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Music has been shown to improve social interaction and attention to verbal stimuli in autism. We report a feasibility randomised controlled trial of an online intervention using music-assisted programmes, compared with best-practice treatment (Social Communication Intervention for Pre-schoolers-Intensive) for language learning in preschool autistic children with minimal verbal language. Minimisation randomisation ensured comparability of groups before intervention. Ninety-one people expressed interest in taking part; 27 met eligibility criteria and were randomised to receive either music-assisted programmes or Social Communication Intervention for Pre-schoolers--Intensive. Children and their parent received two 45-min sessions weekly, over 18 weeks, coached online by a speech and language therapist. A smartphone app was developed to support home-based practice between sessions. Over the study period, 20% of participants completed the intervention and assessments of outcome measures. At 3 months post-intervention follow-up, social responsiveness, understanding of words and phrases and number of words spoken and parent-child interaction improved more in the music-assisted programmes than the Social Communication Intervention for Pre-schoolers-Intensive group. The results demonstrate the feasibility of recruiting this population into a randomised controlled trial and the music-assisted programmes had high perceived acceptability highlighted by parent interviews. A full clinical trial to establish music-assisted programmes' effectiveness in improving early vocabulary learning in autistic children is warranted.

This paper describes the collaborative development of an agenda for research on e-assessment in undergraduate mathematics. We built on an established approach to develop the agenda from the contributions of 22 mathematics education researchers, university teachers and learning technologists interested in this topic. The resulting set of 55 research questions are grouped into 5 broad themes: errors and feedback, student interactions with e-assessment, design and implementation choices, affordances offered by e-assessment tools, and mathematical skills. This agenda gives a framework for a programme of research aligned with practical concerns that will contribute to both theoretical and practical development.

Success of the UK's Spherical Tokamak for Energy Production (STEP) programme requires a robust plasma control system. This system has to guide the plasma from initiation to the burning phase, maintain it there, produce the desired fusion power for the desired duration and then terminate the plasma safely. This has to be done in a challenging environment with limited sensors and without overloading plasma-facing components. The plasma parameters and the operational regime in the STEP prototype will be very different from tokamaks, which are presently in operation. During fusion burn, the plasma regime in STEP will be self-organizing, adding further complications to the plasma control system design. This article describes the work to date on the design of individual controllers for plasma shape and position, magneto hydrodynamic instabilities, heat load and fusion power. Having studied 'normal' operation, the article discusses the philosophy of how the system will handle exceptions, when things do not go exactly as planned. This article is part of the theme issue 'Delivering Fusion Energy – The Spherical Tokamak for Energy Production (STEP)'. [ABSTRACT FROM AUTHOR]

Anxiety in autism is an important treatment target because of its consequences for quality of life and well-being. Growing evidence suggests that cognitive behaviour therapies and mindfulness-based therapies can ameliorate anxiety in autism but cost-effective delivery remains a challenge. This pilot randomised controlled trial examined whether online cognitive behaviour therapy and mindfulness-based therapy self-help programmes could help reduce anxiety in 54 autistic adults who were randomly allocated to either an online cognitive behaviour therapy (n = 16) or mindfulness-based therapy (n = 19) programme or a waitlist control group (n = 19). Primary outcome measures of anxiety, secondary outcome measures of broader well-being and potential process of change variables were collected at baseline, after programme completion, and then 3 and 6 months post-completion. Baseline data confirmed that intolerance of uncertainty and emotional acceptance accounted for up to 61% of self-reported anxiety across all participants. The 23 participants who were retained in the active conditions (14 mindfulness-based therapies, 9 cognitive behaviour therapies) showed significant decreases in anxiety that were maintained over 3, and to some extent also 6 months. Overall, results suggest that online self-help cognitive behaviour therapy and mindfulness-based therapy tools may provide a cost-effective method for delivering mental health support to those autistic adults who can engage effectively with online support tools.

Background: Managing diagnostic uncertainty is a major challenge in primary care due to factors such as the absence of definitive tests, variable symptom presentations and disease evolution. Maintaining patient trust during a period of investigative uncertainty, whilst minimising scope for diagnostic error is a challenge. Mismanagement can lead to diagnostic errors, treatment delays, and suboptimal patient outcomes. Objective: Our aim was to explore how UK primary care physicians (GPs) address and communicate diagnostic uncertainty in practice. Design: This qualitative study used video and audio-recordings. Verbatim transcripts were coded with a modified, validated tool to capture GPs' actions and communication in primary care consultations that included diagnostic uncertainty. The tool includes items relating to advice regarding new symptoms or symptom deterioration (sometimes called 'safety netting'). Video data was analysed to identify GP and patient body postures during and after the delivery of the management plan. Participants: All patient participants had a consultation with a GP, were over the age of 50 and had (1) at least one new presenting problem or (2) one persistent problem that was undiagnosed. Approach: Data collection occurred in GP-patient consultations during 2017–2018 across 7 practices in UK during 2017–2018. Key results: GPs used various management strategies to address diagnostic uncertainty, including (1) symptom monitoring without treatment, (2) prescribed treatment with symptom monitoring, and (3) addressing risks that could arise from administrative tasks. GPs did not make management plans for potential treatment side effects. Specificity of uncertainty management plans varied among GPs, with only some offering detailed actions and timescales. The transfer of responsibility for the management plan to patients was usually delivered rather than negotiated, with most patients confirming acceptance before concluding the discussion. Conclusions: We offer guidance to healthcare professionals, improving awareness of using and communicating management plans for diagnostic uncertainty. [ABSTRACT FROM AUTHOR]

Joint Institutions are created from two different universities joining together to create a collaborative research and education effort. Compared to traditional universities, several unique challenges present themselves from this arrangement. We are especially interested in the student experience at UK-China Joint Institutes. We therefore organized a conference with the UK-China Joint Institute Alliance to aggregate knowledge on this issue. This paper summarizes the topics presented and discussed at the conference including: student learning and methods with which to measure and improve it, monitoring and incentivizing student engagement, the transition period from high school to university, teaching evaluations of staff, and lastly, learning and teaching during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Recognised as essential for high-quality dementia service, person-centred care aims to understand and respect the unique needs of each individual. Self-experience practices may offer caregivers an opportunity to acquire knowledge, empathy, and skills related to person-centred care, especially through recreating experiences similar to dementia. Given the need to enhance the understanding of self-experience practices in dementia care, a more comprehensive investigation of these training interventions for (future) caregivers is needed. Methods: We conducted a scoping review to map the evidence on the use of self-experience practices in dementia training. We systematically searched Cochrane Library, MEDLINE via PubMed, CINAHL, and Web of Science. We also searched for grey literature, as well as registry entries, and conducted backward citation tracking of included reviews. We analysed data on intervention characteristics, factors influencing the implementation, and learning outcomes based on Kirkpatrick's model. Results: We included 44 reports across 30 intervention programmes. The majority of reports (91%) were published from 2016 onwards, with 32% originating from the USA and 25% from the UK. We identified passive, interactive, immersive, and multicomponent self-experience interventions in dementia education and training. Learning outcomes based on Kirkpatrick's model were fairly distributed across all identified modalities. Both consumers and providers emphasised aspects related to the development and implementation of practices, particularly organisational-related considerations such as temporal and spatial planning of trainings. Conclusions: Our review highlights diverse interventions incorporating self-experience practices, with an increasing role for technological tools. While self-experience interventions engage participants, the impact on individuals with dementia and organisational levels remain largely unreported. Our overview, informed by current literature, underscores unique considerations and challenges associated with dementia-related self-experience practices. Implementing and evaluating complex training interventions using self-experience practices should consider ethical aspects. Trial registration: Registry: Registered within the Open Science Framework (available at https://osf.io/fycxa/). [ABSTRACT FROM AUTHOR]

