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THE LINK TO THE ARTICLE FOR THIS DATA SET IS: http://hdl.handle.net/10344/4205, This is the data set for the article titled “Psychological distress and coping amongst higher education students: A mixed method enquiry”. Published online in PLOS ONE. The data was collected in the 2010/2011 academic year. Two files are included, the raw data file and a file which contains the codes used for the data.

Bilingualism was implemented in the Community of Madrid (Spain) more than ten years ago, through the incorporation of the English language in the teaching methods of certain schools. Since that time, various research projects have been carried out, with the objective of comparing the academic performance of students in bilingual schools with those in nonbilingual schools. The present paper makes use of primary education data from the Department of Education and Research for the Community of Madrid in an effort to analyze whether or not bilingualism results in the relative improvement of educational outcomes achieved in primary schools in the Region of Madrid, in Spain. More specifically, the data used is from sixth grade classrooms, given that, generally speaking, in this grade all schools give a standardized test which measures academic performance in Math, Science and Technology, Spanish Language Arts and English Language Arts. Our assessment makes use of a multinomial logit model, and includes the most common variables found in the research on the determination of educational outcomes (variables related to whether or not schools are bilingual, which is the main focus of this paper), as well as other less common variables considered to be relevant. These include absenteeism, satisfaction levels among families and students, and the percentage of students in second chance programs. The results show that bilingualism does not lower children performance in the subjects taught in English or in the subjects taught in Spanish. Academic performance in Mathematics, Scienceand Technology, and Spanish Language Arts is similar with respect to those schoolswhich are not bilingual. However, results in English are significantly higher in bilingual schools when compared to non-bilingual schools., Una pequeña parte por Mutua Madrileña, Depto. de Economía Aplicada, Pública y Política, Fac. de Ciencias Económicas y Empresariales, TRUE, pub

Air pollution is one of the most severe environmental problems that Mexico is currently facing. The objective of this paper is to quantify the most relevant socioeconomic driving forces behind air polluting emissions and, more specifically, 7 local pollutants in Mexico. We do so in a multilevel version of the Stochastic Impacts by Regression on Population, Affluence and Technology (STIRPAT) model that accounts for the spatial heterogeneity at the municipal level across the country. The results show that the most relevant variables to determine the emissions of atmospheric pollutants are the population, the harvested area and the number of cars, while technological development helps to mitigate such emissions. The ecological elasticities are, in all cases, smaller than one. Our purpose is to provide quantitative information about these socioeconomic driving forces of air deterioration as a basis to establish some recommendations for environmental policy decision-making., Depto. de Análisis Económico y Economía Cuantitativa, Fac. de Ciencias Económicas y Empresariales, TRUE, pub

INTRODUCTION: Approximately 2 million babies are stillborn annually worldwide, most in low- and middle-income countries. Present review studies of the parental and healthcare providers' experiences of stillbirth often include a variety of settings, which may skew the findings as the available resources can vary considerably. In high-income countries, the prevalence of stillbirth is low, and support programs are often initiated immediately when a baby with no signs of life is detected. There is limited knowledge about what matters to parents, siblings, and healthcare providers when a baby is stillborn in high-income countries. OBJECTIVES: This systematic review and interpretive meta-synthesis aim to identify important aspects of care and support for parents, siblings, and healthcare professionals in high-income countries from the diagnosis of stillbirth throughout the birth and postpartum period. METHODS: A systematic review and qualitative meta-synthesis were conducted to gain a deeper and broader understanding of the available knowledge about treatment and support when stillbirth occurred. Relevant papers were identified by systematically searching international electronic databases and citation tracking. The quality of the included studies was assessed, and the data was interpreted and synthesised using Gadamer's hermeneutics. The review protocol, including qualitative and quantitative study approaches, was registered on PROSPERO (CRD42022306655). RESULTS: Sixteen studies were identified and included in the qualitative meta-synthesis. Experiences of care and support were interpreted and identified as four fusions. First, Personification is of central importance and stresses the need to acknowledge the baby as a unique person. The parents became parents even though their baby was born dead: The staff should also be recognised as the individuals they are with their personal histories. Second, the personification is reinforced by a respectful attitude where the paren

Background Over a third of pregnant women (around 250,000) each year in the United Kingdom have experienced trauma such as domestic abuse, childhood trauma or sexual assault. These experiences can have a long-term impact on women’s mental and physical health. This global qualitative evidence synthesis explores the views of women and maternity care professionals on routine discussion of previous trauma in the perinatal period. Methods Systematic database searches (MEDLINE, EMBASE, CINAHL Plus, APA PsycINFO and Global Index Medicus) were conducted in July 2021 and updated in April 2022. The quality of each study was assessed using the Critical Appraisal Skills Programme. We thematically synthesised the data and assessed confidence in findings using GRADECERQual. Results We included 25 papers, from five countries, published between 2001 and 2022. All the studies were conducted in high-income countries; therefore findings cannot be applied to low- or middle-income countries. Confidence in most of the review findings was moderate or high. The findings are presented in six themes. These themes described how women and clinicians felt trauma discussions were valuable and worthwhile, provided there was adequate time and appropriate referral pathways. However, women often found being asked about previous trauma to be unexpected and intrusive, and women with limited English faced additional challenges. Many pregnant women were unaware of the extent of the trauma they have suffered, or its impact on their lives. Before disclosing trauma, women needed to have a trusting relationship with a clinician; even so, some women chose not to share their histories. Hearing trauma disclosures could be distressing for clinicians. Conclusion Discussions of previous trauma should be undertaken when women want to have the discussion, when there is time to understand and respond to the needs and concerns of each individual, and when there are effective resources available for follow up if neede

