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What is a word for when you pass the responsibility of something to someone or something else?

e.g. I x my responsibility of self-defence to the state.

• single-word-requests

• 2 I voted up two answers below - I would note that your question could be improved to suggest which answer would be better for your purpose. If you "pass" responsibility it can mean a few things. If you mean "assign" to another entity you might chose "delegate" where if you mean "give up" you might chose cede. (and for that matter, 'assign' and 'give up' are other alternatives yet less exclusively tied to responsibility) –  Tom22 Commented Mar 28, 2018 at 1:12
• @Tom22 ~ Thank you. However, I do believe delegate may be appropriate for "pass". Are you thinking of "pass off", perhaps? –  Bread Commented Mar 28, 2018 at 1:21
• 1 @Bread .. I agree that 'pass' in the title would fit more with "delegate" however the example of self-defense has it's own quirks to it when coupled with 'pass'. All in all the word "responsibility" does point more to delegate too - vs "right" or "ownership" or "interests" which fit more naturally with 'cede' .. but all could use more from the OP in terms of intent –  Tom22 Commented Mar 28, 2018 at 1:28
• It should be noted that "passing the buck" is an idiom suggesting the "delegation" of responsibility for an action that did not have a positive effect. Doesn't fit the stated example very well, though. –  Hot Licks Commented Mar 28, 2018 at 1:52
• Actually you put my answer in your question: defer . I will no longer answer questions on this site due to what I perceive to be harassment by mods. –  Shelby Moore III Commented Apr 22, 2023 at 5:02

6 Answers 6

Delegate : verb (with object) entrust (a task or responsibility) to another person, typically one who is less senior than oneself. She must delegate duties so as to free herself for more important tasks. The power delegated to him must never be misused. I delegate my responsibility of self-defence to the state.

cede (sēd) TFD

To surrender possession of, especially by treaty. See Synonyms at relinquish. To yield; grant:

I cede my responsibility of self-defence to the state.

I entrust my responsibility of self-defence to the state.

entrust - verb - "If you entrust something important to someone or entrust them with it, you make them responsible for looking after it or dealing with it."

Example sentences from the web:

• I'll entrust the job to you.
• To your care I entrust the book, the embroidery frame, and the letter upon which I had begun.
• People entrust their money to others, who accept the responsibility to deal with it according to the terms agreed.
• He will entrust more responsibilities in your hands and elevate you to your proper status.

transfer (power) to a lower level, especially from central government to local or regional administration.

give an assignment to (a person) to a post, or assign a task to (a person)

Example sentences:

• Measures to devolve power to a Scottish assembly
• The representative devolved his duties to his aides while he was in the hospital
• The U.S. government could devolve a certain responsibility to the states

I relinquish my responsibility of self-defense to the state.

3b : to give over possession or control of : yield - few leaders willingly relinquish power.

"Relinquish." Merriam-Webster.com. Merriam-Webster, n.d. Web. 19 Aug. 2018.

Delegate tends to imply that you have the authority to insist that the delegatee accepts the delegation. It's an offer they can't refuse.

Entrust focuses on the recipient and the thing recieved. This is slightly awkward here because it wouldn't then be self -defense, would it?

Relinquish focuses on the turning over or giving up. I think it works better in this particular case.

Forgo also has the correct sense, but you can't forgo something to some one.

Forsake suggests a totality of abandonment that probably isn't wanted here.

If you take the position that the state legislates the rules and is the one who decides where the responsibility lay, the entire sentence is a bit off. It is the state that causes you to forgo this responsibility. But this can be a matter of degree, and if you are electing to take the fullest advantage of their protection, I think you are choosing to relinquish what discretionary responsibility exists.

E.g. She was delegated to do the job.

• This answer has already been given. –  fev Commented Jun 9, 2021 at 8:06

Not the answer you're looking for? Browse other questions tagged single-word-requests or ask your own question .

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Transfer my service.

A transfer of service occurs when someone assumes billing responsibility for someone else’s mobile number. The transfer requires authorization from both the current owner and the new party responsible for the line.

You can complete a transfer of service for business-to-business line transfers,  transferring a government line or if you have a personal Verizon line that’s managed in My Verizon.

In business-to-business line transfers and government-line transfers, the party relinquishing the line (the existing responsible party) must initiate the transfer, while the transfer of a personal line can be initiated by the existing responsible party or the party that plans to assume responsibility for the line.

Transfer requirements

To make a transfer of service:

• The account balance of the existing account owner must be current
• The existing account owner will continue to be responsible for account charges until the transfer has completed
• The assuming party is subject to a credit check before the line can be transferred
• A security deposit may be required from the assuming party
• If this line is being added to an existing Verizon Wireless account, that account must be current
• All transferred lines may be required to switch to a currently available plan

Any transfer of service not completed within 15 days of the request will be automatically canceled, and a new request must be submitted.

Initiating a transfer by relinquishing your line

My Business Wireless users can initiate a line transfer to another Verizon business customer by relinquishing their line. This includes business-to-business, government-line and personal-line transfers.

To begin a transfer and relinquish your line while logged in My Business Wireless :

• Navigate to Manage > Account > Transfer Service
• Click the Release line tab
• On the Transfer Your Service page, select the desired lines by searching or scrolling, or click Select all to transfer all the lines on an account
• Click Continue
• You can apply this information to all lines by clicking Apply
• Confirm the email address to receive confirmation emails or enter additional emails in the indicated box
• Click Submit

You’ll receive a confirmation number that you can print for your records by clicking Print Confirmation .

The new account holders that will be assuming responsibility for the transferred services will:

• Receive a confirmation email when the existing account holder completes their portion of the transfer process
• Review the Verizon Wireless customer agreement terms in the email before transferring the line of service
• Agree to the Terms and Conditions
• Accept responsibility for the line of service for the remainder of the existing contract line term
• Call Verizon Customer Service at 800.922.0204 and provide the wireless number that is being transferred responsibility (a representative will assist with this request)

Initiating a transfer by requesting a line release

The transfer of personal lines managed in My Business Wireless can also be initiated by the party assuming responsibility for the transferred service by requesting a release while logged in My Business Wireless .

• Click the Assume line tab and then click Request release
• Enter the mobile numbers you want to assume (up to 10) and then click Verify and submit
• Keep a record of the provided Request Number

The current account owner (relinquishing party) will receive an email with instructions to continue the transfer process. Once they do, you will receive an email directing you back to My Business Wireless to complete the transfer.

• Click the link in the notification email to go back to the Transfer your service page
• Select the Assume line and Complete transfer tabs if not already selected
• If you have more than one request, select a Request number from the dropdown menu
• In the Lines to assume section, review line details, including equipment, contract term and device payment details
• Click Continue *
• Review the disclosures and then click Agree and Continue
• Select an existing account or create a new account as the destination for the transferred mobile numbers and click Continue
• Select a plan for the mobile numbers and click Continue
• If everything looks right, click Continue
• If changes are needed, make the changes, click Save details and click Continue
• Review the Shopping cart and click Checkout (the shopping cart shows the devices and monthly charge information for any lines you’re assuming)
• Review the Billing information and click Submit order

You’ll receive a confirmation number. Print the page for your records by clicking View/print details .

* If you have more than one transfer request, repeat steps 3 to 5 for each request.

Note: Transfer requests are active for 15 days. You can cancel pending requests by clicking Cancel request on the Transfer your service page.

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Sentence examples for transfer of responsibility from inspiring English sources

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There was some discordance between national societies and competent authorities' responses to the question about the transfer of responsibility for making Guidelines available.

But there has been no accompanying transfer of responsibility .

"Our objective must be a strategy, the transfer of responsibility " to Afghans, she said.

The White House will now find it easier to advocate for a rapid transfer of responsibility to Afghan forces.

This transfer of responsibility to men of issues so often pigeonholed as "women's matters", is one avenue of promise.

And that bureaucracy, the transfer of responsibility from people to their elected representatives, is where it starts to go wrong.

Yes, a transfer of responsibility would upset the delicate war-zone power balance between the State and Defense Departments.

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What is a Transfer of Responsibility

A Transfer of Responsibility is the process used to change the ownership of one or more wireless numbers for an existing or new customer.

• An administrative fee may apply.

You must meet the following criteria before proceeding with a Transfer of Responsibility:

• The account must be in good standing with no past due balances.
• The account holder must authorize this request by contacting  Customer Care . It's recommended to have the new customer (taking over the line) available.
• The new customer will be informed of the credit check requirement and the price plan tenure, terms and conditions will also be explained.

What will happen after I perform a Transfer of Responsibility?