Pressure on evaluators has been investigated recently by surveys in the USA, the UK, Germany, and Switzerland. This study compares the results of those studies regarding pressure on evaluators in different countries. The findings suggest that independence of evaluations does not exist for many respondents. Moreover, the person who commissioned the evaluator for evaluation is identified by all studies as the primary influencing stakeholder in the evaluation process. In terms of differences, Germany seems to be more prone to pressure on evaluators. However, German evaluators do not show stronger tendencies to surrender to pressure than the other countries' respondents. We suggest that this pattern may be explained by the strong state tradition in Germany as opposed to the U.S. and Switzerland, in conjunction with evaluators' profession-based, principled resistance to such pressure.

For the first issue of the renamed journal, Modern British History co-editor Erik Linstrum convened a group of scholars to reflect on the past, present, and possible futures of the field. The resulting contributions make no claim to provide a comprehensive or representative survey. Rather, they offer a variety of perspectives on where modern British history has been and where it might be going. Several contributions, written by former editors of Twentieth Century British History , drawn on the history of the journal as a way of thinking about the direction of the field and its subfields. Others consider the place of modern Britain in the wider discipline of history, grappling with questions of temporality and embodiment; the institutional and material contexts of scholarship; the role of national histories in a transnational world; and the response of historical writing to epidemiological, humanitarian, and ecological crisis. The sequence of contributions mirrors the evolution of the journal since its founding in 1990, beginning with political history and gradually encompassing a much broader range of subjects and methodologies as well as an expanded geographical ambit. Here are archive stories, pleas for new subjects, roadmaps for new approaches to old subjects, and attempts to identify master narratives. Taken together, these contributions demonstrate that modern British history has many houses—which is both a sign of intellectual vitality and a challenge for anyone wishing to generalize about the 'state of the field'. If British modernity remains an abundant resource for 'thinking with', its contours and frontiers are tantalizingly up for grabs. [ABSTRACT FROM AUTHOR]

Mental health symptoms are highly prevalent in university students and have been further exacerbated following the COVID-19 pandemic. The aim of this study was to examine the prospective prediction of five mental health symptoms (anxiety, depression, insomnia, suicidality, substance misuse risk) on university non-completion. Baseline data were collected between July and September 2020 following the first UK lockdown and prior to the 2020/2021 academic year. Univariate binary logistic regression analyses were performed using data from 147 participants who were due to graduate at the end of the 2020/2021 academic year. Only substance misuse risk was found to predict university non-completion, with students with a higher risk of substance misuse more likely to not complete their university course. There appears to be an association between substance misuse risk and university non-completion; however, this was attenuated once study characteristic covariates (study level, changes in study hours and study engagement) were included, indicating possible associations between these variables. Future research should further consider the role of substance use in this population and the relationship with study characteristics, engagement and university completion. [ABSTRACT FROM AUTHOR]

Cowpox virus is considered to be a re-emerging zoonotic pathogen and a public health threat due to increasing numbers of cases in humans and animals in Europe over the past decade, including within the United Kingdom (UK). We present epidemiological data and diagnostic features of 27 recent, naturally occurring cowpox cases in zoo and wild animals across the UK, including the first reports of cowpox in two snow leopards (Panthera uncia), a Bengal tiger (Panthera tigris tigris), three Chilean pudus (Pudu puda), a Malayan tapir (Tapirus indicus) and a Eurasian otter (Lutra lutra), and the first reports of Orthopoxvirus infection in a lar gibbon (Hylobates lar), a Southern tamandua (Tamandua tetradactyla) and an aardvark (Orycteropus afer). This study provides a detailed overview of cowpox infections in a wide range of non-domestic animal species, presents a range of methods for diagnosis and demonstrates the value of retrospective analysis of pathology surveillance in revealing epidemiological links. [Display omitted] [ABSTRACT FROM AUTHOR]

This study aims to further our understanding of metalearning activity through the analysis of qualitative data gathered from 370 first-year microeconomics students in three UK universities. The students were asked to produce undirected reflective essays in response to a personal "learning profile" generated before, and after, the teaching of a threshold concept. The purpose was to compare the capacity and/or inclination of students studying threshold concepts to write about their learning in a manner that conveys an understanding of the self, and sense of control, in the associated process. Findings are first, that as a posited benefit of the metalearning experience a majority of students demonstrate an increased level of control over their learning of threshold concepts, and second that the metalearning activity may provide the basis for study support intervention, tailored to the individual student's needs as identified in their self-reported learning profile and reflective essay. (Contains 3 tables and 3 notes.)

In the USA and UK, at least one in ten children and young people have special health, developmental and mental health concerns. Most of these people have typically developing brothers and sisters. As the people who, over the course of their lifetimes together, will be most involved with their siblings with special needs, it is important that typically developing brothers and sisters are involved and empowered in their growing relationship with their sibling. This article discusses the importance of providing relevant support for siblings and recognising, validating and including their unique perspectives. It presents the Sibshop model of sibling support, pioneered and directed by Donald Meyer at the Sibling Support Project in Seattle, USA, followed by Sally Conway's description of Sunsibs, a sibling participation model from Sunfield School in the UK adapted from Sibshops.

The authors investigated whether speakers who named several objects processed them sequentially or in parallel. Speakers named object triplets, arranged in a triangle, in the order left, right, and bottom object. The left object was easy or difficult to identify and name. During the saccade from the left to the right object, the right object shown at trial onset (the interloper) was replaced by a new object (the target), which the speakers named. Interloper and target were identical or unrelated objects, or they were conceptually unrelated objects with the same name (e.g., "bat" [animal] and [baseball] "bat"). The mean duration of the gazes to the target was shorter when interloper and target were identical or had the same name than when they were unrelated. The facilitatory effects of identical and homophonous interlopers were significantly larger when the left object was easy to process than when it was difficult to process. This interaction demonstrates that the speakers processed the left and right objects in parallel. (Contains 1 figure, 1 table, and 2 footnotes.)

