Physician-based prehospital teams provide advanced critical care services in the UK (eg, prehospital anaesthesia). The last review of such teams in 2009, which included England, Wales and Northern Ireland, reported only one physician-based prehospital team available 24/7. Helicopter Emergency Medical Services (HEMS) across the UK offer paid physician-based teams, while other organisations may provide physician-based teams on a voluntary ad hoc basis. The primary aim of this study was to determine if access to a physician-based HEMS team has changed in the past 12 years. An online survey was distributed to all UK HEMS organisations in January 2024. The primary outcome measure was the number of physician-based teams operated by HEMS in 2024 and the operational hours of such teams. Secondary outcomes included interventions offered by HEMS teams and any additional medical teams offered (eg, paramedic only). All 21 HEMS responded. The number of potentially available physician-based HEMS teams has increased from 11 in England, Wales and Northern Ireland in 2009 to 28 in 2024, with two services in Scotland (total=30). HEMS providing consistent 24/7 physician-based prehospital teams increased from one (5.9%) in 2009 to 11 (52.4%) in 2024. The East of England has the highest 24/7 availability, with Northern Ireland, South West England and Northern England the least. Within physician-based teams, variation remains in advanced interventions available-for example, 19 services (90.4%) offer blood transfusion while only one (4.7%) offers resuscitative balloon occlusion of the aorta. Only one service is completely government funded; the others are funded by charity alone or a combination of charity and government sources. Both geographical and temporal variations in access to a physician-based HEMS remain across the UK, although there has been improvement since 2009. However, within this provision, variation exists in terms of interventions provided such as the provision of blood products.

Lifestyle factors such as smoking and alcohol may influence colon cancer (CC) survival, but it is unclear whether their effects vary by tumour-infiltrating immune biomarkers. This study examined CC-specific survival by smoking and alcohol status, stratified by immune cell density, in a large population-based cohort. The study included 661 individuals who underwent surgery for stage II or III CC between 2004 and 2008 within two Health and Social Care (HSC) Trusts in Northern Ireland. Representative formalin-fixed, paraffin-embedded (FFPE) tumour blocks were retrieved, and immunohistochemistry (IHC) was performed on tissue microarrays constructed from both the central tumour and the invasive margin. Cox proportional hazards models were used to assess CC-specific survival, adjusting for key clinical and demographic confounders. Ever smoking, compared to never smoking, was associated with poorer CC-specific survival among individuals with lower densities of CD3+, CD4+ and FOXP3+ tumour-infiltrating immune cells. Among those with higher CD8+ cell density in the central tumour, ever smoking was linked to worse outcomes. Similar patterns were seen in the invasive margin, although these were not all statistically significant. No significant associations were observed between alcohol use and survival across any immune biomarker subgroups. Smoking was associated with poorer survival among patients with CC, and this association appears to be modified by the density of tumour-infiltrating immune cells.

Containing the crisis: mentalisation-based therapy reduces acute service use for emotionally unstable personality disorder in Northern Ireland.

ABSTRACT Undergraduate legal education in England and Wales has recently seen a shift away from prescription, by the professional bodies, of the content of an undergraduate law degree. The lack of such regulatory requirements calls into question the shape, scale and scope of the core curriculum within law schools, which sits alongside an increasingly diverse elective curriculum. This paper explores the core curriculum across providers in England, Wales and Northern Ireland through an analysis of module information taken from course specifications and related materials. It identifies that while there is still widespread provision of the traditional foundations of legal knowledge subjects, there are significant disparities in credit weighting and degree structure across providers. It also analyses the wide range of non-foundation of legal knowledge modules found within the core curriculum, developing four themes: the established core, the new core, the core adjacent and the specialist core to consider the role of these subjects and how different drivers of curriculum development are reflected in the similarities and differences seen across the sector.

This paper considers spelling in samples of writing collected in October 2019 (pre COVID-19) from 267 children in the 8–9 age range in 143 mainstream primary schools who were identified by their schools as presenting with the most severe specific literacy difficulties in their age group. They were referred to the Northern Ireland Education Authority Psychology Service for assessment and were formally assessed to provide standardized scores for literacy attainment and cognitive profile. They presented with a cognitive profile which included a standardized score of 90 or above in one or more of the subtests of the Wechsler (2016) Intelligence Scale for Children (WISC). Spelling in independent writing samples was analysed to establish what sources of linguistic knowledge (phonemic, orthographic and morphemic) the children were drawing on to spell words. It was evident from the analysis of these writing samples that children were dependent on phoneme-to-grapheme correspondence when spelling, often selecting letters that did represent the phonemes but it was the wrong selection of letters for phonemes with multiple mappings. The observed pattern of errors indicates that these 267 children had difficulty developing orthographic knowledge resulting in phonologically plausible spelling choices impacting spelling accuracy. The development of orthographic knowledge was limited or had failed to develop for this group of children.