• The new customer will assume full responsibility for the account. (Note: You are still responsible for all monthly charges and usage up until the day the transfer is completed.)
• The security deposit you paid for the wireless number, if applicable, will be refunded to your account once the transfer is completed.
• Prorated charges and minutes
• Voicemail will be reset
• Any current services on the line will be removed.

When a Transfer of Responsibility is not permitted?

• Account must show one payment post activation.
• If a hardware upgrade has been completed in the last 60 days.
• If invoice containing equipment charge has not been paid in full.

Information for customer taking over the device:

• Credit Check will be required before taking responsibility for the device.
• Total responsibility for the Wireless Number will be transferred.

Transfer of responsibility authorization lasts for 30 days. (You have 30 days to call Rogers and complete the Transfer of Responsibility).

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What Is Transfer Pricing?

How transfer pricing works, transfer pricing and taxes, transfer pricing and the irs, the bottom line.

• Corporate Finance

Transfer Pricing: What It Is and How It Works, With Examples

Yarilet Perez is an experienced multimedia journalist and fact-checker with a Master of Science in Journalism. She has worked in multiple cities covering breaking news, politics, education, and more. Her expertise is in personal finance and investing, and real estate.

Investopedia / Jessica Olah

Transfer pricing is an accounting practice that represents the price that one division in a company charges another division for goods and services provided.

Transfer pricing allows for the establishment of prices for the goods and services exchanged between subsidiaries , affiliates , or commonly controlled companies that are part of the same larger enterprise. Transfer pricing can lead to tax savings for corporations, though tax authorities may contest their claims.

Key Takeaways

• Transfer pricing accounting occurs when goods or services are exchanged between divisions of the same company.
• A transfer price is based on market prices in charging another division, subsidiary, or holding company for services rendered.
• Companies use transfer pricing to reduce the overall tax burden of the parent company.
• Companies charge a higher price to divisions in high-tax countries (reducing profit) while charging a lower price (increasing profits) for divisions in low-tax countries.
• The IRS states that transfer pricing should be the same between intercompany transactions as it would have been had the company done the transaction outside the company.

Transfer pricing is an accounting and taxation practic e that allows for pricing transactions internally within businesses and between subsidiaries that operate under common control or ownership. The transfer pricing practice extends to cross-border transactions as well as domestic ones.

A transfer price is used to determine the cost to charge another division, subsidiary, or holding company for services rendered. Typically, transfer prices are reflective of the going market price for that good or service. Transfer pricing can also be applied to intellectual property such as research, patents, and royalties.

Multinational corporations (MNCs) are legally allowed to use the transfer pricing method to allocate earnings among their subsidiary and affiliate companies that are part of the parent organization . However, companies sometimes can also use (or misuse) this practice by altering their taxable income, thus reducing their overall taxes. The transfer pricing mechanism is a way that companies can shift tax liabilities to low-cost tax jurisdictions.

To better understand how transfer pricing impacts a company's tax bill, let's consider the following scenario. Let's say that an automobile manufacturer has two divisions: Division A, which manufactures software, and Division B, which manufactures cars. Division A sells the software to other carmakers as well as its parent company. Division B pays Division A for the software, typically at the prevailing market price that Division A charges other carmakers.

Let's say that Division A decides to charge a lower price to Division B instead of using the market price. As a result, Division A's sales or revenues are lower because of the lower pricing. On the other hand, Division B's costs of goods sold (COGS) are lower, increasing the division's profits. In short, Division A's revenues are lower by the same amount as Division B's cost savings—so there's no financial impact on the overall corporation.

However, let's say that Division A is in a higher tax country than Division B. The overall company can save on taxes by making Division A less profitable and Division B more profitable. By making Division A charge lower prices and pass those savings on to Division B, boosting its profits through a lower COGS, Division B will be taxed at a lower rate. In other words, Division A's decision not to charge market pricing to Division B allows the overall company to evade taxes.

In short, by charging above or below the market price, companies can use transfer pricing to transfer profits and costs to other divisions internally to reduce their tax burden.

The IRS states that transfer pricing should be the same between intercompany transactions that would have otherwise occurred had the company done the transaction with a party or customer outside the company. According to the IRS website, transfer pricing is defined as follows:

The regulations under section 482 generally provide that prices charged by one affiliate to another, in an intercompany transaction involving the transfer of goods, services, or intangibles, yield results that are consistent with the results that would have been realized if uncontrolled taxpayers had engaged in the same transaction under the same circumstances.

As a result, the financial reporting of transfer pricing has strict guidelines and is closely watched by tax authorities. Auditors and regulators often require extensive documentation. If the transfer value is done incorrectly or inappropriately, the financial statements may need to be restated, and fees or penalties could be applied.

However, there is much debate and ambiguity surrounding how transfer pricing between divisions should be accounted for and which division should take the brunt of the tax burden.

Tax authorities have strict rules regarding transfer pricing to discourage companies from using it to avoid taxes.

Examples of Transfer Pricing

A few prominent cases remain a matter of contention between tax authorities and the companies involved.

Because the production, marketing, and sales of Coca-Cola Co. ( KO ) are concentrated in various overseas markets, the company continues to defend its $3.3 billion transfer pricing of a royalty agreement. The company transferred IP value to subsidiaries in Africa, Europe, and South America between 2007 and 2009. The IRS and Coca-Cola continue to battle through litigation, and the case has yet to be resolved.

Ireland-based medical device maker Medtronic and the IRS met in court between June 14 and June 25, 2021, to try and settle a dispute worth $1.4 billion . Medtronic is accused of transferring intellectual property to low-tax havens globally. The transfer involves the value of intangible assets between Medtronic and its Puerto Rican manufacturing affiliate for the tax years 2005 and 2006. The court had initially sided with Medtronic, but the IRS filed an appeal. In mid-2022, the court found that Medtronic did not meet its burden of proof requirement, and the IRS abused its discretion by modifying the method it proposed Medtronic used.

What Are Commonly Used Methods of Transfer Pricing?

The Comparable Uncontrolled Price Method is one of the most commonly used transfer pricing methods.

What Are the Disadvantages of Transfer Pricing?

One of the key disadvantages is that the seller is at risk of selling for less, netting them less revenue. The practice also give multinational corporations a tax loophole.

What Is the Purpose for Transfer Pricing?

Transfer pricing acts to distribute earnings throughout an organization but is primarily used to skirt tax laws and reduce tax burdens by multinational companies.

Transfer pricing is a legal technique used by large businesses to move profits around from parent companies to subsidiaries and affiliates to ensure funds are evenly distributed. However, many multinational corporations use it as a tactic to lower their tax burdens and end up fighting the IRS in court.

Internal Revenue Service. " Transfer Pricing ."

ITR World Tax. " The Coca-Cola Company & Subsidiaries, Petitioner v Commissioner of Internal Revenue, Respondent ."

U.S. Securities and Exchange Commission. " Updated Information Related to Tax Audits ."

Medtronic Investor Relations. " Annual Report 2020 ," Page 30.

International Tax Review. " The IRS Takes Facebook to Court Over Its Irish Tax Structure ."

United States Courts. " United States Court of Appeals for the Eighth Circuit, No. 17-1866, Medtronic, Inc. & Consolidated Subsidiaries v. Commissioner of Internal Revenue ."

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Synonyms for Transfer of responsibilities

60 other terms for transfer of responsibilities - words and phrases with similar meaning.

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Title Transfers and Changes

To prove vehicle ownership, it’s important to have a valid, up-to-date, and accurate California Certificate of Title. Here’s how you can transfer and change a title. 

Transfer your Title online!

You can now transfer a title online. Learn more about the steps and get started.

How to Transfer a Title

Anytime there’s a change to a vehicle or vessel’s registered owner or lienholder, that change must be updated in DMV’s records within 10 days and the California Certificate of Title must be transferred to the new owner.

A change in ownership is usually due to:

• Sale, gift, or donation
• Adding or deleting the name of an owner
• Inheritance
• Satisfaction of lien (full payment of car loan)

To transfer a title, you will need:

• Either the California Certificate of Title or an Application for Replacement or Transfer of Title (REG 227) (if the title is missing). 
• The signature(s) of seller(s) and lienholder (if any).
• The signature(s) of buyer(s).
• A transfer fee .

Depending on the type of transfer, you might need to complete and submit additional forms. See below for other title transfers and title transfer forms.

Submit your title transfer paperwork and fee (if any) to a DMV office or by mail to: 

DMV PO Box 942869 Sacramento, CA 94269

Rush Title Processing

If you need us to expedite your title processing, you can request rush title processing for an additional fee.

