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OBJECTIVES: The Strengthening Families Programme 10-14 (SFP10-14) is a USA-developed universal group-based intervention aiming to prevent substance misuse by strengthening protective factors within the family. This study evaluated a proportionate universal implementation of the adapted UK version (SFP10-14UK) which brought together families identified as likely/not likely to experience/present challenges within a group setting. DESIGN: Pragmatic cluster-randomised controlled effectiveness trial, with families as the unit of randomisation and embedded process and economic evaluations. SETTING: The study took place in seven counties of Wales, UK. PARTICIPANTS: 715 families (919 parents/carers, 931 young people) were randomised. INTERVENTIONS: Families randomised to the intervention arm received the SFP10-14 comprising seven weekly sessions. Families in intervention and control arms received existing services as normal. OUTCOME MEASURES: Primary outcomes were the number of occasions young people reported drinking alcohol in the last 30 days; and drunkenness during the same period, dichotomised as 'never' and '1-2 times or more'. Secondary outcomes examined alcohol/tobacco/substance behaviours including: cannabis use; weekly smoking (validated by salivary cotinine measures); age of alcohol initiation; frequency of drinking >5 drinks in a row; frequency of different types of alcoholic drinks; alcohol-related problems. Retention: primary analysis included 746 young people (80.1%) (alcohol consumption) and 732 young people (78.6%) (drunkenness). RESULTS: There was no evidence of statistically significant between-group differences 2 years after randomisation for primary outcomes (young people's alcohol consumption in the last 30 days adjusted OR=1.11, 95% CI 0.72 to 1.71, p=0.646; drunkenness in the last 30 days adjusted OR=1.46, 95% CI 0.83 to 2.55, p=0.185). There were no statistically significant between-group differences for other substance use outcomes, or those relati

Background Local government has become a key constituent for addressing health inequalities and influencing the health of individuals and communities in England. Lauded as an effective approach to tackle the multiple determinants of health, there are concerns that generating and utilising research evidence to inform decision-making and action is a challenge. This research was conducted in a local authority situated in the north of England and addressed the research question – ‘What is the capacity to collaborate and deliver research?’. The study explored the assets that exist to foster a stronger research culture, identified barriers and opportunities for developing research capacity, and how a sustainable research system could be developed to impact on local residents’ health and reduce health inequalities. Methods This was a qualitative study utilising semi-structured interviews and focus groups. The study used an embedded researcher (ER) who was digitally embedded within the local authority for four months to conduct the data collection. Senior Managers were purposively sampled from across the local authority to take part in interviews. Three focus groups included representation from across the local authority. Framework analysis was conducted to develop the themes which were informed by the Research Capacity Development framework. Results Tensions between research led decision making and the political and cultural context of local government were identified as a barrier to developing research which addressed health inequalities. Research was not prioritised through an organisational strategy and was led sporadically by research active employees. A recognition across leaders that a culture shift to an organisation which used research evidence to develop policy and commission services was needed. Building relationships and infrastructure across local government, place-based collaborators and academic institutions was required. The embedded researcher approach is o

I. The Protection of Adults: An Overview: A. Adults ’ Protection Defined; B. A Legal Landscape Marked by Diversity; C. The Impact of Measures of Protection on Capacity. - II. Adults’ Protection as a Human Rights Concern: A. The New Paradigm of Disability; B. Universal and Regional Instruments on the Rights Relating to Disability; C. The Contribution of Civil Society. - III. The Role of Private International Law in the Realisation of the Fundamental Rights of Adults: A. The Right to Obtain Support in Cross-Border Cases; B. The Instrumentality of Private International Law. - IV. The Hague Adults Convention: A. Origins and Principal Orientations of the Convention; B. Some Key Features of the Convention: (i) An ‘Integral’ Regime; (ii) The Choice of Habitual Residence as the Main Connecting Factor; (iii) The Respect for, and Promotion of, the Adult's Self-Determination; (iv) Adults’ Protection Outside Judicial or Administrative Proceedings; (v) The Promotion of Inter-Jurisdictional Dialogue and Cooperation. - V. The International Protection of Adults in Prospect. - VI Concluding Remarks.

Irritable bowel syndrome (IBS) results from disordered brain-gut interactions. Identifying susceptibility genes could highlight the underlying pathophysiological mechanisms. We designed a digestive health questionnaire for UK Biobank and combined identified cases with IBS with independent cohorts. We conducted a genome-wide association study with 53,400 cases and 433,201 controls and replicated significant associations in a 23andMe panel (205,252 cases and 1,384,055 controls). Our study identified and confirmed six genetic susceptibility loci for IBS. Implicated genes included NCAM1, CADM2, PHF2/FAM120A, DOCK9, CKAP2/TPTE2P3 and BAG6. The first four are associated with mood and anxiety disorders, expressed in the nervous system, or both. Mirroring this, we also found strong genome-wide correlation between the risk of IBS and anxiety, neuroticism and depression (rg > 0.5). Additional analyses suggested this arises due to shared pathogenic pathways rather than, for example, anxiety causing abdominal symptoms. Implicated mechanisms require further exploration to help understand the altered brain-gut interactions underlying IBS.

