Anatomy and ultrastructure of the proboscis in <i>Mesorhynchus terminostylis</i> (Platyhelminthes, Rhabdocoela)

The ultrastructural organization of the proboscis in Mesorhynchus terminostylis is distinctly different from that in other members of the Polycystididae in which it is currently classified. The sheath epithelium is formed by three belts, all with intra-epithelial nuclei. The apical belt of the bipartite cone epithelium has a single intrabulbar nucleus, and the basal belt possesses five insunk nucleiferous cell parts behind the bulb. Six types of glands surface through the epithelia; the three types emerging through the cone epithelium can be homologized with those described for Polycistis naegelii. Only uniciliary receptors are found in the epithelium. The musculature in the bulb has a very loose appearance, and the bulbar septum appears to be a bipartite basement membrane. The septum can be considered the basement membrane of the cone epithelium as if the contractile portion of the inner longitudinal muscles have invaded the epithelium and come to lie between the epithelial cells and the basement membrane. Thus the inner musculature of the bulb is entirely intraepithelial as is the case for Psammorhynchus tubulipenis and Cytocystis clitellatus. The systematic position of M. terminostylis remains uncertain but seems to lie between Psammorhynchus and Cytocystis on one hand and Koinocystididae and Polycystididae on the other

Identifying public health policymakers' sources of information: comparing survey and network analyses.

Background: Research suggests that policymakers often use personal contacts to find information and advice. However, the main sources of information for public health policymakers are not known. This study aims to describe policymakers' sources of information. A questionnaire survey of public health policymakers across Greater Manchester (GM) was carried out (response rate 48%). All policy actors above Director level involved in public health policy (finding, analyzing or producing information, producing or implementing policy) in GM were included in the sampling frame. Respondents were provided with a list of sources of information and asked which they used (categorical data) and to name specific individuals who acted as sources of information (network data). Data were analyzed using frequencies and network analysis. The most frequently chosen sources of information from the categorical data were NICE, government websites and Directors of Public Health. However, the network data showed that the main sources of information in the network were actually mid-level managers in the NHS, who had no direct expertise in public health. Academics and researchers did not feature in the network. Both survey and network analyses provide useful insights into how policymakers access information. Network analysis offers practical and theoretical contributions to the evidence-based policy debate. Identifying individuals who act as key users and producers of evidence allows academics to target actors likely to use and disseminate their work

Effect of heuristics on serendipity in path-based storytelling with linked data

Path-based storytelling with Linked Data on the Web provides users the ability to discover concepts in an entertaining and educational way. Given a query context, many state-of-the-art pathfinding approaches aim at telling a story that coincides with the user's expectations by investigating paths over Linked Data on the Web. By taking into account serendipity in storytelling, we aim at improving and tailoring existing approaches towards better fitting user expectations so that users are able to discover interesting knowledge without feeling unsure or even lost in the story facts. To this end, we propose to optimize the link estimation between - and the selection of facts in a story by increasing the consistency and relevancy of links between facts through additional domain delineation and refinement steps. In order to address multiple aspects of serendipity, we propose and investigate combinations of weights and heuristics in paths forming the essential building blocks for each story. Our experimental findings with stories based on DBpedia indicate the improvements when applying the optimized algorithm

Testing the impact of local alcohol licencing policies on reported crime rates in England.

