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This study examines how psychological aspects of vestibular disorders are currently addressed highlighting any national variation.
Method
An online survey was completed by 101 UK healthcare professionals treating vestibular disorders. The survey covered service configurations, attitudes towards psychological aspects and current clinical practice.
Results
Ninety-six per cent of respondents thought there was a psychological component to vestibular disorders. There was a discrepancy between perceived importance of addressing psychological aspects and low confidence to undertake this. Those with more experience felt more confident addressing psychological aspects. History taking and questionnaires containing one or two psychological items were the most common assessment approaches. Discussing symptoms and signposting were the most frequent management approaches. Qualitative responses highlighted the interdependence of psychological and vestibular disorders which require timely intervention. Barriers included limited referral pathways, resources and interdisciplinary expertise.
Conclusion
Although psychological distress is frequently identified, suitable psychological treatment is not routinely offered in the UK.
The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) will be held in Washington DC, USA, from Saturday, 26 August, 2023 to Friday, 1 September, 2023, inclusive. The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery will be the largest and most comprehensive scientific meeting dedicated to paediatric and congenital cardiac care ever held. At the time of the writing of this manuscript, The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery has 5,037 registered attendees (and rising) from 117 countries, a truly diverse and international faculty of over 925 individuals from 89 countries, over 2,000 individual abstracts and poster presenters from 101 countries, and a Best Abstract Competition featuring 153 oral abstracts from 34 countries. For information about the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery, please visit the following website: [www.WCPCCS2023.org]. The purpose of this manuscript is to review the activities related to global health and advocacy that will occur at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery.
Acknowledging the need for urgent change, we wanted to take the opportunity to bring a common voice to the global community and issue the Washington DC WCPCCS Call to Action on Addressing the Global Burden of Pediatric and Congenital Heart Diseases. A copy of this Washington DC WCPCCS Call to Action is provided in the Appendix of this manuscript. This Washington DC WCPCCS Call to Action is an initiative aimed at increasing awareness of the global burden, promoting the development of sustainable care systems, and improving access to high quality and equitable healthcare for children with heart disease as well as adults with congenital heart disease worldwide.
This report addresses the critical issues of implementation of the long-term public service agenda. The authors draw upon a unique range of research, practice and theory from the fields of community development, regeneration projects, public and private sector management and organisation development, as well as public and social policy.
In November 2019, an outbreak of Shiga toxin-producing Escherichia coli O157:H7 was detected in South Yorkshire, England. Initial investigations established consumption of milk from a local dairy as a common exposure. A sample of pasteurised milk tested the next day failed the phosphatase test, indicating contamination of the pasteurised milk by unpasteurised (raw) milk. The dairy owner agreed to immediately cease production and initiate a recall. Inspection of the pasteuriser revealed a damaged seal on the flow divert valve. Ultimately, there were 21 confirmed cases linked to the outbreak, of which 11 (52%) were female, and 12/21 (57%) were either <15 or >65 years of age. Twelve (57%) patients were treated in hospital, and three cases developed haemolytic uraemic syndrome. Although the outbreak strain was not detected in the milk samples, it was detected in faecal samples from the cattle on the farm. Outbreaks of gastrointestinal disease caused by milk pasteurisation failures are rare in the UK. However, such outbreaks are a major public health concern as, unlike unpasteurised milk, pasteurised milk is marketed as ‘safe to drink’ and sold to a larger, and more dispersed, population. The rapid, co-ordinated multi-agency investigation initiated in response to this outbreak undoubtedly prevented further cases.
The years between 1258 and 67 comprise one of the most influential periods in the Middle Ages in England. This turbulent decade witnessed a bitter power struggle between King Henry III and his baronsover who should control the government of the realm. Before England eventually descended into civil war, a significant proportion of the baronage had attempted to transform its governance by imposingon the crown a programme of legislative and administrative reform far more radical and wide-ranging than Magna Carta in 1215. Constituting a critical stage in the development of parliament, the reformist movement would remain unsurpassed in its radicalism until the upheavals of the seventeenth century. Simon de Montfort, the baronial champion, became the first leader of a political movement to seize power and govern in the king's name. The essays collected here offer the most recent research into and ideas on this pivotal period. Several contributions focus upon the roles played in the political struggle by particular sections of thirteenth-century society, including the Midland knights and their political allegiances, aristocratic women, and the merchant elite in London. The events themselves constitute the second major theme of this volume, with subjects such as the secret revolution of 1258, Henry III's recovery of power in 1261, and the little studied maritime theatre during the civil wars of 1263-7 being considered.
