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Objectives This study investigated sustainability and multimorbidity alongside barriers to employment including health and policy to demonstrate intersectional impact on return-to-work success within a UK welfare-to-work programme.Design Cohort study design: The study calculated the proportion of time spent employed after experiencing a job start and the proportion retaining work over 6 months. Employment/unemployment periods were calculated, sequence-index plots were produced and visualisations were explored by benefit type and age.Setting This study used confidential access to deidentified data from unemployed Work Programme clients operated by Ingeus on behalf of the UK Government in Scotland between 1 April 2013 and 31 July 2014.Participants 13 318 unemployed clients aged 18–64 years were randomly allocated to a Work Programme provider and monitored over 2 years.Results This study has two distinct groupings. ‘Employment and Support Allowance (ESA)’ corresponding to those with work-limiting disability in receipt of related state financial support, and ‘Jobseeker’s Allowance (JSA)’ corresponding to unemployment claimants. Despite fewer and later job starts for ESA clients, those that gained employment spend relatively more subsequent time in employment when compared with individuals without work-limiting conditions (ESA clients under 50, 0.73; ESA clients over 50, 0.79; JSA clients under 50, 0.67 and JSA clients over 50, 0.68). Proportion in permanent jobs was higher among ESA than JSA clients (JSA under 50, 92%; JSA over 50, 92%; ESA under 50, 95% and ESA over 50, 97%).Conclusion The research demonstrated that returning to paid employment after a reliance on welfare benefits is challenging for people aged over 50 and those with disability. The study found that although fewer older ESA claimants entered employment, they typically remained in employment more than JSA clients who did not leave the Work Programme early. This indicates the importance of identifying risk factors for job loss in ageing workers and the development of interventions for extension of working lives.

Objectives Children of women who use substances are difficult to research at a population-level using traditional research methods due to the complexity of their lives. Resultingly, we have little robust evidence on their outcomes. This study developed an administrative data cohort of children exposed to opioids and explored health outcomes. Methods Using data from birth records, antenatal records, prescription data, hospital/psychiatric hospital admissions, and drug and alcohol service data, we identified 6,408 children (born 2009-2019) in Scotland who were exposed to opioids through illicit use and/or medication assisted treatment (i.e. methadone/buprenorphine). A control group (n. 19,089) of children not exposed to opioids were matched on age of mother and Scottish Index of Multiple Deprivation. Data were described and linear and logistic regression models were used to examine the relationship between risk factors (such as drug and alcohol use in pregnancy, gestation at booking and at birth), and key early outcomes. Results Although the majority of women had their substance use recorded in antenatal records, 28.9\% did not, demonstrating the importance of using multiple administrative datasets to form the cohort. Children in the cohort were more likely to experience a range of adverse outcomes including being born early (17\% born prematurely, compared with 6.5\% in control group), having a below normal Apgar score (the scoring system used to assess newborns shortly after birth) (2.9\% in cohort vs. 1.5\% in controls), having significantly lower birthweight, length and head circumference, and more likely to be removed from their mother prior hospital discharge. Differences between the cohorts remained after controlling for other risk factors including alcohol use, and gestation. Conclusion This feasibility study brought together a cohort of children usually excluded from traditional forms of research. The research demonstrated early differences in outcomes between exposed children and others from similar socio-economic groups. The next stage of this research is exploring health and development outcomes in the preschool period.

Abstract Background Modern health surveillance and planning requires an understanding of how preventable risk factors impact population health, and how these effects vary between populations. In this study, we compare how smoking, alcohol consumption, diet and physical activity are associated with all-cause mortality in Canada and the United States using comparable individual-level, linked population health survey data and identical model specifications. Methods The Canadian Community Health Survey (CCHS) (2003–2007) and the United States National Health Interview Survey (NHIS) (2000, 2005) linked to individual-level mortality outcomes with follow up to December 31, 2011 were used. Consistent variable definitions were used to estimate country-specific mortality hazard ratios with sex-specific Cox proportional hazard models, including smoking, alcohol, diet and physical activity, sociodemographic indicators and proximal factors including disease history. Results A total of 296,407 respondents and 1,813,884 million person-years of follow-up from the CCHS and 58,232 respondents and 497,909 person-years from the NHIS were included. Absolute mortality risk among those with a ‘healthy profile’ was higher in the United States compared to Canada, especially among women. Adjusted mortality hazard ratios associated with health behaviours were generally of similar magnitude and direction but often stronger in Canada. Conclusion Even when methodological and population differences are minimal, the association of health behaviours and mortality can vary across populations. It is therefore important to be cautious of between-study variation when aggregating relative effect estimates from differing populations, and when using external effect estimates for population health research and policy development.

