Cent In England Research Articles

Who Owns the Heat? The Scope for Geothermal Heat to Contribute to Net Zero

Abstract Geothermal resources can be used to produce heat or generate electricity. It has been estimated that the UK has sufficient geothermal resources to meet all its heating demands for the next 100 years and provide 9 per cent of England’s and 85 per cent of Scotland’s electricity demand. Geothermal resources therefore have the potential to make a significant contribution to the achievement of net zero carbon emissions, particularly in relation to the decarbonization of the heating and cooling of buildings, but are currently underutilized in the UK. This article examines the implications that the lack of clear definition of ‘heat’ and questions regarding its ownership have on the regulation of geothermal resources. It considers a number of possibilities for the ownership model for heat and concludes that a hybrid model of ownership in which geothermal heat is owned by the Crown but ownership of the land within which it is located remains in private ownership may create a regime in which geothermal heat can be used efficiently and sustainably and which helps the industry grow.

Mental Health Support Teams: How to maximise the impact of the new workforce for children and young people

Mental Health Support Teams were implemented with the aim of increasing mental health provision for children in schools. Ensuring the success of these teams requires the appropriate training, supervision and sustainability plan for the roles, and the ERG worked to produce a briefing paper outlining considerations we felt were important to enable to roles to be effective. The briefing also considered how to make the practitioner roles effective and sustainable. During the party conference session we focussed our political engagement on Children and Young People’s Mental Health with events on this topic at both Labour and Conservative party conferences. We officially launched our Mental Health Support Team (MHST) briefing at a Labour fringe panel event, attended by MPs, members of the ERG and Young Minds. As well as our own events, we engaged with policy makers and senior parliamentarians, including shadow education secretary Angela Rayner. All opportunities identified at conference have been followed up. Our MHST briefing was well received by external stakeholders, with the Central for Mental Health quoting our paper in Making the grade: How education shapes young people’s mental health. Additionally, colleagues at NHSE have made our briefing available on an online platform that will reach all of the MHST sites. However, it remains to be see how effects the MHSTs will become, particularly as the Government’s current target is only to cover 25 to 30 per cent of England.

Weekend admission and mortality for gastrointestinal disorders across England and Wales.

BackgroundLittle has been reported on mortality following admissions at weekends for many gastrointestinal (GI) disorders. The aim was to establish whether GI disorders are susceptible to increased mortality following unscheduled admission on weekends compared with weekdays.MethodsRecord linkage was undertaken of national administrative inpatient and mortality data for people in England and Wales who were hospitalized as an emergency for one of 19 major GI disorders.ResultsThe study included 2 254 701 people in England and 155 464 in Wales. For 11 general surgical and medical GI disorders there were little, or no, significant weekend effects on mortality at 30 days in either country. There were large consistent weekend effects in both countries for severe liver disease (England: 26·2 (95 per cent c.i. 21·1 to 31·6) per cent; Wales: 32·0 (12·4 to 55·1 per cent) and GI cancer (England: 21·8 (19·1 to 24·5) per cent; Wales: 25·0 (15·0 to 35·9) per cent), which were lower in patients managed by surgeons. Admission rates were lower at weekends than on weekdays, most strongly for severe liver disease (by 43·3 per cent in England and 51·4 per cent in Wales) and GI cancer (by 44·6 and 52·8 per cent respectively). Both mortality and the weekend mortality effect for GI cancer were lower for patients managed by surgeons.DiscussionThere is little, or no, evidence of a weekend mortality effect for most major general surgical or medical GI disorders, but large weekend effects for GI cancer and severe liver disease. Lower admission rates at weekends indicate more severe cases. The findings for severe liver disease may suggest a lack of specialist hepatological resources. For cancers, reduced availability of end-of-life care in the community at weekends may be the cause.

Ploughing the Wrong Furrow

The precautionary principle provides non-farming interest groups with a pseudo-official means of influencing policy. The result is a drift towards overregulation and regulatory failures which are in conflict with the efficient working of the single market. Official estimates suggest that compliance with existing agricultural regulations amount to £590 million a year in England, representing an increase in total operational costs by a little more than five per cent in England. This significantly underestimates the true cost of regulations because compliance costs do not take into account the longer term, and potentially much larger, costs arising from the impact on competitiveness and the affordability of food. Researchers estimate that overall crop yields would be around half their current levels without the use of crop protection products. Further restrictions on pesticide use would reduce crop yields across the EU and substantially increase the price of food. It is unlikely that the benefits of the current regulatory burden outweigh the costs. The EU’s precautionary approach discourages the development of technologies with even a low, theoretical probability of harm despite offering the likelihood of faster agricultural productivity growth.

