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Background: The practice of palliative sedation continues to raise ethical questions among people, which in turn leads to its varied acceptance and practice across regions. As part of the Palliative Sedation European Union (EU) project, the aim of the present study was to determine the perceptions of palliative care experts regarding the practice of palliative sedation in eight European countries (The Netherlands, Belgium, Germany, UK, Italy, Spain, Hungary, and Romania). Methods: A specifically designed survey, including questions on the most frequently used medications for palliative sedation, their availability per countries and settings, and the barriers and facilitators to the appropriate practice of palliative sedation was sent to expert clinicians involved and knowledgeable in palliative care in the indicated countries. A purposive sampling strategy was used to select at least 18 participating clinicians per consortium country. Descriptive statistical analysis was conducted on the survey data. Results: Of the 208 expert clinicians invited to participate, 124 participants completed the survey. Midazolam was perceived to be the most frequently used benzodiazepine in all eight countries. 86% and 89% of expert clinicians in Germany and Italy, respectively, perceived midazolam was used "almost always", while in Hungary and Romania only about 50% or less of the respondents perceived this. Levomepromazine was the neuroleptic most frequently perceived to be used for palliative sedation in the Netherlands, Spain, Germany, and the United Kingdom. Between 38- 86% of all eight countries´ expert clinicians believed that opioid medications were "almost always" used during palliative sedation. The perceived use of IV hydration and artificial nutrition "almost always" was generally low, while the country where both IV hydration and artificial nutrition were considered to be "very often" given by a third of the expert clinicians, was in Hungary, with 36% and 27%, respectively. Conclusions: Our study provides insight about the differences in the perceived practice of medication during palliative sedation between eight European countries. In countries where palliative care services have been established longer perceptions regarding medication use during palliative sedation were more in line with the recommended European guidelines than in Central and Eastern European countries like Romania and Hungary. [ABSTRACT FROM AUTHOR]

Dynamic face stimuli are increasingly used in face perception research, as increasing evidence shows they are perceived differently from static photographs. One popular method for creating dynamic faces is the dynamic morph, which can animate the transition between expressions by blending two photographs together. Although morphs offer increased experimental control, their unnatural motion differs from the biological facial motion captured in video recordings. This study aimed to compare ratings of emotion intensity and genuineness in video recordings, dynamic morphs, and static photographs of happy, sad, fearful, and angry expressions. We found that video recordings were perceived to have greater emotional intensity than dynamic morphs, and video recordings of happy expressions were perceived as more genuine compared to happy dynamic morphs. Unexpectedly, static photographs and video recordings had similar ratings for genuineness and intensity. Overall, these results suggest that dynamic morphs may be an inappropriate substitute for video recordings, as they may elicit misleading dynamic effects. [ABSTRACT FROM AUTHOR]

Background: Artificial intelligence (AI) has numerous applications in pathology, supporting diagnosis and prognostication in cancer. However, most AI models are trained on highly selected data, typically one tissue slide per patient. In reality, especially for large surgical resection specimens, dozens of slides can be available for each patient. Manually sorting and labelling whole‐slide images (WSIs) is a very time‐consuming process, hindering the direct application of AI on the collected tissue samples from large cohorts. In this study we addressed this issue by developing a deep‐learning (DL)‐based method for automatic curation of large pathology datasets with several slides per patient. Methods: We collected multiple large multicentric datasets of colorectal cancer histopathological slides from the United Kingdom (FOXTROT, N = 21,384 slides; CR07, N = 7985 slides) and Germany (DACHS, N = 3606 slides). These datasets contained multiple types of tissue slides, including bowel resection specimens, endoscopic biopsies, lymph node resections, immunohistochemistry‐stained slides, and tissue microarrays. We developed, trained, and tested a deep convolutional neural network model to predict the type of slide from the slide overview (thumbnail) image. The primary statistical endpoint was the macro‐averaged area under the receiver operating curve (AUROCs) for detection of the type of slide. Results: In the primary dataset (FOXTROT), with an AUROC of 0.995 [95% confidence interval [CI]: 0.994–0.996] the algorithm achieved a high classification performance and was able to accurately predict the type of slide from the thumbnail image alone. In the two external test cohorts (CR07, DACHS) AUROCs of 0.982 [95% CI: 0.979–0.985] and 0.875 [95% CI: 0.864–0.887] were observed, which indicates the generalizability of the trained model on unseen datasets. With a confidence threshold of 0.95, the model reached an accuracy of 94.6% (7331 classified cases) in CR07 and 85.1% (2752 classified cases) for the DACHS cohort. Conclusion: Our findings show that using the low‐resolution thumbnail image is sufficient to accurately classify the type of slide in digital pathology. This can support researchers to make the vast resource of existing pathology archives accessible to modern AI models with only minimal manual annotations. [ABSTRACT FROM AUTHOR]

Welfare chauvinism, that is, the exclusion of non-citizens who live permanently within a state from social benefits and services, has become a mainstream form of welfare policy opposition advocated by some political parties and members of the public. While existing studies have successfully cast a light on the roots and scope of these policies, welfare chauvinism effectively encompasses a wide range of ideas that all have different meanings. Drawing on the stances taken by populist radical right parties, this article introduces five categories (or frames) of welfare chauvinism: temporary, selective, functional, cultural and, in its most extreme form, unconditional chauvinism. The article then illustrates how such categorization is applied empirically by focusing on the stances taken by three populist radical right parties and open-ended discussions held during mini-publics in examples of three different institutional forms of welfare state: Denmark, Germany and the United Kingdom. This article offers a more precise depiction of how this form of opposition to welfare state policies plays out in the public sphere, taking full account of how different forms and frames of welfare chauvinism yield different policy outcomes and implications in different institutional and political contexts. [ABSTRACT FROM AUTHOR]

This study analyses the role of generalized trust and control in households' employment of domestic help. Applying a basic trust game with uncertainty, we argue that households differ in their estimate of the proportion of opportunistic domestic workers, variation which we ascribe to generalized trust. Households with low trust should estimate a lower proportion of non-opportunistic individuals, making them less willing to accept a domestic worker. Control, through direct supervision of the domestic worker, is assumed to serve as a substitute for trust and is expected to increase acceptance. We also consider the role of income, which we expect to alter the relation between the potential losses and gains associated with outsourcing. To test our hypotheses, we use a factorial survey conducted in 2020 in Germany and the UK (N = 1877) which enables us to explore the robustness of the effects across countries. Experimental results show that individuals are more accepting of domestic outsourcing if they have higher trust, higher income, and if control of the worker is easily possible. Interaction effects reveal that the positive effect of higher trust and higher income is only relevant in low control situations. This suggest that households with higher trust and income have an advantage when it comes to fully utilizing the benefits of domestic help since costly control is not required. Consequently, the results substantially contribute to existing literature on explaining causes of social inequality in service use beyond financial restrictions and shed light on the complex interplay of trust and control. [ABSTRACT FROM AUTHOR]

Background: Primary care physicians often lack resources and training to correctly diagnose and manage chronic insomnia disorder. Tools supporting chronic insomnia diagnosis and management could fill this critical gap. A survey was conducted to understand insomnia disorder diagnosis and treatment practices among primary care physicians, and to evaluate a diagnosis and treatment algorithm on its use, to identify ways to optimize it specifically for these providers. Methods: A panel of experts developed an algorithm for diagnosing and treating chronic insomnia disorder, based on current guidelines and experience in clinical practice. An online survey was conducted with primary care physicians from France, Germany, Italy, Spain, and the United Kingdom, who treat chronic insomnia patients, between January and February 2023. A sub-sample of participants provided open-ended feedback on the algorithm and gave suggestions for improvements. Results: Overall, 106 primary care physicians completed the survey. Half (52%, 55/106) reported they did not regularly screen for insomnia and half (51%, 54/106) felt they did not have enough time to address patients' needs in relation to insomnia or trouble sleeping. The majority (87%,92/106) agreed the algorithm would help diagnose chronic insomnia patients and 82% (87/106) agreed the algorithm would help improve their clinical practice in relation to managing chronic insomnia. Suggestions for improvements were making the algorithm easier to read and use. Conclusion: The algorithm developed for, and tested by, primary care physicians to diagnose and treat chronic insomnia disorder may offer significant benefits to providers and their patients through ensuring standardization of insomnia diagnosis and management. [ABSTRACT FROM AUTHOR]

