Action learning and healthcare: affinities and challenges

Action learning has been used in healthcare settings to bring about changes to how services are delivered, to help individuals to develop their knowledge and skills, including leadership development, and to enable the development of collective abilities and communities of practice. It is evident that there are some positive elements in the healthcare environment that support the processes of action learning – what we might call affinities between the environment and these processes. However, those who have practised action learning in these environments also know that difficulties and disablers can arise, to derail or block the processes – what we might, perhaps optimistically, call challenges

Barriers to effective healthcare for patients who have smell or taste disorders

Objectives: Smell/taste disturbances are a common but underrated, under-researched and under treated sensory loss and an independent risk factor for reduced longevity. This study aimed to characterise the experience of patients with these disorders in seeking help. Design: The study was designed by patients together with clinicians through a dedicated workshop and conducted as a cross-sectional survey to capture experiences in public and private healthcare settings internationally. Setting: Primary, secondary and tertiary care. Participants: Any members of the public self-reporting a smell/taste disorder were invited to participate. Main outcome measures: The survey captured information including experience of getting consultations and referrals to medical professionals, treatments offered, costs incurred and related problems with mental health. Results: Of 673 participants; 510 female, 160 male, 3 not stated, self-reported aetiology included sinonasal disease (24%), idiopathic (24%) and post-viral olfactory dysfunction (22%); true gustatory disorders were typically rare. Failure of medical professionals to recognise the problem was a key concern - 64%, 76% and 47% of GPs, ENT specialists and Neurologists acknowledged respectively. Other issues included repeated ineffective treatments, difficulties getting referrals to secondary/tertiary care, mental health problems (60%) and a mean personal cost of £421 to seeking advice and treatment. Whilst the participants were self-selecting, however they do represent those who are seeking help and intervention for their disorders. Conclusion: There is an unmet need for these patients in accessing healthcare including a clear need to improve education of and engagement with the medical profession in Otorhinolaryngology, General Practice and other specialties, in order to remove the current barriers they face

Cerebral blood flow predicts differential neurotransmitter activity

Application of metabolic magnetic resonance imaging measures such as cerebral blood flow in translational medicine is limited by the unknown link of observed alterations to specific neurophysiological processes. In particular, the sensitivity of cerebral blood flow to activity changes in specific neurotransmitter systems remains unclear. We address this question by probing cerebral blood flow in healthy volunteers using seven established drugs with known dopaminergic, serotonergic, glutamatergic and GABAergic mechanisms of action. We use a novel framework aimed at disentangling the observed effects to contribution from underlying neurotransmitter systems. We find for all evaluated compounds a reliable spatial link of respective cerebral blood flow changes with underlying neurotransmitter receptor densities corresponding to their primary mechanisms of action. The strength of these associations with receptor density is mediated by respective drug affinities. These findings suggest that cerebral blood flow is a sensitive brain-wide in-vivo assay of metabolic demands across a variety of neurotransmitter systems in humans

Morphological cells in the Ragusa littoral (Sicily, Italy)

Geomorphologic information, topographic maps (dated 1967), aerial photographs (dated 1999 and 2008), and spatial analysis procedures were used to investigate a 90 km long coastal sector in South Sicily (Italy). Information was obtained on coastal erosion/accretion areas, general sediment circulation pattern and littoral cell distribution. Human-made structures and natural headlands constituted important artificial limits dividing littoral in morphological cells. Ports and harbours were observed at Scoglitti, Punta Secca, Marina di Ragusa, Donnalucata and Pozzallo. Most of them worked as “transit” limits which interrupted predominant, eastward directed sedimentary transport, this way generating accretion in updrift (west) side of mentioned structures and erosion in downdrift (east) side. During the 1967–2008 period, about 62,000 m2 and 42,000 m2 of beach surface were respectively formed updrift of Scoglitti and Donnalucata ports. The construction of Pozzallo port gave rise to the formation of a “convergent” limit which favoured large accretion (94,000 m2) east of port structure. Most important natural structures were observed at Punta Zafaglione, P. Braccetto and Cava d’Aliga. The knowledge of littoral cell distribution acquires a great importance for appropriate management of coastal erosion processes which may be mitigated installing by-passing systems in ports and harbours and carrying out nourishment works in eroding areas, often located downdrift of ports and harbours (when these structures work as transit limits) and in central part of littoral cells (when these structures work as convergent limits)