Adverse Childhood Experiences (ACEs) and Positive Childhood Experiences (PCEs) are each independently associated with a range of adult outcomes, including mental health, substance use, and criminal justice involvement. However, few studies have examined how the balance between these experiences influences outcomes. This study explores the predictive utility of a PCE:ACE ratio. Unlike previous measures of resiliency and risk protection scales that treat risk and protective factors as parallel dimensions, the ratio is population-level heuristic intended to capture the relative balance of positive versus adverse experiences using a single relational metric. Using data from a representative sample of 1,203 adults in Northern Ireland, participants completed validated measures of 13 ACEs and 10 positive childhood experiences (PCEs) A weighted PCE:ACE ratio was calculated, and participants were categorised into high, moderate, or low ratio groups. Findings showed that a higher ratio was significantly associated with reduced odds of arrest, incarceration, school exclusion, substance use, and mental health diagnosis, even after adjusting for age, gender, and deprivation. Those in the low-ratio group had the highest rates of adverse outcomes. While the ratio offers an intuitive and accessible framework for understanding developmental balance, limitations include the potential for oversimplification of distinct ACE-PCE profiles. These findings support the feasibility of a ratio-based approach that standardises balance rather than the independent accumulation of risks and strengths, and suggests that a stronger balance of protective experiences may buffer the impact of adversity. Further research is needed to explore threshold effects and interaction dynamics. However, the ratio provides a useful metric and sound basis for capturing population health and the extent to which public investment is tipped in favour of positive or less positive outcomes.

The Consumer Insights Tracker is an online monthly tracking survey commissioned by the Food Standards Agency (FSA). It monitors the behaviour and attitudes of consumers aged 16+ in England, Wales and Northern Ireland in relation to food. Each month, the survey is conducted with approximately 2,000 consumers. This report presents findings for topics that are tracked regularly including consumer concerns in relation to food, food affordability, and trust in the FSA as a regulator. It also includes questions on cell-cultivated products (CCPs) and cannabidiol (CBD) that were included in October 2025 and December 2025 respectively. Sometimes other topics are included on an ad-hoc basis. All findings are available in the accompanying data tables: Consumer Insights Tracker July 2023 - present. (https://data.food.gov.uk/catalog/datasets/0bfd916a-4e01-4cb8-ba16-763f0b36b50c)

ABSTRACT This special issue examines twenty-five years of devolution in the United Kingdom by focusing on the evolution of representative institutions and parliamentary practices across the devolved territories. Since its introduction at the end of the 1990s, devolution has transformed the UK's constitutional landscape, giving rise to new legislatures and executives while preserving parliamentary sovereignty at Westminster. The contributions explore how these devolved institutions have developed over time, both individually and in relation to one another, within an asymmetrical and often contested system of territorial governance. Particular attention is paid to the functioning of parliaments as sites of representation, negotiation and conflict, as well as to the mechanisms designed to manage relations between the central and devolved levels of government. Several articles address the impact of Brexit on intergovernmental and interparliamentary relations, highlighting the strain placed on existing conventions and cooperative frameworks. The issue also considers the ways in which devolved parliaments have provided arenas for the articulation of nationalist claims, challenging earlier assumptions that devolution would stabilise the Union. Comparative perspectives on Scotland and Wales, alongside analyses of Northern Ireland's distinctive power-sharing arrangements, underline the diversity of representative models that have emerged, closely bound up with questions of institutional legitimacy, territorial representation and political authority in the contemporary United Kingdom.

Book review of Lubit, Amanda J. 2025. Life as a Migrant Muslim Woman in Sectarian Northern Ireland: An Exploration of Gender, Visibility, Movement, and Placemaking. New York: Berghahn Books, 205 pp.

ABSTRACT This article assesses 25 years of devolution in Northern Ireland. It shows that devolution in Northern Ireland has had mixed and very paradoxical results. The introduction, highlighting the fact that Northern Irish devolution was part of a long and multi-levelled peace process, shows the fundamental differences with Wales and Scotland. In the first section, the article shows that the consociational power-sharing institutions established in Stormont after the Good Friday/Belfast Agreement have significantly contributed to ending intercommunal violence in the province. Yet, in the second section, it shows that, in practice, these institutions have simultaneously failed to transcend the ethno-communal divide, which they instead contributed to entrenching and institutionalizing.

