Constituent Countries Research Articles

Incidence Trends in Head and Neck Cancer Subsites: A National Population-Based Study (2001-2020).

This descriptive epidemiological study aims to investigate trends in head and neck cancer (HNC) within the anatomical divisions of laryngeal, oropharyngeal, and oral cavity cancers over the past two decades. Retrospective population-based observational study. Scotland, a constituent country of the United Kingdom, with a population of 5.5 million. Newly diagnosed HNC patients in Scotland registered in the Scottish Cancer Registry from 2001 to 2020. Trends in age-standardised incidence rates from 2001 to 2020 for each HNC subsite, anatomical division, and individual sociodemographic using joinpoint regression analysis and Poisson regression analysis. Overall, HNC incidence rates have remained stable, with an average annual percentage change (AAPC) of 0.29% (p = 0.34). However, oropharyngeal cancer showed a significant increase in incidence rates with an AAPC of 3.76% (p < 0.001); the tonsils (C09) and the base of the tongue (C01) experienced the greatest increases in AAPC of 4.63% (p = 0.001) and 4.79% (p < 0.001), respectively. Conversely, laryngeal cancer rates declined significantly, with an AAPC of -2.56% (p < 0.001). This decline was primarily influenced by annual reductions of -2.40% (p = 0.09) in cancers affecting the glottis (C32.0). Incidence rates for oral cavity cancer remained mostly stable, with an AAPC of -0.60% (p = 0.08). This analysis highlights that behind a stable HNC incidence rate over the past 20 years, there are differential trends among various anatomical divisions with an overall increasing burden of oropharyngeal cancer and declining rates of laryngeal cancer.

Data as infrastructure: Systematic data curation addressing fundamental data content differences across the UK

Objective and ApproachHealth Data Research UK, the UK national institute for health data science, is coordinating efforts alongside national academic partners to streamline data curation at disease, population, and data structure level to enhance data offerings and provide networked data infrastructure supporting whole-UK research. Due to clinical, coding, and system differences across the constituent countries of the UK, data is often not standardised for whole-UK analyses, creating burden on research teams and leading to long data preparation times in order to run even distributed analyses. The approach to solve this is multi-faceted, including deploying data curation and cohort creation algorithms into health data providers’ environments, and through the novel integration of federated analytics solutions (such as those piloted through recent national infrastructure programmes) improving data access and research deployment efficiency. ResultsStandardising data through clinical and structural data curation directly deployed to health data providers creates a framework for whole-UK studies to be readily achievable, and provide the data infrastructure base to integrate new technical federated analytics solutions to deploy and reproduce analytics without unnecessary large scale data migration. Conclusions and ImplicationsSystematic curation of health data within national data providing organisations provides flexibility and choice for researchers in terms of the data they will apply for to answer vital research questions affecting the UK populace. Such advances will improve the quality and efficiency of research for all corners of the UK, and create a community of practice in terms of developing data from health systems to research environments.

The current and future cancer burden in the Gulf Cooperation Council (GCC) countries.

Cancer is a leading cause of morbidity and mortality in the Gulf Cooperation Council (GCC) countries. This study aims to provide cancer incidence and mortality estimates in 2020 in the GCC countries alongside future projections for 2040 to shape cancer control policy in the region. The estimated numbers of new cancer cases and deaths were extracted from the GLOBOCAN database developed by the International Agency for Research on Cancer; new cancer cases, cancer deaths, and corresponding age-standardized incidence and mortality rates for the year 2020 are presented. An estimated 42,475 new cancer cases and 19,895 deaths occurred in the GCC countries in 2020, with corresponding age-standardized incidence and mortality rates of 96.5 and 52.3 per 100,000, respectively. Female breast (16%), colorectal (13%), and thyroid (9%) were the most common types of cancer in the GCC countries, accounting for almost 40% of all cancer incidence. Colorectal (14%) followed by breast cancer (9%) were the leading causes of cancer death, though the magnitude of rates of the major cancer types varied substantially across the GCC countries. Even if we assume rates in the region will remain unchanged over the next two decades, the cancer burden in the GCC will increase by 116% (Saudi Arabia) to 270% (Qatar), reaching nearly 104,000 cancer cases by the year 2040. The sharp increase in the estimated cancer incidence and mortality predicted over the next decades in the region requires workforce and financial planning for the healthcare systems in the constituent countries, alongside broader strengthening of national cancer prevention and control efforts.

