Journal articles on the topic 'Scotland. Development Department'

AbstractThe Department of Agriculture and Fisheries for Scotland (DAFS) have a responsibility to comment on all proposed changes of use in agricultural land in Scotland, whether this be to urban and industrial use or to forestry. The Macaulay Institute for Soil Research, through its Department of Soil Survey, has mapped the soils of Scotland, demonstrating in the process very clear links between the underlying solid and drift geology, and soil development and land use. Two series of interpretative maps have been produced, one at 1:250 000 of the entire country and one at 1:50 000 of the arable lands. These incorporate both climatic and site factors with soil type to provide a classification of agricultural potential. This work will be implemented in Scotland by DAFS as part of their planning-related functions in 1987. This paper describes the links between geology and soil maps, and the approaches taken in both land classification compilation and application. In conclusion, the basis for land suitability maps for specific purposes, now being actively developed to provide further guidance for assessing the impact of land use change in Scotland, is described.

A pilot telemedicine network was established in 11 sites using funding provided by the Department of Trade and Industry in the UK. The main purpose of the project was to develop and evaluate clinical and educational links between central and peripheral sites in Scotland. The results were very encouraging, and clinical services were established in accident and emergency medicine, tele-ultrasound and clinical psychology. An undergraduate medical teaching service was also successfully established. All of these services are to be continued after the completion of the project. Many lessons were learned during the establishment of this network which will be useful in future projects. These included the importance of training for telemedicine users, the importance of identifying a telemedicine champion, the pitfall of health economics and the fact that services must be needs driven.

This paper presents the results of a study which estimates the practical wind energy resource for the Tayside Region of Scotland. The study considered all technical, environmental and legislative factors relevant to wind energy development. Due consideration was also given to National Planning Policy Guideline (NPPG6): Renewable Energy and Planning Advice Note 45 (PAN45): Renewable Energy Technology, issued by the Scottish Office Environment Department, in addition to the policies of the planning authorities within Tayside with regards to such matters as development in National Scenic Areas and other designated areas. An area of 1290 km2 was identified as being the minimum practical resource which is free from environmental and technical constraints and which has sufficiently high wind speeds to make extraction of energy from the wind commercially viable. This area could accommodate an installed wind energy capacity of 9675 MW and produce 24.6 TWh of wind generated electricity per annum.

Summary Excavation and survey work ahead of the new M74 road development, jointly funded by Historic Scotland and Scottish Office Industry Department (Roads), at an unenclosed platform settlement, with its accompanying field system, has yielded an Early Bronze Age radiocarbon date from a primary hut platform structure. Subsequent re-use of the single excavated platform stance is dated to the Pre-Roman Iron Age.

Excavation ahead of the M74 road development was undertaken at a cairnfield and other settlement remains at Fall Kneesend. The project was funded by the National Roads Directorate of the Scottish Office Development Department and managed on their behalf by Historic Scotland. The remains of a cremation pyre were found beneath one of the cairns, and an early Bronze Age radiocarbon date was obtained from this deposit. Later buildings placed among the cairnfield were excavated and are thought to have been associated with shieling activity.

In the following article, Christine Hamilton and Adrienne Scullion review the system of theatre provision and production that exists in the rural areas of Scotland, most especially in the Highlands and Islands, assessing the policy framework that exists in the nation as a whole and in the Highlands and Islands in particular. They highlight the role and responsibilities of volunteers within the distribution of professional theatre in Scotland, challenge the response of locally based theatre-makers and nationally responsible agencies to represent rural Scotland, and raise issues fundamental to the provision of culture nationally. In doing so, they question what we expect theatre policy to deliver in rural areas, and what we expect rural agents to contribute to theatre provision and policy. Finally, they suggest that, in the system of rural arts in Scotland, there are wider lessons for the development of arts in and the arts of other sparsely populated and fragile communities. Christine Hamilton is the director and Adrienne Scullion the academic director of the Centre for Cultural Policy Research at the University of Glasgow, where Adrienne teaches in the Department of Theatre, Film, and Television Studies.

Christine Hallett is Professor of Social Policy and Chair of the Department of Applied Social Science, University of Stirling, Scotland. She has written extensively in the area of child protection policy, child inquiries and inter-professional communication. In 1992, in conjunction with Elizabeth Birchall, she completed a major review of the literature on the issue of co-ordination in child protection work. It has formed the basis for a research study funded by the Department of Health Into inter-agency and professional co-ordination in the practice and policies of child protection.This interview was conducted whilst I was on a study tour of Great Britain supported by a Creswick Foundation Fellowship in Family Relations and Child Development and the Department of Social Work, Monash University. In the interview, Christine discusses her views about the efficacy of co-ordination, its drawbacks and the policy implications for emphasising the importance of inter-agency co-ordination in protecting children.

An account of the work of the engagement and participation officers with lived experience as users and carers in the MWC, showing: the history of user and carer involvement in the Commission, the reason for the employment of the present workers and the creation of the department of engagement and participation. Told from the perspective of lived experience of using services, describing the development of the roles to date, the activities carried out to date, especially those connected with mental health law, capacity, and the role of the NPM in safeguarding against cruel and degrading treatment and torture, some assessments of the impact of these activities and a presentation of the personal perspective of using lived experience as an integral part of a professional role.

The Highlands and Islands Development Board (HIDB) is developing a strategy for the production and marketing of high health breeding sheep. Farmers and crofters in the North of Scotland, with HIDB support, have formed the Highlands and Islands Sheep Health Association (HISHA) to produce and market high health sheep. HISHA has over 500 members with a total of 250,000 breeding ewes. Members’ flocks are monitored by the Scottish Veterinary Investigation Service for Enzootic Abortion of Ewes (EAE) and for vaccination against Clostridial Diseases and Pasteurella. A requirement for information on the sheep health concerns and experiences of the potential purchasers of high health breeding sheep was identified. A survey was undertaken of lowground sheep farmers in Grampian and the Borders of Scotland to provide this information.The objectives were to determine, firstly, lowground sheep farmers’ concerns on sheep health; secondly, their experience of sheep disease problems; and thirdly, their awareness of sheep diseases that can be introduced by wintering sheep for another farmer or through purchased sheep. The survey was carried out by postal questionnaire and the Department of Agriculture and Fisheries for Scotland (DAFS) prepared a mailing list from their census records. The DAFS also undertook the despatch and receipt of the questionnaires to preserve farmer confidentiality. The data was analysed using the Scientific Information Retrieval Data Base Management Systems analytical package.

Purpose The paper aims to examine how Scottish facility and estate managers have developed estates and facilities management strategies to ensure that the Scottish government civil estate has remained fit for purpose in a period of rapid social, economic and technological change, and political development covering the devolution period. Design/methodology/approach This paper examines the development of the policy frameworks within which facility mangers have worked and how they have adapted the asset portfolio to meet the demands of modern working practices and the budgetary disciplines resulting from economic change. Findings The period 1989-2015 has shown major changes. It commenced with a highly centralised model driven by the Whitehall Department of the Treasury and run by the Property Services Agency. Just before and during devolution, there was administrative decentralisation of activity to agencies and non-departmental public bodies, and this was reflected in decentralised property management first to departments and then to the agencies and non-departmental public bodies. During this time, profound changes occurred in working practices, e-mail, e-records, mobile telephones and open-plan layouts; remote working changed the ways buildings were used. Public sector property was used to promote distribution of jobs to outer areas. Towards the latter end of the period from 2008 onwards, the economic difficulties have led to acute budget pressures, and from 2011 onwards, there has been a trend both in Whitehall, and the Scottish devolved administration towards greater corporate management of the estate to drive down costs and promote more modern ways of working which may lead to a model similar to the one which prevailed at the start of the period. Research limitations/implications The paper explains the development of the management framework and changes on the estate itself to inform the debate between policymakers, academic researchers and FM practitioners interested in the efficient use of central government assets. Practical implications The paper will help academics and practitioners understand the historic context within which they are working. Social implications The paper indicates how the Scottish Government has adapted its property assets to meet the needs of users. Originality/value The paper is an historic exposition of how public sector facility managers have adapted the management of the Scottish Government estate in Scotland to meet the needs of central government staff and the public to whom it provides wider services and considers how this illuminates wider FM issues.

Objective: To study the implications of hormone replacement therapy (HRT) treatment in the pathogenesis of Reinke's oedema (via a possible pseudo-hypothyroidism effect), and also to study why the disease affects a predominantly post-menopausal female population.Design: Prospective case series study.Setting: Two teaching hospitals and two district general hospitals in Scotland, UK.Subjects: Thirty-three patients diagnosed with Reinke's oedema who presented in the out-patient department before or after treatment.Results: Thyroid function tests were normal in all but two cases. Only three patients were receiving HRT treatment.Conclusions: The study produced no evidence to support a relationship between HRT treatment and the pathogenesis of Reinke's oedema; this supports previous studies which concluded that thyroid function was not related to the development of Reinke's oedema. Some new ideas regarding hormonal factors in Reinke's oedema are discussed.

SynopsisThe history of Edinburgh's sewage disposal to the sea from the open ditch system of the 17th century to the present day, together with the changes in legislation affecting sewage discharges to the firth, are reviewed. During the last thirty years sewage discharges have been monitored monthly for levels of faecal coliform bacteria at approximately thirty-four shore sites and twenty offshore sites. These coliform counts are used as bacteriological indicators of sewage pollution, in order to assess the risk to humans of infections that might result from the consumption of contaminated shellfish or from bathing in sewage-polluted waters. Most of the areas sampled from the inner firth were shown to be grossly polluted, particularly in late summer, and regularly to exceed guideline levels throughout the year. Since the commissioning of the new Seafield sewage works in 1979, a general improvement in bacterial and viral counts has been recorded on the south shore of the inner firth. In the last decade two European Community directives relating to the quality of seawater for bathing and shellfish growing have been promulgated, which set guideline and mandatory levels for the number of faecal coli in seawater. The Scottish Development Department has recently designated five beaches as bathing beaches and two areas on the north and south shores of the firth as shellfish growing areas. These areas have been regularly monitored by the Forth River Purification Board and the published results of both surveys are analysed. The virological studies carried out by the Forth Pollution Group of Napier College before and after the major change in the sewage discharge pattern into the Firth of Forth are reviewed.