[EN] Deserts are stressful environments where the living beings must acquire different strategies to survive due to the water stress conditions. From the late Albian to the early Cenomanian, the northern and eastern parts of Iberia were the location of the desert system represented by deposits assigned to the Utrillas Group, which bear abundant amber with numerous bioinclusions, including diverse arthropods and vertebrate remains. In the Maestrazgo Basin (E Spain), the late Albian to early Cenomanian sedimentary succession represents the most distal part of the desert system (fore-erg) that was characterised by an alternation of aeolian and shallow marine sedimentary environments in the proximity of the Western Tethys palaeo-coast, with rare to frequent dinoflagellate cysts. The terrestrial ecosystems from this area were biodiverse, and comprised plant communities whose fossils are associated with sedimentological indicators of aridity. The palynoflora dominated by wind-transported conifer pollen is interpreted to reflect various types of xerophytic woodlands from the hinterlands and the coastal settings. Therefore, fern and angiosperm communities abundantly grew in wet interdunes and coastal wetlands (temporary to semi-permanent freshwater/salt marshes and water bodies). In addition, the occurrence of low-diversity megafloral assemblages reflects the existence of coastal salt-influenced settings. The palaeobotanical study carried out in this paper which is an integrative work on palynology and palaeobotany, does not only allow the reconstruction of the vegetation that developed in the mid-Cretaceous fore-erg from the eastern Iberia, in addition, provides new biostratigraphic and palaeogeographic data considering the context of angiosperm radiation as well as the biota inferred in the amber-bearing outcrops of San Just, Arroyo de la Pascueta and La Hoya (within Cortes de Arenoso succesion). Importantly, the studied assemblages include Afropollis, Dichastopollenites

The settlement of cold and arid environments by Pleistocene hunter-gatherers has been a heated topic in Paleolithic Archaeology and the Quaternary Sciences for years. In the Iberian Peninsula, a key area for studying human adaptations to such environments is composed by the large interior and upland regions of the northern and southern plateaus (Mesetas) and bordering areas. As, traditionally, these regions have been relatively under-investigated compared to the ecologically more favored coastal areas of the peninsula, our knowledge of the human settlement of the whole Iberian hinterland remains scarce for the Last Glacial. In this paper we present the discovery and first geoarcheological, paleoenvironmental and chronometric evidence obtained at Charco Verde II, a new site close to the southwestern foothills of the Iberian system range (Guadalajara province, Spain), bearing a sequence of Magdalenian human occupations starting at least at 20.8–21.4 ka cal BP during the Last Glacial Maximum, and covering Greenland Stadial 2 until ∼15.1–16.6 ka cal BP, including Heinrich stadial 1. As this site is located in an upland region which today faces one of the harshest climates in Iberia, such occupation sequence, occurred during some of the coldest and most arid phases of the Last Glacial, has relevant implications for our understanding of human-environment-climate interactions and population dynamics in Iberia and Western Europe. These findings support the hypothesis that the Iberian hinterland was not avoided by Upper Paleolithic hunter-gatherers due to ecological constraints, but it hosted a complex and relatively dense settlement at least in some areas, even during cold periods. This suggest, one more time, that the historical scarcity of Upper Paleolithic sites in inland Iberia is, to a significant extent, an artifact of research bias.

Animal mobility is a common strategy to overcome scarcity of food and the related over-grazing of pastures. It is also essential to reduce the inbreeding rate of animal populations, which is known to have a negative impact on fertility and productivity. The present paper shows the geographic range of sheep provisioning in different phases of occupation at the Iron Age site of Turó de la Font de la Canya (7th to 3rd centuries BC). Strontium isotope ratios from 34 archaeological sheep and goat enamel, two archaeological bones and 14 modern tree leaves are presented. The isotopic results suggest that sheep and goats consumed at the site were reared locally (within a few kilometres radius) during the whole period of occupation. The paper discusses the isotopic results in light of the socio-political structure of this period, as complex, strongly territorial societies developed during the Iron Age in the north-east Iberian Peninsula.

Effective postnatal care is important for optimal care of women and newborns-to promote health and wellbeing, identify and treat clinical and psychosocial concerns, and to provide support for families. Yet uptake of formal postnatal care services is low and inequitable in many countries. As part of a larger study examining the views of women, partners, and families requiring both routine and specialised care, we analysed a subset of data on the views and experiences of women related to routine postnatal care. We undertook a qualitative evidence synthesis, using a framework analysis approach. We included studies published up to December 2019 with extractable qualitative data, with no language restriction. We focused on women in the general population and their accounts of routine postnatal care utilization. We searched MEDLINE, PUBMED, CINAHL, EMBASE, EBM-Reviews, and grey literature. Two reviewers screened each study independently; inclusion was agreed by consensus. Data abstraction and scientific quality assessment were carried out using a study-specific extraction form and established quality assessment tools. The analysis framework was developed a priori based on previous knowledge and research on the topic and adapted. Due to the number of included texts, the final synthesis was developed inductively from the initial framework by iterative sampling of the included studies, until data saturation was achieved. Findings are presented by high versus low/middle income country, and by confidence in the finding, applying the GRADE-CERQual approach. Of 12,678 papers, 512 met the inclusion criteria; 59 articles were sampled for analysis. Five themes were identified: access and availability; physical and human resources; external influences; social norms; and experience of care. High confidence study findings included the perceived low value of postnatal care for healthy women and infants; concerns around access and quality of care; and women's desire for more emotional a

Temperate grassland soils store significant amounts of carbon (C). Estimating how much livestock grazing and manuring can influence grassland soil organic carbon (SOC) is key to improve greenhouse gas grassland budgets. The Rothamsted Carbon (RothC) model, although originally developed and parameterized to model the turnover of organic C in arable topsoil, has been widely used, with varied success, to estimate SOC changes in grassland under different climates, soils, and management conditions. In this paper, we hypothesise that RothC-based SOC predictions in managed grasslands under temperate moist climatic conditions can be improved by incorporating small modifications to the model based on existing field data from diverse experimental locations in Europe. For this, we described and evaluated changes at the level of: (1) the soil water function of RothC, (2) entry pools accounting for the degradability of the exogenous organic matter (EOM) applied (e.g., ruminant excreta), (3) the month-on-month change in the quality of C inputs coming from plant residues (i.e above-, below-ground plant residue and rhizodeposits), and (4) the livestock trampling effect (i.e., poaching damage) as a common problem in areas with higher annual precipitation. In order to evaluate the potential utility of these changes, we performed a simple sensitivity analysis and tested the model predictions against averaged data from four grassland experiments in Europe. Our evaluation showed that the default model's performance was 78% and whereas some of the modifications seemed to improve RothC SOC predictions (model performance of 95% and 86% for soil water function and plant residues, respectively), others did not lead to any/or almost any improvement (model performance of 80 and 46% for the change in the C input quality and livestock trampling, respectively). We concluded that, whereas adding more complexity to the RothC model by adding the livestock trampling would actually not improve the mod

