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This Position Paper from the Academy of Nutrition Sciences is the third in a series which describe the nature of the scientific evidence and frameworks that underpin nutrition recommendations for health. This paper focuses on evidence which guides the application of dietary recommendations for individuals. In some situations, modified nutrient intake becomes essential to prevent deficiency, optimise development and health, or manage symptoms and disease progression. Disease and its treatment can also affect taste, appetite and ability to access and prepare foods, with associated financial impacts. Therefore, the practice of nutrition and dietetics must integrate and apply the sciences of food, nutrition, biology, physiology, behaviour, management, communication and society to achieve and maintain human health. Thus, there is huge complexity in delivering evidence-based nutrition interventions to individuals. This paper examines available frameworks for appraising the quality and certainty of nutrition research evidence, the development nutrition practice guidelines to support evidence implementation in practice and the influence of other sources of nutrition information and misinformation. The paper also considers major challenges in applying research evidence to an individual and suggests consensus recommendations to begin to address these challenges in the future. Our recommendations target three groups; those who deliver nutrition interventions to individuals, those funding, commissioning or undertaking research aimed at delivering evidence-based nutrition practice, and those disseminating nutritional information to individuals. [ABSTRACT FROM AUTHOR]

As UK cities and towns become increasingly ethnically and culturally diverse, researchers have tuned into how people inhabit multiculturalism. Ethnographic approaches have focused on the kind of togetherness that people generate as they go about their everyday lives, observing the affective textures of interactions and happenings of the here and now in granular detail. Missing from these accounts is what crowdsourced data might add to understandings of how multicultural places are experienced. What is vital about this kind of data is that it is 'big', involving a diversity of voices similarly intent on messaging their experiences, presenting opportunities to scale up the affect of encounters and to quantify what is difficult to qualify. This paper brings Digital Geographies into conversation with research on everyday multiculturalism to examine qualitatively and quantitatively how social media use folds into and expresses various practices of sociality and connection. Our paper involves Twitter, Nando's and the city of Leicester in the UK to challenge and advance ways of understanding everyday multiculturalism in an era of global migration and ethnically complex populations. [ABSTRACT FROM AUTHOR]

Latent fingerprint deposits on thermal paper sourced from the U.S., China, the U.K., and Australia have been visualized by heating. U.S. and Chinese sourced paper produced two distinct types of fingerprint development. In one type (type 1), the paper dye colors where the deposit is present (as previously reported) and in the other type (type 2) the 'inverse' of this gives paper coloring only in areas not coincident with the deposit. Both development types gave identifiable fingerprints, the majority fading within 24 h of heating. Fingerprint development from U.K. and Australian sourced paper was exclusively type 1 and resistant to fading. Temperatures for fingerprint visualization were higher for U.S. paper (64-71°C) and Chinese paper (75-95°C) than for U.K. and Australian sourced paper (43-50°C). Particularly for Chinese sourced paper, these temperatures were within a few degrees of the normal paper color temperature. A mechanism for type 2 fingerprint development is proposed. [ABSTRACT FROM AUTHOR]

Embedding employability in higher education is a key Teaching Excellence Framework requirement, and psychology departments across the UK recognise that this is indeed important for students' employability prospects. The Final Year Research Project is the most important independent piece of work that psychology undergraduate students undertake, contributing considerably to the overall degree classification. Therefore, it can provide a fertile ground for embedding employability and allows for innovation in teaching and supervision of projects. Yet, based on our extensive Final Year Research Project supervision and coordination experience, this opportunity tends to be overlooked by psychology departments, project coordinators and supervisors; often resulting in projects being given insufficient attention in students' job and further study applications and interviews. In this practice exchange paper, we first detail how employability is built into Years One and Two of our undergraduate degree, before outlining how it is integrated in Year Three within Final Year Research Projects. We then describe and discuss several initiatives that we developed and implemented to embed employability in Final Year Research Projects. We developed the 3R approach to helping students Recognise and Reflect on their skill development and Relate them to the next step in their career. [ABSTRACT FROM AUTHOR]

Presents a study that compared examiners' judgments of the grade-worthiness of candidates' A-level examination work at question paper level and at subject level. Suggests that examiners may have compensated to some extent for the different aspects of the subject tested in different question papers when they made holistic judgments. (CMK)

Purpose: To generate a large cohort of those in 2019 seriously considering applying to study Medicine, collecting data on a range of socioeconomic and other demographic factors that influence choice of medical schools and to link to other datasets to form a longitudinal study of progress through medical school and careers in medicine., Design: Cross-sectional questionnaire studies, part of the longitudinal UK Medical Applicant Cohort Study (UKMACS)., Setting: UK medical school admissions in 2020., Participants: UK residents aged 16+ and seriously considering applying to study Medicine. The cohort was primarily drawn from those registering in 2019 for the U(K)CAT (University Clinical Aptitude Test (formerly the UK Clinical Aptitude Test)) with additional potential applicants responding to an open call. Participants consented to their data being linked within the UK Medical Education Database., Findings to Date: UKMACS Wave 1 questionnaire respondents consisted of 6391 consenting respondents from across the UK. In 2019, 14 980 of the 17 470 UK-domiciled medicine applicants were first-time applicants. The questionnaires show that many of these applicants have a need for more help and guidance to make informed choices, with less advantaged groups reporting themselves as being at a disadvantage when applying due to limited understanding of information and limited access to guidance to enable informed and effective decision-making., Future Plans: To link the cohort with successive Universities and Colleges Admissions Service and other datasets to analyse outcomes of applications and establish national longitudinal evidence to understand how medical choices are made and how they impact on educational, career and workforce outcomes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Initial Teacher Education (ITE) for the post-compulsory sector (PCE) in the UK is currently under review. Despite earlier plans to substantially increase the use of technology in ITE the Lifelong Learning UK (LLUK) consultation findings recommend that "we will expect that teachers do develop their skills in this area to a limited extent on a mandatory basis" (LLUK, 2011b:12). This is a disappointing departure as other commissioned work such as that from the Learning and Skills Improvement Service (LSIS) (2009: 8) review of workforce development identified that this area was in need of continuous updating. This article will consider the need more than ever before to explore what Barnett identifies (2007: 1) as the links between teaching and learning in higher education and "pedagogic bungee jumping" with the development of cultures supportive to experimental technology use in ITE focusing upon a group of teacher educators in a West Midlands ITE Partnership (higher education institute (HEI) and partner colleges).