Here we report the first regional-scale study of Archean plutonic rocks from 50,000 km of the northeast Democratic Republic of Congo (DRC). We include 50 new U-Pb zircon Sensitive High-Resolution Ion MicroProbe (SHRIMP) ages supported by petrographic and whole rock geochemical data from a further ~400 samples, and 39 additional U-Pb zircon ages reported by Kabete et al. (submitted) and Bird (2016). Felsic-intermediate magmatism across the northeast DRC occurred from ~ 3200 to 2530 Ma. Plutonism before ~ 2670 Ma is restricted to the West Nile Gneiss in eastern and northern-most DRC, whereas plutonism across the remainder of the northeast DRC initiated between 2670 and 2640 Ma. Two Neoproterozoic granite plutons ~ 1000–950 Ma are also present within the West Nile Gneiss. Magmatism between ~ 2670 and 2530 Ma marks the principal period of crustal growth in the northeast DRC. Felsic-intermediate plutonism between ~ 2670 and 2600 Ma included two suites of magnesian, calc-alkaline rocks, (1) a sodic-calcic suite with high Sr/Y ratios (>40) comparable with tonalite-trondhjemite-granodiorite (TTG) suites in other Archean terranes, and (2) a calc-alkaline to high-K suite of granitoids with low Sr/Y ratios (<40) and lower Na and Al contents, comparable with “low-Ca” granites in the Yilgarn Craton. In contrast, most granitoids emplaced between ~ 2600 and 2530 Ma have ferroan, high-K calc-alkaline compositions, and are enriched in high field strength (HFSE) and rare Earth elements (REE). Although the HFSE-elevated granitoids are comparable with Closepet-type, and “mafic granites” in other Neoarchean terranes, their volume within the northeast DRC appears unprecedented. Before ~ 2600 Ma partial melting of hydrous metabasalts at depths > 40 km is inferred to have produced the high Sr/Y magnesian granitoids, whereas the low Sr/Y magnesian granitoids were derived from melting-assimilation-storage-hybridization (MASH) processes in the overlying low-mid crust during the same period. T

AIMS: To investigate whether effects of the ASSIST (A Stop Smoking In Schools Trial) school-based smoking prevention intervention diffused from students to the people they lived with. DESIGN: Secondary analysis of a cluster-randomized control trial (cRCT). SETTING: England and Wales. PARTICIPANTS: A total of 10 730 students aged 12-13 years in 59 schools assigned using stratified block randomization to the control (29 schools, 5372 students) or intervention (30 schools, 5358 students) condition. INTERVENTION AND COMPARATOR: The ASSIST intervention involves 2 days of off-site training of influential students to encourage their peers not to smoke during a 10-week period. The control group continued with their usual education. MEASUREMENTS: The outcomes were the proportion of students who self-reported living with a smoker and the smoking status of each resident family member/caregiver. Follow-up assessments were immediately after the intervention and at 1 and 2 years post-intervention. FINDINGS: The odds ratio (OR) for living with a smoker in the intervention compared with the control groups was 0.86 [95% confidence interval (CI) = 0.72, 1.03] immediately after the intervention, OR = 0.84 (95% CI = 0.72, 0.97) at a 1-year follow-up and OR = 0.86 (95% CI = 0.75, 0.99) at 2-year follow-up. In a three-tier multi-level model with data from all three follow-ups, student-reported smoking by fathers (OR = 0.90, 95% CI = 0.80, 1.00), brothers (OR = 0.78, 95% CI = 0.67, 0.92) and sisters (OR = 0.80, 95% CI = 0.69, 0.92) was lower in the intervention compared with control group. Subgroup analyses by baseline smoking status suggested that these effects were more consistent with prevention of uptake than prompting cessation. CONCLUSIONS: A Stop Smoking In Schools Trial (ASSIST) school-based smoking prevention intervention may have reduced the prevalence of smoking in people who lived with ASSIST-trained students. This indirect transmission is consistent with the predictions of di

Pattern Informatics (PI) technique can be used to detect precursory seismic activation or quiescence and make an earthquake forecast. Here we apply the PI method for optimal forecasting of large earthquakes in Japan, using the data catalogue maintained by the Japan Meteorological Agency. The PI method is tested to forecast large (magnitude m ≥ 5) earthquakes spanning the time period 1995-2004 in the Kobe region. Visual inspection and statistical testing show that the optimized PI method has forecasting skill, relative to the seismic intensity data often used as a standard null hypothesis. Moreover, we find in a retrospective forecast that the 1995 Kobe earthquake (m = 7.2) falls in a seismically anomalous area. Another approach to test the forecasting algorithm is to create a future potential map for large (m ≥ 5) earthquake events. This is illustrated using the Kobe and Tokyo regions for the forecast period 2000-2009. Based on the resulting Kobe map we point out several forecasted areas: The epicentral area of the 1995 Kobe earthquake, the Wakayama area, the Mie area, and the Aichi area. The Tokyo forecast map was created prior to the occurrence of the Oct. 23, 2004 Niigata earthquake (m = 6.8) and the principal aftershocks with 5.0 ≤ m. We find that these events were close to in a forecasted area on the Tokyo map. The PI technique for regional seismicity observation substantiates an example showing considerable promise as an intermediate-term earthquake forecasting in Japan