The cutting of trees for site construction and development had become a predominant factor in Ghana. Besides, the practice of cutting and leaving tree roots in the soil had become an impediment, such as harbouring wild reptiles like snakes, iguanas and an infestation of termites. These factors endanger individual lives, especially living in such environments. This study focused on repurposing wood detritus as a functional concept in the interior design. The study sought to analyse neem tree roots and their properties for a decorative piece in interior design. As a studio-based inquiry, the study employed the aesthetico-action model with a narrative method on the techniques and procedures for executing the studio work. It was evident from the studio practice that wood detritus such as neem tree root serves as an embodiment of inherent qualities, ideas and artistic expressions based on its roots' natural forms. Artists should focus on tree roots (stumps) left in the soil and on the environment as a material for art production in the interior space design.

There is increasing interest amongst researchers and policy makers in identifying the effect of public health interventions on health inequalities by socioeconomic status (SES). This issue is typically addressed in evaluation studies through subgroup analyses, where researchers test whether the effect of an intervention differs according to the socioeconomic status of participants. The credibility of such analyses is therefore crucial when making judgements about how an intervention is likely to affect health inequalities, although this issue appears to be rarely considered within public health. The aim of this study was therefore to assess the credibility of subgroup analyses in published evaluations of public health interventions. An established set of 10 credibility criteria for subgroup analyses was applied to a purposively sampled set of 21 evaluation studies, the majority of which focussed on healthy eating interventions, which reported differential intervention effects by SES. While the majority of these studies were found to be otherwise of relatively high quality methodologically, only 8 of the 21 studies met at least 6 of the 10 credibility criteria for subgroup analysis. These findings suggest that the credibility of subgroup analyses conducted within evaluations of public health interventions’ impact on health inequalities may be an underappreciated problem. Keywords: Health inequalities, Health inequities, Equity and public health interventions, Policy impact by socioeconomic status

Addressing social determinants of health (SDoH) has been acknowledged as an essential objective for the promotion of both population health and health equity. Extant literature has identified seven potential areas of investment to address SDoH: investments in sexual and reproductive health and family planning, early learning and child care, education, universal health care, as well as investments to reduce child poverty, ensure sustainable economic development, and control health hazards. The aim of this paper is to produce a ‘report card’ on Canada’s success in reducing socioeconomic and health inequities pertaining to these seven policy domains, and to assess how Canadian trends compare to those in the United Kingdom (UK), a country with a similar health and welfare system. Summarising evidence from published studies and national statistics, we found that Canada’s best successes were in reducing socioeconomic inequalities in early learning and child care and reproductive health—specifically in improving equity in maternal employment and infant mortality. Comparative data suggest that Canada’s outcomes in the latter areas were like those in the UK. In contrast, Canada’s least promising equity outcomes were in relation to health hazard control (specifically, tobacco) and child poverty. Though Canada and the UK observed similar inequities in smoking, Canada’s slow upward trend in child poverty prevalence is distinct from the UK’s small but steady reduction of child poverty. This divergence from the UK’s trends indicates that alternative investment types and levels may be needed in Canada to achieve similar outcomes to those in the UK. Keywords: Canada, United Kingdom, Health equity, Health and social policy, Lifecourse epidemiology, Public health