ObjectivesAdolescents with a chronic medical condition (CMC) are at greater risk of mental health difficulties, but demographic factors and subjective health may confound this relationship.DesignUsing data from a nationally representative adolescent sample from Northern Ireland (N = 1,299), we examined whether three CMC categories were associated with symptoms of depression, anxiety, posttraumatic stress disorder, and with suicidal thoughts or plans, and attempts.MethodsHierarchical multiple regression analyses were conducted to test whether the CMC classifications explained a significant proportion of the variance across the mental health variables, while controlling for age, sex, and subjective health. A multinomial logistic regression analysis was conducted to test whether the CMC classifications were associated with suicidality.ResultsCMC categories explained a small but statistically significant proportion of variance in mental health. Age was associated with suicidal thoughts or plans, and suicide attempts. Subjective health emerged as the factor most strongly linked to all criterion variables except suicidality.ConclusionsSubjective health may be more strongly related to adolescent mental health than previously identified. Future research could explore potential psychosocial factors associated with these CMC classifications to clarify the links between CMCs and mental health.

Background Systematic reviews can be resource-intensive and require timely completion, yet experienced reviewers may have limited availability, necessitating the inclusion of novice screeners. This Study Within A Review (SWAR) will pilot and examine the feasibility of study methods to explore whether training and level of experience within the screening pair affects the reliability of decisions made by novice screeners during study selection. Methods A 2(training: task-specific, minimal guidance) x 2(experience level of screening partner, ‘Reviewer 1’: moderate experience, minimal experience) pilot randomised trial will be conducted within a host systematic review in the topic area of depression and psychosocial functioning. Participants ( N = 12), consisting of higher education students with no prior experience in evidence synthesis, will be randomised to one of the four conditions to complete a standardised study selection task at title/abstract level ( k = 219 records) on Covidence screening software, blindly and independently. Total participation time is estimated at 5 hours. Screening decisions made by participants will be assessed for reliability against the consensus-based decisions by two reviewers with content and methodological expertise (expert standard), through calculation of chance-corrected Cohen’s kappa, prevalence-adjusted bias-adjusted kappa (PABAK), and percentage of agreement, then compared across the conditions. Secondary outcomes will include reliability within the screening pair (participant and allocated screening partner), validity of screening decisions (false positives, false negatives, sensitivity, specificity), feasibility measures, including time taken to complete the study selection task and success of blinding, as well as acceptability. Conclusions Findings will be used to inform the design of subsequent trial work to determine the efficacy of training and screener pairing for study selection. Ultimately, these insights will help to build capacity among novice screeners to engage with evidence synthesis and work alongside experienced review teams. Registration Northern Ireland Hub for Trials Methodology Research SWAR Registry: SWAR 38 .

ABSTRACT In 2024 the Royal College of Paediatrics and Child Health (RCPCH) called for the law in England and Northern Ireland to be reformed to ban parents from physically punishing their children, similar to the laws that were introduced in Scotland in 2020 and in Wales in 2022. This call by the RCPCH, and the changes introduced in Scotland and Wales, makes it timely to consider the need for law reform to better protect children’s rights. However, neither domestic law in England and Northern Ireland, nor international children’s rights laws, provide children with an unambiguous and enforceable right to freedom from parental disciplinary violence. This article circumvents rights-based discourses and instead engages with Dixon and Nussbaum’s capabilities approach which conceptualises rights in terms of the capabilities, entitlements and freedoms needed to promote human flourishing. Analysing the child’s right to freedom from violence through the capabilities approach allows us to argue for redrawing the boundary between the private and public space of family life to challenge the ambiguous protection of children from violence in the family. The capabilities approach shifts the focus beyond the limitations of a solely rights‐based discourse to considering whether the protection from physical punishment provided to children in England and Northern Ireland sufficiently acknowledges the primary focus of the capabilities approach, namely to expand the child’s opportunities for human flourishing.

ABSTRACT Liverpool’s World Museum and Belfast’s Ulster Museum are home to important United Kingdom ethnographic collections beyond the British Museum in London. They are also located in “difficult” cities, understood here as sites with dark histories and legacies, namely Northern Ireland’s “Troubles” and Britain’s largest slaving port, respectively. This article examines the extent to which this affects efforts to adopt a decolonial perspective on collections that are closely connected to British imperial conquest. It argues that while the World Museum’s “Benin and Liverpool” exhibit achieves a synergy between colonial contextualization and co-curation, the Ulster Museum’s “Inclusive Global Histories” exhibit appears to omit the colonial element from its explicit commitment to decolonization.

