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Tutors play an important role in effective Mathematics Learning Support, and ensuring good initial training and development is key. Typically, in the UK and Ireland, tutors do not gain any formal recognition for the training they receive. This paper details a four competences model of training for tutors and presents the analysis of feedback from 11 tutors and two staff involved in piloting the model at two institutions. The model, which is informed by professional development guidelines, consultation across the mathematical sciences community, and enabled by a national Mathematics Learning Support Network, provides immediate recognition of the professional development undertaken and is amenable to formal accreditation. A structure of four digital badges is used to assign immediate value to the training and development of tutors. To add further value for tutors, a capstone tutor badge has been established for those completing all four competences. Thematic analysis of feedback from the piloting of the model identifies three overarching themes: the importance of community, developing as a professional, and motivating and enabling professional development. Although primarily of interest to those involved in Mathematics Learning Support, the innovative structure of the model and the insights gained from its piloting are such that it offers potential for genuine transferability across other subject disciplines.

Mathematics Support Centres are available in the majority of Higher Education Institutions in Ireland and the UK. Whilst the online presence of these centres appears to be increasing, there is little research to date which considers its breadth or effectiveness. In this paper we consider the results of a survey on the online presence of support centres in Ireland and the UK. We discuss the opportunities that arise from such a presence, the challenges that exist and what the results of the survey mean for individual practitioners and the wider mathematics support community.

Suicide is the leading cause of unnatural death among people with schizophrenia. Substance use is a highly prevalent comorbid feature of schizophrenia and a modifiable risk factor for suicide. However, no studies have examined changes in the frequency of substance use or self-poisoning in those who died by suicide over time. Knowing this could support more tailored approaches to reducing specific risk factors and access to means in those with schizophrenia who are at risk of suicide. We conducted an 11-year observational study on a clinical survey of people with schizophrenia in the UK who died by suicide within 12 months of contact with mental health services between 2010 and 2020 (n = 2718). Overall, alcohol, cannabis and stimulants were the most frequently reported substances. The odds of lifetime use significantly increased over time for cannabis, stimulants, heroin, and benzodiazepines. There were differences in socio-demographic, behavioural and clinical factors between those with recent and historical alcohol and drug use before death. Deaths by hanging, jumping and self-poisoning were the most common suicide methods. Though deaths by hanging significantly increased over time, deaths by self-poisoning significantly decreased, especially by means of psychotropic medication and opioids. To improve risk management, clinical efforts should focus on identifying and treating people with schizophrenia using specific substances. Nationwide initiatives for improving safety in prescribing could be contributing to reduced risks of suicide via self-poisoning in this group. [ABSTRACT FROM AUTHOR]

Mathematics Learning Support (MLS), which is available in the majority of Higher Education Institutions (HEIs) in Ireland and the UK, is traditionally available only to students of those institutions. In this paper, we describe a drop-in model of MLS at Maynooth University (MU) which has been available for secondary school students since 2009. This service is mainly staffed by volunteer undergraduate trainee teachers. Their feedback, the main focus of this paper, which has been collected over ten years, indicates that this experience has had a positive impact on their teaching practice. School students are also very positive about the support and MU enthusiastically endorses the service. We conclude that there are no obvious downsides to the provision of this type of support and we believe that more institutions should consider making it available. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic and response changed clinical service delivery and practice for speech and language therapists (SLTs) in the United Kingdom. SLTs work with children with neurodisability regarding both difficulties with their communication and eating and drinking skills (oropharyngeal dysphagia). This survey aimed to specifically explore the impact of the COVID‐19 pandemic on SLT practice for school‐aged children with dysphagia. Methods: UK‐based SLTs working with school‐aged children with neurodisability and oropharyngeal dysphagia were recruited to share their perceptions on the impact of COVID‐19 on practice. Four questions focusing on COVID‐19 impact were part of a larger online survey exploring SLT clinical practice regarding mealtime management of children with neurodisability and oropharyngeal dysphagia, which included demographic information, service delivery, assessment and intervention practices. COVID‐19 impact questions were a mixture of multiple choice and free text responses. The survey was disseminated using professional networks and social media, between 14 May and 30 July 2021. Data were analysed using descriptive statistics and qualitative content analysis. Results: One hundred and two participants answered at least one of the four COVID‐19 questions. Eighty‐two per cent of SLTs either agreed or strongly agreed that COVID‐19 impacted on service delivery to children and families. Negative impacts on service delivery included school absences/closures, home visiting restrictions, families declining input and/or having barriers to telehealth use and the impact of mask wearing on interactions. Positive impacts included increased telehealth access and skills, increased contact with families and focus on children's eating and drinking function within the home environment. Participants aimed to maintain the increased contact with families alongside a hybrid service delivery approach of in‐person and virtual appointments. Conclusions: This survey provides novel information capturing SLT practice change across two waves of COVID‐19 and return to in‐person practice for UK children with neurodisability. [ABSTRACT FROM AUTHOR]

Objective: Combat exposure can increase the risk of subsequent psychological ill-health in armed forces (AF) personnel. A U.S. postdeployment psycho-educational intervention, Battlemind, showed a beneficial effect on mental health in U.S. military personnel exposed to high combat levels. We evaluated the effectiveness of an anglicized version of postdeployment Battlemind. Method: Battlemind was adapted for the United Kingdom. The main amendments were to sections about carrying weapons, driving, and alcohol misuse. The anglicized Battlemind was compared with the U.K. standard postdeployment brief in a cluster randomized controlled trial. At baseline, 2,443 U.K. AF personnel returning from Afghanistan via Cyprus completed questionnaires about their combat experiences and mental health. Of these, 1,616 (66%) completed 6-month follow-up questionnaires. We used the Posttraumatic Stress Disorder Checklist (PCL-C) to measure probable posttraumatic stress disorder and the General Health Questionnaire (GHQ-12) to measure common mental disorders. Secondary outcomes included alcohol misuse, assessed with the Alcohol Use Disorders Identification Test (AUDIT), and binge drinking. Mixed-effects models were used to account for possible cluster effects. Results: We did not find a difference in mental health or overall AUDIT score. Those who received Battlemind versus the standard brief were less likely to report binge drinking, although the effect size was small (adjusted odds ratio = 0.73, 95% CI [0.58, 0.92]). Conclusions: The anglicized Battlemind did not improve mental health but had a modest impact on the reporting of binge drinking. Alcohol misuse is problematic in military populations; therefore, an intervention that reduces binge drinking may be helpful. (Contains 4 tables and 1 figure.)