The development of telecare services in the UK has been supported by grants from the respective governments of Scotland and Wales, and by the Department of Health in England. New services are being established, sometimes to operate alongside existing community equipment services and community alarm services. Elsewhere they are embracing a wider range of services including rehabilitation, intermediate care and health services designed to reduce use of unscheduled care services. This paper discusses the difficulties in understanding the scope of telecare services, and the definitions of services that will need to be confirmed if service users are to be able to choose appropriately if offered direct payments. Two service models are offered, one of which uses telehealth as an umbrella term to cover all telecare, e‐care and m‐care, and telemedicine, where the former includes all such services offered in the service user's home, including those of a medical nature. The second model views telecare alongside assistive technologies and telemedicine as one of three technology groups designed to make people more independent, or to bring care closer to home. There is significant overlap between the three groups, which justifies the introduction of a new term ‐ ARTS (assistive and remote technology services) ‐ to describe this area of support.

IntroductionThis protocol describes an observational study which set out to assess whether frailty and/or multimorbidity correlates with short-term and medium-term outcomes in patients diagnosed with COVID-19 in a European, multicentre setting.Methods and analysisOver a 3-month period we aim to recruit a minimum of 500 patients across 10 hospital sites, collecting baseline data including: patient demographics; presence of comorbidities; relevant blood tests on admission; prescription of ACE inhibitors/angiotensin receptor blockers/non-steroidal anti-inflammatory drugs/immunosuppressants; smoking status; Clinical Frailty Score (CFS); length of hospital stay; mortality and readmission. All patients receiving inpatient hospital care >18 years who receive a diagnosis of COVID-19 are eligible for inclusion. Long-term follow-up at 6 and 12 months is planned. This will assess frailty, quality of life and medical complications.Our primary analysis will be short-term and long-term mortality by CFS, adjusted for age (18–64, 65–80 and >80) and gender. We will carry out a secondary analysis of the primary outcome by including additional clinical mediators which are determined statistically important using a likelihood ratio test. All analyses will be presented as crude and adjusted HR and OR with associated 95% CIs and p values.Ethics and disseminationThis study has been registered, reviewed and approved by the following: Health Research Authority (20/HRA1898); Ethics Committee of Hospital Policlinico Modena, Italy (369/2020/OSS/AOUMO); Health and Care Research Permissions Service, Wales; and NHS Research Scotland Permissions Co-ordinating Centre, Scotland. All participating units obtained approval from their local Research and Development department consistent with the guidance from their relevant national organisation.Data will be reported as a whole cohort. This project will be submitted for presentation at a national or international surgical and geriatric conference. Manuscript(s) will be prepared following the close of the project.

IntroductionWeight management interventions in research studies and in clinical practice differ in length, advice, frequency of meetings, staff and cost. Very few real-world programmes have published patient-related outcomes, and those that have published used different ways of reporting the information, making it impossible to compare interventions and further develop the evidence base. Developing a core outcome set for behavioural weight management programmes (BWMPs) for adults with overweight and obesity will allow different BWMPs to be compared and reveal which interventions work best for which members of the population.Methods and analysisAn expert group, comprised of 40 people who work in, refer to, or attend BWMPs for adults with overweight and obesity, will be asked to decide which outcomes services should report. An online Delphi process will be employed to help the group reach consensus as to which outcomes should be measured and reported, and which definitions/instruments should be used in order to do so. The first stage of the Delphi process (three rounds of questionnaires) will focus on outcomes while the second stage (three additional rounds of questionnaires) will focus on definition/instrument selection.Ethics and disseminationEthical approval for this study has been received from the University of Glasgow College of Medical, Veterinary and Life Sciences Ethics Committee. With regard to disseminating results, a report will be submitted to our funding body, the Chief Scientist Office of the Scottish Government Health Department. In addition, early findings will be shared with Public Health England and Health Scotland, and results communicated via conference presentations, peer review publication and our institutions’ social media platforms.

The role of nutrition in determining the reproductive performance of sows is still controversial. Much of the dispute arises because in many published experiments there were very few sows in each treatment group. In addition, there have been substantial changes In the husbandry of sows over recent years, and these include the much earlier weaning of the litter at as little as three weeks of age, the breeding of the gilt at a younger age since she reaches 100 kg very much more quickly, and the development of facilities which allow each sow to be treated as an individual. A further change has been in the genotype of the breeding female which means that quite often she enters the reproductive phase of her life carrying very much less adipose tissue than hitherto. The recent development of equipment and techniques to monitor the backfat thickness of sows during life has introduced a new management tool, for which guidelines are readily given, but for which hard experimental evidence is often lacking. The purpose of the coordinated experiment reported here was to attempt to establish critical factors in the history of the sow which put her reproductive performance at particular risk and to evaluate widely recommended practices of Increasing the feed Intake at over the terminal phase of pregnancy, The work was jointly funded by the Department of Agriculture for Scotland and each of the centres.

IntroductionThe prevalence of at-risk drinking is far higher among those in contact with the criminal justice system (73%) than the general population (35%). However, there is little evidence on the effectiveness of alcohol brief interventions (ABIs) in reducing risky drinking among those in the criminal justice system, including the prison system and, in particular, those on remand. Building on earlier work, A two-arm parallel group individually randomised Prison Pilot study of a male Remand Alcohol Intervention for Self-efficacy Enhancement (APPRAISE) is a pilot study designed to assess the feasibility and acceptability of an ABI, delivered to male prisoners on remand. The findings of APPRAISE should provide the information required to design a future definitive randomised controlled trial (RCT).Methods and analysisAPPRAISE will use mixed methods, with two linked phases, across two prisons in the UK, recruiting 180 adult men on remand: 90 from Scotland and 90 from England. Phase I will involve a two-arm, parallel-group, individually randomised pilot study. The pilot evaluation will provide data on the likely impact of A two-arm parallel group individually randomised Prison Pilot study of a male Remand Alcohol Intervention for Self-efficacy Enhancement (APPRAISE), which will be used to inform a future definitive multicentre RCT. Phase II will be a process evaluation assessing how the ABI has been implemented to explore the change mechanisms underpinning the ABI (figure 1) and to assess the context within which the ABI is delivered.Ethics and disseminationThe APPRAISE protocol has been approved by the East of Scotland Research Ethics Committee (19/ES/0068), National Offender Management System (2019-240), Health Board Research and Development (2019/0268), Scottish Prison Service research and ethics committee, and by the University of Edinburgh’s internal ethics department. The findings will be disseminated via peer-reviewed journal publications, presentations at local, national and international conferences, infographics and shared with relevant stakeholders through meetings and events.Trial registration numberISRCTN27417180.

The organization of the national health service in the United Kingdom has been under constant review and revision since its inception after the Second World War. Central government spends £35,894 million each year on the Health Service and it is the country's largest employer. Total health expenditure in the United Kingdom accounts for 6.1% of the Gross Domestic Product. This apparently compares unfavorably with 12.4% total health expenditure in the United States.States. However the public health expenditure is identical in the two countries, 5.2%, and this figure is similar in most developed countries including Australia, Denmark, Spain and Switzerland. The overall regional administration of the Health Service in England (Scotland, Wales and Northern Ireland have slightly different organizations) is well established, although the names of the different strata of administration change from time to time. The Secretary of State for Health oversees the Department of Health including the National Health Service Management Executive. Under this Management Executive are 14 Regional Health Authorities covering 100% of the total population.There are within the London area several Special Health Authorities set up in the past because of the particular expertise which they provided. These are under review and will almost certainly lose their special status in the future because of the improvements and increase in services nationwide. The Regional Health Authorities have under their care 177 District Health Authorities and 90 Family Health Service Authorities.They do not manage the National Health Service Trusts—a new development which allows hospitals and other organizations within the Health Service to work autonomously to provide NHS services.

ObjectiveIn 2015, the Department of Health in England announced an ambition to reduce ‘brain injuries occurring during or soon after birth’. We describe the development of a pragmatic case definition and present annual incidence rates.DesignRetrospective cohort study using data held in the National Neonatal Research Database (NNRD) extracted from neonatal electronic patient records from all National Health Service (NHS) neonatal units in England, Wales and Scotland. In 2010–2011, population coverage in the NNRD was incomplete, hence rate estimates are presented as a range; from 2012, population coverage is complete, and rates (95% CIs) are presented. Rates are per 1000 live births.SettingNHS neonatal units in England.PatientsInfants admitted for neonatal care; denominator: live births in England.Main outcome measure‘Brain injuries occurring at or soon after birth’ defined as infants with seizures, hypoxic-ischaemic encephalopathy, stroke, intracranial haemorrhage, central nervous system infection and kernicterus and preterm infants with cystic periventricular leucomalacia.ResultsIn 2010, the lower estimate of the rate of ‘Brain injuries occurring at or soon after birth’ in England was 4.53 and the upper estimate was 5.19; in 2015, the rate was 5.14 (4.97, 5.32). For preterm infants, the population incidence in 2015 was 25.88 (24.51, 27.33) and 3.47 (3.33, 3.62) for term infants. Hypoxic-ischaemic encephalopathy was the largest contributor to term brain injury, and intraventricular/periventricular haemorrhage was the largest contributor to preterm brain injury.ConclusionsAnnual incidence rates for brain injuries can be estimated from data held in the NNRD; rates for individual conditions are consistent with published rates. Routinely recorded clinical data can be used for national surveillance, offering efficiencies over traditional approaches.

