Race, class, and community in a southern forest-dependent region

Based on a Community and Environment in Rural America survey, this brief looks at four counties in Alabama. It finds blacks and whites have different outcomes in the community, despite expectations of regional stability and greater equality. Though they reported similar rates of social mobility, African Americans in the Black Belt of Alabama are disproportionately poorer and employed in lower-skill jobs than whites

Experimentally validated continuous-time repetitive control of non-minimum phase plants with a prescribed degree of stability

This paper considers the application of continuous-time repetitive control to non-minimum phase plants in a continuous-time model predictive control setting. In particular, it is shown how some critical performance problems associated with repetitive control of such plants can be avoided by use of predictive control with a prescribed degree of stability. The results developed are first illustrated by simulation studies and then through experimental tests on a non-minimum phase electro-mechanical system

Delivering successful randomized controlled trials in surgery:methods to optimize collaboration and study design

Randomized controlled trials in surgery are notoriously difficult to design and conduct due to numerous methodological and cultural challenges. Over the last 5 years, several UK-based surgical trial-related initiatives have been funded to address these issues. These include the development of Surgical Trials Centers and Surgical Specialty Leads (individual surgeons responsible for championing randomized controlled trials in their specialist fields), both funded by the Royal College of Surgeons of England; networks of research-active surgeons in training; and investment in methodological research relating to surgical randomized controlled trials (to address issues such as recruitment, blinding, and the selection and standardization of interventions). This article discusses these initiatives more in detail and provides exemplar cases to illustrate how the methodological challenges have been tackled. The initiatives have surpassed expectations, resulting in a renaissance in surgical research throughout the United Kingdom, such that the number of patients entering surgical randomized controlled trials has doubled

From social contract to 'social contrick' : the depoliticisation of economic policy-making under Harold Wilson, 1974–75

The 1974-79 Labour Governments were elected on the basis of an agreement with the TUC promising a redistribution of income and wealth known as the Social Contract. However, the Government immediately began to marginalise these commitments in favour of preferences for incomes policy and public expenditure cuts, which has led the Social Contract to be described as the 'Social Contrick'. These changes were legitimised through a process of depoliticisation, and using an Open Marxist framework and evidence from the National Archives, the paper will show that the Treasury's exchange rate strategy and the need to secure external finance placed issues of confidence at the centre of political debate, allowing the Government to argue there was no alternative to the introduction of incomes policy and the reduction of public expenditure

Real-time energy storage simulators for the electricity grid

In this paper, a novel Distributed Real-Time Simulation Environment (DRTSE) which enables the coordinated control of multiple Real-Time Simulators (RTSs) positioned across the UK is introduced and demonstrated for an energy storage application. Using RTSs instead of physical energy storage assets enables the testing of different communication and control strategies, thereby reducing the risk of failure when the physical storage assets are deployed. In addition, the testing of different storage types (e.g. batteries, compressed air, flywheels, etc.) and storage locations can be conducted without expensive hardware modifications. In this paper, technical details of the RTSs are given, including the hardware and electrical storage models. The Central Controller (CC) and communication are also described, and results from the DRTSE presented

Designing a complex intervention for dementia case management in primary care

Background: Community-based support will become increasingly important for people with dementia, but currently services are fragmented and the quality of care is variable. Case management is a popular approach to care co-ordination, but evidence to date on its effectiveness in dementia has been equivocal. Case management interventions need to be designed to overcome obstacles to care co-ordination and maximise benefit. A successful case management methodology was adapted from the United States (US) version for use in English primary care, with a view to a definitive trial. Medical Research Council guidance on the development of complex interventions was implemented in the adaptation process, to capture the skill sets, person characteristics and learning needs of primary care based case managers. Methods: Co-design of the case manager role in a single NHS provider organisation, with external peer review by professionals and carers, in an iterative technology development process. Results: The generic skills and personal attributes were described for practice nurses taking up the case manager role in their workplaces, and for social workers seconded to general practice teams, together with a method of assessing their learning needs. A manual of information material for people with dementia and their family carers was also created using the US intervention as its source. Conclusions: Co-design produces rich products that have face validity and map onto the complexities of dementia and of health and care services. The feasibility of the case manager role, as described and defined by this process, needs evaluation in ‘real life’ settings

Social media for dissemination and public engagement in neurosurgery-the example of Brainbook.

BACKGROUND: Public engagement has become one of the most effective tools in gaining feedback and perspectives from members of the public, involving patients with decisions, and inspiring young people to carry the medical profession forwards. Brainbook is a multi-platform, social media-based resource that was created specifically to enhance public engagement in neurosurgery and results from one of its case discussions will be reported in this paper. METHODS: A Brainbook case was created in collaboration with the NIHR Global Health Research Group on Neurotrauma and presented over 3 days (23-25 February 2018). YouTube videos were created depicting the management of an acute subdural haematoma using patient interviews, medical illustration, consultant-led discussion and operative footage. Content was shared across all Brainbook social media platforms and analytics were gathered through social media applications. RESULTS: Over a 72-hour time period, and across multiple social media accounts, 101,418 impressions were achieved (defined as penetrance onto individual media feeds and total views of the content), with active discussion on social media. CONCLUSIONS: Neurosurgical content published across multiple social media outlets represents an encouraging and exciting potential for global engagement across multiple audiences. Social media can be an effective method of not only disseminating neurosurgical knowledge, but activating and engaging the public, allied healthcare professionals, medical students and neurosurgeons