragmented nature of the habitats used by this species. Patterns of haplotype variation between selected and neutral genomic regions suggest that evolution associated with climate adaptation is polygenic, resulting from the independent spread of alleles throughout the established range of this species, rather than the colonization of pre‐adapted genotypes from coastal populations. These data suggest that rapid responses to climate change do not depend on the availability of pre‐adapted genotypes. Instead, the evolution of novel forms of biotic interaction in A. agestis has occurred during range expansion, through the assembly of novel genotypes from alleles from multiple localities. [ABSTRACT FROM AUTHOR]

Differences in preferences for body size between cultures are well documented. A well known explanation is that differences are a result of psychological adaptation to local environments. Since the optimal body size (often measured as Body Mass Index/BMI, weight divided by squared height kg/m2) for health differs between areas, the attractiveness and health judgements should also be different. Until now, no study has directly tested whether the difference in attractiveness perception is accompanied by a difference in health perception. In the current study, we compared the attractiveness and health judgements of male and female bodies varying in BMI and muscularity between British and Chinese participants. Since the health risks are greater for Chinese than British individuals with increasing BMI, one may expect Chinese participants to perceive a lower BMI as more attractive and healthier than British participants. Analyses showed that, although the Chinese participants preferred thinner partners compared to their British counterparts, there was no difference in the health judgements made by Chinese and British participants. Moreover, the male and female bodies that were seen as most attractive were thinner than those perceived as most healthy by Chinese participants. These findings challenge the adaptation account that people adjust their mate preferences to match what is most healthy in local environments. [ABSTRACT FROM AUTHOR]

This is a study of the challenges faced by Chinese expatriate managers and their strategic responses in securing a workable degree of alignment in UK subsidiaries, against a backdrop of competing home‐country and host‐country pressures. Although much of the literature on home‐country and host‐country effects tends to either adopt a culture or an institutional approach, this study highlights the intermeshed nature of the two. In locating cultural dynamics within an institutional firmament, this study juxtaposes the effects of each and draws conclusions as to their intersection. It is founded on in‐depth interviews with home‐country and host‐country managers. The findings suggest, on the one hand, Chinese expatriate managers tended to see local regulations as an obstacle to efficiency, rather than as a means to access context‐specific complementarities. On the other hand, these managers recognized the need to fit in with established locally specific ways of doing things and in securing sufficient staff buy in to sustain operations, and played a key intermediary role between headquarters and subsidiary. [ABSTRACT FROM AUTHOR]

Wheat is a major crop worldwide, mainly cultivated for human consumption and animal feed. Grain quality is paramount in determining its value and downstream use. While we know that climate change threatens global crop yields, a better understanding of impacts on wheat end‐use quality is also critical. Combining quantitative genetics with climate model outputs, we investigated UK‐wide trends in genotypic adaptation for wheat quality traits. In our approach, we augmented genomic prediction models with environmental characterisation of field trials to predict trait values and climate effects in historical field trial data between 2001 and 2020. Addition of environmental covariates, such as temperature and rainfall, successfully enabled prediction of genotype by environment interactions (G × E), and increased prediction accuracy of most traits for new genotypes in new year cross validation. We then extended predictions from these models to much larger numbers of simulated environments using climate scenarios projected under Representative Concentration Pathways 8.5 for 2050–2069. We found geographically varying climate change impacts on wheat quality due to contrasting associations between specific weather covariables and quality traits across the UK. Notably, negative impacts on quality traits were predicted in the East of the UK due to increased summer temperatures while the climate in the North and South‐west may become more favourable with increased summer temperatures. Furthermore, by projecting 167,040 simulated future genotype–environment combinations, we found only limited potential for breeding to exploit predictable G × E to mitigate year‐to‐year environmental variability for most traits except Hagberg falling number. This suggests low adaptability of current UK wheat germplasm across future UK climates. More generally, approaches demonstrated here will be critical to enable adaptation of global crops to near‐term climate change. [ABSTRACT FROM AUTHOR]

Our findings provide evidence that railway workers showed low levels of mental wellbeing during the third period of lockdown during the COVID-19 pandemic in the United Kingdom (December 2020–March 2021). The benefits of fostering both individual and team resilience as well as encouraging mental health help-seeking is emphasised. Objective: Railway workers have provided an essential service throughout the COVID-19 pandemic. This study explored the effects of COVID-19 on the mental well-being of railway workers (N = 906) in the United Kingdom during the third lockdown period. Method: The online survey included measures of COVID-19–related risk factors (perceived risk, stress, burnout, trauma) and protective factors (resilience coping, team resilience, general help seeking) associated with mental well-being. Responses were analyzed using multiple regression and content analysis. Results: COVID-19–related risk factors negatively predicted well-being. Higher scores on adaptive resilience, intentions to seek help, and team resilience significantly predicted higher mental well-being scores. Mental health decline throughout the COVID-19 pandemic and concerns for the future were reported. Conclusions: Building a resilient railway workforce requires attention to staff mental well-being and to ensuring that support systems are robust and accessible. [ABSTRACT FROM AUTHOR]

Non-use of climate information is often attributed to scientists failing to understand what decision-makers need. In response, co-production offers one promising method to improve the usability, and therein, use of climate information. Yet it remains unclear to what extent usability and use are linked, or if other factors influence the non-use of climate information. This paper critically examines two efforts to co-produce climate information for UK adaptation decision-making: the first and second cycles of the climate change risk assessment to gather evidence and then inform the national adaptation programme. To do this, a mixed methods approach was used: (i) textual analysis of official Government documents, and (ii) in-depth interviews with key actors. Our research found that the institutional-political context in which climate information is produced and used, played a significant role in defining who the user should be, how the data analysis was performed, and the extent to which that information was used. Just because something is co-produced does not mean it will be usable, nor does something that's usable automatically mean it will be used. Unless new research seeks to better understand how the modes of production (linear vs. co-production) influence the use of climate information, who uses it, and how it's used, questions will remain over whether the right barriers to climate inaction have been tackled. • Co-production promises to improve the usability and use of climate information. • We conducted an interview and document analysis of the UK's climate change risk assessments. • Use and usability of climate information differ. • More research is needed on the difference co-production makes to use and usability of climate information. [ABSTRACT FROM AUTHOR]