Current approaches to the management of hepatitis C

AbstractHepatitis C can lead to cirrhosis, decompensated liver disease and hepatocellular carcinoma. The authors discuss today's recommended management and the GP's role in diagnosis, screening and referral.

Impact of UK Colorectal Cancer Screening Pilot on hospital diagnostic services

To determine the impact of the UK Colorectal Cancer Screening Pilot on hospital services involved in the diagnosis of colorectal cancer (predominantly colonoscopy, double contrast barium enema and pathology). Routine data from seven hospitals at two sites within Scotland and England participating in the Pilot were collected on activity levels and waiting times for key hospital services (GI medicine, surgery and radiology), plus questionnaire survey data from hospital consultants. Hospital colonoscopy activity increased by 31 per cent in Scotland and 21 per cent in England due to the investigation of faecal occult blood testing (FOBt) positive subjects. The demand for symptomatic (non-screening) colonoscopy also increased. Pilot-generated activity was less than predicted for barium enema services (maximum 3 per cent increase in service volume) but greater than expected for pathology, with approximately 200 specimens/month generated. Out-patient review of Pilot colonoscopy patients and associated administrative duties added substantially to overall GI service workload, but quantification was limited by the quality of routinely available data. There was a wide discrepancy in colonoscopy waiting times between screened and symptomatic patients, with predominantly longer waits for symptomatic patients: otherwise the quality of colonoscopy services appeared to improve. In any future national screening programme, follow-up of patients with adenomas will result in a further increase of 28 per cent in the number of colonoscopies generated (over and above colonoscopy for FOBt-positive subjects), adding substantially to overall workload. During the planning of any successful national colorectal cancer screening programme, careful consideration must be given to the wider aspects of workload associated with screening, as well as to the implementation of appropriate hospital data collection systems.

William H Hubbard, Karl Pitkänen, Jürgen Schlumbohm, Sølvi Sogner, Gunnar Thorvaldsen and Frans van Poppel, Historical studies in mortality decline, II. Hist.-Filos. Klasse Skrifter og avhandlinger Nr.3, Oslo, Novus Forlag in association with the Centre for Advanced Study, at the Norwegian Academy of Science and Letters, 2002, pp. 134, €22.70, Kr 182.00 (paperback ISBN 82-7099-360-3, ISSN 1502-9727).

William H Hubbard, Karl Pitkänen, Jürgen Schlumbohm, Sølvi Sogner, Gunnar Thorvaldsen and Frans van Poppel, Historical studies in mortality decline, II. Hist.-Filos. Klasse Skrifter og avhandlinger Nr.3, Oslo, Novus Forlag in association with the Centre for Advanced Study, at the Norwegian Academy of Science and Letters, 2002, pp. 134, €22.70, Kr 182.00 (paperback ISBN 82-7099-360-3, ISSN 1502-9727). - Volume 48 Issue 3

Incidence of exertional rhabdomyolysis in polo horses in the USA and the United Kingdom in the 1999/2000 season

A questionnaire was used to determine the incidence of exertional rhabdomyolysis and the factors that might have contributed to its occurrence among 423 polo horses in 11 yards. The yards...

