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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]

An introduction is presented in which the editor discusses various articles on topics including ENT specialist training in the United Kingdom, providing valuable insights for aspiring ENT surgeons regarding portfolio building, competitiveness of the process, and strategies for success.

The discourse of deservingness has been mobilised against certain groups in the UK society navigating UK labour markets, among them refugees and asylum seekers. These discourses, leading to the stigmatisation of the unemployed are coupled with an emphasis on the importance of individuals taking responsibility to develop their 'employability'. Little attention has been paid to scrutinise the contrast between the deservingness rhetoric and policy making with the actual conditions newcomers, and in particular refugees and asylum seekers, are confronted with when seeking employment. Our paper fills such a gap by indicating key contradictions at the heart of labour market integration in the UK. On the one hand, the emphasis on deservingness is coupled with policy discourses that construct an environment shaped by welfare and labour market chauvinism. On the other hand, the policy architecture is fundamentally flawed in a number of ways in terms of the support mechanisms necessary to ensure that newcomers can successfully integrate into the labour market. [ABSTRACT FROM AUTHOR]

Employment subsidies are important active labour market policy (ALMP) tools, suited to a variety of labour market challenges. This paper engages with recent ALMP categorisation debates by appraising Cronert's (2019) recent typology of employment subsidies. It uses empirical material to assess the typology's explanatory power and produce insights to inform further typological development. The illustrative case of the British ' Wage Incentive' (2012-2014) is used to assess the typology's analytical purchase. Cronert's typology helpfully identifies key distinctions in the distributional profiles of employment subsidies, but further understanding of the category is impeded by the practice of defining them as demand-side interventions. The paper argues for a reappraisal of their supply-side characteristics, maintaining that the (potential) worker should be included in the analysis, and that employment subsidies' relationship with training and job creation should be acknowledged. It proposes a redefinition of employment subsidies reflecting their real-world use, and suggests a framework for further exploring varieties of employment subsidy design from the perspective of beneficiaries. [ABSTRACT FROM AUTHOR]

Summary: Electroencephalogram-based evidence was accepted in a UK law court for the first time in 1939. This paper gives an account of that case, not previously clinically reported, and the individuals involved. Why it was not published in the literature at the time is explored and parallels with more recent technologies are highlighted. [ABSTRACT FROM AUTHOR]

Immigration measures such as deportation are currently not regarded as punitive and there has been little exploration of this from a legal perspective. This paper will consider this issue in depth, covering little discussed case law from the European Court of Human Rights. It will also explore how this legal position on deportation does not reflect the findings of other disciplines such as criminology and sociology on how immigration measures are used and experienced as punitive. This paper will build on existing literature by demonstrating the significance of a recent development in UK law to this debate. Section 47 of the Nationality and Borders Act 2022 (NBA 2022) introduced a 'stop the clock' provision into the Early Removal Scheme for foreign national prisoners. This new provision may prompt the judiciary to revisit the question of whether deportation is punitive in some contexts. [ABSTRACT FROM AUTHOR]

Introduced in the United Kingdom in 2012, Universal Credit (UC) is a welfare benefit that replaces six working-age 'legacy' benefits for out-of-work and low-income people. Designed with the aim of simplifying benefits and incentivising paid work, UC represents a deepening of conditionality in the British welfare state. Considering these developments, this paper quantitatively investigates the effect of UC on recipients' life satisfaction. Data from the United Kingdom Household Longitudinal Study is analysed, primarily using a fixed-effects regression approach. Results reveal a significantly negative effect of UC recipience on life satisfaction. Robustness checks and alternative model specifications, including difference-in-differences and inverse probability weighting, confirm this finding. Additionally, mediation models give credence to the idea that UC also negatively affects life satisfaction indirectly by increasing psychological distress. Heterogeneity tests indicate that UC has a less negative effect on single parents' life satisfaction compared to non-parents. Meanwhile, UC has a significantly more negative effect on the life satisfaction of people not in paid work (for reasons other than unemployment) than those in paid work. Discussion focuses on the potential effect of welfare conditionality specifically, and implications for future research and policy are explored. [ABSTRACT FROM AUTHOR]

