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Harmonised health outcomes across administrative data: lessons, opportunities, and challenges from UK Biobank
No full textMigration, remittances and petty corruption in Africa
No full textDriven by rising access to mobile money and growing diaspora communities, remittances to African countries have reached record highs. Yet while scholars have connected aggregate remittance flows to macro-level political change, we know little about how these transfers shape individual-level dynamics among recipients. Since private sector markets are weak in many parts of Africa, we argue that recipients cannot easily substitute government services and so use their outside income to seek preferential access to them instead. This increases exposure to bribes from public officials, driving broader perceptions of corruption and reducing willingness to pay tax. We present evidence from survey data across the African continent, a preregistered list experiment in Ghana, and in-depth focus group discussions with recipients. We also introduce novel measures of remittances that capture distinct dimensions of receipt and compare dynamics across them. The paper contributes to the literature on remittances and political behaviour, alongside ongoing policy debates about cash transfers, corruption, and institutional development
Schools using nature for education and wellbeing: the Cherwell School
Get PDFThis practice-led case study is part of a research project looking at Nature-based programmes in secondary schools for mental health and wellbeing. Four case studies were produced in 2025 with secondary school teachers which use nature-based programmes. The Cherwell School is a large mixed state secondary school, with a sixth form, in Oxford, UK. The school has a split site, both with large green spaces.
Baseline household income is associated with severity and course of severe mental illness
Get PDFBackground: Poverty is associated with the severity of common mental health disorders and increased physical comorbidities. However, its effects on severe mental illness (SMI), beyond increasing their incidence, are less understood, especially in low- and middle-income countries. We here examined the relationship between baseline household income and subsequent mental and physical health outcomes in a large cohort of individuals diagnosed with schizophrenia or bipolar disorder in Colombia. Methods: Retrospective cohort and case–control study using electronic health records from over 5 million Colombians. We identified individuals diagnosed with schizophrenia or bipolar disorder and their baseline household income. Mental health outcomes included third-line antipsychotic treatments (clozapine or antipsychotic polypharmacy) and psychiatric hospitalizations. Physical outcomes included diagnoses of hypertension, type 2 diabetes, and HbA1c levels, compared with rates in individuals without SMI. Results: We included 12,216 (6,485 women) participants newly diagnosed with bipolar disorder or schizophrenia between 2019 and 2023. Compared to middle-income participants (between 700USD/month) were more likely to require third-line antipsychotic treatment (OR 1.84 [1.64, 2.08]) and psychiatric hospitalization (incidence rate ratio 1.30 [1.21, 1.41]). Low-income participants with SMI had hypertension and diabetes rates like middle-income participants without SMI who were 20 years older. However, the combined effect of SMI and low income together posed a less-than-additive risk. Lower income was associated with higher HbA1c levels in diabetes, while a diagnosis of SMI was associated with lower levels. Conclusions: Low income at SMI onset is associated with worse mental and physical health outcomes
Harnessing Phase Separation for the Development of High‐Performance Hydrogels
Get PDFHydrogels are indispensable for the development of next‐generation bioelectronics, soft robotics, and biomedical devices, where their mechanical properties determine performance and reliability. Among strategies to enhance hydrogel mechanics, phase separation enables controlled heterogeneity resulting in gel networks that are reinforced by more than just covalent bonds and polymer entanglements. By regulating the demixing of polymer‐rich and solvent‐rich domains, phase separation leads to architectures that couple strength, elasticity, and dynamic responsiveness. This article reviews the recent advances in designing high‐performance phase‐separated hydrogels by linking phase separation behavior within polymer networks to emergent properties such as toughness, fatigue resistance, adhesion, and stimuli‐responsiveness. We highlight how mesoscale organization governs multifunctional performance and demonstrate how these principles help resolve the key trade‐offs in critical applications, such as high‐pressure hemostatic sealants, low‐impedance bioelectronics, perfusable tissue engineering scaffolds, and adaptive soft robotics. Finally, we discuss critical challenges, including in situ characterization and scalability, and future opportunities like machine‐learning‐guided design, which are essential to translate phase separation from a materials heuristic into design rules for reliable, high‐performance hydrogel materials