Introduction: Most patients with Adrenal insufficiency (AI) require lifelong glucocorticoid replacement. They need to increase glucocorticoids during physical illness or major stressful situations and require parenteral hydrocortisone in the event of an adrenal crisis. Patients with AI have impaired quality of life and high mortality; approximately 1 in 6-12 patients are hospitalised at least once/year from a potentially preventable adrenal crisis. Adoption of selfmanagement behaviours are crucial; these include adherence to medication, following “sick day rules” and associated behaviours that aid prevention and treatment of adrenal crisis such as symptom monitoring, having extra tablets, carrying a medical-alert ID and injection kit, and self-injecting when necessary. Current patient education is ineffective at supporting self-management behaviour change or reducing adrenal crisis-related hospitalisations. This research study aims to gain an in-depth understanding of the barriers and enablers to self-management for patients with AI and to develop an evidence based digital self-management behaviour change intervention. Methods: The study is conducted in accordance with the MRC Framework for developing complex interventions. Underpinned by the Behaviour Change Wheel (BCW), the Theoretical Domains Framework (TDF), and the Person Based Approach, this research will be conducted in two phases: Phase 1 will involve a sequential qualitative/quantitative mixed-methods study involving focus group interviews followed by a cross-sectional survey with patients with AI recruited from patient advocacy groups and endocrine clinics in the UK. Phase 2 will develop the Support AI, a website-based digital behaviour change intervention (DBCI) informed by Phase 1 findings to support self-management for patients with AI. The most appropriate behaviour change techniques (BCTs) will be selected utilising a nominal group technique with an Expert Panel of 10-15 key stakeholders. The design of the Support AI website will be guided by the Person-Based Approach using an Agile iterative “think-aloud” technique with 12- 15 participants over 3 usability testing iterations. Conclusion: A theory- and evidence-based digital behaviour change intervention will be developed which will be tested in a feasibility randomised trial following completion of this study. The projected benefit includes cost effective health care service (reduced hospitalisations and demand for specialist services) and improved health outcomes and quality of life for patients with AI. [ABSTRACT FROM AUTHOR]

Background: The identification of effective dementia prevention strategies is a major public health priority, due to the enormous and growing societal cost of this condition. Consumption of a Mediterranean diet (MedDiet) has been proposed to reduce dementia risk. However, current evidence is inconclusive and is typically derived from small cohorts with limited dementia cases. Additionally, few studies have explored the interaction between diet and genetic risk of dementia. Methods: We used Cox proportional hazard regression models to explore the associations between MedDiet adherence, defined using two different scores (Mediterranean Diet Adherence Screener [MEDAS] continuous and Mediterranean diet Pyramid [PYRAMID] scores), and incident all-cause dementia risk in 60,298 participants from UK Biobank, followed for an average 9.1 years. The interaction between diet and polygenic risk for dementia was also tested. Results: Higher MedDiet adherence was associated with lower dementia risk (MEDAS continuous: HR = 0.77, 95% CI = 0.65–0.91; PYRAMID: HR = 0.86, 95% CI = 0.73–1.02 for highest versus lowest tertiles). There was no significant interaction between MedDiet adherence defined by the MEDAS continuous and PYRAMID scores and polygenic risk for dementia. Conclusions: Higher adherence to a MedDiet was associated with lower dementia risk, independent of genetic risk, underlining the importance of diet in dementia prevention interventions. [ABSTRACT FROM AUTHOR]

In capital markets, digitisation and cloud technology have catalysed opportunities for AI by enabling firms to collect, store and analyse larger datasets from a variety of internal sources than ever before. The past year brought greater regulatory activity around AI in the UK, EU and US than in any prior year, although regulatory regimes remain disparate. When considering legal issues that arise from use of AI, facets of multiple legal fields are relevant, albeit differing between jurisdictions, such as intellectual property rights frameworks and contractual areas such as data ownership, data rights, risk and liability allocation and compliance responsibilities. In this paper, the key legal considerations and recent regulatory developments are categorised into four actionable, international themes: (i) due diligence of data as an asset; (ii) effective organisational ongoing controls; (iii) intellectual property management; and (iv) third party contract and risk management. With so much in flux, we find that the best approach for now is to consider such themes and ensure robust governance, transparency and explainability of each of the AI systems, human oversight of the AI and contractual arrangements with third party providers. Perhaps ironically, 'getting AI right' is currently, to a large extent, more an art of human judgement than any formulaic compliance with rules. [ABSTRACT FROM AUTHOR]

Purpose: The Oxford WebQ is a web-based 24-h dietary assessment method which has been used in UK Biobank and other large prospective studies. The food composition table used to calculate nutrient intakes has recently been replaced with the UK Nutrient Databank, which has food composition data closer in time to when participants completed the questionnaire, and new dietary variables were incorporated. Here we describe the updated version of the Oxford WebQ questionnaire nutrient calculation, and compare nutrient intakes with the previous version used. Methods: 207,144 UK Biobank participants completed ≥ 1 Oxford WebQs, and means and standard deviations of nutrient intakes were averaged for all completed 24-h dietary assessments. Spearman correlations and weighted kappa statistics were used to compare the re-classification and agreement of nutrient intakes between the two versions. Results: 35 new nutrients were incorporated in the updated version. Compared to the previous version, most nutrients were very similar in the updated version except for a few nutrients which showed a difference of > 10%: lower with the new version for trans-fat (− 20%), and vitamin C (− 15%), but higher for retinol (+ 42%), vitamin D (+ 26%) and vitamin E (+ 20%). Most participants were in the same (> 60%) or adjacent (> 90%) quintile of intake for the two versions. Except for trans-fat (r = 0.58, κ = 0.42), very high correlations were found between the nutrients calculated using the two versions (r > 0.79 and κ > 0.60). Conclusion: Small absolute differences in nutrient intakes were observed between the two versions, and the ranking of individuals was minimally affected, except for trans-fat. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to understand how physical activity and sedentary behaviour levels of pregnant women with gestational diabetes in the UK have been affected by COVID-19. Methods: An online survey exploring physical activity and sedentary behaviour levels of pregnant women with gestational diabetes during COVID-19 was distributed through social media platforms. Women who had been pregnant during the COVID-19 outbreak and had gestational diabetes, were resident in the UK, were 18 years old or over and could understand written English were invited to take part. Results: A total of 724 women accessed the survey, 553 of these met the eligibility criteria and took part in the survey. Sedentary time increased for 79% of the women during the pandemic. Almost half of the women (47%) were meeting the physical activity guidelines pre COVID-19 during their pregnancy, this dropped to 23% during the COVID-19 pandemic. Fear of leaving the house due to COVID-19 was the most commonly reported reason for the decline. Significant associations were found between meeting the physical activity guidelines during COVID-19 and educational attainment, fitness equipment ownership and knowledge of how to exercise safely in pregnancy. Conclusions and implications: These results show the impact of COVID-19 on physical activity and sedentary behaviour levels and highlight the need for targeted public health initiatives as the pandemic continues and for future lockdowns. Women with gestational diabetes need to know how it is safe and beneficial to them to engage in physical activity and ways to do this from their homes if fear of leaving the house due to COVID-19 is a barrier for them. Online physical activity classes provided by certified trainers in physical activity for pregnant women may help them remain active when face-to-face appointments are reduced and limited additional resources are available. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between unemployment and psychological well-being before and during the Great Recession across 249 UK local authority districts (LADs). Substantial evidence demonstrates that unemployment has a large negative effect on psychological well-being. However, unique social norms develop in geographical areas with high unemployment rates, which significantly reduce the negative impact of unemployment on well-being. Though the post-2007 Great Recession period was characterized by widespread unemployment, few studies have examined the impact of this crisis on well-being in high- and low-unemployment local areas. The analysis constructs a rich panel data set which follows 15,798 individuals from 1998 to 2014, and applies difference-in-differences fixed-effects and general method of moments estimators. The findings indicate that unemployment had a large negative impact on psychological well-being. However, the magnitude of this effect did not change (or was even slightly lower) during the Great Recession. Furthermore, the unemployment social norm also ceased to have any additional effect on well-being during the Great Recession in high-unemployment LADs, as opposed to the pre-recession period. [ABSTRACT FROM AUTHOR]

