True technology-enabled mental health care: trust, agency and ageing

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What factors influence mitigative capacity ?

Cet article s'intéresse aux déterminants de la capacité à atténuer le changement climatique. Ceux-ci ont été élaborés initialement dans un papier de Yohe puis dans le troisième rapport d'évaluation du GIEC. Après avoir revisité la définition de la capacité à atténuer le changement climatique, nous identifions trois groupes de facteurs influençant de façon croisée cette capacité : des facteurs économiques, technologiques et institutionnels. Au niveau économique, ce sont à la fois le revenu, le coût de réduction des émissions et le coût d'opportunité lié aux réductions qui forgent la capacité d'atténuation. Du côté technologique, c'est la capacité à absorber ou à développer des technologies peu émettrices de gaz à effet de serre qui est déterminante. Enfin, au niveau institutionnel, l'efficacité de la régulation gouvernementale, la transparence des règles de marché, une main d'œuvre qualifiée et une sensibilisation de la population sont des éléments clés. Notre analyse est menée à la fois qualitativement et quantitativement. Elle permet de montrer comment les facteurs influençant la capacité d'atténuation varient d'un pays à l'autrechangement climatique ; capacité d'atténuation ; politique environnementale

Risk factors associated with becoming NEET’s: a review of the literature applied to the demographics of the Fenland area

NEET is a government acronym for people currently "not in education, employment, or training". People under the designation are called NEETs (or Neets). In the United Kingdom, the classification comprises people aged between 16 and 24 (some 16-year-olds are still of compulsory school age); the subgroup of NEETs aged 16–18 is frequently of particular focus. The "NEET group" is not a uniform set of individuals. This literature review explores some of the risk factors that are known to contribute towards NEET status in young people and looks at the interventions that have been implemented to address these risks. It also explores the specific demographics of Fenland in relation to NEET figures and offers an overview of the background and circumstances of young people and their families in that district which might be linked to the development of NEET status

Evaluating Biochar for the Sustainable Treatment of Heavy Metals in Stormwater: Characteristics, Mechanisms, and Barriers

Heavy metals, such as copper, zinc, and cadmium, are ubiquitous in stormwater and potentially toxic to aquatic organisms at low concentrations. Removal of heavy metals contamination by conventional treatment is expensive and does not always reduce metals concentrations low enough to ensure safety of all aquatic species. This research seeks to evaluate the effectiveness of biochar as a low-cost, sustainable solution for the remediation of heavy metals in stormwater. Biochar has proven effective in removing metals; however, specific sorption mechanisms and reactive properties are not well defined. In this work, different biomass feedstocks (Douglas fir chips and hazelnut shells) were pyrolyzed at varying temperatures to determine the effects of biomass feedstock and production conditions on biochar characteristics and metals removal. Adsorption experiments were conducted in batch reactors and constant flow fixed-bed column filtration experiments. Results of copper removal from batch adsorption experiments were used to select an optimal thermally-altered media for further characterization and evaluation in column filtration experiments. Batch and fixed-bed column results indicate that hazelnut shells pyrolyzed at 700oC exhibit superior performance in copper removal compared to other types of biochar and granular activated carbon (GAC), the current prevailing adsorbent media. Adsorption results were used in conjunction with biochar characterization and modeling techniques to elucidate the mechanisms for metals removal by biochar. Modeling of batch and continuous flow experiments moved beyond common empirical isotherm models and employed thermodynamically-based surface complexation modeling to predict metals adsorption under varying solution conditions and incorporating electrostatic effects. These electrostatic models are better equipped to evaluate metals removal by biochar in solutions of varying pH, ionic strength, and metals loading, making them more suitable for application in complex stormwater systems. Model parameters, including surface site density and surface complexation constants, were determined by fitting simulation results to experimental results of potentiometric titrations and copper sorption edges over varied pH. Defining the fundamental pathways for metals removal will inform engineering design to optimize biochar production conditions and advance sustainability. Researchers and practitioners involved in biochar agricultural and environmental applications, bio-energy and biochar production, and forest management were interviewed to determine what questions remained in their fields that were acting as barrier to widespread biochar implementation. Interviews and questions presented in field workshops were video recorded at US Biochar Initiative (USBI) conference hosted at Oregon State University (OSU) in 2016. The “Burning Questions of Biochar” are presented in this document and a complementary edited video. The goal disseminating these questions is to encourage cross-discipline communication between aspects of the biochar business system, to highlight common barriers and to form collaborative solutions. The most common concern presented from all fields examined was that biochar characteristics are not well-documented in the myriad of published studies. Lack of characterization makes it difficult if not impossible to compare biochar results across studies with varying environmental or biochar production conditions. There was a cross-cutting need to understand mechanisms by which biochar provides benefits to environmental and agricultural applications. Defining mechanisms for soil and water improvement must also be linked to biochar characteristics to understand how biochar will affect target applications based on production and site conditions. Biochar benefits in agricultural and environmental applications need to be confirmed by long-term field-scale trials to understand how environmental conditions affect biochar performance over time

‘I'm not just a number on a sheet, I’m a person’: Domiciliary care, self and getting older