Adrian Jobson is an Associate Lecturer at Canterbury Christ Church University.
Contributors: Sophie Ambler, Nick Barratt, David Carpenter, Peter Coss, Mario Fernandes, Andrew H. Hershey, Adrian Jobson, Lars Kjaer, John A. McEwan, Tony Moore, Fergus Oakes, H.W. Ridgeway, Christopher David Tilley, Benjamin L. Wild, Louise J. Wilkinson.
The thirteenth century saw major developments in England's administration, as the procedures and processes of government expanded rapidly, the principles enshrined in Magna Carta became embedded, knights and burgesses were summoned to Parliament for the first time, and nothing short of a political revolution took place. The essays here draw on material available for the first time via the completion of the project to calendar all the Fine Rolls of Henry III; these rolls comprise the last series of records of the English Chancery from that period to become readily available in a convenient form, thereby transforming access to several important fields of research, including financial, legal, political and social issues. The volume covers topics including the evidential value of the fine rolls themselves and their wider significance for the English polity, developments in legal and financial administration, the roles of women and the church, and the fascinating details of the development of the office of escheator. Related or parallel developments in Scotland, Wales and Ireland are also dealt with, giving a broader British dimension.
Louise J. Wilkinson is Professor of Medieval History, Canterbury Christ Church University; David Crook is Honorary Research Fellow at the National Archives and the University of Notthingham.
Contributors: Nick Barratt, Paul Brand, David Carpenter, David Crook, Paul Dryburgh, Beth Hartland, Philippa Hoskin, Charles Insley, Adrian Jobson, Tony Moore, Alice Taylor, Nicholas Vincent, Scott Waugh, Louise Wilkinson
Dinosaur body fossil material is rare in Scotland, previously known almost exclusively from the Great Estuarine Group on the Isle of Skye. We report the first unequivocal dinosaur fossil from the Isle of Eigg, belonging to a Bathonian (Middle Jurassic) taxon of uncertain affinity. The limb bone NMS G.2020.10.1 is incomplete, but through a combination of anatomical comparison and osteohistology, we determine it most likely represents a stegosaur fibula. The overall proportions and cross-sectional geometry are similar to the fibulae of thyreophorans. Examination of the bone microstructure reveals a high degree of remodelling and randomly distributed longitudinal canals in the remaining primary cortical bone. This contrasts with the histological signal expected of theropod or sauropod limb bones, but is consistent with previous studies of thyreophorans, specifically stegosaurs. Previous dinosaur material from Skye and broadly contemporaneous sites in England belongs to this group, including Loricatosaurus and Sarcolestes and a number of indeterminate stegosaur specimens. Theropods such as Megalosaurus and sauropods such as Cetiosaurus are also known from these localities. Although we find strong evidence for a stegosaur affinity, diagnostic features are not observed on NMS G.2020.10.1, preventing us from referring it to any known genera. The presence of this large-bodied stegosaur on Eigg adds a significant new datapoint for dinosaur distribution in the Middle Jurassic of Scotland.
The scarcity of Romano-British human remains from north-west England has hindered understanding of burial practice in this region. Here, we report on the excavation of human and non-human animal remains1 and material culture from Dog Hole Cave, Haverbrack. Foetal and neonatal infants had been interred alongside a horse burial and puppies, lambs, calves and piglets in the very latest Iron Age to early Romano-British period, while the mid- to late Roman period is characterised by burials of older individuals with copper-alloy jewellery and beads. This material culture is more characteristic of urban sites, while isotope analysis indicates that the later individuals were largely from the local area. We discuss these results in terms of burial ritual in Cumbria and rural acculturation. Supplementary material is available online (https://doi.org/10.1017/S0068113X20000136), and contains further information about the site and excavations, small finds, zooarchaeology, human osteology, site taphonomy, the palaeoenvironment, isotope methods and analysis, and finds listed in Benson and Bland 1963.
