Search Results (2,251)

This study investigates the impact of digitalisation and intangible investment—specifically digital skills and software adoption—on productivity in the United Kingdom’s banking sector. Software adoption is captured through banks’ investment in enterprise systems (CRM/ERP, cloud computing, and related applications), rather than a single software version. Drawing on detailed bank-level data from six major UK banks over the period 2007–2022, this research provides empirical evidence that higher intensities of digital human capital and intangible assets are positively associated with improvements in both employee productivity and overall bank performance. A standard deviation increase in software specialist employment is associated with productivity gains of 10.3% annually, though this upper-bound estimate likely combines direct effects with complementary factors such as concurrent IT investments (e.g., cloud infrastructure) and managerial innovations. The findings also highlight substantial heterogeneity across banks, with younger institutions experiencing more pronounced benefits from intangible investment due to their greater flexibility and innovation capacity. Furthermore, this study reveals that the adoption of high-speed internet and investment in IT hardware have a strong positive effect on bank productivity, particularly in the wake of the COVID-19 pandemic, which accelerated digital transformation across the sector. However, the observational nature of the study and the limited sample size necessitate caution in generalising the findings. While the results have implications for digital workforce development and technology infrastructure, policy recommendations should be interpreted as preliminary, pending further validation in broader samples and diverse institutional settings. This study concludes by advocating for targeted strategies to expand digital skills, promote software diffusion, and modernise infrastructure to facilitate productivity convergence, while emphasising the need for future research to address potential endogeneity and external validity limitations. Full article

Background: Children with disabilities face complex, systemic health access barriers rooted in societal, institutional, and structural inequities, requiring urgent global policy attention. Publications on access to health services for this population category have been found to have a significant growth in both quantity and content. The article aims to examine the structure and evolution of scientific literature in analyzing the healthcare system through the lens of inclusive services. Methods: We present the bibliometric profile of the global literature on access to health services for children with disabilities, the publication trends, the structure of research in this field concerning geographical distribution, methodological approaches, and interdisciplinary collaborations, and the core research topics, conceptual clusters, and future research directions in the field. The publications were screened from Web of Science databases, using PRISMA methodology. Finally, 1100 academic publications published between 1984 and 2025, obtained from a total of 432 different sources, the majority of which were peer-reviewed journals, were screened. Results: The calculated annual publication growth rate of 8.37% and the distinct upward trend observed, especially after 2015. The highest level was reached in 2023, with over 90 publications showing that the topic has become a focus of international academic interest. The USA (33.5%), the United Kingdom (15.7%), Australia (9.5%), and Canada (9.5%) stood out in publications, and there were strong collaborative networks among European nations (8.2%). Conclusions: Although high-income countries still appear to play a dominant role in research production, expanding international collaborations and distributing resources more equitably will contribute to the development of more inclusive solutions on a global scale. Temporal trends show an evolution toward diagnostic processes, family-centered approaches, and psychosocial dimensions. The results draw a clear picture of the current research landscape regarding access to health services for pediatric disability populations and identify potential directions for future research. Full article

Background: Sexual violence poses a significant challenge to European lawmakers, impacting the victim’s physical and psychological health. This study examines sexual violence legislation across EU member states, Switzerland, and the UK, analyzing similarities, differences, challenges, and potential solutions for effective policy development. The research was motivated by the adoption of EU Directive 2024/1385. Methods: This study analyzes sexual violence legislation across European countries in a comparative and qualitative way, highlighting differences, commonalities, and the potential for uniform regulation. The data were collected from the literature published between 2015 and 2024, focusing the EU member states, Switzerland, and the United Kingdom. Results: The examination of the norms governing sexual offenses in various European countries revealed significant differences in legislative frameworks, reflecting diverse cultural, ethical, and legal perspectives. Conclusions: Despite European countries sharing the goal of protecting victims and combating sexual violence, there are significant legislative disparities. Key recommendations include enhancing EU member state cooperation, implementing joint training programs, developing a specific EU directive, and creating coordinated prevention and education programs. While respecting national legal diversity, a unified approach is needed for effective prevention and prosecution of sexual violence across Europe. Full article