Human Factors methods play a key role in challenging assumptions, analyzing interactions, and informing decision‐making in complex sociotechnical systems and organizations that manage safety risks. Structured methodological approaches also have a role to play in better understanding properties of systems such as adaptation. Adaptation is increasingly recognized as being an important feature that supports the production of safety in complex sociotechnical systems. A safety management intervention, introduced to address a real risk in UK air traffic control but which resulted in unanticipated, maladaptive, and emergent effects, is analyzed using the Hierarchical Task Analysis, Systems Theoretic Accident Model and Processes, Functional Resonance Analysis Method, Human Factors Analysis and Classification System, Cognitive Work Analysis, Critical Decision Method, and Event Analysis of Systemic Teamwork Methods. The results from the application of each of the methods are presented and the different perspectives on adaptation that the methods provide are compared. A methodological framework is presented that has the potential to explore the factors of adaptation across the organizational hierarchy and assist safety practitioners in supporting decision makers in safety‐related organizations. [ABSTRACT FROM AUTHOR]

The global health emergency of COVID-19 in early 2020 placed much of the population under quarantine. Interstitial Lung Disease in childhood (chILD) was recommended to be a pediatric clinically extremely vulnerable (CEV) group in April 2020 for shielding due to the unknown health consequences of COVID-19 in children with chronic respiratory conditions. This qualitative longitudinal research study explores how chILD parents in the UK experienced COVID-19 lockdown from over two interview time points. Participants (n = 8) were recruited from chILD patient organizations and online communities. Interview one focused on the period between January 2020 to July 2020, gaining personal insight into respondent's experience of lockdowns, which included questions on support systems and media coverage of COVID-19. The second interview enquired how respondents managed further UK lockdowns between September 2020 and May 2021. The main themes were uncertainty and adaptation. Respondents described how they navigated the UK lockdowns and undertook various risk management strategies for pandemic isolation. Once these were established, routine and positive family bonding was reported, along with a reluctant acceptance of the COVID-19 virus and continued shielding. As new COVID-19 information emerged, risk management strategies changed or remained for some respondents, bringing a feeling of living with COVID-19 as a "new normal". (Understanding the unique insights people with rare diseases such as chILD face during a global pandemic adds to policy and healthcare literature. Recommendations include further study of caregiver traits and resilience, essential facets of positive pandemic adaptation., (© 2024 The Author(s). Pediatric Pulmonology published by Wiley Periodicals LLC.)

Industrial pollution is a major driver of ecosystem degradation, but it can also act as a driver of contemporary evolution. As a result of intense mining activity during the Industrial Revolution, several rivers across the southwest of England are polluted with high concentrations of metals. Despite the documented negative impacts of ongoing metal pollution, brown trout (Salmo trutta L.) survive and thrive in many of these metal-impacted rivers. We used population genomics, transcriptomics, and metal burdens to investigate the genomic and transcriptomic signatures of potential metal tolerance. RADseq analysis of six populations (originating from three metal-impacted and three control rivers) revealed strong genetic substructuring between impacted and control populations. We identified selection signatures at 122 loci, including genes related to metal homeostasis and oxidative stress. Trout sampled from metal-impacted rivers exhibited significantly higher tissue concentrations of cadmium, copper, nickel and zinc, which remained elevated after 11 days in metal-free water. After depuration, we used RNAseq to quantify gene expression differences between metal-impacted and control trout, identifying 2042 differentially expressed genes (DEGs) in the gill, and 311 DEGs in the liver. Transcriptomic signatures in the gill were enriched for genes involved in ion transport processes, metal homeostasis, oxidative stress, hypoxia, and response to xenobiotics. Our findings reveal shared genomic and transcriptomic pathways involved in detoxification, oxidative stress responses and ion regulation. Overall, our results demonstrate the diverse effects of metal pollution in shaping both neutral and adaptive genetic variation, whilst also highlighting the potential role of constitutive gene expression in promoting metal tolerance., (© 2024 The Author(s). Molecular Ecology published by John Wiley & Sons Ltd.)

In this article, we considered women's experiences of undertaking Higher Education (HE) study (Foundation Degree in Early Years (EY)) drawing on research based in the North of England, UK. The study, informed by a social constructionist approach, explored 10 women's experiences of work–life balance (WLB) and well-being alongside HE study through semi-structured interviews. A focus group explored women's personal perceptions of WLB and well-being. The findings were analysed thematically and we argue that the formation of a third sphere of commitment (HE study) disrupted WLB and created some disequilibrium, which impacted upon the women's well-being. The women underwent a transformative process as initial academic inexperience and lack of belonging in University was replaced by confidence and student identity. This transformation was made possible through personal adaptations, diverse strategies and motivation that indicated individual and collective resilience. One noticeable strategy involved the overlapping of commitment spheres, including HE study taking place at home. While being challenging to manage, this contributed to an important cultural shift as study became normal for households, creating the 'learning family'. [ABSTRACT FROM AUTHOR]

First performed at Watford Palace Theatre in 2004, Tanika Gupta's version of William Wycherley's The Country Wife (1675) relocates the Restoration classic to twenty-first-century London, reframing its libertine plot as a witty satire on sexual and gender mores in contemporary Britain. In this new setting, Wycherley's comic masterpiece is revisited from a multicultural perspective, and his merciless exposure of social hypocrisies becomes infused with the adaptor's keen awareness of diversity and its complexities. This article draws attention to Gupta's play as a culturally significant intervention in the reception history of Restoration theatre culture. By opening up Wycherley's comedy to the representation of Britain's "new ethnicities," I suggest, Gupta's work has paved the way for the more inclusive, multiculturally conscious approach to the Restoration canon that is observable in the new spate of revivals and adaptations produced during the last decade or so. [ABSTRACT FROM AUTHOR]

