How men receive and utilise partner support when trying to change their diet and physical activity within a men’s weight management programme

We thank: the FFIT participants and their partners who took part in the research; The Scottish Premier Football League (SPFL) Trust, the football clubs and the coaches; and the Population Health Research Facility at MRC/CSO Social and Public Health Sciences Unit, University of Glasgow.Peer reviewedPublisher PD

Size-at-maturity of Brown Crab (Cancer pagurus) in Scottish waters based on gonadal and morphometric traits

CRediT authorship contribution statement Carlos Mesquita: Conceptualization, Methodology, Formal analysis, Writing - original draft. Helen Dobby: Conceptualization, Writing - review & editing, Supervision. Stephanie Sweeting: Methodology, Data curation, Formal analysis. Catherine S. Jones: Supervision, Writing - review & editing. Graham J. Pierce: Conceptualization, Writing - review & editing, Supervision.Peer reviewedPostprin

Societal costs of chemotherapy in the UK: an incidence-based cost-of-illness model for early breast cancer

Aim To estimate annual societal costs associated with chemotherapy for early breast cancer in the UK. Design Mixed methods: (a) an incidence-based cost-of-illness model was developed of indirect costs in patients with breast cancer and carers, and estimated from diagnosis through active treatment until death; (b) interviews with stakeholders were also undertaken to understand actual experiences and impacts of these costs. Data sources Model data were collated from relevant national data sources covering general population statistics, UK cancer registries, clinical guidelines and published literature, and patient survey data. Patient and staff views were collected through semistructured interviews. Participants Model: patients with early breast cancer receiving systemic anticancer therapy in the UK. Interviews were undertaken with women who had chemotherapy and medical practitioners involved in breast cancer care. Results Total costs of chemotherapy in the UK economy are over £248 million. Societal productivity losses amount to £141.4 million, which includes £3.2 million associated with premature mortality, short-term and long-term work absence (£28.6 million and £105 million, respectively). £3.4 million is associated with mortality losses from secondary malignancies due to adjuvant chemotherapy. A further £1.1 million in lost productivity arises from informal care provision. Out-of-pocket costs per round of chemotherapy account for £4.2 million, or an annual average of almost £1100 per patient. Interview findings support the cost burden modelled and also highlight the impact on cognitive function of patients and how this could increase the cost burden to patients, their families and wider society. In addition, estimated costs for carer emotional well-being are £82 million in lost quality of life. Conclusion Chemotherapy use carries significant indirect costs for society, as well as patients and their carers. These wider costs and societal perspective should be considered by commissioners to ensure chemotherapy is better targeted at those who most need it and to avoid placing unnecessary costs on patients, their caregivers and wider society

Exploring the links between unhealthy eating behaviour and heavy alcohol use in the social, emotional and cultural lives of young adults (aged 18–25)::A qualitative research study

Alcohol use peaks in early adulthood and can contribute both directly and indirectly to unhealthy weight gain. This is the first qualitative study to explore the links between unhealthy eating behaviour and heavy alcohol use in the social, emotional and cultural lives of young adults. We conducted 45 in-depth interviews with 18–25-year-olds in North-East England to inform development of a dual-focused intervention to reduce health risk due to excess weight gain and alcohol use. Data were analysed thematically, following the principles of constant comparison, resulting in three intersecting themes: (1) how food and alcohol consumption currently link together for this population group; (2) influences upon linked eating and drinking behaviours and (3) young adults’ feelings and concerns about linked eating and drinking behaviours. Socio-cultural, physical and emotional links between food and alcohol consumption were an unquestioned norm among young adults. Eating patterns linked to alcohol use were not tied only to hunger, but also to sociability, traditions and identity. Young adults conceptualised and calculated risks to weight, appearance and social status, rather than to long-term health. This study is the first to evidence the deeply interconnected nature of food and alcohol consumption for many young adults. Findings have important implications for intervention development, UK public health policy and practice, and point to a need for similar research in other countries

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial