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The purpose of this study was to assess the factors affecting caudal screw loosening after spinopelvic fixation for adult patients with spinal deformity. This meta-analysis calculated the weighted mean difference (WMD) and odds ratio (OR) using Review Manager ver. 5.3 (RevMan; Cochrane, London, UK). The loosening group was older than the control group (WMD, 2.17; 95% confidence interval [CI], 0.48-3.87; p =0.01). The S2 alar-iliac (S2AI) could prevent the caudal screw from loosening (OR, 0.43; 95% CI, 0.20-0.94; p =0.03). However, gender distribution (p =0.36), the number of fusion segments (p =0.24), rod breakage (p =0.97), T-score (p =0.10), and proximal junctional kyphosis (p =0.75) demonstrated no difference. Preoperatively, only pelvic incidence (PI) in the loosening group was higher (WMD, 5.08; 95% CI, 2.71-7.45; p <0.01), while thoracic kyphosis (p =0.09), lumbar lordosis (LL) (p =0.69), pelvic tilt (PT) (p =0.31), pelvic incidence minus lumbar lordosis (PI-LL) (p =0.35), sagittal vertical axis (SVA) (p =0.27), and T1 pelvic angle (TPA) demonstrated no difference (p =0.10). PI-LL (WMD, 6.05; 95% CI, 0.96-11.14; p =0.02), PT (WMD, 4.12; 95% CI, 0.99-7.26; p =0.01), TPA (WMD, 4.72; 95% CI, 2.35-7.09; p <0.01), and SVA (WMD, 13.35; 95% CI, 2.83-3.87; p =0.001) were higher in the screw loosening group immediately postoperatively. However, TK (p =0.24) and LL (p =0.44) demonstrated no difference. TPA (WMD, 8.38; 95% CI, 3.30-13.47; p <0.01), PT (WMD, 6.01; 95% CI, 1.47-10.55; p =0.01), and SVA (WMD, 23.13; 95% CI, 12.06-34.21; p <0.01) were higher in the screw loosening group at the final follow-up. However, PI-LL (p =0.17) demonstrated no significant difference. Elderly individuals were more susceptible to the caudal screw loosening, and the S2AI screw might better reduce the caudal screw loosening rate than the iliac screws. The lumbar lordosis and sagittal alignment should be reconstructed properly to prevent the caudal screw from loosening. Measures to block sagittal alignment deterioration could also prevent the caudal screw from loosening. [ABSTRACT FROM AUTHOR]

Sufficient evidence supports arguments that early life conditions can influence adult morbidity and mortality in the past and present. Critical periods in which individuals are more susceptible to stressors leading to long‐term effects vary, but how often and to what degree these long‐term effects occur is less certain. To evaluate skeletal stress markers that fully develop during different life history stages (i.e., childhood and adolescence) and explore their influence on adult morbidity and mortality, we constructed four growth trajectory categories to estimate the effect of developmental timing of stress indicators on adult mortality risk in skeletal samples from post‐medieval London (n = 118 individuals). To construct these growth trajectory categories, linear enamel hypoplasia and tibial length were used as evidence of early life stress during childhood and extended into adolescence. Pairwise relationships between growth trajectory scores and variables such as age, sex, and cemetery were explored using Chi‐square and Fisher's exact tests. Long‐term effects were also evaluated using Factorial ANOVA as a multifactorial method to test correlations between categorical variables of early life stress and adult mortality risk. Results suggest there was no relationship between age‐at‐death and growth trajectory score, with the only significance in growth disruption score being between tibial stunting and age‐at‐death in males. Socioeconomic status did not impact results of this study, with only two statistically significant relationships noted for one cemetery. Results comparing males and females also yielded no significant differences, indicating sex was not a significant covariate. Overall, this paper presents a model that can help investigate differences between various developmental origins frameworks and be built upon by future researchers using different stress indicators, datasets, and skeletal samples to investigate potential change through time in lived experiences and how that change through time impacts patterns of mortality risk. [ABSTRACT FROM AUTHOR]

The importance of home in constructing notions of identity, self, and belonging is well recognized in the aging in place literature. However, much of the research has focused on mainstream population groups, rather than on the experiences of ethnic minority communities, whose lifecourse trajectories may reveal one of transience in relation to place, aging and home. Based on 48 semi-structured individual interviews and five community mapping workshops with 65 older Turkish adults living in north London, this paper aims to provide insight into how the home is negotiated and understood by older Turkish migrants. Thematic analysis of the data revealed three interrelated themes important to the narratives of older Turkish people: "Home as a reflection of identity and self", "Home as a social and cultural place" and "Transnationality, mobility and home". [ABSTRACT FROM AUTHOR]