Quadruplex structures have been identified in a plethora of organisms where they play important functions in the regulation of molecular processes, and hence have been proposed as therapeutic targets for many diseases. In this paper we report the extensive bioinformatic analysis of the SARS-CoV-2 genome and related viruses using an upgraded version of the open-source algorithm G4-iM Grinder. This version improves the functionality of the software, including an easy way to determine the potential biological features affected by the candidates found. The quadruplex definitions of the algorithm were optimized for SARS-CoV-2. Using a lax quadruplex definition ruleset, which accepts amongst other parameters two residue G- and C-tracks, 512 potential quadruplex candidates were discovered. These sequences were evaluated by their in vitro formation probability, their position in the viral RNA, their uniqueness and their conservation rates (calculated in over seventeen thousand different COVID-19 clinical cases and sequenced at different times and locations during the ongoing pandemic). These results were then compared subsequently to other Coronaviridae members, other Group IV (+)ssRNA viruses and the entire viral realm. Sequences found in common with other viral species were further analyzed and characterized. Sequences with high scores unique to the SARS-CoV-2 were studied to investigate the variations amongst similar species. Quadruplex formation of the best candidates were then confirmed experimentally. Using NMR and CD spectroscopy, we found several highly stable RNA quadruplexes that may be suitable therapeutic targets for the SARS-CoV-2.

There are strong interactions between an economic system and its ecological context. In this sense, livestock have been an integral part of human economies since the Neolithic, contributing significantly to the creation and maintenance of agricultural anthropized landscapes. For this reason, in the frame of the ERC-StG project ’ZooMWest’ we collected and analyzed thousands of zooarchaeological data from NE Iberia. By considering these data in comparison with ecological indicators (archaeobotanical remains) and archaeological evidence (settlement characteristics and their distribution) this paper seeks to characterize changes in animal production and the relationship between people, livestock, and their environment. These methods allow for an investigation of the topic at different scales (site, zone, territory) with a broad diachronic perspective, and for consideration of orography and cultural traditions alongside climatic factors. Through this integration of various streams of evidence, we aim to better understand the structure of ancient economic systems and the way they conditioned human decision-making on animal production. Results show a shifting relationship with the territory between the Bronze Age and Late Antiquity, in which market requirements and an economic model with a higher degree of integration increasingly influenced husbandry strategies. These processes are reflected in changes in land use and forms of territorial occupation, although along different rhythms and trajectories.

Cremation 168 from the second half of the 8th century BCE (Pithekoussai’s necropolis, Ischia Island, Italy), better known as the Tomb of Nestor’s Cup, is widely considered as one of the most intriguing discoveries in the Mediterranean Pre-Classic archaeology. A drinking cup, from which the Tomb’s name derives, bears one of the earliest surviving examples of written Greek, representing the oldest Homeric poetry ever recovered. According to previous osteological analyses, the Cup is associated with the cremated remains of a juvenile, aged approximately 10–14 years at death. Since then, a vast body of literature has attempted to explain the unique association between the exceptionality of the grave good complex, the symposiac and erotic evocation of the Nestor’s Cup inscription with the young age of the individual buried with it. This paper reconsiders previous assessments of the remains by combining gross morphology with qualitative histology and histomorphometric analyses of the burnt bone fragments. This work reveals the commingled nature of the bone assemblage, identifying for the first time, more than one human individual mixed with faunal remains. These outcomes dramatically change previous reconstructions of the cremation deposit, rewriting the answer to the question: who was buried with Nestor’s Cup?

Automatic optic disc (OD) localization and segmentation is not a simple process as the OD appearance and size may significantly vary from person to person. This paper presents a novel approach for OD localization and segmentation which is fast as well as robust. In the proposed method, the image is first enhanced by de-hazing and then cropped around the OD region. The cropped image is converted to HSV domain and then V channel is used for OD detection. The vessels are extracted from the Green channel in the cropped region by multi-scale line detector and then removed by the Laplace Transform. Local adaptive thresholding and region growing are applied for binarization. Furthermore, two region properties, eccentricity, and area are then used to detect the true OD region. Finally, ellipse fitting is used to fill the region. Several datasets are used for testing the proposed method. Test results show that the accuracy and sensitivity of the proposed method are much higher than the existing state-of-the-art methods.

Published: October 7, 2020, Learning new content and vocabulary in a foreign language can be particularly difficult. Yet, there are educational programs that require people to study in a language they are not native speakers of. For this reason, it is important to understand how these learning processes work and possibly differ from native language learning, as well as to develop strategies to ease this process. The current study takes advantage of emotionality—operationally defined as positive valence and high arousal—to improve memory. In two experiments, the present paper addresses whether participants have more difficulty learning the names of objects they have never seen before in their foreign language and whether embedding them in a positive semantic context can help make learning easier. With this in mind, we had participants (with a minimum of a B2 level of English) in two experiments (43 participants in Experiment 1 and 54 in Experiment 2) read descriptions of made-up objects—either positive or neutral and either in their native or a foreign language. The effects of language varied with the difficulty of the task and measure used. In both cases, learning the words in a positive context improved learning. Importantly, the effect of emotionality was not modulated by language, suggesting that the effects of emotionality are independent of language and could potentially be a useful tool for improving foreign language vocabulary learning.

One of the key challenges in real-time systems is the analysis of the memory hierarchy. Many Worst-Case Execution Time (WCET) analysis methods supporting an instruction cache are based on iterative or convergence algorithms, which are rather slow. Our goal in this paper is to reduce the WCET analysis time on systems with a simple lockable instruction cache, focusing on the Lock-MS method. First, we propose an algorithm to obtain a structure-based representation of the Control Flow Graph (CFG). It organizes the whole WCET problem as nested subproblems, which takes advantage of common branch-and-bound algorithms of Integer Linear Programming (ILP) solvers. Second, we add support for multiple locking points per task, each one with specific cache contents, instead of a given locked content for the whole task execution. Locking points are set heuristically before outer loops. Such simple heuristics adds no complexity, and reduces the WCET by taking profit of the temporal reuse found in loops. Since loops can be processed as isolated regions, the optimal contents to lock into cache for each region can be obtained, and the WCET analysis time is further reduced. With these two improvements, our WCET analysis is around 10 times faster than other approaches. Also, our results show that the WCET is reduced, and the hit ratio achieved for the lockable instruction cache is similar to that of a real execution with an LRU instruction cache. Finally, we analyze the WCET sensitivity to compiler optimization, showing for each benchmark the right choices and pointing out that O0 is always the worst option.

