Cybersecurity Maturity in the Pacific Islands – Informing a Regional CERT Framework

Cybersecurity acts as a strong influence on national governments’ security, economic, physical and social interests. A common policy goal of governments is to protect their respective interests by supporting cybersecurity threat and attack response capabilities. Contemporary research addresses the use of multi-national CERT frameworks to improve national cybersecurity capability maturity and resilience, however little research has been conducted into the efficacy of such frameworks with Pacific Island nations. This research employs a qualitative interview technique to develop an inductive model for a regional Pacific Islands CERT framework. The research proposes a Pacific Islands regional model based on a network of affiliated national CERTs that operate independently and reflect their respective national interests, while collaborating on matters of shared interest, supported by regional partners providing targeted assistance to build national and regional cybersecurity capability maturity and resilience

'She chose suicide’- An exploration of family members’ bereavement experience following a suicide as a known end-of-life choice

The research explores family members’ bereavement experience following a relative’s suicide as a known end-of-life choice. This investigation demarcates a subset of suicide whereby a person has systematically planned to end their life. This research utilises a mixed-methods methodological approach through a two-phase data collection process. A convenience sample focuses on 21 suicide deaths reported to the NSW State Coroner between 2011 and 2016. A review of the case files, including a thematic analysis of suicide notes, provides contextual information regarding the death. Semi-structured interviews with eight family members explore their bereavement experience following a relative’s suicide as a known end-of-life choice. A complete case file review and family member interviews confirm that poor health and a decline in quality of life contributed to their end-of-life decision. Framing suicide as a choice by the deceased person removes ambiguity about the deliberate intention of their actions and directs family members’ bereavement experience accordingly. Interviews with family members identify four key themes of their experience: preparedness for the death, responses to the death, explaining the death to others, and support needs. Prior knowledge of their relative’s end-of-life opinion and intentions allowed family members to prepare for the death. In doing so, family members do not report experiences of rumination, stigma or shame surrounding the circumstances of the death; instead, they focus on their experiences of sadness and loss of their relative. Family members can choose when to disclose information about the death and identify formal and informal support networks that are helpful to them. A vital outcome of the research is the importance of access to support services before the planned suicide. As a final point, family members reflect on the coronial process as being non-invasive in their circumstances. These findings contribute to clinical practice by providing insight into the bereavement experiences of family members following a suicide as an end-of-life choice. This knowledge encourages a broadening of thinking about types of suicide, identifies gaps in bereavement support currently offered and highlights the importance of accurate manner of death reporting by the coroner. Further research will allow clinicians from all disciplines to better support the needs of family members bereaved by suicide as a known end-of-life choice

Mutational signatures in tumours induced by high and low energy radiation in Trp53 deficient mice.

Ionising radiation (IR) is a recognised carcinogen responsible for cancer development in patients previously treated using radiotherapy, and in individuals exposed as a result of accidents at nuclear energy plants. However, the mutational signatures induced by distinct types and doses of radiation are unknown. Here, we analyse the genetic architecture of mammary tumours, lymphomas and sarcomas induced by high (56Fe-ions) or low (gamma) energy radiation in mice carrying Trp53 loss of function alleles. In mammary tumours, high-energy radiation is associated with induction of focal structural variants, leading to genomic instability and Met amplification. Gamma-radiation is linked to large-scale structural variants and a point mutation signature associated with oxidative stress. The genomic architecture of carcinomas, sarcomas and lymphomas arising in the same animals are significantly different. Our study illustrates the complex interactions between radiation quality, germline Trp53 deficiency and tissue/cell of origin in shaping the genomic landscape of IR-induced tumours

Mathematics education policy: a horizon scan [Abstract only]

