Migrant Roma in the United Kingdom and the need to estimate population size

Within the political framework of the European Union (EU), there has been long standing recognition that the on-going exclusion of Roma represents a key challenge for human rights, justice and social inclusion agendas. By introducing a requirement for Member States to produce National Roma Integration Strategies (NRIS), the European Commission hopes that Member States will work in partnership with the EU and key stakeholders to achieve inclusion objectives in respect of housing, health, education and employment. The form and content of the United Kingdom’s (UK) NRIS submission has been criticised in a number of key areas; notably its ‘migrant blind’ approach (Craig, 2011; 2013). This article draws on recent research undertaken by the authors (Brown, Martin and Scullion, 2013), which aimed to estimate the size of the recently arrived Roma population in the UK and document some of the local level responses as a result of this migration. It provides an overview of the context giving rise to the research, and how previous population estimates have been attempted, both across the EU and in the UK. The paper considers whether conventional methodologies can be fit for purpose when attempting to assess the population size of a transnational and highly mobile ethnic group, or whether more experimental approaches might yield a fresh approach. More specifically, it examines the strengths and weaknesses of adopting a place typology approach (Lupton et al., 2011). Finally the paper looks at the publication of research about Roma populations in a highly politicised arena in the wake of ongoing national and international attention on Rom

The limits of inclusion? Exploring the views of Roma and non Roma in six European union member states

This final research report for the Roma SOURCE project presents an analysis of new qualitative data generated in 24 focus groups with members of both Roma and non Roma populations resident in the six Member States in which the Roma SOURCE partners are situated (i.e. Bulgaria, Greece, Hungary, Italy, Spain and the United Kingdom). It builds on the literature and policy review previously presented in an earlier interim report which combined contextual discussions on the general situation of Roma in Europe with more specific information (drawn from the ‘country reports’ compiled by Roma SOURCE project partners), about the particular circumstances of Roma populations in those six Member States (rf. Brown, Dwyer and Scullion, 2012). A key aim of the fieldwork which underpins this final report was to access, and make sense of, a range of views and opinions about the extent to which Roma and non Roma people believed they routinely led segregated or integrated lives

The limits of inclusion? Exploring the views of Roma and non Roma in six European union member states : Executive summary

This research forms part of the Roma SOURCE (Sharing of Understanding Rights and Citizenship in Europe) project. Roma SOURCE involved eight organisations from six European Union Member States (i.e. Bulgaria, Greece, Hungary, Italy, Spain and the United Kingdom). The research aimed to consider the extent to which Roma and majority communities in the six identified Member States lead integrated lives by conducting empirical research with Roma and non Roma populations. This summary is based on analysis of data generated in 24 focus groups with members of Roma and non Roma communities in the six EU Member States listed above. The focus groups were convened in 2012. A total of 180 respondents (92 men, 88 women), took part in the focus groups, with representatives from 14 nationalities

Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness.

