How can subnational governments develop and deliver distinctive policy agendas?

Emily St.Denny, Andrew Connell, and Steve Martin analyse two contrasting attempts by the Welsh Government to develop and deliver distinctive subnational policies. They demonstrate the importance of looking beyond formal institutional powers and of paying attention to policymakers’ political skills and visibility, as well as to the strategies and tactics that they employ in deploying formal powers

How can subnational governments deliver their policy objectives in the age of austerity? Reshaping homelessness policy in Wales

This article explores how a devolved government in a small country, faced with external constraints beyond its immediate control, can deploy policy resources to shape a distinctive approach to public services. We analyse recent homelessness policy in Wales using the NATO (Nodality, Authority, Treasure, Organisation) typology of tools of government proposed by Hood and Margetts, and show how this can be applied usefully to understand the choices that governments must make in conducting relationships with other institutions. We conclude that a combination of Nodality and Authority provide powerful resources for a subnational government which has only limited formal powers and fiscal autonomy

Formation of functional gap junctions in amniotic fluid-derived stem cells induced by transmembrane co-culture with neonatal rat cardiomyocytes

Amniotic fluid-derived stem cells (AFSC) have been reported to differentiate into cardiomyocyte-like cells and form gap junctions when directly mixed and cultured with neonatal rat ventricular myocytes (NRVM). This study investigated whether or not culture of AFSC on the opposite side of a Transwell membrane from NRVM, allowing for contact and communication without confounding factors such as cell fusion, could direct cardiac differentiation and enhance gap junction formation. Results were compared to shared media (Transwell), conditioned media and monoculture media controls. After a 2-week culture period, AFSC did not express cardiac myosin heavy chain or troponin T in any co-culture group. Protein expression of cardiac calsequestrin 2 was up-regulated in direct transmembrane co-cultures and media control cultures compared to the other experimental groups, but all groups were up-regulated compared with undifferentiated AFSC cultures. Gap junction communication, assessed with a scrape-loading dye transfer assay, was significantly increased in direct transmembrane co-cultures compared to all other conditions. Gap junction communication corresponded with increased connexin 43 gene expression and decreased phosphorylation of connexin 43. Our results suggest that direct transmembrane co-culture does not induce cardiomyocyte differentiation of AFSC, though calsequestrin expression is increased. However, direct transmembrane co-culture does enhance connexin-43-mediated gap junction communication between AFSC

Can meso-governments use metagovernance tools to tackle complex policy problems?

In recent years, a range of countries have devolved significant powers, responsibilities and funding to the regional level. This paper explores how and why the resulting meso-governments may use the tools of metagovernance. A detailed empirical analysis of homelessness policy in Wales found that skilful deployment of metagovernance tools enabled its meso-government to exploit the advantages of geographical and relational proximity to policy communities, while mitigating some of the constraints of its intermediate constitutional status, including limited formal powers and policy capacity. Junior government officials played multiple roles in homelessness networks, shaping and steering them through active network management while also participating in them. This ‘governor-participant’ role blurs the distinction made in the existing literature between ‘hands-on’ and ‘hands-off’ metagovernance tools. It also shows that, in the case of meso-governments at least, it is possible for low-ranking officials to exercise greater agency in policy development than has previously been assumed

Citrus polyphenols in brain health and disease: Current perspectives

In addition to essential micronutrients such as vitamin C, citrus fruits represent a considerably rich source of non-essential bioactive compounds, in particular flavanones which form a sub-set of the flavonoid group. Preclinical studies have demonstrated the neuroprotective potential of citrus flavonoids and have highlighted both the well-established (anti-inflammatory and anti-oxidative properties), and newly emerging (influence upon blood-brain barrier function/integrity) mechanistic actions by which these neurological effects are mediated. Encouragingly, results from human studies, although limited in number, appear to support this preclinical basis, with improvements in cognitive performance and disease risk observed across healthy and disease states. Therefore, citrus fruits – both as whole fruit and 100% juices – should be encouraged within the diet for their potential neurological benefit. In addition, there should be further exploration of citrus polyphenols to establish therapeutic efficacy, particularly in the context of well-designed human interventions

