Large-Scale Integration of Nanoelectromechanical Systems for Gas Sensing Applications

We have developed arrays of nanomechanical systems (NEMS) by large-scale integration, comprising thousands of individual nanoresonators with densities of up to 6 million NEMS per square centimeter. The individual NEMS devices are electrically coupled using a combined series-parallel configuration that is extremely robust with respect to lithographical defects and mechanical or electrostatic-discharge damage. Given the large number of connected nanoresonators, the arrays are able to handle extremely high input powers (>1 W per array, corresponding to <1 mW per nanoresonator) without excessive heating or deterioration of resonance response. We demonstrate the utility of integrated NEMS arrays as high-performance chemical vapor sensors, detecting a part-per-billion concentration of a chemical warfare simulant within only a 2 s exposure period

Nanoelectromechanical Resonator Arrays for Ultrafast, Gas-Phase Chromatographic Chemical Analysis

Miniaturized gas chromatography (GC) systems can provide fast, quantitative analysis of chemical vapors in an ultrasmall package. We describe a chemical sensor technology based on resonant nanoelectromechanical systems (NEMS) mass detectors that provides the speed, sensitivity, specificity, and size required by the microscale GC paradigm. Such NEMS sensors have demonstrated detection of subparts per billion (ppb) concentrations of a phosphonate analyte. By combining two channels of NEMS detection with an ultrafast GC front-end, chromatographic analysis of 13 chemicals was performed within a 5 s time window

‘This Adds Another Perspective’: Qualitative Descriptive Study Evaluating Simulation-Based Training for Health Care Assistants, to Enhance the Quality of Care in Nursing Homes

open access articleMuch of the UK’s ageing population lives in care homes, often with complex care needs including dementia. Optimal care requires strong clinical leadership, but opportunities for staff development in these settings are limited. Training using simulation can enable experiential learning in situ. In two nursing homes, Health Care Assistants (HCAs) received training in clinical communication skills (Situation-Background-Assessment-Recommendation Education through Technology and Simulation, SETS: group training with an actor simulating scenarios); and dementia (A Walk Through Dementia, AWTD: digital simulation, delivered one-to-one). In this qualitative descriptive study, we evaluated the potential of this training to enhance HCAs’ clinical leadership skills, through thematic analysis of 24 semi-structured interviews with HCAs (before/after training) and their managers and mentors. Themes were checked by both interviewers. HCAs benefitted from watching colleagues respond to SETS scenarios and reported greater confidence in communicating with registered healthcare professionals. Some found role-play participation challenging. AWTD sensitised HCAs to the experiences of residents with dementia, and those with limited dementia experience gained a fuller understanding of the disease’s effects. Staffing constraints affected participation in group training. Training using simulation is valuable in this setting, particularly when delivered flexibly. Further work is needed to explore its potential on a larger scale

Long-term population dynamics of dreissenid mussels (Dreissena polymorpha and D. rostriformis): a cross-system analysis

Dreissenid mussels (including the zebra mussel Dreissena polymorpha and the quagga mussel D. rostriformis) are among the world's most notorious invasive species, with large and widespread ecological and economic effects. However, their long-term population dynamics are poorly known, even though these dynamics are critical to determining impacts and effective management. We gathered and analyzed 67 long-term (>10 yr) data sets on dreissenid populations from lakes and rivers across Europe and North America. We addressed five questions: (1) How do Dreissena populations change through time? (2) Specifi- cally, do Dreissena populations decline substantially after an initial outbreak phase? (3) Do different measures of population performance (biomass or density of settled animals, veliger density, recruitment of young) follow the same patterns through time? (4) How do the numbers or biomass of zebra mussels or of both species combined change after the quagga mussel arrives? (5) How does body size change over time? We also considered whether current data on long-term dynamics of Dreissena populations are adequate for science and management. Individual Dreissena populations showed a wide range of temporal dynamics, but we could detect only two general patterns that applied across many populations: (1) Populations of both species increased rapidly in the first 1-2 yr after appearance, and (2) quagga mussels appeared later than zebra mussels and usually quickly caused large dedines in zebra mussel populations. We found little evidence that combined Dreissena populations declined over the long term. Different measures of population performance were not congruent; the temporal dynamics of one life stage or population attribute cannot generally be accurately inferred from the dynamics of another. We found no consistent patterns in the long-term dynamics of body size. The long-term dynamics of Dreissena populations probably are driven by the ecological characteristics (e.g., predation, nutrient inputs, water temperature) and their temporal changes at individual sites rather than following a generalized time course that applies across many sites. Existing long-term data sets on dreissenid populations, although dearly valuable, are inadequate to meet research and management needs. Data sets could be improved by standardizing sampling designs and methods, routinely collecting more variables, and increasing support