The importance of Social Prescribing (SP) has been highlighted in the National Health Service (NHS) Long-Term Plan. SP is enabling healthcare professionals to refer patients to a link worker, to co-design a non-clinical social prescription to improve their health and well-being. Our aim was to explore perceptions, understanding, and awareness of SP amongst United Kingdom (UK) medical students. Views were collected using pre- and post-session surveys around teaching sessions in 27 UK medical schools as part of NHS England's National SP Student Champion Scheme. Pre-session surveys suggested 93% (n = 848) of respondents had not heard of the concept of SP before the session. Post-session surveys highlighted that 98% (n = 895) regarded the concept as useful and relevant to their future careers. Findings show a lack of awareness regarding Social Prescribing (SP) amongst UK medical students. New strategies are needed to ensure the doctors of tomorrow are equipped with the necessary tools to achieve the recent outcomes for graduates and implement plans for the NHS and general practice which highlight the importance of personalised care. We believe general practice can play an integral role in shaping values and beliefs amongst tomorrow's doctors through formal education and mentoring. [ABSTRACT FROM AUTHOR]

Background In Mediterranean countries, adherence to a traditional Mediterranean dietary pattern (MedDiet) is associated with better cognitive function and reduced dementia risk. It is unclear if similar benefits exist in non-Mediterranean regions. Objectives The aims of this study were to examine associations between MedDiet adherence and cognitive function in an older UK population and to investigate whether associations differed between individuals with high compared with low cardiovascular disease (CVD) risk. Methods We conducted an analysis in 8009 older individuals with dietary data at Health Check 1 (1993–1997) and cognitive function data at Health Check 3 (2006–2011) of the European Prospective Investigation into Cancer and Nutrition–Norfolk (EPIC-Norfolk). Associations were explored between MedDiet adherence and global and domain-specific cognitive test scores and risk of poor cognitive performance in the entire cohort, and when stratified according to CVD risk status. Results Higher MedDiet adherence defined by the Pyramid MedDiet score was associated with better global cognition (β ± SE = −0.012 ± 0.002; P  < 0.001), verbal episodic memory (β ± SE = −0.009 ± 0.002; P  < 0.001), and simple processing speed (β ± SE = −0.002 ± 0.001; P  = 0.013). Lower risk of poor verbal episodic memory (OR: 0.784; 95% CI: 0.641, 0.959; P  = 0.018), complex processing speed (OR: 0.739; 95% CI: 0.601, 0.907; P  = 0.004), and prospective memory (OR: 0.841; 95% CI: 0.724, 0.977; P  = 0.023) was also observed for the highest compared with the lowest Pyramid MedDiet tertiles. The effect of a 1-point increase in Pyramid score on global cognitive function was equivalent to 1.7 fewer years of cognitive aging. MedDiet adherence defined by the Mediterranean Diet Adherence Screener (MEDAS) score (mapped through the use of both binary and continuous scoring) showed similar, albeit less consistent, associations. In stratified analyses, associations were evident in individuals at higher CVD risk only (P  < 0.05). Conclusions Higher adherence to the MedDiet is associated with better cognitive function and lower risk of poor cognition in older UK adults. This evidence underpins the development of interventions to enhance MedDiet adherence, particularly in individuals at higher CVD risk, aiming to reduce the risk of age-related cognitive decline in non-Mediterranean populations. [ABSTRACT FROM AUTHOR]

Background: Many women in prison are mothers and an increasing number are pregnant. These women face the harsh reality of potentially being separated from their babies or children, which can have detrimental effects on both the mother and the child. Aims: To review the literature surrounding the impact of mothers and children staying together in a prison environment. Method: The review focused on papers from the past 9 years and included mothers whose children resided with them in prison, and mothers who had been separated from their babies after giving birth in prison. Three articles were identified: two qualitative studies based on interviews with imprisoned mothers, and one quantitative study into re-offending rates of women who had been released from a prison nursery programme. Findings: Keeping their babies and mother together in a prison environment resulted in a positive outcome, particularly for the mothers. However, when thinking about the welfare of the child, there need to be sufficient opportunities to allow for their physical, social and emotional development. The common themes that emerged during this literature review were: low re-offending rates, motherhood producing motivation for change, and the effect of staying together on maternal and child wellbeing. Conclusions: This review highlighted the need for further studies, especially focusing on prisons in the UK. [ABSTRACT FROM AUTHOR]

Background Little is known about changes in blood fatty acid compositions over time and the correlates of any changes in a general population. Objective The aim of this study was to estimate changes in 27 individual plasma phospholipid fatty acids and fatty acid groups over time, and to identify potential correlates of these changes. Methods Plasma phospholipid fatty acids were profiled at 3 time-points (1993–1997, 1998–2000, 2004–2011) among 722 participants in the European Prospective Investigation into Cancer and Nutrition-Norfolk Study, UK. Linear regression models were used to estimate both 1) mean changes over time in 27 individual fatty acids and 8 prespecified fatty acid groups and 2) associations of changes in dietary and lifestyle factors with changes in the 8 fatty acid groups, mutually adjusted for dietary/lifestyle factors and other confounders. The prespecified fatty acid groups were odd-chain saturated fatty acids (SFAs), even-chain SFAs, very-long-chain SFAs, marine n–3 polyunsaturated fatty acids (PUFAs), plant n–3 PUFA, n–6 PUFAs, monounsaturated fatty acids (MUFAs), and trans-fatty acids (TFAs). Results Adjusted for confounders, fatty acid concentrations decreased for odd-chain SFAs (annual percentage difference in mol percentage: −0.63%), even-chain SFAs (−0.05%), n–6 PUFAs (−0.25%), and TFAs (−7.84%). In contrast, concentrations increased for marine n–3 PUFAs (1.28%) and MUFAs (0.45%), but there were no changes in very-long-chain SFAs or plant n–3 PUFA. Changes in fatty acid levels were associated with consumption of different food groups. For example, a mean 100 g/d increase in fatty fish intake was associated with a 19.3% greater annual increase in marine n–3 PUFAs. Conclusions Even-chain SFAs and TFAs declined and marine n–3 PUFAs increased over time. These changes were partially explained by changes in dietary habits, and could potentially help interpret associations of baseline fatty acid composition with future disease risk. [ABSTRACT FROM AUTHOR]

