Funding Period Research Articles

O.4.4-2 Cross-sectoral sporting programs aimed at children from low-income families: lessons learnt from the Netherlands

Abstract Purpose Children from low-income families participate less often in sport and physical activity than children from high-income families. In the Netherlands, sporting programs were implemented by sports clubs in collaboration with other local organizations to stimulate physical activity among children from poor families. These programs were funded by the Dutch government within the program ‘Sport Impulse Youth from Low Income Neighborhoods’ (2014-2020). The aim of the research was to get insight into the implementation and successfulness of these sporting programs with regard to increasing sport participation among the target group. Methods After the two-year funding period, online questionnaires were sent to project coordinators and group interviews were conducted with project coordinators and collaborating partners (funding period 2014-2017). During the final funding period (2018-2020), also group interviews were conducted with participating children and parents. The research focused on the reach and implementation of the programs, involvement of parents, experienced effects, and factors influencing sport participation among the target group. Results Sporting programs were often adapted to the local context. Furthermore, there was little collaboration with key figures in the neighborhood that were close to the target group. The target group was predominantly reached through providing sport activities at schools in low-income neighborhoods. Providing different sport activities and personal guidance, stimulated children’s participation. However, a lack of follow-up activities and a lack of parental involvement, hindered structural sport participation. Conclusions The target group can be reached with these kind of sporting programs. To enhance program effectiveness, it is important to involve parents and to ensure suited follow-up activities are available. Furthermore, it is important that the sport coach is someone who is familiar with the background of the target group. Moreover, collaborations with key figures in the neighborhood could help in attracting more participants. Finally, adaptations in sporting programs should be thoroughly monitored. Funding source This study was funded by ZonMw, The Netherlands.

Opportunities and Limits of a Disciplinary Repository Using the Example MO|RE data (eResearch Infrastructure for Motor Research Data)

Out of two funding periods by the German Research Foundation resulted the first disciplinary repository for sports science motor activity research data MO|RE data. MO|RE data addresses sports scientists, researchers from related disciplines and practitioners such as teachers and educators, which work with or generate human motor performance test data as well. It has five main functions: publishing, storing, searching, citing and mapping. There are still some limitations as well as not exploited opportunities. Opportunities include among others the international expansion. Limitations are e.g., that linking health and motor test data is difficult due to data protection law. The sharing of sensitive data is not possible with the current concept and needs further solutions as e.g., remote access or workstations for guest researchers. In future, those data sets must be kept in mind to cover the requirements of research data management in sports science. Overall, the need for further development and optimization of MO|RE data repository in sports science becomes apparent to maximize its potential and ensure that it meets the evolving needs of researchers in the field.

Neighbourhood regeneration through a longitudinal lens: Exploring crisis temporalities in Bristol, UK

AbstractThis paper employs a longitudinal lens to examine the temporal dimensions of urban neighbourhood regeneration. Specifically, it focuses on four neighbourhoods in Bristol, UK, which were subject to the flagship New Deal for Communities programme from 2000 to 2010. By combining past research into the (then) emerging impact of the NDC with data from more recent enquiries into the daily lives and experiences of residents after the programme's end, the paper considers if and how these neighbourhoods were altered and whether the NDC programme continues to have impact beyond its funding period. The aim is not simply to evaluate the programme's success and legacy, but also to reflect on how past policies interact with present and future temporalities. As such, community perspectives of continuity and change are used as a basis for discussion of the ways in which the urban present is assembled. Within this discussion, the impact of the coronavirus emergency and austerity measures on these neighbourhoods is considered. Both crises underline that regeneration is a dynamic and vulnerable process that does not follow a predetermined or linear trajectory. For this reason, the paper emphasises the need to move beyond singular, snapshot inquiries and instead adopt a longitudinal approach that considers developments beyond the immediate and visible outcomes of urban policy.