Principles and priorities for integrated tuberculosis screening and care: A modified Delphi consensus exercise
Get PDFTuberculosis predominates in communities with multiple health and socioeconomic vulnerabilities. Tuberculosis diagnosis presents an opportunity for expanded health services to tuberculosis-affected households. We conducted a modified Delphi process to ascertain if and how expanded services should be offered to people with tuberculosis and their households. Purposively invited panellists were identified through professional networks and included researchers, service providers, policymakers and members of tuberculosis-affected communities. Panellists completed two online survey rounds. Round one sought to establish consensus on the perceived value of integration and capture diverse views on service integration priorities through free-text responses. Round two explored broad consensus statements (consensus defined as ≥75% agreement) developed from round one responses using Likert scales and country-specific priorities. Free-text responses were analysed using inductive thematic analysis. The percentage of panellists agreeing with each statement was calculated as a proportion of all responses, overall and by pre-specified subgroups of professional categories and WHO region. In round one, 223 panellists from 44 countries indicated strong support for expanded and better integrated services for people with tuberculosis (98% agreement), and their household contacts (84%). In round two, 324 people from 68 countries reached consensus on key motivations for service integration. These included improved tuberculosis treatment and other health outcomes among people with tuberculosis, and increased tuberculosis screening and preventive treatment uptake among contacts. Almost all (>99%) panellists agreed that people with tuberculosis should be routinely screened for relevant non-tuberculosis conditions, but only 69% thought this was appropriate among household contacts. There was consensus (93%) that population-wide tuberculosis screening should be integrated with other disease screening. Multiple, often context-specific, considerations for implementation were highlighted. Integrated tuberculosis screening and care is highly valued by global tuberculosis experts. This international consensus provides a strong mandate for research evaluating the feasibility and effectiveness of integrated tuberculosis service delivery and further policy and guideline development
The effects of AI-generated reformulation text as a form of feedback on EFL writing
Get PDFExploring the ethical and effective use of generative AI tools in education, particularly in enhancing writing skills of second language (L2), is critical. Specifically, AI-generated reformulation texts can serve as an effective technique for written corrective feedback (WCF), helping to make students’ essays sound more native-like while preserving their original ideas. Despite its promise, the reformulation technique has been underutilized and under-researched in L2 writing due to its demanding nature. This study aims to investigate the impact of AI-generated reformulation texts on improving L2 writing through a three-stage process involving initial writing, revision with AI feedback, and a final rewrite. Sixty university students of English as Foreign Language (EFL) were divided into experimental and control groups, with the former receiving AI feedback and the latter self-correcting their work. Statistical analyses revealed that AI-generated feedback did not significantly improve EFL students’ argumentative writing scores compared to self-correction in the control group. However, the degree to which students accepted the AI-generated reformulations was a strong predictor of writing score improvements, particularly in organization, suggesting that adherence to AI feedback enhanced initial revisions. Additionally, participants in the experimental group noticed more language features than those in the control group, indicating that AI feedback improved learners’ language awareness. The study also contributes to the literature by examining students’ critical use of ChatGPT, focusing on their rejection of AI-generated changes. These rejections were influenced by internal, external, and AI-specific factors, highlighting learners’ critical thinking when interacting with AI tools like ChatGPT
Structural determinants for GPCR-mediated inhibition of TASK K2P channels by diacylglycerol and its dysfunction in disease