Child impeding packs are difficult for children to open so protect them from unintended access to hazardous contents inside the pack. However, if packs are difficult for adults to open, in normal usage scenarios, this may result in a higher occurrence of packs being left open. This research explores differences in ease of usage and closure compliance between two types of child impeding packs of liquid laundry detergent capsules. The two packs, "Pinch & Lift" and "Press & Lift", had different opening and closing mechanisms. "Press & Lift" also included an audible "click" signal to confirm complete closure to the user. The research was performed across two studies. In both studies, the packs were used in participants' homes according to their usual storage and usage practices as replacements to their current liquid laundry detergent capsule pack. All participants had small children living with them in their household. In Study 1, self-reported closure and ease of use data was collected from 99 adult participants in Germany. They used each package in their home for 10 days. Study 2 extended Study 1 by measuring closure rates with an objective assessment using in pack sensors for a 10-day period for each pack. Self-reported closure and ease of use data were also collected. Study 2 was conducted with 87 participants in the United Kingdom. Results across both studies showed "Press & Lift" with the audible "Click" close signal to be rated by participants to be significantly easier to open and close and have a higher self-reported closure rate than "Pinch & Lift". In addition, Study 2 results demonstrated higher closure rates using "Press & Lift" based on the sensor-measured closure compliance. Together, the results suggest transition to a pack with a mechanism that is child impeding and easier for an adult to use with an audible closure signal, like the "Press & Lift" system, has potential to reduce child access to a capsule from a pack by reducing the likelihood of the pack being left open by the adult user. Ultimately, such packs could protect children from potential poisoning injury across a range of consumer products. [ABSTRACT FROM AUTHOR]

• Drivers on slip roads want vehicles on the target lane to decelerate. • Drivers in target lanes rate the behaviour of vehicles on slip roads ambiguously. • AVs are rated identically or even more positively than MVs with identical behaviour. • No different safety distance is kept from automated vehicles. • Results show that cross-border traffic between Germany and UK with AVs is feasible. • Intercultural aspects must still be considered in the development of AVs. To ensure safe and uninterrupted traffic flow, (semi-)automated vehicles must be capable of providing comprehensible and agreeable implicit communication cues to human drivers. This driving simulator study investigated the assessment of implicit communication at a motorway slip road through longitudinal driving dynamics (acceleration, deceleration, and maintaining speed). The second aim of the study was to determine whether expectations of automated vehicles are different from those of human drivers. And thirdly, we investigated whether these findings are country-specific or can be (partially) generalised to other countries. The perception of three means of communication in connection with the presence of a labelling as an automated vehicle (eHMI) was examined in two samples in Germany and England. 27 participants drove from a slip road onto the motorway and interacted with another vehicle. After a stretch on the motorway, they passed a second slip road on which there was a vehicle merging onto the participants lane. This was repeated six times to test all variables. After each situation, the perceived cooperativity and criticality was recorded, as well as the time headway (THW) to the other vehicle. This paper presents the findings from the UK sample and compares them with the German results, which were previously published. Results show, that when the cooperating vehicles are on the slip road, participants from both countries prefer this vehicle to decelerate. However, when participants themselves are on the slip road, expectations for vehicles on the target lane are ambiguous in the UK sample. Except for one aspect (perceived cooperativity of decelerating vehicles on the slip road), the perception of automated vehicles is similar to those of manual drivers. Also, UK participants do not maintain a different safety distance from these vehicles, while this is the case in the German sample. This paper contributes valuable insights into the cross-cultural evaluation of driving dynamics, shedding light on implications for the development and acceptance of automated vehicles. [ABSTRACT FROM AUTHOR]

Background: Atrial Fibrillation After Cardiac Surgery (AFACS) occurs in about one in three patients following Coronary Artery Bypass Grafting (CABG). It is associated with increased short- and long-term morbidity, mortality and costs. To reduce AFACS incidence, efforts are often made to maintain serum potassium in the high-normal range (≥ 4.5mEq/L). However, there is no evidence that this strategy is efficacious. Furthermore, the approach is costly, often unpleasant for patients, and risks causing harm. We describe the protocol of a planned randomized non-inferiority trial to investigate the impact of intervening to maintain serum potassium ≥ 3.6 mEq/L vs ≥ 4.5 mEq/L on incidence of new-onset AFACS after isolated elective CABG. Methods: Patients undergoing isolated CABG at sites in the UK and Germany will be recruited, randomized 1:1 and stratified by site to protocols maintaining serum potassium at either ≥ 3.6 mEq/L or ≥ 4.5 mEq/L. Participants will not be blind to treatment allocation. The primary endpoint is AFACS, defined as an episode of atrial fibrillation, flutter or tachycardia lasting ≥ 30 seconds until hour 120 after surgery, which is both clinically detected and electrocardiographically confirmed. Assuming a 35% incidence of AFACS in the 'tight control group', and allowing for a 10% loss to follow-up, 1684 participants are required to provide 90% certainty that the upper limit of a one-sided 97.5% confidence interval (CI) will exclude a > 10% difference in favour of tight potassium control. Secondary endpoints include mortality, use of hospital resources and incidence of dysrhythmias not meeting the primary endpoint (detected using continuous heart rhythm monitoring). Discussion: The Tight K Trial will assess whether a protocol to maintain serum potassium ≥ 3.6 mEq/L is non inferior to maintaining serum potassium ≥ 4.5 mEq/L in preventing new-onset AFACS after isolated CABG. Trial registration: ClinicalTrials.gov Identifier: NCT04053816. Registered on 13 August 2019. Last update 7 January 2021. [ABSTRACT FROM AUTHOR]

Beginning in the mid-1980s, European governments have increasingly implemented performance-based funding systems for higher education. While a focus on the transnational pressures that contributed to the widespread adoption of performance-based funding in Europe accounts for the impetus for performance-based funding policies, it fails to address how and why the resultant performance-based funding policies are as distinct and different as they are. In this paper, I argue that an institutional logics perspective offers a theoretical account of the performance-based funding policy formation process. I use the United Kingdom (UK), Germany, and France as case studies. I contend that in these three cases, different local logics drove the performance-based funding policy formation process. [ABSTRACT FROM AUTHOR]

Since 9/11, considerable research has been done on US interrogation and detention operations, but comparatively little is known about the involvement of other traditionally liberal states' intelligence agencies and their evolving perspectives on torture-related policies for foreigners abroad. Particularly, the United Kingdom and Germany provide interesting cases; despite similar levels of public and political pressure regarding their indirect involvement in Central Intelligence Agency's operations, the two states took different strategic decisions in 2010 on whether to implement new extraterritorial human rights safeguards. While the United Kingdom introduced a new intelligence guidance for interrogations overseas, the German government opted for policy-continuance, which raises the question why the two states embarked on different policy trajectories, even if they found themselves in contextually similar situations and were subjected to the comparable accountability measures. By bridging insights from Rationalist and normative literature, the article addresses this conundrum by clearly outlining the states' differing strategic preferences, and by dissecting the multi-layered composition of these interests. As a result, the article delineates how strategic constraints pertaining to the states' national, international, or political elite level affect decision-makers' policy responses. [ABSTRACT FROM AUTHOR]

Flashbulb memories (FBMs) refer to vivid and long-lasting autobiographical memories for the circumstances in which people learned of a shocking and consequential public event. A cross-national study across eleven countries aimed to investigate FBM formation following the first COVID-19 case news in each country and test the effect of pandemic-related variables on FBM. Participants had detailed memories of the date and others present when they heard the news, and had partially detailed memories of the place, activity, and news source. China had the highest FBM specificity. All countries considered the COVID-19 emergency as highly significant at both the individual and global level. The Classification and Regression Tree Analysis revealed that FBM specificity might be influenced by participants' age, subjective severity (assessment of COVID-19 impact in each country and relative to others), residing in an area with stringent COVID-19 protection measures, and expecting the pandemic effects. Hierarchical regression models demonstrated that age and subjective severity negatively predicted FBM specificity, whereas sex, pandemic impact expectedness, and rehearsal showed positive associations in the total sample. Subjective severity negatively affected FBM specificity in Turkey, whereas pandemic impact expectedness positively influenced FBM specificity in China and negatively in Denmark. [ABSTRACT FROM AUTHOR]

