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The Gratitude Network, a nonprofit based in Pleasanton, California, has a unique and interesting approach to strengthening education for children globally. The organization accelerates the growth of high-impact social enterprises, both for-profit and nonprofit, working to improve the lives of children and youth around the world, primarily through novel, educational approaches. Through a 12-month leadership development Fellowship for children- and youth-focused social entrepreneurs, The Gratitude Network seeks to expand the leadership capacity of the organization's executive team. The ultimate goal of Gratitude's Fellowship is to help the organization scale and therefore impact and educate increasing numbers of children and youth. To date, Gratitude has worked with more than 100 organizations in over 40 countries, collectively impacting approximately 30 million children.

This paper, based on interviews conducted for the "Early Childhood Oral History Project," draws on oral life-history interviews with 14 prominent early childhood researchers who have been active since the 1970s within diverse European countries. A common theme across the interviews is the key role that collaborative research between academics and early childhood practitioners played in the construction of theories and innovative practices. The interviewees reflect on personal, social-political, epistemological and practical factors that underpinned their engagement in collaborative research, and the challenges they encountered. They give insight into the role practitioners played in the construction of education as a social-historical science--contextualised knowledge that is intrinsically related to ethics, values and innovation.

The article "Communicating Transformation in Food and Agricultural Ecologies" discusses the transformative power of food and its impact on culture, identity, health, ecology, politics, and the economy. It emphasizes the interconnectedness of individuals, foodways, and food systems, and the influence they have on each other. The article also highlights the significance of environmental communication in addressing food issues and calls for a regenerative and reconstitutive approach to environmental communication. The special issue featured in the article includes various research studies on topics such as gene-edited foods, alternative dairy products, vegetarianism and social media, meat-eating in UK news sites, and the influence of social norms on meat consumption. The authors suggest future research directions, including personalized messaging, media influence, and the integration of food and climate change discussions, while emphasizing the importance of informed food choices and holding institutions accountable. [Extracted from the article]

Research into self-directed methods for reducing problematic and harmful gambling is still in its infancy. One strategy that individuals use to prevent gambling involves voluntary self-exclusion (VSE) programs. For example, VSE programs can make it challenging to access betting sites or enable banks to block gambling-related transactions. Although individual VSEs can be helpful when used alone, it is unclear whether their efficacy is enhanced when combined. Furthermore, it is unknown how VSE compliance can be improved. We propose that contingency management (CM), an evidence-based strategy to incentivise abstinence, could encourage continued VSE use, promoting long-lasting recovery from problematic or harmful gambling. Here, we conducted exploratory analyses on VSE use and CM for gambling in two populations (members of the UK general population recruited and students). Participants responded favourably regarding combined VSE use. They felt that providing vouchers exchangeable for goods/services could incentivise gambling abstinence during VSE. However, some were concerned about people potentially "gaming" the system. Participants believed supplementing VSE and CM with social support could encourage abstinence. These attitudes, and recent research on treatment providers' opinions on CM for gambling, suggest that experimental evidence should be sought to determine the efficacy of combined VSE use and CM for gambling. [ABSTRACT FROM AUTHOR]

University students may be at increased risk of gambling related problems. The present study investigated the gambling experience and general wellbeing of domestic and international students attending a highereducation university in the United Kingdom (UK). An online survey consisting of demographic characteristics, gambling experience, problem gambling severity, and general mental health measures was completed by n=402 undergraduates. Results indicated that 44% of students engaged in at-risk gambling and 6% in PG. General mental health scores did not differ across gambling severity. Male gender identity was a significant risk-factor for both at-risk and PG. Accessing university financial hardship funds and being in the final year of study were significant risk-factors for problem gambling. Overall, gambling problems are significant concerns for UK university students and the risk of problematic gambling is associated with financial hardship, year of study, and gender. [ABSTRACT FROM AUTHOR]

The British novelist Nicky Singer talks about becoming a writer, the role of editors and about who decides what can--and what cannot--be published on either side of the Atlantic. Her three novels explore territory which can make publishers nervous: "Feather Boy" (initiation rites and domestic violence), "Doll" (self-harm) and "The Innocent's Story" (terrorist suicide bombing). The sharply contrasting responses from publishers in the United Kingdom and the United States are described. Through Nicky Singer's sometimes extraordinary experiences with publishers runs the implicit question, perhaps as important now as it has ever been: What constraints should there be on what is explored in books for young readers?

The genetic relationship between intelligence and components of cognition remains controversial. Conflicting results may be a function of the limited number of methods used in experimental evaluation. The current study is the first to use CANTAB (The Cambridge Neuropsychological Test Automated Battery). This is a battery of validated computerised cognitive tests, which allows assessment across a number of domains. A sample of 278 female-female Caucasian twin pairs from the UK (aged 18-76) performed such tests to establish the importance of genetic factors on four composite cognitive measures: general memory ability, inspection time (IT), working memory, and reaction time (RT). Estimates of heritability (additive genetic variance) were found to be 57% (95% CI 44, 68) for general memory, 38% (23, 51) for IT and 31% (16, 45) for working memory. The National Adult Reading Test (NART), a measure of IQ, had a heritability of 76%. RT was explained by common environmental influences and nonshared environmental influences. Moderate phenotypic correlations between general memory and NART (r = 0.32) and general memory and working memory (r = 0.42) were also reported. Both relationships could be explained by shared genetic determinants.