ObjectiveTo examine the association between high maternal weight status and complications during pregnancy and delivery.SettingScotland.ParticipantsData from 132 899 first-time singleton deliveries in Scotland between 2008 and 2015 were used. Women with overweight and obesity were compared with women with normal weight. Associations between maternal body mass index and complications during pregnancy and delivery were evaluated.Outcome measuresGestational diabetes, gestational hypertension, pre-eclampsia, placenta praevia, placental abruption, induction of labour, elective and emergency caesarean sections, pre-term delivery, post-term delivery, low Apgar score, small for gestational age and large for gestational age.ResultsIn the multivariable models controlling for potential confounders, we found that, compared with women with normal weight, the odds of the following outcomes were significantly increased for women with overweight and obesity (overweight adjusted ORs; 95% CI, followed by the same for women with obesity): gestational hypertension (1.61; 1.49 to 1.74), (2.48; 2.30 to 2.68); gestational diabetes (2.14; 1.86 to 2.46), (8.25; 7.33 to 9.30); pre-eclampsia (1.46; 1.32 to 1.63) (2.07; 1.87 to 2.29); labour induction (1.28; 1.23 to 1.33), (1.69; 1.62 to 1.76) and emergency caesarean section (1.82; 1.74 to 1.91), (3.14; 3.00 to 3.29).ConclusionsWomen with overweight and obesity in Scotland are at greater odds of adverse pregnancy and delivery outcomes. The odds of these conditions increases with increasing body mass index. Health professionals should be empowered and trained to deliver promising dietary and lifestyle interventions to women at risk of overweight and obesity prior to conception, and control excessive weight gain in pregnancy.

BackgroundThis study aimed to characterize trends in absolute and relative socioeconomic inequalities in adult premature mortality between 1992 and 2017, in the context of declining population-wide mortality rates. We conducted a population-based cohort study of all adult premature deaths in Ontario, Canada using provincial vital statistics data linked to census-based, area-level deprivation indices for socioeconomic status.MethodsThe cohort included all individuals eligible for Ontario's single-payer health insurance system at any time between January 1, 1992 and December 31, 2017 with a recorded Ontario place of residence and valid socioeconomic status information (N = 820,370). Deaths between ages 18 and 74 were used to calculate adult premature mortality rates per 1000, stratified by provincial quintile of material deprivation. Relative inequalities were measured using Relative Index of Inequality (RII) measures. Absolute inequalities were estimated using Slope Index of Inequality (SII) measures. All outcome measures were calculated as sex-specific, annual measures for each year from 1992 to 2017.ResultsPremature mortality rates declined in all socioeconomic groups between 1992 and 2017. Relative inequalities in premature mortality increased over the same period. Absolute inequalities were mostly stable between 1992 and 2007, but increased dramatically between 2008 and 2017, with larger increases to absolute inequalities seen in females than in males.ConclusionsAs in other developed countries, long-term downward trends in all-cause premature mortality in Ontario, Canada have shifted to a plateau pattern in recent years, especially in lower- socioeconomic status subpopulations. Determinants of this may differ by setting. Regular monitoring of mortality by socioeconomic status is the only way that this phenomenon can be detected sensitively and early, for public health attention and possible corrective action.

Background with rationale Children born to opioid-dependent mothers are at a developmental disadvantage from pre-birth. They are additionally affected by the mother’s compromised ability to recognise and respond to the infant’s cues. Development is often compounded by environmental factors. Research to date has primarily focused on early infancy and small, clinical samples. This group is difficult to follow-up using traditional methods due to chaotic home environments, housing instability and parent-child separation. The use of administrative data circumnavigates such difficulties, allowing follow-up of children over longer periods, even when removed from the birth parent. Main Aim This paper will describe the complex creation of a cohort of children born to opioid-dependent women, using administrative data. It will also describe early results about pregnancy and neonatal outcomes. Methods/Approach Data were pooled from women who gave birth between 2007 and 2017 using five datasets (c.5,000 women): women who were recorded as using heroin, street methadone or opioid substitution therapy (OST) on the Drugs Misuse Database, or on OST prescription records; women admitted to hospital, or psychiatric care, for an opioid related reason; and/or women whose children were recorded as having Neonatal Abstinence Syndrome (NAS). Data on children’s neonatal outcomes will be described, including birth weight and gestation, congenital abnormalities, neonatal death and NAS treatment. Models will be fitted to investigate the associations between possible teratogenicity of prenatal opioids and developmental outcomes. Results The development of this cohort using administrative data sources has been complex, requiring five different datasets to ensure all women of interest are captured. Descriptive results on outcomes will be available in the Autumn. Conclusion This administrative data study demonstrates the value of using linked data sources to enhance our knowledge of the trajectories of this vulnerable group of children, and the additional support that they, and their carers, may require.

