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ObjectivesTo describe the uptake and outputs of the National Health Service Health Check (NHSHC) programme in England.DesignObservational study.SettingNational primary care data extracted directly by NHS Digital from 90% of general practices (GP) in England.ParticipantsIndividuals aged 40–74 years, invited to or completing a NHSHC between 2012 and 2017, defined using primary care Read codes.InterventionThe NHSHC, a structured assessment of non-communicable disease risk factors and 10-year cardiovascular disease (CVD) risk, with recommendations for behavioural change support and therapeutic interventions.ResultsDuring the 5-year cycle, 9 694 979 individuals were offered an NHSHC and 5 102 758 (52.6%) took up the offer. There was geographical variation in uptake between local authorities across England ranging from 25.1% to 84.7%. Invitation methods changed over time to incorporate greater digitalisation, opportunistic delivery and delivery by third-party providers.The population offered an NHSHC resembled the English population in ethnicity and deprivation characteristics. Attendees were more likely to be older and women, but were similar in terms of ethnicity and deprivation, compared with non-attendees. Among attendees, risk factor prevalence reflected population survey estimates for England. Where a CVD risk score was documented, 25.9% had a 10-year CVD risk ≥10%, of which 20.3% were prescribed a statin. Advice, information and referrals were coded as delivered to over 2.5 million individuals identified to have risk factors.ConclusionThis national analysis of the NHSHC programme, using primary care data from over 9.5 million individuals offered a check, reveals an uptake rate of over 50% and no significant evidence of inequity by ethnicity or deprivation. To maximise the anticipated value of the NHSHC, we suggest continued action is needed to invite more eligible people for a check, reduce geographical variation in uptake, prioritise engagement with non-attendees and promote greater use of evidence-based interventions especially where risk is identified.

Collaborative Practice in Palliative Care explores how different professions work collaboratively across professional, institutional, social, and cultural boundaries to enhance palliative care. Analysing palliative care as an interaction between different professionals, clients, and carers, and the social context or community within which the interaction takes place, it is grounded in up-to-date evidence, includes global aspects of palliative care and cultural diversity as themes running throughout the book, and is replete with examples of good and innovative practice. Drawing on experiences from within traditional specialist palliative care settings like hospices and community palliative care services, as well as more generalist contexts of the general hospital and primary care, this practical text highlights the social or public health model of palliative care. Designed to support active learning, it includes features such as case studies, summaries, and pointers to other learning resources. This text is an important reference for all professionals engaged in palliative care, particularly those studying for post-qualification programmes in the area.

Sustainable intensification (SI) is a global challenge, aiming to increase food production whilst conserving biodiversity and ecosystem services. This is contrary to the observed trend of agricultural intensification degrading environmental quality. We developed a framework integrating animal nutrition, crop yields and biodiversity modelling to explore SI potential in multiple model dairy farming systems through varying crop composition to provide cattle feed rations. We then identified key drivers of biodiversity gain that may be applicable at a wider scale. We developed multiple feed rations to meet the nutritional demands of a high‐yielding, housed dairy herd. The land area required varied due to productivity and nutritional differences between crops, generating spare land. We used published biodiversity models to compare alpha‐ and beta‐diversity of spiders and plants across 36 scenarios that used the spare land in different ways, for either biodiversity maximisation or additional production. Alpha and beta‐diversity for both taxa was the greatest in scenarios that maximised spare land and utilised this for species‐rich extensive grassland. However, commensurate biodiversity gains for plant alpha‐diversity, and spider and plant beta‐diversity (respectively 100%, 76% and 86% gain relative to that optimal scenario) were achievable when spare land was used for additional crop production. Maximising compositional heterogeneity and adding complementary productive land uses to spared land were key to increasing production and beta diversity, while adding species‐rich productive land uses drove increasing production and alpha diversity. Synthesis and applications. This study indicates the potential for the sustainable intensification of dairy farming systems through the manipulation of feed rations to increase land efficiency and spare land, which could then be used to enhance production and biodiversity. The optimum land composition depends on target goal(s) (e.g. maximising production and/or biodiversity). The greatest ‘win‐wins’ can be achieved by making land cover more diverse and selecting crops that complement each other in the species they support; highlighting the important role of heterogeneity in the crop matrix. Our study provides a framework that integrates agricultural production efficiency and biodiversity modelling to explore potential routes to achieve sustainable intensification goals. This study indicates the potential for the sustainable intensification of dairy farming systems through the manipulation of feed rations to increase land efficiency and spare land, which could then be used to enhance production and biodiversity. The optimum land composition depends on target goal(s) (e.g. maximising production and/or biodiversity). The greatest ‘win‐wins’ can be achieved by making land cover more diverse and selecting crops that complement each other in the species they support; highlighting the important role of heterogeneity in the crop matrix. Our study provides a framework that integrates agricultural production efficiency and biodiversity modelling to explore potential routes to achieve sustainable intensification goals.

Rapid expansion of natural gas drilling in Sublette County, WY (1999–present), has raised concerns about the potential ecological effects of enhanced atmospheric nitrogen (N) deposition to the Wind River Range (WRR) including the Class I Bridger Wilderness. We sampled annual throughfall (TF) N deposition and lichen thalli N concentrations under forest canopies in four different drainages of the WRR. Measurements of TF N deposition and N concentrations in lichen thalli were highest at plots closest to drilling operations (<30 km). N concentrations in lichens decreased exponentially with distance from drilling activity. Highest TF N deposition, 4.1 kg ha −1  year −1 , coincided with clear evidence of damage to lichen thalli. This deposition value is above estimated preindustrial deposition conditions (0.9 kg N ha −1  year −1 ) and regional critical loads (a deposition value below which ecosystem harm is prevented) of N deposition for sensitive ecosystem components. N concentrations in Usnea lapponica were strongly correlated ( r  = 0.96) with TF N deposition, demonstrating that elemental analysis of lichen material can be used to estimate TF N deposition. N concentrations below 1.35 % in U . lapponica and 1.12 % in Letharia vulpina were associated with estimated background conditions of 0.9 kg N ha −1  year −1 . Additional lichen sampling in the Bridger Wilderness is recommended to further quantify and monitor spatial patterns of N deposition and to define areas of elevated N deposition.

