Grading and disease management in national screening for diabetic retinopathy in England and Wales

Aims - A National Screening Programme for diabetic eye disease in the UK is in development. We propose a grading and early disease management protocol to detect sight-threatening diabetic retinopathy and any retinopathy, which will allow precise quality assurance at all steps while minimizing false-positive referral to the hospital eye service. Methods - Expert panel structured discussions between 2000 and 2002 with review of existing evidence and grading classifications. Proposals - Principles of the protocol include: separate grading of retinopathy and maculopathy, minimum number of steps, compatible with central monitoring, expandable for established more complex systems and for research, no lesion counting, no ‘questionable’ lesions, attempt to detect focal exudative, diffuse and ischaemic maculopathy and fast track referral from primary or secondary graders. Sight-threatening diabetic retinopathy is defined as: preproliferative retinopathy or worse, sight-threatening maculopathy and/or the presence of photocoagulation. In the centrally reported minimum data set retinopathy is graded into four levels: none (R0), background (R1), preproliferative (R2), proliferative (R3). Maculopathy and photocoagulation are graded as absent (M0, P0) or present (M1, P1). Discussion - The protocol developed by the Diabetic Retinopathy Grading and Disease Management Working Party represents a new consensus upon which national guidelines can be based leading to the introduction of quality-assured screening for people with diabetes.

Profit, productivity and price performance changes in the water and sewerage industry:an empirical application for England and Wales

This paper aims to analyse the impact of regulation in the financial performance of the Water and Sewerage companies (WaSCs) in England and Wales over the period 1991–2008. In doing so, a panel index approach is applied across WaSCs over time to decompose unit-specific index number-based profitability growth as a function of the profitability, productivity and price performance growth achieved by benchmark firms, and the catch up to the benchmark firm achieved by less productive firms. The results indicated that after 2000 there is a steady decline in average price performance, while productivity improves resulting in a relatively stable economic profitability. It is suggested that the English and Welsh water regulator is now more focused on passing productivity benefits to consumers, and maintaining stable profitability than it was in earlier regulatory periods. This technique is of great interest for regulators to evaluate the effectiveness of regulation and companies to identify the determinants of profit change and improve future performance, even if sample sizes are limited.

Leges marchiarum, or, border-laws : containing several original articles and treaties, made and agreed upon by the commissioners of the respective kings of England and Scotland : for the better preservation of peace and commerce upon the marches of both kingdoms : from the reign of Henry III. to the union of the two crowns in K. James I : with a preface, and an appendix of charters and records, relating to the said treaties /

Signatures : A¹², a⁶, B-M¹².

A catalogue, of the most remarkable collection of prints ever offered to the public; being matchless both for number, variety, beauty, and scarcity : consisting of all the great masters in Europe ... the topography of England, Ireland, Scotland and Wales ... heraldry, and all other antiquities in each country; likewise a wonderful collection both of English and foreign portraits ... : which will be sold by Mr. Greenwood, at his room, in Leicester Square on Monday the 16th day of January, 1786, and the following days.

Issued in 3 parts. The second (p. [81]-158) has special t.p.: A catalogue of the remaining part of this collection of prints ... which will be sold by Mr. Greenwood ... on Tuesday the 21st day of February, 1786, and seventeen following days. The third (p. 159-169) has special t.p.: A continuation, of a most curious, scarce, valuable, and fine collection of all those persons who ... are entitled to a place in the English school ... [sold March 14-15, 1786].

Estimating the incidence, prevalence and true cost of asthma in the UK: Secondary analysis of national stand-alone and linked databases in England, Northern Ireland, Scotland and Wales-a study protocol

Introduction Asthma is now one of the most common long-term conditions in the UK. It is therefore important to develop a comprehensive appreciation of the healthcare and societal costs in order to inform decisions on care provision and planning. We plan to build on our earlier estimates of national prevalence and costs from asthma by filling the data gaps previously identified in relation to healthcare and broadening the field of enquiry to include societal costs. This work will provide the first UK-wide estimates of the costs of asthma. In the context of asthma for the UK and its member countries (ie, England, Northern Ireland, Scotland and Wales), we seek to: (1) produce a detailed overview of estimates of incidence, prevalence and healthcare utilisation; (2) estimate health and societal costs; (3) identify any remaining information gaps and explore the feasibility of filling these and (4) provide insights into future research that has the potential to inform changes in policy leading to the provision of more cost-effective care.