Current nature and management of cancer of the oesophagus and cardia

Aims: To inform the debate about upper gastrointestinal cancer care in the UK, the incidence of cancer of the oesophagus and cardia (OGJ) was determined in the West Midlands, a region covering 10 per cent of England and Wales, with particular reference to the methods of treatment. METHODS: The case-notes of 2776 patients diagnosed with oesophageal and OGJ cancer in the 5 years from 1 January 1992 to 31 December 1996 were scrutinized by one experienced surgeon. Tumour types were classified by histology and site, and treatment modalities assessed for 30-day mortality rate together with life-table analyses. RESULTS: Oesophageal cancer was identified in 2188 patients (61 per cent lower, 34 per cent middle, 4 per cent upper), including 999 squamous carcinomas (27 per cent lower, 64 per cent middle, 9 per cent upper) and 995 adenocarcinomas (97 per cent lower, 3 per cent middle), while there were 588 cases of OGJ cancer (94 per cent adenocarcinomas). Resection was the commonest treatment (865 cases; 31 per cent), with a mortality rate of 10 per cent for oesophageal and 4 per cent for OGJ cancer. Palliative resection had a higher mortality rate than radiotherapy (9 versus 3 per cent), compared with 22 per cent for endoscopic palliation, while the 30-day mortality rate was 30 per cent for the 308 patients given no treatment. CONCLUSIONS: Squamous carcinomas and adenocarcinomas of the oesophageal body are now equally common; lower-third and OGJ tumours are predominantly adenocarcinomas. This study provides baseline data for critical appraisal of potential changes in the delivery of upper gastrointestinal cancer in the UK.

The Black Death in English towns

It seems likely that historians in the past have seriously underestimated the number of English townsmen in the early fourteenth century. In London alone there may have been 80–100,000 around 1300. The population of Norwich in the early fourteenth century was higher than used to be thought, and it was growing: Rutledge proposes 17,000 for 1311 and 25,000 for 1333. Keene's estimate of about 10,000 for Winchester in the early fourteenth century can serve as a basis for estimating the population of other towns in the same period. Those whose taxable value in 1334, and whose contribution to the poll tax of 1377, was at least as great as Winchester's, probably had a population equal to Winchester's or greater around 1300. By this argument about fifteen towns, including London, are likely to have had 10,000 or more people at the beginning of the fourteenth century, and perhaps 5 per cent of England's population lived in towns of this rank. Estimates taking account of smaller towns are much more precarious, but it is possible that all told 10 per cent of England's population lived in towns of over 2,000 inhabitants and that a further 5 per cent lived in small boroughs, some with as few as 300 people. Even this estimate does not take account of many small market towns, not described as boroughs, that had elementary urban characteristics.

Planning Policies and Development Control in the Sussex Downs AONB

Local planning authorities in England and Wales are responsible for the care and administration of Areas of Outstanding Natural Beauty (AONBs). Since 1956 thirty three AONBs have been designated, including some of the best known parts of the countryside such as the Cotswolds and Chilterns, the Cornish coast and Gower peninsula. 1 The statutory purpose of AONB designation is to preserve and enhance natural beauty, but there are no special planning arrangements for AONBs as there are for their counterparts, the national parks. This means that 'preservation' is generally advanced through the ordinary development control process and 'enhancement' through the use of grant aid for such work as tree planting and the reclamation of eyesores and dereliction. In spite of the fact that AONBs now cover nearly 10 per cent of England and Wales there has been virtually no monitoring of their success or failure, although it has been claimed that the designation has enabled substantial new developments to be steered away from sensitive areas of countryside.2 This is probably true, but ultimately it may be the gradual accretion of minor developments that will make more impact on the beauty of these areas than a few major schemes would have done. In 1978 the Countryside Commission instituted a major reappraisal of AONBs. To this end a Discussion Paper3 was produced to which organisations and individuals were invited to respond. In addition the Commission appointed Mr K. S. Himsworth to undertake a study of the effectiveness or otherwise of the designation. His report is expected to be published in 1980/81. The Commission's work will not, however, be sufficiently detailed to include analysis of the day-to-day workings of development control in AONBs and whether designation has had any effect on planning applications received or decisions reached. This paper attempts to throw some light on this topic by outlining the results of a study in East Sussex of the relationship between development control and strategic planning, as revealed through an analysis of planning application data. The study area included part of the Sussex Downs AONB and in this way was similar to some earlier research undertaken by Blacksell and Gilg in East Devon.4 The paper ends with a comparison of the findings from East Sussex and East Devon which tend towards somewhat different conclusions.