Reservoirs play a vital role in the supply and management of water resources and their operation can significantly alter downstream flow. Despite this, reservoirs are frequently excluded or poorly represented in large‐scale hydrological models, which can be partly attributed to a lack of open‐access data describing reservoir operations, inflow and storage. To help inform the development of reservoir operation schemes, we collate a suite of hydrological signatures designed to detect the impacts of reservoirs on the flow regime at large‐scales from downstream flow records only. By removing the need for pre‐and‐post‐reservoir flow timeseries (a requirement of many pre‐existing techniques), these signatures facilitate the assessment of flow alteration across a much wider range of catchments. To demonstrate their application, we calculate the signatures across Great Britain in 111 benchmark (i.e., near‐natural) catchments and 186 reservoir catchments (where at least one upstream reservoir is present). We find that abstractions from water resource reservoirs induce deficits in the water balance, and that pre‐defined flow releases (e.g., the compensation flow) reduce variability in the downstream flow duration curve and in intra‐annual low flows. By comparing signatures in benchmark and reservoir catchments, we define thresholds above which the influence of reservoirs can be distinguished from natural variability and identify 40 catchments significantly impacted by the presence of reservoirs. The signatures also provide insights into local reservoir operations, which can inform the development of tailored reservoir operation schemes, and identify locations where current modeling practices (which lack reservoir representation) will be insufficient. Plain Language Summary: Reservoirs play a vital role in the supply and management of water resources. However, reservoirs are frequently either excluded, or poorly represented in large‐scale river flow simulations due to a lack of open‐access data describing their operation. To help inform the representation of reservoirs, we use a suite of simple metrics to detect where and how rivers are being impacted by upstream reservoirs from records of downstream flow. We apply these metrics over hundreds of gauges across Great Britain and find that abstractions for water supply reduce the volume of water in rivers downstream of reservoirs, and that controlled water releases reduce downstream flow variability. The application of the metrics defined in this study enable us to gain insights into how upstream reservoirs are operated and will help to improve our ability to simulate and predict river flow under changing climate and water demand. Key Points: Hydrological signatures can be used to identify reservoir‐induced hydrological alteration using only downstream flow timeseriesApplication to 186 catchments across Great Britain finds reservoirs often induce losses in the water balance and reduce flow variabilitySignatures provide insights into reservoir operations which will help to design and evaluate new operation schemes in hydrological models [ABSTRACT FROM AUTHOR]

This study examined the long-term correlates of victimization in school with aspects of functioning in adult life, using a specially designed Retrospective Bullying Questionnaire, which also included questions about short-term effects (e. g. suicidal ideation and intrusive memories) and victimization experiences in adulthood. Current relationship quality was assessed in terms of self-perception, attachment style and friendship quality. In total, 884 adults (35% male) from two occupations (teacher, student) and three countries (Spain, Germany, UK) participated. Victims and especially stable victims (in both primary and secondary school) scored lower on general self-esteem and higher on emotional loneliness, and reported more difficulties in maintaining friendships, than non-victims. Victims in secondary school had a lower self-esteem in relation to the opposite sex and were more often fearfully attached. The data revealed additional differences by gender, occupation and country level, but no further interactions with victim status. This indicates a general association between victimization in school and quality of later life predominately robust to variations in gender, occupation and country. Possible limitations caused by the retrospective nature of victimization reports are acknowledged.

Sustained viral response (SVR) rates for direct‐acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection routinely exceed 95%. However, a small number of patients require retreatment. Sofosbuvir, velpatasvir and voxilaprevir (SOF/VEL/VOX) is a potent DAA combination primarily used for the retreatment of patients who failed by DAA therapies. Here we evaluate retreatment outcomes and the effects of resistance‐associated substitutions (RAS) in a real‐world cohort, including a large number of genotype (GT)3 infected patients. 144 patients from the UK were retreated with SOF/VEL/VOX following virologic failure with first‐line DAA treatment regimens. Full‐length HCV genome sequencing was performed prior to retreatment with SOF/VEL/VOX. HCV subtypes were assigned and RAS relevant to each genotype were identified. GT1a and GT3a each made up 38% (GT1a n = 55, GT3a n = 54) of the cohort. 40% (n = 58) of patients had liver cirrhosis of whom 7% (n = 4) were decompensated, 10% (n = 14) had hepatocellular carcinoma (HCC) and 8% (n = 12) had received a liver transplant prior to retreatment. The overall retreatment SVR12 rate was 90% (129/144). On univariate analysis, GT3 infection (50/62; SVR = 81%, p =.009), cirrhosis (47/58; SVR = 81%, p =.01) and prior treatment with SOF/VEL (12/17; SVR = 71%, p =.02) or SOF+DCV (14/19; SVR = 74%, p =.012) were significantly associated with retreatment failure, but existence of pre‐retreatment RAS was not when viral genotype was taken into account. Retreatment with SOF/VEL/VOX is very successful for non‐GT3‐infected patients. However, for GT3‐infected patients, particularly those with cirrhosis and failed by initial SOF/VEL treatment, SVR rates were significantly lower and alternative retreatment regimens should be considered. [ABSTRACT FROM AUTHOR]