Methods and analysis Secondary analyses of data from national health surveys, primary care, prescribing, emergency care, hospital, mortality and administrative data sources will be undertaken to estimate prevalence, healthcare utilisation and outcomes from asthma. Data linkages and economic modelling will be undertaken in an attempt to populate data gaps and estimate costs. Separate prevalence and cost estimates will be calculated for each of the UK-member countries and these will then be aggregated to generate UK-wide estimates.

Ethics and dissemination Approvals have been obtained from the NHS Scotland Information Services Division's Privacy Advisory Committee, the Secure Anonymised Information Linkage Collaboration Review System, the NHS South-East Scotland Research Ethics Service and The University of Edinburgh's Centre for Population Health Sciences Research Ethics Committee. We will produce a report for Asthma-UK, submit papers to peer-reviewed journals and construct an interactive map.

The British angler's manual; or, The art of angling in England, Scotland, Wales, and Ireland: with some account of the principal rivers, lakes, and trout streams, in the United Kingdom; with instructions in fly-fishing, trolling, and angling at the bottom, and more particularly for the trout.

This is a paginal reprint of the 1st edition. The plates are on China paper, mounted.

Travels over England, Scotland, and Wales : giving a true and exact description of the chiefest cities, towns and corporations : together with the antiquities of divers other places, the most famous cathedrals, and other eminent structures : of remarkable caves and wells, with many other diverting passages never before published /

Pagination erratic. Page numbers 37-52 repeated and page numbers 199-212 omitted. Text is complete.

The British angler's manual, or, The art of angling in England, Scotland, Wales, and Ireland, with instructions in fly-fishing, trolling, and angling at the bottom.

Embellished with engravings from pictures and drawings by the author.

The official guide to the London and north western railway : the royal mail west coast route between England, Scotland, Wales, and Ireland : also between the continents of Europe and America.

Mode of access: Internet.

Pre-sentence Report, Magisterial Discourse and Agency in Youth Courts in England

This article draws on interviews with Youth Court magistrates to examine if and how discourses, strategies and technologies of risk governance have affected Youth Court magistrates in England and Wales. The aim of the article is to detail the complex relationship between magisterial agency in decision making and youth justice policies which focus on risk control and management. The article demonstrates that, contrary to what might be assumed from the youth and risk governance theoretical literature, Youth Offending Team risk assessments form only one part of the information used by magistrates to explain young people’s presence in courts. This article concludes that magisterial decision making is framed not by formal, expert assessments of risk, but by magistrates’ claims that they are ‘knowing outsiders’, who through judicious use of information presented to them and their own life experiences are able to make objective judgements about both the risk assessments authored by Youth Offending Teams and the young lawbreakers before them.

Salmonid & freshwater Fisheries statistics England & Wales 1989

This is the Salmonid & Freshwater Fisheries Statistics for England & Wales 1989 produced by the National Rivers Authority (NRA) in 1989. This report is focused on the maintenance, improvement and development of fisheries of England and Wales. This report is the first on salmon and migratory trout catch statistics for England and Wales published by the National Rivers Authority (NRA). From 1989 onwards, these statistics will appear each year as NRA fisheries statistics reports replacing the Data Report Series which was published by the Ministry of Agriculture Fisheries and Food (MAFF) Directorate of Fisheries Research. This report makes a general review of different catches: Northumbria, Yorkshire, Anglian, Thames, Southern, Wessex, South West, Severn-Trent, Welsh and North West.