The Royal Society’s Mathematical Futures Programme, launched in 2020, aims to support the Society’s work in education policy. In this presentation, we share findings from research commissioned as part of this programme, a horizon scan of policy and change in international jurisdictions that contributed to landscaping mathematics education policy. We draw on evidence from ‘high-performing’ jurisdictions and those with similar PISA outcomes to UK nations, supplemented by interviews and workshops with international experts. We report practices and policy initiatives organised around five themes: curriculum and pedagogy, qualifications and assessment, resources and technology, teacher preparation and professional development, and evidence-informed policy development. These include case studies of selected innovations. Factors that either promote or inhibit policy development are identified. Features of effective policy development include clarity of purpose, consensus, feasibility, coherence, systemic alignment, piloting, sustained attention, and collaboration. Analysis demonstrates considerable divergence in England from international innovations in policy development. We argue that innovation in England is more likely to be successful if a parallel approach is adopted, with innovations being developed in parallel with policy developments. Further in-depth reviews are needed, informing developments, guiding investment and supporting consensus building across stakeholders

Development of an intervention programme theory to increase movement in care homes for people with cognitive impairment:Care homes achieving realistic movement strategies (CHARMS)

There is an increase in both the number of people living in care homes, and the cognitive impairments they experience. Some of these experiences of cognitive impairments can be improved by appropriate movement and physical activity interventions, delivered in ways which take into account an individual’s preferences, needs and abilities. A clear intervention programme theory (how we expect an intervention to work) can improve effectiveness, acceptability, transferability and sustainability. We used a systematic framework (Six Steps in Quality Intervention Development) and a co-production approach, to develop an intervention programme theory for Care Homes Achieving Realistic Movement Strategies (CHARMS). We identified twenty factors contributing to low levels of physical activity and movement which we grouped into four categories for change: i) cultural/staff; ii) residents; iii) environmental and iv) policy/system. A theory of change was developed using these categories plus additional theories to create ownership. It became evident that the intervention (the theory of action) needed to include activities in all categories; intervening in just one category (e.g. providing weekly physical activity) was not sufficient in itself. Developing the programme theory enabled care homes to develop activities to meet their specific contextual needs and develop ownership of the process and the intervention

The 'care' of children in need in contemporary Scotland the role of positivism and performance indicators in official imaginings of childhood and wellbeing

Improving the wellbeing of children is an ambition of governments worldwide. This has led to increased activity to measure the implementation of policies intended to achieve this. In this paper, we argue that this is currently limited through the reliance on statistically-driven methods and that there needs to be a fundamental change in how policies are assessed. We examine this within the current policy context for vulnerable children in Scotland

Treatment trends for retinopathy of prematurity in the UK:active surveillance study of infants at risk

OBJECTIVES: To estimate the incidence of severe retinopathy of prematurity (ROP) requiring treatment and describe current treatment patterns in the UK. DESIGN: Nationwide population-based case ascertainment study via the British Ophthalmic Surveillance Unit and a national collaborative ROP special interest group. Practitioners completed a standardised case report form (CRF). SETTING: All paediatric ophthalmologists providing screening and/or treatment for retinopathy in the UK were invited to take part. PARTICIPANTS: Any baby with ROP treated or referred for treatment between 1 December 2013 and 30 November 2014, treated with laser, cryotherapy, vascular endothelial growth factor (VEGF) inhibitor or vitrectomy/scleral buckling, or a combination. MAIN OUTCOME MEASURE: Incidence of ROP requiring treatment. RESULTS: We received 370 CRFs; 327 were included. Denominator from epidemiological data: 8112 infants with birth weight of <1500 g. The incidence of ROP requiring treatment was 4% (327/8112, 95% CI 3.6% to 4.5%). Median gestational age was 25 weeks (IQR 24.3–26.1), and median birth weight 706 g (IQR 620–821). Median age at first treatment was 80 days (IQR 71–96). 204 right eyes (62.39%) had type 1 ROP, and 27 (8.26%) had aggressive posterior ROP. Infants were also treated for milder disease: 9 (2.75%) right eyes were treated for type 2 ROP, and 74 (22.63%) for disease milder than type 1 with plus or preplus, which we defined here as ‘type 2 plus’ disease. First-line treatment was diode laser photoablation of the avascular retina in 90.5% and injection of VEGF inhibitor in 8%. CONCLUSIONS: ROP treatment incidence in the UK is 2.5 times higher than previously estimated. 8% of treated infants receive intravitreal VEGF inhibitor, currently unlicensed. Research is needed urgently to establish safety and efficacy of this approach. Earlier treatment and increasing numbers of surviving premature infants require an increase in appropriate eye care facilities and staff. TRIAL REGISTRATION NUMBER: NCT02484989

An ultrasensitive reverse transcription polymerase chain reaction assay to detect asymptomatic low-density Plasmodium falciparum and Plasmodium vivax infections in small volume blood samples.