Purpose>The purpose of this paper is to investigate psychometric properties of the Self-Efficacy for Therapeutic Use of Self (SETUS) scales, a questionnaire based on the Intentional Relationship model, and to investigate the factor structure and internal consistency of the English version of three-part SETUS questionnaire in occupational therapy students.Design/methodology/approach>The sample of this cross-sectional study included 155 students with age range 18–30 years, of which 95% were women. Principal Components Analysis (PCA) was performed on the questionnaire scales, including the Self-Efficacy for Therapeutic Mode Use (SETMU), Self-Efficacy for Recognizing Interpersonal Characteristics (SERIC) and Self-Efficacy for Managing Interpersonal Events (SEMIE). The internal consistencies were calculated. Pearson correlation analysis was used to evaluate the strength of correlation among the scales.Findings>The PCA confirmed that the items of each of the three proposed scales loaded strongly on one factor (self-efficacy for three factors of therapeutic mode use, recognizing interpersonal characteristics and managing interpersonal events). The Cronbach’s alpha for the SETMU, SERIC and SEMIE was 0.85, 0.95 and 0.96, respectively. The three scales significantly inter-correlated strongly (r ranging 0.74–0.83, all p < 0.001).Originality/value>The SETUS questionnaire comprises three valid and reliable scales. It can be used by occupational therapy supervisors as a means to reflect on students’ self-efficacy in components of therapeutic use of self.

Background Data are the evidentiary basis for scientific hypotheses, analyses and publication, for policy formation and for decision-making. They are essential to the evaluation and testing of results by peer scientists both present and future. There is broad consensus in the scientific and conservation communities that data should be freely, openly available in a sustained, persistent and secure way, and thus standards for 'free' and 'open' access to data have become well developed in recent years. The question of effective access to data remains highly problematic. Discussion Specifically with respect to scientific publishing, the ability to critically evaluate a published scientific hypothesis or scientific report is contingent on the examination, analysis, evaluation - and if feasible - on the re-generation of data on which conclusions are based. It is not coincidental that in the recent 'climategate' controversies, the quality and integrity of data and their analytical treatment were central to the debate. There is recent evidence that even when scientific data are requested for evaluation they may not be available. The history of dissemination of scientific results has been marked by paradigm shifts driven by the emergence of new technologies. In recent decades, the advance of computer-based technology linked to global communications networks has created the potential for broader and more consistent dissemination of scientific information and data. Yet, in this digital era, scientists and conservationists, organizations and institutions have often been slow to make data available. Community studies suggest that the withholding of data can be attributed to a lack of awareness, to a lack of technical capacity, to concerns that data should be withheld for reasons of perceived personal or organizational self interest, or to lack of adequate mechanisms for attribution. Conclusions There is a clear need for institutionalization of a 'data publishing framework' that can address sociocultural, technical-infrastructural, policy, political and legal constraints, as well as addressing issues of sustainability and financial support. To address these aspects of a data publishing framework - a systematic, standard approach to the formal definition and public disclosure of data - in the context of biodiversity data, the Global Biodiversity Information Facility (GBIF, the single inter-governmental body most clearly mandated to undertake such an effort) convened a Data Publishing Framework Task Group. We conceive this data publishing framework as an environment conducive to ensure free and open access to world's biodiversity data. Here, we present the recommendations of that Task Group, which are intended to encourage free and open access to the worlds' biodiversity data.

Aims Changes in land cover resulting from the introduction of non‐native pine plantations and subsequent pine invasion is increasingly affecting forest areas in the Southern Hemisphere, and having negative impacts on diverse ecosystem components. We studied the abundance, biophysical attributes, and flammability of litter in temperate forests modified by the introduction of the non‐native Pinus radiata, and later by its post‐fire invasion from adjacent sites. We also evaluated the short‐term effects on litter of mechanical removal of P. radiata from post‐fire invasion sites. Location North‐western Patagonia, Argentina. Methods We measured abundance, depth, moisture content and determined species composition of litter samples collected at native forest, plantation, and post‐fire invasion and removal sites. We also performed flammability tests on leaf litter samples of the dominant species from each habitat type. In all cases, litter traits from the modified habitats were compared with those obtained from native forest (reference system). Results Moisture content and litter species composition were notably affected by the alteration of habitat. A decrease in species richness and changes in the identity and abundance of the dominant species were the most remarkable shifts recorded in the modified habitats. While pine needles were mainly associated with parameters indicative of high leaf litter flammability, the opposite was found for leaves of the dominant native trees. The removal of invasive pines from early post‐fire invasion did not reveal any biophysical changes in litter that would indicate a tendency towards the conditions found in native forest litter. Conclusions Pine needles as a novel element in litter found in pine‐dominated habitats have a prominent impact on litter traits associated with alterations in key ecosystem properties in comparison with the reference system. For a short‐term recovery of burned, invaded areas, additional ecological practices other than the removal of invasive trees should be conducted to successfully drive successional changes towards conditions similar to those found in native vegetation. The introduction of non‐native pine plantations and subsequent pine invasion is increasingly affecting areas of natural forest in the Southern Hemisphere. We found that pine needles (as a novel element in the litter of the modified habitats) have a negative impact on species composition, quality and flammability of litter – changes that represent increased degradation and fire risk for the area.