Background: Retinoblastoma is a rare form of pediatric eye cancer for which enucleation is a common treatment modality. There is an increasing focus upon the impact of enucleation on children and families. This study aimed to explore the experiences of children and their families following enucleation to consider the barriers that may be encountered when adjusting to living with an artificial eye and identifying the support services and strategies used to address these barriers. Methods: Using a descriptive qualitative approach, interviews were conducted with 12 parents and seven children and thematic analysis was used to identify four themes representing the perspective of parents and children. Results: Parent themes identified were (a) entry into the world of retinoblastoma; (b) the importance of specialist support; (c) a family learning to cope; and (d) navigating school. The perspectives of children were (a) the importance of preparation and play; (b) positive reinforcement and hospital support; (c) support and openness at home; and (d) the importance of good school planning. Two overarching themes related to parent and child adaptation were also identified. Discussion: The study findings reveal that the process of adapting to living with an artificial eye extended to influencing decisions around parenting, learning to advocate for their child, and supporting children through school and peer relationships. For children, the importance of ongoing support and information was vital to enhance understanding, adaptation, and development of independence. Overall, the study suggests that children and families undergoing enucleation need continuing, individualized, and specialist support. [ABSTRACT FROM AUTHOR]

Interorganizational projects often suffer disruptions that require participating organizations to adapt in order to restore project operations. We study the role of communication style in facilitating adaptation to such disruptions. Whereas the literature on interorganizational communication has emphasized communication mode and frequency, we study the content and features of written communication in seven U.K. construction projects. Communication style mattered for adaptation quality in these projects, and we found that several properties of communication style were particularly important for adaptation: cost and information orientation, as well as informality, precision and authenticity. Moreover, managerial slack and organizational reputation were important precursors of communication style. These results provide novel insights into the role of communication style in adaptation to interorganizational project disruptions. We discuss the implications of these insights for research on interorganizational projects in operations and supply chain management. [ABSTRACT FROM AUTHOR]

This study focused on the adaptation experiences of international students who are mothers. Using resilience theory perspectives of adaptation, this research investigated the experiences of female students from Saudi Arabia with respect to parenting and family life while studying in the UK. Interviews were conducted with 23 postgraduate students. Questions focused on their experiences as a mother studying in the UK and their accompanying families' experiences. Responses were analysed using thematic analysis and resilience theory perspectives with data organized into five main resilience themes: challenges and adversities, worries and vulnerabilities, sources of support and protective environments, personal positive experiences and strengths, family positive experiences and strengths. Participants reported experiencing a range of parenting challenges including increased family duties in the absence of extended family support and concerns about their children's upbringing while away from their home country. However, this was balanced by the positive experiences they identified for themselves and their children including personal development and closer relationships within the family. Advantages of resilience theory perspectives included identifying international students' personal strengths, competencies and sources of support. Awareness of benefits as well as potential challenges may help to guide and support students and their families before and during their sojourn. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a highly prevalent condition, with optimal treatment to BP targets conferring significant gains in terms of cardiovascular outcomes. Understanding why some patients do not achieve BP targets would be enhanced through greater understanding of their health-related quality of life (HRQoL). However, the only English language disease-specific instruments for measurement of HRQoL in hypertension have not been validated in accordance with accepted standards. It is proposed that the Spanish MINICHAL instrument for the assessment of HRQoL in hypertension could be translated, adapted and validated for use in the United Kingdom. The aim of the study was therefore to complete this process.Methods: The MINICHAL authors were contacted and the original instrument obtained. This was then translated into English by two independent English-speakers, with these versions then reconciled, before back-translation and subsequent production of a 2nd reconciled version. Thereafter, a final version was produced after cognitive debriefing, for administration and psychometric analysis in the target population of patients living in the Exeter area (Southwest UK) aged 18-80 years with treatment-naïve grade II-III hypertension, before, during and after 18 weeks' intensive treatment.Results: The English-language instrument was administered to 30 individuals (median age: 58.5 years, 53% male). Psychometric analysis demonstrated a floor effect, though no ceiling effect. Internal consistency for both state of mind (StM) and somatic manifestations (SM) dimensions of the instrument were acceptable (Cronbach's alpha = 0.81 and 0.75), as was test-retest reliability (ICC = 0.717 and 0.961) and construct validity, which was measured through co-administration with the EQ-5D-5L and Bulpitt-Fletcher instruments. No significant associations were found between scores and patient characteristics known to affect HRQoL. The EQ-5D-5L instrument found an improvement in HRQoL following treatment, with the StM and SM dimensions of the English language MINICHAL trending to support this (d = 0.32 and 0.02 respectively).Conclusions: The present study details the successful English translation and validation of the MINICHAL instrument for use in individuals with hypertension. The data reported also supports an improvement in HRQoL with rapid treatment of grade II-III hypertension, a strategy which has been recommended by contemporaneous European guidelines. Trial registration ISRCTN registry number: 57475376 (assigned 25/06/2015). [ABSTRACT FROM AUTHOR]

