Thinking About ... Core Funding

Thinking about... core funding draws on learning from their own and others' research and interviews with key informants from seven charitable foundations providing core funding to shed light on why, when and how to use core funding. Their particular focus is social welfarevoluntary organisations, many of which are local. This part of the voluntary sector relies mainly on two types of income – grants from statutory bodies and fundraising from trusts and foundations. This makes their dependence on core funding from trusts and foundations, and full costrecovery, even more critical

Quantum-Cops: When Communities of Practice Resemble Physics

This paper puts forwards a new way to view how Communities of Practice (CoPs) form in environments that make heavy use of information systems. It uses a concept from Physics to suggest a new type of CoP that can exist in workplaces. In order to do that, the paper uses a simplified taxonomy for CoPs to outline the \u27Quantum-CoPs\u27. These Communities are discussed regarding their behaviour and characteristics, and their potential use as fully developed CoPs. The paper presents some preliminary findings from a semi-structured interview conducted in The Higher Education Academy Psychology Network (UK). These findings are contrasted against the theory discussed and some additional proposals are suggested at the end

Corticosteroid Injections For Frozen Shoulder: A Global Online Survey Of Health Professionals’ Current Practice And Opinion

© 2023 World Physiotherapy.Background: Frozen shoulder is a disabling condition characterised by persistent and severe pain and loss of shoulder movement. Corticosteroid injections are targeted at reducing pain in the earlier painful phase (Ahn et al., 2018; Sun, Liu, Chen, & Chen, 2018). Currently, there are no clear guidelines regarding medicines and dose to inject and if this should be under ultrasound or landmark guidance or if an injection should even be considered. This uncertainty results in a range of methods of injections for frozen shoulder. Purpose: To investigate the current practice and opinion of global healthcare providers on injections for frozen shoulder. Methods: Methods An online questionnaire survey was used to investigate current practice and opinions on injections for frozen shoulder. The survey used JISC https://www.onlinesurveys.ac.uk/ and was disseminated via the social media platform Twitter™. It was available for 5 weeks in spring 2022. Further recruitment involved sharing the link once completed creating a ‘snowball’ effect. Results: The total number of respondents was 235 from 33 different countries across 6 continents of which (n=213, 90.6%) were Physical Therapists/Physiotherapists. Other professions were Orthopaedic Consultant (n=10, 4.3%), Sports and Medicine Doctor (n=4, 1.7%), Osteopath (n=3, 1.3%), Physiatrist (n=2, 0.9%), myotherapist (n=1, 0.4%), Radiologist (n=1, 0.4%), Sonographer (n=1, 0.4%). Most people (n=154, 65.5%) reported seeing between one and two cases of FS a week. Only (n=35, 14.9%) respondents neither injected nor referred for injection. The majority (n =155, 66%) reported injections have an important role in the management of frozen shoulder and 191 (81.3%) reported that corticosteroid injections are best administered only during the pain greater than stiffness phase. The glenohumeral joint (GHJ) was most frequently reported as the site to inject (n=136, 57.9%). Triamcinolone Acetonide (TA) was the most frequently reported (n=66, 28.1%) corticosteroid to inject the GHJ and of these, the most frequently reported dose was 40 mg/ml (n= 52, 78.8%). Doses ranged from 10mg/ml to 40mg/ml. Triamcinolone Acetonide was the most frequently reported (n=44, 18.7%) substance to inject for the subacromial space and of these, the most frequently reported dose was 40mg/ml (n=27, 61.4%). Doses ranged from 10mg/ml to 40mg/ml. Lidocaine was the most frequently reported anaesthetic: GHJ (n= 109, 46.4%). Of those who expressed an opinion (n=96, 40.7%) reported the injection should be performed under ultrasound guidance. Conclusion(s): There was overall consensus for the use of corticosteroid injections in frozen shoulder. However, the wide variety of doses and lack on convincing consensus on method of delivery, mirrors the uncertainty in the literature. In some respects, the delivery of injection therapy is probably based on personal preference or local guidance in the absence of universally agreed guidance. Further research should investigate medicine, dose, and method of delivery of corticosteroid injection. Other treatments such as hydrodistension or suprascapular nerve blocks were reported by respondents, and it would be of value to investigate current practice and opinion for both interventions. Implications: This survey highlights the need for injectors to ensure they are benchmarking their practice against current best evidence whilst acknowledging there are gaps in the literature. Keyword 1: Online survey Keyword 2: Corticosteroid injections Keyword 3: Frozen shoulder Funding acknowledgements: No funding was received for this project. Did this work require ethics approval?: Yes Institution: University of Hertfordshire Ethics committee: University of Hertfordshire ECDA Ethical approval number: Ethical approval was granted by Ref: HSK PRG UH 04693 Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2023?: No Consent: Yes Consent: Ye

Results from the third Scottish National Prevalence Survey: is a population health approach now needed to prevent healthcare-associated infections?

