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The Swedish Twin Registry (STR), established in the late 1950s, is one of the world’s most comprehensive twin registries and a cornerstone for research on genetic and environmental determinants of health. STR includes data on Swedish-born twins since 1886, complemented by longitudinal questionnaires, clinical measures, and biobank samples. In 2019, STR became a national research infrastructure with a mission to provide broader data sharing, while in 2025, STR further transitioned into a legally defined role as a ‘certain research database’ under the new Swedish Act on Certain Research Databases. The new legislation provides a framework for collecting and storing personal data with broad consent for future research projects, without requiring ethical approval for the data collection per se. Instead, ethical review is conducted separately for each research project seeking to use STR data. This article aims to describe STR’s current role, governance, and legal context, highlighting implications for data access and biobank integration. The registry currently holds data on more than 160,000 twins, with ongoing ascertainment at 9 months and 9 years with follow-ups at ages 15, 18, and 24. Annual linkages to national health registers enrich longitudinal analyses of disease outcomes. A variable search engine is openly available via STR’s web portal while higher level metadata is provided through Swedish research data services. STR’s evolution illustrates both opportunities and challenges in balancing open science practices, legal compliance, and participant integrity within large-scale research infrastructures.
Ethnic minority groups are disproportionately represented in in-patient mental health services, yet research has largely overlooked their carers’ experiences. Because carers play a crucial role in managing their family member’s mental well-being, gaining insight into their potentially unique challenges and support needs is essential for service development.
Aims
To investigate the experiences of ethnic minority carers of patients receiving in-patient psychiatric care in the UK, identify challenges they face and understand the role of culture and ethnicity in an in-patient setting.
Method
In the UK, ‘ethnic minority’ refers to all individuals from a non-White British background. Twelve carers from ethnic minority groups were recruited from third-sector organisations across the UK to participate in semi-structured interviews online. Audio-recordings of the interviews were transcribed, and data were analysed with reflexive thematic analysis.
Results
Three core themes were identified: ‘The Challenges of Navigating Hospital Admission’, ‘Cultural and Carer Exclusion in in-patient Care’ and ‘Improving the Ethnic Minority Carer Experience’. Findings elucidated the nuanced ways in which culture and ethnicity influence carers’ experiences. Participants highlighted systemic barriers to timely support, experiences of disempowerment and exclusion, and culturally insensitive care. Participants offered recommendations to improve support for carers.
Conclusions
Ethnic minority carers of in-patients experience difficulties arising from a lack of cultural safety within in-patient psychiatric services. Embracing a holistic approach to care and providing comprehensive, culturally responsive guidance and support for carers are essential for promoting equitable mental healthcare.
The diet of Antarctic toothfish (Dissostichus mawsoni) captured by bottom longlines on the Ross Sea continental shelf was examined during four consecutive summer research surveys (2012–2015) within the Ross Sea polynya. The surveys included three areas: south-west continental shelf (Core area), McMurdo Sound and Terra Nova Bay. Toothfish diet comprised mainly small notothens, especially Trematomus spp. (which accounted for 20–52% of total prey weight by area) and icefish (30–57% of total prey weight by area). Notothen prey were mainly Trematomus loennbergii, with Trematomus scotti regularly observed. The most important icefish prey were Chionodraco spp., of which Chionodraco hamatus was most frequently identified, and Neopagetopsis ionah. Dragonfish (Bathydraconidae) were rarely observed, except in 2012 when Gymnodraco acuticeps accounted for ~11% of prey weight. Antarctic silverfish (Pleuragramma antarcticum) were regularly observed but contributed little by weight (0.4–3.6% total prey weight by area). Invertebrates were a relatively small component of toothfish diet, with the prawn Notocrangon antarcticus and the amphipod Eusiris spp. found in ~3–24% and 0–9% of stomachs, respectively, but they were small and weighed little. Icefish (particularly Dacodraco hunteri) were more important than notothens in toothfish diet in Terra Nova Bay. The results indicate that D. mawsoni are predominantly benthic feeders, with no evidence of substantial feeding away from the seafloor in the days before they were caught. In contrast with previous McMurdo Sound diet studies, Antarctic silverfish were of relatively minor importance as a prey item for Antarctic toothfish in other areas of the Ross Sea shelf, which is consistent with a coastal and fast-ice distribution of silverfish and/or a seasonal change in the distribution of silverfish.
To evaluate the impact of systemwide antimicrobial stewardship interventions on antibiotic prescribing patterns for community-acquired pneumonia(CAP) in a community health system.
Design:
Retrospective pre-post implementation study.
Setting:
Adult acute care hospitals in a community health system.
Patients:
Adults 18 years or older admitted to an acute care hospital with a diagnosis of CAP identified by ICD-10 codes.