A grounded theory approach, consistent with the work of Strauss and Corbin, was used to undertake semi-structured interviews with 17 older people, to explore their experiences of living in a care home, during the four- to six-week period following the move. Purposive sampling was initially adopted, thereafter, theoretical sampling was employed to recruit individuals identified by care managers within older peoples' community teams and care home managers within a large Health and Social Care Trust in the United Kingdom. Consistent with grounded theory methodology, data collection and analysis occurred simultaneously. Constant comparative analysis underpinned data analysis and data management techniques. Data analysis revealed five distinct categories that captured these experiences. These were: (a) wanting to connect – 'I am so lost here', (b) wanting to adapt – 'Well mentally you have to make the best of it', (c) waiting for assistance – 'it's a frustration for me', (d) 'waiting on the end' – I am making no plans' and (e) wanting to re-establish links with family and home – 'I love getting home and I like getting out to the town'. Together these five categories formed the basis of the core category, 'Waiting and Wanting', which encapsulates the initial adaptation experiences of the men and women in the study. Findings indicate that individuals were dependent on others to create a sense of belonging, independence and wellbeing. Moreover, risk aversive practices were perceived as a threat to individuals' independence and autonomy. Recommendations include the need to amend policy and practice for the development of a bespoke induction programme for each resident facilitated by a senior member of the care home staff working in partnership with individuals and families, in addition to the health and social care team, to support a more positive transition for new residents, relatives and care home staff. [ABSTRACT FROM AUTHOR]

This grounded theory study sought to explore how older adults' experience the transition from living at home to a care home with a specific focus on the latter part of the first year of the move. The study was carried out within a large Health Trust in the UK between August 2017 and May 2019. Purposive sampling was used in the initial stages of data collection. Thereafter and consistent with grounded theory methodology, theoretical sampling was employed to undertake semi‐structured interviews with 17 individuals from eight care homes between 5 and 12 months after the move. This paper reports five key categories which were: (a) The lasting effect of first Impressions 'They helped me make my mind up' (b) On a Journey 'I just take it one day at a time', (c) Staying connected and feeling 'at home' 'You get something good out of it you know...you get hope'. (d) Managing loss and grief 'It was important for me to say cheerio to the house' and (e) Caring relationships 'I didn't realise that I was lonely until I had company'. Together these five categories formed the basis of the core category 'The Primacy of 'Home' which participants identified as a place they would like to feel valued, nurtured and have a sense of belonging. This study identifies that it is important for individual preferences and expectations to be managed from the outset of the move. Individuals and families need to be supported to have honest and caring conversations to promote acceptance and adaptation to living in a care home while continuing to embrace the heart of 'home'. Key recommendations from this study include the need to raise awareness of the significance of the ongoing psychological and emotional well‐being needs of older people which should be considered in policy directives and clinical practice. [ABSTRACT FROM AUTHOR]

In this paper, we assess the quality of state-of-the-art regional climate information intended to support climate adaptation decision-making. We use the UK Climate Projections 2018 as an example of such information. Their probabilistic, global, and regional land projections exemplify some of the key methodologies that are at the forefront of constructing regional climate information for decision support in adapting to a changing climate. We assess the quality of the evidence and the methodology used to support their statements about future regional climate along six quality dimensions: transparency; theory; independence, number, and comprehensiveness of evidence; and historical empirical adequacy. The assessment produced two major insights. First, a major issue that taints the quality of UKCP18 is the lack of transparency, which is particularly problematic since the information is directed towards non-expert users who would need to develop technical skills to evaluate the quality and epistemic reliability of this information. Second, the probabilistic projections are of lower quality than the global projections because the former lack both transparency and a theory underpinning the method used to produce quantified uncertainty estimates about future climate. The assessment also shows how different dimensions are satisfied depending on the evidence used, the methodology chosen to analyze the evidence, and the type of statements that are constructed in the different strands of UKCP18. This research highlights the importance of knowledge quality assessment of regional climate information that intends to support climate change adaptation decisions. [ABSTRACT FROM AUTHOR]

The UK Climate Change Act requires the Environment Agency to report the risks it faces from climate change and actions taken to address these. Derived information from projections is critical to understanding likely impacts in water management. In 2019, the UK published an ensemble of high-resolution model simulations. The UKCP Local (2.2 km) projections can resolve smaller scale physical processes that determine rainfall and other variables at subdaily time-scales with the potential to provide new insights into extreme events, storm runoff and drainage management. However, simulations also need to inform adaptation. The challenge ahead is to identify and provide derived products without the need for further analysis by decision-makers. These include a wider evaluation of uncertainty, narratives about rainfall change across the projections and bias-corrected datasets. Future flood maps, peak rainfall estimates, uplift factors and future design storm profiles also need detailed guidance to support their use. Central government support is justified in the provision of up-to-date impacts information to inform flood risk management, given the large risks and exposure of all sectors. The further development of projections would benefit from greater focus and earlier scoping with industry representatives, operational tool developers and end users. This article is part of a discussion meeting issue 'Intensification of short-duration rainfall extremes and implications for flash flood risks'. [ABSTRACT FROM AUTHOR]

Social Impact Statement: Climate change presents challenges to agricultural production systems. Wheat is a significant crop in the United Kingdom, occupying 40% of arable land area. Increased temperatures and drought risk are predicted to lead to future productivity losses. Plant breeders and researchers are working to develop more resilient wheat varieties although are often driven by different motivating factors compared to farmers. Here, we report on a dialog with agronomists working with farmers in wheat‐producing regions throughout the UK to gain greater understanding of the farm‐level importance of wheat flowering time and maturity along with the future opportunities and risks presented by earlier flowering varieties. Summary Optimized environmental adaptation is the cornerstone of regional crop breeding. Recent and predicted future instability for long‐standing adaptive response presents new challenges to selective breeding. Wheat is a long day plant, requiring extended daylength to initiate flowering, a response controlled by the Photoperiod‐1 (Ppd‐1) gene. Mutations conferring photoperiod insensitivity arose during domestication, allowing rapid flowering in both short and long days and extending wheat's adaptive range. In the United Kingdom, wheat production is dominated by photoperiod‐sensitive winter varieties which have a relatively narrow window of flowering time. Changing seasonal conditions alongside mounting logistics pressure as a result of loss of effective agrochemicals and increasing seasonal weather fluctuations mean that greater flexibility in varietal flowering time is likely required to sustain UK wheat productivity. In this Opinion piece, we present findings from a recent dialog with UK agronomists on the demand and likely potential for greater flowering time range in winter wheat varieties. This provides important insight connecting farmer priorities and demands with ongoing genetic research and breeding. Our findings highlight the farm‐level importance of wheat phenology and provide recommendations for future research and plant breeding. [ABSTRACT FROM AUTHOR]

