Women, men and coronary heart disease: a review of the qualitative literature

Aim. This paper presents a review of the qualitative literature which examines the experiences of patients with coronary heart disease. The paper also assesses whether the experiences of both female and male patients are reflected in the literature and summarizes key themes. Background. Understanding patients' experiences of their illness is important for coronary heart disease prevention and education. Qualitative methods are particularly suited to eliciting patients' detailed understandings and perceptions of illness. As much previous research has been 'gender neutral', this review pays particular attention to gender. Methods. Published papers from 60 qualitative studies were identified for the review through searches in MEDLINE, EMBASE, CINAHL, PREMEDLINE, PsychINFO, Social Sciences Citation Index and Web of Science using keywords related to coronary heart disease. Findings. Early qualitative studies of patients with coronary heart disease were conducted almost exclusively with men, and tended to generalize from 'male' experience to 'human' experience. By the late 1990s this pattern had changed, with the majority of studies including women and many being conducted with solely female samples. However, many studies that include both male and female coronary heart disease patients still do not have a specific gender focus. Key themes in the literature include interpreting symptoms and seeking help, belief about coronary 'candidates' and relationships with health professionals. The influence of social roles is important: many female patients have difficulties reconciling family responsibilities and medical advice, while male patients worry about being absent from work. Conclusions. There is a need for studies that compare the experiences of men and women. There is also an urgent need for work that takes masculinity and gender roles into account when exploring the experiences of men with coronary heart disease

Tomato: a crop species amenable to improvement by cellular and molecular methods

Tomato is a crop plant with a relatively small DNA content per haploid genome and a well developed genetics. Plant regeneration from explants and protoplasts is feasable which led to the development of efficient transformation procedures. In view of the current data, the isolation of useful mutants at the cellular level probably will be of limited value in the genetic improvement of tomato. Protoplast fusion may lead to novel combinations of organelle and nuclear DNA (cybrids), whereas this technique also provides a means of introducing genetic information from alien species into tomato. Important developments have come from molecular approaches. Following the construction of an RFLP map, these RFLP markers can be used in tomato to tag quantitative traits bred in from related species. Both RFLP's and transposons are in the process of being used to clone desired genes for which no gene products are known. Cloned genes can be introduced and potentially improve specific properties of tomato especially those controlled by single genes. Recent results suggest that, in principle, phenotypic mutants can be created for cloned and characterized genes and will prove their value in further improving the cultivated tomato.