Startup grants and the development of academic startup projects during funding: Quasi-experimental evidence from the German ‘EXIST – Business startup grant’

Public support programs for (academic) startups are an important component of innovation and technology policy. There are many types of startup policy instrument, one of which is supporting prospective founders with startup grants. The present study contributes to the literature by examining the effectiveness of a specific startup grant entitled ‘EXIST – Business Startup Grant’. This measure is Germany’s largest public startup support program and aims to increase the number of technology-oriented and knowledge-based academic startups. The present research investigates the extent to which products of funded startups, the projects’ business planning, the founders’ skills, the degree of networking, and the uptake of external funding evolve over the duration of the grant. Evidence of the effects on these variables is generated by means of a pipeline-based comparison group design. Findings indicate that the startup grant contributes substantially to the development of the products and the business planning of the funded startups, moderately increases their degree of networking and their uptake of external funding, and slightly improves the skills of the founding team during the funding period. Several robustness checks – including a replication by another type of research design, namely a pre-post comparison – strongly support the findings. Hence it is very likely that the program advances startups in their development and thus contributes to later economic success.

How to be in the current situation?

Russian science has faced a number of new challenges that dictate the need to mobilize human and material resources. The article proposes to evaluate the resources that Russian science has at the present time. It is noted that science, as one of the institutions inscribed in the social order, followed and continues to follow the rules of the game that are set by external subjects. After a long period of funding, reforms traumatizing the scientific community, the possibilities of Russian science for independent development are limited. One of its main problems today lies in the field of reproduction, replenishment with qualified personnel capable of independent scientific activity. It is not easy to achieve this, because in the previous period, Russian scientists were oriented towards integration into world science in the role of a catching-up subject, repeating the patterns of Western scientific institutions. In order to change the situation, it is important to radically change the attitude towards scientists, significantly increase funding for science, show respect for the traditions that Russian science has accumulated and were in the past the foundation of its global achievements.

Rationale, Design, and Methods for the Sedentary Behavior Reduction in Pregnancy Intervention (SPRING): Protocol for a Pilot and Feasibility Randomized Controlled Trial.

Adverse pregnancy outcomes (APOs) identify cardiovascular disease risk, but few effective interventions are available. High sedentary behavior (SED) has recently been associated with APOs, but very few randomized controlled trials (RCTs) have tested SED reduction in pregnancy. The Sedentary Behavior Reduction in Pregnancy Intervention (SPRING) pilot and feasibility RCT addresses this gap by testing the feasibility, acceptability, and preliminary pregnancy health effects of an intervention to reduce SED in pregnant women. The objective of this manuscript is to describe the rationale and design of SPRING. Pregnant participants (n=53) in their first trimester, who are at risk for high SED and APO and without contraindications, are randomized in a 2:1 ratio to an intervention or control group. SED (primary outcome) and standing durations, and steps per day, are measured objectively in each trimester for 1 week with a thigh-mounted activPAL3 accelerometer. SPRING also seeks to demonstrate feasibility and acceptability while estimating preliminary effects on maternal-fetal health outcomes assessed during study visits and abstracted from medical records. The pregnancy-customized intervention promotes daily behavioral targets of less than 9 hours of SED and at least 7500 steps, achieved via increased standing and incorporating light-intensity movement breaks each hour. The multicomponent intervention provides a height-adjustable workstation, a wearable activity monitor, behavioral counseling every 2 weeks (through videoconference), and membership in a private social media group. Herein, we review the rationale, describe recruitment and screening processes, and detail the intervention, assessment protocols, and planned statistical analyses. This study was funded by the American Heart Association (20TPA3549099), with a funding period of January 1, 2021, and until December 31, 2023. Institutional review board approval was obtained on February 24, 2021. Participants were randomized between October 2021 and September 2022, with final data collection planned for May 2023. Analyses and submission of results are expected for winter of 2023. The SPRING RCT will provide initial evidence on the feasibility and acceptability of an SED-reduction intervention to decrease SED in pregnant women. These data will inform the design of a large clinical trial testing SED reduction as a strategy to reduce APO risk. ClincialTrials.gov NCT05093842; https://clinicaltrials.gov/ct2/show/NCT05093842. DERR1-10.2196/48228.