Landscape Evaluation in Practice: The Case of South-East Devon

Landscape evaluation has been a statutory duty for both local and central government since the 1947 Town and Country Planning Act and the 1949 National Parks and Access to the Countryside Act came into force, yet there are few agreed procedures for making such evaluations. Although many techniques have been devised, in the main they have not been subjected to sufficiently rigorous and repeated testing for them to be considered truly reliable. In this study, a much discussed technique, developed for the Coventry-Solihull-Warwickshire Sub-Regional Study, is applied to a new area, south-east Devon, and the results are compared with those derived from Warwickshire. THIS paper examines some of the requirements for an effective and widely applicable technique of landscape evaluation. In the context of local and central governmental responsibilities for landscape protection, it considers the need for evaluation techniques and describes how a much discussed technique, developed for the Coventry-Solihull-Warwickshire Sub-Regional Study,1 was applied to the landscape of south-east Devon, explaining why it was chosen and comparing the results derived from rural Devon with those from Warwickshire. In recent years, the potential value of techniques of landscape evaluation to land-use planning has awakened much interest, both among academics and professional planners. More recently, however, the wide variation between available techniques, and an apparent lack of appreciation of what they can and cannot achieve, has produced a situation where widespread doubts have arisen concerning the ultimate utility of the whole exercise. In a general review of the subject, Dunn summed up the 'art' of landscape evaluation as being in a state of confusion.2 One of the chief difficulties stems from the intangible nature of the concept of landscape beauty; inevitably there is much dispute, both over what it is and what its essential components are. Techniques have tended either to be discarded or to be radically changed, so that they fit more closely to the particular concept of landscape held by each individual researcher.3 This is a pity, since it has effectively prevented the majority of techniques from being applied in more than a very few landscapes, thus making it almost impossible to judge their wider effectiveness. Dating from the Town and Country Planning Act 1947 and the National Parks and Access to the Countryside Act I949, central and local government have had a statutory duty to evaluate the aesthetic quality of different landscapes for the purposes of protection and enhancement. The result is a patchwork of National Parks, Areas of Outstanding Natural Beauty and Areas of Great Landscape Value, covering more than 40 per cent of England and Wales.4 In these areas 'development control' is supposed to be more strictly applied, so that the beauty of the landscape may be protected. Although there is general agreement on the need to protect such landscapes, there is considerable disagreement about the details of their boundaries. It has been suggested that the boundaries of, for example, the National Parks should be reviewed,5 but only the vaguest indication of the criteria to be employed has been provided. A nationally agreed technique of landscape evaluation would enable the boundaries for such protected landscapes to be drawn more rationally. What is also required is an agreed method for defining

Whither Tuberculosis?: A Statistical Review of Reports from Selected American and European Communities

Tuberculosis mortality has been declining at an accelerated rate, especially during the past few years. Between 1945 and 1950, the death rate fell in England and Wales by 36 per cent; in the United States, 41 per cent; in Canada, 43 per cent; in France, 49 per cent; in Finland, 50 per cent; Italy, 53 per cent; Norway, 55 per cent; Denmark, 58 per cent; Sweden, 63 per cent; Iceland, 71 per cent; and in the Netherlands, 78 per cent. Tuberculosis morbidity, on the other hand, has tended to remain on a high level: 100,772 new cases reported in the United States in 1940 and 121,228 in 1950; in Canada, 10,226 formerly and 12,429 lately; in England and Wales, 49,967 notifications ten years ago and 52,062 last year; in Denmark, 2,687 new pulmonary cases in 1940 and 2,507 in 1950. Effective prevention of tuberculosis obviously remains elusive so far. Improved forms of treatment in tuberculosis are responsible for the lowering of “community case fatality rates” which ranged between 50 and 60 per cent in 1940, but were reduced in 1950 to 31 per cent in England and Wales, 29 per cent in Scotland and in Canada, 28 per cent in the United States, and only 20 per cent in Denmark. Children have generally enjoyed greater reductions of tuberculosis mortality than older groups of the population. Their death rate in the United States, in spite of an increasing concentration of population in urban, congested centers and large Negro groups has been steadily reduced. Among those under 15 years of age, in the year 1949 it averaged for the entire country 3.9 per 100,000. In the state of Minnesota, it was as low as 1.3. Abroad, the same year, the death rate of the children in Denmark was 3.6; but, in Norway, it was 8.1; and in England and Wales 12.1. BCG vaccination has been widely used in the Scandinavian countries—little in Iceland—and only very recently to any extent in the United States or in England and Wales. In the state of New Jersey, special measures for the protection of school children—periodic x-ray examination of school personnel along with tuberculin testing and x-raying of pupils annually—resulted in 1949 in reducing the death rate of children under 15 to 2.7 or only one-third of that prevailing in Norway. The death rate of the children in Denmark was 44 per cent of that of Norway. Appreciative acknowledgments are due particularly to the following European authorities who promptly made available their latest tuberculosis data: Miss Julie E. Backer, Chief of the Demographic Section of the Norwegian Central Bureau of Statistics; Dr. Konrad Birkhaug, former Director, National B.C.G. Laboratory, Bergen, Norway; Dr. Tobias Gedde-Dahl, Secretary-General, Norwegian National Tuberculosis and Public Health Association; A. Koller, Director, Swiss Federal Bureau of Statistics; Prof. Giovanni L'Eltore, General Secretary, Italian Federation Against Tuberculosis; Valter Lindberg, Central Statistical Office, Finland; Miss Marie Lindhardt, Head, Statistical Section, The National Health Service of Denmark; Dr. John Lundquist, Secretary-General, Swedish National Association against Tuberculosis; Dr. Sigurdur Sigurdsson, Medical Director, Tuberculosis Control, Iceland; Dr. Norman Smith, Deputy Senior Medical Officer, Ministry of Health, England; Dr. J. Ch. W. Verstege, Deputy Director General, Netherlands Central Bureau of Statistics.