Background The interpretation of patient-reported outcomes requires appropriate comparison data. Currently, no patient-specific reference data exist for the Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF), Upper Extremity (UE), and Pain Interference (PI) scales for individuals 50 years and older. Questions/purposes (1) Can all PROMIS PF, UE, and PI items be used for valid cross-country comparisons in these domains among the United States, the United Kingdom, and Germany? (2) How are age, gender, and country related to PROMIS PF, PROMIS UE, and PROMIS PI scores? (3) What is the relationship of age, gender, and country across individuals with PROMIS PF, PROMIS UE, and PROMIS PI scores ranging from very low to very high? Methods We conducted telephone interviews to collect custom PROMIS PF (22 items), UE (eight items), and PI (eight items) short forms, as well as sociodemographic data (age, gender, work status, and education level), with participants randomly selected from the general population older than 50 years in the United States (n = 900), United Kingdom (n = 905), and Germany (n = 921). We focused on these individuals because of their higher prevalence of surgeries and lower physical functioning. Although response rates varied across countries (14% for the United Kingdom, 22% for Germany, and 12% for the United States), we used existing normative data to ensure demographic alignment with the overall populations of these countries. This helped mitigate potential nonresponder bias and enhance the representativeness and validity of our findings. We investigated differential item functioning to determine whether all items can be used for valid crosscultural comparisons. To answer our second research question, we compared age groups, gender, and countries using median regressions. Using imputation of plausible values and quantile regression, we modeled age-, gender-, and country-specific distributions of PROMIS scores to obtain patient-specific reference values and answer our third research question. Results All items from the PROMIS PF, UE, and PI measures were valid for across-country comparisons. We found clinically meaningful associations of age, gender, and country with PROMIS PF, UE, and PI scores. With age, PROMIS PF scores decreased (age ßMedian = -0.35 [95% CI -0.40 to -0.31]), and PROMIS UE scores followed a similar trend (age ßMedian = -0.38 [95% CI -0.45 to -0.32]). This means that a 10-year increase in age corresponded to a decline in approximately 3.5 points for the PROMIS PF score--a value that is approximately the minimumclinically important difference (MCID). Concurrently, we observed a modest increase in PROMIS PI scores with age, reaching half theMCIDafter 20 years. Women in all countries scored higher than men on the PROMIS PI and 1 MCID lower on the PROMIS PF and UE. Additionally, there were higher T-scores for the United States than for the United Kingdom across all domains. The difference in scores ranged from 1.21 points for the PROMIS PF to a more pronounced 3.83 points for the PROMIS UE. Participants from the United States exhibited up to half an MCID lower T-scores than their German counterparts for the PROMIS PF and PROMIS PI. In individuals with high levels of physical function, with each 10-year increase in age, there could be a decrease of up to 4 points in PROMIS PF scores. Across all levels of upper extremity function, women reported lower PROMIS UE scores than men by an average of 5 points. Conclusion Our study provides age-, gender-, and country-specific reference values for PROMIS PF, UE, and PI scores, which can be used by clinicians, researchers, and healthcare policymakers to better interpret patient-reported outcomes and provide more personalized care. These findings are particularly relevant for those collecting patient-reported outcomes in their clinical routine and researchers conducting multinational studies. We provide an internet application (www.common-metrics.org/PROMIS_ PF_and_PI_Reference_scores.php) for user-friendly accessibility in order to perform age, gender, and country conversions of PROMIS scores. Population reference values can also serve as comparators to data collected with other PROMIS short forms or computerized adaptive tests. Level of Evidence Level II, diagnostic study. [ABSTRACT FROM AUTHOR]

Financing entrepreneurship spurs innovation and economic growth. Digital financial platforms that crowdfund equity for entrepreneurs have emerged globally, yet they remain poorly understood. We model equity crowdfunding in terms of the relationship between the number of investors and the amount of money raised per pitch. We examine heterogeneity in the average amount raised per pitch that is associated with differences across three countries and seven platforms. Using a novel dataset of successful fundraising on the most prominent platforms in the UK, Germany, and the USA, we find the underlying relationship between the number of investors and the amount of money raised for entrepreneurs is loglinear, with a coefficient less than one and concave to the origin. We identify significant variation in the average amount invested in each pitch across countries and platforms. Our findings have implications for market actors as well as regulators who set competitive frameworks. [ABSTRACT FROM AUTHOR]

Despite its common usage, the meaning of 'democratic' in democratic intelligence oversight has rarely been spelled out. In this article, we situate questions regarding intelligence oversight within broader debates about the meanings and practices of democracy. We argue that the literature on intelligence oversight has tended to implicitly or explicitly follow liberal and technocratic ideas of democracy, which have limited the understanding of oversight both in academia and in practice. Thus, oversight is mostly understood as an expert, institutional and partially exclusive arrangement that is supposed to strike a balance between individual freedom and collective security, with the goal of establishing the legitimacy of and trust in intelligence work in a national setting. 'Healthy' or 'efficient' democratic oversight then becomes a matter of technical expertise, non-partisanship, and the ability to guard secrets. By analysing three moments of struggle around what counts as intelligence oversight across Germany, the UK, and the US, this article elucidates their democratic stakes. Through a practice-based approach, we argue that oversight takes much more agonistic, contentious, transnational, and public forms. However, these democratic practices reconfiguring oversight remain contested or contained by dominant views on what constitutes legitimate and effective intelligence oversight. [ABSTRACT FROM AUTHOR]

Introduction: Educators require focused training to foster the development of intercultural competence in nurses. Training programs for educators need to be based on a comprehensive profile with a focus on intercultural learning. This study aims to define and validate a profile of the Intercultural Nursing Educator (INE). Method: The Delphi method was used with an iterative, multi-stage process to transform opinions into group consensus. A total of 46 European, African, and American experts from the nursing and intercultural field participated. Inclusion criteria required English at a level of B2, expertise in the field of intercultural competence, experience in teaching intercultural competence in the nursing context, and publications focused on intercultural topics. Results: The INE profile was developed and all 126 competencies were validated. Discussion and conclusion: The profile is freely available on the project website and provides the basis for curricula, training programs and assessment of the required competences. [ABSTRACT FROM AUTHOR]

How families balance employment and the care of young children has become a focus of dynamic policy change in many high-income countries since the 1990s. While there has been a broad shift across the OECD away from male-breadwinner model work-family policy regimes, there is much variation in the extent to which policies targeted at fathers have been part of these changes. Examining this variation, this article compares two cases which both represent 'late path shifters' away from the male-breadwinner family model, yet whose trajectory in terms of 'father politics' are very different: Germany, which has introduced well-remunerated, non-transferable periods of leave for fathers, and the UK, where leave policy has remained overwhelmingly focused on mothers. This article seeks to explain these different trajectories through an analysis of the political role of ideas in the two processes of reform. Drawing on documentary analysis and interviews with policymakers, it argues that a substantial shift in ideas about the role of fathers underpinned the reforms in Germany, while no such shift took place in the UK. This difference is explained with reference to political conditions, which created similar but different windows of opportunity for change, and the impact of existing policy legacies. [ABSTRACT FROM AUTHOR]

Especially in young and middle adulthood, the integration of working and private life can be challenging. The current study showed a significant association between anxiety, stress, depressive symptoms and WLB in a sample of Generation Z. Thus, WLB can be considered a significant factor in mental health among Generation Z. Objective: Mental health can be negatively affected if work and private life demands are not balanced. This study proposes exploring work-life balance (WLB) as a predictor of Generation Z's mental health outcomes. Methods: A cross-sectional online study was conducted to collect data on mental health outcomes and WLB from a sample of Generation Z (N = 134). Three regression models were calculated to examine the predictive effect of WLB on stress, anxiety, and depressive symptoms. Results: The results show a strong statistically significant association between all three mental health outcomes. The regression model suggests work-life balance as a predictor of stress (β =.−0.404 P = 0.001, R2 = 0.16) and anxiety (β =.−256 P = 0.001, R2 = 0.06). Conclusion: WLB must be considered a significant factor in mental health problems among Generation Z. [ABSTRACT FROM AUTHOR]