Transfer Fees

Depending on the type of transfer, you may need to pay the following fees:

• Replacement title
• Use tax, based on the buyer’s county of residence
• Registration

See the full list of fees .

Renewal fees and parking/toll violation fees don’t need to be paid to issue a replacement California Certificate of Title.

Title Transfer Forms

These forms may be required when transferring ownership of a vehicle or vessel:  Application for Replacement or Transfer of Title (REG 227) Vehicle/Vessel Transfer and Reassignment (REG 262) form (call the DMV’s automated voice system at 1-800-777-0133 to have a form mailed to you) Statement of Facts (REG 256) Lien Satisfied/Title Holder Release (REG 166) Notice of Transfer and Release of Liability Smog certification Vehicle Emission System Statement (Smog) (REG 139) Declaration of Gross Vehicle Weight (GVW)/Combined Gross Vehicle Weight (CGW) (REG 4008) Affidavit for Transfer without Probate (REG 5) Bill of Sale (REG 135) Verification of Vehicle (REG 31)

Other Title Transfers

When you’re buying a new car or a used car from a dealership, the dealer will handle the paperwork and you’ll receive your title from DMV in the mail.

When vehicle ownership is transferred between two private parties, it’s up to them to transfer the title. If you have the California Certificate of Title for the vehicle , the seller signs the title to release ownership of the vehicle. The buyer should then bring the signed title to a DMV office to apply for transfer of ownership. 

If you don’t have the California Certificate of Title , you need to use an Application for Replacement or Transfer of Title (REG 227) to transfer ownership. The lienholder’s release, if any, must be notarized. The buyer should then bring the completed form to a DMV office and we will issue a new registration and title.

Make sure you have all signatures on the proper lines to avoid delays.

Other Steps for the Seller When Vehicle Ownership is Transferred

• 10 years old or older.
• Commercial with a GVW or CGW of more than 16,000 pounds.
• New and being transferred prior to its first retail sale by a dealer.
• Complete a Notice of Transfer and Release of Liability (NRL) within 5 days of releasing ownership and keep a copy for your records.

Once the seller gives the buyer all required documentation and DMV receives the completed NRL, the seller’s part of the transaction is complete.

*If the vehicle has been sold more than once with the same title, a REG 262 is required from each seller.

Other Steps for the Buyer When Vehicle Ownership is Transferred

• Current registered owner(s), how names are joined (“and/or”), and lienholder/legal owner (if any).
• License plate number, vehicle identification number (VIN), make, model, year, and registration expiration date.
• Title brands (if any).
• Words “Nontransferable/No California Title Issued,” indicating a California title was not issued and a REG 227 cannot be used (see FAQs).
• Get a smog inspection (if applicable).

Once the buyer has provided the DMV with all the proper documents and fees, the vehicle record is updated to reflect the change of ownership and a registration card is issued.

A new title is issued from DMV headquarters within 60 calendar days.

To transfer a vehicle between family members, submit the following:

• The California Certificate of Title properly signed or endorsed on line 1 by the registered owner(s) shown on the title. Complete the new owner information on the back of the title and sign it.
• A Statement of Facts (REG 256) for use tax and smog exemption (if applicable).
• Odometer disclosure for vehicles less than 10 years old.
• Transfer fee .

You may transfer a vehicle from an individual to the estate of that individual without signatures on the Certificate of Title.

Submit the following:

• The California Certificate of Title. On the back of the title, the new owner section must show “Estate of (name of individual)” and their address. Any legal owner/lienholder named on the front of the title must be re-entered on the back of the title.
• A Statement of Facts (REG 256) confirming the owner is deceased and Letters Testamentary have not been issued. The person completing the statement must indicate their relationship to the deceased.

Use tax and a smog certification are not required.

Vehicle ownership can be transferred to a deceased owner’s heir 40 days after the owner’s death, as long as the value of the deceased’s property in California does not exceed:

• $150,000 if the deceased died before 1/1/20.
• $166,250 if the deceased died on or after 1/1/20.

If the heir will be the new owner, submit the following to a DMV office:

• The California Certificate of Title. The heir must sign the deceased registered owner’s name and countersign on line 1. The heir should complete and sign the back of the title.
• Affidavit for Transfer without Probate (REG 5) , completed and signed by the heir.
• An original or certified copy of the death certificate of all deceased owners.

If the heir prefers to sell the vehicle, the buyer also needs (in addition to the items above):

• Bill of Sale (REG 135) from the heir to the buyer.
• Transfer fee (two transfer fees are due in this case).

To transfer vessel ownership, submit the following:

• The California Certificate of Ownership. The registered owner signs line 1. The legal owner/lienholder (if any) signs line 2. Complete the new owner information on the back of the certificate and sign it.
• Bill(s) of sale, if needed to establish a complete chain of ownership.
• A Vessel Registration Fee .
• Use tax based on the tax rate percentage for your county of residence.

After you sell a vessel, complete a Notice of Transfer and Release of Liability (NRL) within five days of releasing ownership and keep a copy for your records.

How to Update or Change a Title

Because a California Certificate of Title is a legal document, it is important to keep it accurate and up-to-date. Here’s how you can update or change a title. 

Order a Replacement California Certificate of Title

You must order a replacement California Certificate of Title when the original is lost, stolen, damaged, illegible, or not received. 

To order a replacement title, submit the following:

• Application for Replacement or Transfer of Title (REG 227) .
• The original title (if you have it).
• California photo driver license (if submitting form in person).
• Replacement title fee .
• If another replacement title was issued in the past 90 days, a Verification of Vehicle (REG 31) completed by the California Highway Patrol (CHP). This requirement only applies if the registered owner’s name or address doesn’t match DMV records*.

You can submit your application either in-person* at a DMV office or by mail:

Department of Motor Vehicles Registration Operations PO Box 942869 Sacramento, California 94269-0001

If you’re submitting your form to a DMV office, we recommend you make an appointment so you can avoid any lines. 

You’ll receive your title by mail 15-30 calendar days from the date you submit the replacement title application.

*If you’re applying for a replacement title and the registered owner’s name or address doesn’t match DMV records (except for obvious typographical errors), you must submit your application in person with proof of ownership (e.g. registration card) and an acceptable photo ID (e.g. driver’s license/ID card).

Online Replacement Title Request

Visit our Virtual Office to request a replacement title online.

Change or Correct a Name on a Title

Your true full name must appear on your vehicle or vessel California Certificate of Title and registration card. If your name is misspelled, changes (e.g as a result of marriage or divorce), or is legally changed, you need to correct your name on your title.

To change or correct your name, submit:

• California Certificate of Title with your correct name printed or typed in the “New Registered Owner” section
• A completed Name Statement in Section F of the Statement of Facts (REG 256) .

You may submit your application to any DMV office or by mail to:

Department of Motor Vehicles Vehicle Registration Operations PO Box 942869 Sacramento, CA 94269-0001

Removing Information that was Entered by Mistake

If a name or other information is entered on a title by mistake, complete a Statement to Record Ownership (REG 101) .

Frequently Asked Questions

If the vehicle has a legal owner/lienholder, then section 5 of the REG 227 needs to be notarized. If the registration does not show a legal owner/lienholder, notarization is not required.

Need help finding the lienholder on your vehicle title? We keep a listing of banks, credit unions, and financial/lending institutions that may have gone out of business, merged, changed their name, or been acquired by another financial institution.

No. You must obtain a title from the state where the vehicle was last titled.

If you’re unable to obtain a title from that state, provide documentation that they cannot issue a title. A motor vehicle bond may be required

Contact us for more information .

Need something else?

Fee calculator.

Use our fee calculator to estimate any applicable registration or title transfer fees.

Renew Your Vehicle Registration

You need to renew your vehicle registration every 1-5 years in California, depending on the vehicle. Make sure your registration is up-to-date.

Make an Appointment

Some applications can be submitted to a DMV office near you. Make an appointment so you don’t have to wait in line.

General Disclaimer

When interacting with the Department of Motor Vehicles (DMV) Virtual Assistant, please do not include any personal information.

When your chat is over, you can save the transcript. Use caution when using a public computer or device.

The DMV chatbot and live chat services use third-party vendors to provide machine translation. Machine translation is provided for purposes of information and convenience only. The DMV is unable to guarantee the accuracy of any translation provided by the third-party vendors and is therefore not liable for any inaccurate information or changes in the formatting of the content resulting from the use of the translation service.

The content currently in English is the official and accurate source for the program information and services DMV provides. Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. If any questions arise related to the information contained in the translated content, please refer to the English version.