The focus of this article is to consider visual portrayals and representations of disability. The images selected for analysis came from online university prospectuses as well as a governmental guidance framework on the tuition of dyslexic students. Greater understanding, human rights and cultural change have been characteristic of much UK governmental policy regarding disability, and legislation has potentially strengthened the quest for equality of opportunity. However, publicly available institutional promotional visual material appears to contradict policy messages. To interrogate this contradiction, this article presents a tripartite critique whereby three researchers provide a self-inventory of their backgrounds and theoretical and ontological positioning, before presenting their differing interpretations of visual representations of disability. Following an agreed methodological and analytical framework, they addressed the question: what do visual representations of dyslexia and disability look like and what messages do they convey? (Contains 1 figure.)

Mending tears in translucent papers is a challenging task that requires mending materials with specific mechanical and optical properties. Recently, translucent films from microfibrillated cellulose have been suggested as an attractive alternative to traditional repair materials. We prepared custom films from a commercial microfibrillated cellulose suspension and compared their mechanical and optical properties as mending supports with commercially manufactured microfibrillated cellulose films and Japanese tissue. Tear mending of modern and historic translucent paper samples using the custom-made films and Klucel G or isinglass as adhesives showed satisfactory strength and resilience, and accelerated ageing tests yielded acceptable visual results. A case study on a translucent paper document from the collection of The National Archives, UK, is detailed. We conclude that custom-made tear mending materials from commercially available microfibrillated cellulose suspensions present a cost-effective and attractive approach for the mending of translucent papers. [ABSTRACT FROM AUTHOR]

In November 2010, the British Government, modifying one of the proposals in the Browne Report published in October, decided to allow English universities to charge tuition fees of up to 9,000 British Pounds, while removing almost all the public funding previously provided in the form of a block grant. This had consequences the Government should perhaps have foreseen. HEIs, unsure whether they could remain financially viable if they did not, went for the highest fee allowed. The consequence is that the new system could cost the taxpayer more in providing loans for students at this level than the continuance of direct public funding would have done. Policy was developed to reduce this cost, and one of the ideas which emerged was to allow more providers into the system, including private providers. This has prompted discussion of the resulting value for money, for students and for taxpayers, and then of the meaning of "value", and then of the need to protect the quality of the courses on offer and the "value" of the resulting qualifications. A number of changes seem likely to be necessary in consequence, among them the revision of the rules for granting degree-awarding powers and university title to private providers both profit-making and non-profit-making. This article explores the case for and against these changes.

Perceptions of the role and efficacy of written feedback in teaching and learning among teaching staff in British higher education institutions have not been extensively researched. In the present study 48 lecturers in one university and from a cross-section of disciplinary backgrounds were interviewed with respect to their lived experiences with writing assessment feedback. Like most universities, theirs has a stated commitment to academic excellence by, among other things, ensuring timely and useful feedback on assignments. The findings suggest, however, that institutional policies and departmental practices related to formative assessment in this respect are not having the intended effect. Teachers have varied perceptions and beliefs about the purposes of written feedback, and are uncertain about what it achieves and what use students make of it. Far from enhancing written feedback, innovative practices and procedures have created new problems for teachers. There is a clear need for continuing research in this area.

Plain language summary: Increasingly, births around the world are started artificially using medications or other methods. This process is known as induction of labour. As it becomes more common, methods are needed to meet the different clinical needs and birth preferences of women. Induction of labour typically includes a combination of the medication dinoprostone inserted into the vagina, artificial rupture of membranes ('releasing the waters'), and synthetic oxytocin (hormone given via a drip). This paper reviews some of the methods less commonly used for induction in the UK, namely a drug called misoprostol, which can be given orally or vaginally, and 'mechanical' methods, where labour is started by stretching the cervix (neck of the womb), most commonly with a soft silicone tube with a balloon near the tip, filled with water. Low‐dose oral misoprostol tablets are now commercially available in the UK. Other methods for labour induction are not reviewed in detail in this paper. The evidence suggests mechanical induction of labour (using a balloon catheter) and misoprostol are both at least as safe and effective as using the standard drug, dinoprostone. There is evidence to suggest a balloon catheter may reduce the chance of serious negative outcomes for babies when compared with dinoprostone, and that giving low‐dose oral misoprostol results in fewer caesarean births. Where possible and after informed consent, the method of induction of labour should be personalised to suit the individual woman, her clinical condition, and the setting in which she is giving birth. Local contexts and resources also need to be taken into account. To date, research into women's perspectives and experiences of induction of labour have been significantly lacking. [ABSTRACT FROM AUTHOR]

There is an increasing focus on collecting more diverse demographic data from research participants but standard methodological approaches still hinder such efforts. This paper addresses the need for methodological improvements by advocating for the inclusion of self-written diversity statements in demographic surveys as a form of epistemic justice. Using examples from a large qualitative research study, I demonstrate the depth and richness of data that can be obtained through self-written diversity statements. In particular, I highlight the benefits of combining open-ended demographic questions and self-written diversity statements into holistic introductory stories to help capture the complexity of participants' intersectional identities. Therefore, I argue that using such an approach gives participants the agency to choose how they are represented in research.