Varieties of central banking: the Nordic Model beyond a fiscal-centric approach

ABSTRACT Since policymakers and scholars coined the term in the 1930s, the Nordic Model has often been considered to denote a homogeneous political entity in which the constituent countries are ostensibly interchangeable. As a result, seldom attention has been afforded to what fundamentally differentiates Denmark, Finland, Norway, and Sweden. By going beyond traditional ‘fiscal-centric’ accounts of the Nordic model, and instead focusing on the role of central banks and monetary policy, we show that each country bares far less similarities than has often been assumed in the literature. We trace this heterogeneity back to variegated responses to the 1970s crises of Fordist capitalism and draw on growth model theory to explain this divergent trajectory. We show how these differences shaped how each country responded to the Global Financial Crisis and the COVID-19 pandemic, where a variegated array of monetary measures was employed to uphold their own distinct growth model. By accounting for the role of central banks within the Nordic Model, we propose that it is better understood as a series of models, drawing attention to the function of monetary policy within the growth models perspective in the political economy literature.

The forest biodiversity index (FOBI): monitoring forest biodiversity potential over space and time

Public forest agencies are obligated to take steps to conserve and where possible enhance biodiversity, but they often lack information and tools that support and evidence their decision making. To help inform and monitor impact of management actions and policies aimed at improving forest biodiversity, we have co-developed a quantitative, transparent and repeatable approach for assessing the biodiversity potential of the United Kingdom’s (UK) publicly owned forests over space and time. The FOrest Biodiversity Index (FOBI) integrates several forest biodiversity indicators or ‘metrics’, which characterise management-sensitive woodland and landscape features associated with biodiversity. These are measured or modelled annually using spatially comprehensive forest survey data and other well-maintained spatial environmental datasets. Following metric normalisation and a correlation analysis, a statistically robust selection of these metrics is aggregated using a hierarchical procedure to provide composite index scores. The FOBI metric and index results are provided for every individual public forest, and can be summarised across any reporting region of interest. Compared to existing indicators that rely on sample-based forest data, the results thus better support decisions and obligations at a range of scales, from locally targeted action to national, long-term biodiversity monitoring and reporting. We set out how the FOBI approach and associated bespoke online interfaces were co-developed to meet public forest agency needs in two constituent countries of the UK (England and Scotland), whilst providing a conceptual framework that can be adapted and transferred to other geographic areas and private forests. Example results are reported for England’s public forests for four annual timestamps between 2014 and 2021, which indicate improvements to the biodiversity potential of public forests and surrounding landscapes over this time via increases in their diversity, extent, condition and connectivity.

The burden of dermatitis from 1990–2019 in the Middle East and North Africa region

BackgroundThere are several types of dermatitis, each capable of causing enduring changes that extend beyond physical discomfort. In severe cases, dermatitis can significantly affect mental health, social interactions, and the overall quality of life. This study reports the burden of dermatitis in the Middle East and North Africa (MENA) region from 1990 to 2019, according to sex, age category, and socio-demographic index (SDI).MethodsPublicly available data regarding the point prevalence, incidence, and years lived with disability (YLDs) were collected from the Global Burden of Disease 2019 study for both the MENA region and its constituent countries. The point prevalence, incidence, and YLDs of dermatitis were represented as counts and age-standardised rates with 95% uncertainty intervals (UIs).ResultsIn 2019, the age-standardised point prevalence of dermatitis was 2744.6 (2517.8–3003.1) per 100,000 population, which was 2.3% lower than in 1990. The YLD rate was 92.3 (55.6–143.4) per 100,000 population, which was 3.1% lower than in 1990. The largest point prevalence rates were observed among those aged 70–74, for both sexes. The 2019 MENA/Global DALY ratio was not above one in any age group for either sex. During the period 1990 to 2019, there was no clear correlation between the burden of dermatitis and the SDI level.ConclusionThe dermatitis burden in the MENA region remained relatively stable from 1990 to 2019. Future prevention efforts should focus on improving healthcare access, health education, and workplace safety regulations.