Investigating the sustainability of self-help programmes in the context of leprosy and the work of leprosy missions in Nigeria, Nepal and India: a qualitative study protocol

IntroductionLeprosy occurs among very poor people who may be stigmatised and pushed further to the margins of society. Programmes to improve social integration and stimulate economic development have been implemented...

Associations between farmland birds and fallow area at large scales: Consistently positive over three periods of the EU Common Agricultural Policy but moderated by landscape complexity

Abstract Fallow agricultural land provides habitat for threatened and declining farmland biodiversity. Policy change under the EU's Common Agricultural Policy (CAP) has been driving the area of fallows over the past decades. It is still unclear, whether positive relationships between farmland biodiversity and fallow area are general in time and space, and what landscape factors moderate them at large scales. We analysed associations between fallow area and species richness and abundance of 24 farmland birds in 3 years covering three CAP funding periods, by linking agricultural statistics at the district level to plot‐level bird data from a national‐scale monitoring scheme. We tested whether these relationships are moderated by species' habitat preferences and landscape configurational complexity, measured as the edge density of woody features. Species richness was positively associated with fallow area in all three funding periods. We found a hump‐shaped response along a gradient of increasing landscape configurational complexity. The associations between fallow area and species richness peaked at intermediate values of edge density. The associations between species abundance and fallow area varied among species, but there was strong support for positive and consistent associations in 15 (63%) of the studied species. There was little support for a moderating effect of landscape configurational complexity on the associations of fallow area and bird abundance. Policy implications. To support farmland biodiversity, we suggest promoting fallow land across all agricultural landscapes and anchoring respective ambitious targets in the CAP strategic plans. An increase of fallow land beyond minimum requirements through voluntary measures, such as eco‐schemes and agri‐environment schemes, should particularly target landscapes with intermediate configurational complexity.

Recent advances in understanding the impact of infection and inflammation on hematopoietic stem and progenitor cells

Just over one decade ago, it was discovered that hematopoietic stem cells (HSCs) could directly respond to inflammatory cytokines by mounting a proliferative response thought to mediate the emergency production of mature blood cells. In the intervening years, we have gained mechanistic insight into this so-called activation process and have started to learn such a response may come at a cost in terms of ultimately resulting in HSC exhaustion and hematologic dysfunction. In this review article, we report the progress we have made in understanding the interplay between infection, inflammation and HSCs during the funding period of the Collaborative Research Center 873 “Maintenance and Differentiation of Stem Cells in Development and Disease”, and place this work within the context of recent output by others working within this field.

WYZWANIA PRAWA ROLNEGO. KILKA REFLEKSJI

The aim of the paper is to identify the challenges facing agricultural law and to undertake their assessment in the light of the development of this branch of law. On the one hand, new regulations and CAP instruments for the upcoming funding period will have to be followed as of January 2023. On the other hand, it will be necessary to confront the effects brought about by COVID-19, the war in Ukraine and the changing climate. Agricultural law, itself being subject to change and undergoing various stages of development, has always responded to the contemporary challenges, at a particular place and time. It can be concluded that the numerous and complex problems faced by agricultural law today go beyond agriculture alone, understood as a branch of primary production. Agricultural activity must ensure food security and food safety but should be pursued under conditions respecting the environment and combatting climate change through sustainable development. The negative consequences of such activity need to be reduced, however, without causing damage to primary production. In these difficult times, the pursuit of food security must not undermine the manufacturing role played by agriculture.

Oxygen‐Free Production—From Vision to Application

As oxygen negatively affects most production processes in the metalworking industry, a truly oxygen‐free production environment appears attractive in terms of the resulting material and component properties. This overview summarizes research conducted within the Collaborative Research Centre (CRC) 1368. The objectives of this CRC are twofold. First, a fundamental understanding of the mechanisms that govern the interaction between a metal surface and the environment is established. Second, it is researched how this understanding can be exploited to improve current production processes and even develop completely new ones. Herein, data obtained within the first funding period, which already demonstrate that significant effects can be realized in processes such as thermal spraying, cold rolling, compound casting, laser brazing, milling or hot stamping to name just a few examples, are presented. In addition, key aspects such as initial deoxidation of the workpieces, their transport under conditions that prevent reoxidation, and the tools needed to establish and control an oxygen‐free process environment are given, and the ramifications with respect to actual applications are discussed.