Methods:
This retrospective, pre-post implementation study was completed at four adult acute care hospitals in a community health system. Antimicrobial stewardship interventions targeted toward CAP were rolled out between July 2020 and March 2021. Data to capture prescribing habits was collected pre and postimplementation. The inclusion criteria were patients who were at least 18 years old, admitted to an adult acute care hospital, and diagnosed as CAP based on ICD-10 code, while exclusion criteria were patients who were transferred from another hospital, had a pneumonia with an onset of 48 hours or later after admission, or had a concomitant non-respiratory tract infection during receipt of antibiotics for CAP. The primary outcome was percentage of patients who received empiric anti-MRSA or antipseudomonal antimicrobial coverage for CAP in accordance with current guideline recommendations.
Results:
Four hundred patients were included in the analysis, with 207 patients in the preimplementation arm and 193 patients in the postimplementation arm. The percentage of patients who received appropriate empiric coverage significantly increased from 34.7% in the preimplementation group to 60.1% in the postimplementation group (P < .0001).
Conclusions:
Multifaceted antimicrobial stewardship interventions significantly improve guideline-concordant empiric MRSA and P. aeruginosa antimicrobial coverage.
Bactrian, the principal written language of pre-Islamic Afghanistan, was little known until the early 1990s, when more than 150 contracts, economic documents and letters, together with a few Buddhist texts, were acquired by collectors. Most of these were published by Nicholas Sims-Williams between 2001 and 2012 in three volumes entitled Bactrian Documents from Northern Afghanistan. The present article presents two additional documents which have come to light more recently, a receipt for a sum of ten dirhams and a letter from an otherwise unknown ruler of Rōb, modern Rui in the Hindukush mountains. The text and translation of the documents are accompanied by a discussion of their linguistic and historical significance.
Past research has documented a substantial finance wage premium. We examine whether this premium reflects differences in lifetime career opportunities. Using resume data, we reconstruct career trajectories in finance and nonfinance sectors and build synthetic measures of career attractiveness that account for compensation levels, growth, and risk. We find that asset management and investment banking provide a sizable risk-adjusted career premium relative to banking, insurance, and other sectors. This premium has declined across cohorts, particularly relative to high tech. Labor-market entry patterns respond to these premia: potential entrants treat finance and high-tech careers as substitutes when choosing where to start.
Mental health encompasses subjective well-being (SWB) as well as psychopathology (PP). SWB and PP are related but separate domains: some individuals experience high SWB despite high PP, and others experience low SWB despite minimal PP. Given substantial and heterogeneous developmental changes in both domains during adolescence, examining their co-developmental trajectories may clarify how they integrate across this period.
Methods
Using data from the Tokyo Teen Cohort (N = 2994), a population-based prospective birth cohort study, we conducted parallel process latent class growth analysis to cluster SWB–PP trajectories at ages 10, 12, 14, and 16 years. We then investigated various sociodemographic, individual, familial, and socioenvironmental correlates for each class.
Results
We identified four distinct classes: high SWB–low PP (55.0%), high SWB–mid PP (20.2%), low SWB–mid PP (17.0%), and mid SWB–high PP (7.7%). SWB declined from ages 10 to 16 years across all four classes. Lower PP did not necessarily correspond to higher SWB, and in some pairs of classes, the relationship between SWB and PP levels was reversed. When comparing the two classes with moderate PP, higher aspirations, more prosocial behavior, and better interpersonal relationships were associated with the high SWB class. In contrast, being female and having a higher household income were associated with the low SWB class.
Conclusions
Discrepant SWB–PP trajectories suggest characteristic patterns of developmental integration between these domains during adolescence. Considering their interplay may complement domain-specific approaches and inform psychosocial supports aimed at maintaining SWB even in the presence of PP.
Health system integration has been actively promoted in recent years as a promising approach to defragmentize the current delivery framework of health services and contain costs. Yet, integration often faces significant barriers from the bureaucratic sphere. Successful integration is hardly due to good technical design alone; rather, it is often explained by how the policy dimension of the reform is managed. This study embraces a policy sciences perspective to explain the micro policy dynamics of health system integration reforms in a fragmented health system. Engaging the policy entrepreneurship literature, it investigates the county medical conglomeration innovations that have flourished in China in the past few years. Two pioneer counties were selected for in-depth case studies. Qualitative methods were extensively used in data analysis. Analytical attention was specifically focused on how a small team of local policy entrepreneurs championed the reforms amidst multiple constraints. The analysis revealed the varying momentum of policy entrepreneurs and the distinctive reform pathways across the two cases. A certain degree of similarity was also observed in their use of entrepreneurial strategies to promote integration reforms. Importantly, close vertical integration combined with a bundled global budget was adopted in both cases, and this model was subsequently diffused to other localities.
