159370 research outputs found
Sort by
“It was a force for good but…”: a mixed-methods evaluation of the implementation of the high in fat, sugar and salt (HFSS) legislation in England
Full text linkBackground
In 2022, legislation in England restricted products high in fat, sugar, or salt (HFSS) in prominent store locations. This study explores retail sector (including enforcement of legislation in retail) responses to the legislation’s implementation.
Methods
Four major UK retailers – ASDA, Morrisons, Sainsbury’s and Tesco − completed business-level online surveys. Interviews were conducted with representatives from three retailers (n = 13; Asda, Morrisons, Sainsbury’s), the British Retail Consortium (n = 1), and primary authority enforcement (n = 1) (N = 15). Data were collected between July and November 2024. Findings informed co-production workshops (n = 3) to develop policy recommendations.
Results
Stakeholders supported legislation aims but voiced concerns about complexities with interpretation and implementation, limited communication with government, access to product nutrition data, and delays to guidance. Retailers utilised various HFSS product promotional strategies while achieving compliance. Retailers reported very limited enforcement. These findings were synthesised and facilitated the development of seven policy recommendations through co-production workshops between academics and the Institute of Grocery distribution.
Conclusion
HFSS legislation represents a landmark shift in regulation of the retail food environment, but clearer, timely guidance, data provision, and transparent co-production with actors cognisant of the food sector is needed to ensure legislation can be effectively implemented, enforced and evaluated
Methotrexate for Osteoarthritis: What Does the Evidence Say?
No full textOsteoarthritis (OA) is a leading cause of disability worldwide, characterised by chronic pain and reduced quality of life. Despite its prevalence, pharmacotherapy options remain limited. Inflammation has emerged as a promising target, with anti-inflammatory agents used in other rheumatological conditions, such as methotrexate (MTX), being explored for OA treatment. MTX is a cornerstone therapy in rheumatoid arthritis (RA), owing to its broad immunomodulatory properties and well-established clinical efficacy. This review summarises evidence from seven randomised controlled trials and two observational studies investigating MTX in knee and hand OA. Studies varied considerably in terms of sample size, study population, MTX dosage and follow-up duration. Overall, study outcomes were conflicting in terms of MTX effect on OA symptoms. However, trials with larger sample sizes and higher MTX doses (> 15 mg/week) consistently reported benefits for pain in knee and hand OA, with a favourable safety profile, supporting MTX as a potential OA treatment. There is still a need for further research to refine dosing strategies, assess longer term use and evaluate cost-effectiveness. Given the complex heterogeneity of OA, stratification by OA phenotype, particularly consideration of local and systemic inflammation, may also be important to underpin selection of a population most likely to respond to MTX treatment. Considerations for the use of MTX in older adults, where comorbidities and polypharmacy may impact use, will also be essential for clinical implementation
Large-Scale Chamber Tests of In-Room Germicidal Ultraviolet (GUV) Systems: Review and Best Practices
No full textDisease outbreaks, including epidemics and pandemics, can disrupt virtually all aspects of social structure and function. Given the likelihood that additional outbreaks will occur in the future, probably involving airborne pathogens, there is a need to develop and implement strategies to mitigate disease transmission associated with these events. In-room (upper-room and whole-room) germicidal ultraviolet (GUV) systems can play key roles in these mitigation strategies and chamber tests are likely to be important for validation of their performance.
At present, no uniform standard exists for conducting large-scale chamber tests or for translating the results of those experiments to application environments. In recognition of these needs, an ad-hoc committee was formed to address these issues. The goals of this effort were to conduct a critical review of the literature related to large-scale tests, to suggest “best practices” for these tests (as possible), and to suggest methods for translation of results from the test environment to the application environment.