Summary Background Healthcare associated infections (HAI) are a major public health concern and a significant cause of morbidity and mortality. A robust and current evidence base that is specific to local, national and Europe-wide settings is necessary to inform the development of strategies to reduce HAI and contain antimicrobial resistance (AMR). Aim To measure the prevalence of HAI and antimicrobial prescribing and identify key priority areas for interventions to reduce the burden of infection. Methods A national rolling PPS in National Health Service (NHS) acute, NHS non-acute, NHS paediatric and independent hospitals was carried out between September and November 2016 using the European Centre for Disease Prevention and Control protocol designed for the European PPS. Findings The prevalence of HAI was 4.6%, 2.7% and 3.2% in acute adults, paediatric and non-acute patient groups, respectively. The most common HAI types reported in adult patients were urinary tract infection and pneumonia. The prevalence of antimicrobial prescribing was 35.7%, 29.3% and 13.8% in acute adults, paediatric and non-acute patient groups, respectively. Respiratory, skin and soft tissue, gastrointestinal and urinary tract infections were the most common infections being treated at the time of survey. Conclusion HAI continues to be a public health concern in Scotland. UTI and pneumonia continue to place a significant burden on patients and on healthcare delivery, including those that develop in the community and require hospital admission. A broader population health approach which focuses on reducing the risk of infection upstream would reduce these infections in both community and hospital settings

Health services in northern Australia depend on student placements post COVID-19

[Excerpt] The early and comprehensive public health biosecurity response to COVID‐19 in northern Australia undoubtedly has saved many lives in remote and rural Aboriginal and Torres Strait Islander communities. However, the strict quarantine of remote and rural communities has also meant reduced access of communities to various services, including health services.1 For example, short‐term contract funded agency nurses or health professionals are unable or unwillingly to quarantine for two weeks (at a cost of AU$2,500) before entering communities. Equally, some communities may prefer not to be exposed to the risk of COVID‐19, but in either case, the result is reduced services

Corticosteroid injections for non-spinal musculoskeletal conditions. Consideration of local and systemic adverse drug reactions and side effects

© New Zealand Journal of Physiotherapy. This is an open access article under the Creative Commons Attribution-NonCommercial-NoDerivatives CC BY-NC-ND licence, https://creativecommons.org/licenses/by-nc-nd/4.0/Following specialist training, physiotherapists in some countries, such as the United Kingdom and Norway perform landmark, and ultrasound guided, soft tissue and joint injections for a wide range of musculoskeletal conditions. Whether they inject or not, physiotherapists may wish to recommend injections, and people requiring care commonly seek physiotherapist’s opinions on injection therapy. Globally, there has been a substantial increase in the use of corticosteroid injections to treat musculoskeletal conditions. Those performing injections or providing advice need be cognisant of the possible harms of the procedures and communicate this information sensitively to those considering the procedures. This review synthesises evidence for local and systemic adverse reactions and side effects related to corticosteroid injections in the treatment of non-spinal musculoskeletal conditions. Multiple databases including PubMed, Medline, PEDro, Cinahl were searched, and all levels of evidence were included if they added to the review. Serious adverse events appear to be rare, possibly in part, due to under-reporting of side effects. Where available, suggestions for minimising risk and aftercare have been made. As substantial gaps in the evidence were found, areas for further research are suggested and a decision-making tool is included to facilitate whether to proceed to injection, proceed with precaution or no injection.Peer reviewe

Aerosol Retrievals from Different Polarimeters During the ACEPOL Campaign Using a Common Retrieval Algorithm

In this paper, we present aerosol retrieval results from the ACEPOL (Aerosol Characterization from Polarimeter and Lidar) campaign, which was a joint initiative between NASA and SRON the Netherlands Institute for Space Research. The campaign took place in OctoberNovember 2017 over the western part of the United States. During ACEPOL six different instruments were deployed on the NASA ER-2 high-altitude aircraft, including four multi-angle polarimeters (MAPs): SPEX airborne, the Airborne Hyper Angular Rainbow Polarimeter (AirHARP), the Airborne Multi-angle SpectroPolarimetric Imager (AirMSPI), and the Research Scanning Polarimeter (RSP). Also, two lidars participated: the High Spectral Resolution Lidar-2 (HSRL-2) and the Cloud Physics Lidar (CPL). Flights were conducted mainly for scenes with low aerosol load over land, but some cases with higher AOD were also observed. We perform aerosol retrievals from SPEX airborne, RSP (410865 nm range only), and AirMSPI using the SRON aerosol retrieval algorithm and compare the results against AERONET (AErosol RObotic NETwork) and HSRL-2 measurements (for SPEX airborne and RSP). All three MAPs compare well against AERONET for the aerosol optical depth (AOD), with a mean absolute error (MAE) between 0.014 and 0.024 at 440 nm. For the fine-mode effective radius the MAE ranges between 0.021 and 0.028 m. For the comparison with HSRL-2 we focus on a day with low AOD (0.020.14 at 532 nm) over the California Central Valley, Arizona, and Nevada (26 October) as well as a flight with high AOD (including measurements with AOD>1.0 at 532 nm) over a prescribed forest fire in Arizona (9 November). For the day with low AOD the MAEs in AOD (at 532 nm) with HSRL-2 are 0.014 and 0.022 for SPEX and RSP, respectively, showing the capability of MAPs to provide accurate AOD retrievals for the challenging case of low AOD over land. For the retrievals over the smoke plume a reasonable agreement in AOD between the MAPs and HSRL-2 was also found (MAE 0.088 and 0.079 for SPEX and RSP, respectively), despite the fact that the comparison is hampered by large spatial variability in AOD throughout the smoke plume. A good comparison is also found between the MAPs and HSRL-2 for the aerosol depolarization ratio (a measure of particle sphericity), with an MAE of 0.023 and 0.016 for SPEX and RSP, respectively. Finally, SPEX and RSP agree very well for the retrieved microphysical and optical properties of the smoke plume