Robust empirical evidence supports the idea that embryonic and, more generally, intrauterine disruptions induced by the 1918-flu pandemic had long-term consequences on adult health status and other conditions. In this paper we assess the 1918-flu long-term effects not just of in utero exposure but also during infancy and early childhood. A unique set of events that took place in Puerto Rico during 1918–1919 generated conditions of a “double quasi-natural experiment”. We exploit these conditions to empirically identify effects of exposure to the 1918 flu pandemic and those of the devastation left by an earthquake-tsunami that struck the island in 1918. Because the earthquake-tsunami affected mostly the Western coast of the island whereas early (in utero and postnatal) exposure to the flu was restricted to those born in the interval 1917–1920, we use geographic variation to identify the effects of the quake and timing of birth variation to identify those of the flu. We benefit from availability of information on markers of nutritional status in a nationally representative sample of individuals aged 75 and older in 2002. We make two contributions. First, unlike most fetal origins research that singles out early nutritional status as a determinant of adult health, we hypothesize that the 1918 flu damaged the nutritional status of adult survivors who, at the time of the flu, were in utero or infants. Second, we target markers of nutritional status largely set when the adult survivors were infants and young children. Estimates of effects of the pandemic are quite large mostly among females and those who were exposed to the earthquake-tsunami. Impacts of the flu in areas less affected by the earthquake are smaller but do vary by area flu severity. These findings constitute empirical evidence supporting the conjecture that effects of the 1918 flu and/or the earthquake are associated not just with disruption experienced during the fetal period but also postnatally.

There is a significant number of funerary contexts for the Early Neolithic in the Iberian Peninsula, and the body of information is much larger for the Late Neolithic. In contrast, the archaeological information available for the period in between (ca. 4800-4400/4200 cal BC) is scarce. This period, generally called Middle Neolithic, is the least well-known of the peninsular Neolithic sequence, and at present there is no specific synthesis on this topic at the peninsular scale. In 2017, an exceptional funerary context was discovered at Dehesilla Cave (Sierra de Cádiz, Southern Iberian Peninsula), providing radiocarbon dates which place it at the beginning of this little-known Middle Neolithic period, specifically between ca. 4800–4550 cal BC. Locus 2 is a deposition constituted by two adult human skulls and the skeleton of a very young sheep/goat, associated with stone structures and a hearth, and a number of pots, stone and bone tools and charred plant remains. The objectives of this paper are, firstly, to present the new archaeological context documented at Dehesilla Cave, supported by a wide range of data provided by interdisciplinary methods. The dataset is diverse in nature: stratigraphic, osteological, isotopic, zoological, artifactual, botanical and radiocarbon results are presented together. Secondly, to place this finding within the general context of the contemporaneous sites known in the Iberian Peninsula through a systematic review of the available evidence. This enables not only the formulation of explanations of the singular new context, but also to infer the possible ritual funerary behaviours and practices in the 5th millennium cal BC in the Iberian Peninsula.

Producción Científica, Efficient ventilation in hospital airborne isolation rooms is important vis-à-vis decreasing the risk of cross infection and reducing energy consumption. This paper analyses the suitability, Ministry of Finance and Competitiveness, State Secretariat for Research, Development and Innovation, Spain, the National R&D project with reference DPI2014-55357-C2-1-R, European Regional Development Fund (ERDF)

This paper examines the interrelationships among 9 advanced economies using a novel multichannel approach to investigate, beyond the usual causal relationships, the time-varying dimension of the channels conveying causal relationships. The model is derived from the well-known Markov Switching setting and account for systems described by multiple variables. A Markov switching causality measure is adapted to account for information transmissions between distinct multivariate systems. Each country is described by 5 different fundamental variables reflecting its state. Our multichannel causality measure is then applied on these sets of time series to determine, over time, the main channels through which the information is transmitted between the different countries. In a second step, we investigate the relationships existing between these countries and the commodity markets and look at the possible use of the commodity markets as an indirect channel of information transmission between countries.

Published: May 17, 2018, Previous studies indicated that cognitive conflict continues to bias actions even after a movement has been initiated. The present paper examined whether cognitive control also biases actions after movement initiation. To this end, we had participants perform a Stroop task in which we manipulated the item-specific proportion of (in)congruent trials (80% congruent vs. 20% congruent). Importantly, participants responded via mouse movements, allowing us to evaluate various movement parameters: initiation times, movement times, and movement accuracy. Results showed that mouse movements were faster and more accurate during congruent trials compared to incongruent trials. Moreover, we observed that this congruency effect was larger for 80% congruent compared to 20% congruent items, which reflects itemspecific cognitive control. Notably, when responses were initiated very fast ± rendering virtually no time for stimulus processing before movement onset ± this item-specific control was observed only in movement times. However, for relatively slow initiated responses, item specific control was observed both in initiation and in movement times. These findings demonstrate that item-specific cognitive control biases actions before and after movement initiation.

Domestication of wild cattle, sheep, and pigs began a process of body size diminution. In most of Western Europe this process continued across prehistory and was not reversed until the Roman period. However, in Italy, an increase in livestock body size occurred during the Iron Age, earlier than the Western provinces. In order to better understand the nature and timing of this early increase in animal size, this paper presents a detailed regional study of taxonomic abundance and biometric data from zooarchaeological assemblages recovered from the Po and Venetian–Friulian Plains in northern Italy. Our results demonstrate a high level of regionality in the choice of species exploited, with husbandry systems focused on different domesticates, as well as regional differences in animal size. However, despite significant variation in species frequencies, settlement structure, and epigraphic tradition, all areas with sufficient data demonstrate similar significant changes in livestock body size. Cattle and sheep increased incrementally in size prior to the Roman conquest in all regions considered; surprisingly, pigs continued to decrease in size throughout later prehistory. The incremental pace and pan-regional character of the size change in cattle and sheep suggests an internally motivated phenomenon rather than herd replacement with a new larger population, as might follow colonisation or conquest. The divergence in size trends for bovids and suids suggests a noteworthy change in cattle and sheep herding practices during the Iron Age or final centuries of the Bronze Age, in contrast with greater continuity in pig management. Our analysis provides a thorough zooarchaeological synthesis for northern Italy and, for the first time, demonstrates that both cattle and sheep increased in size outside of Roman territory well before the conquest of this area. This study offers a basis for future chemical analyses (DNA, isotopes), which will further investigate the cause(s) of live