Aim: To conduct an open‐label study to provide UK real‐world evidence regarding the use of insulin glargine 300 units/ml (U300) in people with Type 1 diabetes mellitus. Methods: People with Type 1 diabetes who had been prescribed U300 ≥6 months before data collection and had HbA1c levels recorded within 3 months prior to U300 (baseline) were included. The primary endpoint was change in HbA1c from baseline to month 6 after U300 initiation. Other endpoints included number of documented hypoglycaemic and diabetic ketoacidosis episodes, and change in daily basal insulin dose. Results: A total of 298 people with Type 1 diabetes were included [mean age 42.1 years, mean HbA1c 79 mmol/mol (9.4%)]. After U300 initiation, the mean reduction in HbA1c from baseline to month 6 was –4 mmol/mol (–0.4%; P<0.001; n=188). The total daily basal insulin dose at 6 months was 1.3 units higher than at the time of U300 initiation (P<0.001; n=275) but was not significantly different from the prior basal insulin dose. There was no clinically significant difference in weight between baseline and month 6 [mean difference +0.7 kg, 95% CI –0.1, 1.5; P=0.084; n=115). During the 6 months before and after U300 initiation, severe hypoglycaemic episodes were documented for 6/298 and 4/298 participants. Diabetic ketoacidosis episodes requiring Accident and Emergency department visits or hospitalization were documented for 4/298 and 6/298 participants, before and after U300 initiation, respectively. Conclusions: In people with Type 1 diabetes, a change in basal insulin to U300 was associated with clinically and statistically significant HbA1c improvements, without significant changes in basal insulin dose and weight. Documented severe hypoglycaemia episodes and diabetic ketoacidosis requiring Accident and Emergency department visits or hospitalization were low and similar before and after U300 initiation. What's new?: This descriptive, retrospective study provides real‐world data on the use of a second‐generation basal insulin, insulin glargine 300 units/ml (U300), in Type 1 diabetes across the UK.Overall, participants who switched to U300 demonstrated improvements in HbA1c without significant changes in basal insulin dose and weight from baseline.The number of participants with documented severe hypoglycaemia and ketoacidosis requiring Accident and Emergency department visits or hospitalization was low and similar prior to and after U300 initiation.Results from this real‐world study show that observations made in randomized controlled trials translate to people with Type 1 diabetes treated with U300 in clinical practice in the UK. [ABSTRACT FROM AUTHOR]

Background People with diabetes and severe mental illness ( SMI) experience poorer outcomes than those with diabetes alone. To improve outcomes, it is necessary to understand the difficulties that people with SMI experience in managing their diabetes. Aims To identify barriers and enablers to effective diabetes self-management experienced by people with SMI and type 2 diabetes. Method Qualitative methodology using semi-structured interviews was employed. Development of the interview topic guide and analysis of the transcripts were informed by the Theoretical Domains Framework for behaviour change, which consists of fourteen theoretical domains that have been found to influence behaviour. Results Fourteen people with SMI and type 2 diabetes took part in the study. Participants considered diabetes self-management to be important, were aware of the risks of poor diabetes control but struggled to follow recommended advice, particularly if their mental health was poor. Support from family and health professionals was considered an important enabler of diabetes self-management. Conclusions New approaches are required to support diabetes self-management in people with SMI. This study identified some of the important domains that may be targeted in new interventions. [ABSTRACT FROM AUTHOR]

Carotenoids are found in abundance in fruit and vegetables, and may be involved in the positive association of these foods with bone health. This study aimed to explore the associations of dietary carotenoid intakes and plasma concentrations with bone density status and osteoporotic fracture risk in a European population. Cross-sectional analyses (n 14 803) of bone density status, using calcaneal broadband ultrasound attenuation (BUA) and longitudinal analyses (n 25 439) of fracture cases were conducted on data from the prospective European Prospective Investigation into Cancer and Nutrition-Norfolk cohort of middle-aged and older men and women. Health and lifestyle questionnaires were completed, and dietary nutrient intakes were derived from 7-d food diaries. Multiple regression demonstrated significant positive trends in BUA for women across quintiles of dietary α-carotene intake (P=0·029), β-carotene intake (P=0·003), β-cryptoxanthin intake (P=0·031), combined lutein and zeaxanthin intake (P=0·010) and lycopene intake (P=0·005). No significant trends across plasma carotenoid concentration quintiles were apparent (n 4570). The Prentice-weighted Cox regression showed no trends in fracture risk across dietary carotenoid intake quintiles (mean follow-up time 12·5 years), except for a lower risk for wrist fracture in women with higher lutein and zeaxanthin intake (P=0·022); nevertheless, inter-quintile differences in fracture risk were found for both sexes. Analysis of plasma carotenoid data (mean follow-up time 11·9 years) showed lower hip fracture risk in men across higher plasma α-carotene (P=0·026) and β-carotene (P=0·027) quintiles. This study provides novel evidence that dietary carotenoid intake is relevant to bone health in men and women, demonstrating that associations with bone density status and fracture risk exist for dietary intake of specific carotenoids and their plasma concentrations. [ABSTRACT FROM PUBLISHER]

This article will examine the issue of piracy and how the prohibition of piracy developed in international law from the 19th century onwards. The campaigns against piracy in the 19th century influenced the development of international law into the 21st century with the prohibition on piracy achieving the status of peremptory norm 'jus cogens' under international law. The anti-piracy campaign of the British led to the signing of treaties which, although ostensibly designed to prohibit the trade, had the effect of consolidating British power and influence over the Gulf States and furthered imperial interests there. The campaign also further contributed to the notion of the 'civilising mission'. The legacy of the campaigns reverberate in the contemporary debates about piracy, particularly in relation to the so-called pirates who operate off the west coast of Africa. [ABSTRACT FROM AUTHOR]

Background Total nutrient intake ( TNI) is intake from food and supplements. This provides an assessment of nutrient adequacy and the prevalence of excessive intake, as well as the response with respect to biomarkers. Cod liver oil ( CLO) is the most frequently consumed supplement in the UK, containing nutrients that might have varying influences on health. We calculated TNI for vitamins A, D and E, as well as eicosapentaenoic acid ( EPA) and docosahexaenoic acid ( DHA), and assessed associations with the respective blood concentrations. Methods Seven-day diet diaries and blood samples were taken from two subsets of the European Prospective Investigation into Cancer ( EPIC-Norfolk) cohort (age range 39-79 years; n = 1400 for vitamin D; n = 6656 for remaining nutrients). TNI was calculated for the subgroups: nonsupplement users, those consuming the nutrient in supplement form and those consuming a supplement without this nutrient. Results CLO-related nutrients were supplemented by 15%-33%, which approximately doubled median intakes. Almost everyone in the supplement + vitamin A group reached the estimated average requirement; however, guideline levels were likely to be exceeded. Partial correlations between intake of vitamins A and D and biomarkers were low and modestly strengthened by the inclusion of supplement sources (correlation = 0.01-0.13). Correlations between biomarker and TNI of vitamin E and EPA+ DHA were in the range 0.40-0.46; however, vitamin E exceeding food intake resulted in attenuated coefficients. Linear associations between food or TNI EPA+ DHA and plasma were weak but consistent across subgroups. Conclusions CLO-related nutrients contribute substantially to nutrient intake, with a risk of over-consumption. Apart from EPA+ DHA, biomarker data suggest that CLO-related nutrients in supplements are not linearly associated with vitamin status. [ABSTRACT FROM AUTHOR]

