Essex Review (Windsor)

Title Variations Windsor Review Review Publication Dates 1878: Oct. 11 (Vol. 1: no. 1) - 1902 Frequency Weekly Online Holdings 1878: Nov. 1 (Vol. 1: no. 4) 8 p.1885: Dec. 25 (Vol. 8: no. 7) 8 p.1899: July 28 (Vol. 23: no. 30) 12 p. (pages 3-10 are missing)https://scholar.uwindsor.ca/essexcountyontarionewspapers/1011/thumbnail.jp

Armed violence and rural livelihoods

This briefing paper examines relationships between armed violence affecting rural communities and efforts to maintain, restore and promote already fragile livelihoods. It is one of a series of briefings addressing issues surrounding the interaction between armed violence and poverty-reducing development. This paper seeks to provide an introduction for the staff of the UK government¿s Department for International Development (DFID) and other donor agencies to some of the issues raised in trying to make this connection and to stimulate thinking on these questions in analysis and policy. Some of the key questions to be addressed are: ¿ How can DFID¿s current sustainable rural livelihoods framework be applied to contexts of armed violence? ¿ What are the implications of these relationships for planning and programming rural development? ¿ Conversely, how might development interventions tackle the prevalence and spread of Small Arms and Light Weapons (SALW) and other factors fostering violence that affect livelihood

Effects of NIOMR smoking kiln and oven on the crude protein, minerals and vitamins of catfish Clarias gariepinus

The effects of two different preservative methods, NIOMR Smoking Kiln and Oven drying on Crude Protein minerals and Vitamin of clarias gariepinus were studied. Clarias gariepinus were obtained from the fish farm of African Regional Aquaculture Centre, Aluu, Port Harcourt. The crude protein, minerals and vitamins of the fresh fish were determined immediately while two other batches were separately dried using oven at 50~'C for 30minutes and NIOMR Smoking Kiln at 70~'C for 3 hours. Result of the crude protien of fresh fish was 21.84 ~c 1.10 which increased to 59.53 ~c 1.88 and 35.41 ~c 1.00 in both NIOMR smoking and oven, respectively. This means that, there was a significant different in both dryers on the crude protein. This will improve the knowledge and capacity of rural women and agricultural communities on the appropriate processing method for fish. The mineral and vitamins of oven dried and NIOMR Smoking kiln were analyzed. The vitamin content of both the fish, dried and smoking kiln shows no significant different except in vitamin A which was significant (p<0.05).There was significant different (p<0.05) in the mineral content of the two different drying method except in sodium, Potassium and Phosphorus of the drying method. This result indicates that the two drying methods have effects on the nutritional quality of catfish

Education for collaboration: the influence of the third space on professional boundaries

The delivery of integrated care requires the establishment of effective professional relationships that foster collaborative working across health systems. Evidence for how to prepare practitioners to work in those settings is limited. By exploring an innovative postgraduate Programme for Integrated Child Health (PICH) this article highlights the conditions by which effective collaboration can be encouraged. Our qualitative evaluation of PICH involved one-to-one semi-structured interviews with 23 postgraduate general practice and paediatric trainees and their mentors. We analysed the data using the concept of the ‘third space’, where multiple discourses between individuals with diverse professional backgrounds occur, enabling creative exploration of tensions inherent in new ways of working in order to identify enablers and barriers to collaboration. Our analysis identified three themes that enabled collaboration: effective communication, boundary work and educational spaces; and four themes that were barriers: traditional hierarchical professional identities, curriculum design, financial systems and workplace spaces. PICH demonstrated the value of educational spaces and their role in enabling collaborative practice, as participants explored their professional identities and those of other disciplines. Structural factors in the workplace which inhibit collaborative practice were also evident. We conclude by proposing a model for collaborative learning in third spaces based upon the recognition that, while educational programmes alone will not lead to change, they have the potential to inform the development of productive workplace spaces that will be required if collaborative practice in healthcare is to become a reality

Harm minimisation for the management of self-harm: a mixed-methods analysis of electronic health records in secondary mental healthcare