An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics

For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types

State of the climate in 2013

In 2013, the vast majority of the monitored climate variables reported here maintained trends established in recent decades. ENSO was in a neutral state during the entire year, remaining mostly on the cool side of neutral with modest impacts on regional weather patterns around the world. This follows several years dominated by the effects of either La Niña or El Niño events. According to several independent analyses, 2013 was again among the 10 warmest years on record at the global scale, both at the Earths surface and through the troposphere. Some regions in the Southern Hemisphere had record or near-record high temperatures for the year. Australia observed its hottest year on record, while Argentina and New Zealand reported their second and third hottest years, respectively. In Antarctica, Amundsen-Scott South Pole Station reported its highest annual temperature since records began in 1957. At the opposite pole, the Arctic observed its seventh warmest year since records began in the early 20th century. At 20-m depth, record high temperatures were measured at some permafrost stations on the North Slope of Alaska and in the Brooks Range. In the Northern Hemisphere extratropics, anomalous meridional atmospheric circulation occurred throughout much of the year, leading to marked regional extremes of both temperature and precipitation. Cold temperature anomalies during winter across Eurasia were followed by warm spring temperature anomalies, which were linked to a new record low Eurasian snow cover extent in May. Minimum sea ice extent in the Arctic was the sixth lowest since satellite observations began in 1979. Including 2013, all seven lowest extents on record have occurred in the past seven years. Antarctica, on the other hand, had above-average sea ice extent throughout 2013, with 116 days of new daily high extent records, including a new daily maximum sea ice area of 19.57 million km2 reached on 1 October. ENSO-neutral conditions in the eastern central Pacific Ocean and a negative Pacific decadal oscillation pattern in the North Pacific had the largest impacts on the global sea surface temperature in 2013. The North Pacific reached a historic high temperature in 2013 and on balance the globally-averaged sea surface temperature was among the 10 highest on record. Overall, the salt content in nearsurface ocean waters increased while in intermediate waters it decreased. Global mean sea level continued to rise during 2013, on pace with a trend of 3.2 mm yr-1 over the past two decades. A portion of this trend (0.5 mm yr-1) has been attributed to natural variability associated with the Pacific decadal oscillation as well as to ongoing contributions from the melting of glaciers and ice sheets and ocean warming. Global tropical cyclone frequency during 2013 was slightly above average with a total of 94 storms, although the North Atlantic Basin had its quietest hurricane season since 1994. In the Western North Pacific Basin, Super Typhoon Haiyan, the deadliest tropical cyclone of 2013, had 1-minute sustained winds estimated to be 170 kt (87.5 m s-1) on 7 November, the highest wind speed ever assigned to a tropical cyclone. High storm surge was also associated with Haiyan as it made landfall over the central Philippines, an area where sea level is currently at historic highs, increasing by 200 mm since 1970. In the atmosphere, carbon dioxide, methane, and nitrous oxide all continued to increase in 2013. As in previous years, each of these major greenhouse gases once again reached historic high concentrations. In the Arctic, carbon dioxide and methane increased at the same rate as the global increase. These increases are likely due to export from lower latitudes rather than a consequence of increases in Arctic sources, such as thawing permafrost. At Mauna Loa, Hawaii, for the first time since measurements began in 1958, the daily average mixing ratio of carbon dioxide exceeded 400 ppm on 9 May. The state of these variables, along with dozens of others, and the 2013 climate conditions of regions around the world are discussed in further detail in this 24th edition of the State of the Climate series. © 2014, American Meteorological Society. All rights reserved

Anticoagulant rodenticides in red kites (Milvus milvus) in Britain in 2017 and 2018