As breaking news unfolds people increasingly rely on social media to stay abreast of the latest updates. The use of social media in such situations comes with the caveat that new information being released piecemeal may encourage rumours, many of which remain unverified long after their point of release. Little is known, however, about the dynamics of the life cycle of a social media rumour. In this paper we present a methodology that has enabled us to collect, identify and annotate a dataset of 330 rumour threads (4,842 tweets) associated with 9 newsworthy events. We analyse this dataset to understand how users spread, support, or deny rumours that are later proven true or false, by distinguishing two levels of status in a rumour life cycle i.e., before and after its veracity status is resolved. The identification of rumours associated with each event, as well as the tweet that resolved each rumour as true or false, was performed by journalist members of the research team who tracked the events in real time. Our study shows that rumours that are ultimately proven true tend to be resolved faster than those that turn out to be false. Whilst one can readily see users denying rumours once they have been debunked, users appear to be less capable of distinguishing true from false rumours when their veracity remains in question. In fact, we show that the prevalent tendency for users is to support every unverified rumour. We also analyse the role of different types of users, finding that highly reputable users such as news organisations endeavour to post well-grounded statements, which appear to be certain and accompanied by evidence. Nevertheless, these often prove to be unverified pieces of information that give rise to false rumours. Our study reinforces the need for developing robust machine learning techniques that can provide assistance in real time for assessing the veracity of rumours. The findings of our study provide useful insights for achieving this aim.

Manure from animal farms and sewage sludge contain pathogens and opportunistic organisms in various concentrations depending on the health of the herds and human sources. Other than for the presence of pathogens, these waste substances are excellent nutrient sources and constitute a preferred organic fertilizer. However, because of the pathogens, the risks of infection of animals or humans increase with the indiscriminate use of manure, especially liquid manure or sludge, for agriculture. This potential problem can increase with the global connectedness of animal herds fed imported feed grown on fields fertilized with local manures. This paper describes a simple, easy-to-use, low-tech hygienization method which conserves nutrients and does not require large investments in infrastructure. The proposed method uses the microbiotic shift during mesophilic fermentation of cow manure or sewage sludge during which gram-negative bacteria, enterococci and yeasts were inactivated below the detection limit of 3 log10 cfu/g while lactobacilli increased up to a thousand fold. Pathogens like Salmonella, Listeria monocytogenes, Staphylococcus aureus, E. coli EHEC O:157 and vegetative Clostridium perfringens were inactivated within 3 days of fermentation. In addition, ECBO-viruses and eggs of Ascaris suum were inactivated within 7 and 56 days, respectively. Compared to the mass lost through composting (15–57%), the loss of mass during fermentation (< 2.45%) is very low and provides strong economic and ecological benefits for this process. This method might be an acceptable hygienization method for developed as well as undeveloped countries, and could play a key role in public and animal health while safely closing the nutrient cycle by reducing the necessity of using energy-inefficient inorganic fertilizer for crop production.

Stone tool use by wild chimpanzees of West Africa offers a unique opportunity to explore the evolutionary roots of technology during human evolution. However, detailed analyses of chimpanzee stone artifacts are still lacking, thus precluding a comparison with the earliest archaeological record. This paper presents the first systematic study of stone tools used by wild chimpanzees to crack open nuts in Bossou (Guinea-Conakry), and applies pioneering analytical techniques to such artifacts. Automatic morphometric GIS classification enabled to create maps of use wear over the stone tools (anvils, hammers, and hammers/ anvils), which were blind tested with GIS spatial analysis of damage patterns identified visually. Our analysis shows that chimpanzee stone tool use wear can be systematized and specific damage patterns discerned, allowing to discriminate between active and passive pounders in lithic assemblages. In summary, our results demonstrate the heuristic potential of combined suites of GIS techniques for the analysis of battered artifacts, and have enabled creating a referential framework of analysis in which wild chimpanzee battered tools can for the first time be directly compared to the early archaeological record.

Limiting warming by the end of the century to 1.5̊C compared to pre-Industrial times requires reaching and sustaining net zero global carbon dioxide (CO2) emissions and declining radiative forcing from non-CO2 greenhouse gas (GHG) sources such as methane (CH4). This implies eliminating CO2 emissions or balancing them with removals while mitigating CH4 emissions to reduce their radiative forcing over time. The global cattle sector (including Buffalo) mainly emits CH4 and N2O and will benefit from understanding the extent and speed of CH4 reductions necessary to align its mitigation ambitions with global temperature goals. This study explores the utility of an alternative usage of global warming potentials (GWP*) in combination with the Transient Climate Response to cumulative carbon Emissions (TCRE) to compare retrospective and projected climate impacts of global livestock emission pathways with other sectors (e.g. fossil fuel and land use change). To illustrate this, we estimated the amount and fraction of total warming attributable to direct CH4 livestock emissions from 1750 to 2019 using existing emissions datasets and projected their contributions to future warming under three historical and three future emission scenarios. These historical and projected estimates were transformed into cumulative CO2 equivalent (GWP100) and warming equivalent (GWP*) emissions that were multiplied by a TCRE coefficient to express induced warming as globally averaged surface temperature change. In general, temperature change estimates from this study are comparable to those obtained from other climate models. Sustained annual reductions in CH4 emissions of 0.32% by the global cattle sector would stabilize their future effect on global temperature while greater reductions would reverse historical past contributions to global warming by the sector in a similar fashion to increasing C sinks. The extent and speed with which CH4 mitigation interventions are introduced by the sector will

Although the understanding of and motivation behind individual trading behavior is an important puzzle in finance, little is known about the connection between an investor's portfolio structure and her trading behavior in practice. In this paper, we investigate the relation between what stocks investors hold, and what stocks they buy, and show that investors with similar portfolio structures to a great extent trade in a similar way. With data from the central register of shareholdings in Sweden, we model the market in a similarity network, by considering investors as nodes, connected with links representing portfolio similarity. From the network, we find investor groups that not only identify different investment strategies, but also represent individual investors trading in a similar way. These findings suggest that the stock portfolios of investors hold meaningful information, which could be used to earn a better understanding of stock market dynamics.

Several recent studies have described a strong correlation between nutritional or economic data and the number of Nobel awards obtained across a large range of countries. This sheds new light on the intriguing question of the key predictors of Nobel awards chances. However, all these studies have been focused on a single predictor and were only based on simple correlation and/or linear model analysis. The main aim of the present study was thus to clarify this debate by simultaneously exploring the influence of food consumption (cacao, milk, and wine), economic variables (gross domestic product) and scientific activity (number of publications and research expenditure) on Nobel awards. An innovative statistical analysis, hierarchical partitioning, has been used because it enables us to reduce collinearity problems by determining and comparing the independent contribution of each factor. Our results clearly indicate that a country’s number of Nobel awards can be mainly predicted by its scientific achievements such as number of publications and research expenditure. Conversely, dietary habits and the global economy variable are only minor predictors; this finding contradicts the conclusions of previous studies. Dedicating a large proportion of the GDP to research and to the publication of a high number of scientific papers would thus create fertile ground for obtaining Nobel awards.