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Wells Fargo Illegally Claims Customers Are Liable for Unauthorized Transfers, Say Victims of Bank Fraud, As New Class-Action Lawsuit Filed in Federal Court

Wells Fargo is facing a new proposed class-action lawsuit, accused of breaking the law by forcing customers to accept responsibility for unauthorized transfers.

The suit , filed by Jennifer Rice and Erik Westervelt in a Pennsylvania federal court, alleges Wells Fargo routinely violates the Electronic Funds Transfer Act by not reimbursing victims for their losses.

In December of 2023, the couple says they received a call from someone claiming to be from Wells Fargo who informed him that they had detected a fraudulent wire transfer on his account to the tune of $24,557.89.

The person on the phone said they could halt the transfer as long as he could confirm the six digit code sent to him via text message.

When Westervelt confirmed to code, the $24,557.89 vanished from the joint account via wire transfer to an unknown user at Discover Bank.

After realizing he had been speaking with a con artist, Westervelt immediately went to the local Wells Fargo branch to report what happened. The bank’s fraud department confirmed that the money had left his account and that they would be investigating the incident.

But after seven days, Wells Fargo called Westervelt and Rice to inform them they would not be reimbursed because they were the ones that “authorized” the transfer. The pair say they did nothing of the sort and claim Wells Fargo went back and forth multiple times between promising to reimburse and then reversing its stance.

The plaintiffs reference the Electronic Funds Transfer Act, which states,

“A consumer is not liable for any unauthorized electronic fund transfer unless such transfer was made using an accepted card for the account and the issuing institution has provided a means to identify the person using said accepted card.”

Westervelt and Rice and seeking statutory damages of $1,000 per class member, plus fees, costs and a jury trial.

Disclaimer: Opinions expressed at The Daily Hodl are not investment advice. Investors should do their due diligence before making any high-risk investments in Bitcoin, cryptocurrency or digital assets. Please be advised that your transfers and trades are at your own risk, and any losses you may incur are your responsibility. The Daily Hodl does not recommend the buying or selling of any cryptocurrencies or digital assets, nor is The Daily Hodl an investment advisor. Please note that The Daily Hodl participates in affiliate marketing.

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Denzel Dumfries makes Harry Kane confession after controversial semi-final penalty

Denzel Dumfries' attempt to block a Harry Kane shot ended up in a penalty for England as the Dutch defender shoulder the responsibility despite the controversial call

• 07:45, 11 Jul 2024
• Updated 09:54, 11 Jul 2024

Denzel Dumfries has taken full responsibility for the controversial penalty awarded to England but maintains "I barely touched him".

The Dutch were stunned when the Three Lions were given a penalty in their semi-final following a VAR check. Dumfries had attempted to block a Harry Kane volley and the Bayern Munich man stayed down, which gave time for the replays to be reviewed.

Kane's foot looked to have made contact with Dumfries, who was looking to block the shot, but few initially thought it would be given as a spot kick. The referee went over to the monitor however and gave the decision, allowing England to equalise.

The Inter Milan man confessed the minute he saw the referee take a second look, he knew what was coming. He said: “I want to block the shot. I barely touch him. I do think [it’s a VAR penalty]. You know when he goes to the sideline, he can give it. I take full responsibility”.

It ruled out Xavi Simons' powerful opener and gave England parity, before they scored their winner in the 90th minute courtesy of Ollie Watkins. The Netherlands though were focused on the referee and his divisive call after the game as their tournament came to an end.

Did England deserve the penalty? Vote in our poll HERE to have your say.

Dutch boss Ronald Koeman said: "In my opinion it should not have been a penalty. He kicked the ball and the boots touched. I think that we cannot play properly football and this is due to VAR. It really breaks football."

Virgil van Dijk endured another heartbreak on the international stage as the Liverpool man struggles to replicate his club success with his country. The prospect of a major tournament final was on the cards in Dortmund and he was also left fuming with the officials.

The centre-half said: "I don’t know what to say, I don’t know if I should say something about this. But I think it says it all that the referee went in quite quickly after the game, had no time to shake his hand."

Gary Neville , part of the ITV punditry line-up, confessed that handing England a penalty was "an absolutely disgraceful decision." He went on to add: "There's no way that was a penalty. He just goes in naturally to block the shot. It's not a penalty for me."

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• Open access
• Published: 10 July 2024

Ready to leave? – Adolescents’ and parents’ perceptions of transition from paediatric to adult rheumatology care

• A. Vermé   ORCID: orcid.org/0009-0008-4541-1133 1 , 2 ,
• Marika Wenemark   ORCID: orcid.org/0000-0002-6281-7783 1 , 3 , 4 ,
• J. Granhagen Jungner   ORCID: orcid.org/0000-0003-4103-6539 1 ,
• E. Broström   ORCID: orcid.org/0000-0002-2967-8080 1 &
• C. Bartholdson   ORCID: orcid.org/0000-0001-5807-3438 1 , 2  

BMC Health Services Research volume  24 , Article number:  795 ( 2024 ) Cite this article

Metrics details

In Sweden, approximately 2000 children live with Juvenile Idiopathic Arthritis (JIA). About half of them continue to have an active disease and need to transfer to adult rheumatology care. This study aimed to investigate Swedish adolescents’ and parents´ perceptions of readiness for transition from pediatric to adult rheumatology care.

The study was a cross-sectional quantitative study. Patients at the pediatric rheumatology clinic at a university hospital in Sweden and members of The Swedish National Organization for Young Rheumatics aged 14–18 and their parents were invited to participate in the study. Data was collected with the Readiness for Transition Questionnaire (RTQ) focusing on adolescents' transition readiness, adolescents' healthcare behaviors and responsibility, and parental involvement. Data were analyzed with descriptive statistics. Comparative analyses were made using non-parametric tests with significance levels of 0.05 as well as factor analyses and logistic regression.

There were 106 adolescents (85 girls, 20 boys) and 96 parents answering the RTQ. The analysis revealed that many adolescents and parents experienced that the adolescents were ill-prepared to take over responsibility for several healthcare behaviors, such as booking specialty care appointments, calling to renew prescriptions and communicating with medical staff on phone and to transfer to adult care. Parents and adolescents alike stated that it was especially difficult for the adolescents to take responsibility for healthcare behaviors meaning that the adolescents had to have direct interaction with the healthcare professionals (HCPs) at the paediatric rheumatology clinic, for example to renew prescriptions. It was evident that the adolescents who perceived they were ready to take responsibility for the aspects related to direct interaction with HCPs were more overall ready to be transferred to adult care.

Adolescents need more support to feel prepared to transfer to adult care. With the results from this study, we can develop, customize, and optimize transitional care programs in Sweden for adolescents.

Peer Review reports

Juvenile Idiopathic Arthritis (JIA) is a heterogeneous group of disorders categorized into seven subgroups, all of which have inflammatory arthritis as a common denominator [ 1 ]. JIA can arise at any time during childhood, and girls are more likely than boys to be affected [ 2 ]. Yearly, 150–200 children in Sweden are diagnosed with JIA and around 1 500–2 000 children live with the disease [ 3 ]. Approximately half of the adolescents with JIA continue to have an active disease as they enter adulthood, and need to transfer to adult care [ 4 , 5 ]. In Sweden, most adolescents will be transferred to adult care at the age of 18 years. The transfer from paediatric to adult rheumatology care is, for some, perceived as difficult, and can cause anxiety among adolescents and their parents [ 6 ].

There is a distinction between transfer and transition. The term ‛transfer’ refers to an occurrence or series of events when adolescents with ongoing physical and medical issues move from receiving care in a paediatric setting to an adult medical setting. ‘Transition’, on the other hand, is a process that occurs throughout adolescence and aims to educate adolescents to manage their lives and health in relation to their chronic illness. The learning process should start before the adolescent enters puberty, and last until they are old enough to take care of themselves [ 7 ]. The Society for Adolescent Medicine defines transitional care as “the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centred to adult-oriented healthcare systems” (p.570) [ 8 ].

Previous research shows that the transition process gives the best results if initiated as soon as the child enters adolescence. It can begin as early as 11 years of age but not later than the age of 14 [ 9 ]. The necessity of starting the process in early adolescence was also demonstrated by McDonagh and colleagues, who examined a coordinated evidence-based approach. Twelve months following the program’s implementation, the youngest group (aged 11) displayed significant gains in knowledge of arthritis, an increase in self-medication, and increased satisfaction with rheumatology care [ 10 ].