How does protest affect political speech? Protest is an important form of political claim-making, yet our understanding of its influence on how individual legislators communicate remains limited. Our paper thus extends a theoretical framework on protests as information about voter preferences, and evaluates it using crowd-sourced protest data from the 2017–2019 Fridays for Future protests in the UK. We combine these data with ~2.4m tweets from 553 legislators over this period and text data from ~150k parliamentary speech records. We find that local protests prompted MPs to speak more about the climate, but only online. These results demonstrate that protest can shape the timing and substance of political communication by individual elected representatives. They also highlight an important difference between legislators' offline and online speech, suggesting that more work is needed to understand how political strategies differ across these arenas. [ABSTRACT FROM AUTHOR]

The Attorney General for England and Wales is the Government's Senior Law Officer who, inter alia, initiates certain kinds of legal proceedings. She is also a politician: a member of the House of Commons or the House of Lords and appointed to Government by the Prime Minister. This paper considers the Attorney General's role in initiating contempt proceedings against fellow politicians. I detail a number of cases where politicians have been involved in potential contempts by publication. I argue that, in such cases, the Attorney General's position may amount to an actual or perceived conflict of interest and may breach the principle that justice should be seen to be done. [ABSTRACT FROM AUTHOR]

Coronations in Great Britain previously offered an occasion for national civic and spiritual renewal. However, the recent crowning of Charles III threw a spotlight on some of the deepening dissonance, diversity and divisions within British society. This paper is an 'in principle' argument for change and development. As the clamour for constitutional reform in the United Kingdom continues, and the awkwardness of Church of England bishops sitting in the House of Lords becomes more apparent, the time is ripe to reconsider disestablishment. In particular, the power and privilege of one denomination over all others is interrogated in relation to a kenotic ecclesiology, and which may now require the intentional divesting of kingly power: not clinging to status any longer, but self-emptying and embracing equality. [ABSTRACT FROM AUTHOR]

Objective: Warthin's tumours are the second most common benign parotid tumours in the UK. The World Health Organization states that 5–14 per cent of patients have bilateral Warthin's tumours. This study aimed to: assess the presence of contralateral Warthin's tumours in patients who underwent surgery over the past 16 years at a head and neck unit in England, and perform the first systematic literature review on bilateral Warthin's tumours. Methods: A retrospective analysis was conducted on patients diagnosed with Warthin's tumour based on histology between 2005 and 2020. Additionally, a systematic review (International Prospective Register of Systematic Reviews ('PROSPERO') registration number: CRD42022326846) was performed using PubMed and the Cochrane Library. Results: Among 290 patients diagnosed with Warthin's tumours based on histology following surgery, 24.5 per cent had bilateral Warthin's tumours. The systematic review identified 157 papers, with 14 meeting the inclusion criteria. Conclusion: This study revealed that 24.5 per cent of patients had bilateral Warthin's tumours, deviating from the suggested range. These findings are of interest to surgeons discussing the disease with patients. [ABSTRACT FROM AUTHOR]

Previous research has found varied effects of informal care provision on the carer's health status. Few studies have, however, examined this relationship dynamically. This paper is the first to analyse trajectories of care among men and women in mid-life and their impact on health outcomes using a nationally representative prospective cohort study. Data from three waves of the United Kingdom (UK) National Child Development Study (N = 7,465), when the respondents were aged 46, 50 and 55, are used to derive care trajectories capturing the dynamics of care provision and its intensity. Logistic regression investigates the impact of caring between the ages of 46 and 55 on the carers' report of depression and poor health at age 55. At age 46, 9 per cent of men and 16 per cent of women provided some level of informal care; rising to 60 per cent for both genders at ages 50 and 55. Just 7 per cent of women and 4 per cent of men provided care at all observation points, with the most common trajectory being 'starting to care' at ages 50 or 55. New carers experienced a lower risk of depression at age 55, reflecting that they may not have experienced the caring role long enough to have an adverse impact on their wellbeing. The findings highlight that the majority of individuals with surviving parents experience caring at some point during mid-life, underlining the need for further longitudinal research to better understand the complex relationships between care-giving and health for different groups of cares. [ABSTRACT FROM AUTHOR]

Policymakers are liable to 'treasure what is measured' and overlook phenomena that are not. In an era of increased reliance on administrative data, existing policies also often determine what is measured in the first place. We explore this two-way interaction between measurement and policy in the context of the investment incomes and capital gains that are missing from the UK's official income statistics. We show that these 'missing incomes' change the established picture of economic inequality over the past decade, revealing rising top income shares during the period of austerity. The underestimation of these forms of income in official statistics has hidden the impact of tax policies that disproportionately benefit the wealthiest. We urge a renewed focus on how policy affects and is affected by measurement. [ABSTRACT FROM AUTHOR]