Personality plays a role in human behavior, and thus can influence consumer decisions on environmental goods and services. This paper analyses the influence of the big five personality dimensions (extraversion, agreeableness, conscientiousness, neuroticism and openness) in a discrete choice experiment dealing with preferences for the development of an environmental program for forest management in Spain. For this purpose, a reduced version of the Big Five Inventory survey (the BFI-10) is implemented. Results show a positive effect of openness and extraversion and a negative effect of agreeableness and neuroticism in consumers' preferences for this environmental program. Moreover, results from a latent class model show that personal traits help to explain preference heterogeneity.

In the USA, the relationship between the legal availability of guns and the firearm-related homicide rate has been debated. It has been argued that unrestricted gun availability promotes the occurrence of firearm-induced homicides. It has also been pointed out that gun possession can protect potential victims when attacked. This paper provides a first mathematical analysis of this tradeoff, with the goal to steer the debate towards arguing about assumptions, statistics, and scientific methods. The model is based on a set of clearly defined assumptions, which are supported by available statistical data, and is formulated axiomatically such that results do not depend on arbitrary mathematical expressions. According to this framework, two alternative scenarios can minimize the gun-related homicide rate: a ban of private firearms possession, or a policy allowing the general population to carry guns. Importantly, the model identifies the crucial parameters that determine which policy minimizes the death rate, and thus serves as a guide for the design of future epidemiological studies. The parameters that need to be measured include the fraction of offenders that illegally possess a gun, the degree of protection provided by gun ownership, and the fraction of the population who take up their right to own a gun and carry it when attacked. Limited data available in the literature were used to demonstrate how the model can be parameterized, and this preliminary analysis suggests that a ban of private firearm possession, or possibly a partial reduction in gun availability, might lower the rate of firearm-induced homicides. This, however, should not be seen as a policy recommendation, due to the limited data available to inform and parameterize the model. However, the model clearly defines what needs to be measured, and provides a basis for a scientific discussion about assumptions and data.

Understanding how institutional incentives and mechanisms for assigning recognition shape access to a permanent job is important. This study, based on data from questionnaire survey responses and publications of 1,257 university science, biomedical and engineering faculty in Spain, attempts to understand the timing of getting a permanent position and the relevant factors that account for this transition, in the context of dilemmas between mobility and permanence faced by organizations. Using event history analysis, the paper looks at the time to promotion and the effects of some relevant covariates associated to academic performance, social embeddedness and mobility. We find that research productivity contributes to career acceleration, but that other variables are also significantly associated to a faster transition. Factors associated to the social elements of academic life also play a role in reducing the time from PhD graduation to tenure. However, mobility significantly increases the duration of the non-tenure stage. In contrast with previous findings, the role of sex is minor. The variations in the length of time to promotion across different scientific domains is confirmed, with faster career advancement for those in the Engineering and Technological Sciences compared with academics in the Biological and Biomedical Sciences. Results show clear effects of seniority, and rewards to loyalty, in addition to some measurements of performance and quality of the university granting the PhD, as key elements speeding up career advancement. Findings suggest the existence of a system based on granting early permanent jobs to those that combine social embeddedness and team integration with some good credentials regarding past and potential future performance, rather than high levels of mobility.

This paper examines how to maximize contribution in public good dilemmas by arranging people into homogeneous or heterogeneous subgroups. Past studies on the effect of homogeneity of efficacy have exclusively manipulated group composition in their experimental designs, which might have imposed a limit on ecological validity because group membership may not be easily changed in reality. In this study, we maintained the same group composition but varied the subgroup composition. We developed a public good dilemmas paradigm in which participants were assigned to one of the four conditions (high- vs. low-efficacy; homogeneous vs. heterogeneous subgroup) to produce their endowments and then to decide how much to contribute. We found that individuals in homogeneous and heterogeneous subgroups produced a similar amount and proportion of contribution, which was due to the two mediating effects that counteracted each other, namely (a) perceived efficacy relative to subgroup and (b) expectation of contribution of other subgroup members. This paper demonstrates both the pros and cons of arranging people into homogeneous and heterogeneous subgroups of efficacy.

This study was conducted in order to map European research in chronic respiratory diseases (CRDs). It was intended to assist the European Commission and other research funders to identify gaps and overlaps in their portfolios, and to suggest ways in which they could improve the effectiveness of their support and increase the impact of the research on patient care and on the reduction of the incidence of the CRDs. Articles and reviews were identified in the Web of Science on research in six non-communicable respiratory diseases that were published in 2002–13 from 31 European countries. They represented only 0.8% of biomedical research output but these diseases accounted for 4.7% of the European disease burden, as measured by Disability-Adjusted Life Years (DALYs), so the sub-field is seriously under-researched. Europe is prominent in the sub-field and published 56% of the world total, with the UK the most productive and publishing more than France and Italy, the next two countries, combined. Asthma and Chronic Obstructive Pulmonary Disease (COPD) were the diseases with the most publications and the highest citation rates. They also received the most funding, with around two acknowledgments per paper (in 2009–13), whereas cystic fibrosis and emphysema averaged only one. Just over 37% of papers had no specific funding and depended on institutional support from universities and hospitals.

Science and engineering research has becoming an increasingly international phenomenon. Traditional bibliometric studies have not captured the evolution of collaborative partnerships between countries, particularly in emerging technologies such as stem cell science, in which an immense amount of investment has been made in the past decade. Analyzing over 2,800 articles from the top journals that include stem cell research in their publications, this study demonstrates the globalization of stem cell science. From 2000 to 2010, international collaborations increased from 20.9% to 36% of all stem cell publications analyzed. The United States remains the most prolific and the most dominant country in the field in terms of publications in high impact journals. But Asian countries, particularly China are steadily gaining ground. Exhibiting the largest relative growth, the percent of Chinese-authored stem cell papers grew more than ten-fold, while the percent of Chinese-authored international papers increased over seven times from 2000 to 2010. And while the percent of total stem cell publications exhibited modest growth for European countries, the percent of international publications increased more substantially, particularly in the United Kingdom. Overall, the data indicated that traditional networks of collaboration extant in 2000 still predominate in stem cell science. Although more nations are becoming involved in international collaborations and undertaking stem cell research, many of these efforts, with the exception of those in certain Asian countries, have yet to translate into publications in high impact journals.