Hundreds of thousands of genetic variants have been reported to cause severe monogenic diseases, but the probability that a variant carrier develops the disease (termed penetrance) is unknown for virtually all of them. Additionally, the clinical utility of common polygenetic variation remains uncertain. Using exome sequencing from 77,184 adult individuals (38,618 multi-ancestral individuals from a type 2 diabetes case-control study and 38,566 participants from the UK Biobank, for whom genotype array data were also available), we apply clinical standard-of-care gene variant curation for eight monogenic metabolic conditions. Rare variants causing monogenic diabetes and dyslipidemias display effect sizes significantly larger than the top 1% of the corresponding polygenic scores. Nevertheless, penetrance estimates for monogenic variant carriers average 60% or lower for most conditions. We assess epidemiologic and genetic factors contributing to risk prediction in monogenic variant carriers, demonstrating that inclusion of polygenic variation significantly improves biomarker estimation for two monogenic dyslipidemias. Penetrance of variants in monogenic disease and clinical utility of common polygenic variation has not been well explored on a large-scale. Here, the authors use exome sequencing data from 77,184 individuals to generate penetrance estimates and assess the utility of polygenic variation in risk prediction of monogenic variants. [ABSTRACT FROM AUTHOR]

Background: Airway bacterial dysbiosis is a feature of chronic obstructive pulmonary disease (COPD). However, there is limited comparative data of the lung microbiome between healthy smokers, non-smokers and COPD.Methods: We compared the 16S rRNA gene-based sputum microbiome generated from pair-ended Illumina sequencing of 124 healthy subjects (28 smokers and 96 non-smokers with normal lung function), with single stable samples from 218 COPD subjects collected from three UK clinical centres as part of the COPDMAP consortium.Results: In healthy subjects Firmicutes, Bacteroidetes and Actinobacteria were the major phyla constituting 88% of the total reads, and Streptococcus, Veillonella, Prevotella, Actinomyces and Rothia were the dominant genera. Haemophilus formed only 3% of the healthy microbiome. In contrast, Proteobacteria was the most dominant phylum accounting for 50% of the microbiome in COPD subjects, with Haemophilus and Moraxella at genus level contributing 25 and 3% respectively. There were no differences in the microbiome profile within healthy and COPD subgroups when stratified based on smoking history. Principal coordinate analysis on operational taxonomic units showed two distinct clusters, representative of healthy and COPD subjects (PERMANOVA, p = 0·001).Conclusion: The healthy and COPD sputum microbiomes are distinct and independent of smoking history. Our results underline the important role for Gammaproteobacteria in COPD. [ABSTRACT FROM AUTHOR]

Background: The vsMS survey was conducted to better understand the negative effects of fatigue, cognitive impairment, emotional burden, and decreased physical functioning on the personal, professional, and social lives of individuals with multiple sclerosis (MS). Methods: The vsMS survey was an online survey conducted in Australia, Canada, France, Italy, Spain, the United Kingdom, and the United States that assessed the impact of MS on individuals' daily activities, emotional well-being, relationships, and employment. Results: The survey included 1075 participants with relapsing-remitting MS. Almost 42% of participants reported that their ability to perform and manage daily activities had worsened during the previous 2 years. More than 50% reported limitations in daily activities due to fatigue, physical weakness, problems with balance/coordination, heat/cold sensitivity, memory problems, numbness/tingling, trouble concentrating, impaired movement/muscle stiffness, and impaired sleeping. Participants also reported a negative effect on emotional and social factors, including self-esteem, general outlook, well-being, maintaining/ starting relationships, ability to progress in their career/keep their job, and ability to cope with life roles. Conclusions: These data highlight the importance of addressing the impact of MS and the social and emotional disease burdens on daily activities when planning the care of patients with MS. [ABSTRACT FROM AUTHOR]

Amid ongoing disruption, discourse about journalism increasingly emphasizes innovation within the newsroom and the rise of entrepreneurial initiatives outside it. This article uses the concept of interpretive repertoires to explore how students enrolled in journalism programmes in Britain and the Netherlands understand innovation and entrepreneurialism in relation to changing industry circumstances and long-standing conceptualizations of occupational norms and behaviours. We find shared repertoires that embrace technological change, but generally within an acceptance of traditional normative practice. [ABSTRACT FROM AUTHOR]

Purpose: This study was aimed to determine whether structured written and verbal education provided to patients by community pharmacists about high blood pressure (BP) and its treatment would be (a) better retained and (b) be associated with improved BP control as compared to patients receiving verbal advice only.Methods: The study was designed as a randomised controlled trial and was conducted in the West Midlands, UK, between January 2014 and June 2014. The primary outcome measures were differences in systolic and diastolic BP from baseline and retention of information about high BP assessed with a questionnaire at 2-, 4- and 26-week follow-up points.Results: A total of 64 adults were included in the study. At the week 26 follow-up, compared to participants in the control group, there was a significant improvement in the knowledge of intervention participants about the risks associated with high BP (p < 0.001) and awareness about potential adverse effects of the new BP medicine (p < 0.001). Similarly, there was a greater and more significant reduction in systolic BP in favour of the intervention group 8 mmHg (95% CI 2.1-13.3 p = 0.009) compared to 6 mmHg (95% CI 0.6-11.7 p = 0.02) in the control group at the week 4 follow-up. However, this greater effect of an intervention on BP was not sustained at the 26-week follow-up. For diastolic BP, there was no added effect of the intervention.Conclusion: This randomised controlled trial suggests that although written advice provided by community pharmacists in comparison to verbal advice was more effective in improving knowledge and understanding of patients about hypertension and its treatment, it did not lead to better blood pressure control. [ABSTRACT FROM AUTHOR]

