Religion, anti-slavery, and identity: Irish Presbyterians, the United States, and transatlantic evangelicalism, c. 1820-1914

Scholars have devoted much attention to the causes and consequences of Presbyterian emigration from Ulster to the thirteen colonies before 1776. This article moves beyond the eighteenth century to examine the continued religious links between Presbyterians in Ireland and the United States in the nineteenth century. It begins with an examination of the influence of evangelicalism on both sides of the Atlantic and how this promoted unity in denominational identity, missionary activity to convert Catholics, and revivalist religion during the first half of the century. Though Irish Presbyterians had great affection for their American co-religionists, they were not uncritical, and significant tensions did develop over slavery. The article then examines the religious character of Scotch-Irish or Ulster-Scots identity in the late nineteenth century, which was articulated in response to the alleged demoralising influence of large-scale Irish immigration during and after the Famine of the 1840s, the so-called Romanisation of Catholicism, and the threat of Home Rule in Ireland. The importance of identity politics should not obscure religious developments, and the article ends with a consideration of the origins and character of fundamentalism, perhaps one of the most important cultural connections between Protestants in Northern Ireland and the United States in the twentieth century.

A review of offshore wind power development in the United Kingdom

Currently wind power is dominated by onshore wind farms. However, as the demand for power grows driven by security of energy supply issues, dwindling fossil fuel supplies and greenhouse gas emissions reduction targets, offshore wind power will develop rapidly because of the decline of viable onshore sites. The United Kingdom has a target of 21% renewable electricity by 2020 and this is expected to come mostly from wind power. Britain is the most active internationally in terms of offshore wind farm development with almost 48GW in some stage of development. In addition the Scottish Government, the Northern Ireland Executive and the Government of Ireland undertook the 'Irish-Scottish Links on Energy Study' (ISLES), which examined the feasibility of creating an offshore interconnected transmission network and subsea electricity grid based on renewable energy sources off the coast of western Scotland and the Irish Sea. The aim of this paper is to provide an appraisal of offshore wind power development with a focus on the United Kingdom. © 2013 IEEE.

Power system performance of offshore wind in the United Kingdom in 2030

At least 34 % of the United Kingdom’s power must come from renewable energy sources to meet planned European Union targets in 2030. Wind power will provide the majority of this renewable electricity with an estimated 36 GW offshore and 21 GW onshore. The success of the Crown Estate’s leasing rounds 1 and 2 in offshore wind has meant the United Kingdom is now one of the world leaders in offshore wind power development. Leasing round 3 will see offshore wind in the United Kingdom surpass 36 GW of installed capacity. This is a significant increase from the current installed offshore wind capacity of 3.6 GW. This research investigates the power system performance of offshore wind power in the United Kingdom in 2030.

Knowledge and risk perceptions of the Ebola virus in the United States

Objectives
The Ebola epidemic has received extensive media coverage since the first diagnosed cases of the virus in the US. We investigated risk perceptions of Ebola among individuals living in the US and measured their knowledge of the virus.

Method
US residents completed an online survey (conducted 14–18 November 2014) that assessed their Ebola knowledge and risk perceptions.

Results
Respondents who were more knowledgeable of Ebola perceived less risk of contracting the virus and were less worried about the virus, but also regarded Ebola as more serious than less knowledgeable respondents. The internet served as a major source of additional information among knowledgeable respondents.

Conclusion
The findings suggest that the provision of health information about Ebola may be effective in informing the public about Ebola risks and of preventive measures without curtailing the seriousness of the virus. Policymakers may seek to further exploit the internet as a means of delivering information about Ebola in the US and worldwide.

How should teaching on whole person medicine, including spiritual issues, be delivered in the undergraduate medical curriculum in the United Kingdom?

Background

Although the General Medical Council recommends that United Kingdom medical students are taught ‘whole person medicine’, spiritual care is variably recognised within the curriculum. Data on teaching delivery and attainment of learning outcomes is lacking. This study ascertained views of Faculty and students about spiritual care and how to teach and assess competence in delivering such care.

A questionnaire comprising 28 questions exploring attitudes to whole person medicine, spirituality and illness, and training of healthcare staff in providing spiritual care was designed using a five-point Likert scale. Free text comments were studied by thematic analysis. The questionnaire was distributed to 1300 students and 106 Faculty at Queen’s University Belfast Medical School.

351 responses (54 staff, 287 students; 25 %) were obtained. >90 % agreed that whole person medicine included physical, psychological and social components; 60 % supported inclusion of a spiritual component within the definition. Most supported availability of spiritual interventions for patients, including access to chaplains (71 %), counsellors (62 %), or members of the patient’s faith community (59 %). 90 % felt that personal faith/spirituality was important to some patients and 60 % agreed that this influenced health. However 80 % felt that doctors should never/rarely share their own spiritual beliefs with patients and 67 % felt they should only do so when specifically invited. Most supported including training on provision of spiritual care within the curriculum; 40-50 % felt this should be optional and 40 % mandatory. Small group teaching was the favoured delivery method. 64 % felt that teaching should not be assessed, but among assessment methods, reflective portfolios were most favoured (30 %). Students tended to hold more polarised viewpoints but generally were more favourably disposed towards spiritual care than Faculty. Respecting patients’ values and beliefs and the need for guidance in provision of spiritual care were identified in the free-text comments.