The field of matter transport is central to understanding the processing of materials and their subsequent mechanical properties. While thermodynamics determines the final state of a material system, it is the kinetics of mass transport that governs how it gets there. This book, first published in 2000, gives a solid grounding in the principles of matter transport and their application to a range of engineering problems. The author develops a unified treatment of mass transport applicable to both solids and liquids. Traditionally matter transport in fluids is considered as an extension of heat transfer and can appear to have little relationship to diffusion in solids. This unified approach clearly makes the connection between these important fields. This book is aimed at advanced undergraduate and beginning graduate students of materials science and engineering and related disciplines. It contains numerous worked examples and unsolved problems. The material can be covered in a one semester course.
The emergence of punk in Britain (1976–1978) is recalled and documented as a moment of rebellion, one in which youth culture was seen to challenge accepted values and forms of behaviour, and to set in motion a new kind of cultural politics. In this article we do two things. First, we ask how far punk's challenge extended. Did it penetrate those political, cultural and social elites against which it set itself? And second, we reflect on the problem of recovering the history and politics of moments such as punk, and on the value of archives to such exercises in recuperation. In pursuit of both tasks, we make use of a wide range of historical sources, relying on these rather than on retrospective oral or autobiographical accounts. We set our findings against the narratives offered by both subcultural and mainstream histories of punk. We show how punk's impact on elites can be detected in the rhetoric of the popular media, and in aspects of the practice of local government and the police. Its impact on other elites (e.g. central government or the monarchy) is much harder to discern. These insights are important both for enriching our understanding of the political significance of punk and for how we approach the historical record left by popular music.
We explore the variation in pupil attainment at the end of secondary schooling in England. The paper links data on all schools and all pupils within these schools to analyse the role of the school in accounting for this variation. We analyse a number of different indicators of pupil attainment including value added between the end of primary and secondary schooling and attainment levels at the end of secondary schooling. We examine indicators that were the focus of the school accounting framework as well as other indicators that were not directly part of how schools were assessed. We show that schools account for a minority of the variance in pupil attainment, and the extent of the variation accounted for by the school is sensitive to the measure of pupil attainment used. In addition, we find that the majority of the explained school-level variance in attainment is related to school composition. However, most of the variance in attainment remains unexplained, raising questions about what other factors contribute to the variation in school performance.
In this paper, we summarise and critique a network meta-analysis (NMA) of antidepressant efficacy and tolerability for paediatric depression and an accompanying editorial. Although we agree that many of the extant studies are flawed, this meta-analysis showed clear efficacy of fluoxetine in the NMA, and for sertraline and escitalopram in pairwise analyses. Consequently, these papers underestimate the benefits of antidepressants for paediatric depression, and provide support for current practice guideline, which recommends the use of an antidepressant if the patient does not respond to psychotherapy. In these circumstances, fluoxetine should be the first choice, with escitalopram and sertraline as alternatives.
Declaration of interest
D.A.B. receives royalties from Guilford Press, has or will receive royalties from the electronic self-rated version of the C-SSRS from eResearch Technology, Inc., is on the editorial board of UpToDate, and is a reviewer for Healthwise. R.D.G. serves as an expert witness for the US Department of Justice, Pfizer, Wyeth and GSK; and is the founder of Adaptive Testing Technologies. P.W. receives personal fees from Lundbeck and Takeda. B.D. reports a licensing agreement with Lundbeck for a psychosocial treatment manual for depression. No other disclosures were reported.
Geochemical and related studies have been made of near-surface sediments from the River Clyde estuary and adjoining areas, extending from Glasgow to the N, and W as far as the Holy Loch on the W coast of Scotland, UK. Multibeam echosounder, sidescan sonar and shallow seismic data, taken with core information, indicate that a shallow layer of modern sediment, often less than a metre thick, rests on earlier glacial and post-glacial sediments. The offshore Quaternary history can be aligned with onshore sequences, with the recognition of buried drumlins, settlement of muds from quieter water, probably behind an ice dam, and later tidal delta deposits. The geochemistry of contaminants within the cores also indicates shallow contaminated sediments, often resting on pristine pre-industrial deposits at depths less than 1m. The distribution of different contaminants with depth in the sediment, such as Pb (and Pb isotopes), organics and radionuclides, allow chronologies of contamination from different sources to be suggested. Dating was also attempted using microfossils, radiocarbon and 210Pb, but with limited success. Some of the spatial distribution of contaminants in the surface sediments can be related to grain-size variations. Contaminants are highest, both in absolute terms and in enrichment relative to the natural background, in the urban and inner estuary and in the Holy Loch, reflecting the concentration of industrial activity.