BackgroundHighly sensitive, scalable diagnostic methods are needed to guide malaria elimination interventions. While traditional microscopy and rapid diagnostic tests (RDTs) are suitable for the diagnosis of symptomatic malaria infection, more sensitive tests are needed to screen for low-density, asymptomatic infections that are targeted by interventions aiming to eliminate the entire reservoir of malaria infection in humans.MethodsA reverse transcription polymerase chain reaction (RT- PCR) was developed for multiplexed detection of the 18S ribosomal RNA gene and ribosomal RNA of Plasmodium falciparum and Plasmodium vivax. Simulated field samples stored for 14 days with sample preservation buffer were used to assess the analytical sensitivity and specificity. Additionally, 1750 field samples from Southeastern Myanmar were tested both by RDT and ultrasensitive RT-PCR.ResultsLimits of detection (LoD) were determined under simulated field conditions. When 0.3 mL blood samples were stored for 14 days at 28 °C and 80% humidity, the LoD was less than 16 parasites/mL for P. falciparum and 19.7 copies/µL for P. vivax (using a plasmid surrogate), about 10,000-fold lower than RDTs. Of the 1739 samples successfully evaluated by both ultrasensitive RT-PCR and RDT, only two were RDT positive while 24 were positive for P. falciparum, 108 were positive for P. vivax, and 127 were positive for either P. vivax and/or P. falciparum using ultrasensitive RT-PCR.ConclusionsThis ultrasensitive RT-PCR method is a robust, field-tested screening method that is vastly more sensitive than RDTs. Further optimization may result in a truly scalable tool suitable for widespread surveillance of low-level asymptomatic P. falciparum and P. vivax parasitaemia

Advantages and limitations of naturalistic study designs and their implementation in alcohol hangover research

In alcohol hangover research, both naturalistic designs and randomized controlled trials (RCTs) are successfully employed to study the causes, consequences, and treatments of hangovers. Although increasingly applied in both social sciences and medical research, the suitability of naturalistic study designs remains a topic of debate. In both types of study design, screening participants and conducting assessments on-site (e.g., psychometric tests, questionnaires, and biomarker assessments) are usually equally rigorous and follow the same standard operating procedures. However, they differ in the levels of monitoring and restrictions imposed on behaviors of participants before the assessments are conducted (e.g., drinking behaviors resulting in the next day hangover). These behaviors are highly controlled in RCTs and uncontrolled in naturalistic studies. As a result, the largest difference between naturalistic studies and RCTs is their ecological validity, which is usually significantly lower for RCTs and (related to that) the degree of standardization of experimental intervention, which is usually significantly higher for RCTs. In this paper, we specifically discuss the application of naturalistic study designs and RCTs in hangover research. It is debated whether it is necessary to control certain behaviors that precede the hangover state when the aim of a study is to examine the effects of the hangover state itself. If the preceding factors and behaviors are not in the focus of the research question, a naturalistic study design should be preferred whenever one aims to better mimic or understand real-life situations in experimental/intervention studies. Furthermore, to improve the level of control in naturalistic studies, mobile technology can be applied to provide more continuous and objective real-time data, without investigators interfering with participant behaviors or the lab environment impacting on the subjective state. However, for other studies, it may be essential that certain behaviors are strictly controlled. It is, for example, vital that both test days are comparable in terms of consumed alcohol and achieved hangover severity levels when comparing the efficacy and safety of a hangover treatment with a placebo treatment day. This is best accomplished with the help of a highly controlled RCT design