This article reviews recent climatically extreme periods in Great Britain and presents results from the latest general circulation model (GCM) experiments showing the possible spatial patterns and magnitude of future climate change for this region. During the last decade the British Isles has seen record-breaking periods of above-average temperatures, alongside periods with above and below-average precipitation, combined with an increase in winter precipitation and a decrease in summer precipitation. The impacts of these anomalies, coupled with the possibility that future climate change may increase their frequency and/or severity, have prompted the UK Department of the Environment, Transport and Regions and other organizations involved in environmental management, such as the Environment Agency, to commission a number of studies into their impacts. These have highlighted wide-ranging impacts on the natural environment of Great Britain and on human ativities to the extent of affecting the national economy. The use of GCMs for the development of future climate change scenarios is reviewed. Results from recent ensemble GCM experiments with and without the effects of sulphate aerosols are presented. These show broadly similar changes in temperature and precipitation to previous climate change scenarios prepared for Great Britain. In summary, the scenarios suggest the following: a warming of about 3 8C (3.5 8C) over the region by 2100 with (without) the effects of sulphate aerosols; slight increases in annual precipitation over northern England and Scotland, more pronounced increases over the whole of the region in winter; and slight decreases in precipitation over Wales and central England in summer. These changes are synchronous with decreases in the number of wet-days and increases in the intensity of precipitation on wet-days. The high level of uncertainty associated with regional scenarios of temperature and precipitation is discussed and emphasized

The policy process in the devolved Scottish system reconciles the Scottish themes of delivering social policy from the centre, through channels of advice and professional direction, and the New Labour theme of broad social policy strategies aiming at better service delivery and employment outcomes. Beneath the surface issues there is a trend to re-structure some services. The Scottish Executive's strategy Social Justice, set out in annual reports, relates devolved and non-devolved responsibilities in a way that has implications for the structure of Executive departments and the policy-making demands made upon civil servants. The research reported here uses interviews with officials to explore the structures of policy making in the Executive within a context of expectations about ministerial and official roles inherited from the previous administrative devolution.

Abstract The territorial departmental select committees have largely escaped academic scrutiny since their establishment in 1979 (for Scotland and Wales) and 1994 (Northern Ireland). This article charts the history of territorial representation in Westminster, including the creation of grand committees for Scotland and Wales and a Northern Ireland Standing Committee, before explaining the forces that led to the creation of territorial departmental select committees. The article then explores the work of these committees after their formation, and explores how they have responded to the devolution dispensations in their respective nations. A key theme of this article is the influence of constitutional developments in Scotland, Wales and Northern Ireland on territorial committees at Westminster. Indeed, as this article highlights, the different timings of establishment, the asymmetric levels of (in)stability in the various devolution dispensations and prolonged suspensions of devolution in Northern Ireland have had an impact on the role of the respective territorial select committees.

Struther Arnott worked tirelessly as a researcher, teacher, leader and maker and implementer of policy in universities in Britain and the USA, always carrying his colleagues along with him through his infectious energy and breadth of academic enthusiasms and values. His outlook was shaped by the stimulus of a broad Scottish education that launched wide interests inside and outside science, including the history and literature of classical civilizations. His early research, with John Monteath Robertson FRS, was into structure determination by X-ray diffraction methods for single crystals, at a time when the full power of computers was just becoming realized for solution of the phase problem. With tenacity and originality, he then extended these approaches to materials that were to a greater or lesser extent disordered and even more difficult to solve because their diffraction patterns were poorer in information content. He brought many problems to definitive and detailed conclusion in a field that had been notable for solutions that were partial or vague, especially with oriented fibres of DNA and RNA but also various polysaccharides and synthetic polymers. His first approach was to use molecular model building in combination with difference Fourier analysis. This was followed later, and to even greater effect, by a computer refinement method that he developed himself and called linkedatom least-squares refinement. This has now been adopted as the standard approach by most serious centres of fibre diffraction analysis throughout the world. After the 10 years in which he consolidated his initial reputation at the Medical Research Council Biophysics Unit at King's College, London, in association with Maurice Wilkins FRS, he moved to Purdue University in the USA, first as Professor of Biology then becoming successively Head of the Department of Biological Sciences and Vice-President for Research and Dean of the Graduate School. As well as continuing his research, he contributed to the transformation of biological sciences at that university and to the development of the university's general management. He finally returned to his roots in Scotland as Principal and Vice-Chancellor of the University of St Andrews, to draw on his now formidable experience of international scholarship and institutional management, to reshape the patterns of academic life and mission to sit more happily and successfully within an environment that had become beset with conflict and change. He achieved this without disturbance to the harmony and wisdom embodied in the venerable traditions of that ancient Scottish yet cosmopolitan university.

The seven river purification boards, which cover the whole of mainland Scotland, are strictly single-purpose authorities whose function is to control pollution of inland and coastal waters. Unlike the water authorities in England and Wales they are not responsible for the management of water supplies, sewerage, sewage treatment, land drainage, flood prevention or fisheries. However, the author contends that it is this singleness of purpose and the complete independence of the boards from the polluters, whether local authorities or private industries, which has led in Scotland to better progress in the restoration of polluted waters than south of the border, progress which has been clearly demonstrated in recent government reports. Moreover, through close consultation at the planning stage with government departments, local authorities and other bodies, the river boards do have a significant influence on developments which affect the aquatic environment and hence are involved in the wider aspects of river basin management.

Alain Passes describes the relationships between identity, language and recent sociocultural developments within the Pa'ikwené communities. He argues that ‘language loss is not identity loss’ and that identity can be manifested in many different dimensions. He uses recent observations of recent social phenomena among Pa'ikwené to support his ideas. Short description by Michal Gilewski ACKNOWLEDGEMENT The article is based on a paper presented at CIASE, department of social anthropology, Unwersity of St. Andrews, Scotland, 17 April, 2003.

This article offers some reflections on the processes of nation-making and state formation as they affected the oldest ethnic and cultural grouping in the British Isles, that of the Gaedhil, roughly in the period 1450–1650, and examines the ways in which these processes have been portrayed by historians. At the present day the Gaelic language remains the normal medium of communication in small areas of western Ireland and western Scotland; and in respect of political developments in both Scotland and Ireland, Gaelic customs and culture have exercised a much more substantial influence. Despite these similarities, there remain significant differences between British and Irish historians in the ways in which the Gaelic contribution to nation-making and state formation have been presented.A basic distinction advanced by historians both of Ireland and Scotland has been one between the Gaelic peoples inhabiting Ireland and those resident in Scotland. It can be argued that this may reflect the relative importance of the Gaelic contribution to the making of two separate kingdoms, and ultimately two separate states; but it also means that the wider process of interaction and assimilation between Gaedhil and Gaill is split into separate Irish and Scottish experiences. In theory, these two Gaelic experiences should provide material for a comparative study of a particularly illuminating kind, but in practice other historiographical influences have generally militated against this kind of comparative history. One such is the more marginal position of Gaelic studies within Scottish historiography than is the case in Ireland. Considering that half of Scotland was still Gaelic-speaking in 1700, for instance, it is remarkable how few Scottish historians seem able to make use of Gaelic sources. Another is the practice of establishing separate departments of history in the universities for the teaching of national history. This has meant, for instance, that students are usually taught that portion of the Gaedhil/Gaill interaction process which relates to the ‘nation’ by specialist teachers of national history. Yet, since these national surveys reflect modern nations and modern national boundaries, students are trained to study Irishmen and Scots in the making rather than to consider how the inhabitants of late medieval Gaeldom might have viewed developments in the wider Gaelic world. Arguably, behind these approaches lies the influence of the modern nation-state. Scotland and Northern Ireland remain part of a multi-national British state which is dominated by England.

This volume contains edited versions of 13 of the papers presented at a 1994 University of Edinburgh conference entitled, “Issues and Perspectives in Language Learning: Scottish and Wider Dimensions.” The general topics include: I. The typical pattern of studies in language departments (four papers), II. The relationship of different parts of degree curricula (four papers), III. Languages in the working world; learners, their backgrounds and expectations (one paper), IV. Developments of new methods and using new technology (three papers), V. The particular place of language study in Scotland (one paper), and VI. A summary report of the Round Table discussions.

Background:Large numbers of patients with rheumatoid arthritis (RA) receive regular opioids despite significant toxicity and a lack of evidence supporting their use in non-cancer pain. In order to address this situation, we need to understand when opioids are started in early RA where this has not been studied.Objectives:To examine the temporal trend of opioid prescriptions before and after RA symptom onset and to compare this with DMARD and NSAID prescriptions.Methods:RA participants (cases) were recruited as part of the Scottish Early Rheumatoid Arthritis (SERA) inception cohort1. Controls without RA (five per case), matched for sex, age and post code over the same time period, were obtained through routine data linkage. Prescription data between Jan 2009 to Nov 2019 of cases and matched controls were compared using date of RA symptom onset as reference point. The Prescriptions Per Participant (PPP) for each three-month block was estimated by dividing the number of prescribed drugs in the selected drug classes (assigned using the British National Formulary) in that time block by the number of participants in each group. The differences between mean PPP of the RA cases and controls in each time block were tested by t-test for independent groups and subsequent adjustment for multiple testing.Results:1,720,335 prescriptions were available for analysis with 421,961 items for 950 RA cases and 1,299,374 items for 4,558 matched controls. As expected, DMARD prescriptions in the SERA cases increased after the symptom onset period and were then sustained (Figure 1: top left panel). NSAID prescriptions in RA cases peaked during the 3 months after symptom onset and then reduced progressively (top right panel). Opioid analgesic prescriptions for the RA cases increased two-fold during the reference period and then reduced 6-9 months post-symptom onset. However, unlike NSAIDs, after this there was no further significant reduction in opioid prescriptions in the RA cases, which remained stable and significantly higher than in the controls for the remaining study period. The non-opioid analgesic mean PPP increased sharply at the time of symptom onset, with a steady gradual upward trend over time (lower right panel).Conclusion:Opioid prescriptions increase significantly at the time of RA symptoms onset. Despite rapid introduction of DMARDs and resultant reductions in NSAIDs, analgesic use remains significantly higher than in controls. Further research is required to identify the factors associated with persistent opioid use in early RA with interventions aimed at the first 6 months.References:[1]Dale et al. BMC Musculoskelet Disord. 2016;17:461.Acknowledgements:The work was supported by Health Data Research UK which receives its funding from HDR UK Ltd funded by the UKRI MRC, EPSRC, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientists Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust.The SERA study was jointly funded by the Chief Scientists Office Scotland and Pfizer Ltd.Disclosure of Interests:None declared