The British paper and board industry opposed plans to establish the Western European free trade area and the more modest EFTA, arguing that British producers would be unable to compete successfully against their Nordic rivals. The paper industry did support British entry to the EEC, but only because this was considered to be a less bad option than continued membership of EFTA. It is argued that while the British government could not fundamentally change its European policy solely because it harmed the interests of one particular industry, pressure from business and fears that increased competition would lead to increased unemployment gradually persuaded it to find ways to reduce competition. However, this policy probably encouraged many companies to delay efforts to modernise production. [ABSTRACT FROM AUTHOR]

Introduction: Asthma is the most common chronic respiratory disease in children and adults. Asthma results in significant disease-related morbidity, healthcare costs and, in some cases, death. Despite efforts through implementation of national guidelines to improve asthma care, the UK has one of the highest asthma-related morbidity and mortality rates in the western world. New approaches are necessary to prevent asthma attacks in children and adults. The objectives of this study are to assess the association between demographic and clinical factors and asthma-related hospital admissions in children and adults, describe the epidemiology of asthma phenotypes among hospital attenders, and externally validate existing asthma risk prediction models., Methods and Analysis: This is a retrospective cohort study of children and adults with asthma. Data will be extracted from the Clinical Practice Research Datalink (CPRD) Aurum database, which holds anonymised primary care data for over 13 million actively registered patients and covers approximately 19% of the UK population. The primary outcome will be asthma-related hospital admissions. The secondary outcomes will be prescriptions of short courses of oral corticosteroids (as a surrogate measure for asthma exacerbations), a composite outcome measure including hospital admissions and prescriptions of short courses of oral corticosteroids and delivery of asthma care management following hospital discharge. The primary analysis will use a Poisson regression model to assess the association between demographic and clinical risk factors and the primary and secondary outcomes. Latent class analysis will be used to identify distinct subgroups, which will further our knowledge on potential phenotypes of asthma among patients at high risk of asthma-related hospital admissions. A Concordance statistic (C-statistic) and logistic regression model will also be used to externally validate existing risk prediction models for asthma-related hospitalisations to allow for the optimal model to be identified and evaluated provide evidence for potential use of the optimal performing risk prediction model in primary care., Ethics and Dissemination: This study was approved by the CPRD Independent Scientific Advisory Committee (reference number: 21_000512). Findings from this study will be published in a peer-reviewed journal and disseminated at national and international conferences., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

A consensus statement for the management for patients of all ages with all stages of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) - All StAGEs - is proposed by representatives of the UK National Cancer Research Institute (NCRI) Hodgkin lymphoma study group and the Children's Cancer & Leukaemia Group. Based on current practices and published evidence, a consensus has been reached regarding diagnosis, staging and risk-ik7 stratified management which includes active surveillance, low- and standard-dose immunochemotherapy and radiotherapy., (© 2022 British Society for Haematology and John Wiley & Sons Ltd.)

This article presents the results of a life-cycle materials and energy flow analysis for the pulp and paper cycle in the United Kingdom. Material flows are reconstructed for the period between 1987 and 1996 for all major processes associated with the paper cycle, and system energy requirements are calculated over this period using the best available data. Attention is drawn to the import dependence of U.K. paper demand, and the significant energy requirements associated with upstream forestry processes. The historical trend analysis is then used to model possible future developments in materials and energy consumption until 2010 under a variety of assumptions about process technology improvements, wastepaper utilization rates, and changing demand trends. The results indicate that policy options to increase recycling yield some energy benefits, but these are small by comparison with the benefits to be gained by reducing consumption of paper and improving process technology. The structure of the electricity supply industry in the United Kingdom means that global energy benefits could also be achieved by increasing the contribution from imported pulp. [ABSTRACT FROM AUTHOR]

This article traces the history of the only surviving autograph manuscript of Ode to a Nightingale, composed two hundred years ago in May 2019, and preserved since 1933 in the Fitzwilliam Museum. It tests Charles Armitage Brown's famous eyewitness account of the moment of composition against the physical reality of the manuscript, and examines its materiality in some detail. It also traces the history of the manuscript's fortunes through the nineteenth and early twentieth centuries, and examines the role of collectors, curators and conservators in ensuring its survival and its continued presence in the UK. [ABSTRACT FROM AUTHOR]

In December 2020, seeking to start cashing in on its desired 'Brexit dividends', the UK Government published the Green Paper 'Transforming Public Procurement'. The Green Paper sets out a blueprint for the reform of UK public procurement law that aims to depart from the regulatory baseline of EU law and deliver a much-touted 'bonfire of procurement red tape'. The Green Paper seeks 'to speed up and simplify [UK] procurement processes, place value for money at their heart, and unleash opportunities for small businesses, charities and social enterprises to innovate in public service delivery'. The Green Paper aims to do so by creating 'a progressive, modern regime which can adapt to the fastmoving environment in which business operates' underpinned by 'a culture of continuous improvement to support more resilient, diverse and innovative supply chains.' I argue that the Green Paper has very limited transformative potential and that its proposals merely represent an 'EU law +' approach to the regulation of public procurement that would only result in an overcomplicated regulatory infrastructure, additional administrative burdens for both public buyers and economic operators, and tensions and contradictions in the oversight model. I conclude that a substantial rethink is needed if the Green Paper's goals are to be achieved. [ABSTRACT FROM AUTHOR]