In the transition process, it is important to include the parents and to help them adjust to their new role as they will no longer be the ones who have the main responsibility for the adolescent’s healthcare [ 11 ]. During the transition process, healthcare professionals (HCPs) should try to strengthen the adolescent’s independence without undermining the parent’s role [ 12 ]. HCPs, adolescents, and parents must try to create a common view on how the transition process facilitates and strengthens the adolescent’s independence [ 13 ].

There are several methods for measuring readiness for transition targeting adolescents, parents, and HCPs. In the literature, both quantitative [ 14 , 15 , 16 , 17 ] and qualitative [ 18 , 19 , 20 , 21 ] methods are used. In Sweden the Readiness for Transition Questionnaire (RTQ) has recently been used [ 26 ]. Results from previous research measuring readiness show that both adolescents and parents need more knowledge about transition. In a study with 49 patients suffering from JIA and 103 parents, Matsumoto (2021) shows that over half of the adolescents and about one-third of their parents had limited knowledge about what transitional care was, and over half of the adolescents and nearly four-fifths of the parents felt worried to transfer to adult care [ 22 ]. This study also showed that about half of both the adolescents and the parents were not given the opportunity to talk to the doctor about the upcoming transfer to adult care. A major worry was that the medical doctors in adult care would not have adequate knowledge about JIA [ 22 , 23 ]. In another study by Sömnez (2021), of 157 patients with different rheumatology diagnoses and their parents, half of the adolescents and almost all the parents wanted to stay in paediatric care [ 23 ] and were, accordingly, not sufficiently ready for transfer. Moreover, age seems to be an important determinator for perceptions of readiness for transfer from paediatric rheumatology [ 24 ]. Bingham and colleagues found that older children had higher self-reported autonomy in most questions asked regarding accessing medical care [ 25 ]. Other patient characteristics associated with high self-perceived autonomy included having a family member with a similar disease, having a younger parent, and longer disease duration [ 25 ].

Transfer to adult rheumatology is under-researched [ 10 ]. In Sweden, no studies have been made on readiness for transfer to adult care among adolescents with JIA and there is no structured transition program or guidelines for this patient group. In order to tailor and improve transitional care for adolescents with JIA, it is essential to know how ready adolescents and their parents feel about different aspects of the transition and, ultimately, the transfer from paediatric to adult care. Investigation of adolescents’ and parents’ readiness could facilitate understanding of the transition process and create foundations for individualized support.

The aim of this study was to investigate Swedish adolescents with JIA and their parents’ perceptions of readiness for transition from paediatric to adult rheumatology care.

Study design

A cross-sectional quantitative study.

Participants

Data were collected from March 2020 to March 2022. Patients at the paediatric rheumatology clinic at a university hospital in Stockholm and members of the Swedish National Organization for Young Rheumatics were invited, together with their parents, to participate in the study.

Inclusion criteria

Confirmed Juvenile Idiopathic Arthritis, adolescents turning 14 the year of inclusion and adolescents up to 18 years.

Exclusion criteria

Uncertain paediatric rheumatic disease. Non-Swedish speaking adolescents/parents.

Questionnaire

The readiness for transition questionnaire (RTQ) was originally developed and validated by Gilleland [ 15 ] for patient groups with different chronic diagnoses, and is also available in a parental version [ 15 ]. The questionnaire has been translated and culturally adapted into Swedish [ 26 ] using scientific guidelines [ 27 ]. The first part of the RTQ covers four questions about responsibility for healthcare [ 15 ]. Furthermore, the RTQ covers adolescent responsibility and parental involvement in different healthcare-related behaviours, as well as final questions about overall transition readiness and overall readiness for responsibility for healthcare [ 15 ]. Included healthcare-related behaviours are, for example, regular blood samples, taking medications, and being in contact with the clinic. The questions about healthcare-related behaviours have five possible answers for adolescent responsibility: 1 = Not responsible at all; 2 = Sometimes responsible; 3 = Often responsible; 4 = Almost always responsible; and 5 = Not relevant. The same behaviours are also investigated in the section about parental involvement, with response options as follows: 1 = Not involved at all; 2 = Sometimes involved; 3 = Often involved; 4 = Almost always involved; and 5 = Not relevant. The response option Not relevant was added for questions related to healthcare behaviours during the adaptation process [ 26 ]. Response alternatives to the final overall questions are: Not at all ready; Somewhat ready; Mostly ready; and Completely ready.

In the present study, two minor adjustments were made to the Swedish version [ 26 ], in both the adolescent and parent versions: 1) the word “daily” was excluded from the question about daily medications since not all medications are taken daily within paediatric rheumatology, and 2) the example of type of clinics in the question about scheduling specialty care appointments was replaced by clinics more relevant to the patient group. Furthermore, questions ( n  = 5) about health were excluded due to ambiguities in what adolescents include in the health concept, and that the original questionnaire [ 15 ] focused on healthcare and not health.

Data collection

In total, 225 members of the Swedish National Organization for Young Rheumatics and 110 patients from the paediatric rheumatology clinic were invited to participate in the study by a research invitation letter sent to their home addresses. The research invitation letter included information explaining the purpose of the study and separate QR codes for adolescents and parents to access the digital anonymous RTQ. One reminder was sent to the intended study participants at one point.

Ethical approval declarations

The study was approved by the Ethical Review Board in Sweden Dnr 2019–01540.

Data analysis

Data were analysed with descriptive statistical methods calculating percentages, medians, ranges, means, and standard deviations. Comparative analyses were made using non-parametric tests (Mann Whitney U test) with a significance level of 0.05. The two parts concerning adolescent responsibility and parental involvement for different healthcare-related behaviours were combined to obtain a measure of the adolescent’s level of “independent responsibility”. In the combined measure, no distinction was made between the two response options “Often” and “Almost always” since we found it difficult to distinguish between them. The independent responsibility measures are described below:

No responsibility – Adolescent not responsible at all.

Minor responsibility – Adolescent sometimes responsible.

Shared responsibility – Adolescent often responsible with parents often involved.

Major responsibility – Adolescent often responsible with parents sometimes or not at all involved.

Factor analysis (Varimax rotated principal component analysis) was used to investigate the dimensions of the items. Logistic regression was used to analyse what factor(s) explain adolescents feeling almost fully or fully ready to transfer to adult care.

Out of 335 patients receiving the invitation, including an invitation to their parents, 106 adolescents (girls n  = 85, boys n  = 20, one missing) and 96 parents answered the questionnaire. The response rate was 32% for adolescents but unknown for parents since information about the number of parents in each family receiving the invitation is missing. Adolescents’ ages ranged from 13 to 18 years old (Fig.  1 ) with a median age of 16 years (participants who were 13 years old were turning 14 the same year). Sociodemographic questions in RTQ include age and gender but not diagnosis subgroup. Therefore, we do not know which subgroup of JIA the participants had. The clinic treats patients with all types of JIA and therefore it can be assumed, but not certain, that there also were a spread of JIA sub group diagnosis among the respondents.

Age distribution in the adolescent group ( n  = 104)

Responsibility and involvement in different healthcare-related behaviours

Adolescents and parents were asked about how much responsibility the adolescents took for different healthcare-related behaviours, and how much the parents were involved in, for example, taking medication, renewing prescriptions, and attending medical appointments (Table  1 ). In general, 16–18-year-old adolescents reported taking more responsibility and having lower parental involvement than 13–15-year-olds. For several behaviours, there were significant differences between the two age groups of adolescents (Table 2 ). When analysing gender, one significant difference emerged; namely, girls reported more responsibility for communication with the clinic on the phone compared to boys (p value = 0.045) (Table 2 ). The adolescents reported themselves as taking greater responsibility than the parents reported them as doing. However, both adolescents and parents reported equally that the adolescents took less responsibility for tasks involving direct contact with the clinic (Table  1 ). Both adolescents and parents reported that the parents were largely involved in healthcare-related behaviours. The younger adolescents (13–15 years) reported that their parents were more involved in healthcare-related behaviours than the older adolescents (16–18 years) reported (Table  1 ).

Adolescents’ and parents' perception of independent responsibility regarding different healthcare-related behaviours

In the combined measure of responsibility with different levels of parental involvement, the analysis showed that direct contact with the healthcare system was most challenging for adolescents (Fig.  2 ). In many of the other healthcare-related behaviours, for example, taking medication, getting regular labs, and explaining the disease to others, the adolescents perceived themselves as taking major responsibility, while perceiving parents as often involved. A small proportion of adolescents perceived themselves as taking major responsibility without parental involvement. The substantial progress in responsibility, compared between the younger and older adolescent groups, was for getting regular labs and attending medical appointments. For the more challenging activities, there was progress between the younger and older age groups, but still, less than 25% of the older adolescents perceived major responsibility, with parents often/sometimes involved.