Radiation, Smoke and Clouds Observed in the Southeastern Atlantic With the Research Scanning Polarimeter During ORACLES

The ObseRvations of Aerosols above Clouds and their interactions (ORACLES) project is making a series of field deployments to the southeastern Atlantic with NASA ER-2 and P3 aircraft to acquire both detailed remote sensing observations and in situ measurements of the aerosols and clouds in that region. This area is home to one of the largest low-level cloud decks on Earth that is seasonally affected by vast plumes of smoke from biomass burning, which in effect provides a natural experiment testing the radiative and microphysical interactions between the smoke and the clouds. The downward solar radiation at the surface, or cloud top, is always reduced by the presence of smoke. However, whether the amount of sunlight reflected back out to space is increased, or decreased by the presence of smoke is sensitively dependent on the brightness of the clouds and the fraction of light that the smoke absorbs each time light hits a smoke particle. In this study we use data from the Research Scanning Polarimeter, an along track scanning instrument, that provides measurements of the Stokes parameters I, Q and U at 410, 470, 555, 670, 865, 960, 1590, 1880 and 2260 nm at 150 viewing angles over a range of +/- 60 from nadir for each contiguous sub-aircraft pixel (~ 300 m in size). A retrieval algorithm is applied to the data acquired with a table look up technique, similar to that of the operational POLDER algorithm, to provide a first guess of the complex refractive index, optical depth and size distribution of the smoke particles together with cloud droplet size and optical depth. A subsequent iterative fitting procedure, where the fact that the doubling/adding method allows the construction of the Green's function for the radiative transfer equation, is used to obtain an efficient and statistically optimal estimate of the aerosol and cloud retrieval parameters. These retrieval parameters are evaluated against in situ observations, when available, and the optical depth and intensive lidar variables that are measured by the High Spectral Resolution Lidar 2. Finally, the aerosol and cloud retrievals are used to evaluate the variations in top of the atmosphere, surface/cloud top shortwave radiative forcing and atmospheric absorption that are caused by variations in the smoke and clouds

Transcription controls growth, cell kinetics and cholesterol supply to sustain ACTH responses

Chronic ACTH exposure is associated with adrenal hypertrophy and steroidogenesis. The underlying molecular processes in mice have been analysed by microarray, histological and immunohistochemical techniques. Synacthen infused for 2 weeks markedly increased adrenal mass and plasma corticosterone levels. Microarray analysis found greater than 2-fold changes in expression of 928 genes (P < 0.001; 397 up, 531 down). These clustered in pathways involved in signalling, sterol/lipid metabolism, cell proliferation/hypertrophy and apoptosis. Signalling genes included some implicated in adrenal adenomas but also upregulated genes associated with cyclic AMP and downregulated genes associated with aldosterone synthesis. Sterol metabolism genes were those promoting cholesterol supply (Scarb1, Sqle, Apoa1) and disposal (Cyp27a1, Cyp7b1). Oil red O staining showed lipid depletion consistent with reduced expression of genes involved in lipid synthesis. Genes involved in steroidogenesis (Star, Cyp11a1, Cyp11b1) were modestly affected (P < 0.05; <1.3-fold). Increased Ki67, Ccna2, Ccnb2 and Tk1 expression complemented immunohistochemical evidence of a 3-fold change in cell proliferation. Growth arrest genes, Cdkn1a and Cdkn1c, which are known to be active in hypertrophied cells, were increased >4-fold and cross-sectional area of fasciculata cells was 2-fold greater. In contrast, genes associated with apoptosis (eg Casp12, Clu,) were downregulated and apoptotic cells (Tunel staining) were fewer (P < 0.001) and more widely distributed throughout the cortex. In summary, long-term steroidogenesis with ACTH excess is sustained by genes controlling cholesterol supply and adrenal mass. ACTH effects on adrenal morphology and genes controlling cell hypertrophy, proliferation and apoptosis suggest the involvement of different cell types and separate molecular pathways