Quality Signaling Through Crowdfunding Pricing

Problem definition: This paper studies an entrepreneur’s pricing strategy in a reward-based crowdfunding campaign under asymmetric product quality information. We propose two signaling mechanisms and investigate how entrepreneurs can leverage their pricing strategy to signal a high-quality project. Academic/practical relevance: This problem is relevant to practice, as asymmetric quality information is a significant concern in reward-based crowdfunding. High-quality entrepreneurs seek credible mechanisms to signal the quality of projects to customers. Methodology: We develop a stylized game-theoretic signaling model with funding and regular selling periods that captures asymmetric quality information between an entrepreneur and customers. Results: We propose a new theory on quality signaling in crowdfunding. We show that contingent access to the regular selling market after running a successful crowdfunding campaign allows high-quality entrepreneurs to signal their quality through low funding prices (one-price signaling). A high-quality entrepreneur can increase his funding price and still signal his high-quality level if he commits to the future regular selling price (two-price signaling). We show that the distinct feature of crowdfunding, that is, the probabilistic nature of crowdfunding, plays different roles in one- and two-price signaling. It is the driving force for the separating equilibrium in one-price signaling, and in two-price signaling, it affects how the entrepreneur should manipulate his funding and regular selling prices to reduce signaling cost. Managerial implications: Entrepreneurs should be mindful of pricing in funding and regular selling periods because it could play an essential role in signaling quality information. Our findings suggest practical tools for quality signaling in crowdfunding. We also investigate when price commitment is the most beneficial for a high-quality entrepreneur, looking for potential signaling mechanisms. Funding: W. Zhou acknowledges financial support from the National Natural Science Foundation of China [Grant 72192823 and Grant 71821002]. Supplemental Material: The online appendices are available at https://doi.org/10.1287/msom.2022.1177 .

Exploring Justice in the Process of Redesigning Local Development Strategies for LEADER: Representation, Distribution, and Recognition

After its first funding period from 1991 to 1994, LEADER was positively evaluated as a successful strategy to empower actors at the regional level, enable regional development and contribute to territorial cohesion within the European Union. Critical studies, however, have highlighted elitist tendencies in LEADER processes and asked whether the proclaimed goal of strengthening ‘the local’ contributes to new or other forms of social and spatial injustice. Our research focus lies in how representation, distribution, and recognition—as the three interrelated dimensions of justice according to Nancy Fraser—are featured in the discourse related to redesigning a local development strategy (LDS). During this process, which is conceived as the most open and inclusive phase in each LEADER funding period, we conducted expert interviews and participatory observations in a case study region and gathered media reports, documents, and official regulations. In our analysis of issues of representation, distribution, and recognition, we also focus on the spatial scales that are referred to and the ways in which the involved actors challenge and justify the status quo. Our analysis explicates the actors’ implicit normative understandings as well as their different perspectives and positions considering perceived injustice. Even though the LDS process provides opportunities to negotiate these positions and to work towards more just representation, distribution, and recognition, they are partly constrained by structural and individual dependencies.

Building Research Infrastructure: The Development of a Technical Assistance Group-Service Center at an RCMI.