Little is known about what recovery means to those with chronic fatigue syndrome/myalgic encephalomyelitis, a poorly understood, disabling chronic health condition. To explore this issue, semi-structured interviews were conducted with patients reporting improvement (n = 9) and deterioration (n = 10) after a guided self-help intervention, and analyzed via "constant comparison." The meaning of recovery differed between participants—expectations for improvement and deployment of the sick role (and associated stigma) were key influences. While some saw recovery as complete freedom from symptoms, many defined it as freedom from the "sick role," with functionality prioritized. Others redefined recovery, reluctant to return to the lifestyle that may have contributed to their illness, or rejected the concept as unhelpful. Recovery is not always about eliminating all symptoms. Rather, it is a nexus between the reality of limited opportunities for full recovery, yet a strong desire to leave the illness behind and regain a sense of "normality." [ABSTRACT FROM AUTHOR]

Summertime overheating in dwellings in temperate climates is widespread. Overheating in bedrooms disrupts sleep, degrading health and wellbeing, and can be life-threatening. Air-conditioning homes is a solution, but is expensive and adds load onto electricity networks. An alternative is to provide safe havens, a cool retreat for sleeping when the main bedroom overheats. This paper estimates the number of English dwellings that might already have such spaces. The 2017 Energy Follow Up Survey (EFUS) to the English Housing Survey (EHS) provides temperatures measured in the main bedroom, up to two other bedrooms and the living room of 750 homes. These data were collected in 2018, a summer typical of those expected in the 2050s. The main bedroom overheated in 19% of the housing stock as judged by an adaptive comfort criterion. Up to 76% of these homes had living rooms that could provide a safe haven, and in up to 46% an alternative bedroom might provide a safe haven. Very few, if any, flats and small-area dwellings had a safe haven. These figures provide an upper-bound estimate; in practice the useable number of safe havens is likely to be less. [ABSTRACT FROM AUTHOR]

TESOL postgraduate students come to the UK from China seeking an authentic environment in which to develop their English language skills and learn about their host culture. This paper provides a substantive review of the historical context of higher education in China, including its Confucian cultural heritage, and shows its evolution from a system of rote learning to one increasingly embracing critical thinking and active classrooms. Significant previous studies on the Chinese international student experience in Western academic contexts are then presented. Applying this, we present a needs analysis conducted at a British university to elucidate perceived missing adaptation support and the resulting programme, demonstrating what was successful and providing best practice recommendations for other universities looking to enhance sociocultural support for this changing student population. Our goal is to assert the need for Western higher education to acknowledge the changing profile Chinese international students, specifically postgraduates, will have upon matriculation. [ABSTRACT FROM AUTHOR]

Media coverage of climate change impacts and adaptation will likely influence how citizens think society can and should adapt. Here, we undertook the first analysis of UK newspaper adaptation coverage. We identified five prominent adaptation narratives: (1) the government should build more flood defences, (2) home owners should buy flood insurance, (3) individuals should become more informed, (4) the farming industry should innovate, (5) and the natural environment should fight for its survival. We find that only some of the more immediate climate change impacts likely to affect the UK are presented as necessitating a response. The government is considered primarily responsible while UK citizens are given few and narrow responsibilities. The range of adaptive actions under consideration is limited and unchallenging to the status quo. In summary, newspaper coverage presents a restricted view as to when the UK should adapt and how it could adapt. [ABSTRACT FROM AUTHOR]

• We compared multilevel coastal flood risk reduction governance and public finance in the UK, Germany, the Netherlands and Australia. • We evaluated alignment of multilevel governance arrangements to spillovers from coastal risk reduction based on fiscal federalism. • We find diverse coastal flood risk governance arrangements ranging from highly centralised to full decentralisation. • We find that multilevel coastal flood risk governance arrangements are reflective of the distribution of the benefits across different levels of government. • We find that major fiscal redistributions may be put under pressure by rising costs under SLR and coastal development. Coastal flood risk reduction (CFRR) presents a significant public funding challenge, due to its high upfront costs and long-term benefits, and this challenge will increase with future sea-level rise. The funding challenge necessarily involves multiple levels of government, due to the regional nature of CFRR public goods involved. Yet there has been little research comparing such multilevel arrangements across countries, and in particular exploring the performance of public funding arrangements for providing coastal flood risk reduction. We address this gap, applying fiscal federalism to develop a multilevel governance analysis of public decision-making and fiscal authorities for CFRR in the Netherlands, Germany, the UK and Australia. For each country, we locate key decision-making and fiscal authorities in multilevel governance arrangements, and analyse their alignment with the benefits of CFRR measures (spillovers). We find diverse coastal flood risk governance arrangements ranging from highly centralised (NL), mixed arrangements, involving regional centralisation (Germany) or partial devolvement (UK), to full decentralisation (AUS). Further, we find that in accordance with fiscal federalism, multilevel coastal flood risk governance arrangements are generally reflective of the distribution of the benefits across different levels of government, with some exceptions (Germany and UK). Finally, exploring the outlook of current arrangements under sea-level rise, we find that major fiscal redistributions may be put under pressure by rising costs likely under SLR and future coastal development. This is particularly the case for those systems which operate under hazard-based, as opposed to risk-based, coastal protection policies. Further, we find that both fully and moderately decentralised arrangements may require greater central support for alternative measures, such as retreat, in light of growing financial burdens on local governments. [ABSTRACT FROM AUTHOR]