Bad Practice in Erosion Management: The Southern Sicily Case Study

This case study from Sicily illustrates a common sequence of events where one unwise action was countered with another, which in turn created additional problems. The situation arose through strong political interference and ignorance (or lack of concern) regarding the environmental impacts of human interventions on the shoreline and by the public perception that government has a duty to protect private property. The poor design and location of ports and harbours produced infilling problems and huge updrift accretion with concomitant downdrift erosion. The human-induced coastal retreat was counteracted by the progressive emplacement of breakwaters creating a “domino” effect. On many occasions these were constructed to protect unplanned and illegal (in the sense that they do not conform to planning regulations) beachfront summer houses. Without the presence of these structures, there would have been no need for publicly funded intervention. Furthermore, only a narrow coastal belt close to the shoreline is used by bathers on the wide beaches formed updrift of ports and harbours and in the lee of breakwaters, most of the accreted beach being unused or partially occupied by tourist developments. Thus beach users and municipalities acquired some benefits from beach accretion at specific sites, the opposite being true in eroding areas

The GOGREEN survey: Post-infall environmental quenching fails to predict the observed age difference between quiescent field and cluster galaxies at z>1

We study the star formation histories (SFHs) and mass-weighted ages of 331 UVJ-selected quiescent galaxies in 11 galaxy clusters and in the field at 11 has been driven by different physical processes than those at play at z=0

The second iteration of the Systems Prioritization Method: A systems prioritization and decision-aiding tool for the Waste Isolation Pilot Plant: Volume 1, Synopsis of method and results

In March 1994, the US Department of Energy Carlsbad Area Office (DOE/CAO) embarked on an effort to design and implement a performance- based decision-aiding tool to provide an analytical basis for planning, prioritizing, and selecting programmatic options for the Waste Isolation Pilot Plant (WIPP). This tool, called Systems Prioritization Method (SPM) defines the most viable combinations of scientific investigations, engineered alternatives (EAs), and waste acceptance criteria (WAC) for supporting the final WIPP compliance application. The scope of SPM is restricted to selected portions of applicable Environmental Protection Agency (EPA) long-term performance regulations. SPM calculates the probabilities of certain sets of activities demonstrating compliance with various regulations. SPM provides results in the form of a decision matrix to identify cost-effective programmatic paths with a high probability of successfully demonstrating compliance

Error determination in the photogrammetric assessment of shoreline changes

The evaluation of error or uncertainty in shoreline change studies is an issue of prime importance for providing an adequate framework for calculated rates of change and to allow the establishment of threshold values above which the rates would be significant. In this note, a practical, easy-to-use method is presented to estimate error involved in the calculation of shoreline changes on aerial photographs, including the three most used types of shoreline indicators: high water line, dune/cliff toe and cliff top. This approach takes into account the specific characteristics of each shoreline proxy, such as relief in the case of the cliff top or tidal oscillations in the case of the high water line. At the same time it includes the error components that are independent from the proxy, basically related to the technical aspects of the process such as photo scanning and georeferencing. A practical example of application of the method is provided for several types of data inputs, based on shoreline changes around the Bay of Cádiz (SW Spain)

Cross-border trafficking in human beings: prevention and intervention strategies for reducing sexual exploitation

Over the years, growing attention has been given to the phenomenon of trafficking in human beings (THB). Sexual exploitation was until recently by far the most commonly identified feature of THB, followed by forced labour. Many activities to combat trafficking for the purpose of sexual exploitation have been initiated by numerous supranational, international as well as national organizations. Much is written about these initiatives, but some areas have been neglected. Knowledge on ‘what works’ is in particular limited. The growing attention to THB entails a demand for more information. The severity of the crime and the impact on its victims makes it of utmost importance to gain more insight into the working and effectiveness of anti-trafficking strategies and interventions. The main objective of this review was to assess the presently available evidence on the effects of interventions that aim to prevent and suppress trafficking in human beings