A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build

Introduction: The COVID-19 pandemic posed a significant lifecourse rupture, not least to those who had specific physical vulnerabilities to the virus, but also to those who were suffering with mental ill health. Women and birthing people who were pregnant, experienced a perinatal bereavement, or were in the first post-partum year (i.e., perinatal) were exposed to a number of risk factors for mental ill health, including alterations to the way in which their perinatal care was delivered. Methods: A consensus statement was derived from a cross-disciplinary collaboration of experts, whereby evidence from collaborative work on perinatal mental health during the COVID-19 pandemic was synthesised, and priorities were established as recommendations for research, healthcare practice, and policy. Results: The synthesis of research focused on the effect of the COVID-19 pandemic on perinatal health outcomes and care practices led to three immediate recommendations: what to retain, what to reinstate, and what to remove from perinatal mental healthcare provision. Longer-term recommendations for action were also made, categorised as follows: Equity and Relational Healthcare; Parity of Esteem in Mental and Physical Healthcare with an Emphasis on Specialist Perinatal Services; and Horizon Scanning for Perinatal Mental Health Research, Policy, & Practice. Discussion: The evidence base on the effect of the pandemic on perinatal mental health is growing. This consensus statement synthesises said evidence and makes recommendations for a post-pandemic recovery and re-build of perinatal mental health services and care provision

Tracking Cancer Evolution Reveals Constrained Routes to Metastases: TRACERx Renal.

Clear-cell renal cell carcinoma (ccRCC) exhibits a broad range of metastatic phenotypes that have not been systematically studied to date. Here, we analyzed 575 primary and 335 metastatic biopsies across 100 patients with metastatic ccRCC, including two cases sampledat post-mortem. Metastatic competence was afforded by chromosome complexity, and we identify 9p loss as a highly selected event driving metastasis and ccRCC-related mortality (p = 0.0014). Distinct patterns of metastatic dissemination were observed, including rapid progression to multiple tissue sites seeded by primary tumors of monoclonal structure. By contrast, we observed attenuated progression in cases characterized by high primary tumor heterogeneity, with metastatic competence acquired gradually and initial progression to solitary metastasis. Finally, we observed early divergence of primitive ancestral clones and protracted latency of up to two decades as a feature of pancreatic metastases

From the Sum of Near-Zero Energy Buildings to the Whole of a Near-Zero Energy Housing Settlement: The Role of Communal Spaces in Performance-Driven Design

Almost a century ago Modernism challenged the structure of the city and reshaped its physical space in order to, amongst other things, accommodate new transportation infrastructure and road networks proclaiming the,nowadays much-debated ‘scientificated’ pursuit of efficiency for the city. This transformation has had a great impact on the way humans still design, move in, occupy and experience the city. Today major cities in Europe, such as Paris and London, are considering banning vehicles from their historic centers. In parallel, significant effort is currently underway internationally by designers, architects, and engineers to integrate innovative technologies and sophisticated solutions for energy production, management, and storage, as well as for efficient energy consumption, into the architecture of buildings. In general, this effort seeks for new technologies and design methods (e.g., DesignBuilder with EnergyPlus simulation engine; Rhicoceros3D with Grasshopper plugin and Ecotect, Radiance and EnergyPlus tools) that would enable a holistic approach to the spatial design of Near-Zero Energy buildings, so that their ecological benefits are an added value to the architectural design and a building’s visual, and material, impact on its surrounding space. The paper inquires how the integration of such technological infrastructure and performance-orientated interfaces changes yet again the structure and form of cities, and to what extent it safeguards social rights and enables equal access to common resources. Drawing from preliminary results and initial considerations of ongoing research that involve the construction of four innovative NZE settlements across Europe, in the context of the EU-funded ZERO-PLUS project, this paper discusses the integration of novel infrastructure in communal spaces of these settlements. In doing so, it contributes to the debate about smart communities and their role in the sustainable management of housing developments and settlements that are designed and developed with the concept of smart territories

Tracking Cancer Evolution Reveals Constrained Routes to Metastases: TRACERx Renal.

Clear-cell renal cell carcinoma (ccRCC) exhibits a broad range of metastatic phenotypes that have not been systematically studied to date. Here, we analyzed 575 primary and 335 metastatic biopsies across 100 patients with metastatic ccRCC, including two cases sampledat post-mortem. Metastatic competence was afforded by chromosome complexity, and we identify 9p loss as a highly selected event driving metastasis and ccRCC-related mortality (p = 0.0014). Distinct patterns of metastatic dissemination were observed, including rapid progression to multiple tissue sites seeded by primary tumors of monoclonal structure. By contrast, we observed attenuated progression in cases characterized by high primary tumor heterogeneity, with metastatic competence acquired gradually and initial progression to solitary metastasis. Finally, we observed early divergence of primitive ancestral clones and protracted latency of up to two decades as a feature of pancreatic metastases

Re-materialising energy use through transparent monitoring systems

This paper reviews the effect of transparent energy monitoring systems on the purchasing, production and energy use behaviour of consumers and producers. Relevant literature is explored on the linkages between feedback, risk and responsibility, knowledge, economic drivers, and sustainable energy consumption. Drawing on international as well as UK-specific experiences, the paper focuses on the prospects for current and future energy monitoring systems to ‘re-materialise’ energy use in economic and environmental terms that are more meaningful, and thus more behaviourally significant, to a substantially wider range of energy users than today's. Appliance labelling, smart metering and carbon footprint analyses are explored as case studies

Making energy visible: A qualitative field study of how householders interact with feedback from smart energy monitors

This paper explores how UK householders interacted with feedback on their domestic energy consumption in a field trial of real-time displays or smart energy monitors. After examining relevant bodies of literature on the effects of energy feedback on consumption behaviour, and on the complex role of energy and appliances within household moral economies, the paper draws on qualitative evidence from interviews with 15 UK householders trialling smart energy monitors of differing levels of sophistication. It focuses specifically on householder motivations for acquiring the monitors, how the monitors have been used, how feedback has changed consumption behaviour, and the limitations to further behavioural change the householders experienced. The paper concludes by identifying significant implications for future research and policy in this area