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is a proven way to prevent and control hypertension and other chronic disease. Because the DASH diet emphasizes plant-based foods, including vegetables and grains, adhering to this diet might also bring about environmental benefits, including lower associated production of greenhouse gases (GHGs). Objective: The objective was to examine the interrelation between dietary accordance with the DASH diet and associated GHGs. A secondary aim was to examine the retail cost of diets by level of DASH accordance. Design: In this cross-sectional study of adults aged 39-79 y from the European Prospective Investigation into Cancer and Nutrition-Norfolk, United Kingdom cohort (n = 24,293), dietary intakes estimated from food-frequency questionnaires were analyzed for their accordance with the 8 DASH food and nutrient-based targets. Associations between DASH accordance, GHGs, and dietary costs were evaluated in regression analyses. Dietary GHGs were estimated with United Kingdom-specific data on carbon dioxide equivalents associated with commodities and foods. Dietary costs were estimated by using national food prices from a United Kingdom-based supermarket comparison website. Results: Greater accordance with the DASH dietary targets was associated with lower GHGs. Diets in the highest quintile of accordance had a GHG impact of 5.60 compared with 6.71 kg carbon dioxide equivalents/d for least-accordant diets (P < 0.0001). Among the DASH food groups, GHGs were most strongly and positively associated with meat consumption and negatively with whole-grain consumption. In addition, higher accordance with the DASH diet was associated with higher dietary costs, with the mean cost of diets in the top quintile of DASH scores 18% higher than that of diets in the lowest quintile (P < 0.0001). Conclusions: Promoting wider uptake of the DASH diet in the United Kingdom may improve population health and reduce diet-related GHGs. However, to make the DASH diet more accessible, food affordability, particularly for lower income groups, will have to be addressed. [ABSTRACT FROM AUTHOR]

A biography of Irish engineer William Dargan is presented. It mentions that he was born in 1799 near Tullow town in Ireland. Topics discussed include his travel to London, England for Commons sessions, his appointment to rebuild the entire road with Scottish engineer Thomas Telford, and his works and acquiring the experience of canal construction in England. It discusses the construction of Ireland's first railway, the Dublin & Kingstown, the Ulster Canal, and Belfast port.

A correction to this paper has been published: https://doi.org/10.1007/s00394-021-02591-3 [ABSTRACT FROM AUTHOR]

Aims and Objectives To explore the effect contact with a heart failure nurse can have on patients' illness beliefs, mood and quality of life. Background There is growing interest in patients' illness beliefs and the part they play in a patients understanding of chronic disease. Design Secondary analysis on two independent datasets. Patients were recruited from five UK hospitals, four in London and one in Sussex. Patients were recruited from an inpatient and outpatient setting. The first dataset recruited 174 patients with newly diagnosed heart failure, whilst the second dataset recruited 88 patients with an existing diagnosis of heart failure. Methods Patients completed the Minnesota Living with Heart Failure Questionnaire, Hospital Anxiety and Depression Scale, Illness Perception Questionnaire and the Treatment Representations Inventory at baseline and six months. We used a linear regression model to assess the association that contact with a heart failure nurse had on mood, illness beliefs and quality of life over a six-month period. Results Patients who had contact with a heart failure nurse were more satisfied with their treatment and more likely to believe that their heart failure was treatable. Contact with a heart failure nurse did not make a statistically significant difference to mood or quality of life. Conclusions This study has shown that contact with a heart failure nurse can improve patient satisfaction with treatment decisions but has less influence on a patient's beliefs about their personal control, treatment control and treatment concerns. With appropriate support, skills and training, heart failure nurses could play an important role in addressing individual patient's beliefs. There is a need to further investigate this. Relevance to clinical practice Exploring patients' illness beliefs and mood could help to enhance person-centred care. Heart failure nurses would need additional training in the techniques used. [ABSTRACT FROM AUTHOR]

Background: Stable-isotope ratios of carbon (13C/12C, expressed as δ13C) and nitrogen (15N/14N, or δ15N) have been proposed as potential nutritional biomarkers to distinguish between meat, fish, and plant-based foods. Objective: The objective was to investigate dietary correlates of δ13C and δ15N and examine the association of these biomarkers with incident type 2 diabetes in a prospective study. Design: Serum δ13C and δ15N (‰) were measured by using isotope ratio mass spectrometry in a case-cohort study (n = 476 diabetes cases; n = 718 subcohort) nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population-based cohort. We examined dietary (food-frequency questionnaire) correlates of δ13C and δ15N in the subcohort. HRs and 95% CIs were estimated by using Prentice-weighted Cox regression. Results: Mean (±SD) δ13C and δ15N were -22.8 ± 0.4‰ and 10.2 ± 0.4‰, respectively, and δ13C (r = 0.22) and δ15N (r = 0.20) were positively correlated (P < 0.001) with fish protein intake. Animal protein was not correlated with δ13C but was significantly correlated with δ15N (dairy protein: r = 0.11; meat protein: r = 0.09; terrestrial animal protein: r = 0.12, P ≤ 0.013). δ13C was inversely associated with diabetes in adjusted analyses (HR per tertile: 0.74; 95% CI: 0.65, 0.83; P-trend < 0.001], whereas δ15N was positively associated (HR: 1.23; 95% CI: 1.09, 1.38; P-trend = 0.001). Conclusions: The isotope ratios δ13C and δ15N may both serve as potential biomarkers of fish protein intake, whereas only δ15N may reflect broader animal-source protein intake in a European population. The inverse association of δ13C but a positive association of δ15N with incident diabetes should be interpreted in the light of knowledge of dietary intake and may assist in identifying dietary components that are associated with health risks and benefits. [ABSTRACT FROM AUTHOR]

Background Several cross-sectional studies have shown an association between exposure to life events and psychological problems in adults with intellectual disability (ID). To establish life events as a risk factor, prospective designs are needed. Methods Support staff informants provided data on the psychological problems of 68 adults with ID and their recent exposure to life events. Using data collected on the same sample 3.5 to 4 years earlier, prospective analysis of the relationships between life events exposure and psychological problems over time was explored. Results Hierarchical linear regression analyses demonstrated a contribution of life events to the prediction of later psychological problems after controlling for earlier psychological problems. Exploratory analyses showed that the relationship between life events and psychological problems might be unidirectional, and non-spurious; remaining present once the impact of other correlates of psychological problems was controlled. Conclusions These data offer support for the status of life events (with a negative valence) as a risk factor for psychological problems in adults with ID. To establish life events as a causal risk factor, research is needed to examine the mechanisms via which life events have their impact on psychological well-being. [ABSTRACT FROM AUTHOR]

Aim: Relatives of service users involved with Early Intervention in Psychosis services often experience substantial distress and need associated with their role as caregivers. This study adapted versions of the Relatives Cardinal Needs Schedule and the Texas Inventory of Grief and tested their utility for use among relatives of service users experiencing a first episode of psychosis. Methods: Staff, service users and relatives were consulted and a pilot took place which facilitated the creation of the Relatives' Urgent Needs Schedule - Early Intervention version (RUNS-EI) and the Texas Inventory of Grief - Early Intervention version (TIG-EI). Thirty service user-caregiver dyads were recruited for the evaluation of reliability and validity. Results: The level of 'urgent need' identified by the RUNS-EI demonstrated good concurrent validity with measures of service user social and global functioning as well as measures assessing relatives' distress, expressed emotion and grief. The measure demonstrated acceptable interrater and test-retest reliability. The profile of need is reported. The TIG-EI demonstrated 'excellent' internal consistency. It also demonstrated good concurrent validity with increased TIG-EI scores correlated with reduced service user social and global functioning as well as increased scores on measures assessing relatives' distress, expressed emotion and caregiving needs. Conclusions: Results appear to support these assessments' utility as measures of need for psychosocial intervention and grief among relatives supporting service users experiencing a first episode of psychosis. [ABSTRACT FROM AUTHOR]