A Correction to this paper has been published: https://doi.org/10.1038/s41597-021-00851-9.

We offer a UK-based commentary on the recent “Perspective” published in IJHPM by Thakkar and Sullivan. We are sympathetic to the authors’ call for increased funding for health service and policy research (HSPR). However, we point out that increasing that investment – in any of the three countries they compare: Canada, the United States and the United Kingdom– will ipso facto not necessarily lead to any better use of research by health system decision-makers in these settings. We cite previous authors’ descriptions of the many factors that tend to make the worlds of researchers and decision-makers into “two solitudes.” And we call for changes in the structure and funding of HSPR, particularly the incentives now in place for purely academic publishing, to tackle a widespread reality: most published research in HSPR, as in other applied fields of science, is never read or used by the vast majority of decision-makers, working out in the “real world.”

Several countries have increased their legal minimum age for work in line with international conventions on child labor. We evaluated the effect of increasing the legal minimum age for work on school attendance in 3 low- and middle-income countries using difference-in-differences analyses. Increasing the legal minimum age for work increased school attendance by 3.0 (0.2, 5.8) percentage-points in Malawi, and 2.0 (0.2, 3.6) percentage-points in Colombia. In Malawi, we found a greater policy effect among girls compared to boys. In Colombia, the poorest tercile experienced the greatest improvement in educational outcomes. We found no evidence of an impact of increasing the legal minimum age for work on school attendance in Burkina Faso. Our findings suggest that increasing the legal minimum age for work has had a positive effect on educational outcomes in some low and middle income countries. Keywords: Child welfare, Attendance, Child labor, Developing nations, Labor legislation

Abstract Background Adiposity rebound is considered critical to the development of overweight and obesity. The purpose of this study was to investigate how growth has changed in comparison to the UK 1990 BMI growth reference curves between the ages 4–8 years and identify any marked deviations in growth. We also examined potential maternal and child risk/protective factors associated with the altered growth patterns. Methods We used data from birth cohort 1 of the Growing Up in Scotland study. Height and weight data (N = 2 857) were available when the children were aged approximately 4 (sweep 4), 6 (sweep 6) and 8 years (sweep 7). For each child, percentile change per month was calculated to identify deviations from the UK 1990 growth patterns. Marked changes (>10 % annual change) in percentiles or weight category between each sweep for each child were considered as reflecting a decreasing (leptogenic), increasing (obesogenic) or no change pattern. Logistic regression was used to explore which maternal or child risk factors were associated with belonging to the different growth patterns. Results Sixty six percent (66 %) of the cohort did not show marked changes in BMI percentile and growth compared to the UK 1990 reference population. However, the median BMI percentile of this group was around the 70th. The most common deviation in BMI percentile was early decrease (11.5 %). In terms of weight categories, contemporary maternal obesity (odd ratio (OR) =2.89; 95 % confidence interval (CI) 2.09, 3.98) and mother smoking during pregnancy (OR =1.56; 95 % CI 1.13, 2.15) were found to be significantly associated with increased odds of obesogenic growth trajectory relative to no change trajectory. Breastfeeding (OR = 1.18; 95 % CI 0.88, 1.57) was also associated with increased odds of obesogenic growth but this was not significant in the adjusted model. Conclusions This study has shown that there is a substantial shift in the general population distribution of BMI since 1990. We identified maternal weight status as the strongest obesogenic factor and this is an indication that more innovative obesity preventive strategies should also consider intergenerational approaches.