Second generation anticoagulant rodenticides (SGARs) can be toxic to all mammals and birds. Various studies have shown that, in Britain, there is widespread exposure to SGARs in a diverse range of predatory mammals and birds, including red kites (Milvus milvus) which scavenge dead rats, a target species for rodent control. The Wildlife Incident Monitoring Scheme (WIIS) and the Predatory Bird Monitoring Scheme (PBMS) have shown that some mortalities result from this secondary exposure. In the present study, we analysed liver SGAR residues in 77 red kites that had been found dead in Britain in either 2017 or 2018. The carcasses were submitted to and necropsied by the Disease Risk Analysis and Health Surveillance (DRAHS) programme, the PBMS, the WIIS for England & Wales, the WIIS for Scotland and the Raptor Health Scotland study; the livers from the kites were subsequently analysed for SGAR residues. All the organisations are partners in the WILDCOMS network that promotes collaboration among surveillance schemes that monitor disease and contaminants in vertebrate wildlife. All of the 66 kites from England & Wales and 10 of the 11 red kites from Scotland had detectable liver residues of at least one SGAR. When considering the sample of kites as a whole, brodifacoum, difenacoum and bromadiolone were each detected in 73, 71 and 60 kites, respectively. Difethialone was found in 11 individuals while flocoumafen was detected in only one bird. Sum liver SGAR concentrations ranged between non-detected and 1218 ng/g wet wt. (arithmetic mean: 246 ng/g, median 154 ng/g). Post-mortem examinations indicated that 13 (16.8%) of red kites examined had internal haemorrhaging that was not associated with detectable trauma and had detectable liver SGAR concentrations. These birds had sum SGAR liver concentrations that ranged from 135 ng/g wet weight to 1218 ng/g wet weight. SGARs were considered a contributory cause of death in these cases. The stewardship scheme for anticoagulant rodenticides came fully into force in mid-2016 as re-registration of products for use in the UK was completed. A key aim is to reduce exposure of non-target wildlife to anticoagulant rodenticides but stewardship also aims to maintain efficacious rat control and so the number and density of AR-contaminated rats may remain unchanged. However, diligent searching, removal and safe disposal of poisoned rats, as promoted by stewardship, might be expected to reduce the availability of poisoned dead rats to red kites [and other scavengers] and thereby reduce the proportion of birds that are exposed and/or the magnitude of exposure. Concomitant with stewardship was a relaxation of the indoor use only restriction previously applied to brodifacoum, flocoumafen and difethialone, the three most acutely toxic SGARs. Any consequent increase in outdoor use of these three SGARs could increase the risk of secondary exposure in red kites. We therefore compared the data in the current report with that collected in 2015 and 2016 to determine if there was any evidence of a change in pattern or magnitude of exposure in red kites that might be connected to stewardship and/or change in usage restriction. The proportion of red kites exposed to SGARs in 2015 (90.6%), 2016 (89.6%) 2017 (96,4%) and 2018 (100%) was always 90% or more; the higher percentages in 2017 and 2018 were principally due to a greater proportion of birds from Scotland containing residues. Brodifacoum and difenacoum were the most prevalent compounds (89% of red kites across the four years for each compound) along with bromadiolone (75%). On average, there were residues of three different SGARs in each kite liver. There was no significant difference between years in liver sum (Σ) SGAR concentrations. We investigated if there was a change between years in the exposure of red kites to brodifacoum, flocoumafen and difethialone, the compounds for which indoor only usage restrictions were relaxed in 2016. To enable statistical analysis of data on residue prevalence, it was necessary to pool the data into two-year blocks. Data on presence/absence of detectable brodifacoum, flocoumafen or difethialone residues were therefore compared for 2015/16 (pre and year of implementation of change in usage restriction) and 2017/18 (post-change in usage restriction). The proportion of red kites with detectable residues was 82% (50 out of 61 red kites) in 2015/16 but significantly higher (95%; 73 out of 77 red kites) in 2017/18. However, there was also an increase [albeit not statistically significant] in the proportion of red kites with detectable liver difenacoum or bromadiolone residues (90% in 2015/16 vs. 97% in 2017/18). Therefore, these data may simply reflect an increase in the prevalence of exposure to SGARs generally rather than any effect of change in usage restriction. There was no difference between the four years in the summed magnitude of liver brodifacoum, difethialone and flocoumafen concentrations. The percentage of red kites examined that were diagnosed as birds in which SGARs were implicated as a contributory cause of death did not differ significantly between individual years nor show a significant trend across the years; the overall average across the four years was 22%. However, if data were pooled by pairs of years (2017/8 vs 2015/16), the proportion of red kites for which SGARs were implicated as a contributory cause of death was lower (18%) in 2017/18 than in 2015/16 (33%) for red kites from England & Wales. Our findings do not indicate that there has been any reduction in exposure in red kites to SGARs following implementation of stewardship, in terms of either the proportion of individuals exposed or the magnitude of residues detected. There is some evidence (depending upon the statistical approach used) that the proportion of red kites in which SGARs were implicated as a contributory mortality factor has decreased in more recent years. There was no clear evidence that relaxation of usage restrictions on brodifacoum, difethialone and flocoumafen has altered the pattern of residue accumulation in red kites to date

Compositional tuning of ferromagnetism in Ga1-xMnxP

We report the magnetic and transport properties of Ga1-xMnxP synthesized via ion implantation followed by pulsed laser melting over a range of x, namely 0.018 to 0.042. Like Ga1-xMnxAs, Ga1-xMnxP displays a monotonic increase of the ferromagnetic Curie temperature with x associated with the hole-mediated ferromagnetic phase while thermal annealing above 300 C leads to a quenching of ferromagnetism that is accompanied by a reduction of the substitutional fraction of Mn. However, contrary to observations in Ga1-xMnxAs, Ga1-xMnxP is non-metallic over the entire composition range. At the lower temperatures over which the films are ferromagnetic, hole transport occurs via hopping conduction in a Mn-derived band; at higher temperatures it arises from holes in the valence band which are thermally excited across an energy gap that shrinks with x.Comment: To be published in Solid State Communication

Second generation anticoagulant rodenticide residues in red kites 2022

•Second-generation anticoagulant rodenticides (SGARs) can be toxic to all mammals and birds if consumed. Various studies have shown that, in Britain, there is widespread exposure to SGARs in a diverse range of predatory mammals and birds, including red kites (Milvus milvus) which scavenge dead rats, a target species for rodent control. The Wildlife Incident Investigation Scheme (WIIS) and the Predatory Bird Monitoring Scheme (PBMS) have shown that some mortalities result from this secondary exposure. •In the present study, we analysed liver SGAR residues in 14 red kites that had been found dead in Britain in 2022. One bird collected in 2021 was also chemically analysed and added to the time trend analysis of this report. The carcasses were submitted to and necropsied by the Disease Risk Analysis and Health Surveillance (DRAHS) programme, the PBMS, and the WIIS for England & Wales. In 2022, there were no birds received from Scotland (i.e., no bird from the WIIS for Scotland and the Raptor Health Scotland study). All these organisations are partners in the WILDCOMS (Wildlife Disease & Contaminant Monitoring & Surveillance Network) network that promotes collaboration among surveillance schemes that monitor disease and contaminants in vertebrate wildlife in the UK. •The UK Rodenticide Stewardship Regime (hereafter referred to as the stewardship scheme) began to come into force in mid-2016 as re-registration of products for use in the UK was approved by the HSE; full implementation of the scheme was in early 2018. The key aim of this stewardship initiative is to support competence among all users of professional SGAR products. A potential benefit of this may be the reduced exposure of non-target wildlife to anticoagulant rodenticides. However, the number and density of SGAR-contaminated rats may remain unchanged although diligent searching, removal, and safe disposal of poisoned rats, as promoted by the stewardship regime, might be expected to reduce the availability of poisoned dead rats to red kites (and other scavengers) and thereby reduce the proportion of birds that are exposed and/or the magnitude of exposure. Concomitant with the stewardship scheme was a relaxation of the indoor-use-only-restriction applied to brodifacoum, flocoumafen, and difethialone, the three most acutely toxic SGARs to use indoor and outdoor around buildings. Any consequent increase in outdoor use of these three SGARs could increase the risk of secondary exposure in red kites. We therefore compared the data in the current report with that collected in 2015 and 2016 to determine if there was any evidence of a change in pattern or magnitude of exposure in red kites that might be connected to stewardship and/or change in usage restriction. •All of the 14 red kites from England & Wales in 2022 had detectable liver residues of at least one type of SGAR. Brodifacoum, difenacoum, and bromadiolone were each detected in 13, 13 and 6 red kites, respectively. Difethialone was found in two individuals while flocoumafen was detected in no bird. •The proportion of analysed red kites exposed to SGARs in 2015 (91%), 2016 (90%), 2017 (96%), 2018 (100%), 2019 (91%), 2020 (88%), 2021 (98%), and 2022 (100%) was similar at circa 90% or more; the higher percentages in 2017 and 2018 were principally due to a greater proportion of birds from Scotland containing residues than observed in other years. However, all red kites from England and Wales were exposed to SGARs in 2022. Difenacoum, brodifacoum, and bromadiolone were the most prevalent compounds (detected in 87%, 87%, and 75% of red kites across the eight years for each compound, respectively). On average, there were detectable residues of two different SGARs in each red kite liver likely demonstrating multiple exposures. •Sum liver SGAR concentrations in birds