Abstract: The need to increase the recovery rates of recyclables from households, reducing at the same time the collection costs, has favoured the spreading of commingled collection systems. This study presents a thorough analysis of the quality of a secondary source of recovered paper of a Spanish newsprint mill, imported from the United Kingdom, where these systems are widely practiced. The results show that the quality of recovered paper from commingled systems is very far from the quality obtained with selective systems: the unusable material content vary from 1% to 29% (11.9% on average) compared to less than 1%. Larger materials recovery facilities (MRFs), less oversaturated and with advanced sorting techniques, have demonstrated to be able to render better qualities, the unusable material content varying from 0.3% to 16.6% (8.1% on average). However, the quality is still far from contamination levels typically found with selective systems, especially in terms of non-paper components. This fact limits significantly the use of this recovered paper for graphic paper production where the major potential for an extended use of recovered paper in papermaking lies. Furthermore, there is a discussion on the cost efficiency of these systems and how the legislation and private or public initiatives are affecting the spreading of these systems, especially in the United States and the United Kingdom. [Copyright &y& Elsevier]

Examines the role of differentiated papers in Mode One Business Studies tests in promoting the goals of the United Kingdom's General Certificate of Secondary Education (GCSE). Explores the matching of candidates to papers, targeting papers, the nature of questions asked, and grading. Concludes that the technique allows students to advance through examination. (SG)

An essay is presented which discusses the relationship between the theft of paper, the use of paper as a food wrapper for cheese and London, England's book industry from 1750 through 1799. An overview of the theft of paper from London printers and booksellers and its sale to cheese shops is provided.

Objective: We evaluated reporting completeness and transparency in randomized controlled trials (RCTs) conducted using administrative data based on 2021 CONSORT Extension for Trials Conducted Using Cohorts and Routinely Collected Data (CONSORT-ROUTINE) criteria., Study Design and Setting: MEDLINE and the Cochrane Methodology Register were searched (2011 and 2018). Eligible RCTs used administrative databases for identifying eligible participants or collecting outcomes. We evaluated reporting based on CONSORT-ROUTINE, which modified eight items from CONSORT 2010 and added five new items., Results: Of 33 included trials (76% used administrative databases for outcomes, 3% for identifying participants, 21% both), most were conducted in the United States (55%), Canada (18%), or the United Kingdom (12%). Of eight items modified in the extension; six were adequately reported in a majority (>50%) of trials. For the CONSORT-ROUTINE modification portion of those items, three items were reported adequately in >50% of trials, two in <50%, two only applied to some trials, and one only had wording modifications and was not evaluated. For five new items, four that address use of routine data in trials were reported inadequately in most trials., Conclusion: How administrative data are used in trials is often sub-optimally reported. CONSORT-ROUTINE uptake may improve reporting., Competing Interests: Declaration of Competing Interests All authors have completed the ICJME uniform disclosure form and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, (Copyright © 2021. Published by Elsevier Inc.)

Focuses on the beginnings of paper money circulation and the Neapolitan public banks in Great British. Conceptualization of the possibility of replacing coin money with printed money by Leonardo da Vinci; Attribution of the development of paper money to China; Role of Neapolitan public banks.

The research presented in this paper supports claims by feminists and queer theorists that there are numerous and diverse sex/gender/desire categories (Bem, 1995). Taken from a broader digital ethnography of digital sex markets in the United Kingdom, the findings are based on ten in-depth interviews with those who identified as men or 'gender flexible' and who buy and/or sell sex within digital markets. The participants featured in this paper used digital sex markets as a space to explore and express non-normative/subversive sexual and gender identities. Yet for many of them, these subversive acts were bounded by the market, so they were able to uphold masculine heterosexual identities outside of sex markets. The relative privacy of digital sex markets empowered them to maintain heterosexist power, reducing the social risks of stigmatisation and ostracisation associated with subversive sexual and gender identities. The thematic analysis revealed the limitations of heteronormative and homonormative labels and assumptions of sex work relations, thus, prompting the need to write this paper. Framing sex markets in narrow binary terms, as either homosexual or heterosexual markets, or research participants as customers or workers do not reflect the fluidity and diversity evident in this small yet revealing sample. The study shows multiple and fluid expressions of sex/gender/desire; and a duality in market roles as workers and/or customers amongst men engaged in digital sex markets. [ABSTRACT FROM AUTHOR]

Plain language summary: This paper deals with the use of hormone replacement therapy (HRT) after the removal of fallopian tubes and ovaries to prevent ovarian cancer in premenopausal high risk women. Some women have an alteration in their genetic code, which makes them more likely to develop ovarian cancer. Two well‐known genes which can carry an alteration are the BRCA1 and BRCA2 genes. Examples of other genes associated with an increased risk of ovarian cancer include RAD51C, RAD51D, BRIP1, PALB2 and Lynch syndrome genes. Women with a strong family history of ovarian cancer and/or breast cancer, may also be at increased risk of developing ovarian cancer. Women at increased risk can choose to have an operation to remove the fallopian tubes and ovaries, which is the most effective way to prevent ovarian cancer. This is done after a woman has completed her family. However, removal of ovaries causes early menopause and leads to hot flushes, sweats, mood changes and bone thinning. It can also cause memory problems and increases the risk of heart disease. It may reduce libido or impair sexual function. Guidance on how to care for women following preventative surgery who are experiencing early menopause is needed. HRT is usually advisable for women up to 51 years of age (average age of menopause for women in the UK) who are undergoing early menopause and have not had breast cancer, to minimise the health risks linked to early menopause. For women with a womb, HRT should include estrogen coupled with progestogen to protect against thickening of the lining of the womb (called endometrial hyperplasia). For women without a womb, only estrogen is given. Research suggests that, unlike in older women, HRT for women in early menopause does not increase breast cancer risk, including in those who are BRCA1 and BRCA2 carriers and have preventative surgery. For women with a history of receptor‐negative breast cancer, the gynaecologist will liaise with an oncology doctor on a case‐by‐case basis to help to decide if HRT is safe to use. Women with a history of estrogen receptor‐positive breast cancer are not normally offered HRT. A range of other therapies can be used if a woman is unable to take HRT. These include behavioural therapy and non‐hormonal medicines. However, these are less effective than HRT. Regular exercise, healthy lifestyle and avoiding symptom triggers are also advised. Whether to undergo surgery to reduce risk or not and its timing can be a complex decision‐making process. Women need to be carefully counselled on the pros and cons of both preventative surgery and HRT use so they can make informed decisions and choices. [ABSTRACT FROM AUTHOR]