BACKGROUND: Excessive alcohol use contributes to public nuisance, antisocial behaviour, and domestic, interpersonal and sexual violence. We test whether licencing policies aimed at restricting its spatial and/or temporal availability, including cumulative impact zones, are associated with reductions in alcohol-related crime. METHODS: Reported crimes at English lower tier local authority (LTLA) level were used to calculate the rates of reported crimes including alcohol-attributable rates of sexual offences and violence against a person, and public order offences. Financial fraud was included as a control crime not directly associated with alcohol abuse. Each area was classified as to its cumulative licensing policy intensity for 2009-2015 and categorised as 'passive', low, medium or high. Crime rates adjusted for area deprivation, outlet density, alcohol-related hospital admissions and population size at baseline were analysed using hierarchical (log-rate) growth modelling. RESULTS: 284 of 326 LTLAs could be linked and had complete data. From 2009 to 2013 alcohol-related violent and sexual crimes and public order offences rates declined faster in areas with more 'intense' policies (about 1.2, 0.10 and 1.7 per 1000 people compared with 0.6, 0.01 and 1.0 per 1000 people in 'passive' areas, respectively). Post-2013, the recorded rates increased again. No trends were observed for financial fraud. CONCLUSIONS: Local areas in England with more intense alcohol licensing policies had a stronger decline in rates of violent crimes, sexual crimes and public order offences in the period up to 2013 of the order of 4-6% greater compared with areas where these policies were not in place, but not thereafter

Assessing the contribution of alcohol-specific causes to socio-economic inequalities in mortality in England and Wales 2001-16

Background and Aims When measuring inequalities in health, public health and addiction research has tended to focus on differences in average life‐span between socio‐economic groups. This does not account for the extent to which age of death varies between individuals within socio‐economic groups or whether this variation differs between groups. This study assesses (1) socio‐economic inequalities in both average life‐span and variation in age at death, (2) the extent to which these inequalities can be attributed to alcohol‐specific causes (i.e. those attributable only to alcohol) and (3) how this contribution has changed over time. Design Cause‐deleted life table analysis of national mortality records. Setting England and Wales, 2001–16. Cases All‐cause and alcohol‐specific deaths for all adults aged 18+, stratified by sex, age and quintiles of the index of multiple deprivation (IMD). Measurements Life expectancy at age 18 yearss and standard deviation in age at death within IMD quintiles and the contribution of alcohol to overall differences in both measures between the highest and lowest IMD quintiles by comparing observed and cause‐deleted inequality ‘gaps’. Findings In 2016, alcohol‐specific causes reduced life expectancy for men and women by 0.26 and 0.14 years, respectively, and increased the standard deviation in age at death. These causes also increased the inequality gap in life expectancy by 0.33 years for men and 0.17 years for women, and variation in age at death by 0.14 years and 0.13 years, respectively. For both measures, the contribution of alcohol to mortality inequalities rose after 2001 and subsequently fell back. For women, alcohol accounted for 3.6% of inequality in age at death and 6.0% of life‐span uncertainty, suggesting that using only the former may underestimate alcohol‐induced inequalities. There was no comparable difference for men. Conclusions Deaths from alcohol‐specific causes increase inequalities in both life expectancy and variation in age of death between socio‐economic groups. Using both measures can provide a fuller picture of overall inequalities in health

Reweighting national survey data for small area behaviour estimates : modelling alcohol consumption in local authorities in England

Background There are likely to be differences in alcohol consumption levels and patterns across local areas within a country, yet survey data is often collected at the national or sub-national/regional level and is not representative for small geographic areas. Methods This paper presents a method for reweighting national survey data—the Health Survey for England—by combining survey and routine data to produce simulated locally representative survey data and provide statistics of alcohol consumption for each Local Authority in England. Results We find a 2-fold difference in estimated mean alcohol consumption between the lightest and heaviest drinking Local Authorities, a 4.5-fold difference in abstention rates, and a 3.5-fold difference in harmful drinking. The method compares well to direct estimates from the data at regional level. Conclusions The results have important policy implications in itself, but the reweighted data can also be used to model local policy effects. This method can also be used for other public health small area estimation where locally representative data are not available

Estimating the effectiveness of an enhanced ‘Improving Access to Psychological Therapies’ (IAPT) service addressing the wider determinants of mental health: a real-world evaluation