Social care funding is reducing in spite of a growing older population. Within this context, domiciliary services are increasingly failing to deliver care that respects the individuality and heterogeneity of older people (EHRC, 2011). To date, there has been limited research in the U.K. that explores, from the older person’s perspective, how care practices interact with self. Using biographical narrative methodology, this study takes a constructionist approach to understand the individual’s lived experience of care and how it interacts with sense of self. A three-stage model of data collection was used, beginning with a narrative biographic enquiry, exploring with participants (65yrs+, n=17) their journeys into care and any possible relationship to personal identity. Stage 2 involved a two-week period of diary completion, with participants recording daily reflections on their care experiences. In stage 3, a semi-structured interview explored the diary entries, linking back to the narrative biographic enquiry to reveal ways in which specific care practices interacted with the sense of self. The findings reveal that a strong relationship between older person and formal carer, forged through familiarity, regularity and consistency, plays a significant role in promoting feelings of autonomy. Furthermore, such relationship mediates against the loss of executional autonomy that often accompanies increasing disability. Maintaining autonomy and control was a recurring theme, including in relation to home, privacy and dignity. Feelings of autonomy are also promoted when formal carers understand the unique ways in which individuals experience ageing and being in the cared-for relationship. This paper suggests that a care approach should be based on two tenets. First, a knowledge and insight into the importance of understanding and respecting the older person’s continuing development of self, and second applying this knowledge to care through a positive, stable and consistent relationship between the older person and the carer

Multiple and Intersecting Experiences of Women in Prostitution: Improving Access to Helping Services

When women involved in prostitution experience multiple and intersecting needs, they may face barriers in accessing help and support. These barriers can include geographical location and opening hours of agencies, limited childcare support, and a lack of female-only provision. As a result, women are frequently disadvantaged, and their personal safety put at risk, as they become increasingly vulnerable to exploitation, particularly if they do not have access to secure accommodation. This research project seeks to understand the choices and decisions women make when they engage with helping services. The findings report on an in-depth qualitative study with 11 women involved in, or at risk of involvement in, prostitution. The women attended a third sector drop-in centre in an English city. Semi-structured interviews were used to understand the experiences that led participants to seek support and what they liked or did not like about helping services. Interviews were transcribed and analysed using Bacchi’s (1999) ‘What is the problem?’ approach in order to understand how women framed their experiences, as well as how they negotiated service provision. Women’s decisions to use services were shaped by a number of factors, including knowledge, availability, suitability, and assessment of caregivers’ behaviour. The way caregivers behaved was important in determining whether they could be trusted. A dissonance emerged between the framing of women’s needs by policy and services, and women’s lived experiences. This mismatch led to a complex network of support services that were both difficult for women to access and often failed to meet their needs. It is vital that social care services and training providers pay attention to the interactions between caregivers and women seeking help and support. A model is presented to reflect the decisions and choices made by women when seeking help and support, and the associated responses required by policy, service commissioners and providers

ISSLS PRIZE IN BIOENGINEERING SCIENCE 2019: biomechanical changes in dynamic sagittal balance and lower limb compensatory strategies following realignment surgery in adult spinal deformity patients.

Study designA longitudinal cohort study.ObjectiveTo define a set of objective biomechanical metrics that are representative of adult spinal deformity (ASD) post-surgical outcomes and that may forecast post-surgical mechanical complications. Current outcomes for ASD surgical planning and post-surgical assessment are limited to static radiographic alignment and patient-reported questionnaires. Little is known about the compensatory biomechanical strategies for stabilizing sagittal balance during functional movements in ASD patients.MethodsWe collected in-clinic motion data from 15 ASD patients and 10 controls during an unassisted sit-to-stand (STS) functional maneuver. Joint motions were measured using noninvasive 3D depth mapping sensor technology. Mathematical methods were used to attain high-fidelity joint-position tracking for biomechanical modeling. This approach provided reliable measurements for biomechanical behaviors at the spine, hip, and knee. These included peak sagittal vertical axis (SVA) over the course of the STS, as well as forces and muscular moments at various joints. We compared changes in dynamic sagittal balance (DSB) metrics between pre- and post-surgery and then separately compared pre- and post-surgical data to controls.ResultsStandard radiographic and patient-reported outcomes significantly improved following realignment surgery. From the DSB biomechanical metrics, peak SVA and biomechanical loads and muscular forces on the lower lumbar spine significantly reduced following surgery (- 19 to - 30%, all p < 0.05). In addition, as SVA improved, hip moments decreased (- 28 to - 65%, all p < 0.05) and knee moments increased (+ 7 to + 28%, p < 0.05), indicating changes in lower limb compensatory strategies. After surgery, DSB data approached values from the controls, with some post-surgical metrics becoming statistically equivalent to controls.ConclusionsLongitudinal changes in DSB following successful multi-level spinal realignment indicate reduced forces on the lower lumbar spine along with altered lower limb dynamics matching that of controls. Inadequate improvement in DSB may indicate increased risk of post-surgical mechanical failure. These slides can be retrieved under Electronic Supplementary Material