Social commentators in countries such as the United Kingdom and the United States are beginning to recognise that encouraging older adults' use of information and communication technologies (ICTs) is essential for the creation of bona fide information societies. To date, however, few studies have examined in detail older adults' access to and use of ICTs. This important aspect of the interaction between population ageing and societal change is more complex than the published literature's portrayal of a dichotomy between ' successful users' and ' unsuccessful non-users'. The paper examines the extent and nature of ICT access and use by older adults in their everyday lives. Information was collected from a sub-sample of 352 adults aged 60 or more years taken from a large household survey of ICT use in England and Wales among 1,001 people. The findings suggest that using a computer is not only a minority activity amongst older adults but also highly stratified by gender, age, marital status and educational background. Conversely, non-use of computers can be attributed to their low relevance and ' relative advantage ' to older people. The paper concludes by considering how political and academic assumptions about older people and ICTs might be refocused, away from trying to 'change ' older adults, and towards involving them in changing ICT.KEY WORDScomputers, information and communications technology, older adults, digital divide.The number of older people becoming ' silver surfers ' by establishing expertise in using new technology is growing fast. IT and the Internet has the power to transform their lives … 24 hours a day, seven days a week through the click of a button (Ian McCartney, Cabinet Office Minister. See Cabinet Office

Summary Background Adverse reactions to food include immune mediated food allergies and non‐immune mediated food intolerances. Food allergies and intolerances are often confused by health professionals, patients and the public. Aim To critically review the data relating to diagnosis and management of food allergy and food intolerance in adults and children. Methods MEDLINE, EMBASE and the Cochrane Database were searched up until May 2014, using search terms related to food allergy and intolerance. Results An estimated one‐fifth of the population believe that they have adverse reactions to food. Estimates of true IgE‐mediated food allergy vary, but in some countries it may be as prevalent as 4–7% of preschool children. The most common food allergens are cow's milk, egg, peanut, tree nuts, soy, shellfish and finned fish. Reactions vary from urticaria to anaphylaxis and death. Tolerance for many foods including milk and egg develops with age, but is far less likely with peanut allergy. Estimates of IgE‐mediated food allergy in adults are closer to 1–2%. Non‐IgE‐mediated food allergies such as Food Protein‐Induced Enterocolitis Syndrome are rarer and predominantly recognised in childhood. Eosinophilic gastrointestinal disorders including eosinophilic oesophagitis are mixed IgE‐ and non‐IgE‐mediated food allergic conditions, and are improved by dietary exclusions. By contrast food intolerances are nonspecific, and the resultant symptoms resemble other common medically unexplained complaints, often overlapping with symptoms found in functional disorders such as irritable bowel syndrome. Improved dietary treatments for the irritable bowel syndrome have recently been described. Conclusions Food allergies are more common in children, can be life‐threatening and are distinct from food intolerances. Food intolerances may pose little risk but since functional disorders are so prevalent, greater efforts to understand adverse effects of foods in functional disorders are warranted.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery datasets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5×10−8) and used pathway analysis to identify JAK-STAT/IL12/IL27 signaling and cytokine-cytokine pathways, for which relevant therapies exist.

This paper presents a description of the background characteristics and attainment profile of pupils eligible for free school meals (FSM) in England, and of those missing a value for this variable. Free school meal eligibility is a measure of low parental income, widely used in social policy research as an individual indicator of potential disadvantage. It is routinely treated as context for judging both individual and school-level attainment, as an indicator of school composition, and has been proposed as the basis for the pupil premium funding policy for schools. Knowledge of the quality, reach and limitations of FSM as an indicator is therefore fundamental to accurate decision-making in a number of important areas. This paper uses a national dataset of all pupils (PLASC) for 2007. It looks at the relationship between different indicators of pupil background and attainment to help decide how useful FSM remains in relation to its suggested alternatives, and how to handle the crucial question of missing data and to describe more fully than previously the national picture of who is eligible for free school meals. The results show that, while the distinction between take-up and eligibility has been eroded, FSM remains a useful and clear stratifying variable for pupil attainment patterns in school, linked to type of school attended, school mobility, living in care, special needs, first language and minority ethnic group. The pupils missing FSM values fall into two groups, based largely on their type of school and how long they have been there. One group attends fee-paying schools and is most similar to non-FSM pupils elsewhere and could be aggregated with them in future analyses that do not want to omit them. The remaining missing FSM pupils form a deprived and perhaps superdeprived group. These should not be omitted, nor assumed to be like non-FSM pupils, as currently happens in official school performance figures in England in a way that disadvantages schools with very deprived intakes. The proposal here is that missing FSM pupils in statefunded institutions should be treated in future as a third distinct group. If these issues about missing data are resolved, and other limitations accepted, FSM remains a better indicator of low socioeconomic status than the current alternatives discussed in the paper.

SUMMARY Background: Antidepressants are used in the treatment of irritable bowel syndrome but it is unclear whether any symptomatic improvement is due solely to correction of an associated affective disorder, or whether these drugs have effects on bowel function which may be of therapeutic benefit. Intestinal transit is known to be abnormal in some irritable bowel syndrome patients. Methods: We have studied the effects of imipramine, a tricyclic antidepressant with mixed pharmacological properties, and paroxetine, a selective 5‐hydroxy‐tryptamine re‐uptake inhibitor, on intestinal transit times. Results: Median (range) whole gut transit time was lower in 10 diarrhoea‐predominant irritable bowel syndrome patients, 22.2 (3.6–51.6) h, compared to 28 control subjects 39.6 (7.2–68.4) h, (P < 0.05). Similarly, orocaecal transit time was shorter at 55 (30–90) min in diarrhoea‐predominant irritable bowel syndrome patients compared to 75 (40–150) min in controls, (P < 0.05). Four days’administration of imipramine increasing to a daily dose of 100 mg prolonged both orocaecal and whole gut transit times in 12 control subjects and six diarrhoea‐predominant irritable bowel syndrome patients. In contrast, 30 mg paroxetine daily for 4 days reduced orocaecal transit time in ten controls and eight irritable bowel syndrome patients, but had no effect on whole gut transit time. Conclusion: Short‐term administration of antidepressants alters intestinal transit, but the selective 5‐hydroxytryptamine re‐uptake inhibitor, paroxetine, has different effects to the tricyclic drug, imipramine. These effects on transit precede any effects on mood. Although there is a high prevalence of affective disorder in irritable bowel syndrome clinic patients, these drugs may have additional therapeutic actions on the gut. These actions might be taken into account when prescribing antidepressants in irritable bowel syndrome.