Background Addressing the wider determinants of mental health alongside psychological therapy could improve mental health service outcomes and population mental health. Objectives To estimate the effectiveness of an enhanced ‘Improving Access to Psychological Therapies’ (IAPT) mental health service compared with traditional IAPT in England. Alongside traditional therapy treatment, the enhanced service included well-being support and community service links. Design A real-world evaluation using IAPT’s electronic health records. Setting Three National Health Service IAPT services in England. Participants Data from 17 642 service users classified as having a case of depression and/or anxiety at baseline. Intervention We compared the enhanced IAPT service (intervention) to an IAPT service in a different region providing traditional treatment only (geographical control), and the IAPT service with traditional treatment before additional support was introduced (historical control). Primary outcome measures Patient Health Questionnaire-9 (PHQ-9) Depression Scale (score range: 0–27) and Generalised Anxiety Disorder-7 (GAD-7) Anxiety Scale (score range: 0–21); for both, lower scores indicate better mental health. Propensity scores were used to estimate inverse probability of treatment weights, subsequently used in mixed effects regression models. Results Small improvements (mean, 95% CI) were observed for PHQ-9 (depression) (−0.21 to –0.32 to −0.09) and GAD-7 (anxiety) (−0.23 to –0.34 to −0.13) scores in the intervention group compared with the historical control. There was little evidence of statistically significant differences between intervention control and geographical control. Conclusions Embedding additional health and well-being (H&W) support into standard IAPT services may lead to improved mental health outcomes. However, the lack of improved outcomes compared with the geographical control may instead reflect a more general improvement to the intervention IAPT service. It is not clear from our findings whether an IAPT service with additional H&W support is clinically superior to traditional IAPT models

Characterising restrictions on commercial advertising and sponsorship of harmful commodities in local government policies: a nationwide study in England.

BackgroundCommercial advertising and sponsorship drive the consumption of harmful commodities. Local authorities (LAs) have considerable powers to reduce such exposures. This study aimed to characterize local commercial policies across all English LAs.MethodsWe conducted a census of all English LAs (n = 333) to identify local commercial policies concerning advertising and sponsorship of tobacco, alcohol, less healthy foods and gambling, through online searches and Freedom of Information requests. We explored policy presence, commodity frequency and type, and associations with LA characteristics (region, urban/rural and deprivation).ResultsOnly a third (106) of LAs in England had a relevant policy (32%). These included restrictions on tobacco (91%), gambling (79%), alcohol (74%) and/or less healthy foods (24%). Policy prevalence was lowest in the East of England (22%), North East (25%) and North West (27%), higher in urban areas (36%) than rural areas (28%) and lower in the least (27%) compared with the most (38%) deprived areas. Definitions in policies varied, particularly for alcohol and less healthy foods.ConclusionsEnglish LAs currently underutilize their levers to reduce the negative impacts of harmful commodity industry marketing, particularly concerning less healthy foods. Standardized guidance, including clarity on definitions and application, could inform local policy development

Investigating local policy drivers for alcohol harm prevention: a comparative case study of two local authorities in England

Background: The considerable challenges associated with implementing national level alcohol policies have encouraged a renewed focus on the prospects for local-level policies in the UK and elsewhere. We adopted a case study approach to identify the major characteristics and drivers of differences in the patterns of local alcohol policies and services in two contrasting local authority (LA) areas in England. Methods: Data were collected via thirteen semi-structured interviews with key informants (including public health, licensing and trading standards) and documentary analysis, including harm reduction strategies and statements of licensing policy. A two-stage thematic analysis was used to categorize all relevant statements into seven over-arching themes, by which document sources were then also analysed. Results: Three of the seven over-arching themes (drink environment, treatment services and barriers and facilitators), provided for the most explanatory detail informing the contrasting policy responses of the two LAs: LA1 pursued a risk-informed strategy via a specialist police team working proactively with problem premises and screening systematically to identify riskier drinking. LA2 adopted a more upstream regulatory approach around restrictions on availability with less emphasis on co-ordinated screening and treatment measures. Conclusion: New powers over alcohol policy for LAs in England can produce markedly different policies for reducing alcohol-related harm. These difference are rooted in economic, opportunistic, organisational and personnel factors particular to the LAs themselves and may lead to closely tailored solutions in some policy areas and poorer co-ordination and attention in others