from 2022 ranged between 30 and 988 ng/g wet weight (arithmetic mean: 380 ng/g wet weight, median 257.9 ng/g wet weight). Necropsy examinations indicated that two red kites showed signs of being poisoned by SGARs (i.e., showing internal haemorrhaging that is not associated with detectable trauma and also having detectable liver SGAR concentrations). These samples accounted for 17% of the red kites of the year excluding uncertain poisoning cases. These two birds had sum SGAR liver concentrations of 544.2 and 661.6 ng/g wet weight. SGARs were considered a contributory cause of death resulting from unspecified use in these cases. SGARs were a contributory cause of death in 16% of the red kite cases examined across all eight years. Over the period 2015 to 2022, a reduction has been observed in the percentage of red kites examined that were diagnosed as birds in which SGARs were implicated as a contributory cause of death. However, given that the WIIS scheme specifically examines suspected poisoning incidents, it is likely that poisoned birds are over represented in this sample compared to the population as a whole in all eight years. Due to these reasons, caution should be used when interpreting evident changes in poisoned bird rates due to the opportunistic sampling methods used in this study that may lead to over reporting of poisoned birds. Those rates being subject to variations in relative contribution of the WIIS and PBMS to each year’s sample. It should be noted that sub-lethal poisoning due to SGAR exposure is not considered in this report. •There were statistically significant differences between years in median summed SGAR residues for non-poisoned birds and in all red kites combined with poisoned and non-poisoned birds. The magnitude of accumulated summed SGAR residues, particularly sum of brodifacoum, flocoumafen, and difethialone concentrations, was significantly higher in 2022 than in 2019. Given low occurrence and low concentrations of flocoumafen and difethialone residues, it is demonstrated that the magnitude of brodifacoum residues has increased over recent years. •Data on presence/absence of detectable brodifacoum, flocoumafen or difethialone residues were compared for 2015/2016 and 2017/18/19/20/21/22. The proportion of red kites with detectable residues of these three SGARs was not significantly different between 2015/2016 (82%) and 2017/18/19/20/21/22 (89%). Similarly, there was no significant difference in the proportion of red kites with detectable liver difenacoum or bromadiolone residues (90% in 2015/2016 vs. 94% in 2017/18/19/20/21/22). Since the implementation of the stewardship regime, no difference in exposure pattern relating to active ingredients has been detected with the exception of an increase in the concentrations of brodifacoum. •Spatial analysis by county/region indicated that across the monitoring period highest exposure to SGARs in red kites appeared to be around the Berkshire/Hampshire and, to a lesser extent, North Yorkshire. •Our findings do not indicate that there has been a consistent broad scale change in exposure in red kites to SGARs following implementation of stewardship in terms of either the proportion of the sample exposed or the magnitude of sum SGARs residues detected. However, there is evidence that the proportion of red kites in which SGARs were implicated as a contributory mortality factor has decreased in more recent years. Alternative approaches to monitoring SGARs in red kites could be considered that analyse a random but representative sample, and as part of such a programme there may also be value in monitoring SGARs in the blood of tracked individuals. Brodifacoum exposure has increased in recent years, but whether this change in exposure has been caused by the relaxation of usage restrictions on brodifacoum, difethialone and flocoumafen is still a question to be addressed