Students and Faculty generally recognise a spiritual dimension to health and support provision of spiritual care to appropriate patients. There is lack of consensus whether this should be delivered by doctors or left to others. Spiritual issues impacting patient management should be included in the curriculum; agreement is lacking about how to deliver and assess.

Research in Progress: Medical Research Council United Kingdom Refractory Asthma Stratification Programme (RASP-UK)

The UK Refractory Asthma Stratification Programme(RASP-UK) will explore novel biomarker stratificationstrategies in severe asthma to improve clinicalmanagement and accelerate development of newtherapies. Prior asthma mechanistic studies have notstratified on inflammatory phenotype and theunderstanding of pathophysiological mechanisms inasthma without Type 2 cytokine inflammation is limited.RASP-UK will objectively assess adherence tocorticosteroids (CS) and examine a novel compositebiomarker strategy to optimise CS dose; this will alsoaddress what proportion of patients with severe asthmahave persistent symptoms without eosinophilic airwaysinflammation after progressive CS withdrawal. There will be interactive partnership with the pharmaceutical industry to facilitate access to stratified populations for novel therapeutic studies.

The implausibility of ‘usual care’ in an open system: sedation and weaning practices in Paediatric Intensive Care Units (PICUs) in the United Kingdom (UK).

Background
The power of the randomised controlled trial depends upon its capacity to operate in a closed system whereby the intervention is the only causal force acting upon the experimental group and absent in the control group, permitting a valid assessment of intervention efficacy. Conversely, clinical arenas are open systems where factors relating to context, resources, interpretation and actions of individuals will affect implementation and effectiveness of interventions. Consequently, the comparator (usual care) can be difficult to define and variable in multi-centre trials. Hence outcomes cannot be understood without considering usual care and factors that may affect implementation and impact on the intervention.

Methods
Using a fieldwork approach, we describe PICU context, ‘usual’ practice in sedation and weaning from mechanical ventilation, and factors affecting implementation prior to designing a trial involving a sedation and ventilation weaning intervention. We collected data from 23 UK PICUs between June and November 2014 using observation, individual and multi-disciplinary group interviews with staff.

Results
Pain and sedation practices were broadly similar in terms of drug usage and assessment tools. Sedation protocols linking assessment to appropriate titration of sedatives and sedation holds were rarely used (9 % and 4 % of PICUs respectively). Ventilator weaning was primarily a medical-led process with 39 % of PICUs engaging senior nurses in the process: weaning protocols were rarely used (9 % of PICUs). Weaning methods were variably based on clinician preference. No formal criteria or use of spontaneous breathing trials were used to test weaning readiness. Seventeen PICUs (74 %) had prior engagement in multi-centre trials, but limited research nurse availability. Barriers to previous trial implementation were intervention complexity, lack of belief in the evidence and inadequate training. Facilitating factors were senior staff buy-in and dedicated research nurse provision.

Conclusions
We examined and identified contextual and organisational factors that may impact on the implementation of our intervention. We found usual practice relating to sedation, analgesia and ventilator weaning broadly similar, yet distinctively different from our proposed intervention, providing assurance in our ability to evaluate intervention effects. The data will enable us to develop an implementation plan; considering these factors we can more fully understand their impact on study outcomes.

Construction Industry Attitudes to Global Environmental Change: A Comparison with the United Kingdom and Japan

With the continued diffusion of global boundaries coupled with the onset of increased environmental pressure, construction industry attitudes are also shifting. The aim of this paper is to evaluate the construction industry attitudes to global environmental change in both the United Kingdom and Japan. In order to achieve this goal, a qualitative mixed method approach is adopted, encompassing a desk based critique of the literature coupled with an industry interview from both regions. This methodology is adopted with the objective of ascertaining if there are any geographical similarities or differences with the regions in question. The resulting information is analyzed and the results deciphered utilizing mind mapping techniques in the dissemination of the data obtained with the objective of identifying various traits within the data. The results indicate that the United Kingdom and Japan both illustrate various attributes in relation to attitudes towards the global environment. In particular, research indicates that in the Japanese construction industry, there is a distinct lack of enthusiasm shown in construction industry attitudes to counteract environmental challenges currently being faced by implementing sustainable practices, compared to attitudes in the UK construction industry. One of the reasons identified for this, is the lack of leadership provided by the corresponding government, thus resulting in the lack of promotion of sustainable practices in the region. The benefit of this research is that it enables various industry leaders, regardless of geographical location, to actively consider the attitudes and perceptions of those around them, particularly in relation to the sensitive topic of global environmental change within the industry. Where the findings are acknowledged and also utilized, the results should aid in the improvement of the industry on an international scale, while also improving the overall persona of environmental change within the sector.

A steady ship: A quiet year for the United Kingdom Supreme Court

This piece reviews the decisions issued by the UK's Supreme Court during 2014, comparing the output with the previous year's and highlighting some particularly important cases.