The review includes a summary of existing standards for large-scale testing. These standards provide recommendations for chamber dimensions, materials of construction, and operating conditions. Challenge agents used in these tests are summarized, including viral (phage), bacterial, and non-microbial agent options and their corresponding methods for culture and analysis. Methods of challenge agent introduction and collection are also summarized. Fluence rate field characterization will play critical roles in interpreting chamber test results and translation to application environments; fluence rate field modeling and measurement methods are reviewed and summarized. The implications of the well-mixed assumption, which is commonly applied, are summarized together with methods that can be used to assess mixing behavior. Basic attributes of health and safety issues related to chamber tests are summarized from the literature and from experience
Establishing the Ca reaction at 392 MeV under quasi-free scattering conditions
Full text linkThe reaction offers a direct means to probe preformed -cluster structures in nuclei under quasi-free scattering conditions. Previous studies around 100 MeV provided valuable insights into clustering, but quantitative comparison with microscopic cluster wave functions remained limited due to strong distortion effects. At higher energies, the reaction mechanism becomes simpler and the distorted-wave impulse approximation (DWIA) provides a more reliable framework for quantitative analysis. In the present work, the Ca reaction was measured at an incident energy of 392 MeV using the high-resolution Grand Raiden and LAS spectrometers at RCNP. Despite the small cross section in this energy region, the achieved resolution allowed clear separation of the ground and excited states of the residual Ar nucleus, and corresponding momentum distributions were extracted. DWIA calculations using a Woods-Saxon Ar bound-state wave function yielded an experimental spectroscopic factor of , consistent with the previous result at 101.5 MeV . This agreement demonstrates that the reaction mechanism is well described across a wide energy range. The present study establishes the feasibility of high-precision measurements at several hundred MeV and highlights their potential as a quantitative probe of clustering in medium-mass nuclei, forming the basis for systematic studies in both stable and unstable systems
Realising the digital twin: a thematic review and analysis of the ethical, legal, and social issues for digital twins in healthcare
Full text linkThis paper examines ethical, legal, and social issues (ELSI) associated with healthcare digital twins (DTs). Using a systematic thematic analysis, we identify key themes across ethical, legal, and social categories, as well as practical barriers to adoption and implementation. Findings reveal a range of concerns (e.g. lack of empirical validation of DT value propositions) and gaps between the promise of healthcare DTs and the reality of deploying them within existing healthcare systems. By mapping the identified barriers to the Non-adoption, abandonment, scale-up, spread, and sustainability (NASSS) framework, we seek to demonstrate how healthcare DTs require systematic assurance and capability development. We provide practical recommendations for how this can be achieved, with specified stakeholder groups, to help build trustworthy and ethical DTs with demonstrable healthcare value
Reclassification of variants of uncertain significance in type I collagen genes: a national reference laboratory experience
Full text linkBackground: The availability of large volumes of data from genetic testing has enabled the interpretation of more DNA variants, contributing to a greater number of identified variants of uncertain significance (VUS). The growing number of VUS causes a burden of inconclusive findings in clinical practice. Osteogenesis imperfecta (OI) is a genetically heterogeneous connective tissue disorder causing bone fragility and limb deformity. Pathogenic variants in two collagen genes, COL1A1 and COL1A2, account for around 90% of all OI.
Methods: Data mining of the variants from Sheffield Diagnostic Genetics Service, the national OI testing hub (UK), was conducted to collate all VUS in COL1A1 and COL1A2 identified. All VUS were then reclassified according to the latest 2024 ACGS (Association for Clinical Genomic Science) best practice guidelines.
Results: A total of 161 VUS in COL1A1 and 98 VUS in COL1A2 were identified and reanalysed. For COL1A1, we found that 2% VUS were upgraded to likely pathogenic (LP), 23% of the VUS were downgraded to likely benign and benign, 12% were reclassified as hot VUS and the remaining 63% have not changed classification as VUS. With regard to COL1A2, only 1% of the VUS were upgraded to LP, 25% were downgraded to likely benign and benign, 13% were reclassified as hot VUS and 61% remained as VUS.