Background: Adverse Drug Reactions (ADRs) are a major public health problem. Prompt reporting of suspected ADRs is fundamental in the post-marketing surveillance of medicines and helps in ensuring medicine safety. However, fewer ADRs are reported in general and in particular by community pharmacists. There is limited knowledge about the factors which are preventing community pharmacists in the UK from reporting an ADR. Objectives: To identify the barriers to ADR reporting among community pharmacists practicing in the UK. Methods: A cross sectional study using a 25-items questionnaire (both online and paper based) including 10 barriers to ADR reporting was conducted from 1st April 2012 to September 2012. Community pharmacists practicing in the West Midlands, UK, were approached for the participation in this study. Chi-Square and regression were applied to identify covariates for the barriers to ADR reporting. A significant value of 0.05 was assigned for analysis. Results: Of the 230 invited community pharmacists, 138 pharmacists responded (response rate 60%). The median age of respondents was 31 years. All pharmacists reported that they would report both serious and mild ADRs from drugs with black triangle among children as well as adults. About 95% (n=131) of the pharmacists were familiar with the paper based ADR reporting system. Storebased pharmacists were more likely to be more confident about which ADRs to report [0.680, 95% Confidence Interval 0.43-3.59]. Lack of time 46.4% (n=64), and pharmacists perception that ADR is not serious enough to report (65.2%; n=90) were identified as barriers to ADR reporting. Majority 63.0% (n=87) of the pharmacists identified training and information about what to report and access to Information Technology (IT) (For example access to internet connection) 61.6% (n=85) as facilitators to ADR reporting process. Conclusion: Lack of time and ADRs considered not serious enough by pharmacists to report were barriers to ADR reporting. Further training and education about the types of ADRs to be reported can help to improve the reporting of ADRs. [ABSTRACT FROM AUTHOR]

The arrival and discharge of seven antibiotics were monitored at two trickling filter sewage treatment plants of 6000 and 11,000 population equivalents (PE) and two activated sludge plants of 33,000 and 162,000 PE in Southern England. The investigation consisted of 24 h composite samples taken on two separate days every summer from 2012 to 2015 and in the winter of 2015 (January) from influent and effluent. The average influent concentrations generally matched predictions based on England-wide prescription data for trimethoprim, sulfamethoxazole, azithromycin, oxytetracycline and levofloxacin (within 3-fold), but were 3–10 times less for clarithromycin, whilst tetracycline influent concentrations were 5–17 times greater than expected. Over the four years, effluent concentrations at a single sewage plant varied by up to 16-fold for clarithromycin, 10-fold for levofloxacin and sulfamethoxazole, 7-fold for oxytetracycline, 6-fold for tetracycline, 4-fold for azithromycin and 3-fold for trimethoprim. The study attempted to identify the principal reasons for this variation in effluent concentration. By measuring carbamazepine and using it as a conservative indicator of transport through the treatment process, it was found that flow and hence concentration could alter by up to 5-fold. Measuring influent and effluent concentrations allowed assessments to be made of removal efficiency. In the two activated sludge plants, antibiotic removal rates were similar for the tested antibiotics but could vary by several-fold at the trickling filter plants. However, for clarithromycin and levofloxacin the variations in effluent concentration were above that which could be explained by either flow and/or removal alone so here year on year changes in consumption are likely to have played a role. [ABSTRACT FROM AUTHOR]