Independent responsibility (a combined measure of adolescent responsibility in relation to parent involvement) for different healthcare-related behaviours

Adolescents’ and parents’ perceptions of overall readiness to transfer to adult care

There was a significant difference ( p value = 0.005) (Table 2 ) between the age groups when reporting perceptions of overall readiness to transfer to adult care. In the younger group (13–15 years), 2% perceived that they were fully ready to transfer to adult care compared to 7% of the adolescents in the older group (16–18 years) (Table 3 ). Moreover, in the younger age group (13–15 years), 48% perceived that they were not ready to transfer to adult care compared to 24% in the older age group (16–18 years). There were no significant gender differences when adolescents reported perceptions on how fully ready they were to transfer to adult care.

Parents’ perceptions are congruent with the younger age group of adolescents. Three percent reported that they perceived their adolescents as being fully ready to transfer and half (49%) of the parental group reported that they did not perceive their adolescents as ready to transfer (Table 3 ).

Factors influencing adolescents’ and parents’ perception of overall readiness to transfer to adult care

A factor analysis revealed two factors with eigenvalues above 1, explaining 63.9% of the variance (Table  4 ). Factor 1 includes variables that have to do with bookings and communication by telephone, conceptualized as “Administration”. Factor 2 includes handling labs/medications and communicating in person, which seem related to engagement and routines of the healthcare, conceptualized as “Engagement”.

The engagement factor gets high scores in the group that feels not ready for transfer and increases for the group that feels rather ready. Thus, it seems that this factor includes the first steps to independent responsibility for healthcare. Adolescents’ and parents’ results are in reasonable agreeance for Factor 2 (Table  5 ). The administrative factor is continuously increasing in the three levels of readiness, and there is a bigger gap between the group that feels rather ready and the group that feels almost/fully ready. Parents especially don’t seem to judge their adolescents as fully ready for transfer until they also show independent responsibility for administrative matters.

Separate logistic regressions for adolescents and parents showed that only Factor 1 (administrative) was significant for explaining being almost/fully ready for transfer when also controlling for Factor 2 (engagement) (Table  6 ).

This cross-sectional quantitative study’s analysis reveals that many adolescents with JIA were ill-prepared to transfer to adult care. The same issue was reported by their parents. Parents and adolescents alike stated that it was difficult for the adolescents to take responsibility for several healthcare-related behaviours connected to adolescents’ direct interaction with the HCPs at the paediatric rheumatology clinic. It was evident that the adolescents who perceived they were ready to take responsibility for the aspects related to direct interaction with HCPs were more ready to be transferred to adult care.

As mentioned above, challenging healthcare-related behaviours for adolescents included them having direct contact with HCPs, e.g., calling to book an appointment or renew prescriptions. The same results have been shown in other studies [ 24 , 26 ]. The reasons for these results are not clear. One could argue that the feeling of uncertainty and the fear of making mistakes could be one explanation. Research has shown that adolescents transitioning from adolescent to adult care felt anxious, uncertain, and fearful [ 28 ], which could reinforce the fear of making mistakes. The two items that involve using the phone – to communicate with HCPs and renew prescriptions – seem especially difficult for adolescents. There may be several reasons why young people find it challenging to contact healthcare providers by phone. One reason may be that the phone hours are during the day when they are at school, which makes it difficult for them to handle the contact on their own without having to leave classes. Another reason may be that adolescents rarely make telephone calls, and are especially uncomfortable talking to adults on the phone. On the other hand, adolescents are used to using their mobile phones for many other things and it is an environment they feel safe in, which could be argued would perhaps contribute to them feeling comfortable to contact healthcare providers. Healthcare clinics caring for adolescents must fulfill their task to be adolescent-friendly and customize accessibility according to adolescents’ preferences. Using digital platforms, including communication pathways such as chats, could be one solution and would increase flexibility regarding contact times with HCPs. The digital opportunities that exist today could, perhaps, also be utilized in the transition work itself. In a study by Miller [ 29 ], it was shown that adolescents who were given the opportunity to use digital transition support by an app on their phone increased their self-confidence in taking care of their illness, and the proportion of those who took responsibility for booking visits to the healthcare system. They also used the app to increase their knowledge of their disease [ 29 ].

The present study also provides us with the knowledge that this group of adolescents did not feel ready to transfer to adult care. Only a small percent (5%) of the adolescents reported that they were fully ready to transfer. Our results demonstrate that neither does it seem to be enough to take responsibility for some possibly simpler behaviours to feel fully ready. We speculate that the challenge is, perhaps above all, to start taking responsibility for ‛adult’ things, like booking and calling, i.e., the behaviours included in factor 1. However, it may be difficult for adolescents to evaluate whether they are ready to be transferred, as the idea of it may be abstract and they may not know what to expect. They might not know geographically where they are going, which medical doctor to see, and how the care is conducted there. Despite years of increased study and policy focus on the topic of transition, there are still unmet requirements for adolescents and their families. As a crucial component of an adolescent’s development, health transitions take place concurrently with, and in relation to, a variety of other significant transitions, like transitioning from childhood to being an adolescent, that has an impact on many different facets of life [ 30 ], and which may complicate the process further.

Additionally, our analysis reveals that the levels of readiness increase with the age of the adolescents. This result was expected and has been described by others [ 30 ], and is most likely associated with the developmental process of going from adolescence to adulthood [ 31 ].

In this study, parents graded the adolescents less ready for the transfer than the adolescents graded themselves. Similar results have been reported in other studies investigating transition among adolescent’s with chronic diseases [ 26 ]. Only 13% of parents reported that their adolescent was almost or fully ready to transfer, which is low even compared to the youngest age group’s own perception of readiness. The results could be related to a variety factors. One possibility is that adults and adolescents interpret “fully ready” different. Some adolescents may, for example, express readiness without realizing the impact of more independent responsibility that their parents may include in their interpretation of readiness. However, the results may also be an effect of parents underestimating the adolescent’s knowledge and ability. This could mean that adolescents never develop abilities to take responsibility if parents, for example, continue to administer medications and communicate with healthcare providers [ 32 ]. It is therefore important for HCPs to enable adolescents to increase their abilities and put them to use to support positive adolescent development. For instance, adolescents could practice asking questions about the care or sensitive topics if they are given the chance to do so while their parents are present. Although the group of boys is small, the results show that boys seem to perceive themselves as ready for transfer to a greater degree than girls. In the present study population, this perhaps can be explained by gender roles and that girls are a little more open about their lack of abilities, knowledge, and about expressing worries about the transfer. However, the girls reported to a larger extent than boys that they take responsibility for talking on the phone with HCPs. In a study by Eaton et al., the opposite was shown since they concluded that girls were more ready to transfer and had less parent involvement than boys [ 33 ]. We speculate that this might be due to culture and/or contextual differences, which makes measuring readiness among adolescents in specific contexts and cultures extra important, to enable support to be tailored according to specific needs. In a Swedish study by Burström et al. [ 26 ], the aims were to investigate levels of readiness for transition in adolescents with congenital heart disease and to compare adolescents’ levels with their parents’ assessments. Similarly to our study, they demonstrated that adolescents scored higher on overall readiness than their parents. However, they did not compare girls’ and boys’ readiness but investigated differences in perceptions between mothers and fathers. The results show that parents, regardless of gender, perceive adolescents’ responsibility equally. However, perceptions of parental involvement differed between parental genders, meaning that mothers to a greater extent than fathers, perceived themselves as involved [ 26 ]. We would argue that this again indicates that differences in perceptions of transition readiness depend on contexts, and that it is important to study the specific population in order to offer tailored support.

Another interesting question about concepts that might have influenced our results, is how the participants interpreted responsibility. If a parent asks an adolescent to call and renew a prescription and the adolescent does so, the adolescent will probably feel that they have taken responsibility, but in fact, the parent was the one responsible for checking that the prescription needed to be renewed and arranging for it to be done. The meaning and interpretation of responsibility for different age groups and parents would be interesting for further studies, to get deeper knowledge about how to communicate about and support independent responsibility for adolescents.

As a final remark, we would argue that to meet adolescents’ and parents’ needs for transition during adolescence, HCPs in both child and adult healthcare must have adequate training. The HCPs need to have good knowledge of adolescents’ normal development and be able to use it in relation to the difficulties that can arise if they also have a chronic illness. It is also important that HCPs are willing to bring up and talk about sensitive topics, for example, sex, alcohol, and relationships. Studies show that structured transition programs can increase both adolescents’ and parents’ confidence regarding the transfer to adult care [ 25 ]. This means that introducing a person-centred transition program does not only mean educating patients and parents, but also ensuring that HCPs have adequate knowledge to enable transition in an optimal and positive way.