This paper summarizes key shifts in judicial decisions relating to public health powers during the pandemic and the implications of those decisions for public health practice. Then, it gives a preview and call for partnership in developing a legal framework for authority that guides public health to better activities, processes, and accountability in service of the public's health. [ABSTRACT FROM AUTHOR]

Although there has been significant research on the relationship between alcohol consumption and demographic and psychological influences, this does not consider the effect of social influence among older drinkers and if these effects differ between men and women. One aspect of social influence is social capital. The aim of this paper is to examine whether relational and cognitive social capital are associated with higher or lower risk of alcohol use among adults aged 50 years or older and to assess the extent to which this relationship differs between men and women. To investigate this, data were collected from a cross-sectional questionnaire survey of adults over the age of 50 in the United Kingdom who were recruited from general practitioners. The sample consisted of 9,984 individuals whose mean age was 63.87 years. From these data, we developed proxy measures of social capital and associate these with the respondent's level of alcohol consumption as measured on the Alcohol Use Disorders Identification Test (AUDIT-10) scale. In the sample, just over 20 per cent reported an increasing risk or dependency on alcohol. Using two expressions of social capital – relational (social relationships) and cognitive (knowledge acquisition and understanding) – we found that greater levels of both are associated with a reduced risk of higher drinking risk. Being female had no significant effect when combined with relational capital but did have a significant effect when combined with cognitive capital. It is argued that interventions to enhance social relations among older people and education to help understand alcohol risks would be helpful to protect older people from the damaging effects of excessive alcohol consumption. [ABSTRACT FROM AUTHOR]

Inter- and intragenerational relationships are known to be important in maintaining the wellbeing of older people. A key aspect of these relationships is the exchange of both emotional and instrumental social support. However, relatively little is known about how this exchange of support changes in the context of widespread disruption. The COVID-19 pandemic provides an opportunity to examine how older people's family relationships are impacted by such social change. The present qualitative study explores how older people in the United Kingdom experienced changes in inter- and intragenerational support during the COVID-19 pandemic. Participants (N = 33) were recruited through a large-scale nationally representative survey (https://www.sheffield.ac.uk/psychology-consortium-covid19). We asked how life had been pre-pandemic, how they experienced the first national lockdown and what the future might hold in store. The data were analysed using constructivist grounded theory. This paper focuses on the importance of family relationships and how they changed as a consequence of the pandemic. We found that the family support system had been interrupted, that there were changes in the methods of support and that feelings of belonging were challenged. We argue that families were brought into disequilibrium through changes in the exchange of inter- and intragenerational support. The important role of grandchildren for older adults was striking and challenged by the pandemic. The significance of social connectedness and support within the family had not changed during the pandemic, but it could no longer be lived in the same way. The desire to be close to family members and to support them conflicted with the risk of pandemic infection. Our study found support for the COVID-19 Social Connectivity Paradox: the need for social connectedness whilst maintaining social distance. This challenged family equilibrium, wellbeing and quality of life in older people. [ABSTRACT FROM AUTHOR]

This paper compares social policy responses to the cost-of-living crisis in the United Kingdom (UK) and Ireland. In seeking to protect citizens from an inflationary shock, a series of fundamental social policy questions arise. What would the aims of support packages be? To what extent should support be universal or targeted? If targeted, did existing policy architectures facilitate or frustrate the targeting of support? As the scale and persistence of the inflationary shock became evident, smaller and near-universal responses gave way to larger support packages with a greater reliance on targeting. Social security systems played an important role in policy responses, though often by passporting one-off payments rather than a strengthening of these core programmes. Passporting led both to improved distributional outcomes vis-à-vis the more universal elements but created new administrative challenges and led to rough justice in some circumstances. The reliance on one-off payments underlined the temporary nature of policy responses. [ABSTRACT FROM AUTHOR]

