A Delphi survey was used as part of a process to identify priority animal-based welfare measures as a starting point for developing a future dairy cattle welfare assessment framework for Indonesian dairy farms. Two rounds of an e-survey were used to reach a consensus of expert opinion from four organisations associated with dairy cattle welfare in Indonesia. Sixty-three respondents were identified as ‘experts’ and sent Delphi survey 1, which asked them to list, for Indonesian dairy farms, three key welfare problems and six animal-based welfare measures that could be used to identify those problems. The 47 experts who responded to survey 1 identified 54 different welfare problems and 83 different animal-based measures. In the follow-up Delphi survey 2, 44 experts rated the importance (5-point scale) of each of the 83 measures and ranked their five most important measures. Based on the importance score, a final consensus set of 20 animal-based measures was produced after checking for duplication. This set of measures was weighted towards negative health effects, likely due to the dominance of veterinarians in the panel, highlighting a prioritisation bias in Indonesian veterinarians’ thinking towards negative health effects rather than behavioural and positive welfare. Lameness, mastitis, and heat stress were the key health and welfare issues highlighted by the panellists. These surveys have identified potential measures supporting the development of a framework to address priority welfare problems on Indonesian smallholder dairy farms. However, a wider perspective on welfare priorities in Indonesian cattle is needed before the protocol is finalised.

Building on recent studies of classical resilience, this article scrutinizes the second-century BC inscriptions on the monument of Aemilius Paullus at Delphi, erected in 167 BC. By analysing the epigraphic reuse of its surfaces, the article posits that the Roman pillar played a crucial political role in the second century BC. It functioned as a material device used by Delphi, the Amphictyony and pro-Roman Greek agents to consolidate their interstate authority and legitimacy amidst the intricate military dominance of Rome and the influence of the Greek leagues. These inscriptions reveal the interplay of new pro-Roman elites, interstate arbitrations, Greek memorialization and Roman provincialization, all converging to signify the rapid transformations of this era. Consequently, this study contributes to a more nuanced understanding of Greek ideological adaptations to Roman power during this period.

In 2020, over 13.4 million babies globally (>10% of all live births) were born preterm(1). Nutrition during the neonatal period plays a crucial role in supporting optimal growth, brain development, and reducing the risk of metabolic diseases later in life(2). Current guidelines on nutrition for preterm infants contain inconsistent recommendations(3), most of which are based on very low certainty of evidence. Challenges in formulating recommendations for nutrition in preterm infants partly arise from inconsistent reporting of outcomes in nutrition intervention studies(4). We aimed to develop a standardised reporting framework for measures of nutrition intake and growth outcomes in preterm nutrition studies. Measures of nutrition intake and growth outcomes were identified in a scoping review, curated, and presented in two real-time Delphi surveys to participants from three stakeholder groups with experience in preterm infants, nutrition, and growth: healthcare consumer; healthcare professional, and researcher. The first survey was to identify measures deemed critical for reporting in a minimum reporting set; the second on how to report these measures. Questions were rated for their importance on a 9-point Likert scale. Items were considered for inclusion when ≥80% of all participants scored the item as 7–9 (critical for inclusion) and <15% scored as 1–3, or when ≥80% of healthcare consumers scored the item as 7–9. The standardised reporting framework was finalised during three online consensus meetings, where stakeholders were given the opportunity to discuss and then vote on the importance of each item. Items receiving ≥80% “critical for inclusion” votes from all attendees or from consumers were included. We recruited 313 participants from 32 countries for survey 1, and 121 participants from 26 countries for survey 2. The proportions of stakeholder groups in both surveys were similar: 12% consumers; 73-77% healthcare professionals, and 11-15% researchers. Eight measures are included in the final standardised reporting framework:(1) the type of milk the baby receives;(2) the type of supplement to milk that a baby receives;(3) the nutrition that the baby actually receives;(4) the time period over which the measurement of the nutrition that the baby actually receives was made; (5) baby’s weight; (6) baby’s length/height; (7) baby’s head circumference; and (8) the time point at which, or the time interval over which, the measurement of size or growth was made. These eight measures are accompanied by 22 recommended measurement methodologies. This standardised reporting framework should be used in the development of future study protocols, evidence syntheses, and nutrition guidelines for preterm infants. Widespread adoption of this framework in preterm nutrition studies would improve the design of studies, the comparability of research findings, thereby facilitating reliable evidence synthesis, and potentially could support the development of evidence-based clinical guidelines and practice.