Background: Role functioning (RF) as a core construct of health-related quality of life (HRQOL) comprises aspects of occupational and social roles relevant for patients in all treatment phases as well as for survivors. The objective of the current study was to improve its assessment by developing a computer-adaptive test (CAT) for RF. This was part of a larger project whose objective is to develop a CAT version of the EORTC QLQ-C30 which is one of the most widely used HRQOL instruments in oncology.Methods: In accordance with EORTC guidelines, the development of the RF-CAT comprised four phases. Phase I involved the conceptualization of RF. In Phase II, a provisional list of items was defined and revised by experts in the field. In phase III, feedback was obtained from cancer patients in various countries. Phase IV comprised field testing in an international sample, calibration of the item bank, and evaluation of the psychometric performance of the RF-CAT.Results: Phases I-III yielded a list of 12 items eligible for phase IV field-testing. The field-testing sample included 1,023 patients from Austria, Denmark, Italy, and the UK. Psychometric evaluation and item response theory analyses yielded 10 items with good psychometric properties. The resulting item bank exhibits excellent reliability (mean reliability = 0.85, median = 0.95). Using the RF-CAT may allow sample size savings from 11 % up to 50 % compared to using the QLQ-C30 RF scale.Conclusions: The RF-CAT item bank improves the precision and efficiency with which RF can be assessed, promoting its integration into oncology research and clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To examine the relationship between patient/family engagement in goal planning, satisfaction with the goal setting process and associated goal attainment and functional gains during rehabilitation. Method: A prospective cohort analysis of consecutively completed episodes for patients discharged over a 1-year period (January-December 2013) in a specialist neurological rehabilitation service in the UK. Participants were adults (n=83) with neurological disabilities (mean±SD age: 42.8 ±15.0 years; programme length: 98 ± 47 days; male to female ratio: 69 :31; diagnosis: brain injury (n=75, 90%), spinal cord injury (n=5, 6%), other neurological conditions (n=3, 4%)). The measures used were six-point visual analogue scales to rate goal engagement and goal satisfaction, Goal Attainment Scaling (GAS) and the UK Functional Assessment Measure (UK FIM+FAM). Results: Significant improvements were seen between admission and discharge for patient goal engagement (Mann-Whitney z=-2.2, p=0.027) and satisfaction (z=-2.2, p=0.031). Significant correlations were seen between goal engagement and goal satisfaction for patients on admission (Spearman's rho 0.41, p=0.03) and for their families on discharge (rho 0.82, p<0.001). Patients' goal engagement by discharge was strongly correlated with GAS achieved T-scores (rho 0.54, p<0.001) and with functional gain (change in FIM+FAM-Motor subscale rho 0.46, p<0.001). Conclusions: Active involvement of patients and their families in meaningful goal planning is an important component of rehabilitation that is associated with improved goal attainment and better functional outcomes. [ABSTRACT FROM AUTHOR]

Data from two large-scale surveys of Black and Minority Ethnic (BME) and White young men in London were analysed to measure the extent and impact of police stops on their attitudes to policing and Metropolitan Police Service officers. Using procedural justice theory as a framework for analysis, the perceived presence or absence of trust, respect, neutrality, and voice for those stopped compared with those not stopped in both groups is described. Four main findings are identified: the proportion reporting they had been stopped in the last year was substantially greater for the BME than for the White males; overall, the majority of both BME and White males (whether or not stopped) were positive about policing in London; however, negative and statistically significant differences were noted between those stopped and not stopped for both the BME and White groups. Officers paying due regard to delivering procedural justice is proposed as a preventive to future public disorder. [ABSTRACT FROM PUBLISHER]

Aim To investigate the effect of hospitalization on oral health as assessed by dental plaque. Materials and Methods Observational study in a critical care unit ( CCU). Participants were recruited within 24 h of admission. Dental plaque amount was assessed at baseline, 1 and 2 weeks using the Debris index-soft deposits (Greene & Vermillion 1960). Results Fifty participants were recruited with 36 available for outcome assessment at 1 week and 10 at 2 weeks. The principal reason for losses was early discharge with no evidence of a difference between patients present only at baseline and those present at 1 week. The median value for dental plaque at baseline was 4 (95% CI: 4, 6). The median dental plaque increase from baseline to week 1 was 1.5 (95% CI: −1, 4), and this was statistically significant ( p = 0.04). The median increase from week 1 to week 2 was 1.0 (95% CI −8, 6) and not statistically significant ( p = 0.68). Conclusions Oral health as assessed by dental plaque deteriorates following hospitalization in CCU. Such change could lead to impairment of quality of life and well-being as well as to increasing the risk of important healthcare-associated infections such as nosocomial pneumonia. [ABSTRACT FROM AUTHOR]

The article analyzes the manner of observation applied by Doris Lessing in "London Observed" and argues that she depicts British family structure as unstable and ineffective or only partially effective as a mechanism for problem resolution. Topics discussed include the stories' emphasis on the spatial difference between observer and observed, reinforcing Lessing's interest in how a more privileged observer watches a less aware society and the stories' focus on transformed family relationships.

OBJECTIVE: A widely used illicit recreational drug among young adults, 3,4-methylenedioxymethamphetamine (MDMA) or ecstasy, is an indirect monoaminergic agonist/reuptake inhibitor affecting the serotonin system. Preclinical studies found prenatal exposure related to long-term learning and memory impairments. There are no studies of sequelae of prenatal MDMA exposure in humans, despite potential harmful effects to the fetus. METHODS: A total of 96 women in the United Kingdom (28 MDMA users; 68 non-MDMA) were interviewed about recreational drug use during pregnancy. Their infants were seen at 12 months using standardized assessments of cognitive, language, and motor development (Preschool Language Scale, Bayley Mental and Motor Development and Behavior Rating Scales [Mental Development Index, Psychomotor Development Index, Behavioral Rating Scale]). Mothers completed the Child Domain Scale of the Parenting Stress Index, The Home Observation of the Environment Scale (in interview), the Brief Symptom Inventory, and the Drug Abuse Screening Test. Women were primarily middle class with some university education, in stable partner relationships, and polydrug users. MDMA and other drug effects were assessed through multiple regression analyses controlling for confounding variables, and analysis of covariance comparing heavier versus lighter and nonexposed groups. RESULTS: Amount of prenatal MDMA exposure predicted poorer infant mental and motor development at 12 months in a dose-dependent manner. Heavily exposed infants were delayed in motor development. Lighter-exposed infants were comparable to nonexposed infants. There were no effects on language, emotional regulation, or parenting stress. CONCLUSIONS: Findings document persistent neurotoxic effects of heavier prenatal MDMA exposure on motor development through the first year of life. [ABSTRACT FROM AUTHOR]

