The political economy of bovine tuberculosis in Great Britain

A brief history of bovine tuberculosis (bTB) and its control in Great Britain is presented. Numerous diverse policies to control the disease in man, cattle and wildlife have been pursued over the last 100 years and many millions of pounds have been spent. After notable success in reducing the incidence and prevalence of bTB in cattle in GB from the 1950s to the mid-1980s, the number of cattle slaughtered has increased with increased geographical spread continually since that time with a high point of bTB incidence in 2008. This increase appeared to coincide with changing policy regarding the control of the disease in badgers with a more humane approach adopted and with strengthened protection for badgers through legislation. Indeed, much controversy has been involved in the debate on the role of badgers in disease transmission to cattle and the need for their control as vectors of the disease with various commissioned research projects, trials, public consultations and media attention. The findings of two social science investigations presented as examples showed that citizens generally believed that bTB in cattle is an important issue that needs to be tackled but objected to badgers being killed, whilst cattle farmers were willing to pay around £17/animal/year for a bTB cattle vaccine. It is noted that successes regarding the control of bTB in other countries have combined both cattle and wildlife controls and had strong involvement from industry working with government.

Species distribution models for crop pollination: a modelling framework applied to Great Britain

Insect pollination benefits over three quarters of the world's major crops. There is growing concern that observed declines in pollinators may impact on production and revenues from animal pollinated crops. Knowing the distribution of pollinators is therefore crucial for estimating their availability to pollinate crops; however, in general, we have an incomplete knowledge of where these pollinators occur. We propose a method to predict geographical patterns of pollination service to crops, novel in two elements: the use of pollinator records rather than expert knowledge to predict pollinator occurrence, and the inclusion of the managed pollinator supply. We integrated a maximum entropy species distribution model (SDM) with an existing pollination service model (PSM) to derive the availability of pollinators for crop pollination. We used nation-wide records of wild and managed pollinators (honey bees) as well as agricultural data from Great Britain. We first calibrated the SDM on a representative sample of bee and hoverfly crop pollinator species, evaluating the effects of different settings on model performance and on its capacity to identify the most important predictors. The importance of the different predictors was better resolved by SDM derived from simpler functions, with consistent results for bees and hoverflies. We then used the species distributions from the calibrated model to predict pollination service of wild and managed pollinators, using field beans as a test case. The PSM allowed us to spatially characterize the contribution of wild and managed pollinators and also identify areas potentially vulnerable to low pollination service provision, which can help direct local scale interventions. This approach can be extended to investigate geographical mismatches between crop pollination demand and the availability of pollinators, resulting from environmental change or policy scenarios.

Using reanalysis data to quantify extreme wind power generation statistics : a 33 year case study in Great Britain

With a rapidly increasing fraction of electricity generation being sourced from wind, extreme wind power generation events such as prolonged periods of low (or high) generation and ramps in generation, are a growing concern for the efficient and secure operation of national power systems. As extreme events occur infrequently, long and reliable meteorological records are required to accurately estimate their characteristics. Recent publications have begun to investigate the use of global meteorological “reanalysis” data sets for power system applications, many of which focus on long-term average statistics such as monthly-mean generation. Here we demonstrate that reanalysis data can also be used to estimate the frequency of relatively short-lived extreme events (including ramping on sub-daily time scales). Verification against 328 surface observation stations across the United Kingdom suggests that near-surface wind variability over spatiotemporal scales greater than around 300 km and 6 h can be faithfully reproduced using reanalysis, with no need for costly dynamical downscaling. A case study is presented in which a state-of-the-art, 33 year reanalysis data set (MERRA, from NASA-GMAO), is used to construct an hourly time series of nationally-aggregated wind power generation in Great Britain (GB), assuming a fixed, modern distribution of wind farms. The resultant generation estimates are highly correlated with recorded data from National Grid in the recent period, both for instantaneous hourly values and for variability over time intervals greater than around 6 h. This 33 year time series is then used to quantify the frequency with which different extreme GB-wide wind power generation events occur, as well as their seasonal and inter-annual variability. Several novel insights into the nature of extreme wind power generation events are described, including (i) that the number of prolonged low or high generation events is well approximated by a Poission-like random process, and (ii) whilst in general there is large seasonal variability, the magnitude of the most extreme ramps is similar in both summer and winter. An up-to-date version of the GB case study data as well as the underlying model are freely available for download from our website: http://www.met.reading.ac.uk/~energymet/data/Cannon2014/.

Bridging the two cultures. Commercial archaeology and the study of prehistoric Britain

This paper was given at a meeting of the Society held on 12 January 2006 and it discusses the relationship between academic research and developer-funded archaeology in Britain today, highlighting the strengths and weaknesses of each. It considers the relationship between archaeological theory and practice and discusses the changing roles of academics, fieldworkers and managers. It argues that important issues need to be resolved, including the dissemination of information from recent archaeological fieldwork and the use of ‘grey literature’ in informing more ambitious interpretations of the past.

The Palaeolithic Rivers of Southwest Britain

The Palaeolithic Rivers of Southwest Britain (PRoSWeB) project synthesises the archaeological evidence for the Lower and Middle Palaeolithic occupation of south-west Britain (c. 500,000 - 40,000 BP), with a principal focus upon the archaeological and geological potential of the region's Middle Pleistocene fluvial environments. South-west Britain was defined as the region west of the headwaters of the Rivers Frome and Piddle and south-west of the River Avon.

What is the new medicines use review ‘patient survey’ attempting to capture in the context of existing patient satisfaction with pharmacy questionnaires and a new conceptual framework?