Alcohol companies are increasingly marketing products with nutrition-related claims to appeal to consumers. There are concerns around the potential of such claims to mislead; however, there is limited research on consumers’ attitudes to claims, why they use them and how they influence product selection. The aim of this study was to explore these issues among Australian consumers.
Design:
Nine online focus groups were conducted with approximately nine individuals per group (n 83). Groups were stratified by age, sex and drinking status. Participants were asked about their alcohol purchasing behaviours and presented with a selection of alcohol products that displayed nutrition-related claims (e.g. zero sugar).
Setting:
Australia.
Participants:
Australian adults who consumed alcohol at least twice per month.
Results:
Three major themes emerged from the data. First, most participants appeared to trust on-pack claims, viewing them as tools for making healthier choices. Claims were cited as being particularly useful when placed on the front of packaging to assist the rapid identification of products perceived as ‘healthier’ options. Second, participants appeared to use claims primarily to identify nutrients or ingredients they wanted to avoid, especially sugar, calories and preservatives. Finally, most participants supported the use of claims, with few raising concerns about them being potentially misleading.
Conclusion:
The results of this study add to growing evidence indicating that nutrition-related claims can mislead consumers about the healthiness of alcoholic beverages. Policymakers should seek to restrict the use of claims while also working to increase awareness of the health risks associated with alcohol consumption.
This article explores factors contributing to the launching of private prosecutions for criminal libel during World War I in Calgary against the proprietor of a small newspaper. In the first of the cases considered here, the allegations of this originally English journalist—that a Jewish-owned business had German and Austrian employees—had the potential to inflame local ethic tensions and provoke violence, but the Crown sat on the sidelines while the lumber company prosecuted. In the second case, the libellous text suggested that Calgary’s former Member of Parliament, R.B. Bennett, and his associate William P. McLaws were party to financial improprieties around spending on munitions manufacturing in Medicine Hat. Again, the Crown lawyers watched while Bennett prosecuted and McLaws did not. This article explores the strategic decision-making behind a prosecutorial approach now largely unfamiliar to us.
Francis Drake’s journey around the world between 1577 and 1580 is renowned as one of the most famous voyages in history. The circumnavigation was a great achievement for England, but the official story Queen Elizabeth and her Privy Council maintained for nine years was that Drake was a pirate, and that the treasure he captured on the voyage would be returned to Spain. Upon his return, information about the voyage and his route were suppressed and the crew was sworn to secrecy: they were not to reveal where they travelled on ‘pain of death’. Here I present the case that perhaps the most important state secret of all was that the official land claim record falsified the position of Nova Albion, Drake’s claim on the west coast of what is now the United States. Between the draft and the published version, the claim was moved south by several degrees to the northern border of New Spain. It is not likely that the differing latitudes were a scribal or typographic error. The Chinese porcelain sherds once thought to be from vessels in Drake’s cargo that proved he was in the San Francisco Bay area can now be considered artefacts from a later Spanish shipwreck, and Drake’s true ‘fair & good bay’ known as the bay of Nova Albion may be found six degrees further north. This ruse enabled England, by the rules of the time, to claim the lion’s share of uncharted territory north of Spain’s colonial boundary.
Solar photovoltaic (PV) modules continue to make a significant contribution to the ongoing process of smooth transitioning from fossil fuels to renewable energy. However, when exposed to solar irradiation, a PV module suffers significant performance degradation due to rising operating temperature, underscoring the necessity for suitable thermal management strategies. In this review, the different water-based cooling techniques that have been adopted in non-concentrating photovoltaic modules have been identified, classified, reviewed and compared, and the scope for further research has been discussed in detail. The maximum temperature reduction observed with intentional and unintentional cooling techniques was about 50 °C and 15 °C, respectively. The maximum photovoltaic electrical efficiency improvement was about 19% and 15%, respectively, when compared to an uncooled module, due to intentional and unintentional cooling techniques. Unintentional cooling techniques like floating photovoltaics, photovoltaic/thermal collectors, and hybrid photovoltaic-solar still offer benefits such as water evaporation prevention, hot water generation and desalinated water production, respectively. Intentional cooling techniques seem to consume more water and add additional benefits like module cleaning and tertiary wastewater treatment. The least water consumption was observed with the evaporative cooling technique. Potential water quality degradation was a main concern in immersion cooling and floating PV. Except for evaporative and immersion cooling techniques, other intentional techniques require additional energy for water pumping/circulation. Water seepage into the module layers has serious effects on the module’s life time and performance. Suitable research gaps in each water-based module cooling technique have been identified and reported. This review work will provide the necessary information to researchers to select suitable cooling techniques based on the requirement for further investigation and development.
