Claiming but connected to work : Welfare at a (Social) Distance Rapid Report #1

This report presents the first findings from the Welfare at a (Social) Distance project, a major national research project investigating the benefits system during the COVID19 pandemic, funded by the Economic and Social Research Council as part of UK Research and Innovation’s rapid response to COVID-19. It draws upon a new survey of 2,364 new Universal Credit (UC)/Jobseekers’ Allowance (JSA) claimants (carried out between 25th May and 3rd June) to look at how far benefit claimants are connected to the world of work, helping to better understand the emerging picture from recent UK labour market statistics

Claiming But Connected to Work

This report presents the first findings from the Welfare at a (Social) Distance project, a major national research project investigating the benefits system during the COVID-19 pandemic, funded by the Economic and Social Research Council as part of UK Research and Innovation’s rapid response to COVID-19. It draws upon a new survey of 2,364 new Universal Credit (UC)/Jobseekers’ Allowance (JSA) claimants (carried out between 25th May and 3rd June) to look at how far benefit claimants are connected to the world of work, helping to better understand the emerging picture from recent UK labour market statistics

Performing heritage: the use of live 'actors' in heritage presentations

This paper investigates the phenomenon of 'living history' presentations of heritage, using live 'actors' to portray historical characters. Its aim is to discuss these presentations in the context of what may be understood as 'heritage', and of the nature of 'performance'. Four case studies of heritage sites, each important as a tourist attraction, have been selected for detailed study, together with a number of other examples of heritage performance. It is clear from the empirical work that different performance strategies are employed within the heritage industry and by individual 'actors'. Most of the performers take part as a leisure activity, and many do not consider themselves to be 'performing' at all. The greatest concern of participants lies in the degree of authenticity of the performance. Through 'living history', the 'actors' are drawn into an experience of heritage which has real meaning for them, and which may contribute both to a sense of identity and to an enhanced understanding of society, past and present. The popularity of such presentations with visitors also indicates that similar benefits are perceived by the 'audience'

At the edge of the safety net: Unsuccessful benefits claims at the start of the COVID-19 pandemic

There has been much scrutiny of the British benefits system during COVID-19, and most experts agree that the benefits system has performed well, even if historic weaknesses remain. Yet little attention has been paid to those who start a claim that is ultimately not successful. This report focuses on these ‘unsuccessful claimants’, using new YouGov survey data and interview evidence funded by the Health Foundation

Macrophage Subset Sensitivity to Endotoxin Tolerisation by Porphyromonas gingivalis

Macrophages (MΦs) determine oral mucosal responses; mediating tolerance to commensal microbes and food whilst maintaining the capacity to activate immune defences to pathogens. MΦ responses are determined by both differentiation and activation stimuli, giving rise to two distinct subsets; pro-inflammatory M1- and anti-inflammatory/regulatory M2- MΦs. M2-like subsets predominate tolerance induction whereas M1 MΦs predominate in inflammatory pathologies, mediating destructive inflammatory mechanisms, such as those in chronic P.gingivalis (PG) periodontal infection. MΦ responses can be suppressed to benefit either the host or the pathogen. Chronic stimulation by bacterial pathogen associated molecular patterns (PAMPs), such as LPS, is well established to induce tolerance. The aim of this study was to investigate the susceptibility of MΦ subsets to suppression by P. gingivalis. CD14hi and CD14lo M1- and M2-like MΦs were generated in vitro from the THP-1 monocyte cell line by differentiation with PMA and vitamin D3, respectively. MΦ subsets were pre-treated with heat-killed PG (HKPG) and PG-LPS prior to stimulation by bacterial PAMPs. Modulation of inflammation was measured by TNFα, IL-1β, IL-6, IL-10 ELISA and NFκB activation by reporter gene assay. HKPG and PG-LPS differentially suppress PAMP-induced TNFα, IL-6 and IL-10 but fail to suppress IL-1β expression in M1 and M2 MΦs. In addition, P.gingivalis suppressed NFκB activation in CD14lo and CD14hi M2 regulatory MΦs and CD14lo M1 MΦs whereas CD14hi M1 pro-inflammatory MΦs were refractory to suppression. In conclusion, P.gingivalis selectively tolerises regulatory M2 MΦs with little effect on pro-inflammatory CD14hi M1 MΦs; differential suppression facilitating immunopathology at the expense of immunity

Consensus Recommendations for Sick Day Medication Guidance for People With Diabetes, Kidney, or Cardiovascular Disease:A Modified Delphi Process

Rationale &amp; Objective: Sick day medication guidance (SDMG) involves withholding or adjusting specific medications in the setting of acute illnesses that could contribute to complications such as hypotension, acute kidney injury (AKI), or hypoglycemia. We sought to achieve consensus among clinical experts on recommendations for SDMG that could be studied in future intervention studies. Study Design: A modified Delphi process following guidelines for conducting and reporting Delphi studies. Setting &amp; Participants: An international group of clinicians with expertise relevant to SDMG was recruited through purposive and snowball sampling. A scoping review of the literature was presented, followed by 3 sequential rounds of development, refinement, and voting on recommendations. Meetings were held virtually and structured to allow the participants to provide their input and rapidly prioritize and refine ideas.Outcome: Opinions of participants were measured as the percentage who agreed with each recommendation, whereas consensus was defined as &gt;75% agreement. Analytical Approach: Quantitative data were summarized using counts and percentages. A qualitative content analysis was performed to capture the context of the discussion around recommendations and any additional considerations brought forward by participants. Results: The final panel included 26 clinician participants from 4 countries and 10 clinical disciplines. Participants reached a consensus on 42 specific recommendations: 5 regarding the signs and symptoms accompanying volume depletion that should trigger SDMG; 6 regarding signs that should prompt urgent contact with a health care provider (including a reduced level of consciousness, severe vomiting, low blood pressure, presence of ketones, tachycardia, and fever); and 14 related to scenarios and strategies for patient self-management (including frequent glucose monitoring, checking ketones, fluid intake, and consumption of food to prevent hypoglycemia). There was consensus that renin-angiotensin system inhibitors, diuretics, nonsteroidal anti-inflammatory drugs, sodium/glucose cotransporter 2 inhibitors, and metformin should be temporarily stopped. Participants recommended that insulin, sulfonylureas, and meglitinides be held only if blood glucose was low and that basal and bolus insulin be increased by 10%-20% if blood glucose was elevated. There was consensus on 6 recommendations related to the resumption of medications within 24-48 hours of the resolution of symptoms and the presence of normal patterns of eating and drinking. Limitations: Participants were from high-income countries, predominantly Canada. Findings may not be generalizable to implementation in other settings. Conclusions: A multidisciplinary panel of clinicians reached a consensus on recommendations for SDMG in the presence of signs and symptoms of volume depletion, as well as self-management strategies and medication instructions in this setting. These recommendations may inform the design of future trials of SDMG strategies.</p

Claimants’ experiences of the social security system during the first wave of COVID-19

COVID-19 arrived in the UK early in March 2020. By 23rd March 2020, the UK experienced the first national lockdown. As businesses and livelihoods stalled, an unprecedented number of applications were made for Universal Credit (UC). Drawing on data from the most comprehensive national study examining working-age benefits — i.e. Employment and Support Allowance (ESA), Jobseekers Allowance (JSA) and Universal Credit (UC) — during the pandemic, this report provides an understanding of the experiences of benefit claimants during the first wave of COVID-1