‘How Belfast got the blues’: Towards an alternative history

This article offers a revisionist history of a key period of Belfast and Northern Ireland’s music scene in the 1960s: the emergence of Them and Van Morrison and the attendant ‘legend’ of the group’s residency in the city’s Maritime Hotel. This formative moment is, somewhat surprisingly, under-explored in popular music studies, and the article seeks to address this relative absence. Van Morrison’s biographies are a vital resource here, and—via discourse analysis—we trace the emergence of a dominant narrative and assess its ideological implications, before moving on to analyse Them’s breakthrough single and related promotional materials. In so doing, we connect the scene that the group both emerged from and represented, to broader popular musical trends, as well as considering how the story of Them’s emergence is supported and framed in contemporary heritage initiatives. The article argues that the myth of Them, Morrison and the Maritime has obscured other ways of approaching the period, and we conclude with a counterhistory by considering an earlier blues/jazz scene in the city and how this might shape an orthodox narrative

Critical shortfalls in the management of PBC: Results of a UK-wide, population-based evaluation of care delivery

Background &amp; Aims: Guidelines for the management of primary biliary cholangitis (PBC) were published by the British Society of Gastroenterology in 2018. In this study, we assessed adherence to these guidelines in the UK National Health Service (NHS). Methods: All NHS acute trusts were invited to contribute data between 1 January 2021 and 31 March 2022, assessing clinical care delivered to patients with PBC in the UK. Results: We obtained data for 8,968 patients with PBC and identified substantial gaps in care across all guideline domains. Ursodeoxycholic acid (UDCA) was used as first-line treatment in 88% of patients (n = 7,864) but was under-dosed in one-third (n = 1,964). Twenty percent of patients who were UDCA-untreated (202/998) and 50% of patients with inadequate UDCA response (1,074/2,102) received second-line treatment. More than one-third of patients were not assessed for fatigue (43%; n = 3,885) or pruritus (38%; n = 3,415) in the previous 2 years. Fifty percent of all patients with evidence of hepatic decompensation were discussed with a liver transplant centre (222/443). Appropriate use of second-line treatment and referral for liver transplantation was significantly better in specialist PBC treatment centres compared with non-specialist centres (p <0.001). Conclusions: Poor adherence to guidelines exists across all domains of PBC care in the NHS. Although specialist PBC treatment centres had greater adherence to guidelines, no single centre met all quality standards. Nationwide improvement in the delivery of PBC-related healthcare is required. Impact and implications: This population-based evaluation of primary biliary cholangitis, spanning four nations of the UK, highlights critical shortfalls in care delivery when measured across all guideline domains. These include the use of liver biopsy in diagnosis; referral practice for second-line treatment and/or liver transplant assessment; and the evaluation of symptoms, extrahepatic manifestations, and complications of cirrhosis. The authors therefore propose implementation of a dedicated primary biliary cholangitis care bundle that aims to minimise heterogeneity in clinical practice and maximise adherence to key guideline standards