BackgroundThe Northern Ireland Biobank was established to facilitate research access to quality‐assured biological samples. Patients, with capacity to consent, are invited to give written consent for collection and retention of clinically surplus material for the purposes of research. In addition, blood can be collected for the purposes of biobanking.MethodSince May 2022 patients have been invited to donate clinically surplus cerebrospinal fluid (CSF) to the NI Biobank. Since March 2023 patients have been invited to donate blood for the purposes of biobanking. CSF is collected using the drip method into false‐bottomed Starstedt tubes. Blood is collected, non‐fasting, into two EDTA bottles. Both are transported at room temperature to Trust (CSF) and NI Biobank (blood) laboratories on the same day. CSF is frozen at ‐80C. Blood is processed within 24 hours and stored as plasma and buffy coat.ResultThus far, n = 37 participants have consented to the retention of their clinical surplus CSF. In addition, n = 105 participants have donated blood for the purposes of biobanking.The main barrier to recruitment has been the availability of staff time to facilitate the consent and sampling processes.ConclusionBiobanking of biological samples, with access to associated clinical data, provides opportunities to study real‐world memory clinic cohorts. Researchers interested in accessing these samples should contact the authors.

The subject of the research is the institute of personnel rotation in the local government system using the example of the Russian Federation, the United States of America, the United Kingdom of Great Britain and Northern Ireland, and Japan. The purpose of the wor k is a comparative analysis of the legal mechanisms of rotation of municipal employees, to identify their effectiveness and the possibilities of adapting foreign experience in Russian practice. The historical aspect considers the process of evolution of the institute of rotation in the history of the Russian Federation, starting from the ancient ladder system and ending with the management experiment in the Yamalo-Nenets Autonomous District. The main goals, grounds, positive and negative consequences of personnel rotation, as well as the importance of this method of personnel management and its consolidation as a separate legal institution of local self-government are established. The novelty of the research lies in the modern analysis of the managerial and legal phenomena of the rotation of municipal employees. A comparison of two similar systems of municipal public administration related to the Anglo-Saxon model in the United States and the United Kingdom of Great Britain and Northern Ireland nevertheless revealed the main differences and features of each. The conclusion is drawn : each local community organizes public authority in a municipality in accordance with current economic needs and political expediency, an important part of which is the regular replacement of employees from the managerial level. The results of the research can be used to improve the legislation of the Russian Federation in the field of municipal administration.

The spread of Phytophthora ramorum, the causal agent of Sudden Oak Death and Sudden Larch Death, has resulted in a destructive loss of trees, woody shrubs, and ornamentals in nurseries and forests in the US, Canada, and Europe since the late 1990s. Twelve lineages of P. ramorum are described that vary in global distribution and virulence. Herein, we present a maximum likelihood phylogeny for P. ramorum inferred using IQ-TREE and Tree-Based Alignment Selector Toolkit (T-BAS). The phylogeny was generated based on six loci (avh120, avh121, btub, gweuk.30.30.1, hsp90, and trp1). This phylogeny of P. ramorum improves on previous phylogenies since it is dynamic and interactive and incorporates a diverse set of all known global lineages from the US, Europe (NA1, NA2, EU1, and EU2), and ancestral lineages from the putative native range in East Asia. The phylogenetic relationships inferred in the T-BAS tree support lineages NP1 and NP2 of P. ramorum as ancestral to NA1 and NA2 lineages found in North America. In addition, East Asian IC1, IC2, IC3, and IC4 lineages are ancestral to EU1 and EU2 lineages found in Europe. We used sequence data generated from isolates of P. ramorum collected from Ireland and Northern Ireland and placed them accurately in the tree. The P. ramorum phylogeny is available through T-BAS within the DeCIFR platform. This "interactive phylogeny" can be used by the research community to rapidly update and better reflect the evolutionary relationships of new lineages of P. ramorum.

Individual-level microsimulation models are essential for evaluating colorectal cancer (CRC) screening programmes to capture the heterogeneity in disease progression. To ensure regional relevance, such models require detailed natural history structures and robust calibration to population-specific data. This study presents the development of the first CRC natural history microsimulation model tailored to Northern Ireland (NI) for evaluating the NI Bowel Cancer Screening Programme (NI BCSP). The model simulates individual trajectories from adenoma onset to CRC diagnosis. Eight natural history parameters were calibrated to sex-specific CRC incidence data, initially using empirical (frequentist) calibration and Approximate Bayesian Computation (ABC) rejection, followed by the ABC-Markov Chain Monte Carlo (ABC-MCMC) algorithm. Other parameters were informed by NI-specific data sources. The frequentist and ABC rejection calibration approach's posterior distributions informed the prior distribution for the ABC-MCMC approach. ABC-MCMC was informative, yielding 55 parameter sets, but results were constrained by limited calibration targets and parameter identifiability. This is the first NI-specific CRC microsimulation model, providing a regionally tailored platform for evaluating screening strategies and supporting policy. Calibration was feasible in a data-limited context, but further refinement and additional targets are needed to improve parameter estimation.

Post-traumatic stress disorder and memory function in older adults exposed to civilian conflict: Findings from the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA).

The patient's perspective: A review of results from a radiotherapy patient experience survey (RPES) at the North West Cancer Centre, Northern Ireland, UK.