Introduction: Recent guidelines developed by the European Association for the Study of Obesity (EASO) and the European Federation of the Associations of Dietitians (EFAD) focused on the dietetic management of obesity in adults. The present study aimed to explore the perspectives of healthcare professionals regarding these guidelines. Methods: In total, 85 registered dietitians/nutritionists from Greece, the Netherlands, the Republic of Ireland, and the United Kingdom completed an online survey, and 10 were interviewed, in February–March 2023. Demographic data were also collected. Results: Awareness of the EASO-EFAD guidelines among registered dietitians/nutritionists was moderate (57.6%), but only 20% had read them in full. Dietitians with higher education and relevant experience were more likely to have read the guidelines. Less than half reported that key evidence-based recommendations, such as individualized medical nutrition therapy and intensive behavioral interventions, are already included in national guidance. Recommendations like portfolio or DASH diets, partial meal replacements, and calorie restriction were less commonly part of national guidance/usual practice. A small percentage of participants described their adoption of several nutritional approaches novel to them. These included the portfolio dietary pattern, partial meal replacements, and intermittent fasting or continuous calorie restriction. For some Irish dietitians, prioritizing weight as the main outcome conflicted with their emphasis on overall health and individualized nutrition therapy. Other barriers of recommendation implementation included exclusive availability in English, rapid changes in obesity management, staffing shortages, limited multidisciplinary collaboration, and inconsistent knowledge among healthcare providers. Conclusions: The present study identified gaps in the adoption of the EASO-EFAD guidelines into dietetic/clinical practice. EFAD will develop strategies to disseminate these guidelines at different levels of stakeholders (national/local authorities, dietitians/nutritionists, and patients). Full article

Blue hydrogen is a promising low-carbon alternative to conventional fossil fuels. This technology has been garnering increasing attention with many technological advances in recent years, with a particular focus on the deployed materials and process configurations aimed at minimising the cost and CO₂ emissions intensity of the process as well as maximising efficiency. However, less attention is given to the practical aspects of large-scale deployment, with the cooling requirements often being overlooked, especially across multiple locations. In particular, the literature tends to focus on CO₂ emissions intensity of blue hydrogen production processes, with other environmental impacts such as water and electrical consumption mostly considered an afterthought. Notably, there is a gap to understand the impact of cooling methods on such environmental metrics, especially with technologies at a lower technology readiness level. Herein, two cooling methods (namely, air-cooling versus water-cooling) have been assessed and cross-compared in terms of their energy impact alongside techno-economics, considering deployment across two specific locations (United Kingdom and Saudi Arabia). A sorption-enhanced steam-methane reforming (SE-SMR) coupled with chemical-looping combustion (CLC) was used as the base process. Deployment of this process in the UK yielded a levelised cost of hydrogen (LCOH) of GBP 2.94/kg H₂ with no significant difference between the prices when using air-cooling and water-cooling, despite the air-cooling approach having a higher electricity consumption. In Saudi Arabia, this process achieved a LCOH of GBP 0.70 and GBP 0.72 /kg H₂ when using air- and water-cooling, respectively, highlighting that in particularly arid regions, air-cooling is a viable approach despite its increased electrical consumption. Furthermore, based on the economic and process performance of the SE-SMR-CLC process, the policy mechanisms and financial incentives that can be implemented have been discussed to further highlight what is required from key stakeholders to ensure effective deployment of blue hydrogen production. Full article

We have developed a generalisable machine learning framework for reservoir quality prediction in deeply buried clastic systems. Applied to the Lower Jurassic deltaic sandstones of the Tilje Formation (Halten Terrace, North Sea), the approach integrates sedimentological facies modelling with mineralogical and petrophysical prediction in a single workflow. Using supervised Extreme Gradient Boosting (XGBoost) models, we classify reservoir facies, predict permeability directly from standard wireline log parameters and estimate the abundance of porosity-preserving grain coating chlorite (gamma ray, neutron porosity, caliper, photoelectric effect, bulk density, compressional and shear sonic, and deep resistivity). Model development and evaluation employed stratified K-fold cross-validation to preserve facies proportions and mineralogical variability across folds, supporting robust performance assessment and testing generalisability across a geologically heterogeneous dataset. Core description, point count petrography, and core plug analyses were used for ground truthing. The models distinguish chlorite-associated facies with up to 80% accuracy and estimate permeability with a mean absolute error of 0.782 log(mD), improving substantially on conventional regression-based approaches. The models also enable prediction, for the first time using wireline logs, grain-coating chlorite abundance with a mean absolute error of 1.79% (range 0–16%). The framework takes advantage of diagnostic petrophysical responses associated with chlorite and high porosity, yielding geologically consistent and interpretable results. It addresses persistent challenges in characterising thinly bedded, heterogeneous intervals beyond the resolution of traditional methods and is transferable to other clastic reservoirs, including those considered for carbon storage and geothermal applications. The workflow supports cost-effective, high-confidence subsurface characterisation and contributes a flexible methodology for future work at the interface of geoscience and machine learning. Full article