Methodological considerations

This study is based on an anonymous survey sent out to adolescents with JIA, with encouragement for their parents to respond to the parent version. However, we do not have information on whether the adolescent lived with a single parent or both parents. The anonymous feature of the survey makes it impossible to link an adolescent to his or her parent(s). Some adolescents may therefore have answered without any parent answering the parent questionnaire and vice versa. Consequently, we do not know how the parents of a specific adolescent responded, and we cannot determine if there is agreement between adolescents and their parents on an individual level. However, our findings indicate that the responses at the group level are consistent. There is also a possibility that both parents chose to participate and answered one questionnaire each. This makes it impossible to calculate a correct response rate for parents as well as compare the results from the adolescent’s and parent’s perspectives in the same family. On the other hand, the advantage of anonymity is that respondents hopefully felt confident to give truthful answers.

When asking the parents about age and gender, some of the parents reported their age and some reported the adolescent’s age. The reports of age and gender are therefore not reliable for parents and not used in the analysis. Furthermore, we did not ask about the age of the adolescent in the parent questionnaire. This means we cannot ensure that the parents’ results correspond to the same age distribution among adolescents as the adolescents’ results.

Another limitation is that background information other than gender and age is not present. This means that we do not know what kind of JIA the patient had. It might have been interesting to be able to see if patients with a milder disease are more prepared for transferring to adult care than those who have a more severe disease or contrariwise. It would have been valuable to ascertain the duration of the adolescents' diagnoses, as this factor might influence their level of responsibility for managing their disease and their readiness for transitioning to adult healthcare. Additionally, investigating the impact of various family structures on the adolescents' ability to assume responsibility for their disease would have been insightful. For instance, the presence of multiple siblings within a family could potentially affect this ability. However, such analyses were not possible in this study due to the lack of relevant background information. As described in the method section, the decision was made to exclude the questions about responsibility for health in the questionnaire. In the original, Gilleland and colleagues use healthcare, and in Burström’s translated Swedish questionnaire, the word health is used [ 26 ]. Since we did not conduct cognitive interviews about what adolescents with JIA refer to and include when thinking about health, we assessed it was more scientifically rigorous to exclude the five questions about health. In future studies, it would be interesting to explore this further in cognitive interviews with adolescents, and thereby find out if it is most suitable to ask about health versus healthcare.

In the combined measure of independent responsibility, no distinction was made between the parent being involved sometimes or not at all. The reason for this is that it seems reasonable that parents are sometimes involved in visits to the clinic or talking to the staff, even if the adolescent takes most of the responsibility. The factor analysis and the two latent factors are based on summaries of the scores (1–4) of the items in each factor. Summarizing ordinal data is not optimal but is used here to give a rough picture of the two different factors in this rather small amount of material. In a future larger study, Rasch analysis could be used to develop a validated measurement scale for independent responsibility.

Lastly, we would like to point out that it is difficult to state the results in the sudy are representative of the population concerned since we have no data on JIA subtypes, for example. Moreover, it is probable that the participants who responded are those who felt most concerned or more comfortable with the subject. However, the results in this study based on the rather large sample of 106 adolescents shows strong indications of levels of readiness in this population. In future research stratified sampling could be used to ensure that each subgroup is adequately represented.

Clinical implications

The results from this study can be used as a foundation for structuring a transition program for adolescents with JIA, including tailoring transition care and creating opportunities for HCPs to focus on the parts of the transition that are perceived as challenging by the adolescents.

Based on the findings of the present study, it is evident that HCPs working in paediatric care have to provide the adolescents and their parents with information and knowledge so that they can feel safe when transferring to adult care. To guarantee an optimal transition from paediatric to adult care, it is imperative to comprehend the special needs of each adolescent, and acknowledge cultural and contextual differences. The RTQ can be used as a screening tool to discover individual needs.

The results of this study show that adolescents need more support to feel ready to take responsibility for specific healthcare-related behaviours and transfer to adult care. The results indicated that the healthcare behaviours most difficult to take responsibility for included adolescents having to make direct contact with healthcare. The parents also perceived that this was the area that was most difficult for the adolescents to take responsibility for. It is important to pay attention to possible gender differences as well as contextual and cultural differences. The RTQ may be a relevant tool to screen for individual needs during the transition process. With the results from this study, we can customize, and thus optimize, transitional care in Sweden for adolescents with JIA.

Availability of data and materials

The datasets supporting the conclusions of this article are included within the article.

Abbreviations

Confidence interval

Factor score

Health Care Professionals

Juvenile Idiopathic Arthritis

Readiness for Transition Questionnaire

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Acknowledgements

We would like to thank all the adolescents and parents who took the time to respond to the questionnaires. We would also like to thank the Swedish National Organization for Young Rheumatics for their collaboration.

Open access funding provided by Karolinska Institute. We are grateful for the financial support from the “Swedish Rheumatic Foundation”, “Association of Rheumatology Nurses in Sweden”, “Norrbacka Eugenia Foundation”, “Swedish Foundation for Child Research”, “SveReFo”, “Crown Princess Lovisa’s Foundation”, “Stig Thune Foundation”, “Sällskapet barnavård”, and research grants from Astrid Lindgrens’ Children’s Hospital. The grant providers were not involved in the study design, data collection and analysis, or preparation of the manuscript.

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A. Vermé, Marika Wenemark, J. Granhagen Jungner, E. Broström & C. Bartholdson

Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden

A. Vermé & C. Bartholdson

Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden

Marika Wenemark

Unit for Public Health and Statistics, East Region, Linköping, Sweden

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CB and AV conceived the initial idea for the study and led the study design, ethics approval, data collection, data analysis, and most writing. CB, AV, and MW performed data analysis. All authors (AV, MW, JGJ, EB, CB) discussed the findings, drafted and approved the final manuscript.

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Ethics approval and consent to participate.

The study complies with the Declaration of Helsinki and was approved by the Swedish Ethical Review Authority Dnr 2019–01540. All the participants received an information letter together with the questionnaire. In this information letter, it was stated that by answering the questionnaire the participants consented to participate in the anonymous study. The information targeting minors, i.e. below 15 years old, was age-adapted and parents received the same information enabling assisting their children to understand the purpose of the study. It was clearly stated that participating in the study by answering the anonymous questionnaire was voluntary and that it did not influence their care under any circumstances.

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Vermé, A., Wenemark, M., Jungner, J.G. et al. Ready to leave? – Adolescents’ and parents’ perceptions of transition from paediatric to adult rheumatology care. BMC Health Serv Res 24 , 795 (2024). https://doi.org/10.1186/s12913-024-11265-9

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Money blog: Nando's launches a ketchup - so we compared all brands. Which is best value - and which has more water than tomatoes?

Welcome to the Money blog, your place for personal finance and consumer news and tips. Leave a comment or your Money Problem/consumer dispute (don't forget to leave a contact number/email) in the box below.

Thursday 11 July 2024 20:08, UK

• Widespread issues with card payments reported - as people turned away from supermarkets
• Nando's launches a ketchup - so we compared all brands. Which is best value - and which has more water than tomatoes?
• Chances of August interest rate cut recede
• Water bills to rise by average 21% over next five years, regulator rules

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Ask a question or make a comment

A new competitor has emerged on the condiment shelf - Nando's ketchup.

It's being advertised as a twist on the traditional sauce, with a touch of "peri-peri magic" for your chips, burgers or bolognese.

This translates into a small amount of spices like cayenne pepper, bird's eye chilli, ginger, garlic, and paprika, as well onion and lemon purees.