Three dual-task experiments investigated the capacity demands of phoneme selection in picture naming. On each trial, participants named a target picture (Task 1) and carried out a tone discrimination task (Task 2). To vary the time required for phoneme selection, the authors combined the targets with phonologically related or unrelated distractor pictures (Experiment 1) or words, which were clearly visible (Experiment 2) or masked (Experiment 3). When pictures or masked words were presented, the tone discrimination and picture naming latencies were shorter in the related condition than in the unrelated condition, which indicates that phoneme selection requires central processing capacity. However, when the distractor words were clearly visible, the facilitatory effect was confined to the picture naming latencies. This pattern arose because the visible related distractor words facilitated phoneme selection but slowed down speech monitoring processes that had to be completed before the response to the tone could be selected. (Contains 3 tables and 3 figures.)

In the UK, the discourse of innocence currently prevails as a major way of understanding children. This article argues that the strength of this discourse lies in its prevalence, its resistance to challenges and the ways in which it connects ideas of innocence and vulnerability. The moral quality of the discourse of innocence works in conjunction with the sacred status of the child, to produce childhood as a moral rhetoric. Children and childhood function to explain and legitimize any practice or opinion as right while removing the necessity to provide reasons: children are the reason. The article also considers how issues around childhood and morality are implicated in the generation of social concern with risks affecting children. (Contains 1 note.)

This paper highlights perspectives on action research in education, health and social care and was originally presented as a keynote at the International Practitioner Research Conference and Collaborative Action Research Conference in 2005. The paper links with the other conference keynote given by Stephen Kemmis, co-author of "Becoming Critical". It reflects on the importance of Being Caring in action research in the context of health and social care; particularly in relation to emotionally supporting practitioners to improve their practice in settings which do not always welcome more emancipatory or critical approaches often used in education. The paper begins by exploring the nature of practitioner research and action research in health and social care and its links with quality. It argues that health and social care professionals have often drawn their methodological understanding from the literature written by colleagues in education. This literature tends to support critical and emancipatory forms of action research, which health and social care professionals have tended to adopt in an uncritical manner. Reflecting on some of the contextual constraints in health and social care, it argues that many of these factors are beyond the control of individual practitioners and suggests a need to focus on the neglected area of emotions, in addition to, contextual issues. To illustrate the usefulness of this approach an example of psychodynamically informed action research is given. The paper concludes that in the quest to be critical, practitioner researchers/action researchers in education, health and social care may be ignoring the emotional contexts in which they work. It suggests that being caring may be the key to being critical.

This article reports on selected findings from an action research study that looked at the lessons learnt from setting up a new in-patient stroke service in a London teaching hospital. Key participants in the design and evaluation of this 2-year study included members of the multi-professional stroke team and support staff within the unit, the hospital management team and representatives of patients and carers. Mixed methods (focus groups, indepth interviews, audits, documentary analysis, participant observation field notes) were used to generate data. Findings demonstrated positive change over time with four main themes emerging from the process: building a team; developing practice-based knowledge and skills in stroke; valuing the central role of the nurse in stroke care; and creating an organisational climate for supporting change. The interplay of these non-linear, but interrelated factors is supported by complexity theory, which includes exploration of how the sum of a whole can be more than its constituent parts. Findings are likely to be of interest to practitioners, managers and policy makers interested in supporting change in a learning organisation. (Contains 2 tables, 2 figures and 1 note.)

Existing literature has highlighted concerns over working conditions in the UK National Health Service (NHS), with healthcare workers frequently citing work-life balance issues and stress as being drivers of attrition and burnout. However, we do not know whether these problems have become worse over time, particularly over the past decade, during which there have been multiple shocks to the UK healthcare system. To investigate this, we analysed data from NHS monthly workforce statistics and the UK Household Longitudinal Study. Three times as many workers left the NHS in 2021 for work-life balance reasons than in 2011, while estimated satisfaction with one's amount of leisure time for healthcare workers fell by three times the amount that it fell for non-healthcare workers. Both satisfaction with amount of leisure time and satisfaction with income have remained lower for healthcare workers than for other public sector workers. By 2020, a worker that had low satisfaction with their amount of leisure time was as much as 22 percentage points less likely than in 2010 to remain in healthcare in the following year. Overall, working conditions in UK healthcare have deteriorated between 2010 and 2020, especially relative to the private sector. However, overall job satisfaction has fallen faster in other areas of the public sector than it has in healthcare, which may indicate wider issues within the UK public sector as a whole. [ABSTRACT FROM AUTHOR]

Provides the views of four advancement officers on why undertaking advancement-related graduate study is valuable. Presents a list with contact information of almost 100 graduate and certificate programs in the United States, Canada, Australia, and the United Kingdom related to institutional advancement. (EV)

Compares and contrasts several models and approaches to citizenship education including those currently in use in Canada, the United States, Australia, and the United Kingdom. Outlines the salient aspects of each approach including emphasis on skills or competencies, necessary knowledge for citizenship, and ideal conceptions of the nature of citizenship. (MJP)

Introduction:Despite the lack of high-quality evidence regarding its long-term effectiveness, intravenous corticosteroid therapy is recommended as the standard treatment of acute multiple sclerosis relapses in Germany. High financial expenses and the equivalent effectiveness of oral corticosteroid therapy contrast with this trend. There is an urgent need to provide patients with evidence-based and comprehensible information on relapse management and to actively involve patients in relapse treatment decisions. Web-based decision support on relapse management could be an effective measure to empower people with multiple sclerosis making informed treatment decisions. Objectives: To develop a web-based programme on relapse management for people with multiple sclerosis and evaluate the feasibility and acceptability of the intervention. Methods: The study followed the first two phases of the UK Medical Research Council Framework for complex interventions. The first phase involved the development of an interactive web-based programme on relapse management. The second phase focused on the feasibility and pilot testing of the programme with people with multiple sclerosis and experts with a professional background in multiple sclerosis. Data was obtained using questionnaires with closed- and open-ended questions as well as qualitative semi-structured telephone interviews. Quantitative data was analyzed descriptively, whereas qualitative data was clustered by topic. Results: Feasibility of the intervention programme was tested with 10 people with multiple sclerosis and 10 experts. Feasibility testing indicated good practicability and acceptance of the content. After revision, the programme was piloted with seven people with multiple sclerosis and three experts. The results showed good acceptance in both groups. Based on the feedback, a final revision was performed. Conclusion: Feasibility and pilot testing indicated good user-friendliness, acceptance, and practicability of the programme. The programme is currently evaluated in a randomized controlled trial (Registration Number on ClinicalTrials.gov: NCT04233970). It is expected that the programme will have a positive impact on patients' relapse management and strengthen their autonomy and participation. [ABSTRACT FROM AUTHOR]