Purpose: Patients with decompensated liver cirrhosis who are admitted to intensive care units (ICU) are perceived, within the UK, as having a particularly poor prognosis. Methods: We performed a descriptive analysis of cirrhosis patients admitted to general critical care units 1995-2008 compared to patients admitted with pre-existing chronic renal failure. Data were obtained from the Intensive Care National Audit and Research Centre Case Mix Programme Database incorporating 192 adult critical care units in England, Wales and Northern Ireland. Results: Cirrhosis accounted for 2.6 % (16,096 patients) of total admissions with mean age 52.5 years and male preponderance (~60 %). Hospital mortality was high (>55 %) although this improved 5 % in recent years, and median length of stay was short (2.5 days). Mortality in cirrhotics with severe sepsis requiring organ support was 65-90 %, compared to 33-39 % in those without. Conversely, patients with chronic renal failure had lower mortality (42 %) despite similar characteristics and higher acute physiology and chronic health evaluation (APACHE) II scores. The APACHE II score under-predicted mortality in cirrhotics. Conclusions: Cirrhosis patients exhibit worse outcomes compared to pre-existing renal failure patients, despite similar characteristics. Survival worsens considerably with organ failure, especially with sepsis. They represent a small number of admissions, albeit increasing over recent years, and, in general, have a short ICU stay. Patients with single organ failure have acceptable survival rates and mortality has improved; although we have no data on those refused ICU admission potentially causing survival bias. Given the extremely high mortality in patients with multi-organ failure, support should be limited/withdrawn in such patients. [ABSTRACT FROM AUTHOR]

How to cite this article: McKenzie Y.A., Alder A., Anderson W., Wills A., Goddard L., Gulia P., Jankovich E., Mutch P., Reeves L.B., Singer A. & Lomer M.C.E. on behalf of Gastroenterology Specialist Group of the British Dietetic Association. (2012) British Dietetic Association evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults. J Hum Nutr Diet . 25, 260-274 Abstract Background: Irritable bowel syndrome (IBS) is a chronic debilitating functional gastrointestinal disorder. Diet and lifestyle changes are important management strategies. The aim of these guidelines is to systematically review key aspects of the dietary management of IBS, with the aim of providing evidence-based guidelines for use by registered dietitians. Methods: Questions relating to diet and IBS symptom management were developed by a guideline development group. These included the role of milk and lactose, nonstarch polysaccharides (NSP), fermentable carbohydrates in abdominal bloating, probiotics and empirical or elimination diets. A comprehensive literature search was conducted and relevant studies from January 1985 to November 2009 were identified using the electronic database search engines: Cinahl, Cochrane Library, Embase, Medline, Scopus and Web of Science. Evidence statements, recommendations, good practice points and research recommendations were developed. Results: Thirty studies were critically appraised. A dietetic care pathway was produced following a logical sequence of treatment and formed the basis of these guidelines. Three lines of dietary management were identified. First line: Clinical and dietary assessment, healthy eating and lifestyle management with some general advice on lactose and NSP. Second line: Advanced dietary interventions to improve symptoms based on NSP, fermentable carbohydrates and probiotics. Third line: Elimination and empirical diets. Research recommendations were also identified relating to the need for adequately powered and well designed randomised controlled trials. Conclusions: These guidelines provide evidence-based details of how to achieve the successful dietary management of IBS. [ABSTRACT FROM AUTHOR]

Background: Rabies is a fatal viral disease that potentially can affect all mammals. Terrestrial rabies is not present in the United Kingdom and has been eliminated from Western Europe. Nevertheless the possibility remains that rabies could be introduced to England, where it would find two potentially suitable hosts, red foxes and badgers. With the aim to analyse the spread and emergency control of rabies in this two species host community, a simulation model was constructed. Different control strategies involving anti-rabies vaccination and population culling were developed, considering control application rates, spatial extent and timing. These strategies were evaluated for efficacy and feasibility to control rabies in hypothetical rural areas in the South of England immediately after a disease outbreak. Results: The model confirmed that both fox and badger populations, separately, were competent hosts for the spread of rabies. Realistic vaccination levels were not sufficient to control rabies in high-density badger populations. The combined species community was a very strong rabies host. However, disease spread within species appeared to be more important than cross-species infection. Thus, the drivers of epidemiology depend on the potential of separate host species to sustain the disease. To control a rabies outbreak in the two species, both species had to be targeted. Realistic and robust control strategies involved vaccination of foxes and badgers, but also required badger culling. Although fox and badger populations in the UK are exceptionally dense, an outbreak of rabies can be controlled with a higher than 90% chance, if control response is quick and follows a strict regime. This requires surveillance and forceful and repeated control campaigns. In contrast, an uncontrolled rabies outbreak in the South of England would quickly develop into a strong epizootic involving tens of thousands of rabid foxes and badgers. Conclusions: If populations of both host species are sufficiently large, epizootics are driven by within-species transmission, while cross-species-infection appears to be of minor importance. Thus, the disease control strategy has to target both host populations. [ABSTRACT FROM AUTHOR]