Objective The aim of this paper is to investigate how doctors working in primary health care in Latin American address patients with common mental disorders and to investigate how stigma can affect their clinical decisions. Methods Using a cross-sectional design, we applied an online self-administered questionnaire to a sample of 550 Primary Care Physicians (PCPs) from Bolivia, Brazil, Cuba and Chile. The questionnaire collected information about sociodemographic variables, training and experience with mental health care. Clinicians’ stigmatizing attitudes towards mental health were measured using the Mental Illness Clinicians' Attitudes Scale (MICA v4). The clinical decisions of PCPs were assessed through three clinical vignettes representing typical cases of depression, anxiety and somatization. Results A total of 387 professionals completed the questionnaires (70.3% response rate). The 63.7% of the PCPs felt qualified to diagnose and treat people with common mental disorders. More than 90% of the PCPs from Bolivia, Cuba and Chile agreed to treat the patients presented in the three vignettes. We did not find significant differences between the four countries in the scores of the MICA v4 stigma levels, with a mean = 36.3 and SD = 8.3 for all four countries. Gender (p = .672), age (p = .171), training (p = .673) and years of experience (p = .28) were unrelated to stigma. In the two multivariate regression models, PCPs with high levels of stigma were more likely to refer them to a psychiatrist the patients with depression (OR = 1.03, 95% CI, 0.99 to 1.07 p<0.05) and somatoform symptoms somatoform (OR = 1.03, 95% CI, 1.00 to 1.07, p<0.05) to a psychiatrist. Discussion The majority of PCPs in the four countries were inclined to treat patients with depression, anxiety and somatoform symptoms. PCPs with more levels of stigma were more likely to refer the patients with depression and somatoform symptoms to a psychiatrist. Stigmatizing attitudes towards mental disorders by

Intimate partner violence (IPV) has significant impacts on mental health. Community-focused interventions have shown promising results for addressing IPV in low-income countries, however, little is known about the implications of these interventions for women’s mental wellbeing. This paper analyses data from a community-focused policy intervention in Rwanda collected in 2013–14, including focus group discussions and in-depth interviews with community members (n = 59). Our findings point to three ways in which these community members responded to IPV: (1) reconciling couples experiencing violence, (2) engaging community support through raising cases of IPV during community discussions, (3) navigating resources for women experiencing IPV, including police, social services and legal support. These community responses support women experiencing violence by helping them access available resources and by engaging in community discussions. However, assistance is largely only offered to married women and responses tend to focus exclusively on physical rather than psychological or emotional forms of violence. Drawing on Campbell and Burgess’s (2012) framework for ‘community mental health competence’, we interrogate the potential implications of these responses for the mental wellbeing of women affected by violence. We conclude by drawing attention to the gendered nature of community responses to IPV and the potential impacts this may have for the mental health of women experiencing IPV.

India, like many developing countries, only recently began to grant pharmaceutical product patents. Indian patent law includes a provision, Section 3(d), which tries to limit grant of “secondary” pharmaceutical patents, i.e. patents on new forms of existing molecules and drugs. Previous research suggests the provision was rarely used against secondary applications in the years immediately following its enactment, and where it was, was redundant to other aspects of the patent law, raising concerns that 3(d) was being under-utilized by the Indian Patent Office. This paper uses a novel data source, the patent office’s first examination reports, to examine changes in the use of the provision. We find a sharp increase over time in the use of Section 3(d), including on the main claims of patent applications, though it continues to be used in conjunction with other types of objections to patentability. More surprisingly, see a sharp increase in the use of the provision against primary patent applications, contrary to its intent, raising concerns about potential over-utilization.

Purpose Medications are mostly taken in patients’ own homes, increasingly administered by carers, yet studies of medication safety have been largely conducted in the hospital setting. We aimed to review studies of how carers cause and/or prevent medication administration errors (MAEs) within the patient’s home; to identify types, prevalence and causes of these MAEs and any interventions to prevent them. Methods A narrative systematic review of literature published between 1 Jan 1946 and 23 Sep 2013 was carried out across the databases EMBASE, MEDLINE, PSYCHINFO, COCHRANE and CINAHL. Empirical studies were included where carers were responsible for preventing/causing MAEs in the home and standardised tools used for data extraction and quality assessment. Results Thirty-six papers met the criteria for narrative review, 33 of which included parents caring for children, two predominantly comprised adult children and spouses caring for older parents/partners, and one focused on paid carers mostly looking after older adults. The carer administration error rate ranged from 1.9 to 33% of medications administered and from 12 to 92.7% of carers administering medication. These included dosage errors, omitted administration, wrong medication and wrong time or route of administration. Contributory factors included individual carer factors (e.g. carer age), environmental factors (e.g. storage), medication factors (e.g. number of medicines), prescription communication factors (e.g. comprehensibility of instructions), psychosocial factors (e.g. carer-to-carer communication), and care-recipient factors (e.g. recipient age). The few interventions effective in preventing MAEs involved carer training and tailored equipment. Conclusion This review shows that home medication administration errors made by carers are a potentially serious patient safety issue. Carers made similar errors to those made by professionals in other contexts and a wide variety of contributory factors were identif

For pilot or experimental employment programme results to apply beyond their test bed, researchers must select ‘clusters’ (i.e. the job centres delivering the new intervention) that are reasonably representative of the whole territory. More specifically, this requirement must account for conditions that could artificially inflate the effect of a programme, such as the fluidity of the local labour market or the performance of the local job centre. Failure to achieve representativeness results in Cluster Sampling Bias (CSB). This paper makes three contributions to the literature. Theoretically, it approaches the notion of CSB as a human behaviour. It offers a comprehensive theory, whereby researchers with limited resources and conflicting priorities tend to oversample ‘effect-enhancing’ clusters when piloting a new intervention. Methodologically, it advocates for a ‘narrow and deep’ scope, as opposed to the ‘wide and shallow’ scope, which has prevailed so far. The PILOT-2 dataset was developed to test this idea. Empirically, it provides evidence on the prevalence of CSB. In conditions similar to the PILOT-2 case study, investigators (1) do not sample clusters with a view to maximise generalisability; (2) do not oversample ‘effect-enhancing’ clusters; (3) consistently oversample some clusters, including those with higher-than-average client caseloads; and (4) report their sampling decisions in an inconsistent and generally poor manner. In conclusion, although CSB is prevalent, it is still unclear whether it is intentional and meant to mislead stakeholders about the expected effect of the intervention or due to higher-level constraints or other considerations.