The Trend of Fertility in Prince Edward Island

Rapid and continuous decline in the size of the human family has been widespread during the last half-century. The main facts are widely known. A brief summary will serve as an introduction to what follows.In most European countries a period of continuous decline in the birth-rate began about 1870. In France the decline began much earlier, in eastern European countries somewhat later. We find the same picture, varying only in time of origin and tempo, in the United States of America, the British Dominions, Russia, and probably in Japan. A precise measure of the trend in terms of gross and net reproduction rates cannot be given over a long period, but the changes in these measures are available for several countries from 1911 to 1931. The drop in the gross reproduction rate in these twenty years was 50 per cent in Sweden, 38 per cent in Denmark, 37 per cent in England and Wales. In Australia it was 41 per cent between 1912 and 1933. Studies of smaller population units reveal the same trend. Among the counties of England and Wales, the smallest percentage decrease between 1911 and 1931 was 18 per cent. In Scotland a few counties showed smaller percentage decreases, the smallest being 11 per cent.

University Education

IN his inaugural address to the Royal Statistical Society on November 20, the president, Prof. Major Greenwood, discussed the “Recent History and Function of University Education”. Speaking of the statistical changes in the proportion of males in England and Wales who have entered upon a uni versity course since 1801, Prof. Greenwood estimated that at the beginning of the nineteenth century, when Oxford and Cambridge were the only English universities, about one-half per cent of males had a university education, a very slightly larger proportion at the middle of the nineteenth century and now about 2 per cent. In Germany, before the Nazi regime, it was estimated that not more than 3 per cent of university students came from working class families. It is unlikely that the proportion is more than 10 per cent in England and Wales. An author writing in the first volume of the Society's Journal estimated that the universities of Great Britain had a total revenue in 1831 of £800,000 per annum; in 1931-32 their total income was £5,874,778, of which more than £2,000,000 came from Parlia mentary grants.

PEPTIC ULCERS (GASTRIC, PYLORIC AND DUODENAL)

The etiology of peptic ulcer in man is unknown. Heredity, occupation, infections, tobacco, alcohol, worry and trauma of the mucous membrane from hot foods have been suggested as etiologic factors, but are inadequate explanations. The relation of vitamins to tuberculous ulceration of the intestine as demonstrated in our previous studies 1 suggested that peptic ulcer might be due to a deficiency of certain vitamins in the dietary. HISTORIC REVIEW The following data also suggest that peptic ulcer may be related to the dietary. The incidence of peptic ulcer varies in different countries: 0.8 per cent in Russia, 1.3 per cent in North America, 5 per cent in England and Germany and 16 per cent in Denmark. A marked increase in the incidence of peptic ulcer occurred in Russia and Germany during the period of partial starvation which followed the World War (from 1914 to 1918). 2 Hutter 3 stated that