ObjectiveA diet rich in phyto-oestrogens has been suggested to protect against a variety of common diseases but UK intake data on phyto-oestrogens or their food sources are sparse. The present study estimates the average intakes of isoflavones, lignans, enterolignans and coumestrol from 7 d food diaries and provides data on total isoflavone, lignan and phyto-oestrogen consumption by food group.DesignDevelopment of a food composition database for twelve phyto-oestrogens and analysis of soya food and phyto-oestrogen consumption in a population-based study.SettingMen and women, aged 40–79 years, from the general population participating in the Norfolk arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) between 1993 and 1997, with nutrient and food data from 7 d food diaries.SubjectsA subset of 20 437 participants.ResultsThe median daily phyto-oestrogen intake for all men was 1199 μg (interquartile range 934–1537 μg; mean 1504 μg, sd 1502 μg) and 888 μg for all women (interquartile range 710–1135 μg; mean 1205 μg, sd 1701 μg). In soya consumers, median daily intakes were higher: 2861 μg in men (interquartile range 1304–7269 μg; mean 5051 μg, sd 5031 μg) and 3142 μg in women (interquartile range 1089–7327 μg; mean 5396 μg, sd 6092 μg). In both men and women, bread made the greatest contribution to phyto-oestrogen intake – 40·8 % and 35·6 %, respectively. In soya consumers, vegetable dishes and soya/goat's/sheep's milks were the main contributors – 45·7 % and 21·3 % in men and 38·4 % and 33·7 % in women, respectively.ConclusionsThe ability to estimate phyto-oestrogen intake in Western populations more accurately will aid investigations into their suggested effects on health. [ABSTRACT FROM AUTHOR]

Background: Most studies of the mental health of UK armed forces focus on retrospective accounts of deployment and few sample personnel while they are deployed.Aims: This study reports the results of a survey of deployed personnel, examining the perceived impact of events at home and military support for the family on current mental health during the deployment.Method: Surveys were conducted with 2042 British forces personnel serving in Iraq and Afghanistan. Prevalence of common mental disorders was assessed with the 12-item General Health Questionnaire (GHQ-12) and post-traumatic stress disorder (PTSD) was assessed with the PTSD Checklist - Civilian version (PCL-C).Results: The prevalence of common mental disorders was 17.8% and of probable PTSD was 2.8%. Perceived home difficulties significantly influenced the mental health of deployed personnel; the greater the perception of negative events in the home environment, the greater the reporting of adverse mental health effects. This finding was independent of combat exposure and was only partially mitigated by being well led and reporting subjectively good unit cohesion; however, the effect of the totality of home-front events was not improved by the latter. Poor perceived military support for the family had a detrimental impact on deployment mental health.Conclusions: The armed forces offer many support services to the partners and families of deployed personnel and ensuring that the efforts being made on their behalf are well communicated might improve the mental health of deployed personnel. [ABSTRACT FROM AUTHOR]

Armed Forces personnel who deploy as individual augmentees (IAs), with a unit other than their formed unit, often fill shortages or provide specialized knowledge or skill sets. This article examined the effect of deploying as an IA on mental health outcomes and unit cohesion. A U.K. military cohort study was used to compare IAs (n = 1352) with personnel who had deployed with a formed unit (n = 2980). Differences between the groups in questionnaire assessed symptoms of post-traumatic stress disorder (PTSD Checklist-Civilian Version), common mental disorders (General Health Questionnaire-12) and alcohol misuse (Alcohol Use Disorders Identification Test) were examined with logistic and negative-binomial regression analyses. There was no difference between IAs and those who deployed with a formed unit in level of unit cohesion, symptoms of post-traumatic stress disorder or common mental disorder. Deploy-ment as an IA was associated with less alcohol misuse (Odds Ratio 0.77, 95% Confidence Interval 0.63-0.94). 1As appeared able to integrate with the group they deployed with as levels of unit cohesion were similar to personnel who deployed with a formed unit. IAs were also at a lower risk of alcohol misuse compared to personnel who deployed with a formed unit. [ABSTRACT FROM AUTHOR]

This article contends that the revolutionary event in 1870, as far as British foreign policy was concerned, was the collapse of French power, rather than the unification of Germany. By focusing on the unification of Germany and Anglo-German relations, historians have missed the centrality of France in nineteenth-century British foreign policy. Despite friction over Belgium, Britain and France co-operated on many issues in the eighteen-sixties, most notably checking Russian ambitions in the Near East. Once French power collapsed in 1870, Britain could no longer resist Russian revisionist claims in the Black Sea. At the same time, Britain was forced to compromise with the United States over outstanding differences dating from the civil war. Isolated on the international stage, the British government had to reorient its policy around the world and the events of 1870 shaped the options open to policymakers in subsequent years. [ABSTRACT FROM AUTHOR]

Background: Humans are exposed to preformed N-nitroso compounds (NOCs) and endogenous NOCs. Several NOCs are potential human carcinogens, including N-nitrosodimethylamine (NDMA), but evidence from population studies is inconsistent. Objective: We examined the relation between dietary NOCs (NDMA), the endogenous NOC index, and dietary nitrite and cancer incidence in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk, United Kingdom, study. Design: This was a prospective study of 23,363 men and women, aged 40-79 y, who were recruited in 1993-1997 and followed up to 2008. The baseline diet was assessed with food-frequency questionnaires. Results: There were 3268 incident cancers after a mean follow-up of 11.4 y. Dietary NDMA intake was significantly associated with increased cancer risk in men and women [hazard ratio (HR): 1.14; 95% CI: 1.03, 1.27; P for trend = 0.03] and in men (HR: 1.24; 95% CI: 1.07, 1.44; P for trend = 0.005) when the highest quartile was compared with the lowest quartile in age- and sex-adjusted analyses but not in multivariate analyses (HR: 1.10; 95% CI: 0.97, 1.24; HR for men: 1.18; 95% CI: 1.00, 1.40; P for trend ≥ 0.05). When continuously analyzed, NDMA was associated with increased risk of gastrointestinal cancers (HR: 1.13; 95% CI: 1.00, 1.28), specifically of rectal cancer (HR: 1.46; 95% CI: 1.16, 1.84) per 1-SD increase after adjustment for age, sex, body mass index, cigarette smoking status, alcohol intake, energy intake, physical activity, education, and menopausal status (in women). The endogenous NOC index and dietary nitrite were not significantly associated with cancer risk. There was a significant interaction between plasma vitamin C concentrations and dietary NDMA intake on cancer incidence (P for interaction < 0.00001). Conclusions: Dietary NOC (NDMA) was associated with a higher gastrointestinal cancer incidence, specifically of rectal cancer. Plasma vitamin C may modify the relation between NDMA exposure and cancer risk. [ABSTRACT FROM AUTHOR]

BackgroundEmployers such as the Armed Forces (AF) and emergency services, who predictably expose their staff to potentially traumatic events (PTEs), often provide psycho-educational briefings in an attempt to mitigate possible adverse psychological sequelae. Within the military, psycho-educational briefings are widely used, particularly following exposure to PTEs on operations. The aim of this review was to evaluate the efficacy of these interventions and make appropriate recommendations.MethodA search of Medline, PsycINFO and EMBASE was conducted, bibliographies of retrieved articles were searched and experts in the field were consulted.ResultsTwo surveys and seven intervention studies were identified for inclusion in the review. Only three studies were randomized controlled trials (RCTs). Overall, the review found some evidence of benefit of psycho-educational interventions but it was not consistent across studies or outcomes and effects were small. However, there was also little evidence to suggest that they caused harm. There was some evidence that the beneficial effects may be greater for those who have been exposed to a higher number of PTEs.ConclusionsGiven the high operational tempo currently faced by coalition forces personnel, there remains a pressing need to identify the most effective way of minimizing the impact of exposure to potentially traumatic deployment incidents. To date, few psycho-educational interventions designed to prevent deployment-related psychological ill-health have been evaluated systematically in methodologically robust studies. The review recommends that future interventions are theoretically based and evaluated in cluster RCTs that examine both process and outcome variables. [ABSTRACT FROM PUBLISHER]