Purpose: During the coronavirus disease 2019 (COVID-19) pandemic, intensive care units (ICUs) around the world introduced virtual visiting to mediate the psychological impact of in-person visiting restrictions. Our objective was to evaluate levels of distress, depression, anxiety, and stress among family members experiencing virtual visits.Methods: Multi-centre prospective observational study recruiting adult family members of critically ill patients in the United Kingdom (UK) using a bespoke virtual visiting solution (aTouchAway). We recruited participants and administered validated questionnaires digitally via their aTouchAway account. Prior to first virtual visit, participants completed the Distress Thermometer (score range 0-10) and the Depression, Anxiety and Stress Scale (DASS)-21. Following first and subsequent virtual visits, participants repeated the Distress Thermometer and completed the Discrete Emotions Questionnaire.Results: We recruited 2166 adult family members of ICU patients in 37 UK hospitals. Most were grown up children (33%) or spouses/partners (23%). Most (91%) were ≤ 65 years. Mean (SD) pre-virtual-visit Distress Thermometer score was 7 (2.6) with 1349/2153 (62%) reporting severe distress. Pre-visit Distress Thermometer scores were associated with relationship type (spouse/partner OR 1.65, 95% CI 1.27-2.12) but not family member age, or length of ICU stay. Mean (SD) post-visit Distress Thermometer score provided by 762 (35%) participants was 1.6 (3.2) points lower than pre-visit (P < 0.001). Of participants experiencing multiple visits, 22% continued to report severe distress. Median (IQR) pre-visit DASS-21 score was 18 (2-42) (1754 participants). Severe-to-extremely severe depression, anxiety, or stress were reported by 249 (14%), 321 (18%), and 165 (9%) participants, respectively. Participants reported a range of emotions with reassurance being the most common, anger being the least.Conclusion: Family members exposed to COVID-19 pandemic ICU visiting restrictions experienced severe distress. One fifth of family members reported severe-to-extremely sever anxiety or depression. Distress score magnitude and prevalence of severe distress decreased after undertaking one or more virtual visits. [ABSTRACT FROM AUTHOR]

Background: The cost of sickness absence has major social, psychological and financial implications for individuals and organisations. Return-to-work (RTW) interventions that support good quality communication and contact with the workplace can reduce the length of sickness absence by between 15 and 30 days. However, initiatives promoting a sustainable return to work for workers with poor mental health on long-term sickness absence across small, medium and large enterprises (SMEs and LEs) are limited. This paper describes the protocol of a pilot randomised controlled trial (RCT) to test the feasibility of implementing a RTW intervention across SMEs and LEs across all sectors. Methods and design: A two-arm feasibility RCT with a 4-month intervention will be conducted in SMEs and LE enterprises from the Midlands region, UK. At least 8 organisations (4 controls and interventions), and at least 60 workers and/or managers, will be recruited and randomised into the intervention and control group (30 interventions, 30 controls). Workers on long-term sickness absence (LTSA) (between 8 and 50 days) and managers with a worker on LTSA will be eligible to participate. The intervention is a behavioural change programme, including a managers and workers RTW toolkit, focused on supporting sickness absence and RTW through the provision of knowledge, problem-solving, action planning, goal setting and positive communication that leads to a sustainable RTW. Organisations assigned to the control group will continue with their usual practice. Measurements of mental health, RTW, work outcomes, quality-of-life, workplace support and communication and other demographic data will be taken at baseline, 2 months and 4 months. Feasibility will be assessed based on recruitment, retention, attrition, completion of measures and intervention compliance for which specific process and research outcomes have been established. A process evaluation will explore the experiences and acceptability of the intervention components and evaluation measures. Exploratory economic evaluation will be conducted to further inform a definitive trial. Discussion: This is a novel intervention using a worker-manager approach to promote a sustainable return to work of workers on long-term sick leave due to poor mental wellbeing. If this intervention is shown to be feasible, the outcomes will inform a larger scale randomised control trial. Trial registration: ISRCTN90032009 (retrospectively registered, date registered 15th December 2020) [ABSTRACT FROM AUTHOR]

Background: Cow's milk allergy (CMA) is one of the most common food allergies among children. Whilst avoidance of cow's milk protein is the cornerstone of management, further treatment of symptoms including those affecting the gastrointestinal, skin and respiratory systems plus other allergic comorbidities, maybe required. This study aimed to quantify the wider economic impact of CMA and its management in the United Kingdom (UK). Methods: We conducted a retrospective matched cohort study on children with CMA (diagnosis read code and/or hypoallergenic formula prescription for ≥3 months) examining healthcare data (medication prescriptions and healthcare professional contacts) from case records within The Health Improvement Network (A Cegedim Proprietary Database) in the UK. A comparative cost analysis was calculated based on healthcare tariff and unit costs in the UK. Results: 6998 children (54% male; mean observation period 4.2 years) were included (n = 3499 with CMA, mean age at diagnosis 4.04 months; n = 3499 matched controls without CMA). Compared to those without CMA, medications were prescribed to significantly more children with CMA (p < 0.001) at a higher rate (p < 0.001). Children with CMA also required significantly more healthcare contacts (p < 0.001) at higher rate (p < 0.001) compared to those without CMA. CMA was associated with additional potential healthcare costs of £1381.53 per person per year. Conclusion: The findings of this large cohort study suggest that CMA and its associated co‐morbidities presents a significant additional healthcare burden with economic impact due to higher prescribing of additional medications. Further research into management approaches that may impact these clinical and economic outcomes of CMA is warranted. [ABSTRACT FROM AUTHOR]

Family mealtimes can be important for supporting children's healthy development, yet the emotional context of mealtimes can vary considerably, likely impacting their overall success and enjoyment. Yet, despite having an important role, little is known about how parents emotionally experience mealtimes with their family. The first aim of the current study was to assess the factor structure of a novel self‐report measure to assess parents' emotional responses experienced during family mealtimes (Mealtime Emotions Measure for Parents; MEM‐P). The second aim was to examine relationships between maternal mealtime emotions and their food parenting practices. Mothers of children aged between 1.5 and 6 years participated in this study. Mothers were invited to complete an online questionnaire measuring family mealtime emotions, anxiety, depression and food parenting practices. Exploratory factor analysis produced a three‐factor solution comprising both positive and negative emotion subscales: MEM‐P Efficacy; MEM‐P Anxiety; MEM‐P Stress and Anger. Mothers' positive mealtime emotions (mealtime efficacy) were related to greater use of practices promoting autonomy, providing a healthy home food environment, and modelling healthy eating. Higher anxiety about mealtimes was related to greater reports of child control over eating, and mealtime stress and anger was associated with greater use of food to regulate emotions. These findings highlight novel relationships between how mothers emotionally experience family mealtimes and the food parenting practices they use with their children. It is important to develop resources to help promote positive maternal experiences of family mealtimes and food‐based interactions. Key messages: Mothers of young children experience a range of positive and negative emotions around family mealtimes.Mothers' mealtime emotions are related to the food parenting practices they report using with their children.Mothers with more positive emotional experiences of family mealtimes (i.e., greater mealtime efficacy) also reported higher use of food parenting practices which promote autonomy in children (e.g., involvement, balance and variety, teaching about nutrition) and which provide feeding structure (e.g., healthy food environment; modelling healthy eating).Some parents may benefit from further support to help them promote more positive mealtime experiences and food‐based interactions. [ABSTRACT FROM AUTHOR]