Prenatal vitamin D deficiency is widely reported and may affect perinatal outcomes. In this secondary analysis of the UK Pregnancies Better Eating and Activity Trial, we examined vitamin D status and its relationship with selected pregnancy outcomes in women with obesity (BMI ≥ 30 kg/m2) from multi-ethnic inner-city settings in the UK. Determinants of vitamin D status at a mean of 17 ± 1 weeks' gestation were assessed using multivariable linear regression and reported as percent differences in serum 25-hydroxyvitamin D (25(OH)D). Associations between 25(OH)D and clinical outcomes were examined using logistic regression. Among 1089 participants, 67 % had 25(OH)D < 50 nmol/l and 26 % had concentrations < 25 nmol/l. In fully adjusted models accounting for socio-demographic and anthropometric characteristics, 25(OH)D was lower among women of Black (% difference = −33; 95 % CI: −39, −27), Asian (% difference = −43; 95 % CI: −51, −35) and other non-White (% difference = −26; 95 % CI: −35, −14) ethnicity compared with women of White ethnicity (n 1086; P < 0·001 for all). In unadjusted analysis, risk of gestational diabetes was greater in women with 25(OH)D < 25 nmol/l compared with ≥ 50 nmol/l (OR = 1·58; 95 % CI: 1·09, 2·31), but the magnitude of effect estimates was attenuated in the multivariable model (OR = 1·33; 95 % CI: 0·88, 2·00). There were no associations between 25(OH)D and risk of preeclampsia, preterm birth or small for gestational age or large-for-gestational-age delivery. These findings demonstrate low 25(OH)D among pregnant women with obesity and highlight ethnic disparities in vitamin D status in the UK. However, evidence for a greater risk of adverse perinatal outcomes among women with vitamin D deficiency was limited. [ABSTRACT FROM AUTHOR]

This article examines UK newspaper coverage during the first wave of the COVID-19 pandemic March-August 2020. A qualitative framing analysis of public messaging on age in five high circulation newspapers provides a detailed account of who is deemed to be at risk of dying from COVID-19. Newspapers represent older people as most at risk, with disability as a secondary factor. Reports on who is responsible, who is at risk, and who is to blame for deaths from COVID-19 are framed as issues of public health and generational fairness, with individual responsibility occupying a prominent role. We also find two counter-frames. First, in letters to the editor, older people's pleas for freedom are framed as a fight for their civil liberties. Second, newspapers praise 99-year-old Captain Tom Moore and frame his behaviour as a source of national pride. We identify this as positive ageism. We conclude that reporting across progressive and conservative newspapers reflects age-based stereotypes and paternalism towards older people. Public figures are represented as scapegoats or heroes, offering distraction from the less newsworthy fact that long-term under-investment in social care increased the risk of dying amongst the old and disabled during the pandemic. [ABSTRACT FROM AUTHOR]

Although reduced working time and furlough policy initiatives are widely regarded as important for economic and business reasons, little is known about their impacts on workers' mental health at the onset of COVID-19 pandemic. Using data from the UK Household Longitudinal Panel Study data from 2018 to February 2020 and April 2020 and change score analysis, this study aims to compare mental health changes between those who worked reduced hours, were furloughed and left/lost paid work. The results suggest that at the onset of COVID-19 reduced working time and furlough can protect workers' mental health, but only for men not for women. The gender differences remain significant even after controlling for housework and childcare responsibilities at the onset of COVID-19. These results highlight the importance of distributing paid work more equitably and formulating gender-sensitive labour market policies in protection of workers' mental health. [ABSTRACT FROM AUTHOR]

Across many countries, increases in inequality driven by rising top incomes and wealth have not been accompanied by growing popular concern. In fact, citizens in unequal societies are less concerned than those in more egalitarian societies. Understanding how the general public perceive richness is an essential step towards resolving this paradox. We discuss findings from focus group research in London, UK, a profoundly and visibly unequal city, which sought to explore public perceptions of richness and the rich. Participants from diverse socio-economic backgrounds discussed their views of the 'wealthy' and the 'super rich' with reference to both vast economic resources and more intangible aspects, including, crucially, security. High levels of wealth and income were perceived to be necessary for achieving security for oneself and one's family. The security of the rich was discussed in contrast to participants' own and others' insecurity in the context of a (neo)liberal welfare regime – specifically, insecurity about housing, personal finances, social security, health care and the future of the welfare state. In unequal countries, where insecurity is widespread, lack of confidence in collective welfare state provision may serve in the public imagination to legitimate private wealth accumulation and richness as a form of self-protection. [ABSTRACT FROM AUTHOR]