There is now an abundance of research which has demonstrated that military personnel who deploy on operations are at increased risk of suffering a variety of mental health difficulties in the immediate and long-term post-deployment period. One consequence of these research findings has been the development of a variety of programmes which attempt to mitigate the increased psychological risk and to assist personnel who are returning from a deployment to make a smooth transition home. Using a three-tiered prevention model, this article reviews some of the key post-deployment issues facing the UK Armed Forces and highlights the recent interventions which have been put in place to promote successful adjustment in the early post-deployment period. The paper is based upon research identified through a thorough literature search for studies which focused on this area and included a recognized measure of mental health as an outcome. The paper focuses on three main areas; psychological decompression, psycho-education and screening. The current philosophical approaches to post-deployment mental health problems of some of the UK's coalition partners are also discussed. [ABSTRACT FROM AUTHOR]

The Irish community is the oldest minority ethnic community in Britain. Despite an older age profile than general or minority ethnic populations, as well as excesses of mental and physical ill-health and socio-economic disadvantage, the age, poor health and social profile of the community is largely ignored by policy makers and providers. Several of these factors predispose the Irish community in England to a higher incidence of dementia. Unlike other minority ethnic groups with growing numbers of people with dementia, the incidence of dementia is already high. Older Irish people are often reluctant to access mainstream services because they fail to recognise their distinct cultural needs and experiences. Irish third sector organisations provide a range of culturally specific services to older people and their carers and increasingly to those with dementia. This article uses data from a mapping exercise which identifies non-governmental services for Irish people with dementia and their carers, explaining what cultural sensitivity means for them. Changes in the UK government and the 'Big Society' agenda pose a threat to dementia services. However prioritising the National Dementia Strategy and revising the National Carers Strategy within this agenda could expand the role of the Irish third sector in England and improve the lives of Irish people with dementia and their carers. [ABSTRACT FROM AUTHOR]

Background: Most research on the mental health of UK armed forces personnel has been conducted either before or after deployment; there is scant evidence concerning personnel while they are on deployment.Aims: To assess the mental health of UK armed forces personnel deployed in Iraq and identify gaps in the provision of support on operations.Method: Personnel completed a questionnaire about their deployment experiences and health status. Primary outcomes were psychological distress (General Health Questionnaire-12, GHQ-12), symptoms of post-traumatic stress disorder (PTSD) and self-rating of overall health.Results: Of 611 participants, 20.5% scored above the cut-off on the GHQ-12 and 3.4% scored as having probable PTSD. Higher risk of psychological distress was associated with younger age, female gender, weaker unit cohesion, poorer perceived leadership and non-receipt of a pre-deployment stress brief. Perceived threat to life, poorer perceived leadership and non-receipt of a stress brief were risk factors for symptoms of PTSD. Better self-rated overall health was associated with being a commissioned officer, stronger unit cohesion and having taken a period of rest and recuperation. Personnel who reported sick for any reason during deployment were more likely to report psychological symptoms. Around 11% reported currently being interested in receiving help for a psychological problem.Conclusions: In an established operational theatre the prevalence of common psychopathology was similar to rates found in non-deployed military samples. However, there remains scope for further improving in-theatre support mechanisms, raising awareness of the link between reporting sick and mental health and ensuring implementation of current policy to deliver pre-deployment stress briefs. [ABSTRACT FROM AUTHOR]

Background: Epidemiological studies have suggested that excessive alcohol intake increases colorectal cancer (CRC) risk. However, findings regarding tumour subsites and sex differences have been inconsistent.Methods: We investigated the prospective associations between alcohol intake on overall and site- and sex-specific CRC risk. Analyses were conducted on 579 CRC cases and 1996 matched controls nested within the UK Dietary Cohort Consortium using standardised data obtained from food diaries as a main nutritional method and repeated using data from food frequency questionnaire (FFQ).Results: Compared with individuals in the lightest category of drinkers (>0-<5 g per day), the multivariable odds ratios of CRC were 1.16 (95% confidence interval (95% CI): 0.88, 1.53) for non-drinkers, 0.91 (95% CI: 0.67, 1.24) for drinkers with 5-<15 g per day, 0.90 (95% CI: 0.65, 1.25) for drinkers with 15-<30 g per day, 1.02 (95% CI: 0.66, 1.58) for drinkers with 30-<45 g per day and 1.19 (95% CI: 0.75, 1.91) for drinkers with >or=45 g per day. No clear associations were observed between site-specific CRC risk and alcohol intake in either sex. Analyses using FFQ showed similar results.Conclusion: We found no significantly increased risk of CRC up to 30 g per day of alcohol intake within the UK Dietary Cohort Consortium. [ABSTRACT FROM AUTHOR]

Purpose - This paper aims to discuss the findings of recent surveys conducted around SUNCAT, the Serials Union Catalogue for the UK research community and the implications for the development of the service. Design/methodology/approach - The results of two surveys are discussed: the first, a short print survey with a small group of inter-library loan librarians, and the second, an online survey open to all SUNCAT users. Findings - SUNCAT is used by both end users and a wide range of library and information professionals for a variety of purposes. The current level of satisfaction with the service is good but desirable developments include adding the serials' holdings data of more libraries, reducing the duplication on the catalogue and adding links to further information. Research limitations/implications - The findings are based on responses from mainly library and information professionals, with limited input from end users. Originality/value - The paper focuses on SUNCAT, which is the most comprehensive source of serials' holdings information in the UK. [ABSTRACT FROM AUTHOR]

The article presents an exploration into the protectorate system of African colonialism during the 19th century and its development within international law. Focus is given to the history of the British presence within Nigeria and the greater West Africa region. An overview is given of the creation of British colonies in the area after the abolition of slavery, the protectorate agreements made between the British and local African tribes, and the slow legal mechanisms by which Great Britain came to control more and more jurisdiction over the legal rights of Africans in international law. Additional mention is given to the legal philosophy of the 19th-century concerning issues such as sovereignty, autonomy, and human rights.