In this study, online sentiment (OS) was used to explore customer experience (CX) for the telecommunications industry. There is no agreed standard for CX measurement with many challenges in metrics like Net Promoter Score (NPS). The study explored the CX of the UK's four biggest consumer-facing telecommunications companies by isolating CX from brand perception sentiment, tracking sentiment along the customer journey and observing CX across platforms. The findings show that CX sentiment can be isolated from brand perception and that customer satisfaction levels change along the customer journey. In addition, CX sentiment also differs between service channels. [ABSTRACT FROM AUTHOR]

Autonomous equipment for crop production is on the verge of technical and economic feasibility, but government regulation may slow its adoption. Key regulatory issues include requirements for on‐site human supervision, liability for autonomous machine error, and intellectual property in robotic learning. As an example of the impact of regulation on the economic benefits of autonomous crop equipment, analysis from the United Kingdom suggests that requiring 100% on‐site human supervision almost wipes out the economic benefits of autonomous crop equipment for small and medium farms and increases the economies‐of‐scale advantage of larger farms. Related Content: How will regulation influence commercial viability of autonomous equipment in US production agriculture? [ABSTRACT FROM AUTHOR]

CALM‐NET was a phase IV exploratory study in the UK that aimed to evaluate if the presence of circulating tumour cells (CTCs) at baseline predicted symptomatic response in patients with midgut neuroendocrine tumours (NETs) treated with lanreotide autogel (LAN). Adults with functional, well/moderately differentiated (Ki‐67 <20%) midgut NETs received LAN 120 mg/28 days for 1 year. CTCs were present in blood if enumeration was >0. Primary endpoint was the clinical value of baseline CTCs to predict symptomatic response (decrease in diarrhoea or flushing of ≥50% frequency, or ≥1 severity level). Other endpoints included progression‐free survival (PFS) and correlations between plasma and urinary biomarkers (including 5‐hydroxyindoleacetic acid [5‐HIAA]). Fifty patients were enrolled; 40 completed the study. Baseline CTCs were present in 22 (45.8%) patients (missing baseline CTC status n = 2). Overall, 87.5% (95% confidence interval [CI]: 73.9; 94.5) of patients had a symptomatic response; a 5.9‐fold higher odds of symptomatic response in patients without CTC versus patients with CTC at baseline was observed, although this was not statistically significant (odds ratio: 0.17 [95% CI: 0.02; 1.65], p =.126). One‐year PFS rate was 66.4% (95% CI: 48.8; 79.2). Biomarker concentrations did not correlate to baseline CTC status. However, there was a strong correlation between plasma and urinary 5‐HIAA (Spearman correlation coefficients ≥0.87 [p <.001], all time points). In conclusion, patients without CTC at baseline may be more likely to achieve a symptomatic response following LAN treatment than patients with CTC. Plasma 5‐HIAA correlated with urinary 5‐HIAA during LAN treatment. ClinicalTrials.gov identifier: NCT02075606. [ABSTRACT FROM AUTHOR]

Collaborations between individuals in firms have important implications for the development of relational and human capital. In knowledge-intensive contexts where collaborations are formed to deliver services to clients, collaboration decisions can involve nontrivial tradeoffs between short-term and long-term benefits: individuals and firms must carefully manage the tradeoffs between leveraging existing relational and human capital for the reliable performance of repeat collaboration and creating new relational and human capital through new collaboration. Building from the premise that servicing clients is central to collaboration decisions in human asset–intensive firms, we examine how client-related factors shape collaboration decisions among lawyers (partners) in UK law firms providing M&A legal advisory services. We focus on three key client-related dimensions that we predict govern collaboration decisions: the depth of individual- and firm-level relationships with the focal client, key client attributes that reflect the client's status and its use of different firms to undertake its outsourced work, and client-driven individual- and firm-level resource constraint. Our empirical findings support our proposition that client-related factors influence the pattern of collaborations between individuals in firms. We also reveal how client-related factors at the individual level can have opposite effects on collaboration decisions from those at the firm level. Overall, our findings contribute to research on relational capital, strategic human capital, team formation, professional service firms, and the microfoundations of strategy. [ABSTRACT FROM AUTHOR]

This article considers the ways in which the male life course in twentieth-century Britain can be reconstructed through individual personal pension files of British disabled ex-servicemen from the First World War. The files contain a range of documentation, including military enlistment and discharge forms, medical records, and correspondence from pensioners, their families, and other advocates. Close reading of five of these files explores pensioners' changing experiences of health and disability. It examines men's physical status as soldiers on enlistment, their ability to find work as physically or psychologically impaired ex-servicemen after the war, the significance of their status as husbands and fathers, and the effects of old age on their identity as men disabled in war. It argues that this ongoing engagement with the gendered legacies of war created a unique and important space in which the memory of the conflict was narrated. [ABSTRACT FROM AUTHOR]

The copepod Calanus finmarchicus (Crustacea, Copepoda) is a key zooplanktonic species with a crucial position in the North Atlantic food web and significant contributor to ocean carbon flux. Like many other high latitude animals, it has evolved a programmed arrested development called diapause to cope with long periods of limited food supply, while growth and reproduction are timed to take advantage of seasonal peaks in primary production. However, anthropogenic warming is inducing changes in the expected timing of phytoplankton blooms, suggesting phenological mismatches with negative consequences for the N. Atlantic ecosystem. While diapause mechanisms are mainly studied in terrestrial arthropods, specifically on laboratory model species, such as the fruit fly Drosophila, the molecular investigations of annual rhythms in wild marine species remain fragmentary. Here we performed a rigorous year‐long monthly sampling campaign of C. finmarchicus in a Scottish Loch (UK; 56.45°N, 5.18°W) to generate an annual transcriptome. The mRNA of 36 samples (monthly triplicate of 25 individuals) have been deeply sequenced with an average depth of 137 ± 4 million reads (mean ± SE) per sample, aligned to the reference transcriptome, and filtered. We detail the quality assessment of the datasets and provide a high‐quality resource for the investigation of wild annual transcriptomic rhythms (35,357 components) in a key diapausing zooplanktonic species. [ABSTRACT FROM AUTHOR]