Abstract Background There has been a rapid increase in the retail availability of e-cigarettes in the UK and elsewhere. It is known that exposure to cigarette point-of-sale (POS) displays influences smoking behaviour and intentions in young people. However, there is as yet no evidence regarding the relationship between e-cigarette POS display exposure and e-cigarette use in young people. Methods This cross sectional survey was conducted in four high schools in Scotland. A response rate of 87 % and a total sample of 3808 was achieved. Analysis was by logistic regression on e-cigarette outcomes with standard errors adjusted for clustering within schools. The logistic regression models were adjusted for recall of other e-cigarette adverts, smoking status, and demographic variables. Multiple chained imputation was employed to assess the consistency of the findings across different methods of handling missing data. Results Adolescents who recalled seeing e-cigarettes in small shops were more likely to have tried an e-cigarette (OR 1.92 99 % CI 1.61 to 2.29). Adolescents who recalled seeing e-cigarettes for sale in small shops (OR 1.80 99 % CI 1.08 to 2.99) or supermarkets (OR 1.70 99 % CI 1.22 to 2.36) were more likely to intend to try them in the next 6 months. Conclusions This study has found a cross-sectional association between self-reported recall of e-cigarette POS displays and use of, and intention to use, e-cigarettes. The magnitude of this association is comparable to that between tobacco point of sale recall and intention to use traditional cigarettes in the same sample. Further longitudinal data is required to confirm a causal relationship between e-cigarette point of sale exposure and their use and future use by young people.

There has been a substantial amount of debate around the role of parental risk aversity in children's health and wellbeing, with results suggesting that, whilst in the short-term, parents may ensure their children's safety, in the longer-term, children's psychological well-being may be compromised, and a lack of activity may result in a range of other poorer outcomes (Little and Wyver, 2008). Whilst some approaches to risk can be seen as extreme, there appears to be a role for healthy, positive risk in parenting (Bundy et al., 2009). Studies to date in this area have mostly comprised a mixture of survey and observational data, with little evidence on the relationship between parental risk aversity and child outcomes, such as accidents and injuries. The current study explores these associations, using data exploring parental perceptions of risk, taken at ages 3 and 5, from the Growing Up in Scotland birth cohort study, linked with administrative hospital data about child accidents and injuries up to age 11. This paper will investigate results on associations between parental perceptions of risk, and child accidents and injuries, as well as exploring whether these impacts change through early to middle childhood, and whether they differ by socio-economic classification.

BACKGROUND:Child marriage harms girls' health and hinders progress toward development goals. Randomized studies have shown that providing financial incentives for girls' education can effectively delay marriage, but larger-scale interventions are needed in light of slow progress toward curbing the practice. Many sub-Saharan African countries eliminated primary school tuition fees over the past two decades, resulting in massive increases in enrolment. We measured the effect of these policies on the probability of primary school completion and of marriage before 15 and 18 years of age. METHODS:We used Demographic and Health Surveys to assemble a dataset of women born between 1970 and 2000 in 16 countries. These data were merged with longitudinal information on the timing of tuition fee elimination in each country. We estimated the impact of fee removal using fixed effects regression to compare changes in the prevalence of child marriage over time between women who were exposed to tuition-free primary schooling and those who were not. RESULTS:The removal of tuition fees led to modest average declines in the prevalence of child marriage across all of the treated countries. However, there was substantial heterogeneity between countries. The prevalence of child marriage declined by 10-15 percentage points in Ethiopia and Rwanda following tuition elimination but we found no evidence that the removal of tuition fees had an impact on child marriage rates in Cameroon or Malawi. Reductions in child marriage were not consistently accompanied by increases in the probability of primary school completion. CONCLUSIONS:Eliminating tuition fees led to reductions in child marriage on a national scale in most countries despite challenges with implementation. Improving the quality of the education available may strengthen these effects and bolster progress toward numerous other public health goals.