In this study, we examine photoprotection for children with Xeroderma pigmentosum (XP), a rare genetic skin disease requiring rigorous photoprotection, to reduce risks of severe burning and skin cancers from exposure to ultraviolet radiation (UVR). We elicit the views and experiences of both children and their parents to inform the care and support provided. Qualitative semistructured interviews were undertaken with 12 child–parent dyads recruited from the National XP Specialist service in London. We employed a framework approach to analysis. This identified a high level of photoprotection based either on "protection" to facilitate normal activities or "avoidance" of outdoor activity with priority given to normality in the future. These approaches were shaped by perceptions of clinical risk, the emphasis given to a normal family life and families' circumstances and resources. The findings contribute to notions of normalization and coping with demanding care regimens and inform approaches to working with families. [ABSTRACT FROM AUTHOR]

Background: Embedding pharmacists in general practice has been shown to create cost efficiencies, improve patient care and free general practitioner capacity. Consequently, there is a drive to recruit additional pharmacists to work within general practices. However, equipping pharmacists with behaviour and influencing skills may further optimise their impact. Key elements which may enhance behaviour and influencing skills include self-efficacy and resilience. Objective: This study aimed to: 1) Assess general practice pharmacists' self-efficacy and resilience. 2) Explore differences primarily between pharmacists reporting lower and higher self-efficacy, secondarily for those reporting lower and higher scores for resilience. Methods: All 159 NHS Greater Glasgow and Clyde general practice pharmacists were invited to complete an online survey in May 2019. The survey captured anonymised data covering: demographics; professional experience; qualifications, prescribing status and preferred learning styles. Unconscious learning needs for behavioural and influencing skills were assessed using validated tools: the new general self-efficacy scale (GSES) and short general resilience scale (GRIT). Participants' responses were differentiated by the lowest quartile and higher quartiles of GSES and GRIT scores, and analysed to identify differences. Results: The survey was completed by 57% (91/159) of eligible pharmacists; mean age 38 (range 24-60) years; 91% were of white ethnicity and 89% female. The median time qualified was 14 (1-38) years and 3 (1-22) years working in general practices. Overall pharmacists scored well on the GSES, mean 25 (SD 3; 95%CI 24.4-25.6), and GRIT, mean 30 (SD 4; 95%CI 29.6-30.4), out of a maximum 32 and 40 respectively. A significant positive correlation between GSES and GRIT scores was found (Pearson's r=0.284, p=0.006). However, no significant differences were identified between pharmacists scoring in the lower and upper quartiles by GSES or GRIT. Overall respondents reported their preferred learning styles were activists (46%) or pragmatists (29%). The majority (91%) preferred blended learning methods as opposed to 38% or less for a range of online methods. Conclusions: General practice pharmacists on average scored highly for self-efficacy and resilience. Higher scores did not appear to be associated with demographic, years of practice, professional or educational experience. Prospective interventions to support those with lower scores may enhance and optimise pharmacists' effectiveness in general practice. [ABSTRACT FROM AUTHOR]

The interactions between value and power in networks of buyer-seller relationships in a quasi-market have been explored during this research, thus beginning to provide empirical evidence in an area that has not previously received detailed attention. Three in-depth case studies were undertaken in the UK National Health Service. In these case studies, the complex sets of relationships between the purchasers and providers of community health care (this includes health visiting, district nursing, and therapies such as chiropody and physiotherapy) were investigated. The findings reveal a number of adaptations that have resulted from the complex set of power and value interactions within the network. The findings confirm that value and power need to be considered from both a dyadic and network perspective and illustrate that business-to-business marketing principles can make a valid contribution to the health care debate. [ABSTRACT FROM AUTHOR]

Parasites are known for their ability to rapidly adapt to changing conditions. For parasitic helminths, changes in climate, along with farming and management practices associated with the intensification of livestock farming, provide novel challenges which can impact on their epidemiology and control. The sustainability of livestock production partially relies on effective control of helminth infection. Therefore, understanding changes in parasite behaviour, and what drives these, is of great importance. Nematodirus battus is an economically important helminth in the UK and temperate regions. Its infective larvae typically overwinter in eggs on pasture and hatch synchronously in spring, causing acute disease in lambs. Attempts to control disease typically rely on whole-flock benzimidazole (BZ) treatments. In recent years, the emergence of BZ-resistance, alongside the hatching of eggs without the classical over-winter 'chill stimulus', have made N. battus more difficult to control. In three previous studies, after collecting a large number of N. battus populations alongside farm management data from commercial farms, we explored the prevalence of genetic mutations associated with BZ-resistance (n = 253 farms), the ability of eggs to hatch with and without a chill stimulus (n = 90 farms) and how farm management practices varied throughout the UK (n = 187 farms). In the present study, we identify factors which may be acting as drivers, or barriers, to either the development of resistance or the variable hatching behaviour of N. battus eggs. Generalised linear mixed effect models were applied to regress experimental hatching and genotyping data on farm management and additional environmental data. Both variable hatching and resistance development appeared associated with the maintenance of parasite refugia as well as grazing management, particularly reseeding of pasture routinely grazed by young lambs each spring and the practice of set-stocked grazing. Effective quarantine measures were identified as the main protective factor for the development of BZ-resistance whereas set stocked grazing and population bottlenecks, resulting from reseeding heavily contaminated pastures, were risk factors. Spring maximum temperature and other climatic factors were associated with 'typical' hatching of eggs following a chill stimulus whilst several management factors were linked with hatching without prior chilling. For example, practices which reduce parasite numbers on pasture (e.g. re-seeding) or restrict availability of hosts (e.g. resting fields), were found to increase the odds of non-chill hatching. Retention of the timing of lambing and infection level of the host within the fitted model indicated that requirement for a chill stimulus prior to hatching may be plastic, perhaps subject to change throughout the grazing season, in response to immune development or parasite density-dependence within the host. Further investigation of the influence of the factors retained within the fitted models, particularly the theme of parasite refugia which was highlighted in relation to both the presence of BZ-resistance alleles and alternative hatching, is required to establish robust, sustainable parasite control and farm management strategies. [Display omitted] • Effective quarantine is a protective factor against BZ-resistance in N. battus. • Requirement for chill stimulus in N. battus egg hatching may be a plastic attribute. • N. battus egg hatching following typical winter chill is driven by climatic factors. • Grazing and pasture management linked to altered hatching behaviour in N. battus. [ABSTRACT FROM AUTHOR]