BACKGROUND: Prevalence of self-harm in the UK was reported as 6.4% in 2014. Despite sparse evidence for effectiveness, guidelines recommend harm minimisation; a strategy in which people who self-harm are supported to do so safely. AIMS: To determine the prevalence, sociodemographic and clinical characteristics of those who self-harm and practise harm minimisation within a London mental health trust. METHOD: We included electronic health records for patients treated by South London and Maudsley NHS Trust. Using an iterative search strategy, we identified patients who practise harm minimisation, then classified the approaches using a content analysis. We compared the sociodemographic characteristics with that of a control group of patients who self-harm and do not use harm minimisation. RESULTS: In total 22 736 patients reported self-harm, of these 693 (3%) had records reporting the use of harm-minimisation techniques. We coded the approaches into categories: (a) ‘substitution’ (>50% of those using harm minimisation), such as using rubber bands or using ice; (b) ‘simulation’ (9%) such as using red pens; (c) ‘defer or avoid’ (7%) such as an alternative self-injury location; (d) ‘damage limitation’ (9%) such as using antiseptic techniques; the remainder were unclassifiable (24%). The majority of people using harm minimisation described it as helpful (>90%). Those practising harm minimisation were younger, female, of White ethnicity, had previous admissions and were less likely to have self-harmed with suicidal intent. CONCLUSIONS: A small minority of patients who self-harm report using harm minimisation, primarily substitution techniques, and the large majority find harm minimisation helpful. More research is required to determine the acceptability and effectiveness of harm-minimisation techniques and update national clinical guidelines

A new method for conditioning stochastic groundwater flow models in fractured media

Many geological formations consist of crystalline rocks that have very low matrix permeability but allow flow through an interconnected network of fractures. Understanding the flow of groundwater through such rocks is important in considering disposal of radioactive waste in underground repositories. A specific area of interest is the conditioning of fracture transmissivities on measured values of pressure in these formations. This is the process where the values of fracture transmissivities in a model are adjusted to obtain a good fit of the calculated pressures to measured pressure values. While there are existing methods to condition transmissivity fields on transmissivity, pressure and flow measurements for a continuous porous medium there is little literature on conditioning fracture networks. Conditioning fracture transmissivities on pressure or flow values is a complex problem because the measurements are not linearly related to the fracture transmissivities and they are also dependent on all the fracture transmissivities in the network. We present a new method for conditioning fracture transmissivities on measured pressure values based on the calculation of certain basis vectors; each basis vector represents the change to the log transmissivity of the fractures in the network that results in a unit increase in the pressure at one measurement point whilst keeping the pressure at the remaining measurement points constant. The fracture transmissivities are updated by adding a linear combination of basis vectors and coefficients, where the coefficients are obtained by minimizing an error function. A mathematical summary of the method is given. This algorithm is implemented in the existing finite element code ConnectFlow developed and marketed by Serco Technical Services, which models groundwater flow in a fracture network. Results of the conditioning are shown for a number of simple test problems as well as for a realistic large scale test case

Filamentous Aggregates Are Fragmented by the Proteasome Holoenzyme.

Filamentous aggregates (fibrils) are regarded as the final stage in the assembly of amyloidogenic proteins and are formed in many neurodegenerative diseases. Accumulation of aggregates occurs as a result of an imbalance between their formation and removal. Here we use single-aggregate imaging to show that large fibrils assembled from full-length tau are substrates of the 26S proteasome holoenzyme, which fragments them into small aggregates. Interestingly, although degradation of monomeric tau is not inhibited by adenosine 5'-(3-thiotriphosphate) (ATPγS), fibril fragmentation is predominantly dependent on the ATPase activity of the proteasome. The proteasome holoenzyme also targets fibrils assembled from α-synuclein, suggesting that its fibril-fragmenting function may be a general mechanism. The fragmented species produced by the proteasome shows significant toxicity to human cell lines compared with intact fibrils. Together, our results indicate that the proteasome holoenzyme possesses a fragmentation function that disassembles large fibrils into smaller and more cytotoxic species.Wellcome Trust, Sir Henry Wellcome Fellowship (101585/Z/13/Z) to Yu Y