Objective: This quali-quantitative study analysed the 100 most-cited papers in core dental public health (DPH) journals focusing on understanding international knowledge production., Methods: The DPH journals were selected from titles and scopes at Web of Science Core Collection database up to March 2020. Further comparisons were performed at Scopus and Google Scholar databases. Some bibliometric parameters were extracted as follows: title, number of citations, citation density (number of citations per year), first author's country, year of publication, study design and subject. VOSviewer software was used to create graphical bibliometric maps., Results: Papers were ranked by the total number of citations, which ranged from 104 to 1,019, and six papers were cited more than 400 times. Papers were published from 1974 to 2013, mainly in Community Dentistry and Oral Epidemiology. Most frequent study designs were cross-sectional (30%) and nonsystematic review (25%). Most papers were from Europe (54%) and North America (31%). First authors were predominantly from the United Kingdom (17%), United States of America (17%) and Canada (14%). VOSviewer map of co-authorship demonstrated the existence of clusters in the research collaboration. Although epidemiology was the most frequent subject (84%), health services research presented eight times higher citation density., Conclusions: Top 100 most-cited papers in core DPH journals were predominantly observational studies from Anglo-Saxon countries. Top 100 most-cited papers in core DPH journals tend to be cross-sectional studies carried out in the United States with highest citation in health services research. Locker D, Petersen PE and Sheiham A are a landmark for DPH field., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: The Patient Information Leaflet (PIL) is an authoritative document that all people with epilepsy in the EU receive when prescribed antiseizure medication (ASM). We undertook the first independent, comprehensive assessment to determine how understandable they are. Regulators state that when patients are asked comprehension questions about them, ≥80% should answer correctly. Also, recommended is that PILs have a maximum reading requirement of US grade 8. Methods: Study 1: We obtained 140 current ASM PILs written in English. "Readability" was assessed using four tests, with and without adjustment for influence of familiar, polysyllabic words. A total of 179 online materials on epilepsy were also assessed. Study 2: Two PILs from Study 1 were randomly selected (Pregabalin Focus; Inovelon) and shown to 35 people from the UK epilepsy population. Their comprehension was assessed. Study 3: To understand whether the student population provides an accessible alternative population for future examination of ASM PILs, Study 3 was completed, using the same methods as Study 2, except that participants were 262 UK university students. Results: Study 1: No PIL had a reading level of grade 8. Median was grade 11. Adjusting for context, the PILs were still at grade 10.5. PILs for branded ASMs were most readable. PILs were no more readable than (unregulated) online materials. Study 2: Users struggled to comprehend the PILs' key messages. The eight questions asked about pregabalin were typically answered correctly by 54%. For Inovelon, it was 62%. Study 3: Most student participants comprehended the PILs' key messages. The questions about Inovelon were answered correctly by 90%; for pregabalin it was 86%. Significance: This is the first independent and comprehensive examination of ASM PILs. It found that PILs being used fail to meet recommendations and regulatory requirements and risk not being understandable to a substantial proportion of users. In finding that people from the epilepsy population differ markedly in comprehension of PILs compared to students, this study highlights the importance of completing user testing with the target population. [ABSTRACT FROM AUTHOR]

In this academic comic (or acadomic) I reflect on impacts to the creative process when reconceptualizing and recontextualizing a comics-based research (CBR) project as an acadomic for an edited book during the Covid-19 pandemic. The lockdowns intensified computer-mediated-communication (CMC) and I am compelled by two years of virtually exclusive engagement with digital technologies to explore the impact unrestrained online activities have on my creative comics practice, on my conceptions of research, and on my experiences as a teacher. Analysis of this process and its impacts is realized through a mixed research methodology that explores the impacts of conceptualizing and making an earlier acadomic, which in turn documents a comics-based research project between university students and a national charity as they successfully collaborate on the creation of a graphic novel. I probe the boundaries of academic writing by visualizing and performing Baudrillard's theoretical violence to critique digital intensification through metaphor, semiotics, and comics. The work for this article was undertaken during the rolling pandemic lockdowns in the UK and around the world from 2020 to 2022. Academic theory and the medium of comics problematize the digital simulacrum as I action a utopian pedagogy that supports balance between traditional and digital techniques. [ABSTRACT FROM AUTHOR]

The article announces the submission of papers about systems thinking and operational research in commemoration of the contribution of Emeritus Professor Mike Jackson.