Like much of the European centre-left, Britain's Labour Party has struggled to appeal to its former core working class support base in recent years. However, this is largely a failure to connect with the 'white working class' (WWC) specifically, whereas support among ethnic minorities remains robust. We hypothesise that Labour could be experiencing a 'trade-off', whereby efforts to cater to minorities harm its perceived ability to represent WWC interests. We test this thesis by examining whether WWC voters are more likely to view minority and working class representation in zero-sum terms and shun Labour when they associate the party with minority interests. We show that the WWC are somewhat less likely to view working class and ethnic minority representation as strongly correlated, and Labour's perceived ability to represent minorities is negatively associated with WWC support. This is not (primarily) about ethnocentrism. Instead, we suggest that 'relative political deprivation' is crucial. [ABSTRACT FROM AUTHOR]

Background: Multimorbidity, the presence of two or more health conditions, has been identified as a possible risk factor for clinical dementia. It is unclear whether this is due to worsening brain health and underlying neuropathology, or other factors. In some cases, conditions may reflect the same disease process as dementia (e.g. Parkinson's disease, vascular disease), in others, conditions may reflect a prodromal stage of dementia (e.g. depression, anxiety and psychosis). Aims: To assess whether multimorbidity in later life was associated with more severe dementia-related neuropathology at autopsy. Method: We examined ante-mortem and autopsy data from 767 brain tissue donors from the UK, identifying physical multimorbidity in later life and specific brain-related conditions. We assessed associations between these purported risk factors and dementia-related neuropathological changes at autopsy (Alzheimer's-disease related neuropathology, Lewy body pathology, cerebrovascular disease and limbic-predominant age-related TDP-43 encephalopathy) with logistic models. Results: Physical multimorbidity was not associated with greater dementia-related neuropathological changes. In the presence of physical multimorbidity, clinical dementia was less likely to be associated with Alzheimer's disease pathology. Conversely, conditions which may be clinical or prodromal manifestations of dementia-related neuropathology (Parkinson's disease, cerebrovascular disease, depression and other psychiatric conditions) were associated with dementia and neuropathological changes. Conclusions: Physical multimorbidity alone is not associated with greater dementia-related neuropathological change; inappropriate inclusion of brain-related conditions in multimorbidity measures and misdiagnosis of neurodegenerative dementia may better explain increased rates of clinical dementia in multimorbidity [ABSTRACT FROM AUTHOR]

Background: The rising number of dementia diagnoses and imminent adoption of disease-modifying treatments necessitate innovative approaches to identify individuals at risk, monitor disease course and intervene non-pharmacologically earlier in the disease course. Digital assessments of dementia risk and cognitive function have the potential to outperform traditional in-person assessments in terms of their affordability, accuracy and longitudinal tracking abilities. However, their accessibility and reliability in older adults is unclear. Aims: To evaluate the usability and reliability of a smartphone assessment of lifestyle and cognitive factors relevant to dementia risk in a group of UK-based older adults. Method: Cognitively healthy adults (n = 756) recruited through the Dementias Platform UK Great Minds volunteer register completed three assessments of cognitive function and dementia risk over a 3-month period and provided usability feedback on the Five Lives smartphone application (app). We evaluated cognitive test scores for age, gender and higher education effects, normality distributions, test–retest reliability and their relationship with participants' lifestyle dementia risk factors. Results: Participants found the app 'easy to use', 'quick to complete' and 'enjoyable'. The cognitive tests showed normal or near-to-normal distributions, variable test–retest reliabilities and age-related effects. Only tests of verbal ability showed gender and education effects. The cognitive tests did not correlate with lifestyle dementia risk scores. Conclusions: The Five Lives assessment demonstrates high usability and reliability among older adults. These findings highlight the potential of digital assessments in dementia research and clinical practice, enabling improved accessibility and better monitoring of cognitive health on a larger scale than traditional in-person assessments. [ABSTRACT FROM AUTHOR]

