Objective: To compare the safety and efficacy of Varisolve® 1% polidocanol microfoam sclerosant with alternative treatments for patients with varicose veins and trunk vein incompetence. Methods: An open-label, multicentre, prospective trial of 710 patients randomized to receive either Varisolve® or alternative treatment (surgery or sclerotherapy). The endpoint was ultrasound-determined occlusion of trunk vein(s) and elimination of reflux, analysed against a non-inferiority hypothesis. Results: Overall, non-inferiority was demonstrated with 83.4% efficacy for Varisolve® compared with 88.1% for alternative treatment at three months, and the corresponding magnitudes were 78.9 and 80.4% at 12 months. Surgery was superior to Varisolve®, but the success rate of 68.2% for Varisolve® (surgery 87.2%) was poor compared with 93.8% success for Varisolve® achieved in those randomized to Varisolve® or sclerotherapy. Varisolve® was superior to sclerotherapy at 12 months ( P = 0.001). Deep vein thrombosis occurred in 11/437 (2.5%) after Varisolve®, in 1/125 (0.8%) after sclerotherapy and in none after surgery. No pulmonary emboli were detected. Conclusion: Overall, Varisolve® was non-inferior to alternative treatment. Surgery was more efficacious, but Varisolve® caused less pain and patients returned to normal more quickly. The Varisolve® technique is a useful additional treatment for varicose veins and trunk vein incompetence.

Empirical child welfare research in England takes insufficient account of wider social theory. Intellectual, professional and political reasons for this are discussed. The implications are considered in relation to one important social problem: the low educational achievement of children looked after by local authorities (‘in care’). It is concluded that the absence of a broader sociological perspective has led to insufficient and simplistic explanations from researchers and policy‐makers of low achievement among looked‐after pupils. It is unwise to rely on official statistics on educational outcome indicators for looked‐after pupils. Previous conceptualization of poor educational performance has been inadequate, and we should refer to low achievement, not ‘underachievement’. The socio‐economic risk factors that are linked with family breakdown and admission to care also predict low educational achievement, such as social class and poverty. Social mobility and transition to adulthood are increasingly problematic in England, making it difficult for care leavers to improve their social position. Parental maltreatment is strongly linked with educational failure. Other countries may do no better than England does. Thus, it is by no means obvious that the care system necessarily jeopardizes looked‐after children’s education.

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The O:E ratios for POSSUM and P-POSSUM were close to unity when the appropriate analysis was performed. Both POSSUM and P-POSSUM overpredicted death if the incorrect analysis was used.

Our work group wishes to thank CFRC staffer Laura Dale at Loughborough for extraordinary efforts in producing this statement in record time and for her care and assistance with all phases of our Summit activity.