Acute Medicine is full of ‘C-words’ – the Nursing and Midwifery Council’s ‘Six Cs’ (Care, Compassion, Competence, Commitment, Courage and Competence) are as relevant on the AMU as anywhere else in the Health Service; acute physicians would probably also include co-ordination, collaboration and crisis management, as winter looms before us. Dan Beckett’s paper from Forth Valley in Scotland, suggests another word that should be added to the list. As we strive to design sustainable rotas which span 7 days and comply with European work-time directives it is understandable that continuity often falls by the wayside, particularly in smaller Units. The transition from the acute medicine team to an in-patient specialist ward will usually, and appropriately, require hand-over of care. However, as described in this paper, patients who remain within the AMU may find that they see a different consultant each day. Moving to a model whereby patients in the AMU remained under the care of the admitting consultant was shown to shorten their AMU length of stay, facilitating transfer to the appropriate in-patient team, although not increasing the proportion of patients discharged directly from the unit. The authors proposed that this latter finding related to changes in the skill mix of the consultant team covering the AMU, demonstrating the complexity of the challenges we face. It would have been interesting to study the impact on patient satisfaction – as well as consultant job satisfaction – from this new model; my own, purely anecdotal data, suggests both may be considerably improved. This month’s case report selection illustrates some interesting clinical conundrums. Lower limb cellulitis is a common reason for presentation to the acute medical, or ambulatory care unit; however, when the rash or erythema is bilateral, there is often an alternative diagnosis. In the case described by Cranga and colleagues, antibiotics turned out be the cause (rather than the solution) to the problem. Early liaison with the dermatology team enabled the diagnosis of acute generalized erythematous pustulosis to be made, and resolution of the condition followed discontinuation of antibiotics. The authors include a useful table to support clinicians in making this (albeit rare) diagnosis. Emily McNicholas reminds us of the importance of a collateral history – it is not hard to see how a patient with fever, confusion and incontinence might be labelled as having a urinary tract infection; the retrospective story of a cocktail stick in the throat prior to onset of the symptoms might have pointed to the correct diagnosis is this had been obtained at the time of admission. This case also shows the dangers of separation of Emergency Department notes from those of hospital in-patients, even within the same organization – a problem which will be familiar to many UK readers of this journal. Patients with frailty represent a significant proportion of admissions to the acute medical take and often provide considerable management challenges. Natalie Offord and colleagues from the British Geriatric Society have described the development of the Frailsafe collaborative which clearly provides a major step forward. At the other end of the age spectrum, adolescents and young adults (AYAs) may represent a different kind of challenge for the acute medicine team. Some of the key messages from the recent Royal College of Physicians’ Acute Care Toolkit for AYAs are summarized in the article on p157. Anyone who is involved in managing this group of patients is recommended to read this article, and please look out for the link to a survey about this at the end of the article.

The paper considers some of the reasons why governments develop food policies, gives examples of what is in food policies at the Scottish and UK levels and explores ways of effectively providing balanced evidence for policy development. It discusses the challenges of exchanging knowledge between the science and policy communities, given their different languages and cultures, highlighting the need for greater mutual understanding of roles and responsibilities. It draws on experience in the Scottish Government of developing the government's ‘Recipe for Success – Scotland's National Food and Drink Policy’ through engagement with stakeholders, scientists and analysts and touches on the more complex nature of the Department for International Development's contribution to meeting the first Millennium Development Goal. It compares the need for collation and analysis of existing evidence during the development of policy, with the desirability of providing policy direction for longer-term strategic research and the challenges of connecting the policy expectations with researchable questions. The paper concludes by emphasising the need to focus research in the short-term on mitigation of climate change through decreasing greenhouse gas emissions associated with the production of food, while also taking an account of economic, health and broader environmental sustainability objectives. A further challenge is to communicate complexity and uncertainty in ways which enable decision-makers from the consumer to policy-makers to make informed choices. Longer-term research needs to focus on the opportunities and risks associated with adapting to climate change.

AbstractBackgroundNecrotising otitis externa is a progressive infection of the external auditory canal which extends to affect the temporal bone and adjacent structures. Progression of the disease process can result in serious sequelae, including cranial nerve palsies and death. There is currently no formal published treatment guideline.ObjectiveThis study aimed to integrate current evidence and data from our own retrospective case series in order to develop a guideline to optimise necrotising otitis externa patient management.MethodsA retrospective review of necrotising otitis externa cases within NHS Lothian, Scotland, between 2013 and 2018, was performed, along with a PubMed review.ResultsPrevalent presenting signs, symptoms and patient demographic data were established. Furthermore, features of cases associated with adverse outcomes were defined. A key feature of the guideline is defining at-risk patients with initial intensive treatment. Investigations and outcomes are assessed and treatment adjusted appropriately.ConclusionThis multi-departmental approach has facilitated the development of a succinct, systematic guideline for the management of necrotising otitis externa. Initial patient outcomes appear promising.

This paper reflects on my work in Scotland in child protection during 2009 and 2010. It reflects on the Scotland I discovered and The Highlands I worked in. It describes recent innovative political decisions that have informed social work practice across all professions and government departments. It describes the implementation of an essentially simple system, which provides support for every child in need, specific to that need. It is a system that could positively inform the further development of child protection in New Zealand. Given the current plan to seek ways to ‘modernise’ Child Youth and Family (CYF), this paper seeks to encourage a debate on the merits of this path-finding Scottish solution to their political, social, ethnic and professional barriers, which could also produce positive outcomes for children in New Zealand (Tolley, 2015). It describes the overlaying of this approach on top of a professional workforce, despite the silo bureaucracy of service delivery and regardless of professional jealousies protecting individual professions. It describes the responsibilities of all who interact with children and sets certain overlying responsibilities for ‘named’ persons. In this way the responsibilities for the protection of children is moved from the realm of the social work profession, which is overloaded, as it is currently in New Zealand, and applied directly to all professions that interact with children. The Scots have produced a reliable system which strengthens protective mechanisms at the point of service delivery to the child. This in turn develops a reliable and accountable protective society, in which children in need are identified early and supported throughout their contact with different services. The goal is an on-going intervention that can achieve change for the child and allow the child to reach their potential. It is an aspirational system of care, aiming for development of innate potential. I reflect on the system and the safety it provided to myself as a social worker, the relief of ‘sharing’ child protection responsibilities with all other professions and the clarity of roles which defines this system.

Purpose – Frequent attendance at emergency departments (ED) has been identified in adult protection reviews as a potential warning sign of the escalation of someone’s vulnerability. Concern has been expressed about the engagement of the National Health Service (NHS) in adult protection and the small number of NHS adult protection referrals. More specifically ED departments have been identified as an area of high patient through put where there has been little evidence around how well adult support and protection (ASP) was being delivered. The paper aims to discuss these issues. Design/methodology/approach – A series of audits were undertaken in three different hospitals across a large Scottish Health Board accessing ED at different times of day on different days of the week to test out whether NHS staff working in EDs are identifying adults who meet the criteria of “an adult at risk”. Findings – The audits identified a total of 11 patients from a total sample of 552 records examined who may have met the criteria to be considered an adult at risk, although further information would have been required to make a fully informed decision. Research limitations/implications – The main study limitation is that the hospitals are all within a single Health Board. The EDs have a large number of admissions and it is possible that a less pressurised area, might have a lower threshold of “risk” than the practitioners involved in the audits. The decision as to whether an adult was considered to meet the three-point test by the three people undertaking the audit was dependent on the quality of information recorded on the patients’ electronic hospital record. Practical implications – It is essential that NHS Boards proactively support practice in ED settings so staff are able to identify adults at risk of harm under the ASP legislation so that ED staff are responsive to ASP needs. Originality/value – The research evidence around adult protection in the UK is still emerging. The development of good practice based on the Scottish Government’s ASP legislation is still being shaped. In England and Wales, the principles of identification and multi-agency working underpinning the safeguarding of vulnerable individuals are broadly similar to Scotland. These audits add to the literature by challenging the assumption that patients who would benefit from local authority investigation and possible support are not being identified within EDs.

AbstractObjectiveTo outline the evolution of school food standards and their implementation and evaluation in each of the four countries of the UK since 2000.DesignReview of relevant policies, surveys and evaluations, including country-specific surveys and regional evaluations.SettingUK: England, Wales, Scotland and Northern Ireland.SubjectsPrimary and secondary schools and schoolchildren.ResultsBy September 2013 standards will have been introduced in all primary and secondary schools in the UK. Evaluations have varied in their scope and timing, relating to government forward planning, appropriate baselines and funding. Where standards have been implemented, the quality and nutritional value of food provided have improved. Emerging evidence shows improved overall diet and nutrient intake by school-aged children as a result.ConclusionsThe re-introduction of school food standards in the UK has not been centrally coordinated, but by September 2013 will be compulsory across all four countries in the UK, except in England where academies are now exempt. Provision of improved school food has had a demonstrable impact on diet and nutrition beyond the school dining room and the school gate, benefiting children from all socio-economic groups. Improved school food and dining environments are associated with higher levels of school lunch take up. Implementation of school food standards requires investment. It is critical to policy development that the value of this investment is measured and protected using planned, appropriate, robust and timely evaluations. Where appropriate, evaluations should be carried out across government departments and between countries.