Conclusion: From this study, we demonstrated that iterative reanalysis of VUS is crucial in clinical practice as new data and evidence become available. This dynamic process will significantly improve diagnostic accuracy and inform patient care decisions
Improving access to free school meals:Evaluating the implementation of free school meal auto-enrolment processes
Full text linkAbstract To receive benefits-related free school meals in England, households must currently have an annual household income of less than £7,400 (before any benefits-related income), and parents must submit an application. However, data estimates that ~11% do not apply. This equates to about 215,000 children who could, but do not, receive meals they are entitled to. As schools receive pupil premium funding based on these free school meal allocations, under registrations can impact children, families and the support that schools can offer. Free school meal auto-enrolment is a term to describe the processes by which local governments use welfare datasets to identify and register entitled children, allowing parents an opportunity to opt out should they wish. This process can increase registration uptake, though the current evidence regarding free school meal auto-enrolment is limited. This study aimed to explore factors that influence the successful implementation of free school meal auto-enrolment from a local government perspective. Qualitative data were collected through semi-structured interviews with local government authority representatives and national stakeholders (n = 20) across England, supported by documentary analysis (n = 142 relevant documents). Data were analysed deductively according to the Context and Implementation of Complex Interventions framework. Results revealed there was variation in how local governments undertook and experienced auto-enrolment processes, based on the degree to which it was prioritised, available resources and encountered barriers. Multiple barriers to implementation were described, including capacity, data access and resistance regarding data sharing legalities from information governance colleagues. While barriers could be overcome with adequate leadership support, funding and capacity, the reliance on these conditions may lead to inconsistent auto-enrolment delivery and a lottery in free school meal access across the country
Piloting a Doctoral Project on Vocabulary Learning: Procedure and Reflection
Full text linkAlthough pilot studies are important in vocabulary research, there is limited practical guidance on how to carry one out. It becomes more difficult when the pilot must be conducted outside the classroom in an unfamiliar location, involves face-to-face meetings with participants, and when the researcher has limited prior knowledge of the target group. This article addresses this gap by offering a researcher’s perspective on the practical implementation of a pilot study on vocabulary learning, including methodological decisions, emergent challenges, and subsequent adaptations to the main study. This article first introduces the background and aims of the pilot study. Then, it describes the procedure of the pilot study, followed by reflections on its benefits and challenges. Finally, it highlights the significance of pilot studies for similar doctoral projects
A Pilot Study on Methods and Researcher Practice in Exploring Teachers’ Cognition and Practices of Mobile-Assisted Language Learning (MALL)
Full text linkThis paper reports on a pilot study conducted as part of a larger doctoral research project that explores Malaysian ESL primary school teachers’ cognition and practices toward Mobile-Assisted Language Learning (MALL). The pilot study was designed to test and improve three research methods: semi-structured, video-stimulated recall and focus group interviews. Two in-service teachers with experience using MALL were selected for the pilot. The pilot study helped in identifying issues such as unclear wording in the interview questions, leading questions and challenges in using video-stimulated recall interview method. It also revealed the importance of building trust with participants and being aware of how the researcher’s background might influence the data. Revisions were made to interview prompts and practical lessons were learned. The pilot study also involved a process of critical reflection on the researcher’s assumptions, practices and ethical responsibilities
Shaping research in marine functional connectivity for integrated and effective marine science and management
Full text linkEffective knowledge of ecological connectivity at sea and at the land–sea interface is key to supporting global policy goals to conserve and restore ocean biodiversity and function. However, a persistent lack of commonality in terminology and understanding around the concept of connectivity in marine ecological studies hampers its integration across disciplines, and its application in spatial planning and policy. Building on an extensive literature review, we clarify definitions and subcategories of marine connectivity, and propose a unified conceptual framework for Marine Functional Connectivity (MFC) research to support the integration of multidisciplinary scientific knowledge into management and policy. We identify key challenges and future directions for advancing this emerging field, bringing together most strands of marine science to understand changes in biodiversity and functional interdependencies between habitats and regions. Embedding this new integrated MFC research at the core of marine environmental science promises to improve significantly predictions of environmental and socio-economic change and the sustainable use of ecosystems and resources at sea and at the land–sea interface
Data sources:
Access Repository Dashboard
Do you manage Open Research Online? Become a CORE Member to access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard! 👇