BACKGROUND: Small abdominal aortic aneurysms (AAAs; 3.0-5.4 cm in diameter) are usually asymptomatic and managed by regular ultrasound surveillance until they grow to a diameter threshold (commonly 5.5 cm) at which surgical intervention is considered. The choice of appropriate surveillance intervals is governed by the growth and rupture rates of small AAAs, as well as their relative cost-effectiveness. OBJECTIVES: The aim of this series of studies was to inform the evidence base for small AAA surveillance strategies. This was achieved by literature review, collation and analysis of individual patient data, a focus group and health economic modelling. DATA SOURCES: We undertook systematic literature reviews of growth rates and rupture rates of small AAAs. The databases MEDLINE, EMBASE on OvidSP, Cochrane Central Register of Controlled Trials 2009 Issue 4, ClinicalTrials.gov, and controlled-trials.com were searched from inception up until the end of 2009. We also obtained individual data on 15,475 patients from 18 surveillance studies. REVIEW METHODS: Systematic reviews of publications identified 15 studies providing small AAA growth rates, and 14 studies with small AAA rupture rates, up to December 2009 (later updated to September 2012). We developed statistical methods to analyse individual surveillance data, including the effects of patient characteristics, to inform the choice of surveillance intervals and provide inputs for health economic modelling. We updated an existing health economic model of AAA screening to address the cost-effectiveness of different surveillance intervals. RESULTS: In the literature reviews, the mean growth rate was 2.3 mm/year and the reported rupture rates varied between 0 and 1.6 ruptures per 100 person-years. Growth rates increased markedly with aneurysm diameter, but insufficient detail was available to guide surveillance intervals. Based on individual surveillance data, for each 0.5-cm increase in AAA diameter, growth rates increased by about 0.5 mm/year and rupture rates doubled. To control the risk of exceeding 5.5 cm to below 10% in men, on average a 7-year surveillance interval is sufficient for a 3.0-cm aneurysm, whereas an 8-month interval is necessary for a 5.0-cm aneurysm. To control the risk of rupture to below 1%, the corresponding estimated surveillance intervals are 9 years and 17 months. Average growth rates were higher in smokers (by 0.35 mm/year) and lower in patients with diabetes (by 0.51 mm/year). Rupture rates were almost fourfold higher in women than men, doubled in current smokers and increased with higher blood pressure. Increasing the surveillance interval from 1 to 2 years for the smallest aneurysms (3.0-4.4 cm) decreased costs and led to a positive net benefit. For the larger aneurysms (4.5-5.4 cm), increasing surveillance intervals from 3 to 6 months led to equivalent cost-effectiveness. LIMITATIONS: There were no clear reasons why the growth rates varied substantially between studies. Uniform diagnostic criteria for rupture were not available. The long-term cost-effectiveness results may be susceptible to the modelling assumptions made. CONCLUSIONS: Surveillance intervals of several years are clinically acceptable for men with AAAs in the range 3.0-4.0 cm. Intervals of around 1 year are suitable for 4.0-4.9-cm AAAs, whereas intervals of 6 months would be acceptable for 5.0-5.4-cm AAAs. These intervals are longer than those currently employed in the UK AAA screening programmes. Lengthening surveillance intervals for the smallest aneurysms was also shown to be cost-effective. Future work should focus on optimising surveillance intervals for women, studying whether or not the threshold for surgery should depend on patient characteristics, evaluating the usefulness of surveillance for those with aortic diameters of 2.5-2.9 cm, and developing interventions that may reduce the growth or rupture rates of small AAAs. FUNDING: The National Institute for Health Research Health Technology Assessment programme

Rights, responsibilities and redress? Research on policy and practice for Roma inclusion in ten Member States

Roma MATRIX (Mutual Action Targeting Racism, Intolerance and Xenophobia) was a two year project (2013-2015) co-funded by the European Union’s Fundamental Rights and Citizenship Programme. The project involved ten European Member States (Bulgaria, Czech Republic, Greece, Hungary, Italy, Poland, Romania, Slovakia, Spain, and United Kingdom - hereafter referred to as the partner states). A total of 20 organisations were partners on the project representing a diverse range of agencies including non-government organisations (NGOs), Roma-led organisations, local government, universities and two private sector companies. A diverse programme of activities was undertaken which included network development, mentoring of people from Roma communities, conferences and workshops, capturing positive images and developing a public media campaign, etc. This work focused on four core areas which underpinned the Roma MATRIX project: Reporting and redress mechanisms for tackling anti-Gypsyism; Roma children in the care system; Employment; Cross-community relations and mediation. This summary report outlines the key research findings

Statistical consideration when adding new arms to ongoing clinical trials: the potentials and the caveats

BACKGROUND: Platform trials improve the efficiency of the drug development process through flexible features such as adding and dropping arms as evidence emerges. The benefits and practical challenges of implementing novel trial designs have been discussed widely in the literature, yet less consideration has been given to the statistical implications of adding arms. MAIN: We explain different statistical considerations that arise from allowing new research interventions to be added in for ongoing studies. We present recent methodology development on addressing these issues and illustrate design and analysis approaches that might be enhanced to provide robust inference from platform trials. We also discuss the implication of changing the control arm, how patient eligibility for different arms may complicate the trial design and analysis, and how operational bias may arise when revealing some results of the trials. Lastly, we comment on the appropriateness and the application of platform trials in phase II and phase III settings, as well as publicly versus industry-funded trials. CONCLUSION: Platform trials provide great opportunities for improving the efficiency of evaluating interventions. Although several statistical issues are present, there are a range of methods available that allow robust and efficient design and analysis of these trials

Gypsy, Traveller and Travelling Showpeople accommodation needs assessment : Hull : Final report

In July 2012 Hull City Council commissioned the Salford Housing & Urban Studies Unit (SHUSU) at the University of Salford to produce an updated Gypsy, Traveller and Travelling Showpeople Accommodation Assessment. The primary purpose of this assessment was to provide up to date information and data regarding the needs and requirements of the Gypsy, Traveller and Travelling Showpeople communities. This report presents the projection of permanent and transit requirements for the period 2012 – 2028. The assessment was undertaken by conducting a review of the following data sources: previous assessments of need and information submitted through the previous regional planning process; the policy and guidance context; the bi-annual Caravan Count; information from the local authority with regards to pitch provision and supply; information from key stakeholders; and a survey of 99 Gypsy and Traveller households