Iodine deficiency is now a significant public-health concern in the UK. Data from the National Diet and Nutrition Survey (NDNS; 2019–2023) shows that several population groups are now classified as mildly iodine deficient, including women of childbearing age. This is a change from previous NDNS data where these groups were iodine sufficient. As iodine is needed for thyroid-hormone production, which are essential for brain development, iodine deficiency prior to, and during, pregnancy may have implications for child cognition – including lower IQ. However, the evidence base for the health effects of mild deficiency is not as strong as in severe deficiency. The WHO recommends salt iodisation to control iodine deficiency in a population, but such a policy was never introduced in the UK and iodised salt is not widely available. While UK milk is rich in iodine and is the principal source, the rise in popularity of plant-based milk alternatives may increase the risk of iodine deficiency. It may be necessary to give personalised advice to those with low iodine intake, but identify those at risk is challenging owing to a lack of a biomarker for iodine in an individual. Population-wide approaches may be required in the UK – for example, fortification of bread with iodised salt or mandatory iodine fortification of plant-based dairy alternatives. This review will critically discuss (i) the data on iodine deficiency in the UK (ii) the evidence base for the health implications of mild deficiency and (iii) the potential public-health solutions.

Scholars often analyse Western–Chinese legal conflicts in the nineteenth-century Qing empire through the lens of extraterritoriality. This article examines the 1895 anti-missionary riot in Chengdu and the ensuing dispute over the responsibility of Qing officials. It highlights the protection of foreign lives and property as a key area of contestation between Western powers and the Qing empire. During the riot, Chengdu authorities exploited their discretionary power to challenge missionary presence and undermine treaty obligations. In response, Western powers began a concerted effort to hold local officials accountable by pressuring the Qing state to impose severe punitive sanctions. The riot and its aftermath reveal how a non-Western state negotiated and enforced obligations required by Eurocentric international law. Protection emerges as a multifaceted instrument for the projection of imperial power and a malleable component of the Western-imposed treaty system, mediating the asymmetrical international relations in the nineteenth century.

The article proposes a new approach to estimating the latent distribution of item response theory (IRT) using kernel density estimation (KDE), particularly the solve-the-equation (STE) algorithm developed by Sheather and Jones (1991). As with existing methods, the KDE method aims to estimate the latent distribution of IRT to reduce biases in parameter estimates when the normality assumption on the latent variable is violated. Simulation studies and an empirical example confirm the robustness of algorithmic convergence of the KDE approach, and show that the KDE approach yields parameter estimates that are more accurate than or comparable to existing methods. Unlike other approaches that require multiple model fits for smoothing parameter selection, KDE requires only a single model-fitting step, substantially reducing computation time. These findings highlight KDE as a practical and efficient method for estimating latent distributions in IRT.

Integrated Soil Fertility Management (ISFM) refers to a holistic approach to managing soil fertility that combines a variety of techniques and practices to improve soil health and enhance agricultural productivity, particularly in smallholder farming systems. Despite the associated higher labor and other input demands associated with ISFM adoption, there is limited empirical evidence regarding the positive outcomes of these investments at the household level. Using data from 380 tomato farmers in three regions of Ghana, we explore the relationship between ISFM adoption and household welfare. The methodology employed relies on inverse probability weighting regression adjustment (IPWRA). The findings reveal that ISFM adoption positively impacts household welfare by increasing net income by GH₵436.88 ($60.43)/ha, improving household assets by GH₵518.17 ($71.67)/ha, enhancing food security by 1.23 points, and reducing household expenditure by GH₵57.39 ($7.94)/ha. The results highlight ISFM’s potential to enhance smallholder welfare through increased income, improved household assets, and better food security, contributing to poverty reduction and sustainable agricultural development. Policies should focus on improving access to fertilizers, seeds, and pesticides, coupled with extension services and farmer education programs to promote ISFM adoption. Tailored interventions targeting older and more experienced farmers, as well as household heads, are essential to overcome barriers to adoption and maximize the economic and welfare benefits of ISFM practices.

In the UK, approximately 64,000 individuals are living with an ileostomy. This surgery creates an opening in the abdominal wall (stoma), allowing for diversion of egesta into a disposable pouch. This procedure impacts nutrient absorption meaning people living with an ileostomy may be subject to sub-optimal nutrition, often compounded by the low-fibre diet – which is frequently encouraged post-operatively. This review explores the restrictive dietary patterns of this population and their effects on nutrition and quality of life, alongside current approaches to improve dietary management and health outcomes. Dietary restriction beyond the post-operative period is frequently reported, with avoidance of high-fibre foods (e.g., fruits and vegetables) being most prevalent. These long-term dietary changes are presumed to impact nutritional status, with current evidence suggesting diminished bone mineral density and vitamin B12. High-output stoma (HOS) and dehydration are significant issues for people living with an ileostomy, and dietary management of stoma output and other ileostomy-related symptoms is a major contributor to food avoidance. The efficacy of oral rehydration solutions (ORS) in management of HOS is well-established; however, due to high concentrations of glucose and sodium, the palatability of such treatments is poor, impacting patient adherence. Encouragingly, personalised dietary advice has shown some positive effects on both quality of life and nutritional outcomes for people living with an ileostomy. However, a greater understanding of dietary management is needed, and there remains scope to improve current dietary advice and enable people living with an ileostomy to benefit from a more complete and unrestricted diet.