As one of the Research Centers for Minority Institutions (RCMI), the Southwest Health Equity Research Collaborative (SHERC) worked over the first five-year period of funding to foster the advancement of Early Stage Investigators, enhance the quality of health disparities research, and increase institution research capacity in basic Biomedical, Behavioral, and/or Clinical research; all priorities of RCMIs. In year 4, the Technical Assistance Group-Service Center (TAG-SC) was created to help achieve these goals. The TAG-SC provides one-on-one investigator project development support, including research design, data capture, and analysis. Successful implementation of the TAG-SC was tracked using Research Electronic Data Capture (REDCap), a secure, web-based software platform allowing for immediate tracking and evaluation processes. In the first two years, 86 tickets were submitted through the REDCap system for methodological support by TAG-SC experts (faculty and staff) for assistance with health-equity related research, primarily SHERC and externally funded Social/Behavioral research projects. The TAG-SC increased the research capacity for investigators, especially within the SHERC. In this manuscript, we describe the methods used to create the TAG-SC and the REDCap tracking system and lessons learned, which can help other RCMIs interested in creating a similar service center offering an innovative way to build methodological infrastructure.

THE IMPLEMENTATION PROCESS OF AN INTERGENERATIONAL COMMUNITY RESEARCH PROJECT: A NARRATIVE REVIEW

Abstract Food for a Long Life (FFLL) was a five-year USDA Children, Youth and Families at Risk intergenerational community research project that sought to increase healthy food consumption, knowledge, and access among preschoolers and older adults living in food insecure communities of Ohio and Virginia. Using the community-based participatory action research approach, community stakeholders jointly participated in all stages of the project to co-create context-specific programming to address needs within their communities with the goal of promoting program sustainability beyond the grant funding period. This presentation will provide a narrative review to explore the implementation process of FFLL by comparing initial project expectations to reality using the community-based participatory research conceptual model (Wallerstein et al., 2008; Wallerstein et al., 2018). By exploring project barriers such as COVID-19, facilitators such as flexible partner relationships, and strategies including promoting early buy-in, we provide an in-depth discussion of project successes and lessons learned.

Clinical outcomes in a large multi‐Centre prospective corneal transplant study

AbstractThe output from Work package 2 (WP2) of the VISICORT project included four deliverables: Establishment of secure multi‐site clinical database of human corneal transplant recipients. Report of 1‐year outcomes from multi‐site prospective biological sampling and clinical follow‐up of full thickness (FT)‐ and posterior lamellar (PL)‐CT recipients Report of 3‐year prospective outcomes of FT‐ and PL‐CT recipients Report of clinical factors associated with adverse immunological outcomes from FT‐ and PL‐CT within the overall transplant practice of a network of 5 leading EU centres. In more general terms, the main mission of WP2 was to develop a cloud‐based system to collect relevant, well‐defined clinical information and track biological samples, to recruit patients from the five clinical centers, to collect biological samples and clinical data and to follow these patients clinically over several years.The current speech focus on the clinical outcomes 928 prospectively enrolled patients followed up to 3 years.Beyond confirming known factors associated with an adverse immunological outcome after FT‐ and PL‐CT such as the influence of primary diagnosis and type of surgery as risk factors, the clinical factors study revealed factors which needs to be explored further on. Identification of a re‐bubbling procedure (repeated injection of air to keep a PL graft in place) as an important risk factor for development of a later acute rejection episode is important as re‐bubbling is necessary in a fair large number of CT‐PL procedures (15–25%). The finding that presence of loose sutures after CT‐FT is a significant risk factor for AGR is not surprising, but further confirms that patients undergoing CT‐FT needs to be followed closely.Concerning graft failure, it is worth to note that presence of diabetes 2 was identified as a significant risk factor for graft failure after CT‐FT. This may be due to a partially neurotrophic disease state in many patients with diabetes 2 and this has to be taken into account when deciding to perform CT‐FT and in the clinical follow‐up, which need to be meticulous.The current clinical variables study is unique, and it would seem compelling to continue the clinical follow‐up of the recruited patients beyond the funding period for VISICORT. This would of course require new grant applications and obtaining new ethical approvals from the ethics committees at the five clinical centres.