Children and young people who come into conflict with the law tend to be disengaged with education and learning. This paper reports on research from an EU Erasmus+ project in Spain, Italy, Germany and the UK. The research focused on the impact of Authentic Inquiry (AI) on learners in custodial or youth justice settings and the impact on educators and their pedagogy. Quantitative data (from 82 educators and 73 young people), demonstrated the young people could be re-engaged with education and learning as evidenced in the change in Learning Power profiles. Qualitative data (from 16 educators and 14 young people) showed the greatest impact to be on the emotional component of engagement. The AI had an impact xon educators as learners by improved Learning Power profiles and on their pedagogical approach. Ways to embed the approach into education in youth justice settings in the different country contexts are discussed. [ABSTRACT FROM AUTHOR]

The current study tested whether the reported lower wellbeing of parents after preterm birth, relative to term birth, is a continuation of a pre-existing difference before pregnancy. Parents from Germany (the German Socio-Economic Panel Study, N = 10,649) and the United Kingdom (British Household Panel Study and Understanding Society, N = 11,012) reported their new-born's birthweight and gestational age, subsequently categorised as very preterm or very low birthweight (VP/VLBW, < 32 weeks or < 1500 g), moderately/late preterm or low birthweight (MLP/LBW, ≥ 32 weeks and < 37 weeks/≥ 1500 g and < 2500 g), or term-born (≥ 37 weeks and ≥ 2500 g). Mixed models were used to analyse life satisfaction, an aspect of wellbeing, at four assessments-two years and six months before birth and six months and two years afterwards. Two years before birth, satisfaction of prospective term-born, MLP/LBW, or VP/VLBW mothers did not significantly differ. However, mothers of VP/VLBWs had lower satisfaction relative to mothers of term-borns at both assessments post-birth. Among fathers, satisfaction levels were similarly equivalent two years before birth. Subsequently, fathers of VP/VLBWs temporarily differed in satisfaction six months post-birth relative to fathers of term-borns. Results indicate that parents' lower life satisfaction after VP/VLBW birth is not a continuation of pre-existing life satisfaction differences. [ABSTRACT FROM AUTHOR]

To describe clinical characteristics and regional treatment patterns of episodic cluster headache (CH). A point-in-time survey of physicians and their patients with CH was conducted in the United States, United Kingdom and Germany in 2017. Overall, 1012 patients with episodic CH were analyzed. Demographic and clinical findings were generally consistent across regions. Most patients were men (66.6%) and the mean age was 40.9 years. The greatest proportion of patients (38.3%) had ≤1 attack per day. The mean number of attacks per day (APD) was 2.4 and mean number of cluster periods per year was 2.6; the mean cluster period duration was 30.8 days. Most patients (69.3%) did not report a specific or predicable time when cluster periods occurred. Acute treatment was prescribed for 47.6% of patients, 10.3% of patients received preventive treatment, and 37.9% of patients received combined acute and preventive treatment; 4.2% of patients were not receiving treatment. Frequently prescribed acute treatments were sumatriptan, oxygen, and zolmitriptan; oxygen use varied considerably across countries and was prescribed least often in the United States. Frequently prescribed preventive treatments were verapamil, topiramate, and lithium. Lack of efficacy and tolerability were the most common reasons for discontinuing preventive treatment. We observed high use of acute treatments, but only half of patients used preventive treatments despite experiencing several cluster periods per year with multiple cluster APD. Further studies about the need for and benefits of preventive treatment for episodic CH are warranted. People with cluster headache (CH) experience headache attacks of excruciating stabbing pain, usually on one side of the head around the eye. These headache attacks typically last between 15 min and 3 h, and come in clusters (or bouts) occurring up to several times a day for a few weeks or months at a time. This greatly impacts a patient's quality of life. We surveyed doctors and their patients across the United States, the United Kingdom and Germany, looking at symptoms that occurred during CH attacks, how long the headache attacks lasted, how often the patient had them, and what medicines were being given. Our results showed that patients with CH suffered from clusters (bouts) of headache attacks several times a year. Nearly, a third of patients had a wrong diagnosis before being diagnosed with CH. Patients experienced stress, agitation, restlessness, difficulty relaxing and depression during a headache attack, especially those who had more CH attacks each day. Although many patients were taking medication, only half of patients were prescribed medicines to prevent their headache attack from starting. Side effects and the medicines not working were the most common reasons patients stopped taking medicine to prevent their headache attacks. The differences seen in medicines prescribed between countries suggest differences in guidance, or in doctors' awareness of current medication guidelines. Further studies about the need for and benefits of medicines to prevent CH attacks are needed. [ABSTRACT FROM AUTHOR]

The dramatic growth in health expenditures is an important health policy concern worldwide. Therefore, understanding the factors that increase health expenditures provides policy makers with evidence for decision-making. We aim to examine long-term effects of carbon dioxide emission, urbanization rate and GDP per capita on health expenditures. This study investigates the effect of carbon dioxide emission, urban population, and GDP per capita on health expenditure for 21 OECD countries over the period 1992–2018. Panel ARDL Approach and Gengenbach, Urbain and Westerlund Panel Co-integration Test have been used in the article. Test results indicate the long-run relationship among health expenditure and carbon dioxide emission, urban population, and GDP per capita. Effect of carbon dioxide emission (CO2), urban population, and GDP per capita is significant and positive on health expenditure. Rapid economic growths of OECD countries recently and environmental pollution have increased health expenditures in the long term. [ABSTRACT FROM AUTHOR]

Since the late 20th century, public discourse in Muslim‐minority countries has centered around the question of how to classify Muslims. In this paper, we compare the state, academic, and self‐classification of Muslims in two countries: the United Kingdom and Germany. We propose that the historical experience of anti‐Semitism makes religion a more salient master category to understand Muslims in Germany, while the history of both anti‐Semitism and anti‐Black racism largely resulting from colonial domination means that religion together with race are master categories used to understand Muslims in the United Kingdom. Through this multilayered ethnographic and historical analysis, we challenge taken‐for‐granted assumptions in both the political and academic milieu about what it means to be Muslim, emphasizing the importance of the interplay between sociopolitical categories and self‐identifications. [ABSTRACT FROM AUTHOR]

Simple Summary: Here, we report real-world treatment patterns and the overall survival of 104 patients with relapsing/refractory (R/R) MF who had received first-line therapy between 1984 and 2016. Our study found that second- and third-line therapies for R/RMF were heterogeneous, including systemic therapies, radiotherapy and topical therapies. More than two-thirds of patients at second- and third-line treatment received chemotherapy, and we observed that the median overall survival was longer with non-chemotherapy (not reached) vs. chemotherapy (6.5 years) treatment, suggesting that non-chemotherapy options may be more beneficial to patients. (1) Background: Most patients with mycosis fungoides (MF), a form of cutaneous T-cell lymphoma (CTCL), develop relapsed/refractory (R/R) disease following front-line systemic therapy. This report describes treatment patterns and outcomes from the subpopulation with R/R MF. (2) Methods: This observational, retrospective, cohort study analyzed patient records (1984–2016) from 27 clinical sites in Europe. Outcomes included treatments received, response to first-, second- and third-line treatment, overall survival (OS) and progression-free survival (PFS). (3) Results: Of 104 patients with MF, 100 received second-line and 61 received third-line therapy. The median (range) times from the start of first-line therapy to the first R/R MF and from the first to the second R/R MF were 11.2 (0.3–166.5) and 13.5 (0.0–174.6) months, respectively. Second-and third-line treatment options varied and comprised systemic therapies (85% and 79% of patients, respectively), radiotherapy (32% and 34%, respectively) and topical therapies (48% and 36%, respectively). The median (95% confidence interval [CI]) OS from the diagnosis of the first R/R MF was 11.5 (6.5–not reached [NR]) years and was higher with non-chemotherapy (NR) versus chemotherapy (6.5 years); the estimated median PFS (95% CI) from the time of the first R/R MF was 1.3 (1.0–2.1) years. (4) Conclusions: High rates of R/R disease were observed after second- and third-line treatments in this real-world cohort, with longer median OS in patients receiving non-chemotherapy treatment versus chemotherapy. Following the standard management of MF and using recently approved targeted therapies can help improve patient outcomes in advanced-stage MF. [ABSTRACT FROM AUTHOR]

Background: Individuals with migraine frequently experience pre- and post-headache symptoms. This analysis aimed to characterize the relative frequency and burden of pre- and post-headache symptoms in people with migraine using data collected through the Chronic Migraine Epidemiology and Outcomes – International Study. Methods: This cross-sectional, observational, web-based survey was conducted in 2021–2022 in Canada, France, Germany, Japan, the United Kingdom, and the United States. Respondents who met modified International Classification of Headache Disorders, 3rd edition, criteria were offered the opportunity to participate. Information collected included migraine-related disability, depression/anxiety symptoms, cutaneous allodynia, activity limitations, and acute treatment optimization. Respondents indicated how often they had pre- or post-headache symptoms using a 5-point scale, ranging from 0 to 4, with a rating of 2 or higher classified as a pre- or post-headache symptom case. Modeling was used to examine relationships with monthly headache days (MHDs) and activity limitations during pre-headache and post-headache phases. Results: Among a total of 14,492 respondents, pre-headache symptoms were reported by 66.9%, while post-headache symptoms were reported by 60.2%. Both pre-headache and post-headache symptoms were reported by 49.5% of respondents, only pre-headache by 17.4%, only post-headache by 10.7%, and neither pre- nor post-headache symptoms by 22.4%. Compared with respondents who experienced only pre- or post-headache symptoms, respondents who experienced both pre- and post-headache symptoms had the highest rates of 4–7, 8–14, and ≥ 15 monthly headache days (23.1%, 14.1%, and 10.9%, respectively). Of respondents with both pre- and post-headache symptoms, 58.5% reported moderate-to-severe disability, 47.7% reported clinically significant symptoms of depression, 49.0% reported clinically significant symptoms of anxiety, and 63.8% reported cutaneous allodynia with headache (ASC-12). Moderate-to-severe activity limitations were reported during the pre-headache (29.5%) and post-headache phases (27.2%). For all outcomes modeled, after controlling for covariates, having pre-headache symptoms, post-headache symptoms, or both were associated with worse outcomes than having neither. Conclusions: Pre- and post-headache phases of migraine are common, carry unrecognized burden, and may be a target for treatment. [ABSTRACT FROM AUTHOR]

The construct of justice sensitivity has four perspectives that capture individual differences in the strength of reactions to injustice when becoming a victim of injustice (victim sensitivity), when witnessing injustice as an outsider (observer sensitivity), when passively benefitting from an injustice done to others (beneficiary sensitivity), or when committing an injustice (perpetrator sensitivity). Individual differences in these four justice sensitivity perspectives are highly relevant in moral research. With just eight items in total, the Justice Sensitivity Short Scales–8 (JSS-8) are a very efficient way to measure the four perspectives. JSS-8 was initially constructed in German (Ungerechtigkeitssensibilität-Skalen–8, USS-8) and later translated into English. In the present study, we empirically validated this English-language adaptation in a heterogeneous quota sample from the UK. The results show that the psychometric properties (i.e., reliability, validity, standardization) of JSS-8 are good, and that they are comparable with those of the German-language source version. Because of the invariance of loadings, intercepts, and residual variances, researchers can compare manifest scale statistics (i.e., means, variances) of JSS-8 across the UK and Germany. JSS-8 is thus particularly suitable for measuring justice sensitivity in various research areas with constraints on assessment time and questionnaire space. [ABSTRACT FROM AUTHOR]

Background: Levodopa (LD) is the most effective drug to treat Parkinson's disease (PD). The recently concluded multinational Parkinson's Real-World Impact Assessment (PRISM) trial revealed highly variable prescription patterns of LD monotherapy across six European countries. The reasons remain unclear. Methods: In this post hoc analysis of PRISM trial data, we used multivariate logistic regression analysis to identify socio-economic factors affecting prescription practice. We applied receiver-operated characteristics and split sample validation to test model accuracy to predict treatment class (LD monotherapy vs. all other treatments). Results: Subject age, disease duration, and country of residence were significant predictors of treatment class. The chance of receiving LD monotherapy increased by 6.9% per year of age. In contrast, longer disease duration reduced the likelihood of receiving LD monotherapy by 9.7% per year. Compared to the other countries, PD patients in Germany were 67.1% less likely and their counterparts in the UK 86.8% more likely to receive an LD monotherapy. The model classification accuracy of treatment class assignment was 80.1%. The area under the curve to predict treatment condition was 0.758 (95% CI [0.715, 0.802]). Split sample validation revealed poor sensitivity (36.6%), but excellent specificity (92.7%) to predict treatment class. Conclusion: The relative lack of socio-economic variables affecting prescription practice in the study sample and limited model accuracy to predict treatment class suggest the presence of additional, country-specific factors affecting prescription patterns that were not assessed in the PRISM trial. Our findings indicate that physicians still avoid prescribing LD monotherapy to younger PD patients. [ABSTRACT FROM AUTHOR]

Participation and accessibility issues faced by gamers with multi-sensory disabilities are themes yet to be fully understood by accessible technology researchers. In this work, we examine the personal experiences and perceptions of individuals with deafblindness who play games despite their disability, as well as the reasons that lead some of them to stop playing games. We conducted 60 semi-structured interviews with individuals living with deafblindness in five European countries: United Kingdom, Germany, Netherlands, Greece and Sweden. Participants stated that reasons for playing games included them being a fun and entertaining hobby, for socialization and meeting others, or for occupying the mind. Reasons for stop playing games included essentially accessibility issues, followed by high cognitive demand, changes in gaming experience due their disability, financial reasons, or because the accessible version of a specific game was not considered as fun as the original one. We identified that a considerable number of individuals with deafblindness enjoy playing casual mobile games such as Wordfeud and Sudoku as a pastime activity. Despite challenging accessibility issues, games provide meaningful social interactions to players with deafblindness. Finally, we introduce a set of user-driven recommendations for making digital games more accessible to players with a diverse combination of sensory abilities. Digital games were considered a fun and entertaining hobby by participants with deafblindness. Furthermore, participants play games for socialization and meeting others, or for occupying the mind. Digital games provide meaningful social interactions and past time to persons with deafblindness. On top of accessibility implications, our findings draw attention to the importance of the social element of gaming for persons with deafblindness. Based on interviews, we introduce a set of user-driven recommendations for making digital games more accessible to players with a diverse combination of sensory abilities. [ABSTRACT FROM AUTHOR]

Comparative studies of agricultural biotechnology regulation have highlighted differences in the roles that science and politics play in decision-making. Drawing on documentary and interview evidence in the United States, the United Kingdom, and Germany, we consider how the "regulatory cultures" that guided national responses to earlier generations of agricultural biotechnology have developed, alongside the emergence of genome editing in food crops. We find that aspects of the "product-based" regulatory approach have largely been maintained in US biosafety frameworks and that the British and German approaches have at different stages combined "process-based" and "programmatic" elements that address the scientific and sociopolitical novelty of genome editing to varying degrees. We seek to explain these patterns of stability and change by exploring how changing opportunity structures in each jurisdiction have enabled or constrained public reasoning around emerging agricultural biotechnologies. By showing how opportunity structures and regulatory cultures interact over the long-term, we provide insights that help us to interpret current and evolving dynamics in the governance of genome editing and the longer-term development of agricultural biotechnology. [ABSTRACT FROM AUTHOR]

Aim: Balanced crop nutrition is key to improve nutrient use efficiency and reduce environmental impact of farming systems. We developed and tested a dynamic model to predict the uptake of P and K in long-term experiments to better understand how changes in soil nutrient pools affect nutrient availability in crop rotations. Methods: Our RC-KP model includes labile and stable pools for P and K, with separate labile pools for placed P and organic fertilizers including farm yard manure (FYM). Pool sizes and crop-specific relative uptake rates determined potential uptake. Actual crop uptake from labile pools was based on concepts developed by Janssen et al. (Geoderma 46:299-318, 1990). The model was calibrated on three long-term experiments from Kenia (Siaya), Germany (Hanninghof) and the United Kingdom (Broadbalk) to estimate parameter values for crop-specific relative uptake rates and site-specific relative transfer rates. Results: The model described N, P and K uptake accurately with a Nash-Sutcliff modelling efficiency of 0.6–0.9 and root mean squared errors of 2.6–3.4 kg P ha−1 and 14–20 kg K ha−1. Excluding organic labile pools did not affect model accuracy in Broadbalk in contrast to Hanninghof where Mg deficiencies affected crop uptakes in treatments without Mg or FYM. Conclusions: This relatively simple model provides a novel approach to accurately estimate N, P and K uptake and explore short- and long-term effects of fertilizers in crop rotations. Interactions between limiting nutrients affecting actual nutrient uptake were captured well, providing new options to include N, P and K limitations in crop growth models. [ABSTRACT FROM AUTHOR]

This paper explores people's acts of disengagement from activist campaign and group spaces in the context of border struggle activism in Germany and the UK as fugitive practices of refusal. These acts of disengagement took the form of remaining silent or intentionally distracted, sleeping during activist meetings, distancing oneself from activist groups during conversations, or completely withdrawing from these spaces. The paper approaches these acts, first, as practices of refusal that expose notions of the political rooted in liberal struggles over power and freedom as not only risky but also inherently self‐defeating and, second, as radically optimistic and vitalising practices of recovery and care that insist on alternative modes of thinking, practising, and experiencing sociality and the political that can inspire us to consider political agency in relation to wider abolitionist projects. [ABSTRACT FROM AUTHOR]

Summary: We studied the characteristics of patients prescribed osteoporosis medication and patterns of use in European databases. Patients were mostly female, older, had hypertension. There was suboptimal persistence particularly for oral medications. Our findings would be useful to healthcare providers to focus their resources on improving persistence to specific osteoporosis treatments. Purpose: To characterise the patients prescribed osteoporosis therapy and describe the drug utilization patterns. Methods: We investigated the treatment patterns of bisphosphonates, denosumab, teriparatide, and selective estrogen receptor modulators (SERMs) in seven European databases in the United Kingdom, Italy, the Netherlands, Denmark, Spain, and Germany. In this cohort study, we included adults aged ≥ 18 years, with ≥ 1 year of registration in the respective databases, who were new users of the osteoporosis medications. The study period was between 01 January 2018 to 31 January 2022. Results: Overall, patients were most commonly initiated on alendronate. Persistence decreased over time across all medications and databases, ranging from 52–73% at 6 months to 29–53% at 12 months for alendronate. For other oral bisphosphonates, the proportion of persistent users was 50–66% at 6 months and decreased to 30–44% at 12 months. For SERMs, the proportion of persistent users at 6 months was 40–73% and decreased to 25–59% at 12 months. For parenteral treatment groups, the proportions of persistence with denosumab were 50–85% (6 month), 30–63% (12 month) and with teriparatide 40–75% (6 month) decreasing to 21–54% (12 month). Switching occurred most frequently in the alendronate group (2.8–5.8%) and in the teriparatide group (7.1–14%). Switching typically occurred in the first 6 months and decreased over time. Patients in the alendronate group most often switched to other oral or intravenous bisphosphonates and denosumab. Conclusion: Our results show suboptimal persistence to medications that varied across different databases and treatment switching was relatively rare. [ABSTRACT FROM AUTHOR]

Background: Generic drug legislation, i.e., simultaneously banning groups of drugs, has been introduced worldwide to counteract the trade and use of emerging "new psychoactive substances" (NPSs) more effectively. Summary: The potential and de facto positive and negative effects of generic drug legislation have been described using an analysis based on documented evaluations of the experiences in the UK and Germany, supplemented with data from other publicly available sources. In particular, the effects of generic drug legislation on availability, use, sales, and overall health harms of NPS, and switches from NPS to traditional (classical) drugs are addressed. The results show that the introduction of generic drug legislation in the UK and Germany has enabled stricter regulation of NPS but has also led to some major harms within the domain of public health. Depending on the population considered, the rate of NPS use remained stable, slightly declined, or increased following the banning of NPS. Once banned, NPSs were more often purchased on the black market, often together with other (more harmful) drugs. Moreover, NPS-related harms did not reduce following the ban, and in some cases even increased. Finally, when harmful NPS, like potent synthetic opioids and cannabinoids, become substantially used and endanger public health, legislators already have the legal means to ban the problem drug, thus overruling the need for a generic ban. Key Messages: Generic drug legislation may facilitate drug law enforcement, but it is not (very) effective in counteracting NPS use and it may increase NPS-related public health problems. It is concluded that, overall, the advantages of generic drug legislation are overshadowed by its serious disadvantages. [ABSTRACT FROM AUTHOR]

Background: Real‐world evidence is increasingly used to guide treatment and regulatory decisions for non‐small cell lung cancer (NSCLC). Real‐world treatment patterns and clinical outcomes among patients with advanced/metastatic NSCLC in France, Germany, Italy, Spain, and the UK (EU5) were assessed. Methods: This retrospective physician‐completed patient chart review assessed treatment patterns (regimen, duration of treatment [DOT], time to discontinuation), and clinical outcomes (duration of response [DOR], progression‐free survival [PFS], and overall survival [OS]) of patients with stage IIIB/C or IV NSCLC who received pembrolizumab‐based first‐line induction chemotherapy. Results: Overall, 322 patients were included; at first‐line maintenance (1LM), 92% had stage IV NSCLC, 68% had nonsquamous histology, and 89% had no central nervous system (CNS)/brain metastasis. The two most common 1LM regimens were pembrolizumab monotherapy (76% overall) and pembrolizumab + pemetrexed (21% overall). Docetaxel monotherapy was the most common second‐line regimen in all countries except Germany (54% overall). For 1LM therapy, the overall median DOT and DOR were 5 and 10 months, respectively; PFS was 7 months and OS was 8 months. Germany had a longer duration of each outcome except for DOR which was longer in Spain. Clinical outcomes were generally poorer for patients with squamous histology and CNS/brain metastases. Conclusions: This study demonstrated differences in treatment patterns and clinical outcomes in NSCLC across the EU5 and patient subgroups. Improved survival was generally associated with response to first‐line therapy, nonsquamous histology, and CNS/brain metastases absence. These real‐world data provide valuable insights which may aid treatment decision‐making and clinical trial design. [ABSTRACT FROM AUTHOR]

As social and health inequalities deepen around the world, scholarship in occupational therapy and occupational science has increasingly emphasised the role of occupation as a powerful tool in transformative processes. To explore how opportunities for everyday doing together may contribute to processes of social transformation by identifying ways occupation is being taken up in socially-transformative practice. A generic descriptive qualitative case study design was utilised in order to describe current practice examples and identify ways occupation was being taken up in five initiatives working towards social transformation located in Canada, Germany, South Africa and the United Kingdom. Focussing on the positioning of occupation within the initiatives, three themes were developed: The intentionality of the process, the nature of occupation within the initiatives, and the role of occupation within the processes of social transformation. Providing examples of agency on the micro level and of engagement with socioeconomic, political and cultural power structures at the societal level, this analysis raises important considerations in addressing how occupational therapy practice can move in socially responsive and transformative directions. [ABSTRACT FROM AUTHOR]

A cornerstone of well-being research is that the resource-rich are happier with their lives than the resource-poor and better positioned to cope with stressful life events. This paper addresses the role of various resources—human, economic, social, and psychological capital—in life satisfaction during the coronavirus pandemic, using panel data from Germany and the United Kingdom for 2020 and 2021. Cross-sectionally, we find life satisfaction to be clearly related to all these forms of capital, with psychological capital being the strongest predictor of life satisfaction. Longitudinally, the capital endowments in 2020 did not predict changes in life satisfaction within individuals from 2020 to 2021, except for psychological capital. Our results suggest two things: first, the unfolding pandemic did not heighten well-being inequalities; and second, weathering the pandemic required psychological resources in the first place. [ABSTRACT FROM AUTHOR]