We've taken a look at how it stacks up against the other ketchups on Asda's shelves below, with some key takeaways:

• Hellmann's has the most tomatoes and the least calories per serving
• Asda's own brand is by far the most affordable - with a very similar ingredients list to market leader Heinz
• Nando's is, just, the most expensive per 100g, though it's tricky to compare against all the below as some are only available in bigger bottles
• The main ingredient in Leon's, uniquely, is not tomatoes but water
• Leon's has the least sugar per serving

Price per 100g: 94.3p (for normal sized bottle) Main ingredient: Tomato paste (140g tomatoes per 100g) Calories: 17kcal per serving Sugar per 100g: 20g

Price per 100g: 80p (for normal sized bottle) Main ingredient: Tomatoes (148g per 100g) Calories: 15kcal per serving Sugar per 100g: 22.8g

Asda own brand

Price per 100g: 14.9p (only available in jumbo sized bottle) Main ingredient: Tomatoes (148g per 100g) Calories: 15kcal per serving Sugar per 100g: 21g

Price per 100g: 92.2p (normal sized bottle) Main ingredient: Water (with tomato paste second at 25%) Calories: Not available Sugar per 100g: 16.6g

Price per 100g: 29.2p (one up from normal sized bottle) Main ingredient: Tomatoes (117g per 100g) Calories: 17kcal per serving Sugar per 100g: 22g

Price per 100g: 40p (two up from normal sized bottle) Main ingredient: Tomatoes (168g of tomatoes per 100g) Calories: 13kcal per serving Sugar per 100g: 18g

Asda is the first to offer Nando's tomato sauce but it is expected to roll out at Sainsbury's, Tesco and other supermarkets in the coming months.

Virgin and Clyesdale Bank have announced a slight drop in their standard variable rate mortgage rates - in what could be seen as a precursor to a base rate cut in a few weeks' time.

From today, their SVR stands at 9.24% - down from 9.49%.

Barclays and Halifax have also announced they are dropping selected fixed- rate deals from tomorrow - continuing a trend we have seen in recent weeks.

Cowboy builders face a crackdown on trader recommendation websites under new guidelines proposed by the industry watchdog.

The Competition and Markets Authority says the web pages must tackle fake reviews and vet the tradespeople they advertise after "worrying evidence" emerged.

The regulator has published a first draft of its advice following concerns over websites that fail to sanction rogue traders, offer a complaints process, or monitor traders while making misleading claims about their trustworthiness.

Plusnet customers will from today see their mid-contract price changes expressed as "pounds and pence" rather than percentages in a bid by the internet provider to make information clearer for customers.

Price comparison service Uswitch has praised the move which gives "greater clarity" to consumers.

"The new model provides certainty when it comes to the cost of your contract and makes it easier for customers to manage their finances," the Uswitch telecoms expert Ernest Doku said.

The new model, which applies to new and existing customers who take out contracts after today, will see mid-contract charges at a flat rate for all customers - a yearly increase of £3 per month.

People with coeliac disease are paying up to 35% more for their weekly shop, research has found, with some even eating gluten to avoid paying higher costs despite the potential impact on their health.

A new report by Coeliac UK has found that 77% of people with the disease struggle to afford gluten-free products from supermarkets.

Seven in 10 people said shopping gluten free "adversely affects their quality of life" due to the cost and availability of the food on supermarket shelves and online.

Around 4% are choosing to eat gluten despite the risk to their health because of concerns around the cost of gluten-free food, while 27% would eat products with "may contain" for the same reason.

The research by Coeliac UK revealed that loaves of bread are 4.5 times more expensive on average, while pasta and plain flour are twice as pricey when made gluten free.

If you're thinking of stocking up on Sainsbury's snacks and drinks for Sunday's big game, you'd better do it ahead of time.

Like rival Tesco, the supermarket has announced it is closing convenience stores and petrol stations early across England so staff can tune into the Euros final.

More than a thousand branches will be closing at 7.30pm on Sunday, rather than 10pm or 11pm.

"We want to give our colleagues the chance to tune in live and cheer on England with friends and family. The atmosphere in stores is electric after last night's win," said Clodagh Moriarty, chief retail and technology officer.

Supermarket hours are unaffected as they usually close before the 8pm kick-off. 

Any online grocery orders which have already been booked will be honoured.

All branches will reopen at their usual time on Monday.

Earlier this week, business presenter Ian King answered questions from Money blog readers about what the new Labour government means for their personal finances.

One question related to the two-child cap on child benefit - which Labour have at times suggested they're ideologically opposed to, but won't commit to changing because of the cost.

Responding to a question about whether taxes could be raised for oil and gas companies to pay for scrapping the cap, King said: "The Resolution Foundation has estimated that the two-child benefit cap will save the government £2.5bn during the current financial year - which would rise to £3.6bn if applied to all families claiming universal credit.

"Labour is committed to raising the levy on North Sea oil and gas producers from the current 75% to 78% - and has earmarked the money raised will go towards funding its wider plans for energy and, in particular, decarbonisation.

"It would be ill-advised to raise taxes further. The decisions it has made have already had an impact on investment in the North Sea, as I report here.

"And don't forget, the cap is not just about saving money. It's also about avoiding awkward newspaper headlines and stories about big families being paid a small fortune in benefits of the kind that embarrassed the last Labour government and angered so many of its traditional working-class supporters in particular."

You can read all 21 of King's answers here ...

A "nationwide issue" has been affecting card payments.

Many social media users were reporting being unable to pay for their shopping in supermarkets this morning.

More than 600 people were flagging issues with Visa on Down Detector as of 9.45am, while over 100 had problems with Mastercard payments as of 10am.

A sign in one Sainsbury's store was requesting customers pay for their shopping in cash.

The supermarket said on social media it had been aware of a "nationwide issue" with card payments.

Vanessa Meehan, in Twickenham, said: "I've just been turned away at Sainsbury's as they can't accept card payments. Petrol station also coned off. The car is running on fumes and I need to get supplies."

A Sainsbury's spokesperson told Sky News at 11am that contactless payments had resumed after being "briefly unavailable for a few minutes this morning".

They said this was caused by an issue with its third-party payment provider.

"We're accepting all payments as usual and continue to monitor the situation. We're sorry for any inconvenience this may have caused," the supermarket said.

Asda also confirmed its payment systems were back up and running following temporary issues with Visa.

A Visa spokesperson confirmed to Sky News it had been aware cardholders were experiencing issues when making payments.

"While Visa's systems are operating normally, we are working with our partners to investigate," they added.

Mastercard said it was "aware of some payment transaction issues at select merchants in the UK" and was working to gather more information.

"There is no current indication that these issues are related to our network," a spokesperson said.

The UK's biggest supermarket chain has told customers its Express stores across England will close at 7.30pm instead of the usual 10pm or 11pm on Sunday - after England reached the Euro 2024 final.

It said the decision had been taken to allow its staff to get home or to the pub in time for kick-off at 8pm. 

Employees who do not want to watch the match will be paid as normal, it said. 

Stores will be open as normal the following morning. 

England are playing Spain in the final - and will have the chance to become the first England men's team to win a major tournament since the World Cup in 1966. 

By James Sillars , business reporter 

Faltering expectations for imminent interest rate cuts are playing out in financial markets today.

The pound is at a four-month high versus the dollar at $1.28.

That has been largely put down to remarks by Bank of England rate-setter Huw Pill, the Bank's chief economist, that the timing of the UK's first rate cut was an "open question".

He spoke up just 24 hours after another member of the monetary policy committee ruled out personal support for a reduction on 1 August.

Jonathan Haskel said too many stubborn inflationary pressures remained.

As such, financial markets now see only a 50/50 chance of a rate reduction to 5% from 5.25% at the next Bank meeting.

The chance of a cut had stood at 60% at the start of the week.

The pound has lifted as higher interest rates are generally supportive of a domestic currency.

Elsewhere, the FTSE 100 has opened to a flat calm - up just a couple of points at 8,000.

A big focus for investors this morning was the interim decision by water regulator Ofwat on what suppliers could charge their customers over the next five years.

To give you some idea of the reaction, shares in United Utilities and Severn Trent opened up by around 2%. Those of Pennon, the company behind South West Water, were up by more than 6%.

Water companies in England and Wales have been told they will not be allowed to impose the hikes to bills they have demanded, the industry regulator has said in an interim verdict on their business plans for the next five years.

Ofwat declared that it was minded to slash, by a third, the combined increases that the 16 companies had submitted.

It left the average bill, the watchdog said, set to rise by £19 a year or 21% over the period.

Read our report here ...

Meanwhile, more compensation, possible refunds and new customer panels have been announced as part of the government's "initial steps" towards ending what it describes as the crisis in the water sector.

You can read this story here ...

The appearance of finer weather helped the economy recover some lost ground in May, according to official figures that were better than expected.

The Office for National Statistics (ONS) recorded gross domestic product growth of 0.4% in the month, compared with its earlier determination of  zero growth during April .

A poll of economists by Reuters had pointed to a 0.2% increase for monthly gross domestic product in May.

On a quarterly basis, the UK's interest rate-driven recession of the second half of 2023 ended at the start of this year as the  Bank of England  ended its rate hiking cycle which was designed to cool inflation by choking demand in the economy.

Read our full story here ...

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