Revision hip arthroplasty in cases with severe acetabular deficiency represents a technical challenge. The aim of this study was to determine: 1. The 9-year survival of the Burch Schneider anti-protrusio cage (BS-APC) in severe acetabular defects. 2. The migration of the cage and correlation of this with functional outcome. 3. The anticipated functional outcome users can expect in a district general hospital setting in the management of severe acetabular defects. A single-surgeon consecutive series of 30 complex acetabular reconstructions using the BS-APC was retrospectively reviewed. Clinical and radiological follow up at 5-9 years was obtained. Survival was established with revisions and further surgery as different end-points. A radiological analysis using ein bilt roentgen analyse (EBRA) was performed. At a mean follow-up of 85 months (range: 64-118) 26 patients (87%) were alive. Nine-year survival was 95% for revision of BS-APC as an end-point and 92% with any cause of further surgery as an endpoint. The mean Oxford Hip Score was 34.5 and UCLA activity score was 4.4. All cases demonstrated evidence of significant migration, but no screws were found to be broken. There was no correlation between cup migration and Oxford hip score (p=0.07). Our non-specialist centre experience suggests the BS-APC should not be dismissed as a reconstruction option in the most severe acetabular defects. [ABSTRACT FROM AUTHOR]

Armed with readily accessible online traffic logs that provide detailed information about the items users are selecting to view, editors are voicing concern about the potential effect on their own content decisions. Through a survey of local British newspaper editors, this article examines the overlap between user preferences, as suggested by assessments of website traffic, and content that editors identify as their best. Results are considered in the context of two related subsets of agenda-setting theory, as well as the sociological process of “making news.” The study finds overlap between broad categories of stories preferred by editors and users, but a considerable disconnect over the nature of the items within those categories. [ABSTRACT FROM AUTHOR]

BACKGROUND: The global public health community has closely monitored the unfolding of the 2009 H1N1 influenza pandemic to best mitigate its impact on society. However, little attention has been given to the impact of this response on the environment. Antivirals and antibiotics prescribed to treat influenza are excreted into wastewater in a biologically active form, which presents a new and potentially significant ecotoxicologic challenge to microorganisms responsible for wastewater nutrient removal in wastewater treatment plants (WWTPs) and receiving rivers. OBJECTIVES: We assessed the ecotoxicologic risks of a pandemic influenza medical response. METHODS: To evaluate this risk, we coupled a global spatially structured epidemic model that simulates the quantities of antivirals and antibiotics used during an influenza pandemic of varying severity and a water quality model applied to the Thames catchment to determine predicted environmental concentrations. An additional model was then used to assess the effects of antibiotics on microorganisms in WWTPs and rivers. RESULTS: Consistent with expectations, our model projected a mild pandemic to exhibit a negligible ecotoxicologic hazard. In a moderate and severe pandemic, we projected WWTP toxicity to vary between 0-14% and 5-32% potentially affected fraction (PAF), respectively, and river toxicity to vary between 0-14% and 0-30% PAF, respectively, where PAF is the fraction of microbial species predicted to be growth inhibited (lower and upper 95% reference range). CONCLUSIONS: The current medical response to pandemic influenza might result in the discharge of insufficiently treated wastewater into receiving rivers, thereby increasing the risk of eutrophication and contamination of drinking water abstraction points. Widespread drugs in the environment could hasten the generation of drug resistance. Our results highlight the need for empirical data on the effects of antibiotics and antiviral medications on WWTPs and freshwater ecotoxicity. [ABSTRACT FROM AUTHOR]

In May 2007, Scots voted into office a party and a political leader publicly committed to holding a referendum on independence from Great Britain within four years. This study analyzes nearly forty-eight hundred comments appended to stories on the scotsman. com Web site, offering one of the first detailed looks at user-generated content on a newspaper-affiliated Web site in the context of a national election. It explores the evolving nature of online political community and the ways in which newspapers are accommodating a networked environment in their political coverage, addressing issues of citizen and journalistic engagement within a communal space. [ABSTRACT FROM AUTHOR]

The article discusses various divorce cases in Great Britain. It states that Section 25 of the Matrimonial Causes Act 1973 provides the discretionary regime under which financial provision on divorce is made. The author claims that the use of a discretionary scheme ensures flexibility in tailoring outcomes to individual cases, but it is often said to be at the expense of certainty and predictability. It highlights the case of White versus White, Miller versus Miller, and Charman versus Charman. It notes that the decision of the Court of Appeal in Charman is to be welcomed and that much of the confusion left in the wake of the House of Lord's decision in Miller has been removed and the senior judiciary have leant their weight to the growing calls for review and reform.

The article presents information on a court case related to negligence of a hospital in Great Britain. In Rees v Darlington Memorial Hospital National Health Service (NHS) Trust, a seven-member panel of the House of Lords unanimously reaffirmed the decision in McEarlane v Tayside Health Board that the parents of a healthy child born after a negligently performed sterilization cannot recover the costs of the child's upbringing from the negligent doctor's NHS Trust. However, the house was split by 4 to 3 in holding that, in accordance with McEarlane, a disabled mother of a healthy child, born after a negligently performed sterilization operation, cannot recover the additional costs of raising the child attributable to her disability.