Range-wide assessment of livestock grazing across the sagebrush biome

Domestic livestock grazing occurs in virtually all sagebrush habitats and is a prominent disturbance factor. By affecting habitat condition and trend, grazing influences the resources required by, and thus, the distribution and abundance of sagebrush-obligate wildlife species (for example, sage-grouse Centrocercus spp.). Yet, the risks that livestock grazing may pose to these species and their habitats are not always clear. Although livestock grazing intensity and associated habitat condition may be known in many places at the local level, we have not yet been able to answer questions about use, condition, and trend at the landscape scale or at the range-wide scale for wildlife species. A great deal of information about grazing use, management regimes, and ecological condition exists at the local level (for individual livestock management units) under the oversight of organizations such as the Bureau of Land Management (BLM). However, the extent, quality, and types of existing data are unknown, which hinders the compilation, mapping, or analysis of these data. Once compiled, these data may be helpful for drawing conclusions about rangeland status, and we may be able to identify relationships between those data and wildlife habitat at the landscape scale

Effects of non-health-targeted policies on migrant health: a systematic review and meta-analysis

Background: Government policies can strongly influence migrants' health. Using a Health in All Policies approach, we systematically reviewed evidence on the impact of public policies outside of the health-care system on migrant health. Methods: We searched the PubMed, Embase, and Web of Science databases from Jan 1, 2000, to Sept 1, 2017, for quantitative studies comparing the health effects of non-health-targeted public policies on migrants with those on a relevant comparison population. We searched for articles written in English, Swedish, Danish, Norwegian, Finnish, French, Spanish, or Portuguese. Qualitative studies and grey literature were excluded. We evaluated policy effects by migration stage (entry, integration, and exit) and by health outcome using narrative synthesis (all included studies) and random-effects meta-analysis (all studies whose results were amenable to statistical pooling). We summarised meta-analysis outcomes as standardised mean difference (SMD, 95% CI) or odds ratio (OR, 95% CI). To assess certainty, we created tables containing a summary of the findings according to the Grading of Recommendations Assessment, Development, and Evaluation. Our study was registered with PROSPERO, number CRD42017076104. Findings: We identified 43 243 potentially eligible records. 46 articles were narratively synthesised and 19 contributed to the meta-analysis. All studies were published in high-income countries and examined policies of entry (nine articles) and integration (37 articles). Restrictive entry policies (eg, temporary visa status, detention) were associated with poor mental health (SMD 0·44, 95% CI 0·13–0·75; I2=92·1%). In the integration phase, restrictive policies in general, and specifically regarding welfare eligibility and documentation requirements, were found to increase odds of poor self-rated health (OR 1·67, 95% CI 1·35–1·98; I2=82·0%) and mortality (1·38, 1·10–1·65; I2=98·9%). Restricted eligibility for welfare support decreased the odds of general health-care service use (0·92, 0·85–0·98; I2=0·0%), but did not reduce public health insurance coverage (0·89, 0·71–1·07; I2=99·4%), nor markedly affect proportions of people without health insurance (1·06, 0·90–1·21; I2=54·9%). Interpretation: Restrictive entry and integration policies are linked to poor migrant health outcomes in high-income countries. Efforts to improve the health of migrants would benefit from adopting a Health in All Policies perspective

Impact of baseline cases of cough and fever on UK COVID-19 diagnostic testing rates: estimates from the Bug Watch community cohort study [version 1; peer review: 1 approved, 1 approved with reservations]

Background: Diagnostic testing forms a major part of the UK’s response to the current coronavirus disease 2019 (COVID-19) pandemic with tests offered to anyone with a continuous cough, high temperature or anosmia. Testing capacity must be sufficient during the winter respiratory season when levels of cough and fever are high due to non-COVID-19 causes. This study aims to make predictions about the contribution of baseline cough or fever to future testing demand in the UK. Methods: In this analysis of the Bug Watch prospective community cohort study, we estimated the incidence of cough or fever in England in 2018-2019. We then estimated the COVID-19 diagnostic testing rates required in the UK for baseline cough or fever cases for the period July 2020-June 2021. This was explored for different rates of the population requesting tests and four COVID-19 second wave scenarios. Estimates were then compared to current national capacity. Results: The baseline incidence of cough or fever in the UK is expected to rise rapidly from 154,554 (95%CI 103,083 - 231,725) cases per day in August 2020 to 250,708 (95%CI 181,095 - 347,080) in September, peaking at 444,660 (95%CI 353,084 - 559,988) in December. If 80% of baseline cough or fever cases request tests, average daily UK testing demand would exceed current capacity for five consecutive months (October 2020 to February 2021), with a peak demand of 147,240 (95%CI 73,978 - 239,502) tests per day above capacity in December 2020. Conclusions: Our results show that current national COVID-19 testing capacity is likely to be exceeded by demand due to baseline cough and fever alone. This study highlights that the UK’s response to the COVID-19 pandemic must ensure that a high proportion of people with symptoms request tests, and that testing capacity is immediately scaled up to meet this high predicted demand