A lack of common terminology and shared understanding of behavioural interventions across academic disciplines and professional groups limits the multidisciplinary application of such interventions and our collective ability to share and compare their effects. The current study attempts to narrow this gap by developing a comprehensive classification system of nudges and similar behavioural interventions that can aid researchers and practitioners in understanding and describing such interventions to steer desired behaviour change. We develop an initial classification system drawing on our expert knowledge and subsequently validate it in an iterative procedure with 44 experts from various fields, disciplines and sectors during two feedback rounds (i.e. a Delphi approach). The result is META BI (Mapping of Environment, Target group and Agent for Behavioural Interventions), a classification system describing interventions across 20 dimensions and using 17 distinct psychological mechanisms. META BI is aligned with a system lens, shifting the focus from single true effects to contextualised assessments. It can help to understand, compare and evaluate nudges and selected interventions for the desired effects.

The estimated global preterm birth rate in 2020(1) was more than 10% of livebirths or 13.4 million infants. Despite the importance of neonatal nutrition in optimising growth, neurodevelopment, and later metabolic disease risk, there is inconsistency in nutrition recommendations for preterm infants(2). Incomplete or inconsistent reporting of outcomes in nutrition intervention studies is part of the reason for the lack of consensus on optimal nutrition. To reduce uncertainty in measuring or reporting nutritional intake and growth outcomes in preterm studies, a consensus process is needed to identify relevant measures for patients, parents/caregivers, researchers, and health professionals. We aimed to develop a minimum reporting set (MRS) for measures of nutritional intake and growth in preterm nutrition studies. We collaborated with a group of international researchers from 13 countries and registered this study at the COMET initiative (registration number 3185). The target population was individuals born preterm at any gestational age and study location whose nutritional intake was assessed before first hospital discharge and whose growth was assessed at any age. Measures reported in preterm nutrition studies were systematically reviewed and used to develop the real-time Delphi survey(3) using Surveylet (Calibrum) software, including 13 questions about nutritional intake and 14 about growth outcomes. We used a snowball process to recruit participants from the consumer, healthcare provider, and researcher stakeholder groups with expertise in preterm infants, nutrition, and growth to rate the importance of each measure on a 9-point Likert scale. Participants initially rated the survey items without seeing other participants’ responses, saved and refreshed the page to see the anonymous responses of other participants, and had the option to change their rating and provide reasons for their answers. Participants’ final scores for each item will be used to identify the consensus criteria for that item(3). To date, we have recruited 246 participants from 31 countries across 5 continents, including 58 (24%) consumers, 156 (63%) healthcare professionals, and 26 (11%) researchers. Preliminary findings indicate that 12 measures of nutritional intake and 4 of growth have met the criteria for inclusion in the MRS. However, participant recruitment and survey responses are ongoing. A final consensus meeting is planned for November 2024 to confirm the MRS.

Delphi studies allow for the generation of a consensus among experts. This has historically been professional experts in their field. This study aimed to obtain a consensus regarding the most important components of cognitive behavioural therapy (CBT) for depression not only for professional experts (therapists) but also for adult experts by experience. Perceptions of importance between therapists and experts by experience differed in multiple areas including content components such as behavioural activation and experiments, psychoeducation, and homework, which the latter did not agree were important. Experts by experience found several components relating to delivery process important which therapists did not, such as delivery method and session length. The strongest agreement from both groups involved the importance of positive therapist factors such as being non-judgemental, knowledgeable, understanding, and trustworthy. Both groups were in agreement on the importance of cognitive restructuring. Neither experts by experience nor therapists met consensus agreement on the inclusion of mindfulness as part of a wider CBT intervention for depression, being rated among the lowest components for both groups. Findings highlight several aspects of CBT content and delivery which may benefit from review in order to increase acceptability for recipients.

Key learning aims

1. (1) To identify what recipients and deliverers feel are the most important parts of a CBT intervention for depression.

2. (2) To compare these responses, and consider reasons why these similarities and differences may exist.

3. (3) To discuss ways in which these differences could impact acceptability and perceived efficacy of cognitive behavioural therapy.

4. (4) To reflect on ways gained knowledge could be used to consider ways to improve the delivery of cognitive behavioural therapy.