We used data from a case–control study investigating risk factors for horse falls in the cross-country phase of eventing in Great Britain (GB) to examine evidence for memory decay and information bias. Responses to two questions obtained by telephone for 173 cases and 521 controls were examined for evidence of differential reporting according to the respondent’s case–control status and performance in the dressage and cross-country phases of competitions. Information bias was found in the accuracy of reporting dressage penalty scores when analysed as a function of performance level (good/poor). Poor dressage performers were less likely to report accurate dressage scores than good performers. The accuracy of reporting dressage scores decreased as the time between the event and questionnaire completion increased, with no case–control interaction. Competitors who incurred cross-country jumping penalties at the event preceding the selected event reported their cross-country scores with less accuracy when compared with competitors who incurred no penalties. No information bias was found when the reporting of dressage and cross-country scores were analysed as a function of respondent category (case/control). [Copyright &y& Elsevier]

The risk of fatal distal limb fractures in thoroughbreds racing in the UK was calculated and shown to vary considerably between the different types of race. Flat turf racing was associated with the lowest risk (0.4 per 1000 starts) and national hunt fiat racing was associated with the highest risk (2.2 per 1000 starts). The types of fracture were classified by detailed radiographic and postmortem examinations of all the cases recorded over two years, and the distribution of the different types of fracture in the five main types of racing was examined. Overall, lateral condylar fractures of the third metacarpus were the most common, and they were also the most common in national hunt-type races (hurdle, steeplechase and national hunt fiat races). In all-weather flat racing biaxial proximal sesamoid fractures were most common, and in turf flat racing fractures of the first phalanx were most common. The risk of fractures of more than one bone was greater in national hunt-type races. [ABSTRACT FROM AUTHOR]

Presents a court case involving transsexual Elizabeth Bellinger and Michael Bellinger in Great Britain. Petition of Elizabeth Bellinger for a High Court declaration on her marriage with Michael Bellinger; Refusal of the High Court to declare the validity of the marriage; Declaration of incompatibility made by the British House of Lords.

Focuses on the achievements of British philosopher R.M. Hare in the field of moral philosophy. Maintenance of the role of reason in ethics; Rejection of 'descriptivism'; Notion that moral judgments are universalizable.

Dexmedetomidine, a highly selective and potent α2-adrenergic agonist, has a potentially useful role as a sedative agent in patients requiring intensive care. As part of a larger European multicentre trial, a total of 119 postoperative cardiac and general surgical patients requiring ventilation and sedation in an intensive care unit were enrolled in four centres in the United Kingdom. One hundred and five patients were randomly allocated to receive either dexmedetomidine or placebo with rescue sedation and analgesia provided by midazolam and morphine, respectively. Compared with the control group, intubated patients receiving dexmedetomidine required 80% less midazolam [mean 4.9 (5.8) μg.kg-1.h-1 vs. 23.7 (27.5) μg.kg-1.h-1, p < 0.0001], and 50% less morphine [11.2 (13.4) μg.kg-1.h-1 vs. 21.5 (19.4) μg.kg-1.h-1,p = 0.0006]. Cardiovascular effects and adverse events could be predicted from the known properties of alpha-2 agonists. In conclusion, dexmedetomidine is a useful agent for the provision of postoperative analgesia and sedation. [ABSTRACT FROM AUTHOR]

Focuses on the effectiveness of the screening program for cervical cancer among women in Great Britain. Adequacy of record and recall systems for women with abnormal findings; Administration of interval screening in women over 35 years of age; Characteristics of women at high risk of developing cervical carcinoma.

Comments on several issues related to the medical service in Great Britain. Increase of prevalence rate of squamous cervical carcinoma; Effects of aprotinin in patients with acute pancreatitis; Classification of non-Hodgkin's lymphomas; Responsibilities of the National Health Service following reorganization.

Explores managerial professionals' views on gender-based preferential hiring versus merit selection, and examines whether their views are affected by different information frames presented to them. Results show that, although the managers sampled in the study opposed preferential hiring in general, they valued a number of the consequences of preferential hiring. Information frame had no effect on male manager's views. However, female managers were significantly persuaded by information emphasizing advantages of gender-based hiring. [ABSTRACT FROM AUTHOR]

Presents letters of several physicians on the articles published in the 'British Medical Journal.' Problems in ear-piercing; Shortage in anaesthetist; Effect of abortion in obstetric patterns.

Reports developments related to medicine in Great Britain as of July 1977. Effectiveness of measles immunization; Symptoms of epilepsy; Evaluation of serological test for tuberculosis.

Focuses on the detection of circulating immune complexes in serum and sputum of patients with cystic fibrosis (C.F.) in Great Britain. Extensive deposits of immunoglobulins and complement immune complexes in several of the C.F. organs; Identification of serum albumin and staphylococcal [alpha]-hemolysin; Sedimentation constant of the immune complexes.

Presents articles on possible developments in Asian studies in the United Kingdom published in the June 1981 edition of the 'Asian Affairs' periodical. Diffusion of Asian studies within universities; Importance of orientalism in learned societies; Interaction between Asian studies with libraries; Media coverage received; Introduction of an international dimension to school curricula.