The fugitive slave circular was one of the most prominent issues in British political debate in 1875 and 1876. The agitation over the instructions issued by the Admiralty on returning fugitive slaves to their masters marked the first significant attack on Disraeli's imperialism, setting the agenda for later attacks, including Gladstone's Midlothian campaign. A study of the agitation and the making of policy shows that humanitarianism retained significant popular appeal between the high points identified by historians in the early nineteenth and early twentieth centuries. This study of the fugitive slave circular examines the different groups involved in the agitation and shows how humanitarian politics were embedded with other contemporary debates about matters such as international law, geopolitics, party politics, the British constitution and religion. [ABSTRACT FROM AUTHOR]

Background: The most effective pharmacological treatments for depression inhibit the transporters that reuptake serotonin (Selective Serotonin Reuptake Inhibitors -- SSRIs) and noradrenaline (Noradrenaline Reuptake Inhibitors -- NaRIs) into the presynaptic terminal. There is evidence to suggest that noradrenaline and serotonin enhancing drugs work through separate mechanisms to produce their clinical antidepressant action. Although most of the current evidence suggests there is little difference in overall efficacy between SSRIs and NaRIs, there are patients who respond to one class of compounds and not another. This suggests that treatment response could be predicted by genetic and/or clinical characteristics. Firstly, this study aims to investigate the influence of a polymorphism (SLC6A4) in the 5HT transporter in altering response to SSRI medication. Secondly, the study will investigate whether those with more severe depression have a better response to NaRIs than SSRIs. Methods/design: The GenPod trial is a multi-centre randomised controlled trial. GPs referred patients aged between 18-74 years presenting with a new episode of depression, who did not have any medical contraindications to antidepressant medication and who had no history of psychosis or alcohol/substance abuse. Patients were interviewed to ascertain their suitability for the study. Eligible participants (with a primary diagnosis of depression according to ICD10 criteria and a Beck Depression Inventory (BDI) score > 14) were randomised to receive one of two antidepressant treatments, either the SSRI Citalopram or the NaRI Reboxetine, stratified according to severity. The final number randomised to the trial was 601. Follow-up assessments took place at 2, 6 and 12 weeks following randomisation. Primary outcome was measured at 6 weeks by the BDI. Outcomes will be analysed on an intention-to-treat basis and will use multiple regression models to compare treatments. Discussion: The results of the trial will provide information about targeting antidepressant treatment for individual patients; in turn this may increase prescribing efficacy, thereby speeding recovery and reducing the cost to the NHS. It will also help to understand the different roles that noradrenaline and serotonin might play in the biology of depression. [ABSTRACT FROM AUTHOR]

Background:It has been suggested that the consumption of a diet rich in phytoestrogens might protect against a variety of diseases common in Western societies. However, there are little available data on the food sources or distribution of intake in the UK diet.Objective:To estimate the average intake and range of soya foods and isoflavones in a population-based cohort and to provide data on isoflavone consumption by food group.Subjects:Men and women (11 843) from the Norfolk arm of the European Prospective Investigation into Cancer and Nutrition (EPIC).Methods:Dietary daidzein and genistein intakes were obtained from 7-day food diaries, completed by participants between 1993 and 1998 and calculated from an in-house food composition database. Energy and anthropometric measurements were also carried out.Results:Average daily isoflavone intakes for both men and women were less than 1 mg (interquartile range (IQR) men: 0.39–0.82 mg; women: 0.30–0.64 mg). However, in soya-consumers, average daily intakes were higher: 8.6 mg in women (IQR: 2.28–10.72 mg) and 7.5 mg in men (IQR: 2.22–9.17 mg). In both men and women, bread and bread rolls made the highest contribution to isoflavone intake – 62.5 and 53.0%, respectively. In soya-consuming men and women, vegetable dishes and milks were the main contributors – 25.0 and 38.5% in men and 38.5% and 26.0% in women, respectively.Conclusions:Isoflavone intake is low in the UK but may be an underestimate due to soya added to commercial products. Future analyses of the isoflavone and lignan content of basic ingredient foods and commercial items commonly consumed in the UK diet will enable more accurate estimates of phytoestrogen intake to be made. The ability to estimate isoflavone intake in Western populations more accurately will enable investigations to be conducted into the suggested beneficial effects of phytoestrogens on health.European Journal of Clinical Nutrition (2007) 61, 248–254. doi:10.1038/sj.ejcn.1602509; published online 30 August 2006 [ABSTRACT FROM AUTHOR]

The potential impact of a chemical pesticide control method has been compared with that of transgenic plants expressing a protease inhibitor conferring insect resistance by utilising a tritrophic system comprising the crop plant Brassica napus (L.) (Oilseed rape), the pest mollusc Deroceras reticulatum (Müller) and the predatory carabid beetle Pterostichus melanarius (huger). Cypermethrin, as the most widely used pesticide in UK oilseed rape (OSR) cultivation, was selected as the conventional treatment. OSR expressing a cysteine protease inhibitor, oryzacystatin-1 (OC-1), was the transgenic comparator. In feeding trials, D. reticulaturn showed no significant long-term effects on measured life history parameters (survival, weight gain, food consumption) as a result of exposure to either the cypermethrin or OC-1 treatment. However, D. reticulatum was able to respond to the presence of the dietary inhibitor by producing two novel proteases following exposure to OC-1-expressing OSR. Similarly, P. melanarius showed no detectable alterations in mortality, weight gain or food consumption when feeding on D. reticula turn previously fed either pesticide-contaminated or GM plant material. Furthermore, as with the slug, a novel form of protease, approximately Mr 27 kDa, was induced in the carabid in response to feeding on slugs fed OC-1-expressing OSR. [ABSTRACT FROM AUTHOR]

This article discusses evidence of cereal yellow dwarf virus in Great Britain. The first clear evidence that the cause of the yellowing was a virus came from transmissions using a culture of Myzus circumflexus maintained in the glasshouse on Vicia faba, and so free from the cereal virus. Plants on which M. circumflexus from beans had fed did not go yellow. They were larger, and matured quicker, than those colonized by M. circumflexus from the yellowed barley. A small field experiment was made in 1955 on Plumage Archer barley. It consisted of three blocks of two plots. Each plot contained four sub-plots of 3 rows of barley 33 inches long, isolated in a much larger area of the crop. The yield of straw was scarcely affected by the virus infection, although reduction in height had been obvious at the earlier observation times. The yellowing symptoms became less obvious when the barley started to ripen, and had the infected plants not been concentrated in a small area they would have been difficult to distinguish. In ordinary field conditions the infected plants are probably scattered among the healthy ones, and so cereal yellows may cause some loss of yield without its presence being noticed.

The author comments on British Conservative Party Leader David Cameron's arguments against redistributing income setting income and parenting against one another as competing factors which he believes are backed up by social science evidence. The author explains how income poverty is an important factor in the quality of parenting, based on parenting research and explained how financial difficulties result to psychological distress which can make parents less effective. The author also points out a study which shows that redistribution works.

Background: The Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me) has been shown to be a reliable and valid questionnaire measuring health-related quality of life (HRQoL) in the US sickle cell disease (SCD) population. The study objective was to test the validity and reliability of the ASCQ-Me for use in the UK.Methods: The US ASCQ-Me, Hospital Anxiety and Depression Scale (HADS), self-reported symptoms, and Medical Outcome Survey Short Form 36 (SF-36) were administered to 173 patients with SCD. Clinical severity was assessed by the number of painful episodes indicated by hospital admissions.Results: The results showed that the item banks of the UK ASCQ-Me had good internal consistency. Anxiety and depression were strongly correlated with the emotional, and social item banks of the UK ASCQ-Me, with moderate correlations between the UK ASCQ-Me item banks and SF-36 components suggesting convergent validity. A confirmatory factor analysis confirmed the conceptual framework of the scale as being the same as the US ASCQ-Me, indicating construct validity. Known groups validity was found, with the ASCQ-Me being able to differentiate by SCD severity groups.Conclusion: The analysis of the sample shows evidence of both validity and reliability of the ASCQ-Me for use in the UK SCD population. [ABSTRACT FROM AUTHOR]