Polypharmacy in older adults increases risks of adverse drug reactions (ADRs), hospitalisations, and mortality. Pharmacist-led interventions using validated tools (e.g., STOPP/START, MAI, STOPPFrail) aim to optimise prescribing, yet their impact on clinical and economic outcomes in UK/Ireland health systems remains underexplored. This systematic review aimed to critically assess the impact of pharmacist-led deprescribing interventions on PIP, clinical outcomes, and costs in older adults (≥65 years) across the UK and Ireland. Following PRISMA 2020 guidelines, four databases (PubMed, Scopus, Web of Science, Cochrane Library) were searched for studies (2010–2024). Eligible studies included randomised trials, observational designs, and intervention studies in hospitals, care homes, community pharmacies, and intermediate care settings. Fourteen studies met the inclusion criteria. The risk of bias was assessed using CASP checklists. Narrative syntheses and heat maps summarised the findings. Twelve of fourteen studies reported positive outcomes: reductions in potentially inappropriate medications, ADRs, medication burdens, and falls/fall risks. Medication appropriateness improved significantly in 35% of studies using the MAI. STOPPFrail reduced PIMs in care homes, while the MAI enhanced complex hospital reviews. Community interventions improved adherence and reduced the use of fall risk drugs. No studies demonstrated a reduction in hospitalisations, mortality, or the length of stays. Economic analyses showed mixed cost-effectiveness. Key barriers included low uptake of pharmacist recommendations and short follow-up periods. Pharmacist-led interventions have significantly improved the prescribing quality and reduced medication-related risks, but they fail to impact hospitalisations or mortality due to implementation gaps. Context-specific tools and policy reforms—including expanded pharmacist roles and electronic decision support—are critical for sustainability. Future research should focus on long-term outcomes, cost-effectiveness, and multidisciplinary integration. Full article

Accurate label claims are essential for consumer trust in probiotic efficacy, yet limited datasets are available for poultry formulations marketed in the United Kingdom. We quantified and identified the viable bacteria in twelve commercial probiotics, seven for poultry and five for human use, using selective plate counts and MALDI-TOF MS. Observed colony forming units (CFU) were compared with declared values using one-sample t-tests, adopting a practical acceptance range of ±0.5 log CFU. Poultry products largely met or exceeded their labels (e.g., P5: 1.4 × 10¹⁰ CFU g⁻¹ vs. 2 × 10⁹ CFU g⁻¹ declared), whereas human products delivered greater variability in both species composition and stated CFU count; one contained no detectable viable bacteria. All products deviated significantly from their label claims (p < 0.05); however, 11 of 12 met the ±0.5 log₁₀ CFU benchmark—10 within the range and 1 above its “≥” value—leaving only one probiotic below the threshold. MALDI-TOF MS confirmed the presence of most labelled species, though Bifidobacterium bifidum was absent from one human product and Bacillus isolates were re-assigned to B. velezensis/B. amyloliquefaciens. These findings indicate robust quality assurance in UK poultry probiotics, but substantial under-delivery in the human probiotics, underscoring the need for harmonized viability standards and tighter post-market surveillance. Full article

Over the past two decades, pregnancy and birth trends have undergone significant shifts across Australia, the United States of America (USA), and the United Kingdom (UK), reflecting changes in societal norms, healthcare advancements, and demographic patterns. Variations in maternal age, birth interventions, and fertility rates highlight the evolving nature of reproductive behaviors and healthcare systems in these nations. The analysis reveals consistent increases in maternal age and gestational diabetes, alongside rising caesarean section rates—particularly in private healthcare settings. While perinatal mortality has declined overall, maternal mortality has increased in the USA and remains disproportionately high among Indigenous women and those in ethnic minorities in all three countries. These findings highlight the influence of structural inequities, healthcare access, and policy differences in maternal health. The review underscores the urgent need for equity-focused, culturally safe, and system-level interventions, as well as improved data collection and international collaboration to reduce preventable maternal and neonatal harms. By comparing these three regions, this review aims to provide insights into the shared challenges and unique approaches shaping childbirth practices in high-income countries in the 21st century. Full article