Among Independence, Sovereignty and Autonomy: The Dutch Caribbean

This paper critiques the structure and functionality of the 21st century nation-state through analysis of emancipatory decisions in the former Dutch Caribbean colonies of Aruba, Curaçao, and Suriname.Suriname, the most culturally Dutch of the Caribbean territories, was the first of the former colonies to secede from the Netherlands. Although Suriname achieved independence in 1975, the economy remained heavily reliant on the policies of the United States. As such, the Surinamese government prioritized the interests of NATO and struggled to reconfigure its preexisting relationship with the suzerain. This dynamic strained Surinamese relation with Latin American nations more actively resisting US imperialism and isolated Suriname politically.Aruba became a constituent country in 1986; however, this shift was not contemporaneously reflected in Curaçao. Curaçao had headed the former Colony of Curaçao and Dependencies, and independence would have weakened its influence on the other islands whose governing structure would have remained unchanged. While Aruba had the opportunity to claim equal status with Curaçao, it instead pursued emancipation. Demographically Mestizo unlike neighboring islands, Aruba was eager to distinguish itself from Curaçao, where advocacy for decolonization arose with support from regional Black Power movements. Aruba and Curaçao had a long history of human exchange with Latin American continent from the pre-Columbian period. The inhabitants, especially those of African descent excluded from citizenship on the basis of race, moved to Spanish colonies where citizenship was granted upon conversion to Roman Catholicism. The people could use religion to obtain citizenship. They had no loyalty to the European empire nor a sense of belonging to any European kingdom. What they wanted was citizenship and human rights.Around the time Suriname declared independence, European governments began to promote neo-liberal policies that advanced smaller or limited government function. The former Dutch empire was itself abandoning its role as sovereign of a nation-state. Aruba, which had witnessed Suriname’s predicament post-independence and where sense of belonging within the nation-state was historically weak, finally elected to retain within the Dutch Kingdom. To become an independent nation would have entailed severing preexisting ties with Europe and rendered the territory more vulnerable, since globalization often facilitates interference from supranational institutions and military alliances such as the EU and NATO. The trajectory of Aruba prompts questions regarding the true definition and function of the 21st century nation-state.Today, even independent nations comply with international regulations and belong to multinational free trade spheres and military alliances. Due to Dutch disinterest, Aruba and Curaçao enjoyed a greater degree of autonomy. Thus, dependent territories such as Aruba that are capable of maintaining intercontinental and supranational affiliations do not immediately necessitate full independence

Impact of Video Games, Gamification, and Game-Based Learning on Sustainability Education in Higher Education

Today, the European Union and the governments of its constituent countries are focused on the development of the Sustainable Development Goals (SDGs) and the 2030 agenda—something that has been translated into education itself. Video games, gamification, and game-based learning have become different strategies and tools to enhance the learning process and some of the growing approaches used by teachers to develop sustainable education in classrooms. This research aims to analyze the characteristics to promote sustainability in education using games and technology, specifically in terms of learning benefits for higher education. A systematic review of the literature was conducted following the PRISMA methodology. At first, 2025 documents were found; after the filtering phases, the number of articles was reduced to 9, which were subsequently analyzed in depth. The results indicated that the benefits of the use of games mediated by technologies include the following: it favors education for sustainability, and it promotes the educational inclusion and the work of various social skills, such as collaborative and cooperative work. Also, there was an increase in the number of publications between 2019 and 2023, reflecting the growing interest in the topic. However, there are some research gaps in this field.