Purpose: The current study examined the sleep, travel, and recovery responses of elite footballers during and after long-haul international air travel, with a further description of these responses over the ensuing competitive tour (including 2 matches). Methods: In an observational design, 15 elite male football players undertook 18 h of predominantly westward international air travel from the United Kingdom to South America (-4-h time-zone shift) for a 10-d tour. Objective sleep parameters, external and internal training loads, subjective player match performance, technical match data, and perceptual jet-lag and recovery measures were collected. Results: Significant differences were evident between outbound travel and recovery night 1 (night of arrival; P < .001) for sleep duration. Sleep efficiency was also significantly reduced during outbound travel compared with recovery nights 1 (P = .001) and 2 (P = .004). Furthermore, both match nights (5 and 10), showed significantly less sleep than nonmatch nights 2 to 4 and 7 to 9 (all P < .001). No significant differences were evident between baseline and any time point for all perceptual measures of jet-lag and recovery (P > .05), although large effects were evident for jet-lag on d 2 (2 d after arrival). Conclusions: Sleep duration is truncated during long-haul international travel with a 4-h time-zone delay and after night matches in elite footballers. However, this lost sleep appeared to have a limited effect on perceptual recovery, which may be explained by a westbound flight and a relatively small change in time zones, in addition to the significant increase in sleep duration on the night of arrival after the long-haul flight. [ABSTRACT FROM AUTHOR]

Global environmental change is one of the most pressing issues facing future generations. Equipping schoolchildren with a clear understanding of physical geography is therefore a key educational priority. Effectively engaging schoolchildren with complex scientific ideas can be challenging, but with the appropriate tools, scientists can play a valuable role in developing meaningful science communication experiences. Climate Explorers addressed these issues by forging a collaboration between physical geography and social science academics, and 320 UK school students and their teachers in seven primary (elementary) schools. Using insights from co-production techniques and storytelling, the project aimed to 1) produce new open access, online climate science education resources, and 2) test co-production and storytelling approaches to physical geography science engagement. Our findings demonstrated that school children responded especially well to working with 'real life' scientists, where meaningful and memorable educational interactions were forged through the use of narratives, personal experiences and tailored language. Here we summarise our approach, and provide templates that can be readily applied by scientists working across the physical geography spectrum anywhere in the world. The flexibility of the templates means that they can be adapted and developed for a range of formats, from small-scale community workshops to national-scale educational initiatives, for delivery both in-person or online. We hope that our approach will provide a springboard to transform and enhance physical geography science communication more broadly. [ABSTRACT FROM AUTHOR]

Background and aims: Request-a-bet services are a modern gambling product delivered via the social network Twitter, which allow sports bettors to design custom bets. The public nature of Twitter data provided a unique opportunity to investigate patterns of bettor preference and the bookmaker profit margin in soccer, the UK’s favorite sport. Methods: Two multi-method studies. Twitter users’ engagement with request-a-bet services was monitored unobtrusively (n 5 1,406), meaning that potential patterns across users’ requests could be observed, and the bookmaker profit margin could be estimated. Twitter users were also surveyed directly (n 5 55), providing self-report measures of requesta-bet usage. Results: Twitter users requested bets with an average potential payoff of £56.5 per £1 risked (median 5 £9). Overall, 9.7% of requested bets paid-off, but these were mostly bets at short odds. This meant that requests yielded a high bookmaker profit margin of 43.7% (roughly eight times higher than current margins in conventional soccer bets), which increased to 74.6% for bets at longer odds. Requested bets also tended to involve star players from the best teams. Finally, 92.7% of surveyed Twitter users reported placing at least one bet via request-a-bet services (mean 5 44.4 bets). Discussion and conclusions: Researchers can use request-a-bet products to increase their understanding of sports betting behavior. Sports bettors should be given information about how much higher the bookmaker profit margin can be in modern sports bets compared to the conventional sports bets that they may be more familiar with. [ABSTRACT FROM AUTHOR]

Summary: Haematopoietic stem cell transplantation (HSCT) remains the only curative option in Fanconi anaemia (FA). We analysed the outcome of children transplanted for FA between 1999 and 2018 in the UK. A total of 94 transplants were performed in 82 patients. Among the donors, 51·2% were matched related donors (MRD) while the remainder were alternative donors. Most patients received a fludarabine–cyclophosphamide (Flu–Cy)‐based conditioning regimen (86·6%) and in vivo T‐cell depletion with alemtuzumab (69·5%). Five‐year overall survival (OS) was 85·4% [70·4–93.2] with MRD, 95·7% [72·9–99.4] with matched unrelated donors (MUD), 44·4% [6·6–78.5] with mismatched unrelated donors (MMUD) and 44·4% [13·6–71.9] with mismatched related donors (MMRD) (P < 0·001). Other factors significantly impacting OS were pre‐transplant bone marrow status, source of stem cells, cytomegalovirus (CMV) serostatus, preparation with Flu–Cy, use of total body irradiation (TBI) and alemtuzumab as serotherapy. In multivariate analysis, absence of myelodysplastic syndrome (MDS) or leukaemia, bone marrow as source of stem cells, cytomegalovirus (CMV) other than +/− (Recipient/Donor) and Flu–Cy were protective factors for five‐year OS. Five‐year chronic graft‐versus‐host‐disease (cGVHD)‐free event‐free survival was 75·4% with the same risk factors except for CMV serostatus. Five‐year non‐relapse mortality was 13·8% [7·3–22.3]. Only five patients (6·1%) developed grade II–IV acute GVHD and two patients chronic GVHD. These data confirm the excellent outcome of matched related or unrelated HSCT in children with FA. [ABSTRACT FROM AUTHOR]

Background: After critical illness, patients are often left with impairments in physical, social, emotional, and cognitive functioning. Peer support interventions have been implemented internationally to ameliorate these issues. Objective: To explore what patients believed to be the key mechanisms of effectiveness of peer support programs implemented during critical care recovery. Methods: In a secondary analysis of an international qualitative data set, 66 telephone interviews with patients were undertaken across 14 sites in Australia, the United Kingdom, and the United States to understand the effect of peer support during recovery from critical illness. Prevalent themes were documented with framework analysis. Results: Most patients who had been involved in peer support programs reported benefit. Patients described 3 primary mechanisms: (1) sharing experiences, (2) care debriefing, and (3) altruism. Conclusion: Peer support is a relatively simple intervention that could be implemented to support patients during recovery from critical illness. However, more research is required into how these programs can be implemented in a safe and sustainable way in clinical practice. [ABSTRACT FROM AUTHOR]

The care and support of older people residing in long-term care facilities during the COVID-19 pandemic has created new and unanticipated uncertainties for staff. In this short report, we present our analyses of the uncertainties of care home managers and staff expressed in a self-formed closed WhatsApp™ discussion group during the first stages of the pandemic in the UK. We categorised their wide-ranging questions to understand what information would address these uncertainties and provide support. We have been able to demonstrate that almost one-third of these uncertainties could have been tackled immediately through timely, responsive and unambiguous fact-based guidance. The other uncertainties require appraisal, synthesis and summary of existing evidence, commissioning or provision of a sector- informed research agenda for medium to long term. The questions represent wider internationally relevant care home pandemic-related uncertainties. [ABSTRACT FROM AUTHOR]

It is well known that the appearance of food, particularly its color, can influence flavor perception and identification. However, food studies involving the manipulation of product color face inevitable limitations, from extrinsic flavors introduced by food coloring to the cost in development time and resources in order to produce different product variants. One solution lies in modern virtual reality (VR) technology, which has become increasingly accessible, sophisticated, and widespread over the past years. In the present study, we investigated whether making a coffee look milkier in a VR environment can alter its perceived flavor and liking. Thirty-two United Kingdom (UK) consumers were given four samples of black cold brew coffee at 4 and 8% sucrose concentration. They wore VR headsets throughout the study and viewed the same coffee in a virtual setting. The color of the beverage was manipulated in VR, such that participants saw either a dark brown or light brown liquid as they sipped the coffee. A full factorial design was used so that each participant tasted each sweetness x color combination, Participants reported sweetness, creaminess, and liking for each sample. Results revealed that beverage color as viewed in VR significantly influenced perceived creaminess, with the light brown coffee rated to be creamier than dark brown coffee. However, beverage color did not influence perceived sweetness or liking. The present study supports the role of VR as a means of conducting food perception studies, either to gain a better understanding of multisensory integration, or, from an industry perspective, to enable rapid product testing when it may be time-intensive or costly to produce the same range of products in the real-world. Furthermore, it opens potential future opportunities for VR to promote healthy eating behavior by manipulating the visual appearance of foods. [ABSTRACT FROM AUTHOR]

Background: This first mixed-methods UK trial examined the feasibility and acceptability of a future definitive randomised controlled trial (RCT) to evaluate whether Family Focussed Treatment for Adolescents with Bipolar Disorder (FFT-A) UK version can improve family functioning and well-being as part of the management of Paediatric Bipolar Disorder (PBD). Method: The trial used a randomised, parallel group, non-blinded design where participants received FFT-A UK (16 sessions over 6 months) immediately or after 12 months (delayed arm). Measures of family functioning, well-being and quality of life of the young person and the main carer (most commonly a parent) were completed at baseline, 6 and 12-months in both arms. Primary outcome measures included rates of eligibility, consent and retention along with estimates of variability in the measures and assessment of the intervention delivery. Qualitative interviews allowed assessment of participants' views about FFT-A and the trial processes. Results: Twenty-seven of 36 young persons with PBD and their families consented; of these, 14 families were randomised to the immediate and 13 to the delayed arm. Two families from the immediate arm withdrew consent and discontinued participation. Quantitative measures were completed by 22 families (88%) at 6-months and 21 families (84%) at 12-months. Qualitative interviews were conducted with 30 participants (9 young people, 15 parents and 6 other family members). Nine families attended 3 post-trial focus groups. Conclusion: It was feasible to recruit and retain to this trial. The results highlighted that trial design and measures were acceptable to participants. A benefit in family relationships was reported by participants which they attributed to the intervention in qualitative interviews. Families recommended that future modifications include definitive trial(s) recruiting participants in the age range 15–25 years as it felt this was the age range with maximum need. Trial registration ISRCTN, ISRCTN59769322. Registered 20 January 2014, http://www.isrctn.com/ISRCTN59769322 [ABSTRACT FROM AUTHOR]

Research has demonstrated that induced mental fatigue impairs soccer-specific technical, tactical and physical performance in soccer players. The findings are limited by the lack of elite players and low ecological validity of the tasks used to induce mental fatigue, which do not resemble the cognitive demands of soccer. The current study collected survey data from English academy soccer players (n = 256; age groups - U14 – U23), with questions comprising of five themes (descriptors of physical and mental fatigue, travel, education, match-play and fixture congestion). The survey consisted of multiple choice responses, checkboxes and blinded/unblinded (for duration based questions) 0-100 arbitrary unit (AU) slider scales. Listening to music (81.6% of players), using social media (58.3%) and watching videos (34.3%) were the most common pre-match activities. Pre-match subjective mental fatigue was low (18.7±18.8 AU), and most frequently reported at the end of a match (47±26 AU) and remained elevated 24-hours post-match (36±27 AU). Travel (29±24 AU), fixture congestion (44±25 AU) and education (30±26 AU) demonstrated a low to moderate presence of subjective mental fatigue. These findings provide an overview of activities performed by English academy soccer players pre-match, and demonstrate that mental fatigue is experienced as a result of match-play. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) remains a leading cause of cancer death worldwide, and despite recent immunotherapeutic advances there remains a need for improved diagnostic, prognostic, and therapeutic tools. UL-16 binding protein 1 (ULBP1) is a ligand of the activatory receptor Natural Killer cell Group 2 receptor D (NKG2D) and is found as a cell-surface protein on some malignant cells including on human hepatocellular carcinomas. We aimed to explore the biological and clinical significance of NKG2D ligands in the circulation of patients with HCC. We measured ULBP1 in the serum of two retrospective cohorts of patients with HCC from the PROLIFICA cohort in The Gambia (n = 43) and from a tertiary care setting in the UK (n = 72) by sandwich ELISA. Exosome isolation by size exclusion was used to compare ULBP1 concentration in exosomes and as free protein. Survival analysis was performed and multiple linear regression and Poisson regression were used to assess the independent effect of ULBP1 concentration. ULBP1 was raised in both cohorts with HCC regardless of the underlying liver disease, and was not associated with markers of cirrhosis such as platelet count or serum albumin. ULBP1 was present predominantly as free protein rather than bound to exosomes. Serum ULBP1 > 2000 pg/ml was associated with a significantly reduced survival in both cohorts (hazard ratios in Gambian and UK cohorts 2.37 and 2.1, respectively). The effect remained significant after adjustment for BCLC staging (p = 0.03). These data suggest that ULBP1 merits further investigation as a prognostic marker in HCC in diverse settings and should also be explored as a therapeutic target. [ABSTRACT FROM AUTHOR]

South Asian communities comprise one of the fastest growing populations in Western countries. However, the sexual health of immigrant men in particular remains vastly understudied and little is known about how and if men access these services. Four multi-disciplinary electronic databases were searched to between 1998 and 2018. The search yielded 586 articles; 407 duplicate articles were removed, and 376 did not meet the inclusion criteria. A total of 10 articles were included in this review. Herein we report the factors shaping sexual health service access and use, namely: (1) cultural and psychological factors; (2) sexual health service accessibility; (3) personal beliefs and patterns in service use; (4) social perspectives and conflicting values on sexual health. We identify the gaps in research needed for policymakers, formal healthcare providers, and South Asian community stakeholders to develop effective and inclusive sexual health programs for South Asian men in Western countries. [ABSTRACT FROM AUTHOR]