The number of citations a peer-reviewed article receives is often used as a measure of its importance and scientific impact. This paper identifies, describes and categorizes the highly cited papers in addiction research on cannabis, heroin, cocaine and psychostimulants. Highly cited papers were identified in the Web of Science Core Collection database. Several bibliometric indicators were calculated. Social network analysis was applied to draw groups of authors and institutions with the greatest number of collaborations and co-words. The number of citations for the top 100 cited articles ranged from 649 to 4,672. The articles were published in 40 journals. The subject category Substance Abuse included 10 papers. The United States was the most productive country (79 papers), followed by the United Kingdom (9). The main funding institutions were the National Institutes of Health in the United States. The network of collaboration between authors distributes the 352 researchers into 53 groups. The three most cited works address the neural basis of drug craving as an incentive-sensitization theory of addiction, the clinical and research uses of the Addiction Severity Index, and the neurocircuitry of addiction. Scientific literature on addictions is widely dispersed both in multidisciplinary and specific journals of neurology, psychiatry and addictions, with relatively few publications providing most of the citations. An ongoing challenge for this field is the concentration of highly cited papers coming from a select number of countries, with the United States being the research hub of the world, with the highest volume of publications and total citations., (Copyright © 2021. Published by Elsevier B.V.)

Background: The most impactful research on pediatric type 1 diabetes (T1D) remains unknown. Objective: We aimed to evaluate the characteristics and impact of the 100 most-cited articles on pediatric T1D. Materials and Methods: Using a predefined bibliometric strategy, the Scopus database was searched for high-cited papers (HCPs) published from 2001 to 2020. Articles were evaluated for data on the publication year, countries, authors, journals, topics, and types. Social network analysis was performed to visualize the interaction among countries, organizations, and authors using VOSviewer software. Results: The top 100 HCPs received 390 to 4634 citations, averaging 773.5 citations per paper (CPP). The funded HCPs (n = 50) had a higher impact (CPP 791.5). The majority of HCPs (n = 83) were collaborative. Classifying by research type, 65 studies were clinical (n = 65), risk factors (n = 27), epidemiology (n = 26), pathophysiology (n = 16), treatment outcome (n = 13), genetics (n = 12), complications (n = 3), quality of life (n = 2), and prognosis (n = 1). The number of authors involved was 1,101, affiliated with 545 organizations in 27 countries; the USA (n = 64) and the UK (n = 24) were the most productive countries, whereas Australia and the UK were the most impactful. D.M. Nathan and J.M. Lawrence were the most prolific authors, while P. Raskin and J.M. Lachin were the most impactful. Conclusions: High-income countries such as the USA, UK, and Australia contribute significantly to high-impact pediatric T1D research. Funding and collaboration improve the impact of citations in publications. Less researched areas such as treatment outcomes, genetics, complications, quality of life, and prognosis should be the focus of future research on pediatric T1D. [ABSTRACT FROM AUTHOR]

The Natural Environment White Paper represents the most important conservation policy shift in the United Kingdom (UK) in twenty years. It formalises the ecosystem approach within national policy objectives and emphasises the economic value of ecosystem services. By analysing the use of various evidence sources, the involvement of science entrepreneurs, and the development of policy narratives, our goal was to understand factors that influenced adoption of an ecosystem service framework in the UK. We interviewed 48 policy actors and found that centrally-sponsored synthesis reports with entrepreneurial authors provided the most influential expert-based knowledge in the development of the White Paper . More recently published reports had greater influence, yet the window of opportunity for scientific evidence having policy impact was greater in the problem-setting stages of policy development. The interaction between teams preparing syntheses and expert entrepreneurs helped influence the construction of strategic policy narratives. Those narratives increased the impact of scientific evidence by communicating and framing key policy-salient messages, and brokering between broad ecosystem-based and environmental economics narratives. The combination of ecological and economics evidence was particularly salient in the UK case due to the context of continued biodiversity loss and the acceptability of valuation narratives within central government. Our findings suggest that evidence impact varies at different stages of the policy process, and that this is driven by the interplay of contextual factors like policy timing, personal influence, and the competition between different sets of actors and narratives. [ABSTRACT FROM AUTHOR]

Background: Patients who are critically ill are at increased risk of hospital acquired pneumonia and ventilator associated pneumonia. Effective evidence based oral care may reduce the incidence of such iatrogenic infection. Aim: To provide an evidence‐based British Association of Critical Care Nurses endorsed consensus paper for best practice relating to implementing oral care, with the intention of promoting patient comfort and reducing hospital acquired pneumonia and ventilator associated pneumonia in critically ill patients. Design: A nominal group technique was adopted. A consensus committee of adult critical care nursing experts from the United Kingdom met in 2018 to evaluate and review the literature relating to oral care, its application in reducing pneumonia in critically ill adults and to make recommendations for practice. An elected national board member for the British Association of Critical Care Nurses chaired the round table discussion. Methods: The committee focused on 5 aspects of oral care practice relating to critically ill adult patients. The evidence was evaluated for each practice within the context of reducing pneumonia in the mechanically ventilated patient or pneumonia in the non‐ventilated patient. The five practices included the frequency for oral care; tools for oral care; oral care technique; solutions used and oral care in the non‐ventilated patient who is critically ill and is at risk of aspiration. The group searched the best available evidence and evaluated this using the Grading of Recommendations Assessment, Development, and Evaluation system to assess the quality of evidence from high to very low, and to formulate recommendations as strong, moderate, weak, or best practice consensus statement when applicable. Results: The consensus group generated recommendations, delineating an approach to best practice for oral care in critically ill adult patients. Recommendations included guidance for frequency and procedure for oral assessment, toothbrushing, and moisturising the mouth. Evidence on the use of chlorhexidine is not consistent and caution is advised with its routine use. Conclusion: Oral care is an important part of the care of critically ill patients, both ventilated and non‐ventilated. An effective oral care programme reduces the incidence of pneumonia and promotes patient comfort. Relevance to Clinical practice: Effective oral care is integral to safe patient care in critical care. [ABSTRACT FROM AUTHOR]