The community pharmacy service medicines use review (MUR) was introduced in 2005 ‘to improve patient knowledge, concordance and use of medicines’ through a private patient–pharmacist consultation. The MUR presents a fundamental change in community pharmacy service provision. While traditionally pharmacists are dispensers of medicines and providers of medicines advice, and patients as recipients, the MUR considers pharmacists providing consultation-type activities and patients as active participants. The MUR facilitates a two-way discussion about medicines use. Traditional patient–pharmacist behaviours transform into a new set of behaviours involving the booking of appointments, consultation processes and form completion, and the physical environment of the patient–pharmacist interaction moves from the traditional setting of the dispensary and medicines counter to a private consultation room. Thus, the new service challenges traditional identities and behaviours of the patient and the pharmacist as well as the environment in which the interaction takes place. In 2008, the UK government concluded there is at present too much emphasis on the quantity of MURs rather than on their quality.[1] A number of plans to remedy the perceived imbalance included a suggestion to reward ‘health outcomes’ achieved, with calls for a more focussed and scientific approach to the evaluation of pharmacy services using outcomes research. Specifically, the UK government set out the main principal research areas for the evaluation of pharmacy services to include ‘patient and public perceptions and satisfaction’as well as ‘impact on care and outcomes’. A limited number of ‘patient satisfaction with pharmacy services’ type questionnaires are available, of varying quality, measuring dimensions relating to pharmacists’ technical competence, behavioural impressions and general satisfaction. For example, an often cited paper by Larson[2] uses two factors to measure satisfaction, namely ‘friendly explanation’ and ‘managing therapy’; the factors are highly interrelated and the questions somewhat awkwardly phrased, but more importantly, we believe the questionnaire excludes some specific domains unique to the MUR. By conducting patient interviews with recent MUR recipients, we have been working to identify relevant concepts and develop a conceptual framework to inform item development for a Patient Reported Outcome Measure questionnaire bespoke to the MUR. We note with interest the recent launch of a multidisciplinary audit template by the Royal Pharmaceutical Society of Great Britain (RPSGB) in an attempt to review the effectiveness of MURs and improve their quality.[3] This template includes an MUR ‘patient survey’. We will discuss this ‘patient survey’ in light of our work and existing patient satisfaction with pharmacy questionnaires, outlining a new conceptual framework as a basis for measuring patient satisfaction with the MUR. Ethical approval for the study was obtained from the NHS Surrey Research Ethics Committee on 2 June 2008. References 1. Department of Health (2008). Pharmacy in England: Building on Strengths – Delivering the Future. London: HMSO. www. official-documents.gov.uk/document/cm73/7341/7341.pdf (accessed 29 September 2009). 2. Larson LN et al. Patient satisfaction with pharmaceutical care: update of a validated instrument. JAmPharmAssoc 2002; 42: 44–50. 3. Royal Pharmaceutical Society of Great Britain (2009). Pharmacy Medicines Use Review – Patient Audit. London: RPSGB. http:// qi4pd.org.uk/index.php/Medicines-Use-Review-Patient-Audit. html (accessed 29 September 2009).

A retrospective audit of medicines use review forms

The medicines use review (MUR) service was introduced in England and Wales in 2005 to improve patients’ knowledge and use of medicines through a private, patient–pharmacist consultation. The pharmacist completes a standard form as a record of the MUR consultation and the patient receives a copy. The 2008 White Paper, Pharmacy in England[1] notes some MURs are of poor or questionable quality and there are anecdotal reports that pharmacists elect to conduct ‘easy’ MURs with patients on a single prescribed medicine only.[2] In 2009, the Royal Pharmaceutical Society of Great Britain (RPSGB) launched a multi-disciplinary audit template to review the effectiveness of MURs and improve their quality.[3] Prior to this, we conducted a retrospective MUR audit in a 1-month period in 2008. Our aims were to report on findings from this audit and the validity of using MUR forms as data for audit.

Methodology for assessing the appropriateness of Continuing Professional Development for pharmacy professionals’ revalidation

From April 2010, the General Pharmaceutical Council (GPhC) will be responsible for the statutory regulation of pharmacists and pharmacy technicians in Great Britain (GB).[1] All statutorily regulated health professionals will need to periodically demonstrate their fitness-to-practise through a process of revalidation.[2] One option being considered in GB is that continuing professional development (CPD) records will form a part of the evidence submitted for revalidation, similar to the system in New Zealand.[3] At present, pharmacy professionals must make a minimum of nine CPD entries per annum from 1 March 2009 using the Royal Pharmaceutical Society of Great Britain (RPSGB) CPD framework. Our aim was to explore the applicability of new revalidation standards within the current CPD framework. We also wanted to review the content of CPD portfolios to assess strengths and qualities and identify any information gaps for the purpose of revalidation.

The aetiology and treatment of developmental stammering in childhood

Developmental stammering (DS, also known as idiopathic stammering or stuttering) is a disorder of speech fluency that affects approximately 0.75% to 1% of the populations of Great Britain, Australia and America,(1-4) although a recent study puts the point prevalence figure at between 1% and 3% in the UK.(5) Prevalence is generally thought to be similar amongst communities worldwide, although there have been occasional suggestions that this figure might be lower in countries where there is less pressure on verbal acuity.(6) DS may be distinguished from neurogenic stammering, which can occur subsequent to neurological damage of various aetiologies (for example, stroke, tumour, degenerative disease) and psychogenic stammering, whose onset can be related to a significant psychological event such as bereavement. While a diagnosis of neurogenic stammering might be made in early childhood and adolescence, both neurogenic and psychogenic types are typically associated with an adult onset. DS is by far the most common form of stammering and usually develops in the pre-school years. The mean age at onset is 4 2, with 75% of cases beginning before the age of 6.(1) However, occasionally, stammering onset may be seen as late as 12 or 13 years of age.