Botanic gardens, as well as being widely acknowledged as beautiful places, are often scientific organisations that aim to engage visitors, including families, in science learning. Yet, the extent to which families view them as settings for science learning is largely unexplored. Drawing upon social constructivist perspectives, this paper investigates families’ views of science learning at Kew Gardens. Kew is one of the largest botanic gardens worldwide and an internationally renowned scientific organisation located in London, UK. Twenty-four families took part in the study, which involved interviews and accompanied visits. Findings indicate that all families referred primarily to the aesthetic beauty of Kew, while its function as a site for science learning was less well acknowledged. However, interpretation helped families establish what constitutes science at Kew, and linked science to the beautiful plants, which offered avenues for families to appreciate science learning. The findings provide implications for developing interpretive provision in botanic gardens. [ABSTRACT FROM AUTHOR]

In this paper we examine the contradictory migration experiences of Indian youth who recently moved to Britain on a student or temporary work visa and discuss the perspectives of their middle-class families in Gujarat. Like many young people in developing countries, our informants dreamed of going to the West to earn money and improve their prospects at home but ended up in low-status, semi-skilled jobs to cover their expenses, living in small guesthouses crammed with newly arrived migrants. Why did these young people leave India and go to London and what do they get by moving abroad? Based on research in London and Gujarat, our findings show that the decision to migrate is shaped by a combination of individual and social motivations. These young people moved to London not only to earn money and gain new experiences but also to escape family pressures by living away from their parents. Their parents encourage them, though they are aware of the difficulties their children face in London. They regard the migration as a requisite precautionary strategy to maintain their status as middle-class families in India, thereby safeguarding the next generation's future prospects. [ABSTRACT FROM PUBLISHER]

Background: The London Classification for anorectal physiological dysfunction specifically proposes rectoanal areflexia (RA), which means the absence of a rectoanal inhibitory reflex (RAIR) based on a manometric diagnosis. Although RA is not observed in healthy people, it can be found in adult patients with functional constipation (FC). This study describes the clinical manifestations of adult patients with FC and RA and their response to biofeedback therapy (BFT). Methods: This retrospective study reviewed the reports of high-resolution anorectal manometry (HR-ARM) and the efficacy of BFT in adult patients with FC. In addition, the Constipation Scoring System (CSS) scale, Patient Assessment of Constipation Symptoms (PAC-SYM) scale, Patient Assessment of Constipation Quality of Life (PAC-QOL) scale, Zung's Self-Rating Anxiety Scale (SAS), Zung's Self-Rating Depression Scale (SDS), balloon expulsion test (BET), and the use of laxatives were assessed. Results: A total of 257 adult patients diagnosed with FC were divided into the RA group (n = 89) and the RAIR group (n = 168). In the RA and RAIR groups, 60 (67.4%) and 117 (69.6%) patients, respectively, had dyssynergic defecation (DD) during simulated defecation. Type II pattern of dyssynergia was most frequently observed in both groups. Compared with the RA group, the RAIR group showed a higher CSS score, physical discomfort score, and prevalence of inadequate relaxation of the anal sphincter (p < 0.001, p = 0.036, and p = 0.017, respectively). The anxiety and depression scores were not different between the two groups. The proportion of patients using volumetric and stimulant laxatives and their combination was significantly higher in FC patients with RA, whereas the efficacy of BFT was significantly lower (p = 0.005, p < 0.001, p = 0.045, and p = 0.010, respectively). Conclusion: Adult FC patients with RA may suffer more severe constipation and have a lower efficacy of BFT compared with those with RAIR. [ABSTRACT FROM AUTHOR]

Examines the transition from school to further education or employment of young people in London, England. Characteristics of young people; Family relations; Post-adolescence status; Refusal to adulthood; Changes in identity, efficacy and self-esteem among young people.