Background Clinical data offer the potential to advance patient care. Neonatal specialised care is a high-cost NHS service received by approximately 80,000 newborn infants each year. Objectives (1) To develop the use of routinely recorded operational clinical data from electronic patient records (EPRs), secure national coverage, evaluate and improve the quality of clinical data, and develop their use as a national resource to improve neonatal health care and outcomes. To test the hypotheses that (2) clinical and research data are of comparable quality, (3) routine NHS clinical assessment at the age of 2 years reliably identifies children with neurodevelopmental impairment and (4) trial-based economic evaluations of neonatal interventions can be reliably conducted using clinical data. (5) To test methods to link NHS data sets and (6) to evaluate parent views of personal data in research. Design Six inter-related workstreams; quarterly extractions of predefined data from neonatal EPRs; and approvals from the National Research Ethics Service, Health Research Authority Confidentiality Advisory Group, Caldicott Guardians and lead neonatal clinicians of participating NHS trusts. Setting NHS neonatal units. Participants Neonatal clinical teams; parents of babies admitted to NHS neonatal units. Interventions In workstream 3, we employed the Bayley-III scales to evaluate neurodevelopmental status and the Quantitative Checklist of Autism in Toddlers (Q-CHAT) to evaluate social communication skills. In workstream 6, we recruited parents with previous experience of a child in neonatal care to assist in the design of a questionnaire directed at the parents of infants admitted to neonatal units. Data sources Data were extracted from the EPR of admissions to NHS neonatal units. Main outcome measures We created a National Neonatal Research Database (NNRD) containing a defined extract from real-time, point-of-care, clinician-entered EPRs from all NHS neonatal units in England, Wales and Scotland (n = 200), established a UK Neonatal Collaborative of all NHS trusts providing neonatal specialised care, and created a new NHS information standard: the Neonatal Data Set (ISB 1595) (see http://webarchive.nationalarchives.gov.uk/±/http://www.isb.nhs.uk/documents/isb-1595/amd-32–2012/index_html; accessed 25 June 2018). Results We found low discordance between clinical (NNRD) and research data for most important infant and maternal characteristics, and higher prevalence of clinical outcomes. Compared with research assessments, NHS clinical assessment at the age of 2 years has lower sensitivity but higher specificity for identifying children with neurodevelopmental impairment. Completeness and quality are higher for clinical than for administrative NHS data; linkage is feasible and substantially enhances data quality and scope. The majority of hospital resource inputs for economic evaluations of neonatal interventions can be extracted reliably from the NNRD. In general, there is strong parent support for sharing routine clinical data for research purposes. Limitations We were only able to include data from all English neonatal units from 2012 onwards and conduct only limited cross validation of NNRD data directly against data in paper case notes. We were unable to conduct qualitative analyses of parent perspectives. We were also only able to assess the utility of trial-based economic evaluations of neonatal interventions using a single trial. We suggest that results should be validated against other trials. Conclusions We show that it is possible to obtain research-standard data from neonatal EPRs, and achieve complete population coverage, but we highlight the importance of implementing systematic examination of NHS data quality and completeness and testing methods to improve these measures. Currently available EPR data do not enable ascertainment of neurodevelopmental outcomes reliably in very preterm infants. Measures to maintain high quality and completeness of clinical and administrative data are important health service goals. As parent support for sharing clinical data for research is underpinned by strong altruistic motivation, improving wider public understanding of benefits may enhance informed decision-making. Future work We aim to implement a new paradigm for newborn health care in which continuous incremental improvement is achieved efficiently and cost-effectively by close integration of evidence generation with clinical care through the use of high-quality EPR data. In future work, we aim to automate completeness and quality checks and make recording processes more ‘user friendly’ and constructed in ways that minimise the likelihood of missing or erroneous entries. The development of criteria that provide assurance that data conform to prespecified completeness and quality criteria would be an important development. The benefits of EPR data might be extended by testing their use in large pragmatic clinical trials. It would also be of value to develop methods to quality assure EPR data including involving parents, and link the NNRD to other health, social care and educational data sets to facilitate the acquisition of lifelong outcomes across multiple domains. Study registration This study is registered as PROSPERO CRD42015017439 (workstream 1) and PROSPERO CRD42012002168 (workstream 3). Funding The National Institute for Health Research Programme Grants for Applied Research programme (£1,641,471). Unrestricted donations were supplied by Abbott Laboratories (Maidenhead, UK: £35,000), Nutricia Research Foundation (Schiphol, the Netherlands: £15,000), GE Healthcare (Amersham, UK: £1000). A grant to support the use of routinely collected, standardised, electronic clinical data for audit, management and multidisciplinary feedback in neonatal medicine was received from the Department of Health and Social Care (£135,494).

Purpose Festivals are often explicitly connected to the destinations in which they take place, explored here as contributing to broader processes of place-making and engagement with local communities. Place is defined at a local scale, primarily as experienced by volunteer contributors to an arts and cultural festival in urban Scotland. Networked relationships between festival volunteers inform the research methods and analysis, reflecting both observer and insider perspectives. This paper aims to comment on varying attitudes among the contributors, relating these findings to their positions in the festival’s social network. Design/methodology/approach Social network analysis methods were used to capture and examine data from a sample of festival volunteers: a survey instrument was distributed among individuals identified by the creative director, acting as a key informant. These data generated information on connections between the respondents, as well as demographic and opinion-based attribute data. Network centrality measures were used to sample the respondents for four follow-up interviews with festival volunteers. Findings The resulting network revealed a core-periphery structure to the festival’s organising team. The influential core group members were more established volunteers, recognised for their value to the team. The festival was widely endorsed as contributing to local place-making, though not uncritically. Management implications were identified for the dual nature of the festival organisation: a formal hierarchy with clear functional departments, acting as a platform for an intangible yet vital social network. Originality/value Social relationships are shown to have profound implications for the management and identity of this volunteer festival, in relation to its host neighbourhood. Combining social network analysis with semi-structured interviews has demonstrated the value of this mixed methods approach.

AbstractObjectives:(1) To identify newly diagnosed cases of methicillin-resistant Staphylococcus aureus ear infection in our local population; (2) to determine the risk factors involved in these patients' clinical courses, and (3) to type the bacterial strains isolated and thus identify whether they were hospital- or community-acquired.Design and setting:Retrospective review of case notes, together with laboratory-based molecular studies in the departments of otolaryngology and medical microbiology in a university teaching hospital in Scotland, UK.Subjects:Over a two-year period, 35 patients were identified with ear swabs positive for methicillin-resistant Staphylococcus aureus infection. These cases came from both hospital and community settings.Main outcome measures:(1) Identification of primary methicillin-resistant Staphylococcus aureus otorrhoea in patients with no previously documented colonisation; and (2) molecular typing of the strains isolated, using spa technology, to identify whether they were hospital- or community-acquired.Results:Of the 35 positive patients, 27 were previously known carriers of methicillin-resistant Staphylococcus aureus. The eight patients with newly diagnosed methicillin-resistant Staphylococcus aureus otorrhoea presented initially in the community. All of these patients had had contact with hospital staff (as in-patients or out-patients) in the weeks preceding development of their ear infection. Using the spa technique for molecular typing, we identified hospital-acquired (‘epidemic’) methicillin-resistant Staphylococcus aureus type 15 in all eight patients' isolates. All were sensitive to topical gentamicin.Conclusions:In our cohort, hospital-acquired methicillin-resistant Staphylococcus aureus type 15 was the commonest cause of methicillin-resistant Staphylococcus aureus otorrhoea, despite the fact that these patients all first presented in the community. We believe that contact with hospital staff or health care workers is a risk factor for acquiring methicillin-resistant Staphylococcus aureus otorrhoea in the community.

Purpose – Enhancing student employability and bridging the gap between theory and practice in law education requires a more multifaceted approach than the traditional mix of lectures, tutorials and simulations. Law placements also provide an opportunity to reinforce the importance of the professional practice standards and requirements laid down by the Law Society of Scotland. The purpose of this paper is to analyse the design and implementation of law placements from the point of initiation to becoming a regular practice. The emphasis is on placements embedded in the programme of study offered to Stage 3 students to facilitate their career choices prior to specialisation in the final year. Design/methodology/approach – This study utilises a longitudinal multi-method approach, allowing the analysis of various aspects the development and practical implementation of law-related placements. The views of students, academic staff and representatives of local employers are gathered by in-depth interviews. A reflective workbook method is also used to analyse the “integration” of learning and to support the “demonstration” and assessment of personal and professional capabilities which are difficult to assess by other means. Findings – The paper presents the challenge faced by a higher education institution in organising meaningful placements and looks at the other avenues explored, particularly in the Third Sector. There are differences in the expectations of law placement providers (law firms and Third Sector organisations) in respect of students’ skill and knowledge base. The students were explicit about the need to demystify the profession and are appreciative of experience with atypical law placement providers which expands their perceptions of the choices within a law career. Students have also indicated a positive alteration in their attitude to the role of reflective practice, which stimulated changes in their behaviour with respect to professional development. Practical implications – The outcomes of the initial stage of this study have implications for law departments in higher education in the context of organising law placements, evaluating their effectiveness and their impact on student employability. Originality/value – Teaching law has its specifics and already employs a number of methods: simulations, negotiation exercises, moots and debates. This paper explores ways of providing a more meaningful practical experience for undergraduate students by placing an emphasis on such elements of professional practice as drafting legal documents and preparing professional opinions, while introducing the complexity of the law profession. Solutions to the challenges faced by the institution in organising those placements are analysed. The study provides an analytical view on the effectiveness of law placements in relation to other widely used approaches to bridging the gap between the theory and practice of law.