Collimated Outflow Formation via Binary Stars. 3-D Simulations of AGB Wind and Disk Wind Interactions

We present three-dimensional hydrodynamic simulations of the interaction of a slow wind from an asymptotic giant branch(AGB) star and a jet blown by an orbiting companion. The jet or "Collimated Fast Wind" is assumed to originate from an accretion disk which forms via Bondi accretion of the AGB wind or Roche lobe overflow. We present two distinct regimes in the wind-jet interaction determined by the ratio of the AGB wind to jet momentum flux. Our results show that when the wind momentum flux overwhelms the flux in the jet a more dis-ordered outflow outflow results with the jet assuming a corkscrew pattern and multiple shock structures driven into the AGB wind. In the opposite regime the jet dominates and will drive a highly collimated narrow waisted outflow. We compare our results with scenarios described by Soker & Rappaport (2000) and extrapolate the structures observed in PNe and Symbiotic stars.Comment: 22 pages, 8 figures, submitted to Ap

Ethical challenges of integration across primary and secondary care: a qualitative and normative analysis

BACKGROUND: This paper explores ethical concerns arising in healthcare integration. We argue that integration is necessary imperative for meeting contemporary and future healthcare challenges, a far stronger evidence base for the conditions of its effectiveness is required. In particular, given the increasing emphasis at the policy level for the entire healthcare infrastructure to become better integrated, our analysis of the ethical challenges that follow from the logic of integration itself is timely and important and has hitherto received insufficient attention. METHODS: We evaluated an educational intervention which aims to improve child health outcomes by making transitions between primary to secondary care more efficient, ensuring children and parents are better supported throughout. The programme provided skills for trainee paediatricians and general practitioners (GPs) in co-designing integrated clinical services. RESULTS: The key ethical challenges of integrated care that arose from a clinical perspective are: professional identity and autonomy in an integrated working environment; the concomitant extent of professional responsibility in such an environment; and the urgent need for more evidence to be produced on which strategies for integrating at scale can be based. CONCLUSIONS: From our analysis we suggest a tentative way forward, viewed from a normative position broadly situated at the intersection of deontology and care ethics. We adopt this position because the primary clinical ethical issues in the context of integrated care concern: how to ensure that all duties of care to individual patients are met in a newly orientated working environment where clinical responsibility may be ambiguous; and the need to orientate care around the patient by foregrounding their autonomous preferences and ensuring good patient clinician relationships in clinical decision-making

Radiotherapy response evaluation using FDG PET-CT - established and emerging applications.

Radiation therapy is a common component of curative cancer treatment. However, there is a significant incidence of treatment failure. In these cases salvage surgical options are sometimes appropriate. Accurate assessment of response and early recognition of treatment success or failure is therefore critical to guide treatment decisions and impacts on survival and the morbidity of treatment. Traditionally, treatment response has depended upon anatomical measurement of disease. However, this may not correlate well with the presence of disease, especially after radiotherapy. Combined positron emission tomography and computed tomography (PET-CT) imaging employs radioactive tracers to identify molecular characteristics of tissue. PET imaging exploits the fact that malignancies have characteristic molecular profiles which differ compared to surrounding tissues. The complementary anatomical and functional information facilitates accurate non-invasive assessment of surrogate biomarkers of disease activity. This article reviews the rationale for PET-CT response assessment in radiation oncology, describing current uses of 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) PET-CT in treatment response following radiotherapy in head and neck, oesophageal, rectal and brain tumours. Emerging applications of FDG PET-CT in cervical and lung carcinomas and hepato-pancreatico-biliary (HPB) tumours particularly pancreatic carcinoma and liver metastases (post selective internal radiotherapy treatment (SIRT)) are reviewed. Finally, the limitations of FDG PET-CT are considered, highlighting areas for future development