Establishment of the Dutch Nationwide, Interdisciplinary Infrastructure and Biobank for Fundamental and Translational Ovarian Cancer Research: Archipelago of Ovarian Cancer Research

Objectives: Ovarian cancer has the worst overall survival rate of all gynecologic malignancies. For the majority of patients, the 5-year overall survival rate of less than 50% has hardly improved over the last decades. To improve the outcome of patients with all subtypes of ovarian cancer, large-scale fundamental and translational research is needed. To accommodate these types of ovarian cancer research, we have established a Dutch nationwide, interdisciplinary infrastructure and biobank: the Archipelago of Ovarian Cancer Research (AOCR). The AOCR will facilitate fundamental and translational ovarian cancer research and enhance interdisciplinary, national, and international collaboration. Design: The AOCR biobank is a prospective ovarian cancer biobank in which biomaterials are collected, processed, and stored in a uniform matter for future (genetic) scientific research. All 19 Dutch hospitals in which ovarian cancer surgery is performed participate and collaborate in the AOCR biobank. Participants/Materials, Setting, Methods: Patients of 16 years and older with suspected or diagnosed ovarian, fallopian tube, or primary peritoneal cancer are recruited for participation. Patients who agree to participate give written informed consent for collection, storage, and issue of their biomaterials for future studies. After inclusion, different blood samples are taken at various predefined time points both before and during treatment. In case of a diagnostic paracentesis or biopsy, the residual biomaterials of these procedures are stored in the biobank. During surgery, primary tumor tissue and, if applicable, tissue from metastatic sites are collected and stored. From each patient, a representative histological hematoxylin and eosin stained slide is digitalized for research purposes, including reassessment by a panel of gynecologic pathologists. Clinical and pathological data are obtained on a per-study basis from Dutch registries. Research proposals for the issue of biomaterials and data are evaluated by both the Archipelago Scientific Committee and the Steering Committee. Researchers using the biomaterials from the AOCR biobank are encouraged to enrich the biobank with data and materials resulting from their analyses and experiments. Limitations: The implementation and first 4 years of collection are financed by an infrastructural grant from the Dutch Cancer Society. Therefore, the main limitation is that the costs for sustaining the biobank after the funding period will have to be covered. This coverage will come from incorporation of budget for biobanking in future grant applications and from fees from external researchers and commercial parties using the biomaterials stored in the AOCR biobank. Moreover, we will apply for grants aimed at sustaining and improving research infrastructures and biobanks. Conclusions: With the establishment of the Dutch nationwide, interdisciplinary Archipelago of Ovarian Cancer Research infrastructure and biobank, fundamental and translational research on ovarian cancer can be greatly improved. The ultimate aim of this infrastructure is that it will lead to improved diagnostics, treatment, and survival of patients with ovarian cancer.

Data and sample sharing as an enabler for large-scale biomarker research and development: The EPND perspective.

Biomarker discovery, development, and validation are reliant on large-scale analyses of high-quality samples and data. Currently, significant quantities of data and samples have been generated by European studies on Alzheimer's disease (AD) and other neurodegenerative diseases (NDD), representing a valuable resource for developing biomarkers to support early detection of disease, treatment monitoring, and patient stratification. However, discovery of, access to, and sharing of data and samples from AD and NDD research are hindered both by silos that limit collaboration, and by the array of complex requirements for secure, legal, and ethical sharing. In this Perspective article, we examine key challenges currently hampering large-scale biomarker research, and outline how the European Platform for Neurodegenerative Diseases (EPND) plans to address them. The first such challenge is a fragmented landscape filled with technical barriers that make it difficult to discover and access high-quality samples and data in one location. A second challenge is related to the complex array of legal and ethical requirements that must be navigated by researchers when sharing data and samples, to ensure compliance with data protection regulations and research ethics. Another challenge is the lack of broad-scale collaboration and opportunities to facilitate partnerships between data and sample contributors and researchers, in addition to a lack of regulatory engagement early in the research process to enable validation of potential biomarkers. A further challenge facing projects is the need to remain sustainable beyond initial funding periods, ensuring data and samples are shared and reused, thereby driving further research and innovation. In addressing these challenges, EPND will enable an environment of faster and more disruptive research on diagnostics and disease-modifying therapies for Alzheimer's disease and other neurodegenerative diseases.