Establishment of the Smooth-scaled Tegulet (Gymnophthalmus underwoodi) and the Common House Gecko (Hemidactylus frenatus) on St. Eustatius

Within the northern Lesser Antilles, the island of Saint Martin, including the Dutch part (St. Maarten, a constituent country of The Netherlands) and the French part (the Collectivity of Saint Martin), is considered the main hub for established non-native reptiles, currently numbering ten species (Table 1) (Dewynter et al. 2022; Thorpe 2022). The islands of Saba and St. Eustatius are special municipalities of The Netherlands and frequently trade with St. Maarten. During the last five years, several new non-native reptile species have been reported on Saba and St. Eustatius, which originate from the non-native populations already present on Saint Martin: the Green Iguana, Iguana iguana (van den Burg et al. 2018, 2022) on St. Eustatius, and the Brahminy Blindsnake, Indotyphlops braminus (van den Burg et al. 2021) and Smooth-scaled Tegulet, Gymnophthalmus underwoodi on Saba (van den Burg et al. 2021). It is believed that these newly established populations have been facilitated by poor biosecurity between the islands. Here, we describe the establishment of two species, G. underwoodi and the Common House Gecko, Hemidactylus frenatus, on St. Eustatius.

ICT Applications for People with Speech and Language Disorders

The digital technology used on smartphones and tablets provides entertainment and offers a number of additional materials and content needed in education. The possibility of using computers for educational and therapeutic purposes has enabled children and users with various health problems, motor impairments, and chronic diseases access to information, education, therapeutic work, monitoring and counselling. As part of the EU projects, the EU constituent countries have developed programmes and applications aimed at education. The project “ICT Competence Network for Innovative Services for Persons with Complex Communication Needs (ICT-AAC)” took place from March 2013 to March 2015 and was carried out by the University of Zagreb in collaboration with other stakeholders: associations and companies. The developed applications are applicable for educational and therapeutic purposes in education as a teaching method and a tool in treating speech and language disorders within speech therapy. In addition to education, there are also applications for communication purposes for people with complex communication needs. This paper briefly presents some of the ICT-AAC applications and their implementation in working with the intended users.

Государства ЕС и пандемия: «за» и «против» евроинтеграции

The article retrospectively analyzes aspects of the development of European integration, which have acquired particular importance during the spread of the coronavirus pandemic in European Union. The author analyzes the trends and prospects for European integration that have emerged during the pandemic, based on the consideration of the foreign policy interests of the EU countries and the systemic role of the EU in the world, influencing the foreign policy of its constituent countries. However, the EU states have shown a tendency to use the advantages of the EU as a regional integration association in the fight against coronavirus, while at the same time have not made the integration processes irreversible. Important issues turned out to be such as the economic benefits of European integration, the role of the EU's soft power in the world, the EU's political splits, and the promptness of the EU's response to international problems. The European Union has shown itself to be a significant player in solving the internal problems of its members, but not so much as to completely replace the activities of local actors. The author emphasizes that the problems and contradictions indicated in the article were typical for the pandemic phase in 2020–2021, while the latest events of the Ukrainian crisis brought new challenges to the fore.

How Can the EU Beating Cancer Plan Help in Tackling Lung Cancer, Colorectal Cancer, Breast Cancer and Melanoma?

Cancer is the second leading cause of mortality in EU countries, and the needs to tackle cancer are obvious. New scientific understanding, techniques and methodologies are opening up horizons for significant improvements in diagnosis and care. However, take-up is uneven, research needs and potential outstrip currently available resources, manifestly beneficial practices—such as population-level screening for lung cancer—are still not generalised, and the quality of life of patients and survivors is only beginning to be given attention it merits. This paper, mainly based on a series of multistakeholder expert workshops organised by the European Alliance for Personalised Medicine (EAPM), looks at some of those specifics in the interest of planning a way forward. Part of this exercise also involves taking account of the specific nature of Europe and its constituent countries, where the complexities of planning a way forward are redoubled by the wide variations in national and regional approaches to cancer, local epidemiology and the wide disparities in health systems. Despite all the differences between cancers and national and regional resources and approaches to cancer care, there is a common objective in pursuing broader and more equal access to the best available care for all European citizens.

GCC Countries’ Financial Scenario: FDI Impression on GDP

Foreign direct investment is accumulation of equity capital, borrowings, and plough back of gains. Foreign financing inflows have significant effect in transforming economy of a nation. However, this investigation makes an effort to test the significance of FDI inflows on GDP apropos constituent countries of Gulf Cooperation Council. The study commenced with the motive to check the trend in FDI inflows and its growth rate, FDI’s impression on GDP, and impact of FDI on per capita GDP in GCC countries. The study is based on secondary data and analytical research design is applied. The study utilized a data of GDP and per capita GDP pertaining from 2000 to 2019. Statistical techniques, such as two-way ANOVA and pair-wise comparison, are applied. It can be concluded that there is cogent variation in GDP and per capita GDP due to inflow of FDI among GCC countries.