Background: Phase three trials of the monoclonal antibodies lecanemab and donanemab, which target brain amyloid, have reported statistically significant differences in clinical end-points in early Alzheimer's disease. These drugs are already in use in some countries and are going through the regulatory approval process for use in the UK. Concerns have been raised about the ability of healthcare systems, including those in the UK, to deliver these treatments, considering the resources required for their administration and monitoring. Aims: To estimate the scale of real-world demand for monoclonal antibodies for Alzheimer's disease in the UK. Method: We used anonymised patient record databases from two National Health Service trusts for the year 2019 to collect clinical, demographic, cognitive and neuroimaging data for these cohorts. Eligibility for treatment was assessed using the inclusion criteria from the clinical trials of donanemab and lecanemab, with consideration given to diagnosis, cognitive performance, cerebrovascular disease and willingness to receive treatment. Results: We examined the records of 82 386 people referred to services covering around 2.2 million people. After applying the trial criteria, we estimate that a maximum of 906 people per year would start treatment with monoclonal antibodies in the two services, equating to 30 200 people if extrapolated nationally. Conclusions: Monoclonal antibody treatments for Alzheimer's disease are likely to present a significant challenge for healthcare services to deliver in terms of the neuroimaging and treatment delivery. The data provided here allows health services to understand the potential demand and plan accordingly. [ABSTRACT FROM AUTHOR]

Background: Nasogastric tube feeding under physical restraint is an intervention that clinicians working in specialist mental health in-patient units may need to implement. Aims: To examine the impact of this intervention on people with lived experience, carers and staff. Method: People with lived experience and parents and/or carers were recruited via UK eating disorder charity Beat. Clinicians were recruited via the British Eating Disorders Society's research forum. Qualitative semi-structured interviews were conducted and transcribed, and the results were thematically analysed. Results: Thirty-six participants took part, and overlapping themes were identified. All participants spoke in relation to four themes: (a) the short-term impact on the patient; (b) the impact on those around the patient; (c) the long-term impact; and (d) the positive impact. Subthemes were identified and explored. Conclusion: This lifesaving intervention can also negatively affect patients, parents and carers, peers and staff. Further research is needed to understand how interactions and environmental modifications can mitigate the negative impacts. [ABSTRACT FROM AUTHOR]

Background: To address if the long-standing association between maternal infection, depression/anxiety in pregnancy, and offspring neurodevelopmental disorder (NDD) is causal, we conducted two negative-control studies. Methods: Four primary care cohorts of UK children (pregnancy, 1 and 2 years prior to pregnancy, and siblings) born between 1 January 1990 and 31 December 2017 were constructed. NDD included autism/autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual disability, cerebral palsy, and epilepsy. Maternal exposures included depression/anxiety and/or infection. Maternal (age, smoking status, comorbidities, body mass index, NDD); child (gender, ethnicity, birth year); and area-level (region and level of deprivation) confounders were captured. The NDD incidence rate among (1) children exposed during or outside of pregnancy and (2) siblings discordant for exposure in pregnancy was compared using Cox-regression models, unadjusted and adjusted for confounders. Results: The analysis included 410 461 children of 297 426 mothers and 2 793 018 person-years of follow-up with 8900 NDD cases (incidence rate = 3.2/1000 person years). After adjustments, depression and anxiety consistently associated with NDD (pregnancy-adjusted HR = 1.58, 95% CI 1.46–1.72; 1-year adj. HR = 1.49, 95% CI 1.39–1.60; 2-year adj. HR = 1.62, 95% CI 1.50–1.74); and to a lesser extent, of infection (pregnancy adj. HR = 1.16, 95% CI 1.10–1.22; 1-year adj. HR = 1.20, 95% CI 1.14–1.27; 2-year adj. HR = 1.19, 95% CI 1.12–1.25). NDD risk did not differ among siblings discordant for pregnancy exposure to mental illness HR = 0.97, 95% CI 0.77–1.21 or infection HR = 0.99, 95% CI 0.90–1.08. Conclusions: Maternal risk appears to be unspecific to pregnancy: our study provided no evidence of a specific, and therefore causal, link between in-utero exposure to infection, common mental illness, and later development of NDD. [ABSTRACT FROM AUTHOR]

Observational evidence linking dietary n -3 PUFA intake and health outcomes is limited by a lack of robust validation of dietary intake using blood n -3 PUFA levels and potential confounding by fish oil supplement (FOS) use. We investigated the relationship between oily fish intake, FOS use and plasma n -3 PUFA levels in 121 650 UK Biobank (UKBB) participants. Ordinal logistic regression models, adjusted for clinical and lifestyle factors, were used to quantify the contribution of dietary oily fish intake and FOS use to plasma n -3 PUFA levels (measured by NMR spectroscopy). Oily fish intake and FOS use were reported by 38 % and 31 % of participants, respectively. Increasing oily fish intake was associated with a higher likelihood of FOS use (P < 0·001). Oily fish intake ≥ twice a week was the strongest predictor of high total n -3 PUFA (OR 6·7 (95 % CI 6·3, 7·1)) and DHA levels (6·6 (6·3, 7·1). FOS use was an independent predictor of high plasma n -3 PUFA levels (2·0 (2·0, 2·1)) with a similar OR to that associated with eating oily fish < once a week (1·9 (1·8, 2·0)). FOS use was associated with plasma n -3 PUFA levels that were similar to individuals in the next highest oily fish intake category. In conclusion, FOS use is more common in frequent fish consumers and modifies the relationship between oily fish intake and plasma n -3 PUFA levels in UKBB participants. If unaccounted for, FOS use may confound the relationship between dietary n -3 PUFA intake, blood levels of n -3 PUFAs and health outcomes. [ABSTRACT FROM AUTHOR]