Forest subsidy distribution in five European countries

Forest subsidies are widely used to achieve policy objectives aimed at maintaining and supporting the provision of the various ecosystem services provided by forests. In the European Union, an important instrument is the European Agricultural Fund for Rural Development (EAFRD) within the EU's Common Agricultural Policy (CAP), but countries also have national subsidy systems. In both cases, individual countries determine which objectives they want to achieve with the subsidy schemes and which measures are supported. In this comparative study, we investigate which forest-related measures are subsidized across Europe and which forest owners, representing a very heterogeneous group, are involved in the activities of the subsidy systems.We collected data on subsidies paid out for forest-related measures from Austria, Finland, Germany, Slovenia and Sweden from the EAFRD funding period 2014–2020 for a comparison of the funded activities. Further, we analysed how subsidies were distributed among private forest owners with forest holdings of different sizes by performing G-tests to compare the observed with the expected subsidies received by forest owners in the different size categories.The results show that through the flexibility given by the CAP for countries to adjust their subsidy programmes to the specific national needs, EAFRD funds and equivalent national subsidies are indeed used for a wide range of activities instead of only a few following one common European goal. Reflecting the different needs and various forest functions, the subsidized activities range from the more ecology-oriented “investment to increase resistance and the ecological value of forests” to the more management-oriented “purchase of new machinery and new equipment for forestry operations”.In all five countries, small-scale forest owners with holdings smaller than 200 ha are the largest owner group and manage a large share of the forest area in private hands (from 47% in Austria to 97% in Slovenia). However, especially owners of the smallest holdings (< 20 ha) rarely use the funding scheme of the EAFRD framework and thus receive a disproportionately low share of subsidies. There might be several reasons for this. Small-scale forest owners are generally less involved regarding policy issues (including subsidy schemes) than owners of larger forest holdings and may not be aware of all funding opportunities. In addition, the considerable effort to apply, including project preparation, administration and documentation may be perceived as a barrier.It became clear that the current subsidy systems of the countries focus on different forest policy objectives. Our study further revealed that the documentation of subsidy distribution is partly unclear and inconsistent across countries hampering European comparisons. However, understanding current subsidy distribution is urgently needed for increasing the effectiveness of subsidy systems to achieve European policy goals of vital multifunctional forests.

Tocilizumab for relapsing and remitting giant cell arteritis: a case series

BackgroundGiant cell arteritis is a large vessel vasculitis of the arteries in the head and neck. The mainstay of management is with high-dose corticosteroids, and patients often face difficulties stopping or reducing steroids without recurrence of symptoms. Corticosteroids are well established to have numerous associated side effects, including osteoporosis, weight gain, and diabetes. Therefore, when tocilizumab was approved for up to 1 year for cases of relapsing or refractory giant cell arteritis by the National Institute of Health and Care Excellence (NICE) in April 2018, this offered an opportunity to benefit from new funding and to reduce steroid burden.Case presentationThis case series describes the impact of the establishment of a new hub and spoke referral pathway for the use of tocilizumab in refractory or relapsing giant cell arteritis, with case examples from consecutive patients who accessed the funding between August 2018 and April 2021. A total of 16 patients were identified: 11 female and 5 male, with an average age of 72.4 (range 61–82) years, with a majority of 11 ethnically white. The central assessing hub is St George’s University Hospitals NHS Foundation Trust Hospital, serving a population of 1.3 million in the south of England. This is the first large case series looking into the impact of the establishment of a regional clinical pathway for the new tocilizumab funding.ConclusionsThe case series demonstrates that the use of tocilizumab has reduced both the duration and the dose of corticosteroids in these 16 cases (mean prednisolone reduction 20.4 mg: 95% CI 13.0–27.8 mg), with 50% of patients continuing on tocilizumab after the initial 12 month funding period. The disease course, patterns of response, and maintenance of remission are discussed, and we describe the benefits of replicating this hub and spoke tocilizumab pathway in other centers.