Population attributable risk for colorectal and breast cancer in England, Wales, Scotland, Northern Ireland, and the United Kingdom.

The population attributable risk (PAR) is a statistic commonly used for quantifying preventability of cancer. We report here PAR estimates for the United Kingdom (UK) along with its constituent countries for up-to-date risk factor-attributable colorectal cancer (CRC) and breast cancer (BC), focusing on diet and nutrition related factors and tobacco (CRC) using representative national surveys. The PAR was calculated using established, modifiable risk factors by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR): physical activity, body mass index (BMI), alcoholic drinks, red meat, processed meat, dietary fiber, dietary calcium, as well as cigarette smoking for CRC, and physical activity, BMI, alcoholic drinks, and fruits and vegetable consumption for BC. National prevalence estimates and relative risks (RRs) for CRC and BC were obtained from meta-analyses or large pooled analyses. Based on eight dietary and lifestyle risk factors, the estimates for attributable cases of CRC for males and females, respectively, were as follows: England: 67% and 60%; Scotland: 68% and 59%, Wales: 66% and 61%; Northern Ireland: 67% and 61%; and UK: 67% and 60%. Excluding smoking, the PAR for the UK was 61% for men and 52% for women. Based on four dietary and lifestyle risk factors, the estimates for BC were as follows: England: 26%, Scotland: 27%; Wales: 25%; Northern Ireland: 26%; and UK: 27%. Up to 67% for CRC and 27% of BC were attributable to modifiable dietary and lifestyle factors in the UK. Moderate differences in PAR are observed between countries due to different prevalence of exposure to risk factors.

Scenario‐based fertility projections incorporating impacts of COVID‐19

AbstractThis paper examines the recent declines in period fertility in the constituent countries of the UK during the past decade and speculates mechanisms through which the COVID‐19 pandemic could influence childbearing in the UK. The effects are likely to differ by age and presence of children. Considering potential forces acting on individuals at different ages and family sizes, we expect that the COVID‐19 pandemic will depress fertility, particularly among younger people. Because fertility at all ages was declining before the onset of the pandemic, this could mean a further decline in period fertility to historically low UK levels. We put forward a number of scenarios to examine the possible impact of the pandemic on numbers of live births. Our projections show that for three scenarios out of four, fertility is expected to decline over the next 3 years, leading to significantly fewer births annually compared with the pre‐pandemic period.

Temporospatial distribution and country of origin of canine transmissible venereal tumours in the UK.

Transmissable venereal tumour (TVT) is a tumour transplanted by physical contact between dogs. Lesions typically affect the genitalia. TVT is not considered enzootic in the United Kingdom (UK), with cases seen in imported dogs. We sought to determine the patient characteristics, temporal and spatial distribution and country of origin of affected dogs in the UK. Electronic pathology records (EPRs) from four UK veterinary diagnostic laboratories collected between 2010 and 2019 were searched for the terms 'venereal' or 'TVT'. Reports were reviewed for statements confirming a TVT and descriptive statistics collated. Of 182 EPRs matching the search terms, a diagnosis of TVT was confirmed in 71. Country of origin was noted in 36 cases (50.7%) with Romania being the most common (n=29). Cases were reported in each UK constituent country, with the majority being in England (64, 90.1%). The incidence of TVT diagnosis increased over the last decade (z=2.78, p=0.005). The incidence of TVT diagnosed in the UK is increasing. The majority of cases were known to have been imported. Autochthonous transmission cannot be excluded due to study design. Vets are encouraged to carefully examine the genitalia of dogs imported to the UK from countries with enzootic TVT.

Understanding variations in reported epidemiology of major lower extremity amputation in the UK: a systematic review

ObjectiveEstimate the prevalence/incidence/number of major lower extremity amputations (MLEAs) in the UK; identify sources of routinely collected electronic health data used; assess time trends and regional variation; and identify reasons...

Higher education financing and the educational aspirations of teenagers and their parents

We study the impact of higher education financing on the academic aspirations of teenagers and their parents. We exploit a reform which introduced a large increase in the tuition fees universities can charge, more generous support for the poorest students and a more redistributive student loan system, and varied across the UK’s constituent countries. Using rare survey data on post compulsory secondary and university education aspirations, we find that teenagers’ aspirations are not responsive to large changes in higher education financing. In contrast, parents adjust their aspirations, resulting in a reduction of the socio-economic aspiration gap for their children.

Global View of Per Capita Daily Vitamin D Supply Estimates as Proxy Measures for Vitamin D Intake Data.

ABSTRACTNationally representative data on vitamin D intake can inform on the adequacy of dietary supply of vitamin D in a population, but such data is lacking for a majority of countries. Estimates of average per capita supply of vitamin D, as calculated using information from the Food and Agriculture Organisation of the United Nations (FAO) national food balance sheets (FBSs) can be used as proxy measures for vitamin D intake within a population. In the present work, FAO national FBSs (from 2004 to 2017) for 173 to 178 countries around the globe were used to generate such average per capita vitamin D supply estimates. For countries where food fortification with vitamin D was common, the estimates accounted for this. Using the 2004–2013 FBS data, there was a large range in average per capita vitamin D supply ranging from 0.3 (Ethiopia) to 17.8 (Maldives) μg/d. Globally, 40, 60, 70, four, two, and two countries had average per capita vitamin D supply estimates <1.5, 1.6–3, 3.1–5.5, 5.6–7.5, 7.6–10, and >10 μg/d, respectively. Pelagic fish was the major contributory food commodity (supplying 53%–86%) in countries with supply >7.6 μg/d. Median per capita vitamin D supply estimates for constituent countries within Africa, Americas, Asia, Europe, and Oceania were 1.4, 2.7, 2.8, 4.1, and 4.7 μg/d, respectively. These overall supply trends were mirrored in the newer, 2014–2017 FBS data. Fortification of milk and dairy or wheat flour with vitamin D had an important impact on the vitamin D supply estimates (average increments of 1.6 and 3.1 μg/d, respectively). Overall, the work showed how the per capita daily vitamin D supply estimates, as surrogate for vitamin D intake data, can highlight countries where inadequacy of supply may be of concern. It also shows how fortification of food with vitamin D can have an important impact on addressing low vitamin D intake. © 2021 The Author. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Economic costs of biological invasions in the United Kingdom

Although the high costs of invasion are frequently cited and are a key motivation for environmental management and policy, synthesised data on invasion costs are scarce. Here, we quantify and examine the monetary costs of biological invasions in the United Kingdom (UK) using a global synthesis of reported invasion costs. Invasive alien species have cost the UK economy between US$6.9 billion and $17.6 billion (£5.4 – £13.7 billion) in reported losses and expenses since 1976. Most costs were reported for the entire UK or Great Britain (97%); country-scale cost reporting for the UK's four constituent countries was scarce. Reports of animal invasions were the costliest ($4.7 billion), then plant ($1.3 billion) and fungal ($206.7 million) invasions. Reported damage costs (i.e. excluding management costs) were higher in terrestrial ($4.8 billion) than aquatic or semi-aquatic environments ($29.8 million), and primarily impacted agriculture ($4.2 billion). Invaders with earlier introduction years accrued significantly higher total invasion costs. Invasion costs have been increasing rapidly since 1976, and have cost the UK economy $157.1 million (£122.1 million) per annum, on average. Published information on specific economic costs included only 42 of 520 invaders reported in the UK and was generally available only for the most intensively studied taxa, with just four species contributing 90% of species-specific costs. Given that many of the invasive species lacking cost data are actively managed and have well-recognised impacts, this suggests that cost information is incomplete and that totals presented here are vast underestimates owing to knowledge gaps. Financial expenditure on managing invasions is a fraction (37%) of the costs incurred through damage from invaders; greater investments in UK invasive species research and management are, therefore, urgently required.