The inclusion of the natural environment in the theory, education and practice of social work has increasingly become a matter of interest amongst scholars and social work educators. There is a large and increasing amount of literature on this topic. However, the inclusion of environmental issues in the curricula seems to be evolving very slowly to date. This paper examines 94 social work curricula in four European countries, and notes the presence of environmental issues in their content, by using term categories. Findings show that the natural environment is extremely under-represented in the education of social workers. The paper argues that social work curiccula need to undergo immediate reform on an international level. The discussion section includes suggestions on how the natural environment could be integrated into social work curricula. The first suggestion is to create new subjects with a direct reference to environmental issues and green social work. The second one is to include in existing subjects topics that will draw on environmental sociology and focus on the interconnections between social and environmental problems. [ABSTRACT FROM AUTHOR]

Digital health technologies (DHTs) can optimise healthcare costs and improve quality and efficiency of care. However, the fast-paced rate of innovation and varying evidence standards can make it difficult for decision-makers to assess these technologies in an efficient and evidence-based manner. We sought to develop a comprehensive framework to assess the value of novel patient-facing DHTs used to manage chronic diseases by eliciting stakeholder value preferences. Literature review and primary data collection from a three-round web-Delphi exercise was utilized. 79 participants from 5 stakeholder groups (patients, physicians, industry, decision makers, and influencers) and 3 countries (United States of America, United Kingdom, and Germany) took part. Likert scale data were statistically analyzed to determine intergroup differences in both country and stakeholder groups, stability of results, and overall consensus. The resulting co-created framework comprised 33 stable indicators with consensus from quantitative value judgments across domains: health inequalities, data rights and governance, technical and security, economic characteristics, clinical characteristics, and user preferences. Lack of stakeholder consensus was observed on the importance of value-based care models, optimizing resources for sustainable systems, and stakeholder involvement in DHT design, development, and implementation; however, this was because of high rates of neutrality and not negative judgments. Supply-side actors and academic experts were the most unstable stakeholder groups. Stakeholder value judgments revealed a need for a coordinated regulatory and health technology assessment policy response that updates laws to meet technological innovations, offers a pragmatic approach to evidence standards to assess DHTs, and involves stakeholders to understand and meet their needs. • Digital health technologies (DHTs) differ from traditional medical technologies because they involve widespread, and sometimes continuous, collection, analysis, and transmission of patient data after market entry. There is currently no technology-agnostic wide-reaching value framework for evaluating DHTs, capturing multiple stakeholder value preferences in different health system archetypes. Through a Delphi exercise, we incorporated diverse stakeholder viewpoints from the United Kingdom, United States, and Germany to propose an evidence-based value framework for assessing patient-facing DHTs focused on chronic disease management. • Statistically significant stakeholder consensus relates to clinical and economic characteristics, which align with current regulations and health technology assessment methodologies and around value indicators that are not reflected in current regulations and health technology assessment policies, particularly regarding personal data rights. Lack of stakeholder consensus centers around the importance of value-based care models, optimizing resources for sustainable systems, and stakeholder involvement in DHT design, development, and implementation and results from high rates of neutrality rather than negative judgments. • We have created a value framework comprising 33 stable indicators with consensus across 6 value domains, notably health inequalities, data rights and governance, technical and security, economic characteristics, clinical characteristics and user preferences. Included indicators are split between ratings of "very important" and "important" resulting from consensus between key stakeholder groups consisting of patients, physicians, supply-side actors, decision makers, and influencers. Decision makers can utilize this framework when assessing potential technologies to include in their health system packages. [ABSTRACT FROM AUTHOR]

Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners. [ABSTRACT FROM AUTHOR]

The book "Britain and the German Churches, 1945–1950. The role of the Religious Affairs Branch in the British zone" by Peter Howson explores the often overlooked period following Germany's defeat in World War II. Howson argues that historians have focused too much on the German church struggle during the Third Reich and neglect the post-war reconstruction period. The book examines the role of the Religious Affairs Branch, which was responsible for denazification and overseeing the German churches. It highlights the challenges faced by the branch, including inter-departmental conflicts and tensions with the German hierarchy. The book also discusses the ecumenical efforts and visits by British church figures to Germany during this time. Overall, the book provides valuable insights into the complex dynamics between religion, politics, and reconstruction in post-war Germany. [Extracted from the article]

Background: The term 'pandemic paranoia' has been coined to refer to heightened levels of mistrust and suspicion towards other people specifically due to the COVID-19 pandemic. In this study, we examine the international prevalence of pandemic paranoia in the general population and its associated sociodemographic profile. Methods: A representative international sample of general population adults (N = 2510) from five sites (USA N = 535, Germany N = 516, UK N = 512, Australia N = 502 and Hong Kong N = 445) were recruited using stratified quota sampling (for age, sex, educational attainment) and completed the Pandemic Paranoia Scale (PPS). Results: The overall prevalence rate of pandemic paranoia was 19%, and was highest in Australia and lowest in Germany. On the subscales of the PPS, prevalence was 11% for persecutory threat, 29% for paranoid conspiracy and 37% for interpersonal mistrust. Site and general paranoia significantly predicted pandemic paranoia. Sociodemographic variables (lower age, higher population size and income, being male, employed and no migrant status) explained additional variance and significantly improved prediction of pandemic paranoia. Conclusions: Pandemic paranoia was relatively common in a representative sample of the general population across five international sites. Sociodemographic variables explained a small but significant amount of the variance in pandemic paranoia. [ABSTRACT FROM AUTHOR]

The article describes the process of recruiting a researcher with a learning disability at a United Kingdom (UK) university. Topics discussed include how the editors choose the paper, the job application process, and how the team works together. The support needed by people with learning disabilities when they apply for a job is also mentioned.

Götz Aly's book Hitler's Beneficiaries considers the Nazi regime an "accommodating dictatorship." According to Aly, the majority of the population benefited from the Nazis' war. He sums up Nazi tax policy under the headings "Tax Breaks for the Masses" and "Tax Rigor for the Bourgeoisie." This perspective represented progress in that, until then, tax policy had not featured in any of the major historical overviews of National Socialism. For a more in-depth assessment of Nazi tax policy, however, it must be compared against the tax policies of Germany's wartime enemies. I compare tax policies in Germany, Britain, and the United States and show that Aly's theories do not hold. They are neither consistent with the declared intentions of those who imposed these policies nor with the results as reflected in the relevant statistics. [ABSTRACT FROM AUTHOR]

Background: Data are limited regarding the combined impact of headache frequency and failure of preventive medication (efficacy and/or tolerability) on the humanistic/economic burden of migraine. Methods: A retrospective, cross-sectional analysis of 2020 National Health and Wellness Survey (NHWS) data was conducted. An opt-in online survey identified adults in France, Germany, Italy, Spain, and United Kingdom with self-reported physician-diagnosed migraine. Participants with ≥ 4 monthly headache days (MHDs) were stratified by prior preventive medication use/failure (preventive naive; 0–1 failure; ≥ 2 failures). Quality-of-life and economic outcomes were compared among groups using generalized linear modeling. Results: Among individuals with ≥ 4 MHDs (n = 1106), the NHWS identified 298 (27%) with ≥ 2 failures, 308 (28%) with 0–1 failure, and 500 (45%) as preventive naive. Individuals with ≥ 2 failures versus preventive-naive individuals had significantly lower scores on the 12-Item Short Form Survey Physical Component Summary (42.2 vs 44.1; P < 0.005), numerically higher scores on the Mental Component Summary (39.5 vs 38.5; P = 0.145), significantly higher scores on the Migraine Disability Assessment (39.1 vs 34.0; P < 0.05), and significantly higher prevalence of depression symptoms (62% vs 47%; P < 0.001) and anxiety symptoms (42% vs 31%; P < 0.01). The ≥ 2 failures group versus the preventive-naive group also had significantly more functional impairment as assessed by mean numbers of migraine-specific missed work days (7.8 vs 4.3) and household activities days (14.3 vs 10.6) in the past 6 months (P < 0.001) as well as the prevalence of absenteeism (19% vs 13%), overall work impairment (53% vs 42%), and activity impairment (53% vs 47%) (all P < 0.05). Emergency department visits (0.7 vs 0.5; P = 0.001) and hospitalizations (0.5 vs 0.3; P < 0.001) in the past 6 months were significantly higher in the ≥ 2 failures group versus the preventive-naive group, while indirect costs (€13,720 vs €11,282) and the proportion of individuals with non-adherence during the past 7 days (73% vs 64%) were numerically higher. Conclusions: Increased burden, quality-of-life impairment, and functional impairment exist among individuals with migraine experiencing ≥ 4 MHDs and more treatment failures. While cause and directionality cannot be determined, these results suggest the need for effective preventive migraine treatments. [ABSTRACT FROM AUTHOR]