Harmful Sexual Behaviour (HSB) has been regularly documented as a demanding area of practice within the United Kingdom (UK). The aim of this paper is to share a practice model developed in an under-resourced inner London borough. The HSB forum is formed of a multi-agency group of professionals and runs monthly providing a platform for practitioners to seek consultation for young people they are working with who are displaying HSB's. Initial feedback for the forum from practitioners has been consistently positive and they have valued specifically the opportunity to formulate, have clear directions, and the multi-disciplinary perspective. In addition, most reported feeling empowered to implement the recommendations suggested. Given the shared vulnerability factors between those displaying HSB's and other at-risk young people such as those who are being sexually exploited, this model provides an innovative way that practitioners can be supported by multiple agencies where there is a lack of specialist services. [ABSTRACT FROM AUTHOR]

Introduction: Health Data Research UK designated seven UK-based Hubs to facilitate health data use for research. PIONEER is the Hub in Acute Care. PIONEER delivered workshops where patients/public citizens agreed key principles to guide access to unconsented, anonymised, routinely collected health data. These were used to inform the protocol., Methods: This paper describes the PIONEER infrastructure and data access processes. PIONEER is a research database and analytical environment that links routinely collected health data across community, ambulance and hospital healthcare providers. PIONEER aims ultimately to improve patient health and care, by making health data discoverable and accessible for research by National Health Service, academic and commercial organisations. The PIONEER protocol incorporates principles identified in the public/patient workshops. This includes all data access requests being reviewed by the Data Trust Committee, a group of public citizens who advise on whether requests should be supported prior to licensed access., Ethics and Dissemination: East Midlands-Derby REC (20/EM/0158): Confidentiality Advisory Group (20/CAG/0084). www.PIONEERdatahub.co.uk., Competing Interests: Competing interests: SG, GP, HP, GMC, CJ, BR, LF, BLC, CA, KWD, EM, CC, ML, SM, SP, JA, RDoal, RDormer, AR and HF have no conflicts of interest. GG reports funding from HDR-UK. ES reports funding from the Wellcome Trust, MRC, HDR-UK, Alpha 1 Foundation (A1F), British Lung Foundation and NIHR., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)

This paper provides empirical evidence that individuals substantially revise their stated wealth redistribution preferences after fiscal scandals. The 2016 Panama Papers scandal revealed top-income tax evasion behaviour simultaneously worldwide. The empirical investigation exploits this event as a quasi-natural experiment. I rely on two original datasets, a UK household longitudinal dataset and a survey conducted in 22 European countries. I use a difference-in-differences strategy and find that pro-redistribution statements increased between 2% and 3.3% after the scandal. Responses are heterogeneous and larger for right-wing individuals and low-income individuals. This change in wealth redistribution preferences is likely to have been translated into a slight change in votes. The results suggest an increase in stated voting intentions for the left and a decrease for the right. Complementary estimations reveal that more media coverage and more individuals involved by country increase the magnitude of the response. [ABSTRACT FROM AUTHOR]

Aims: To explore any changes in the perceived gender and affiliation of first authors of papers published in the British Journal of Orthodontics (BJO) and Journal of Orthodontics (JO), over the last 50 years. Methods: Electronic hand searches of the BJO and JO from 1973 to 2021, were undertaken to identify research and clinical papers published the first volume of the BJO (1973-74) and then the first two volumes of each subsequent decade i.e. 1980-81; 1990-91 to 2020-21. Articles such as Editorials, Product Updates and Abstract summaries, were excluded. The perceived gender of the first author was identified from their forename, internet sources and/or personal knowledge, where possible. The country of the first author's affiliation was identified from the author details stated in the papers. The countries were then grouped into geographical areas. Results: A total of 385 papers were identified with a steady increase from 1973 to 2021. There was a statistically significant increase in papers published by authors who were perceived to be female (odds ratio 8.33; 95% CI 4.75, 14.64). The increase in papers published by non-UK affiliated first authors was significant (odds ratio 5.01; 95% CI 2.78, 9.02). Conclusions: The Journal has seen a significant change, over the last 50 years, in its authorship profile from nearly exclusively male, UK based authors to more than 60% of published papers having a first author who was perceived as being female and 37% originating from outside the UK. [ABSTRACT FROM AUTHOR]

Students of European integration have produced an enormous amount of literature on the intergovernmental negotiations that led to the establishment of such organizations as the OEEC, the EEC and EFTA. However, only a few have devoted substantial attention to the international contacts between companies that attempted to undermine the integration process by building private trade barriers that would replace those that governments had agreed to remove. The paper producers began to build such barriers soon after EFTA and the EEC had been set up. Although these attempts were not always successful, the industrialists did manage to create arrangements that were substantially more extensive in their geographical and product scope than those that had existed before. The British government and the EEC were reluctant to challenge these arrangements, and in some cases even actively promoted them. The interwar decades are widely considered to be the ‘golden era’ for international cartels; but for the paper cartels, the ‘golden era’ began in the 1960s, when previous bilateral links were replaced with multilateral ones. [ABSTRACT FROM PUBLISHER]