Background: The Scottish Government's ‘Route-Map Action Plan' for obesity prevention sets out 62 potential intervention policies across all stages of the life course. We used the ANGELO Framework (Analysis Grid for Environments Linked to Obesity) to assess the appropriateness and likely impact of the balance of measures being proposed. Methods: Two assessors (JM & RJ) independently allocated a category for each intervention according to its domain (physical, economic, legislative or socio-cultural), scale (macro or micro) and predominant ‘focus' (physical activity versus diet). A third assessor (RG) examined discordant allocations. Results: Across the four ANGELO domains, the distribution of interventions was skewed towards socio-cultural measures (37.1%) and the physical environment (33.1%) with less emphasis on legislative or economic interventions (21.8% and 6.4% respectively). Distribution by both intervention scale and focus was more even with just over half of all policies (51.8%) at the macro-level scale and just under half (46.7%) having a dietary focus. Conclusion: The predominance of socio-culturally orientated interventions over their legislative and economic counterparts is at odds with the balance of international evidence on what would be most effective for obesity prevention. The ANGELO framework provides a useful tool for policy makers to monitor progress towards an appropriately balanced policy mix.

OBJECTIVES: In May 2008, the National Health Service (NHS) Lanarkshire (NHSL) implemented a unique telephone-based sickness absence management service entitled “EASY” (Early Access to Support for You). The EASY service supplements existing absence policies and enables telephone communication between the absentee, their line manager, and the EASY service from the first day of absence and referral to occupational health services at day ten. The aim of this study was to determine if the EASY service was effective between May 2008 and May 2012 in reducing sickness absence in NHSL compared to normal occupational healthcare in NHS Scotland and is, as such, a cost-saving intervention. METHODS: This study included time-series analysis of health board sickness absence data and analyses of the EASY service database (survival analyses and Cox’s proportional hazards model). RESULTS: The EASY service was effective in reducing sickness absence by 21% in NHSL, whereas the nonspecific tightening of the sickness absence policies across the rest of Scottish NHS health boards reduced sickness absence by approximately 9%. The richness of the EASY database gave detailed information on absentees by cause, duration, job family, and reporting compliance. The mean duration of musculoskeletal absences was significantly shorter in years 2, 3, and 4 compared to year 1. Those absentees contacted by phone on the first day of absence were more likely to return to work than those contacted on subsequent days. The EASY service improves economic efficiency; the value of the hours saved from the reduced sickness absence exceeds the cost of operating the service. CONCLUSION: The study highlights the importance of an early telephone-based intervention for sickness absence management.

OBJECTIVES:To describe the relationship between minimum wage and overweight and obesity across countries at different levels of development. METHODS:A cross-sectional analysis of 27 countries with data on the legislated minimum wage level linked to socio-demographic and anthropometry data of non-pregnant 190,892 adult women (24-49 y) from the Demographic and Health Survey. We used multilevel logistic regression models to condition on country- and individual-level potential confounders, and post-estimation of average marginal effects to calculate the adjusted prevalence difference. RESULTS:We found the association between minimum wage and overweight/obesity was independent of individual-level SES and confounders, and showed a reversed pattern by country development stage. The adjusted overweight/obesity prevalence difference in low-income countries was an average increase of about 0.1 percentage points (PD 0.075 [0.065, 0.084]), and an average decrease of 0.01 percentage points in middle-income countries (PD -0.014 [-0.019, -0.009]). The adjusted obesity prevalence difference in low-income countries was an average increase of 0.03 percentage points (PD 0.032 [0.021, 0.042]) and an average decrease of 0.03 percentage points in middle-income countries (PD -0.032 [-0.036, -0.027]). CONCLUSION:This is among the first studies to examine the potential impact of improved wages on an important precursor of non-communicable diseases globally. Among countries with a modest level of economic development, higher minimum wage was associated with lower levels of obesity.