Outcomes Based Commissioning (OBC) – for example, Pay for Success (in the US) or Payment by Results (in the UK) – has been suggested as a way to provide 'more' social services for 'less' public resources. Such commissioning is often linked with an innovative financing tool called a Social Impact Bond (SIB). Using data from the Social Finance UK Database and focusing on SIBs in the US and UK, we evaluate whether the SIB approach aligns with the theoretical predictions of social innovation. The results provide limited evidence that SIBs facilitate capital injections from the private sector into the production of social goods as well as facilitate parts of the process of social innovation – namely, piloting and scaling. We conclude that there is significant variation, both between the US and UK and within the US, in social innovation ecosystems and the role played by SIBs. [ABSTRACT FROM AUTHOR]

Terrorism elicits strong public reactions immediately after the attack, with important implications for democratic institutions and individual well-being. Are these effects short-lived? We answer this question using a natural experiment design and combining data on terrorist attacks in the United Kingdom with a Continuous Monitoring Survey. We find that heightened risk perceptions and emotional reactions in the wake of deadly attacks do not dissipate in the very short run but are sustained over time and up to 120 days after the attacks. Whereas large-scale attacks cause a long-lasting shift in risk assessments and emotions, the corresponding effect of smaller-scale terrorism incidents appears to subside within one month. Overall, the impact of terrorism does not fade away easily. [ABSTRACT FROM AUTHOR]

Experiments on the responsiveness of elected officials highlight the tension between the freedom to carry out research and the right of subjects to be treated with respect. Controversy emerges from the power of politicians to block or object to experimental designs using identity deception. One way to resolve this conundrum is to consult citizens who, as constituents of politicians, have an interest in promoting the accountability of elected representatives. Building on the work of Desposato and Naurin and Öhberg, this survey experiment presented research designs to UK citizens for their evaluation. The findings show that citizens strongly approve of experimental research on Members of Parliament (MPs) and are glad to see their representatives participate. There are no differences in support whether designs use identity deception, debriefing, confederates or pre-agreement from MPs. Linked to high interest in politics, more citizens are glad their MPs participate in studies using identity deception than those deploying confederates. [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]

Changes in the labour market, high rates of working age poverty, major welfare reforms and more recently the Covid-19 pandemic have drawn renewed attention to income security. Existing research has identified the important role of relational support in helping people cope with low income, but less is known about the role of support for those coping with the potentially destabilising effects of income change which can affect people over relatively short periods of time. This article focuses on how relational coping strategies are utilised by those experiencing such income change. The data are drawn from a qualitative longitudinal study of the experience of income change and insecurity in 15 low-income households in the UK which included repeated in-depth interviews and weekly financial diaries completed in periods of up to five months. The article explores the relational strategies adopted by participants to 'get by' as well as examining how strategies are adopted by those on different levels of low income and with differing networks. The article argues that these strategies illuminate the importance of income change in the experience of low-income households, develop the concept of income insecurity, and provide lessons for policy in providing flexible and responsive support when income changes. [ABSTRACT FROM AUTHOR]

Background. Paliperidone palmitate 3-monthly (PP3M) has been tested in 1-year controlled studies. The aim of this study was to examine the relapse outcomes with PP3M monotherapy at 3 years in patients with schizophrenia. Methods. This was an observational, non-interventional study of patients started on PP3M according to their clinical need. All patients had a diagnosis of schizophrenia (ICD-10 F20) and were between 18 and 65 years of age. The study took place in a mental health facility in South East London, UK. Results. Among the 166 patients who started PP3M, 97 (58%) met inclusion criteria and were observed for 36 months. In total, five patients (5%) experienced a relapse (defined as step-up in clinical care) while on PP3M. There were no relapses between months 18 and 36. Of the original 97 patients, 56 (58%) remained on PP3M monotherapy at 3 years, and 71 (73%) remained on either PP3M or paliperidone palmitate one-monthly. Reasons for discontinuation of PP3M included patient refusal (n = 11, 33% of discontinuations) and adverse effects in (n = 8, 24%). Conclusion. PP3M is a highly effective monotherapy treatment for reducing relapse in people with schizophrenia. [ABSTRACT FROM AUTHOR]