Use of sedation for disbudding is common practice in a number European countries, with United Kingdom (UK) practices adopting its use. This study assessed the effects of disbudding with and without xylazine sedation on growth rates and calf health on a UK calf rearing unit. Data was collected from 485 dairy crossed with beef breed calves between April and August 2024 from a single calf rearing unit in England. Calves were purchased from multiple farms across the UK and arrived on site at approximately 21 days of age. Calves were disbudded—and, in the case of male calves, surgically castrated—at approximately three weeks after arrival on farm. Pens of calves were assigned to undergo disbudding with (SED, n = 238) or without (CTL = 234) xylazine sedation at a dose of 0.2 mg/kg administered intramuscularly. Calves from both groups were provided with local anaesthetic (procaine hydrochloride) as a cornual nerve block and a non-steroidal anti-inflammatory drug (meloxicam). While other studies have demonstrated some behavioural and physiological indicators of pain to be reduced with sedation, this study found that calves in the SED group had a reduced daily liveweight gain (DLWG) of 0.14 kg/day in the short term (mean 20 days) following disbudding (p < 0.001), but there was no difference in growth rates in the medium-term (mean 43 days) post-disbudding (p = 0.30). Some of this difference could be explained by the slightly higher DLWG pre-disbudding in the CTR group, and it is likely that the physiological impacts of sedation accounted for the rest of this difference. This initial reduction in DLWG following disbudding with sedation should be considered by vets, especially on farms where growth rates may already be compromised. In the sedated calves, 19.3% exhibited either some movement or entry into sternal recumbency. Specifically, a light plane of sedation with calves entering sternal recumbency was associated with a reduction in DLWG of 0.89 kg/day compared to 0.98 kg/day for those that remained in lateral recumbency throughout (p = 0.008). The light plane of sedation may have created additional calf stress, impacted feeding behaviours, and impinged welfare, with further work needed to establish the reasons for insufficient sedation. There was no difference in the number of post-disbudding treatment outcomes between calves disbudded with and without sedation (p = 0.97). Full article

Human brucellosis is a zoonotic, bacterial infection caused by the intracellular, Gram-negative Brucella spp., which is common globally but rare in the United Kingdom, with approximately 20 imported cases per annum following travel to countries with high endemicity. Transmission typically occurs via the ingestion of infected animal products, including unpasteurised dairy products. Human-to-human transmission is rare, and routes include postpartum vertical transmission through breastfeeding. We report here on a familial cluster of three cases within a single UK-based Kurdish household of four, including a 11-month-old infant infected through the consumption of breast milk. Four months prior to presentation, the family had travelled together to northern Iraq for a 5-week holiday and all consumed local dairy products except for the children, including the 11-month-old, who was exclusively breastfed at the time. All three patients, including one adult male with complicated brucellosis, had a favourable outcome with medical therapy.: Brucellosis is an important differential diagnosis in returning travellers and specialist advice should be obtained early to prevent sequelae. It is also important for active case-finding, especially in family units with shared exposure. Paediatricians and adult physicians who may manage brucellosis should consider the possibility of vertical transmission in breastfeeding mothers. Full article

Introduction: The role of urethrectomy at the time of Robotic-Assisted or Open Radical Cystectomy (RARC, ORC) is controversial. Whether urethrectomy should be performed at the time of RARC/ORC or delayed up to a 3–6 month interval is unclear. We performed a retrospective cohort analysis of perioperative and survival outcomes in patients with high-risk NMIBCs or non-metastatic MIBCs at our institution who underwent either concomitant or deferred urethrectomy after RC. Materials and Methods: cTis-T1 or cT2-T4, N0-1, M0 BC patients who underwent RARC or ORC from 2009 to 2024 were reviewed. Clinical, demographic, tumour, and patient characteristics and perioperative variables were assessed across concomitant and delayed urethrectomy groups. Multivariate logistic analysis was performed to estimate the impact of significant variables on intraoperative and postoperative outcomes. Univariable Kaplan–Meier and multivariable Cox regression modelling was implemented to explore the relative effect of time of urethrectomy on progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS). Results: A total of n = 58 patients (n = 47 delayed vs. n = 11 concomitant) with similar demographic characteristics were included. The concomitant urethrectomy group experienced longer operative time and greater blood loss (379 ± 65 min and 430 ± 101 mL vs. 342 ± 82 min and 422 ± 125 mL, with p = 0.049 and p = 0.028, respectively). Hospital readmission rates were higher in the concomitant urethrectomy group (36.4% vs. 8.5%, p = 0.016; OR: 17.9; 95% CI 1.2–265; p = 0.036). In Cox regression analysis, the timing of urethrectomy had no influence on PFS, CSS, or OS (all p > 0.05). Conclusions: Our study suggests that urethrectomy can be safely deferred unless urothelial disease is clearly present pre- or intraoperatively without compromising survival outcome and with the advantage of reducing surgical morbidity at the time of RC. Full article