Accurate estimates of global carbon emissions are critical for understanding global warming. This paper estimates net carbon emissions from land use change in Bolivia during the periods 1990-2000 and 2000-2010 using a model that takes into account deforestation, forest degradation, forest regrowth, gradual carbon decomposition and accumulation, as well as heterogeneity in both above ground and below ground carbon contents at the 10 by 10 km grid level. The approach permits detailed maps of net emissions by region and type of land cover. We estimate that net CO2 emissions from land use change in Bolivia increased from about 65 million tons per year during 1990-2000 to about 93 million tons per year during 2000-2010, while CO2 emissions per capita and per unit of GDP have remained fairly stable over the sample period. If we allow for estimated biomass to increase in mature forests, net CO2 emissions drop to close to zero. Finally, we find these results are robust to alternative methods of calculating emissions.

Background A vast body of global research shows that cultural factors affect the use of skilled maternity care services in diverse contexts. While interventions have sought to address this issue, the literature on these efforts has not been synthesised. This paper presents a systematic mapping of interventions that have been implemented to address cultural factors that affect women's use of skilled maternity care. It identifies and develops a map of the literature; describes the range of interventions, types of literature and study designs; and identifies knowledge gaps. Methods and Findings Searches conducted systematically in ten electronic databases and two websites for literature published between 01/01/1990 and 28/02/2013 were combined with expert-recommended references. Potentially eligible literature included journal articles and grey literature published in English, French or Spanish. Items were screened against inclusion and exclusion criteria, yielding 96 items in the final map. Data extracted from the full text documents are presented in tables and a narrative synthesis. The results show that a diverse range of interventions has been implemented in 35 countries to address cultural factors that affect the use of skilled maternity care. Items are classified as follows: (1) service delivery models; (2) service provider interventions; (3) health education interventions; (4) participatory approaches; and (5) mental health interventions. Conclusions The map provides a rich source of information on interventions attempted in diverse settings that might have relevance elsewhere. A range of literature was identified, from narrative descriptions of interventions to studies using randomised controlled trials to evaluate impact. Only 23 items describe studies that aim to measure intervention impact through the use of experimental or observational-analytic designs. Based on the findings, we identify avenues for further research in order to better document and measure

Objectives: Fertility desires require new understanding in a context of expanding access to antiretroviral therapy for people living with HIV/AIDS in Sub-Saharan Africa. This paper studies the fertility desires and their rationales, of slum-dwelling Kenyan men and women living with HIV/AIDS who know their serostatus, but have different antiretroviral therapy treatment statuses. It addresses two research questions: How do people living with HIV/AIDS consider their future fertility? What factors contribute to an explanation of fertility desires among people living with HIV/AIDS. Methods: A mixed methods study (survey [n = 513] and in-depth interviews [n = 41]) with adults living with HIV/AIDS living in Nairobi slums was conducted in 2010. Regression analyses assess independent relationships between fertility desires and socio-demographic factors. Analyses of in-depth interviews are used to interpret the statistical analyses of fertility desires. Results: Our analyses show that fertility desires are complex and ambivalent, reflecting tensions between familial and societal pressures to have children versus pressures for HIV (re-)infection prevention. More than a third (34%) of men and women living with HIV expressed future fertility desires; however, this is significantly lower than in the general population. Factors independently associated with desiring a child among people living with HIV/AIDS were age, sex, number of surviving children, social support and household wealth of the respondent. Discussion: Increasing access to ART is changing the context of future childbearing for people living with HIV/AIDS. Prevailing values mean that, for many people living with HIV/AIDS, having children is seen as necessary for a ‘‘normal’’ and healthy adult life. However, the social rewards of childbearing conflict with moral imperatives of HIV prevention, presenting dilemmas about the ‘‘proper’’ reproductive behaviour of people living with HIV/AIDS. The health policy and service d

Background The PACE trial compared the effectiveness of adding adaptive pacing therapy (APT), cognitive behaviour therapy (CBT), or graded exercise therapy (GET), to specialist medical care (SMC) for patients with chronic fatigue syndrome. This paper reports the relative cost-effectiveness of these treatments in terms of quality adjusted life years (QALYs) and improvements in fatigue and physical function. Methods Resource use was measured and costs calculated. Healthcare and societal costs (healthcare plus lost production and unpaid informal care) were combined with QALYs gained, and changes in fatigue and disability; incremental cost-effectiveness ratios (ICERs) were computed. Results SMC patients had significantly lower healthcare costs than those receiving APT, CBT and GET. If society is willing to value a QALY at £30,000 there is a 62.7% likelihood that CBT is the most cost-effective therapy, a 26.8% likelihood that GET is most cost effective, 2.6% that APT is most cost-effective and 7.9% that SMC alone is most cost-effective. Compared to SMC alone, the incremental healthcare cost per QALY was £18,374 for CBT, £23,615 for GET and £55,235 for APT. From a societal perspective CBT has a 59.5% likelihood of being the most cost-effective, GET 34.8%, APT 0.2% and SMC alone 5.5%. CBT and GET dominated SMC, while APT had a cost per QALY of £127,047. ICERs using reductions in fatigue and disability as outcomes largely mirrored these findings. Conclusions Comparing the four treatments using a health care perspective, CBT had the greatest probability of being the most cost-effective followed by GET. APT had a lower probability of being the most cost-effective option than SMC alone. The relative cost-effectiveness was even greater from a societal perspective as additional cost savings due to reduced need for informal care were likely.

Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are progressive disabling neurological conditions usually fatal within 10 years of onset. Little is known about the economic costs of these conditions. This paper reports service use and costs from France, Germany and the UK and identifies patient characteristics that are associated with cost. 767 patients were recruited, and 760 included in the study, from 44 centres as part of the NNIPPS trial. Service use during the previous six months was measured at entry to the study and costs calculated. Mean six-month costs were calculated for 742 patients. Data on patient sociodemographic and clinical characteristics were recorded and used in regression models to identify predictors of service costs and unpaid care costs (i.e., care from family and friends). The mean six-month service costs of PSP were €24,491 in France, €30,643 in Germany and €25,655 in the UK. The costs for MSA were €28,924, €25,645 and €19,103 respectively. Unpaid care accounted for 68–76%. Formal and unpaid costs were significantly higher the more severe the illness, as indicated by the Parkinson's Plus Symptom scale. There was a significant inverse relationship between service and unpaid care costs.