Zirconia-Based Compositions for Use in Passive NO\u3csub\u3ex\u3c/sub\u3e Adsorber Devices

A passive NOx adsorbent includes: palladium, platinum or a mixture thereof and a mixed or composite oxide including the following elements in percentage by weight, expressed in terms of oxide: 10-90% by weight zirconium and 0.1-50% by weight of least one of the following: a transition metal or a lanthanide series element other than Ce. Although the passive NOx adsorbent can include Ce in an amount ranging from 0.1 to 20% by weight expressed in terms of oxide, advantages are obtained particularly in the case of low-Ce or a substantially Ce-free passive NOx adsorbent

Using co-production to increase activity in acute stroke units : the CREATE mixed-methods study

Background: Stroke is the most common neurological disability in the UK. Any activity contributes to recovery, but stroke patients can be inactive for > 60% of their waking hours. This problem remains, despite organisational changes and targeted interventions. A new approach to addressing post-stroke inactivity is needed. Experience-based co-design has successfully initiated improvements for patients and staff in other acute settings. Experience-based co-design uses observational fieldwork and filmed narratives with patients to trigger different conversations and interactions between patients and staff to improve health-care services. Objectives: To complete a rapid evidence synthesis of the efficacy and effectiveness of co-production as an approach to quality improvement in acute health-care settings; to evaluate the feasibility and impact of patients, carers and staff co-producing and implementing interventions to increase supervised and independent therapeutic patient activity in acute stroke units; and to understand the experience of participating in experience-based co-design and whether or not interventions developed and implemented in two units could transfer to two additional units using an accelerated experience-based co-design cycle. Design: A mixed-methods case comparison using interviews, observations, behavioural mapping and self-report surveys (patient-reported outcome measure/patient-reported experience measure) pre and post implementation of experience-based co-design cycles, and a process evaluation informed by normalisation process theory. Setting: The setting was two stroke units (acute and rehabilitation) in London and two in Yorkshire. Participants: In total, 130 staff, 76 stroke patients and 47 carers took part. Findings: The rapid evidence synthesis showed a lack of rigorous evaluation of co-produced interventions in acute health care, and the need for a robust critique of co-production approaches. Interviews and observations (365 hours) identified that it was feasible to co-produce and implement interventions to increase activity in priority areas including ‘space’ (environment), ‘activity’ and, to a lesser extent, ‘communication’. Patients and families reported benefits from participating in co-design and perceived that they were equal and valued members. Staff perceived that experience-based co-design provided a positive experience, was a valuable improvement approach and led to increased activity opportunities. Observations and interviews confirmed the use of new social spaces and increased activity opportunities. However, staff interactions remained largely task focused, with limited focus on enabling patient activity. Behavioural mapping indicated a mixed pattern of activity pre and post implementation of co-designed changes. Patient-reported outcome measure/patient-reported experience measure response rates were low, at 12–38%; pre- and post-experience-based co-design cohorts reported dependency, emotional and social limitations consistent with national statistics. Post-experience-based co-design patient-reported experience measure data indicated that more respondents reported that they had ‘enough things to do in their free time’. The use of experience-based co-design – full and accelerated – legitimised and supported co-production activity. Staff, patients and families played a pivotal role in intervention co-design. All participants recognised that increased activity should be embedded in everyday routines and in work on stroke units. Limitations: Communication by staff that enabled patient activity was challenging to initiate and sustain. Conclusions: It was feasible to implement experience-based co-design in stroke units. This resulted in some positive changes in unit environments and increased activity opportunities for patients. There was no discernible difference in experiences or outcomes between full and accelerated experience-based co-design. Future work should consider multiple ways to embed increased patient activity into everyday routines in stroke units

Barriers and facilitators to smoking cessation in a cancer context: A qualitative study of patient, family and professional views