Get PDFTwo-Pore Domain K+ (K2P) channels are crucial determinants of the resting membrane potential and of cellular electrical excitability in many different cell types. TASK-1 and TASK-3 K2P channel activity is also coupled to GPCR signalling pathways via Gαq and their subsequent inhibition is via direct interaction with diacylglycerol (DAG) generated from phosphatidylinositol-4,5-bisphosphate (PIP2) hydrolysis. This regulation is defective in two different neurodevelopmental disorders, but the molecular mechanisms underlying this inhibitory process and the reasons for the GPCR-insensitivity of these disease-causing mutations remain unclear. Here we show that GqPCR inhibition inversely correlates with channel open probability, and results from a state-dependent destabilisation of the open state by DAG promoting channel closure. We also identify a DAG interaction-site within a groove between the M2, M3 and M4 domains, and show the crucial role of residues within this site in mediating the inhibitory effect and defining channel sensitivity. These results not only reveal the structural and molecular mechanisms underlying GqPCR regulation of TASK channels, but also explain the pathogenic effect of a common regulatory defect linked to different K2P channelopathies
Cohort Profile: the SMRU Refugee and Migrant Pregnancy Study in Western Thailand and Eastern Myanmar
Get PDFBackgroundMarginalised populations face significant health risks in pregnancy with reduced access to preventive and life-saving services due to conflict and migration. Infectious disease risk is high and the double burden of malnutrition increases risk from non-communicable disease although only weak epidemiological data supports this in refugees and migrant communities. This manuscript describes the SMRU Refugee and Migrant Pregnancy Cohort commencing nearly 40 years ago, established in response to the very high rate of Plasmodium falciparum maternal mortality in refugee camps on the Thailand Myanmar border.MethodsPregnant women who registered to antenatal care clinics of the Shoklo Malaria Research Unit from 1986 to 2024 living in marginalised communities of refugee and migrants were the eligible population. Pregnancies were prospectively followed from enrolment through to childbirth. Types of data include: 1) medical and obstetric records including patient characteristics, pregnancy progress and birth outcomes and 2) investigations (such as HIV).ResultsAmong 94,645 pregnancies maternal mortality was 176 per 100,000 livebirths (120/68,024). Embedded cohorts included observational and clinical trials, providing evidence on the optimisation of treatment of malaria in pregnancy and on the rapid changes towards non-communicable diseases in refugees and migrants. Low mean height (151.4 cm), well below European and American populations from which the majority of guidelines have been created, questions appropriateness, such as gestational weight gain in pregnancy. A broad scope of research findings including tropical infections impacting pregnancy outcomes, mental health and suicide, a shared platform of "-omics" of Karen and Burmese women from first trimester, and practice of care in low-income settings have emerged and been shared.ConclusionsThe SMRU Refugee and Migrant Pregnancy Cohort findings have had significant local and international impact including changing the World Health Organisation Malaria Treatment Guidelines in pregnancy; and establishing a range of guidelines and tools improving maternal-child health practices
AO Spine Clinical Practice Recommendations: An Overview of the Current State of Fusion Surgery for Patients With Spinal Metastasis: Is Fusion Necessary?
Get PDFStudy DesignLiterature review with clinical recommendations.ObjectiveProviding a clear and concise overview based on the of key literature and consensus expert opinion on spinal fusion following stabilization for spine metastases and offer actionable recommendations on when to fuse and not fuse in this patient population.MethodsKey articles from the published literature on spinal metastases treated with stabilization followed by fusion were reviewed, and clinical recommendations were formulated. The recommendations are categorized as either strong or conditional based on an assessment of methodological quality and expert opinion. This assessment considers factors such as experience, risks, burdens, costs, patient values, and circumstances.ResultsFour articles were selected by practicing spinal oncology surgeons and each was evaluated for its methodological strength and its scientific evidence.ConclusionFusion rarely influences clinical outcomes in metastatic spine surgery. Treatment should prioritize mechanical stability, pain control, functional preservation, and timely continuation of oncologic therapy rather than pursuing bony arthrodesis. Fusion should be considered exclusively in select long-surviving patients, however routine attempts to enhance fusion or delay adjuvant therapy are not justified.[Formula: see text]