Monk fruit extract (Siraitia grosvenorii, MFE) is a natural, non-caloric sweetener known for its intense sweetness, antioxidant properties, and potential metabolic health benefits. While certain aqueous monk fruit decoctions are recognised as non-novel foods in the UK and Ireland due to significant pre-1997 consumption, the European Union (EU) has adopted a more cautious approach under the Novel Food Regulation (EU) 2015/2283. As of October 2024, only one specific aqueous extract of monk fruit has been authorised in the EU under Regulation (EU) 2024/2345, permitting its use in several food categories. However, highly purified mogrosides and non-aqueous extracts remain unapproved due to gaps in toxicological data and the absence of industry-led applications. This review systematically analyses the EU’s regulatory barriers, comparing MFE’s legal status with other approved non-caloric sweeteners such as steviol glycosides and erythritol, and examining regulatory frameworks in the EU, United States, United Kingdom, and China. Findings indicate that although 18 non-caloric sweeteners are currently authorised in the EU, regulatory constraints continue to hinder the broader approval of MFE, limiting innovation and the availability of natural sweeteners for consumers. Harmonising regulations, leveraging international safety assessments, and promoting industry engagement are recommended to advance MFE’s authorisation and support sustainable food innovation in the EU. Addressing these challenges is crucial to ensure that European consumers and industry can benefit from safe, innovative, and health-promoting alternatives to sugar, aligning food policy with broader public health goals and sustainability commitments. Full article

The acoustics of St Paul’s Cathedral, London, have been discussed in previous studies as a space of historical, cultural, societal, and architectural interest in the capital city of the United Kingdom. This paper presents the results from recent acoustic measurements carried out within the space, making use of state-of-the-art measurement techniques and equipment. The results from these measurements provide a new perspective on the acoustic properties of different and distinct spaces within the cathedral, including coupling effects between the main areas, and the whispering gallery effect that can be heard around the walkway at the base of the dome. The discussion includes the analysis of room acoustic parameters included in the international standards and speech intelligibility parameters, and an indirect comparison between the techniques used here and those used in previous studies of this space. Full article

Background: Despite the clinical efficacy of pre-exposure prophylaxis (PrEP) in preventing HIV, uptake remains suboptimal among men who have sex with men (MSM) in the United Kingdom (UK). Sustaining progress in the PrEP cascade requires more than biomedical availability; it demands effective, psychologically informed interventions that address persistent barriers. Psychological factors, such as medical mistrust, low PrEP self-efficacy, and identity-related processes, continue to undermine engagement. This study tested whether narrative persuasion and message framing could influence these barriers. Method: A sample of 253 MSM was recruited to participate in an online experiment and completed baseline measures of identity resilience before being randomly allocated to either the gain-framed (N = 122) or loss-framed (N = 124) narrative condition and then completing post-manipulation measures of medical mistrust and PrEP self-efficacy. After excluding 7 cases due to ineligibility, data from 246 participants were analysed using mediation analysis. Results: Participants in the gain-framed condition reported lower medical mistrust than those in the loss-framed condition. Medical mistrust was, in turn, associated with lower PrEP self-efficacy. Identity resilience was associated with lower medical mistrust and higher PrEP self-efficacy. Discussion: These findings provide novel causal evidence that gain-framed health narratives can reduce mistrust and indirectly enhance PrEP self-efficacy. Identity resilience also emerges as a key psychological factor influencing trust and behavioural confidence. Conclusions: Interventions to improve and sustain PrEP uptake should combine gain-framed, narrative-based messaging with strategies to bolster identity resilience. Such approaches may address psychosocial barriers more effectively and promote equitable PrEP uptake among MSM. Full article