This research consists of a questionnaire survey to the largest UK multinational companies and investigates companies' level of adaptation and standardisation across international marketing tactics. It examines whether multinational companies are adapting or standardising their marketing mix elements when they cross geographical borders and expand their operations to foreign markets. This research identified that both adaptation and standardisation are used at the same time. The level of integration is dependent upon considerations of the relationship between the reasons and elements identified and an understanding of how these are affected by a number of factors. This article proposes a new modelling approach, the AdaptStand Process, which outlines the different stages to be undertaken by multinational companies towards identifying the level of integration across marketing mix elements. Consequently, the results of this research guide marketing practitioners in deciding on implementation of marketing tactics when competing in the international marketing arena. [ABSTRACT FROM AUTHOR]

Transnational academic mobility is of growing importance in higher education. Yet, the acculturation for individual academics is challenging. Taking a phenomenological approach, we interviewed twenty foreign-born academics, who had been living and working in the UK for at least one year, and analysed their emotional experiences of acculturation by chronological stages. Then, using Gross's (Gross, J. J. 1998. "Antecedent-and Response-Focused Emotion Regulation: Divergent Consequences for Experience, Expression, and Physiology." Journal of Personality and Social Psychology 74 (1): 224–237; Gross, J. J. 2014. "Emotion Regulation: Conceptual and Empirical Foundations." In Handbook of Emotion Regulation, 2nd ed., edited by J. J. Gross, 3–20. New York: Guilford) model of emotion regulation, we analysed how participants used emotion regulation processes throughout their adaptation to their new environments. The study makes an original contribution firstly by applying a model of emotion regulation not previously used in researching academic life. Secondly, this study shows that, unlike stage theories, acculturation is not experienced primarily in linear stages, but as an ongoing process during which immigrant academics actively work on changing the things that challenge them. Thirdly, the findings emphasise the contributions rather than deficits of immigrant academics. Implications for supporting immigrant academics' acculturation are discussed. [ABSTRACT FROM AUTHOR]

• Transfusion adaptations show differences between work-as-imagined and work-as-done. • Adaptation triggers are mostly due to staff issues or poor information technology. • Tasks and processes are often adapted instead of the underlying trigger problem. • Most adaptations are forced workarounds, while a few are proactive improvements. • Managers are often unaware of adaptations, so fail to learn from resilient practice. Blood transfusion is considered one of the safer aspects of healthcare, however potentially avoidable patient-safety incidents led to 14 deaths in the United Kingdom in 2017. Improvement initiatives often focus on staff compliance with standard operating procedures. This fails to understand adaptations made in a complex, dynamic environment, so the aim of this study is to examine the extent and nature of adaptations at all stages of the vein to vein transfusion process. Thirty-seven employees described sixty-six adaptations in their transfusion practices, showing clear differences between what has been characterised as work-as-imagined (WAI) and work-as-done (WAD). An analysis of the adaptations using the Systems Engineering Initiative for Patient Safety 2.0 (SEIPS 2.0) shows that triggers for adaptations were mostly staff-related or driven by poor information technology systems, but the resultant adaptations were usually amendments to tasks and processes. The majority of adaptations (83%) were forced – ideal solutions are not possible, so workarounds and coping strategies are required, but some (17%) were proactive – the surrounding system is adequate, but performance is improved by adapting. Managers or colleagues were largely unaware of adaptations made (79%) and, as a result, opportunities may be missed to identify and learn from resilient practices. The Concepts for Applying Resilience Engineering (CARE) model was further articulated in order to shed extra light on triggers and mechanisms. We make a number of suggestions regarding how we can better learn from adaptations and how these could be used to improve the safety of the blood transfusion process. [ABSTRACT FROM AUTHOR]

The first description of the hitherto unknown alate morph of the recently discovered giant aphid species Stomaphis wojciechowskii Depa is presented, based on examination of specimens collected in the United Kingdom and Poland in 2018. A key for the determination of known alate morphs of the genus Stomaphis is provided. Morphological comparisons are made between the alate morph of S. wojciechowskii and the closely-related, sympatric species Stomaphis quercus L., and we discuss how the observed differences may have evolved as an adaptation of each species to the very different ecological niche occupied by their respective ant hosts: S. wojciechowskii to Lasius brunneus (Latreille), and S. quercus to Lasius fuliginosus (Latreille). [ABSTRACT FROM AUTHOR]

To understand how climate adaptation planning and decision-making will progress, a better understanding is needed as to which organisations are expected to take on key responsibilities. Methodological challenges have impeded efforts to identify and track adaptation actors beyond the coarse scale of nation states. Yet, for effective adaptation to succeed, who do national governments need to engage, support and encourage? Using the UK as a case study, we conducted a systematic review of official government documents on climate adaptation, between 2006 and 2015, to understand which organisations are identified as key to future adaptation efforts and tracked the extent to which these organisations changed over time. Our unique longitudinal dataset found a very large number of organisations (n = 568). These organisations varied in size (small-medium enterprises to large multinationals), type (public, private and not-for-profit), sector (e.g. water, energy, transport and health), scale (local, national and international), and roles and responsibilities (policymaking, decision-making, knowledge production, retail). Importantly, our findings reveal a mismatch between official government policies that repeatedly call on private organisations to drive adaptation, on the one hand, and a clear dominance of the public sector on the other hand. Yet, the capacity of organisations to fulfil the roles and responsibilities assigned to them, particularly in the public sector, is diminishing. Unless addressed, climate adaptation actions could be assigned to those either unable, or unwilling, to implement them. [ABSTRACT FROM AUTHOR]