Anticoagulant rodenticides in red kites (Milvus milvus) in Britain 2015

Second generation anticoagulant rodenticides (SGARs) can be toxic to all mammals and birds. Various studies have shown that, in Britain, there is widespread exposure to SGARs in a diverse range of predatory mammals and birds, including red kites (Milvus milvus) which scavenge dead rats, a target species for rodent control. The Wildlife Incident Monitoring Scheme (WIIS) and the Predatory Bird Monitoring Scheme (PBMS) have shown that some mortalities result from this secondary exposure. The aim of the current study was to assess the scale and severity of exposure to SGARs (as assessed from the presence of liver SGAR residues) in red kites found dead in Britain in 2015. Carcasses, typically found by members of the public, were submitted for examination and analysis either to the Institute of Zoology’s Disease Risk Analysis and Health Surveillance programme (DRAHS) or to the Centre for Ecology & Hydrology’s Predatory Bird Monitoring Scheme, partners in the WILDCOMS network. We also report the results of SGAR analysis of red kites from England, Wales and Scotland that died in 2015 and analysed by the WIIS, who are also partners of the WILDCOMS network. Eighteen red kites from England & Wales were necropsied by either the DRAHS or the PBMS and the livers of the birds were analysed for SGARs by the PBMS. All had detectable liver residues of difenacoum and brodifacoum, and most also contained detectable liver bromadiolone residues. Difethialone was less frequently detected and flocoumafen was not detected in any birds. The presence of detectable brodifacoum residues in all birds may partly reflect the predominance of adult birds in the 2015 sample but may also indicate a growing prevalence of exposure to this compound. The percentage of red kites found by the PBMS to contain brodifacoum has increased since 2010 although any influence of age on this trend has not yet been examined. Sum liver SGAR concentrations in the 18 kites ranged between 50 and 1266 ng/g wet wt. (arithmetic mean: 463 ng/g). Post-mortems indicated that 7 of the kites had internal hemorrhaging that was not associated with detectable trauma; these birds typically had elevated sum SGAR liver concentrations. On the basis of these two factors, it is considered probable that SGARs were a contributory cause of death in these birds. The exposure pattern observed in 8 red kites from England & Wales analysed by the WIIS was very similar to that observed in birds analysed by the PBMS, with detectable liver residues of difenacoum and brodifacoum in all birds and bromadiolone in most. SGARs were assessed to be a contributory cause of death in two birds. Thus, of the 26 red kites from England & Wales analysed overall, SGARs were considered to be implicated in the deaths of 9 (35%). Residue data were available through the WIIS for 6 red kites from Scotland that died in 2015. Three kites (50%) had liver residues of at least two SGARs (bromadiolone and difenacoum); brodifacoum was also detected in one of these kites. SGARs were assessed to be a contributory cause of death in the bird that had residues of three SGARs. The data, although sample size is small, suggest that exposure of kites to SGARs may have been less marked in Scotland than in England & Wales in 2015, as has been found for other species