Abstract Epilepsy is common in early childhood. In this age group it is associated with high rates of therapy-resistance, and with cognitive, motor, and behavioural comorbidity. A large number of genes, with wide ranging functions, are implicated in its aetiology, especially in those with therapy-resistant seizures. Identifying the more common single-gene epilepsies will aid in targeting resources, the prioritization of diagnostic testing and development of precision therapy. Previous studies of genetic testing in epilepsy have not been prospective and population-based. Therefore, the population-incidence of common genetic epilepsies remains unknown. The objective of this study was to describe the incidence and phenotypic spectrum of the most common single-gene epilepsies in young children, and to calculate what proportion are amenable to precision therapy. This was a prospective national epidemiological cohort study. All children presenting with epilepsy before 36 months of age were eligible. Children presenting with recurrent prolonged (>10 min) febrile seizures; febrile or afebrile status epilepticus (>30 min); or with clusters of two or more febrile or afebrile seizures within a 24-h period were also eligible. Participants were recruited from all 20 regional paediatric departments and four tertiary children’s hospitals in Scotland over a 3-year period. DNA samples were tested on a custom-designed 104-gene epilepsy panel. Detailed clinical information was systematically gathered at initial presentation and during follow-up. Clinical and genetic data were reviewed by a multidisciplinary team of clinicians and genetic scientists. The pathogenic significance of the genetic variants was assessed in accordance with the guidelines of UK Association of Clinical Genetic Science (ACGS). Of the 343 patients who met inclusion criteria, 333 completed genetic testing, and 80/333 (24%) had a diagnostic genetic finding. The overall estimated annual incidence of single-gene epilepsies in this well-defined population was 1 per 2120 live births (47.2/100 000; 95% confidence interval 36.9–57.5). PRRT2 was the most common single-gene epilepsy with an incidence of 1 per 9970 live births (10.0/100 000; 95% confidence interval 5.26–14.8) followed by SCN1A: 1 per 12 200 (8.26/100 000; 95% confidence interval 3.93–12.6); KCNQ2: 1 per 17 000 (5.89/100 000; 95% confidence interval 2.24–9.56) and SLC2A1: 1 per 24 300 (4.13/100 000; 95% confidence interval 1.07–7.19). Presentation before the age of 6 months, and presentation with afebrile focal seizures were significantly associated with genetic diagnosis. Single-gene disorders accounted for a quarter of the seizure disorders in this cohort. Genetic testing is recommended to identify children who may benefit from precision treatment and should be mainstream practice in early childhood onset epilepsy.

This report provides an account of the excavations of a cropmark enclosure and other prehistoric remains at Dryburn Bridge, near Innerwick in East Lothian. The excavations were directed over two seasons in 1978 and 1979 by Jon Triscott and David Pollock, and were funded by the Ancient Monuments Branch, Scottish Development Department. Features and artefacts of various periods were discovered during the excavations, including a Mesolithic chipped stone assemblage and pits associated with Impressed Ware pottery. A pair of distinctive burial cists dating to c2300-2000 cal BC was discovered, each containing two inhumations, one articulated and the other disarticulated; a Beaker vessel was found directly above one of the cists. By the mid first millennium cal BC a settlement had been founded on the site. Three successive settlement layouts can be interpreted from the excavated structures. The first two phases represent continuous occupation, dating to before 400 cal BC, and consisted of timber roundhouses, other rectangular structures and a small cemetery of pit graves located within a palisaded enclosure. The final occupation phase, which extended into the Roman Iron Age and may have occurred after a break in occupation, consisted of an unenclosed settlement of ring-ditch houses. Historic Scotland and predecessor bodies funded the post-excavation studies and publication of this report.

ABSTRACT ObjectivesEmployment and welfare policy have major impacts on population health and health inequalities. We sought to develop a novel data linkage between administrative welfare data (held by the UK Government’s Department for Work and Pensions, DWP) and health records (from the National Health Service, NHS). We describe the challenges we faced establishing this linkage and explain how they have been overcome over five years. ApproachNational Records Scotland (NRS) is the organisation responsible for statutory demographic data in Scotland, including conducting the decennial census, registering births and deaths. They will act as a Trusted Third Party to facilitate linkage under Scots common law. This work will be supported by the UK’s Administrative Data Research Network. Following a successful pilot, a further project is intended to link data for England and Wales (subject to further applications). ResultsThe Work & Pensions Longitudinal Study (WPLS) is a person-level longitudinal dataset that links benefit and programme information held by DWP since January 2004 with employment records from Her Majesty’s Revenue & Customs for people who have had a benefit spell. The WPLS allows transitions between different benefits and/or employment statuses to be ascertained, including timing of transitions and salaried income post-employment. However, the WPLS includes very limited health information. NHS Scotland has exceptional administrative health records, including person-level information on deaths, hospital admissions (including admission/discharge dates, diagnoses, procedures etc.), cancer registrations (including type, stage, treatment) and community prescriptions. A particular strength is the availability of a unique population identifier which facilitates deterministic linkage across health records. Key issues that needed to be addressed to facilitate the linkage included identification of appropriate research questions that were of high priority to government policymakers, the availability of research infrastructure and reassurances about data security. However, delays in establishing the linkage have been common – particularly as a consequence of the multiple organisations involved and time constraints on public sector staff required to process the linkage. Research topics to be investigated include improved prediction of health and welfare outcomes, investigating the health impacts of job insecurity and evaluating impacts of welfare reform. ConclusionEvidence to improve alignment between health and welfare goals will be achieved through linkage of administrative records in this five year research programme. It has been essential to consider how best to achieve public benefit and minimise privacy risks, while ensuring the needs of policymakers are central to the development of the research.

Abstract Introduction The Global Registry of Acute Coronary Events (GRACE) score is a widely used risk stratification tool in the evaluation of patients with myocardial infarction. However, the performance of GRACE in patients with myocardial infarction secondary to oxygen supply-demand imbalance in the absence of atherothrombosis (type 2 myocardial infarction), is uncertain. Outcomes in patients with type 2 myocardial infarction are poor, and a risk stratification tool is urgently required. Methods We assessed the GRACE score in two cohorts of consecutive patients presenting to the Emergency Department with suspected acute coronary syndrome. One cohort was recruited as part of a stepped wedge cluster randomised controlled trial across ten hospitals in Scotland, and one cohort from a large tertiary centre in Sweden. All diagnoses were adjudicated according to the Fourth Universal Definition. We applied the GRACE 2.0 algorithm to estimate death at one year. We assessed model discrimination using the area under the receiver-operator-curve (AUC), and compared AUC between type 1 and type 2 myocardial infarction using the DeLong test. Calibration was assessed using the Hosmer-Lemeshow (HL) goodness of fit test. Results We identified 2,538 and 1,080 patients with type 1 myocardial infarction from the Scottish and Swedish cohorts, with death from any cause occurring in 378 (14.9%) and 112 (10.4%) patients, respectively. The AUC for the GRACE score was 0.843 (0.823–0.864) and 0.848 (0.810–0.886). There were 642 and 247 patients with type 2 myocardial infarction in the Scottish and Swedish cohorts, respectively, with death occurring in 144 (22.4%) and 57 (23.1%) patients. The AUC was 0.708 (0.662–0.754) and 0.733 (0.657–0.808), (P<0.001 for both compared to type 1 myocardial infarction). The results of the HL Test suggest that the calibration of the GRACE 2.0 score needs further improvement (Table). Evaluation of GRACE 2.0 algorithm Type 1 Myocardial Infarction Type 2 Myocardial Infarction Scotland (n=2,538) Sweden (n=1,080) Scotland (n=642) Sweden (n=247) Deaths 378 (14.9%) 112 (10.4%) 144 (22.4%) 57 (23.0%) AUC (C-statistic) 0.843 (0.823–0.864) 0.848 (0.810–0.886) 0.708 (0.662–0.754) 0.733 (0.657–0.808) P-value for HL <0.001 <0.001 <0.001 <0.001 AUC: Area Under the receiver-operator Curve; HL: Hosmer-Lemeshow test. Figure 1. ROC curves Conclusions The GRACE score provided excellent discrimination for all cause death at one year in two contemporary consecutive patient cohorts with tye 1 myocardial infarction. In patients with type 2 myocardial infarction, GRACE performed well, but recalibration or the development of novel risk scores has the potential to improve risk stratification.