Background  Continued smoking after cancer adversely affects quality of life and survival, but one fifth of cancer survivors still smoke. Despite its demands, cancer presents an opportunity for positive behaviour change. Smoking often occurs in social groups, therefore interventions which target families and individuals may be more successful. This qualitative study explored patients, family members and health professionals’ views and experiences of smoking and smoking cessation after cancer, in order to inform future interventions.  Methods  In-depth qualitative interviews (n=67) with 29 patients, 14 family members and 24 health professionals. Data were analysed using the ‘Framework’ method.  Results  Few patients and family members had used National Health Service (NHS) smoking cessation services and more than half still smoked. Most recalled little ‘smoking-related’ discussion with clinicians but were receptive to talking openly. Clinicians revealed several barriers to discussion. Participants’ continued smoking was explained by the stress of diagnosis; desire to maintain personal control; and lack of connection between smoking, cancer and health.  Conclusions  A range of barriers to smoking cessation exist for patients and family members. These are insufficiently assessed and considered by clinicians. Interventions must be more effectively integrated into routine practice

Genetic Testing in Emerging Economies (GenTEE)

Drivers, barriers and opportunities for genetic testing services in emerging economies: the GenTEE (Genetic Testing in Emerging Economies) project Background: Due to the epidemiological transition in the emerging economies of China, East Asia, India, Latin America, the Middle East and South Africa, these economies are facing (i) an increasing proportion of morbidity and mortality due to congenital and genetic conditions, (ii) a rising need for genetic services to improve patient outcomes and overall population health. These economies are facing the challenge how: (i) to ensure the successful translation of genetic/genomics laboratory and academic research into quality assured pathways, (ii) to develop a service delivery infrastructure that leads to equitable and affordable access to high quality genetic/genomic testing services. Objectives: (i) to document and compare current practices and the state of genetic service provision in eight emerging economies: Argentina, Brazil, China, Egypt, India, Oman, Philippines and South Africa, (ii) to identify current knowledge gaps and unmet service needs. The GenTEE international project is intended to inform policy decisions for the challenges of delivering equitable high quality genetic services and to promote international collaboration for capacity building. Methods: (i) a standardized survey that is the first of its worldwide that allows comparison of services internationally across a number of key dimensions by using a core set of indicators, selected by the GenTEE consortium for their relevance and comparability, (ii) capacity building demonstration projects. To date, the GenTEE project has completed its survey that maps the current state of genetic services in the participating countries and identifies current drivers, barriers and opportunities for genetic services development. Results: There is no equitable access to genetic services in all countries mainly due to financial barriers (underfunded fragmented public services, out-of-pocket expenses tend to be the norm for genetic testing services), geographical barriers (concentration of services in main cities) and skill gaps, resulting in inequitable services or delayed access. The development of services in the private sector is opportunistic and mostly technology and market driven. There is a marked lack of standard operating procedures and agreed quality assessment processes for new technologies. Discussion: International collaborative networks can provide support for capacity building and help to strengthen the provision of quality genetic/genomic services in emerging economies.JRC.I.1-Chemical Assessment and Testin

Collaborative research methods and best practice with children and young people: protocol for a mixed-method review of the health and social sciences literature

Introduction: Children and young people have the right to participate in research on matters that affect them, and their contribution improves research quality and insights from findings. Discrete participatory approaches are used across different disciplines. This review will provide a synthesis of existing literature from different disciplines by working with young people and adults experienced in participatory research to develop a broad definition of child and youth led research and to identify best practice. Methods and analysis: Comprehensive searches will be conducted in eight electronic databases (PsycINFO, Medline, CINAHL, Embase, SocINDEX, ASSIA: Applied Social Sciences Index and Abstracts (Proquest), Social Care Online and SCOPUS). Grey literature reports will also be sourced using Google searching. Eligible studies will be English-language primary studies and reviews on collaborative research with children and young people (aged 5–25 years) published from 2000 onwards. Qualitative and quantitative data will be integrated in a single qualitative synthesis following the JBI convergent integrated approach. Study quality will be assessed by developed checklists based on existing participation tools cocreated with the project steering group and co-creation activities with young people. Ethics and dissemination: Ethical approval is not required as no primary data will be collected. The review will develop guidance on best practice for collaborative research with children and young people, synthesising learnings from a wide variety of disciplines. Dissemination will be via peer-reviewed publications, presentations at academic conferences and lay summaries for various stakeholders. Opportunities for cocreation of outputs will be sought with the young researchers and the project steering committee. PROSPERO registration number: CRD42021246378