Summary: Several jurisdictions across the globe have introduced legislation to legally permit the sale and consumption of recreational cannabis. This editorial considers current evidence from the rest of the world and asks how this might inform the possible consequences of 'legalisation' models in the UK. [ABSTRACT FROM AUTHOR]

Background: This paper investigates whether age of onset of depression, duration of the last episode, number of episodes, and residual symptoms of depression and anxiety are associated with depression relapse in primary care patients who have been on long-term maintenance antidepressant treatment and no longer meet ICD10 criteria for depression., Methods: An observational cohort using data from ANTLER ( N = 478), a double-blind placebo-controlled trial. The primary outcome was time to relapse using the retrospective CIS-R. Participants were followed for 12 months., Results: Primary outcome was available for 468 participants. Time to relapse in those with more than five previous episodes of depression was shorter, hazard ratio (HR) 1.84 (95% confidence interval [CI] 1.23-2.75) compared to people with two episodes; HR 1.57 (95% CI 1.01-2.43) after adjustment. The residual symptoms of depression at baseline were also associated with increased relapse: HR 1.05 (95% CI 1.01-1.09) and HR 1.06 (95% CI 1.01-1.12) in the adjusted model. There was evidence of reduced rate of relapse in older age of onset group: HR 0.86 (95% CI 0.78-0.95); HR attenuated after adjustment HR 0.91 (95% CI 0.81-1.02). There was no evidence of an association between duration of the current episode and residual anxiety symptoms with relapse., Conclusions: The number of previous episodes and residual symptoms of depression were associated with increased likelihood of relapse. These factors could inform joint decision making when patients are considering tapering off maintenance antidepressant treatment or considering other treatments to prevent relapse.

In 1960 Sir Solly Zuckerman proposed the idea of an interdisciplinary department of 'environmental sciences' (ENV) for the newly established University of East Anglia (UEA). Prior to this point, the concept of 'environmental sciences' was little known: since then, departments and degree courses have rapidly proliferated through universities and colleges around the globe. This paper draws on archival research to explore the conditions and contexts that led to the proposal of a new and interdisciplinary grouping of sciences by Zuckerman. It argues that the activities of Zuckerman and other scientists in Britain during the Second World War and in the post-war period helped to create fertile conditions for a new kind of scientific authority to emerge as a tool of governance and source of policy advice. In particular, the specific challenges of post-war Britain - as addressed through scientific advisers and civil servants - led to the 'environment' becoming both the subject of sustained scientific study and an object of concern.

For the past two decades anti-abortionists in the Global North have been aggressively instrumentalising disability in order to undermine women's social autonomy, asserting, falsely, there is an insuperable conflict between disability rights and reproductive rights. The utilisation of disability in struggles over abortion access is not new, it has a history dating back to the interwar era. Indeed, decades before anti-abortionists' campaign, feminists invoked disability to expand access to safe abortion. This paper examines the feminist eugenics in the first organisation dedicated to liberalising restrictive abortion laws, the Abortion Law Reform Association (ALRA), established in England in 1936. ALRA played a vital role in the passage of the Abortion Act 1967 (or the Act) that greatly expanded the grounds for legal abortion, a hugely important gain for women in Britain and beyond seeking legal, safe abortions. In addition, the Act permitted eugenic abortion, which also had transnational effects: within a decade, jurisdictions in numerous Commonwealth countries passed abortion laws that incorporated the Act's eugenics clause, sometimes verbatim. This essay analyses ALRA's role in codifying eugenics in the Abortion Act 1967 and argues that from the outset, ALRA was simultaneously a feminist and eugenist association. Initially, ALRA prioritized their feminist commitment to 'voluntary motherhood' in their campaign whereas starting in the 1940s, they subordinated feminism to negative eugenics, a shift that was simultaneously strategic and a reflection of genuine concern to prevent the birth of children with disabilities.