The COVID-19 Psychological Wellbeing Study was designed and implemented as a rapid survey of the psychosocial impacts of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known as COVID-19 in residents across the United Kingdom. This study utilised a longitudinal design to collect online survey based data. The aim of this paper was to describe (1) the rationale behind the study and the corresponding selection of constructs to be assessed; (2) the study design and methodology; (3) the resultant sociodemographic characteristics of the full sample; (4) how the baseline survey data compares to the UK adult population (using data from the Census) on a variety of sociodemographic variables; (5) the ongoing efforts for weekly and monthly longitudinal assessments of the baseline cohort; and (6) outline future research directions. We believe the study is in a unique position to make a significant contribution to the growing body of literature to help understand the psychological impact of this pandemic and inform future clinical and research directions that the UK will implement in response to COVID-19. [ABSTRACT FROM AUTHOR]

Focuses on issues raised by the White Paper on the future of higher education from the perspective of the post-92 universities, established by the Act of parliament in 1992 in Great Britain. Failure of the White Paper in recognizing realities of shape and structure of educational system; Vision of future of higher education offered by the White Paper.

Objectives: In China, news media are useful for educating the public about the health threats of air pollution. To explore the potential gaps between scientific findings and the public's understanding of them, the characteristics of news media articles and their corresponding scientific papers were analysed., Methods: We used 22 articles relating to the health outcomes of exposure to outdoor air pollution published on Baidu News over the past year. An assessment tool developed by Robinson et al was used to evaluate the quality scores of news articles. Pearson correlation coefficients were used to measure the relationship between news media reporting and the characteristics of scientific papers. Misleading reporting, interpretation, or extrapolation in headlines and text bodies of news articles were examined., Results: The quality scores of the news articles ranged from -4 to 8, with an overall median score of 3. Correlation results showed that the scientific papers citation in Twitter (r = .88, P < .001) and Facebook (r = .64, P < .01) were significantly and positively associated with their citations in news stories. Media misunderstanding of scientific findings was common: 15 news headlines were identified with at least one spin (misrepresentation of scientific results), and 12 news articles had seven types of spin in the body texts., Conclusion: Little media attention has been paid to scientific findings by Chinese researchers. Therefore, researchers and science journalists in China should make a better effort to engage in accurate and informative public discourse on domestic research., (© 2019 John Wiley & Sons, Ltd.)

Competing Interests: Competing interests: None declared.

There is some confusion surrounding the management of people with lymphoedema in the presence of deep vein thrombosis (DVT). This may be in relation to the suitability of commencing compression therapy or regarding the continuation of compression therapy in those who develop DVT. The purpose of this British Lymphology Society position paper is to support evidence-based practice and debunk the myths surrounding the management of DVT and lymphoedema. [ABSTRACT FROM AUTHOR]

The Internet-based Exercise-focused Health App for Lung cancer survivors (iEXHALE) is a mobile web app being developed to provide lung cancer survivors with an algorithm-based, tailor-made, self-management programme to inform their exercise choices and improve symptom severity. The aim of this protocol paper is to detail the plan for conducting the usability study to test the effectiveness, efficiency and simplicity of an exercise-focused self-management mobile web app for lung cancer survivors. The mixed methods study will consist of three consecutive phases, each interspersed with elements of data analysis and app prototype redevelopment. The study will take place in Oxford, United Kingdom. Ethical approvals have been obtained. The study will contribute to lung cancer survivorship research and is important in the app developmental process. This study contributes to the international forum for the exchange of practice, innovation and research, increases transparency in mobile health developmental processes and contributes to the methodological evidence base.

Background: Many previous papers have investigated most-cited articles or most productive authors in academics, but few have studied most-cited authors. Two challenges are faced in doing so, one of which is that some different authors will have the same name in the bibliometric data, and the second is that coauthors' contributions are different in the article byline. No study has dealt with the matter of duplicate names in bibliometric data. Although betweenness centrality (BC) is one of the most popular degrees of density in social network analysis (SNA), few have applied the BC algorithm to interpret a network's characteristics. A quantitative scheme must be used for calculating weighted author credits and then applying the metrics in comparison., Objective: This study aimed to apply the BC algorithm to examine possible identical names in a network and report the most-cited authors for a journal related to international mobile health (mHealth) research., Methods: We obtained 676 abstracts from Medline based on the keywords "JMIR mHealth and uHealth" (Journal) on June 30, 2018. The author names, countries/areas, and author-defined keywords were recorded. The BCs were then calculated for the following: (1) the most-cited authors displayed on Google Maps; (2) the geographical distribution of countries/areas for the first author; and (3) the keywords dispersed by BC and related to article topics in comparison on citation indices. Pajek software was used to yield the BC for each entity (or node). Bibliometric indices, including h-, g-, and x-indexes, the mean of core articles on g(Ag)=sum (citations on g-core/publications on g-core), and author impact factor (AIF), were applied., Results: We found that the most-cited author was Sherif M Badawy (from the United States), who had published six articles on JMIR mHealth and uHealth with high bibliometric indices (h=3; AIF=8.47; x=4.68; Ag=5.26). We also found that the two countries with the highest BC were the United States and the United Kingdom and that the two keyword clusters of mHealth and telemedicine earned the highest indices in comparison to other counterparts. All visual representations were successfully displayed on Google Maps., Conclusions: The most cited authors were selected using the authorship-weighted scheme (AWS), and the keywords of mHealth and telemedicine were more highly cited than other counterparts. The results on Google Maps are novel and unique as knowledge concept maps for understanding the feature of a journal. The research approaches used in this study (ie, BC and AWS) can be applied to other bibliometric analyses in the future., (©Wei-Chih Kan, Willy Chou, Tsair-Wei Chien, Yu-Tsen Yeh, Po-Hsin Chou. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 07.05.2020.)