Timely detection of an inhalational anthrax outbreak is critical for clinical and public health management. Syndromic surveillance has received considerable investment, but little is known about how it will perform relative to routine clinical case finding for detection of an inhalational anthrax outbreak. We conducted a simulation study to compare clinical case finding with syndromic surveillance for detection of an outbreak of inhalational anthrax. After simulated release of 1 kg of anthrax spores, the proportion of outbreaks detected first by syndromic surveillance was 0.59 at a specificity of 0.9 and 0.28 at a specificity of 0.975. The mean detection benefit of syndromic surveillance was 1.0 day at a specificity of 0.9 and 0.32 days at a specificity of 0.975. When syndromic surveillance was sufficiently sensitive to detect a substantial proportion of outbreaks before clinical case finding, it generated frequent false alarms.

Neuroblastomas (NBs) are a clinically heterogeneous group of extra cranial pediatric tumors. Patients with high-risk, metastatic NBs have a long-term survival rate of below 40%, and are often resistant to current therapeutic modalities. Due to toxic side effects associated with radiation and chemotherapies, development of new agents is warranted to overcome resistance and effectively treat this disease in clinic. CARP-1 functional mimetics (CFMs) are an emerging class of small molecule compounds that inhibit growth of diverse cancer cell types. Here we investigated NB inhibitory potential of CFMs and the molecular mechanisms involved. CFM-1, -4, and -5 inhibited NB cell growth, in vitro, independent of their p53 and MYCN status. CFM-4 and -5 induced apoptosis in NB cells in part by activating pro-apoptotic stress-activated kinases (SAPKs) p38 and JNK, stimulating CARP-1 expression and cleavage of PARP1, while promoting loss of the oncogenes C and N-myc as well as mitotic cyclin B1. Treatments of NB cells with CFM-4 or -5 also resulted in loss of Inhibitory κB (IκB) α and β proteins. Micro-RNA profiling revealed upregulation of XIAP-targeting miR513a-3p in CFM-4-treated NB, mesothelioma, and breast cancer cells. Moreover, exposure of NB and breast cancer cells to CFM-4 or -5 resulted in diminished expression of anti-apoptotic XIAP1, cIAP1, and Survivin proteins. Expression of anti-miR513a-5p or miR513a-5p mimic, however, interfered with or enhanced, respectively, the breast cancer cell growth inhibition by CFM-4. CFMs also impacted biological properties of the NB cells by blocking their abilities to migrate, form colonies in suspension, and invade through the matrix-coated membranes. Our studies indicate anti-NB properties of CFM-4 and 5, and suggest that these CFMs and/or their future analogs have potential as anti-NB agents.

Incidence of sudden cardiac death (SCD) in end-stage renal disease (ESRD) remains high. Limited data is available about whether implantable cardioverter-defibrillators (ICDs) can prevent arrhythmic death in patients with chronic kidney disease (CKD). The purpose of this retrospective study was to determine the impact of CKD on all-cause and sudden cardiac death in ICD recipients. We evaluated 441 consecutive patients who underwent ICD implantation at our center between 1994 and 2002. We found that mortality rate was higher in patients with eGFR

Purpose: The paucity of empirical evidence on the limitations of the industrial attachment programme of technical universities for enhancing students' human capital in Africa tends to thwart concrete policy options. Design/methodology/approach: The study used the convergent mixed methods including 594 surveys, two focus groups and in-depth interviews to assess and accentuate the research gap in this study. Findings: Evidence of constraints linked to the industrial attachment programme for developing students' human capital needs include limited funding, logistics and incentive for supervision, incompatible placement and exploitation and sexual harassment of students. Insufficient duration and intrusion of the industrial attachment programme due to labour unrests, inadequate collaboration and fears of student interns breaching organisations' confidentiality policies were also found to hinder the programme. Research limitations/implications: The study's dependence on participants' perspectives has the possibility of being characterised by recollection prejudice. The comparatively limited scope and size of the study participants creates concerns of representativeness and generalisability of the study outcome. Practical implications: The outcome of this study could yield significant practical implications for the planning and operations of the industrial attachment programme of tertiary institutions. It also provides information which could serve as the basis for future research and comprehensive evaluation of the programme's planning and implementation. Originality/value: The authors have delineated empirical evidence on the constraints of the industrial attachment programme of Ghanaian technical universities to inform policy decisions on the planning, operations, funding and evaluation of the programme in collaboration with industry and government.