Refereed publications (also known as peer-reviewed) are the currency of academia, yet many PhD theses in Australia result in only one or two such papers. Typically, a doctoral thesis requires the candidate to present (and pass) a public Confirmation Seminar, around nine to twelve months into candidacy, in which a panel of the candidate’s supervisors and invited experts adjudicate upon whether the work is likely to continue and ultimately succeed in the goal of a coherent and original contribution to knowledge. A Final Seminar, also public and sometimes involving the traditional viva voce or oral defence of the thesis, is presented two or three months before approval is given to send the 80,000 to 100,000 word tome off for external examination. And that soul-destroying or elation-releasing examiner’s verdict can be many months in the delivery: a limbo-like period during which the candidate’s status as a student is ended and her or his receipt of any scholarship or funding guerdon is terminated with perfunctory speed. This is the only time most students spend seriously writing up their research for publication although, naturally, many are more involved in job hunting as they pin their hopes on passing the thesis examination.There is, however, a slightly more palatable alternative to this nail-biting process of the traditional PhD, and that is the PhD by Published Papers (also known as PhD by Publications or PhD by Published Works). The form of my own soon-to-be-submitted thesis, it permits the submission for examination of a collection of papers that have been refereed and accepted (or are in the process of being refereed) for publication in academic journals or books. Apart from the obvious benefits in getting published early in one’s (hopefully) burgeoning academic career, it also takes away a lot of the stress come final submission time. After all, I try to assure myself, the thesis examiners can’t really discredit the process of double-blind, peer-review the bulk of the thesis has already undergone: their job is to examine how well I’ve unified the papers into a cohesive thesis … right? But perhaps they should at least be wary, because, unfortunately, the requirements for this kind of PhD vary considerably from institution to institution and there have been some cases where the submitted work is of questionable quality compared to that produced by graduates from more demanding universities. Hence, this paper argues that in my subject area of interest—film and television studies—there is a huge range in the set requirements for doctorates, from universities that award the degree to film artists for prior published work that has undergone little or no academic scrutiny and has involved little or no on-campus participation to at least three Australian universities that require candidates be enrolled for a minimum period of full-time study and only submit scholarly work generated and published (or submitted for publication) during candidature. I would also suggest that uncertainty about where a graduate’s work rests on this continuum risks confusing a hard-won PhD by Published Papers with the sometimes risible honorary doctorate. Let’s begin by dredging the depths of those murky, quasi-academic waters to examine the occasionally less-than-salubrious honorary doctorate. The conferring of this degree is generally a recognition of an individual’s body of (usually published) work but is often conferred for contributions to knowledge or society in general that are not even remotely academic. The honorary doctorate does not usually carry with it the right to use the title “Dr” (although many self-aggrandising recipients in the non-academic world flout this unwritten code of conduct, and, indeed, Monash University’s Monash Magazine had no hesitation in describing its 2008 recipient, musician, screenwriter, and art-school-dropout Nick Cave, as “Dr Cave” (O’Loughlin)). Some shady universities even offer such degrees for sale or ‘donation’ and thus do great damage to that institution’s credibility as well as to the credibility of the degree itself. Such overseas “diploma mills”—including Ashwood University, Belford University, Glendale University and Suffield University—are identified by their advertising of “Life Experience Degrees,” for which a curriculum vitae outlining the prospective graduand’s oeuvre is accepted on face value as long as their credit cards are not rejected. An aspiring screen auteur simply specifies film and television as their major and before you can shout “Cut!” there’s a degree in the mail. Most of these pseudo-universities are not based in Australia but are perfectly happy to confer their ‘titles’ to any well-heeled, vanity-driven Australians capable of completing the online form. Nevertheless, many academics fear a similarly disreputable marketplace might develop here, and Norfolk Island-based Greenwich University presents a particularly illuminating example. Previously empowered by an Act of Parliament consented to by Senator Ian Macdonald, the then Minister for Territories, this “university” had the legal right to confer honorary degrees from 1998. The Act was eventually overridden by legislation passed in 2002, after a concerted effort by the Australian Universities Quality Agency Ltd. and the Australian Vice-Chancellors’ Committee to force the accreditation requirements of the Australian Qualifications Framework upon the institution in question, thus preventing it from making degrees available for purchase over the Internet. Greenwich University did not seek re-approval and soon relocated to its original home of Hawaii (Brown). But even real universities flounder in similarly muddy waters when, unsolicited, they make dubious decisions to grant degrees to individuals they hold in high esteem. Although meaning well by not courting pecuniary gain, they nevertheless invite criticism over their choice of recipient for their honoris causa, despite the decision usually only being reached after a process of debate and discussion by university committees. Often people are rewarded, it seems, as much for their fame as for their achievements or publications. One such example of a celebrity who has had his onscreen renown recognised by an honorary doctorate is film and television actor/comedian Billy Connolly who was awarded an Honorary Doctor of Letters by The University of Glasgow in 2006, prompting Stuart Jeffries to complain that “something has gone terribly wrong in British academia” (Jeffries). Eileen McNamara also bemoans the levels to which some institutions will sink to in search of media attention and exposure, when she writes of St Andrews University in Scotland conferring an honorary doctorate to film actor and producer, Michael Douglas: “What was designed to acknowledge intellectual achievement has devolved into a publicity grab with universities competing for celebrity honorees” (McNamara). Fame as an actor (and the list gets even weirder when the scope of enquiry is widened beyond the field of film and television), seems to be an achievement worth recognising with an honorary doctorate, according to some universities, and this kind of discredit is best avoided by Australian institutions of higher learning if they are to maintain credibility. Certainly, universities down under would do well to follow elsewhere than in the footprints of Long Island University’s Southampton College. Perhaps the height of academic prostitution of parchments for the attention of mass media occurred when in 1996 this US school bestowed an Honorary Doctorate of Amphibious Letters upon that mop-like puppet of film and television fame known as the “muppet,” Kermit the Frog. Indeed, this polystyrene and cloth creation with an anonymous hand operating its mouth had its acceptance speech duly published (see “Kermit’s Acceptance Speech”) and the Long Island University’s Southampton College received much valuable press. After all, any publicity is good publicity. Or perhaps this furry frog’s honorary degree was a cynical stunt meant to highlight the ridiculousness of the practice? In 1986 a similar example, much closer to my own home, occurred when in anticipation and condemnation of the conferral of an honorary doctorate upon Prince Philip by Monash University in Melbourne, the “Members of the Monash Association of Students had earlier given a 21-month-old Chihuahua an honorary science degree” (Jeffries), effectively suggesting that the honorary doctorate is, in fact, a dog of a degree. On a more serious note, there have been honorary doctorates conferred upon far more worthy recipients in the field of film and television by some Australian universities. Indigenous film-maker Tracey Moffatt was awarded an honorary doctorate by Griffith University in November of 2004. Moffatt was a graduate of the Griffith University’s film school and had an excellent body of work including the films Night Cries: A Rural Tragedy (1990) and beDevil (1993). Acclaimed playwright and screenwriter David Williamson was presented with an Honorary Doctorate of Letters by The University of Queensland in December of 2004. His work had previously picked up four Australian Film Institute awards for best screenplay. An Honorary Doctorate of Visual and Performing Arts was given to film director Fred Schepisi AO by The University of Melbourne in May of 2006. His films had also been earlier recognised with Australian Film Institute awards as well as the Golden Globe Best Miniseries or Television Movie award for Empire Falls in 2006. Director George Miller was crowned with an Honorary Doctorate in Film from the Australian Film, Television, and Radio School in April 2007, although he already had a medical doctor’s testamur on his wall. In May of this year, filmmaker George Gittoes, a fine arts dropout from The University of Sydney, received an honorary doctorate by The University of New South Wales. His documentaries, Soundtrack to War (2005) and Rampage (2006), screened at the Sydney and Berlin film festivals, and he has been employed by the Australian Government as an official war artist. Interestingly, the high quality screen work recognised by these Australian universities may have earned the recipients ‘real’ PhDs had they sought the qualification. Many of these film artists could have just as easily submitted their work for the degree of PhD by Published Papers at several universities that accept prior work in lieu of an original exegesis, and where a film is equated with a book or journal article. But such universities still invite comparisons of their PhDs by Published Papers with honorary doctorates due to rather too-easy-to-meet criteria. The privately funded Bond University, for example, recommends a minimum full-time enrolment of just three months and certainly seems more lax in its regulations than other Antipodean institution: a healthy curriculum vitae and payment of the prescribed fee (currently AUD$24,500 per annum) are the only requirements. Restricting my enquiries once again to the field of my own research, film and television, I note that Dr. Ingo Petzke achieved his 2004 PhD by Published Works based upon films produced in Germany well before enrolling at Bond, contextualized within a discussion of the history of avant-garde film-making in that country. Might not a cynic enquire as to how this PhD significantly differs from an honorary doctorate? Although Petzke undoubtedly paid his fees and met all of Bond’s requirements for his thesis entitled Slow Motion: Thirty Years in Film, one cannot criticise that cynic for wondering if Petzke’s films are indeed equivalent to a collection of refereed papers. It should be noted that Bond is not alone when it comes to awarding candidates the PhD by Published Papers for work published or screened in the distant past. Although yet to grant it in the area of film or television, Swinburne University of Technology (SUT) is an institution that distinctly specifies its PhD by Publications is to be awarded for “research which has been carried out prior to admission to candidature” (8). Similarly, the Griffith Law School states: “The PhD (by publications) is awarded to established researchers who have an international reputation based on already published works” (1). It appears that Bond is no solitary voice in the academic wilderness, for SUT and the Griffith Law School also apparently consider the usual milestones of Confirmation and Final Seminars to be unnecessary if the so-called candidate is already well published. Like Bond, Griffith University (GU) is prepared to consider a collection of films to be equivalent to a number of refereed papers. Dr Ian Lang’s 2002 PhD (by Publication) thesis entitled Conditional Truths: Remapping Paths To Documentary ‘Independence’ contains not refereed, scholarly articles but the following videos: Wheels Across the Himalaya (1981); Yallambee, People of Hope (1986); This Is What I Call Living (1988); The Art of Place: Hanoi Brisbane Art Exchange (1995); and Millennium Shift: The Search for New World Art (1997). While this is a most impressive body of work, and is well unified by appropriate discussion within the thesis, the cynic who raised eyebrows at Petzke’s thesis might also be questioning this thesis: Dr Lang’s videos all preceded enrolment at GU and none have been refereed or acknowledged with major prizes. Certainly, the act of releasing a film for distribution has much in common with book publishing, but should these videos be considered to be on a par with academic papers published in, say, the prestigious and demanding journal Screen? While recognition at awards ceremonies might arguably correlate with peer review there is still the question as to how scholarly a film actually is. Of course, documentary films such as those in Lang’s thesis can be shown to be addressing gaps in the literature, as is the expectation of any research paper, but the onus remains on the author/film-maker to demonstrate this via a detailed contextual review and a well-written, erudite argument that unifies the works into a cohesive thesis. This Lang has done, to the extent that suspicious cynic might wonder why he chose not to present his work for a standard PhD award. Another issue unaddressed by most institutions is the possibility that the publications have been self-refereed or refereed by the candidate’s editorial colleagues in a case wherein the papers appear in a book the candidate has edited or co-edited. Dr Gillian Swanson’s 2004 GU thesis Towards a Cultural History of Private Life: Sexual Character, Consuming Practices and Cultural Knowledge, which addresses amongst many other cultural artefacts the film Lawrence of Arabia (David Lean 1962), has nine publications: five of which come from two books she co-edited, Nationalising Femininity: Culture, Sexuality and Cinema in Britain in World War Two, (Gledhill and Swanson 1996) and Deciphering Culture: Ordinary Curiosities and Subjective Narratives (Crisp et al 2000). While few would dispute the quality of Swanson’s work, the persistent cynic might wonder if these five papers really qualify as refereed publications. The tacit understanding of a refereed publication is that it is blind reviewed i.e. the contributor’s name is removed from the document. Such a system is used to prevent bias and favouritism but this level of anonymity might be absent when the contributor to a book is also one of the book’s editors. Of course, Dr Swanson probably took great care to distance herself from the refereeing process undertaken by her co-editors, but without an inbuilt check, allegations of cronyism from unfriendly cynics may well result. A related factor in making comparisons of different university’s PhDs by Published Papers is the requirements different universities have about the standard of the journal the paper is published in. It used to be a simple matter in Australia: the government’s Department of Education, Science and Training (DEST) held a Register of Refereed Journals. If your benefactor in disseminating your work was on the list, your publications were of near-unquestionable quality. Not any more: DEST will no longer accept nominations for listing on the Register and will not undertake to rule on whether a particular journal article meets the HERDC [Higher Education Research Data Collection] requirements for inclusion in publication counts. HEPs [Higher Education Providers] have always had the discretion to determine if a publication produced in a journal meets the requirements for inclusion in the HERDC regardless of whether or not the journal was included on the Register of Refereed Journals. As stated in the HERDC specifications, the Register is not an exhaustive list of all journals which satisfy the peer-review requirements (DEST). The last listing for the DEST Register of Refereed Journals was the 3rd of February 2006, making way for a new tiered list of academic journals, which is currently under review in the Australian tertiary education sector (see discussion of this development in the Redden and Mitchell articles in this issue). In the interim, some university faculties created their own rankings of journals, but not the Faculty of Creative Industries at the Queensland University of Technology (QUT) where I am studying for my PhD by Published Papers. Although QUT does not have a list of ranked journals for a candidate to submit papers to, it is otherwise quite strict in its requirements. The QUT University Regulations state, “Papers submitted as a PhD thesis must be closely related in terms of subject matter and form a cohesive research narrative” (QUT PhD regulation 14.1.2). Thus there is the requirement at QUT that apart from the usual introduction, methodology and literature review, an argument must be made as to how the papers present a sustained research project via “an overarching discussion of the main features linking the publications” (14.2.12). It is also therein stated that it should be an “account of research progress linking the research papers” (4.2.6). In other words, a unifying essay must make an argument for consideration of the sometimes diversely published papers as a cohesive body of work, undertaken in a deliberate journey of research. In my own case, an aural auteur analysis of sound in the films of Rolf de Heer, I argue that my published papers (eight in total) represent a journey from genre analysis (one paper) to standard auteur analysis (three papers) to an argument that sound should be considered in auteur analysis (one paper) to the major innovation of the thesis, aural auteur analysis (three papers). It should also be noted that unlike Bond, GU or SUT, the QUT regulations for the standard PhD still apply: a Confirmation Seminar, Final Seminar and a minimum two years of full-time enrolment (with a minimum of three months residency in Brisbane) are all compulsory. Such milestones and sine qua non ensure the candidate’s academic progress and intellectual development such that she or he is able to confidently engage in meaningful quodlibets regarding the thesis’s topic. Another interesting and significant feature of the QUT guidelines for this type of degree is the edict that papers submitted must be “published, accepted or submitted during the period of candidature” (14.1.1). Similarly, the University of Canberra (UC) states “The articles or other published material must be prepared during the period of candidature” (10). Likewise, Edith Cowan University (ECU) will confer its PhD by Publications to those candidates whose thesis consists of “only papers published in refereed scholarly media during the period of enrolment” (2). In other words, one cannot simply front up to ECU, QUT, or UC with a résumé of articles or films published over a lifetime of writing or film-making and ask for a PhD by Published Papers. Publications of the candidate prepared prior to commencement of candidature are simply not acceptable at these institutions and such PhDs by Published Papers from QUT, UC and ECU are entirely different to those offered by Bond, GU and SUT. Furthermore, without a requirement for a substantial period of enrolment and residency, recipients of PhDs by Published Papers from Bond, GU, or SUT are unlikely to have participated significantly in the research environment of their relevant faculty and peers. Such newly minted doctors may be as unfamiliar with the campus and its research activities as the recipient of an honorary doctorate usually is, as he or she poses for the media’s cameras en route to the glamorous awards ceremony. Much of my argument in this paper is built upon the assumption that the process of refereeing a paper (or for that matter, a film) guarantees a high level of academic rigour, but I confess that this premise is patently naïve, if not actually flawed. Refereeing can result in the rejection of new ideas that conflict with the established opinions of the referees. Interdisciplinary collaboration can be impeded and the lack of referee’s accountability is a potential problem, too. It can also be no less nail-biting a process than the examination of a finished thesis, given that some journals take over a year to complete the refereeing process, and some journal’s editorial committees have recognised this shortcoming. Despite being a mainstay of its editorial approach since 1869, the prestigious science journal, Nature, which only publishes about 7% of its submissions, has led the way with regard to varying the procedure of refereeing, implementing in 2006 a four-month trial period of ‘Open Peer Review’. Their website states, Authors could choose to have their submissions posted on a preprint server for open comments, in parallel with the conventional peer review process. Anyone in the field could then post comments, provided they were prepared to identify themselves. Once the usual confidential peer review process is complete, the public ‘open peer review’ process was closed and the editors made their decision about publication with the help of all reports and comments (Campbell). Unfortunately, the experiment was unpopular with both authors and online peer reviewers. What the Nature experiment does demonstrate, however, is that the traditional process of blind refereeing is not yet perfected and can possibly evolve into something less problematic in the future. Until then, refereeing continues to be the best system there is for applying structured academic scrutiny to submitted papers. With the reforms of the higher education sector, including forced mergers of universities and colleges of advanced education and the re-introduction of university fees (carried out under the aegis of John Dawkins, Minister for Employment, Education and Training from 1987 to 1991), and the subsequent rationing of monies according to research dividends (calculated according to numbers of research degree conferrals and publications), there has been a veritable explosion in the number of institutions offering PhDs in Australia. But the general public may not always be capable of differentiating between legitimately accredited programs and diploma mills, given that the requirements for the first differ substantially. From relatively easily obtainable PhDs by Published Papers at Bond, GU and SUT to more rigorous requirements at ECU, QUT and UC, there is undoubtedly a huge range in the demands of degrees that recognise a candidate’s published body of work. The cynical reader may assume that with this paper I am simply trying to shore up my own forthcoming graduation with a PhD by Published papers from potential criticisms that it is on par with a ‘purchased’ doctorate. Perhaps they are right, for this is a new degree in QUT’s Creative Industries faculty and has only been awarded to one other candidate (Dr Marcus Foth for his 2006 thesis entitled Towards a Design Methodology to Support Social Networks of Residents in Inner-City Apartment Buildings). But I believe QUT is setting a benchmark, along with ECU and UC, to which other universities should aspire. In conclusion, I believe further efforts should be undertaken to heighten the differences in status between PhDs by Published Papers generated during enrolment, PhDs by Published Papers generated before enrolment and honorary doctorates awarded for non-academic published work. Failure to do so courts cynical comparison of all PhD by Published Papers with unearnt doctorates bought from Internet shysters. References Brown, George. “Protecting Australia’s Higher Education System: A Proactive Versus Reactive Approach in Review (1999–2004).” Proceedings of the Australian Universities Quality Forum 2004. Australian Universities Quality Agency, 2004. 11 June 2008 ‹http://www.auqa.edu.au/auqf/2004/program/papers/Brown.pdf>. Campbell, Philip. “Nature Peer Review Trial and Debate.” Nature: International Weekly Journal of Science. December 2006. 11 June 2008 ‹http://www.nature.com/nature/peerreview/> Crisp, Jane, Kay Ferres, and Gillian Swanson, eds. Deciphering Culture: Ordinary Curiosities and Subjective Narratives. London: Routledge, 2000. Department of Education, Science and Training (DEST). “Closed—Register of Refereed Journals.” Higher Education Research Data Collection, 2008. 11 June 2008 ‹http://www.dest.gov.au/sectors/research_sector/online_forms_services/ higher_education_research_data_ collection.htm>. Edith Cowan University. “Policy Content.” Postgraduate Research: Thesis by Publication, 2003. 11 June 2008 ‹http://www.ecu.edu.au/GPPS/policies_db/tmp/ac063.pdf>. Gledhill, Christine, and Gillian Swanson, eds. Nationalising Femininity: Culture, Sexuality and Cinema in Britain in World War Two. Manchester: Manchester UP, 1996. Griffith Law School, Griffith University. Handbook for Research Higher Degree Students. 24 March 2004. 11 June 2008 ‹http://www.griffith.edu.au/centre/slrc/pdf/rhdhandbook.pdf>. Jeffries, Stuart. “I’m a celebrity, get me an honorary degree!” The Guardian 6 July 2006. 11 June 2008 ‹http://education.guardian.co.uk/higher/comment/story/0,,1813525,00.html>. 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