Impact of baseline cases of cough and fever on UK COVID-19 diagnostic testing rates: estimates from the Bug Watch community cohort study [version 2; peer review: 1 approved, 1 approved with reservations]

Background: Diagnostic testing forms a major part of the UK’s response to the current coronavirus disease 2019 (COVID-19) pandemic with tests offered to anyone with a continuous cough, high temperature or anosmia. Testing capacity must be sufficient during the winter respiratory season when levels of cough and fever are high due to non-COVID-19 causes. This study aims to make predictions about the contribution of baseline cough or fever to future testing demand in the UK. / Methods: In this analysis of the Bug Watch community cohort study, we estimated the incidence of cough or fever in England in 2018-2019. We then estimated the COVID-19 diagnostic testing rates required in the UK for baseline cough or fever cases for the period July 2020-June 2021. This was explored for different rates of the population requesting tests, four COVID-19 second wave scenarios and high and low baseline cough or fever incidence scenarios. / Results: Under the high baseline cough or fever scenario, incidence in the UK is expected to rise rapidly from 250,708 (95%CI 181,095 - 347,080) cases per day in September to a peak of 444,660 (95%CI 353,084 - 559,988) in December. If 80% of these cases request tests, testing demand would exceed 1.4 million tests per week for five consecutive months. Demand was significantly lower in the low cough or fever incidence scenario, with 129,115 (95%CI 111,596 - 151,679) tests per day in January 2021, compared to 340,921 (95%CI 276,039 - 424,491) tests per day in the higher incidence scenario. / Conclusions: Our results show that national COVID-19 testing demand is highly dependent on background cough or fever incidence. This study highlights that the UK’s response to the COVID-19 pandemic must ensure that a high proportion of people with symptoms request tests, and that testing capacity is sufficient to meet the high predicted demand

Critical perspectives on ‘consumer involvement’ in health research: epistemological dissonance and the know-do gap

Researchers in the area of health and social care (both in Australia and internationally) are encouraged to involve consumers throughout the research process, often on ethical, political and methodological grounds, or simply as ‘good practice’. This paper presents findings from a qualitative study in the UK of researchers’ experiences and views of consumer involvement in health research. Two main themes are presented in the paper. Firstly, we explore the ‘know-do gap’ which relates to the tensions between researchers’ perceptions of the potential benefits of, and their actual practices in relation to, consumer involvement. Secondly, we focus on one of the reasons for this ‘know-do gap’, namely epistemological dissonance. Findings are linked to issues around consumerism in research, lay/professional knowledges, the (re)production of professional and consumer identities and the maintenance of boundaries between consumers and researchers

Investigating the Stratigraphy of an Alluvial Aquifer Using Crosswell Seismic Traveltime Tomography

In this study, we investigate the use of crosswell P-wave seismic tomography to obtain spatially extensive information about subsurface sedimentary architecture and heterogeneity in alluvial aquifers. Our field site was a research wellfield in an unconfined aquifer near Boise, Idaho. The aquifer consists of a ~ 20-m-thick sequence of alluvial cobble- and-sand deposits, which have been subdivided into five stratigraphic units based on neutron porosity logs, grainsize analysis, and radar reflection data. We collected crosswell and borehole-to-surface seismic data in wells 17.1 m apart. We carefully considered the impact of well deviation, data quality control, and the choice of inversion parameters. Our linearized inverse routine had a curved-ray forward model and used different grids for forward modeling and inversion. An analysis of the model covariance and resolution matrices showed that the velocity models had an uncertainty of \u3c10 m\u3e/s, a vertical resolution of ~ 1 m, and a horizontal resolution of ~ 5 m. The velocity in the saturated zone varied between 2100 m/s and 2700 m/s. Inclusion of the borehole-to-surface data eliminated the Xshaped pattern that is a common artifact in crosswell tomography, and the increased angular coverage also improved the accuracy of the model near the top of the tomogram. The final velocity model is consistent with previous stratigraphic analyses of the site, although the locations of some of the unit boundaries differ by as much as 2 m in places. The results of this study demonstrate that seismic tomography can be used to image the sedimentary architecture of unconsolidated alluvial aquifers, even when the lithologic contrasts between units are subtle