BACKGROUND: Chronic constipation is a prevalent disorder that affects patients' quality of life and consumes resources in healthcare systems worldwide. In clinical practice, it is still considered a challenge as clinicians frequently are unsure as to which treatments to use and when. Over a decade ago, a Neurogastroenterology & Motility journal supplement devoted to the investigation and management of constipation was published (2009; 21 (Suppl.2)). This included seven articles, disseminating all themes covered during a preceding 2‐day meeting held in London, entitled "Current perspectives in chronic constipation: a scientific and clinical symposium." In October 2018, the 3rd London Masterclass, entitled "Contemporary management of constipation" was held, again over 2 days. All faculty members were invited to author two new review articles, which represent a collective synthesis of talks presented and discussions held during this meeting. PURPOSE: This article represents the first of these reviews, addressing epidemiology, diagnosis, clinical associations, pathophysiology, and investigation. Clearly, not all aspects of the condition can be covered in adequate detail; hence, there is a focus on particular "hot topics" and themes that are of contemporary interest. The second review addresses management of chronic constipation, covering behavioral, conservative, medical, and surgical therapies. [ABSTRACT FROM AUTHOR]

The implementation of community care in the UK has led to the requirement that services should be able to meet the needs of adults with intellectual disability (ID) and additional needs in terms of challenging behaviour. However, the extent to which people with challenging behaviour are present in the community and the extent to which community services can support them effectively still requires significant research. The present study examines the prevalence of challenging behaviour amongst adults with ID residing in three London boroughs and the issues which arise from service delivery to this client group. All service providers and general practitioners in the area were contacted and asked to identify any individuals with ID and challenging behaviour. All responses were screened, and then key staff were interviewed for information on a range of demographic factors and on the Checklist of Challenging Behaviour. The reliability of the instrument was also assessed. Four hundred and forty‐eight individuals were identified from a total borough population of 670 000. There was consistency in the types of behaviour which were frequently identified across the three boroughs. There were significant levels of self‐injury as well as a range of behaviours of the 'hard to engage' type. Most individuals had more then one challenging behaviour and some individuals with seriously aggressive behaviour used local community services. Twenty‐five per cent of the sample lived at home with their families and 50% were in community residential services. The boroughs differed in their ability to manage those with challenging behaviour in that one borough had many more people placed out‐of‐borough. Significant numbers of individuals with challenging behaviour were living in the community. The range and number of behaviours suggest that staff need to be very skilled in supporting such individuals, and that effective planning and support are essential if people with challenging behaviour are to be maintained in community settings. [ABSTRACT FROM AUTHOR]

The article discusses that the breeding status of two additional species that also fell into this category of "presumed breeding, but without proof" have now been proven. Barbara Mulligan found a pupa of Dewick's Plusia Macdunnoughia confusa (Steph.). It mentions that the leaves of a cabbage Brassica oleracea grown on an allotment in the Ealing area of West London on 2 November 2020.

Summary Background Convulsive status epilepticus is the most common childhood medical neurological emergency, and is associated with significant morbidity and mortality. Most data for this disorder are from mainly adult populations and might not be relevant to childhood. Thus we undertook the North London Status Epilepticus in Childhood Surveillance Study (NLSTEPSS): a prospective, population-based study of convulsive status epilepticus in childhood, to obtain a uniquely paediatric perspective. Methods Clinical and demographic data for episodes of childhood convulsive status epilepticus that took place in north London were obtained through a clinical network that covered the target population. We obtained these data from anonymised copies of a standardised admission proforma; accident and emergency, nursing, ambulance, and intensive-care unit notes; and interviews with parents, medical, nursing, and paramedic staff. We investigated ascertainment using capture-recapture modelling. Findings Of 226 children enrolled, 176 had a first ever episode of convulsive status epilepticus. We estimated that ascertainment was between 62% and 84%. The ascertainment-adjusted incidence was between 17 and 23 episodes per 100 000 per year. 98 (56%, 95% CI 48-63) children were neurologically healthy before their first ever episode and 56 (57%, 47-66) of those children had a prolonged febrile seizure. 11 (12%, 6-18) of children with first ever febrile convulsive status epilepticus had acute bacterial meningitis. Conservative estimation of 1-year recurrence of convulsive status epilepticus was 16% (10-24%). Case fatality was 3% (2-7%). Interpretation Convulsive status epilepticus in childhood is more common, has a different range of causes, and a lower risk of death than that in adults. These paediatric data will help inform management of convulsive status epilepticus and appropriate allocation of resources to reduce the effects of this disorder in childhood. [ABSTRACT FROM AUTHOR]