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Monitoring of mammal species is an important part in detecting changes in their status. Efforts are based on a variety of direct and indirect methods and many low density populations are monitored through field signs. We present data on the endangered European red squirrel from Kidland Forest in the UK. We used cone transects to both record changes in seed availability and to monitor population trends. We examined the difficulty of accurately detecting population change when populations are low and field signs are patchily distributed. Current efforts would be sufficient to detect significant population declines of 50-75% in years with a modest squirrel population but not when they fall below one squirrel for every 20 ha of forest. The findings emphasise that monitoring aims have to be clearly defined with an awareness and understanding of what level of change the adopted methodological approach can reliably detect. We propose that mammal monitoring schemes need to be based on a pilot scheme to determine effect size and planned accordingly.

Background Community-acquired pneumonia (CAP) is a common childhood infection. In September 2006, heptavalent pneumococcal conjugate vaccine (PCV7) was added into the UK national immunisation programme. Data from this study were compared with those from a similar study undertaken in the same hospitals in 2000-2001 to describe the disease epidemiological trend. Aim To evaluate the impact of PCV7 on the incidence of all causes childhood CAP. Methods A prospective population-based study including 11 hospitals in the North East of England from August 2008 to July 2009. Eligible cases were all children aged 0-16 years who presented with clinical and radiological features of pneumonia. Demographic and clinical details were recorded. Results Five hundred and seventy-six cases were initially identified, 34 of them had normal chest x-ray and were removed after validation, leaving a total of 542 cases eligible for enrolment (57.7% males; 73.8% under-five). The rate of empyema complication was 5.3%. Lobar consolidation was reported in 29.9%, and pleural effusion was present in 9.6% of the chest x-rays. PCV7 uptake was 88.9% among the eligible group, which is similar to that recorded nationally in the NHS Immunisation Statistics for England 2008-2009. In comparison with the data from 2001 study, there were 28% fewer cases of CAP in 2009 study. The incidence of CAP decreased from 14.4 cases per 10 000 children in 2001 to 11.8 cases per 10 000 children in 2009 (95% CI 0.74 to 0.92). Conclusion This study suggests that following the introduction of PCV7, the incidence of childhood pneumonia seen in hospital has decreased since 2001. [ABSTRACT FROM AUTHOR]

Background: Complete surgical removal of the prostate, radical prostatectomy, is the most frequently used treatment option for men with localised prostate cancer. The use of laparoscopic (keyhole) and robot-assisted surgery has improved operative safety but the comparative effectiveness and cost-effectiveness of these options remains uncertain., Objective: This study aimed to determine the relative clinical effectiveness and cost-effectiveness of robotic radical prostatectomy compared with laparoscopic radical prostatectomy in the treatment of localised prostate cancer within the UK NHS., Data Sources: MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, BIOSIS, Science Citation Index and Cochrane Central Register of Controlled Trials were searched from January 1995 until October 2010 for primary studies. Conference abstracts from meetings of the European, American and British Urological Associations were also searched. Costs were obtained from NHS sources and the manufacturer of the robotic system. Economic model parameters and distributions not obtained in the systematic review were derived from other literature sources and an advisory expert panel., Review Methods: Evidence was considered from randomised controlled trials (RCTs) and non-randomised comparative studies of men with clinically localised prostate cancer (cT1 or cT2); outcome measures included adverse events, cancer related, functional, patient driven and descriptors of care. Two reviewers abstracted data and assessed the risk of bias of the included studies. For meta-analyses, a Bayesian indirect mixed-treatment comparison was used. Cost-effectiveness was assessed using a discrete-event simulation model., Results: The searches identified 2722 potentially relevant titles and abstracts, from which 914 reports were selected for full-text eligibility screening. Of these, data were included from 19,064 patients across one RCT and 57 non-randomised comparative studies, with very few studies considered at low risk of bias. The results of this study, although associated with some uncertainty, demonstrated that the outcomes were generally better for robotic than for laparoscopic surgery for major adverse events such as blood transfusion and organ injury rates and for rate of failure to remove the cancer (positive margin) (odds ratio 0.69; 95% credible interval 0.51 to 0.96; probability outcome favours robotic prostatectomy = 0.987). The predicted probability of a positive margin was 17.6% following robotic prostatectomy compared with 23.6% for laparoscopic prostatectomy. Restriction of the meta-analysis to studies at low risk of bias did not change the direction of effect but did decrease the precision of the effect size. There was no evidence of differences in cancer-related, patient-driven or dysfunction outcomes. The results of the economic evaluation suggested that when the difference in positive margins is equivalent to the estimates in the meta-analysis of all included studies, robotic radical prostatectomy was on average associated with an incremental cost per quality-adjusted life-year that is less than threshold values typically adopted by the NHS (£30,000) and becomes further reduced when the surgical capacity is high., Limitations: The main limitations were the quantity and quality of the data available on cancer-related outcomes and dysfunction., Conclusions: This study demonstrated that robotic prostatectomy had lower perioperative morbidity and a reduced risk of a positive surgical margin compared with laparoscopic prostatectomy although there was considerable uncertainty. Robotic prostatectomy will always be more costly to the NHS because of the fixed capital and maintenance charges for the robotic system. Our modelling showed that this excess cost can be reduced if capital costs of equipment are minimised and by maintaining a high case volume for each robotic system of at least 100-150 procedures per year. This finding was primarily driven by a difference in positive margin rate. There is a need for further research to establish how positive margin rates impact on long-term outcomes., Funding: The National Institute for Health Research Health Technology Assessment programme.

Landscape management practices that alter the degree of habitat fragmentation can significantly affect the genetic structure of animal populations. British red squirrels use "stepping stone" patches of habitat to move considerable distances through a fragmented habitat. Over the past few decades, the planting of a large conifer forest has connected groups of forest fragments in the north of England with those in southern Scotland. This "defragmentation" of the landscape has resulted in substantial genetic mixing of Scottish and Cumbrian genes in squirrel populations up to 100 kilometers from the site of the new forest. These results have implications for the conservation management of animal and plant species in fragmented landscapes such as those found in Britain.