Biliary atresia is a rare bile duct disease resulting in intestinal bile salt depletion due to poor bile flow. Medium-chain triglyceride (MCT) supplementation is widely recommended and used as the main dietary management in infants, however evidence for its use is limited and there is uncertainty regarding the optimal percentage (proportion of total fat that is MCT) and dose (grams/kilogram/day, g/kg/d). The aim was to review the evidence for the impact of MCT on fat absorption, growth, nutritional status and clinical outcomes in infants with biliary atresia and the optimal nutrition profile of MCT supplementation. A scoping review found that the mostly observational, historic evidence for MCT supplementation pointed to greater fat absorption during MCT supplementation compared to no supplementation, but also some evidence of a risk of essential fatty acid deficiency with very high MCT percentage. Only six studies have investigated MCT percentages and only three reported MCT dose. One analysis of MCT in the largest cohort of biliary atresia patients ever presented (n = 200), found no association between MCT percentage with growth, nutritional status or clinical outcomes. Counterintuitively, there was an unexpected inverse association between MCT dose and growth. A possible interpretation was that increased MCT was a consequence of poor growth rather than a cause, as infants either drank more or dietitians prescribed more MCT as fat malabsorption worsened. In conclusion, MCT is widely recommended, however, the evidence for its use is lacking and there remains uncertainty about the optimum percentage and dose for infants with biliary atresia.

The public sphere burgeoned in Korea with the country’s liberation from Japanese colonial rule in 1945, but it took South Korean intellectuals almost two decades to begin questioning the vision of Korean history formed under Japanese influence. This article explores the decolonisation of Korean historiography as reflected in the leading intellectual magazine of the time, Sasanggye (1953–1970). The analysis demonstrates a rapid substitution of the Japanese knowledge system with the American one and a more gradual change in Sasanggye contributors’ attitudes toward history, from the unconditional application of Western standards to a desire to write a “subjective history” of Korea from their own perspective. Still, the epistemology remained only partially decolonised as many epistemes of the colonial era persisted in the circumstances of colonial education-induced myopia, overwhelming American influence, national division and rivalry with North Korea, as well as the even more partial decolonisation of politics, economy, and diplomacy.

The effect of the narrator is understudied in the Narrative Policy Framework. We offer a systematic approach that details narrator definition, features (proximity to audience), and functions (audience trust). Informed by Construal Level Theory, we conducted an exploratory study (n = 2268) that assigned proximal to distal narrator features (“your friend,” “your doctor,” “the CDC,” and a control “someone”) and affixed narrators to visual messages about getting the COVID-19 vaccine. We investigated the extent to which proximity, trust, and congruence between narrator and narrative form predicts motivation to vaccinate. Narrator alone had no significant effect, but the proximal narrator paired with proximal characters in the policy message did have significant effects on motivation to vaccinate. Individual trust of distal narrators elicits affective responses, whereas individual trust of the proximal narrator is associated with motivation. These results suggest effects of narrator feature, characteristic, and function are dynamic and contextual.

This essay problematizes the place of “culture” in Africa-China studies whereby culture is often sidelined as the devalued supplement to political-economic data. Instead, cultural narratives and processes are inseparable from how knowledge and Africa-China relationality are made. We consider how multi-directional reflexivity about the production of a knowledge object (“Africa-China/China-Africa”) intervenes in both outdated forms of Cold War-inflected area studies and emergent hawkish nationalist scholarship. This essay considers Africa-China as method, an approach based in transregional theorizing and relational analysis that attends to the politics of knowledge production and resists instrumentalization of scholarly findings by imperialist or ethnonationalist agendas.

The trend towards health-conscious consumption has led the food industry to enhance the nutritional content of staple products like yoghurt. This review explores the integration of nutrient-rich fruit peels into yoghurt, emphasizing both health benefits and technological advancements. Fruit peels, which are frequently discarded as agro-industrial waste, are abundant in nutrients, antioxidants and dietary fibres, which can boost yoghurt's nutritional profile. Incorporating fruit peels not only supports waste reduction and sustainability but also contributes to the added value of yoghurt products. Technological innovations have made it possible to efficiently process and incorporate these peels while preserving their benefits. The review evaluates various methods such as fermentation, drying and grinding and their effects on yoghurt's taste, texture and shelf-life. Additionally, it considers consumer acceptance and market potential for these enhanced yoghurts. Overall, this approach highlights the promise of fruit peels as functional ingredients, promoting health benefits and advancing yoghurt production technologies.

Artificial intelligence is increasingly being used in medical practice to complete tasks that were previously completed by the physician, such as visit documentation, treatment plans and discharge summaries. As artificial intelligence becomes a routine part of medical care, physicians increasingly trust and rely on its clinical recommendations. However, there is concern that some physicians, especially those younger and less experienced, will become over-reliant on artificial intelligence. Over-reliance on it may reduce the quality of clinical reasoning and decision-making, negatively impact patient communications and raise the potential for deskilling. As artificial intelligence becomes a routine part of medical treatment, it is imperative that physicians recognise the limitations of artificial intelligence tools. These tools may assist with basic administrative tasks but cannot replace the uniquely human interpersonal and reasoning skills of physicians. The purpose of this feature article is to discuss the risks of physician deskilling based on increasing reliance on artificial intelligence.

Over the last decade in the UK the number of medically trained addiction specialists has halved, to record low numbers. Despite acknowledgment of this crisis by the UK Government in its recently published 10-Year Strategic Plan for the Addiction and Recovery Workforce, psychiatric training remains the only available route to gain specialist medical accreditation in the treatment of addiction disorders. This article asks if it is time for the UK to embrace the creation of a new physician-led addiction medicine specialty akin to models developed in Australia and other peer countries.