Consumer trust in the modern food system is essential given its complexity. Contexts vary across countries with regard to food incidents, regulation and systems. It is therefore of interest to compare how key actors in different countries might approach (re)building consumer trust in the food system; and particularly relevant to understanding how food systems in different regions might learn from one another. The purpose of this paper is to explore differences between strategies for (re)building trust in food systems, as identified in two separate empirical studies, one conducted in Australia, New Zealand and the UK (Study 1) and another on the Island of Ireland (Study 2). Interviews were conducted with media, food industry and food regulatory actors across the two studies (n  = 105 Study 1; n  = 50 Study 2). Data were coded into strategy statements, strategies describing actions to (re)build consumer trust. Strategy statements were compared between Studies 1 and 2 and similarities and differences were noted. The strategy statements identified in Study 1 to (re)build consumer trust in the food system were shown to be applicable in Study 2, however, there were notable differences in the contextual factors that shaped the means by which strategies were implemented. As such, the transfer of such approaches across regions is not an appropriate means to addressing breaches in consumer trust. Notwithstanding, our data suggest that there is still capacity to learn between countries when considering strategies for (re)building trust in the food system but caution must be exercised in the transfer of approaches. [ABSTRACT FROM AUTHOR]

In this article, the authors report that almost one in three adults in the UK have experience of learning a language as an adult, but only four percent are currently doing so--one percent less that in 1999, equivalent to a drop of half a million adults learning languages. Figures of speech, NIACE's UK-wide survey of language learning, also found a significant increase in the proportion of adults now learning English. Currently, one percent of adults are learning English, whereas the proportion of adults learning English was barely visible in 1999, when NIACE published its last language survey, "Tongue-tied but trying". Language learning in the UK is complicated, and the new survey shows that the complexity is increasing. More languages are spoken, more people have more than one language and different groups have different motivations and patterns of learning. Since the first language survey in 1999, there has been an increase in the proportion of people within the UK who have a first language other than English and who are currently learning English. Currently, 11 percent have a first language other than English, which is almost double the amount reported in 1999 (six percent). There is a strong link between ethnicity and first language learnt: 73 percent of adults from minority ethnic groups have a first language that is not English, compared to four percent of adults from white groups.

In-play gambling is a recent innovation allowing gambling to occur during the course of a sporting event, rather than merely before play commences. For years, in-play gambling has been marketed in the UK via adverts displaying current betting odds during breaks in televised soccer, e.g., “England to score in the first 20 minutes, 4-to-1.” Previous research shows that this so-called “live-odds” advertising is skewed toward complex events with high profit margins which consumers do not evaluate rationally. Recent UK regulatory guidance on “impulsiveness and urgency,” aiming to enhance consumer protection around gambling advertising, states that gambling advertising should not “unduly pressure the audience to gamble.” We explored the frequency and content of live-odds advertising over the 2018 soccer World Cup, as a case study of the first major televised sporting event after the publication of this UK regulatory guidance. In total, 69 live-odds adverts were shown over 32 matches (M = 2.16 per-match), by five bookmakers. We identified two key features that made advertised bets appear more urgent than necessary. First, 39.1% of bets could be determined before the match ended. Second, 24.6% of bets showed a recent improvement in odds, including a 15.9% subset of “flash odds,” which were limited in both time and quantity. Advertised odds were again skewed toward complex events, with a qualitative trend toward greater complexity than at the previous World Cup. We believe that consumers should be protected against the targeted content of gambling advertising. [ABSTRACT FROM AUTHOR]

Background/Aims: To assess health-related quality of life (HRQoL), treatment patterns, and clinical outcomes of adult (≥18 years) patients with advanced (unresectable or metastatic) pancreatic neuroendocrine neoplasms (PanNENs) treated with everolimus in routine clinical practice. Methods: In a prospective, non-interventional, multi-center study patients administered at least one 10 mg dose of everolimus were evaluated for change in HRQoL (EORTC QLQ-C30 Global Health Status scale) from baseline after 6 months treatment (primary endpoint). Secondary endpoints included disease-specific HRQoL measures (EORTC QLQ-G.I.NET21), clinical outcomes, everolimus treatment patterns, and safety. Results: Forty-eight patients were recruited (between August 2013 and March 2015); the median treatment duration was 27.8 months. EORTC QLQ-C30 Global Health score was not significantly different from baseline after 6 months of treatment (mean difference –1.9 points, p = 0.660, n = 30). In pairwise analyses, the only significant changes in HRQoL from baseline were for EORTC QLQ-C30 physical functioning score at month 3 (adjusted mean difference –8.8 points, p = 0.002, n = 36) and the EORTC QLQ-G.I.NET21 disease-related worries scores at months 1 and 2 (adjusted mean differences: –11.5 points [p = 0.001, n = 44] and –8.8 points [p = 0.017, n = 43], respectively). Disease progression or death was recorded in 44.4% (n = 20/45) patients during follow-up; median progression-free survival was 25.1 months and the cumulative survival rate at 3 years was 71%. No new safety signals were detected. Conclusions: The OBLIQUE study demonstrates that HRQoL is maintained in patients with PanNENs during treatment with everolimus in a UK real-world setting. This study adds to the limited HRQoL data available in this patient group. [ABSTRACT FROM AUTHOR]

Since European Union (EU) enlargement in 2003, labour migration from East to West and South to North has increased. It is to be expected that a share of these workers will want to retire in their host countries. According to the academic literature, EU legislation protects such mobility well by allowing the transfer of rights accrued in any EU country to another. However, such research has focused on legislation, not outcomes. We know little about how migration will affect the financial status of retired migrants in their host country and their ability to sustain a life there, should they stay after retirement. Using migration, wage and pension policy data (Eurostat, Organisation for Economic Co-operation and Development), this paper projects the post-retirement incomes of a range of hypothetical EU migrants, selected in relation to the most common migratory flows since 2003. After having worked in their home countries (Romania, Poland, Bulgaria, Italy) for at least ten years, these people move to richer countries (Italy, Spain, Germany, United Kingdom) and work there for at least 30 years. To determine whether they can remain settled after decades of labour force participation in the host country, the paper adds their pension entitlements from home and host countries and compares this income with the relative poverty line of the host countries. This shows that good portability of entitlements matters little when these are very low because of a large wage gap between home and host country. Thus, after at least 30 years of enjoying all citizenship rights as workers, most of these individuals are projected to receive incomes below the relative poverty line of their host countries and thus experience a sharp drop in this status. Their citizenship is diminished. The paper concludes by considering policies that could avoid such an outcome. [ABSTRACT FROM AUTHOR]