Marine recreational fishing is popular globally and benefits coastal economies and people's well‐being. For some species, it represents a large component of fish landings. Climate change is anticipated to affect recreational fishing in many ways, creating opportunities and challenges. Rising temperatures or changes in storms and waves are expected to impact the availability of fish to recreational fishers, through changes in recruitment, growth and survival. Shifts in distribution are also expected, affecting the location that target species can be caught. Climate change also threatens the safety of fishing. Opportunities may be reduced owing to rougher conditions, and costs may be incurred if gear is lost or damaged in bad weather. However, not all effects are expected to be negative. Where weather conditions change favourably, participation rates could increase, and desirable species may become available in new areas. Drawing on examples from the UK and Australia, we synthesize existing knowledge to develop a conceptual model of climate‐driven factors that could impact marine recreational fisheries, in terms of operations, participation and motivation. We uncover the complex pathways of drivers that underpin the recreational sector. Climate changes may have global implications on the behaviour of recreational fishers and on catches and local economies. [ABSTRACT FROM AUTHOR]

The UK is already experiencing the impacts of climate change and these are expected to increase in scale and severity in the coming decades. Preparing for impacts by undertaking adaptive actions can potentially reduce the level of harm. In the UK, the government's adaptation program aims to develop a "climate-ready society." However, achieving broad public engagement in adaptation presents a significant communications challenge. Here, we aimed to understand how UK residents use and interpret the terms "climate change impacts" and "climate change adaptation." We conducted a secondary analysis of 22 interviews with UK residents, who were recruited for their diverse climate change views. The interviewees expressed a lack of clarity around expected climate change impacts, which did not prevent them from saying that they were already experiencing the effects of a changing climate. Further, threats to cultural norms and values were perceived as serious and emotionally charged. Adaptation was often conflated with mitigation, and responsibility for adaptation was contested. We discuss the implications of our findings for developing more useful public communication about climate change adaptation. [ABSTRACT FROM AUTHOR]

Throughout the period 1860–1914, British Quaker women sought to negotiate the incorporation of fashionable attire into their wardrobes to varying degrees, after the religion's hierarchy made prescriptive religious 'Plain' dress optional in 1860. After centuries of restrictive Advices, which used Scripture alongside peer pressure to encourage female Friends to dress ascetically, Quaker women began to interpret their new sartorial freedoms in diverse ways. Through the presentation of three female case studies from across the period, this article will suggest three newly identified distinct stances that Quaker women enacted in responding to the new Advice and adapting to fashionable ensembles, up until the devastating events of the First World War. These three stances were non-adaptive, semi-adaptive and fully adaptive. Based on empirical research conducted in dress collections across Britain, this article will describe and present the garments worn by these women, to illustrate and introduce these distinct sartorial stances. [ABSTRACT FROM AUTHOR]

The New Zealand government recently announced an intention to make the country carbon neutral by 2050. Interest has been expressed in using the United Kingdom's Climate Change Act 2008 as a model to achieve this goal. However, more needs to be done to critically review the UK legislation's applicability to the New Zealand context. This article identifies some of the issues emerging from a ten-year review of the UK act. It is hoped that close consideration of these issues will inform New Zealand policy and legislative development. [ABSTRACT FROM AUTHOR]

Tom Yendell, an artist based in Hampshire, England, provided the cover art for the Summer 2018 issue of The Open Journal of Occupational Therapy (OJOT). "Silk Flowers" is a mouth painting made from acrylic on silk. Born a bilateral congenital amputee, Tom has learned to use his toes the same ways others use their hands. Tom relies little on aids and adaptations in his everyday life. He believes learning to do things your own way is empowering. As a world-renowned mouth and foot painter, Tom is a living example of how barriers can be overcome by doing things differently. Through his art and charitable works, Tom applies his creative energy, organizational skill, and determination to inspire others to live life to the fullest. [ABSTRACT FROM AUTHOR]

In the United Kingdom (UK) the prison population has increased by around one third since the turn of the millennium amid growing concern over the correctional mission of prisons, the number of prisoners exhibiting mental health difficulties and high levels of recidivism. This study aims to explore the relationship between 'imported' (pre-prison) factors and prisoner mental health status. Prisoners (N = 756) from two UK prisons completed an established measure of mental health (General Health Questionnaire: GHQ-12) and a bespoke survey on pre-prison characteristics and experiences (for example, dispositions, childhood abuse, substance misuse, learning difficulties and employment). Prevalence of mental health difficulties was high, with 40.3% reaching the 'caseness' threshold. Binary logistic regression and odds ratio analyses were used to explore the ability of imported factors to predict mental health 'caseness' and the direction of influence. Collectively, the imported factors correctly predicted the caseness category of 76.5% of participants (p < .001). Pre-prison dispositions proved to be strong predictors of caseness as did childhood sexual abuse and learning difficulties at school. We found the direction of influence of three imported factors differed from all others: unemployment, prior experience of prison and a history of substance misuse. These three factors are associated with a lower rate of mental health caseness. It is of concern that, on release, these same factors are likely to militate against re-integration into society. Imported factors can serve as powerful predictors of 'within-prison' mental health status, but practitioners need to be cognisant of the relative importance and direction of influence of factors, as evidenced by these findings. [ABSTRACT FROM AUTHOR]