Second generation anticoagulant rodenticide residues in red kites 2020

Second generation anticoagulant rodenticides (SGARs) can be toxic to all mammals and birds if consumed. Various studies have shown that, in Britain, there is widespread exposure to SGARs in a diverse range of predatory mammals and birds, including red kites (Milvus milvus) which scavenge dead rats, a target species for rodent control. The Wildlife Incident Investigation Scheme1 (WIIS) and the Predatory Bird Monitoring Scheme (PBMS) have shown that some mortalities result from this secondary exposure. In the present study, we analysed liver SGAR residues in 25 red kites that had been found dead in Britain in 2020. The carcasses were submitted to and necropsied by the Disease Risk Analysis and Health Surveillance (DRAHS) programme, the PBMS, the WIIS for England & Wales, the WIIS for Scotland and the Raptor Health Scotland study. All the organisations are partners in the WILDCOMS (Wildlife Disease & Contaminant Monitoring & Surveillance Network) network that promotes collaboration among surveillance schemes that monitor disease and contaminants in vertebrate wildlife in the UK. The UK Rodenticide Stewardship Regime began to come into force in mid-2016 as reregistration of products for use in the UK was approved by the HSE; full implementation of the scheme was in early 2018. The key aim of this stewardship initiative is to support competence among all SGAR users, a potential benefit of this may be the reduced exposure of non-target wildlife to anticoagulant rodenticides. However, the number and density of SGAR-contaminated rats may remain unchanged although diligent searching, removal and safe disposal of poisoned rats, as promoted by the stewardship regime, might be expected to reduce the availability of poisoned dead rats to red kites (and other scavengers) and thereby reduce the proportion of birds that are exposed and/or the magnitude of exposure. Concomitant with the stewardship scheme was a relaxation of the indoor-use-only-restriction previously applied to brodifacoum, flocoumafen and difethialone, the three most acutely toxic SGARs. Any consequent increase in outdoor use of these three SGARs could increase the risk of secondary exposure in red kites. We therefore compared the data in the current report with that collected in 2015 and 2016 to determine if there was any evidence of a change in pattern or magnitude of exposure in red kites that might be connected to stewardship and/or change in usage restriction. All but one of the 21 red kites from England & Wales and two of the four red kites from Scotland had detectable liver residues of at least one type of SGAR. When considering the sample of red kites as a whole, brodifacoum, difenacoum and bromadiolone were each detected in 21, 19 and 17 red kites, respectively. Difethialone was found in four individuals while flocoumafen was detected in one bird. The proportion of analysed red kites exposed to SGARs in 2015 (91%), 2016 (90%) 2017 (96%), 2018 (100%) 2019 (91%) and 2020 (88%) was similar at circa 88% or more; the higher percentages in 2017 and 2018 were principally due to a greater proportion of birds from Scotland containing residues than observe in other years. Difenacoum, brodifacoum, and bromodialone were the most prevalent compounds (detected in 86%, 85%, and 76% of red kites across the six years for each compound, respectively). On average, there were detectable residues of three different SGARs in each red kite liver likely demonstrating multiple exposures. Sum liver SGAR concentrations in birds from 2020 ranged between non-detectable and 1086 ng/g wet weight (arithmetic mean: 371 ng/g wet weight, median 307 ng/g wet weight). Necropsy examinations indicated that three (13%) of red kites examined had internal haemorrhaging that was not associated with detectable trauma and also had detectable liver SGAR concentrations. These birds had sum SGAR liver concentrations of 663, 905 and 1086 ng/g wet weight. SGARs were considered a contributory cause of death resulting from unspecified use in these cases. SGARs were a contributory cause of death in 17% of the red kite cases examined across all six years. Over the period 2015 to 2020, a reduction has been observed in the percentage of red kites examined that were diagnosed as birds in which SGARs were implicated as a contributory cause of death. However, given that the WIIS scheme specifically examines suspected poisoning incidents, it is likely that poisoned birds are over represented in this sample compared to the population as a whole in all six years. Due to these reasons, caution should be used when interpreting evident changes in mortality rates due to the sampling protocols used in this study that may lead to over reporting of mortality rates, and those rates being subject to variations in relative contribution of the WIIS and PBMS to each year’s sample. There was no statistically significant difference between years, irrespective of cause of death, in median summed SGAR residues, and no evidence that the magnitude of accumulated summed SGAR residues has changed consistently over time. Sum bromadiolone and difenacoum concentrations were lower in 2016 than 2015, however, there was no difference for sum brodifacoum, flocoumafen, and difethialone concentrations. Data on presence/absence of detectable brodifacoum, flocoumafen or difethialone residues were compared for 2015/16 and 2017/18/19/20. The proportion of red kites with detectable residues of these three SGARs was 82% in 2015/16 and similar proportions were observed in 2017/18/19/20 (86%). Similarly, there was no significant difference in the proportion of red kites with detectable liver difenacoum or bromadiolone residues (90% in 2015/16 vs. 93% in 2017/18/19/20). Since the implementation of the stewardship regime no difference in exposure pattern relating to active ingredient has been detected. Our findings do not indicate that there has been a broad scale change in exposure in red kites to SGARs following implementation of stewardship in terms of either the proportion of the sample exposed or the magnitude of sum SGARs residues detected. There is some evidence (depending upon the statistical approach used) that the proportion of red kites in which SGARs were implicated as a contributory mortality factor has decreased in more recent years. Alternative approaches to monitoring SGARs in red kites could be considered that analyses a random but representative sample, and as part of such a programme there may also be value in monitoring SGARs in the blood of tracked individuals. There was no clear evidence that relaxation of usage restrictions on brodifacoum, difethialone and flocoumafen has altered the pattern of residues for these compounds in red kites to date. However, data following full implementation of the rodenticide stewardship scheme is currently limited to four years