Objective: Research has just begun to identify American college students who study abroad as a group at-risk for sexual violence victimization. The purpose of the current study was to examine the context of these incidents. Participants: We utilized a large longitudinal sample of 2,428 United States college students studying abroad for between 4 and 21 weeks in 12 different foreign countries. Methods: We estimated descriptive statistics and logistic regression models to assess prevalence and correlates of sexual victimization abroad, as well as effect size comparisons to quantify changes in drinking abroad. Results: Over one-fifth of students experienced sexual violence while abroad, including sexual assault and verbal coercion. Women, younger students, those who experienced sexual violence prior, and heavier drinkers had the greatest odds of sexual violence victimization abroad. Conclusions: Findings point to the need for evidence-based programming to reduce sexual violence risk among American college students studying in foreign countries. [ABSTRACT FROM AUTHOR]

What is the causal impact of terrorism on immigration policy preferences? Under what circumstances and due to which psychological micro-mechanisms does this impact materialize? To answer these questions, we provide evidence from pre-registered and well-powered experiments for Germany and the United Kingdom. We find that anti-immigration responses to terrorism follow an emotional proximity rationale: terrorism leads to more restrictive migration policy preferences only among individuals with high levels of perceived insecurity, especially when terrorism occurs in their own country. Policy preferences are not affected by terrorism abroad or by information cues on the objectively low probability of being victimized. [ABSTRACT FROM AUTHOR]

Objective: We analyze the effect of job loss on couple's fertility within 5 years, in the United Kingdom and Germany. We contribute to the literature by assessing to what extent a man's and a woman's job loss is consequential. Further, we study the effects based on couples' income, earnings division between partners, parental status, and women's age. Background: A job loss may decrease the couple's fertility as a drop in resources reduces parents' investments to devote to a newborn—or it may increase the risk of a new birth because a job loss reduces the opportunity cost of a birth, especially if the woman loses her job. Method: We analyze couples from large population‐representative panel surveys in Germany (N = 15,029) and the United Kingdom (N = 15,932) containing yearly information about employment, relationship status, and fertility histories. We carry out estimates with linear probability models and inverse probability weighting methods. Results: Our results show that men's and, to a large extent, women's job loss negatively affects the chances of birth, especially in the United Kingdom. The subgroups mostly hit are income‐egalitarian/female breadwinner and childless couples, with women in their mid‐20 s up to late 30 s in the United Kingdom; income‐egalitarian/male‐breadwinner families, with 35‐year to 40‐year‐old women and one child in Germany; middle‐income couples are relatively more affected in both countries. Conclusion: A job loss makes couples less likely to have a child, particularly if the affected partner is a woman. The income effect jointly with other "unemployment scars" likely prevails on the reduction of opportunity costs of job loss. [ABSTRACT FROM AUTHOR]

In fixing the place and provider for the resolution of disputes in advance, choice of court agreements increase procedural legal certainty and the predictability of litigation risks. Hence, their protection is crucial. This article undertakes a functional comparison of the remedies for breach of exclusive choice of court agreements in English and German courts, painting a picture of different approaches to a common problem. English courts, now no longer constrained by EU law, employ an entire arsenal of remedies, most strikingly the anti-suit injunction and damages effectively reversing a foreign judgment. In contrast, German courts exercise greater judicial restraint, even though damages for the breach of a choice of court agreement have recently been awarded for the first time. Against this backdrop, two distinct but interrelated reasons for the diverging approaches are identified and analysed, the different conceptions of choice of court agreements and the different roles of comity and mutual trust. [ABSTRACT FROM AUTHOR]

Objectives: Masculinity is sometimes presumed to be a cause of mental health problems and antisocial behavior in men. This study sought to identify the predictors of men’s mental well-being, including their attitudes to masculinity. Methods: 4,025 men from the UK and Germany (GDR) were asked about their core values, which areas of their life they felt were important, and their opinions about masculinity., Their mental well-being was measured using the Positive Mindset Index (PMI). Multiple linear regression assessed the degree to which their answers were linked to their mental well-being. Results: The results in both countries were similar. The main predictors of higher PMI scores were Personal Growth Satisfaction (UK β = 0.211; t = 6.146; P < 0.0000005; GDR β = 0.160; t = 5.023; P < 0.000001), Age (being older) (UK β = 0.150; t = 4.725; P < 0.00001; GDR β =0.125; t = 4.075; P < 0.00005), not taking a Negative view of Masculinity (UK β = 0.101; t = −3.458; P < 0.001; GDR β = −0.118; t = −4.014; P < 0.0001), and Health Satisfaction (UK β = 0.124; t = 3.785; P < 0.0001; GDR β = 0.118; t = 3.897; P < 0.0001). In addition, in the UK, Education Satisfaction was the fourth strongest predictor of PMI (β = 0.105; t = 3.578; P < 0.0005), and in Germany, Having a Positive View of Masculinity was the fifth strongest predictor of PMI (β = 0.097; t = 3.647; P < 0.0005). Conclusions: These findings are discussed in relation to whether the negative view of masculinity often cited in the media and elsewhere is having a negative impact on men’s mental health. [ABSTRACT FROM AUTHOR]

Simple Summary: As a direct consequence of the COVID-19 pandemic, cancer screening programs, management of chronic disease and cancer treatments were either cancelled or delayed. 164 patients with hepatocellular cancer (HCC) were evaluated to understand the impact of the first lockdown on treatment delays, and 1-year survival. We observed that 70% of patients were not treated within 31 days, with the median time to treatment being 49 days. This was particularly true of those with early-stage disease undergoing surgical or interventional radiology treatment. However, we noted that delay to treatment had no impact on mortality at 1-year. Given the diversity of the patients included in the study, we investigated possible factors influencing treatment delay, such as age, ethnicity, and geographical location. None of these factors were found to be associated with treatment delays. Future studies with longer follow-up are needed to assess whether delay to treatment had a negative impact on patients' survival. Our study allows a better understanding of treatment delays and short-term impact on survival during severe health services disruptions. Findings from this study highlight the need for better prioritisation of HCC treatment services particularly for the management of early-stage disease during any future pandemic lockdown. Introduction: The COVID-19 pandemic has caused severe disruption of healthcare services worldwide and interrupted patients' access to essential services. During the first lockdown, many healthcare services were shut to all but emergencies. In this study, we aimed to determine the immediate and long-term indirect impact of COVID-19 health services utilisation on hepatocellular cancer (HCC) outcomes. Methods: A prospective cohort study was conducted from 1 March 2020 until 30 June 2020, correlating to the first wave of the COVID-19 pandemic. Patients were enrolled from tertiary hospitals in the UK and Germany with dedicated HCC management services. All patients with current or past HCC who were discussed at a multidisciplinary meeting (MDM) were identified. Any delay to treatment (DTT) and the effect on survival at one year were reported. Results: The median time to receipt of therapy following MDM discussion was 49 days. Patients with Barcelona Clinic Liver Cancer (BCLC) stages-A/B disease were more likely to experience DTT. Significant delays across all treatments for HCC were observed, but delay was most marked for those undergoing curative therapies. Even though severe delays were observed in curative HCC treatments, this did not translate into reduced survival in patients. Conclusion: Interruption of routine healthcare services because of the COVID-19 pandemic caused severe delays in HCC treatment. However, DTT did not translate to reduced survival. Longer follow is important given the delay in therapy in those receiving curative therapy. [ABSTRACT FROM AUTHOR]