Co-designing organisational improvements and interventions to increase inpatient activity in four stroke units in England : a mixed-methods process evaluation using normalisation process theory

Objective: To explore facilitators and barriers to using Experience-based Co-design (EBCD) and accelerated EBCD (AEBCD) in the development and implementation of interventions to increase activity opportunities for inpatient stroke survivors. Design: Mixed-methods process evaluation underpinned by normalisation process theory (NPT). Setting: Four post-acute rehabilitation stroke units in England. Participants: Stroke survivors, family members, stroke unit staff, hospital managers, support staff and volunteers. Data informing our NPT analysis comprised: ethnographic observations, n= 366 hours; semi-structured interviews with 76 staff, 53 stroke survivors and 27 family members pre or post EBCD/AEBCD implementation; and observation of 43 co-design meetings involving 23 stroke survivors, 21 family carers and 54 staff Results: Former patients and families valued participation in EBCD/AEBCD perceiving they were equal partners in co-design. Staff engaged with EBCD/AEBCD, reporting it as valuable improvement approach leading to increased activity opportunities. The structured EBCD/AEBCD approach was influential in terms of progressing coherence and cognitive participation and legitimated staff involvement in the process. Researcher facilitation of EBCD/AEBCD supported cognitive participation collective action and reflexive monitoring which was important in implementing and sustaining co-design activities. Observations and interviews post EBCD/AEBCD cycles confirmed creation and use of new social spaces and increased activity opportunities in all units. Changes occurred without increased staffing or organisational resource allocation. EBCD/AEBCD facilitated engagement with wider hospital resources and local communities increasing and enhancing activity opportunities. However, outside of structured group activity many individual staff-patient interactions remained task-focused with limited focus on enabling patient activity. Conclusions: Using EBCD and AEBCD facilitated the development and implementation of environmental changes and revisions to work routines which supported increased activity opportunities in stroke units providing post-acute and rehabilitation care. Former stroke patients and carers contributed to improvements. Normalisation process theory’s generative mechanisms were instrumental in analysis and interpretation of facilitators and barriers at the individual, group and organisational levels

Characterising the biophysical, economic and social impacts of soil carbon sequestration as a greenhouse gas removal technology

To limit warming to well below 2°C, most scenario projections rely on greenhouse gas removal technologies (GGRTs); one such GGRT uses soil carbon sequestration (SCS) in agricultural land. In addition to their role in mitigating climate change, SCS practices play a role in delivering agroecosystem resilience, climate change adaptability, and food security. Environmental heterogeneity and differences in agricultural practices challenge the practical implementation of SCS, and our analysis addresses the associated knowledge gap. Previous assessments have focused on global potentials, but there is a need among policy makers to operationalise SCS. Here, we assess a range of practices already proposed to deliver SCS, and distil these into a subset of specific measures. We provide a multi‐disciplinary summary of the barriers and potential incentives toward practical implementation of these measures. First, we identify specific practices with potential for both a positive impact on SCS at farm level, and an uptake rate compatible with global impact. These focus on: a. optimising crop primary productivity (e.g. nutrient optimisation, pH management, irrigation) b. reducing soil disturbance and managing soil physical properties (e.g. improved rotations, minimum till) c. minimising deliberate removal of C or lateral transport via erosion processes (e.g. support measures, bare fallow reduction) d. addition of C produced outside the system (e.g. organic manure amendments, biochar addition) e. provision of additional C inputs within the cropping system (e.g. agroforestry, cover cropping) We then consider economic and non‐cost barriers and incentives for land managers implementing these measures, along with the potential externalised impacts of implementation. This offers a framework and reference point for holistic assessment of the impacts of SCS. Finally, we summarise and discuss the ability of extant scientific approaches to quantify the technical potential and externalities of SCS measures, and the barriers and incentives to their implementation in global agricultural systems