The action of a finite group G on a subshift of finite type (SFT) X is called free if every point has trivial stabilizer and it is called inert if the induced action on the dimension group of X is trivial. We show that any two free inert actions of a finite group G on an SFT are conjugate by an automorphism of any sufficiently high power of the shift space. This partially answers a question posed by Fiebig. As a consequence, we obtain that every two free elements of the stabilized automorphism group of a full shift are conjugate in this group. In addition, we generalize a result of Boyle, Carlsen, and Eilers concerning the flow equivalence of G-SFTs.
An entropy-constrained closure is developed for steady quasi-one-dimensional flow of a calorically perfect ideal gas. Net irreversibility is represented by a prescribed entropy change between the inlet and outlet or, equivalently, by a stagnation pressure ratio together with the stagnation temperature ratio implied by the energy balance equation. The thermodynamic constraint, enforced through Gibbs relation together with conservation of mass and energy, yields an algebraic mapping from the inlet flow state, area ratio and prescribed stagnation property ratios to the outlet flow state. The momentum balance is retained only as an auxiliary post-processing relation and may be used to infer integral quantities such as a net wall force or an equivalent mean wall pressure. For an ideal gas with integer number of molecular degrees of freedom $f$, the resulting equation reduces to a polynomial of degree $f+1$ in the squared outlet Mach number. The $f=3$ case reduces to a quartic, and the $f\to \infty$ limit admits an explicit Lambert-$W$ solution; existence, multiplicity, choking and admissibility conditions consistent with the second law of thermodynamics are obtained for general $f$. Classical isentropic nozzle, Rayleigh and Fanno flows, normal shocks, and simultaneous friction and heat transfer in a constant-area duct are recovered in the respective limiting cases. Comparisons with experimental measurements of nozzle wall pressures, sudden expansion outlet Mach numbers and sudden contraction stagnation pressure ratios show good agreement with predictions across a wide range of inlet Mach numbers and area ratios.
En este artículo me propongo abordar Advertencias de uso para una máquina de coser (2017), de Eugenia Prado Bassi; y El clan Braniff (2018), de Matías Celedón, como textos chilenos contemporáneos que utilizan la noción de archivo para crear ficciones documentales. La materialidad de la escritura es el resultado de operaciones que involucran máquinas (fotográfica, fotocopiadora, de coser) y la técnica de montaje o collage, cuyo uso convierte al libro en un dispositivo visual que —como en las vanguardias históricas— rompe con la linealidad de la escritura y al mismo tiempo la vinculan con un referente exterior a ella misma, generando tensiones, negociaciones y ambigüedades en torno a la noción de indexicalidad y de virtualidad.
Neurology and psychiatry have operated as separate disciplines for over a century, yet this division reflects historical and institutional developments rather than the underlying biology of the brain. Contemporary neuroscience shows that brain and mental health disorders share genetic susceptibilities, inflammatory and metabolic pathways, environmental and social risk factors, and clinical features that cross diagnostic boundaries. Cognitive, emotional, sensory, and motor symptoms regularly appear across both neurological and psychiatric populations, and conditions such as seizures, psychosis, mood disorders, cognitive disorders, and sleep disorders are common to both. A brain health framework addresses this reality by treating the brain as a single biological organ whose function emerges from the interplay between genome and exposome – including stress, trauma, social context, existential meaning, pollution, and physical health – and which underlies perception, behaviour, cognition, emotion, resilience, and vulnerability. Translating this perspective into practice requires coordinated action across domains. Clinically, collaborative models such as joint neurology–psychiatry consultations and shared outpatient pathways can be implemented within existing resources to improve diagnostic clarity and continuity of care. In training, a more harmonised curriculum with shared foundations in neurobiology, joint seminars, and cross-rotations would equip clinicians with a common language while preserving specialist depth, and support the emerging fields of preventive neurology and preventive psychiatry. In research, organising studies around shared mechanisms and symptom dimensions, and launching joint funding calls, would enhance translational relevance and reduce duplication. To realise this vision, sustained leadership from European professional bodies is essential to establish collaboration as a shared professional standard.
In 742, unit commanders in the Frankish army were granted priests to hear their soldiers’ confessions. These clerics prescribed penance according to ‘tariff books’ which had been introduced from Ireland and Anglo-Saxon England. This repeatable practice supposedly maintained military morale by assuring soldiers of salvation. However, killing in battle had never been deemed a damnable sin. Soldiers, moreover, could atone without confessing to a priest. This article proposes that the primary aim was not to maintain morale but to purify the army and thereby secure divine providence in war.