Injury, Interiority, and Isolation in Men’s Suicidality

Men’s high suicide rates have been linked to individual risk factors including history of being abused as a child, single marital status, and financial difficulties. While it has also been suggested that the normative influences of hegemonic masculinities are implicated in men’s suicide, the gendered experiences of male suicidality are poorly understood. In the current photovoice study, 20 men who previously had suicidal thoughts, plans, and/or attempts were interviewed as a means to better understanding the connections between masculinities and their experiences of suicidality. The study findings revealed injury, interiority, and isolation as interconnected themes characterizing men’s suicidality. Injury comprised an array of childhood and/or cumulative traumas that fueled men’s ruminating thoughts inhibiting recovery and limiting hopes for improved life quality. In attempting to blunt these traumas, many men described self-injuring through the overuse of alcohol and other drugs. The interiority theme revealed how suicidal thoughts can fuel hopelessness amid summonsing remedies from within. The challenges to self-manage, especially when experiencing muddled thinking and negative thought were evident, and led some participants to summons exterior resources to counter suicidality. Isolation included separateness from others, and was linked to abandonment issues and not having a job and/or partner. Self-isolating also featured as a protection strategy to avoid troubling others and/or reducing exposure to additional noxious stimuli. The study findings suggest multiple intervention points and strategies, the majority of which are premised on promoting men’s social connectedness. The destigmatizing value of photovoice methods is also discussed

Knitting Together Communities - Designing the Heart of Six Corners and Old Hill

Knitting together Communities -Designing the Heart of Six Corners and Old Hill Knitting Together Communities – Designing the Heart of Six Corners and Old Hill provides a framework to knit together assets and opportunities for creating a strong identity and sense of coherence for a transformative urban district in Springfield, MA. The Senior Urban Design Studio 2019 created six proposals that were searching for design opportunities that enhance the aesthetic quality of the neighborhood and increase services for the wellbeing of the residents. The two neighborhoods are characterized by strong neighborhood leadership through committed residents, community centers and active religious organizations, and a lively culture of urban agriculture (GTC) that keeps growing and fosters a positive spirit in the community. The studio analyzed the assets of the district, engaged with residents through site visits, personal interviews with community leaders and groups, and a neighborhood engagement workshop. Design Objectives The design program was developed through the engagement with stakeholders, area observations and classical analysis of the area: • More entrances, accessibility and programming for active and passive recreation for the centrally located Ruth Elizabeth Park • Gerrish Park near roundabout needs to be more usable for markets and events • Historic Mill River and Watershops Pond should be connected to the larger green network; Harriet Tubman Park needs to be connected to the water’s edge. • Public art on exterior walls through education at schools and local artists • Synergies between Springfield College neighborhood to create new student housing and provide amenities that integrate this population for mutual benefits • Complete streets through extensive street tree plantings, widening of sidewalks and bicycle lanes • Stormwater management strategies: bioswales along streets, green roofs, infiltration areas in new parks, porous pavement. • Multiple housing opportunities: vacant small lots for infill, mix housing with retail and commercial on upper floors of new buildings, adaptive reuse of historic buildings as live-work spaces • Neighborhood amenities like a grocery store and pharmacy • Spaces for a cultural and commercial hub including all-year activities outsid

Microbial-derived metabolites as a risk factor of age-related cognitive decline and dementia

A consequence of our progressively ageing global population is the increasing prevalence of worldwide age-related cognitive decline and dementia. In the absence of effective therapeutic interventions, identifying risk factors associated with cognitive decline becomes increasingly vital. Novel perspectives suggest that a dynamic bidirectional communication system between the gut, its microbiome, and the central nervous system, commonly referred to as the microbiota-gut-brain axis, may be a contributing factor for cognitive health and disease. However, the exact mechanisms remain undefined. Microbial-derived metabolites produced in the gut can cross the intestinal epithelial barrier, enter systemic circulation and trigger physiological responses both directly and indirectly affecting the central nervous system and its functions. Dysregulation of this system (i.e., dysbiosis) can modulate cytotoxic metabolite production, promote neuroinflammation and negatively impact cognition. In this review, we explore critical connections between microbial-derived metabolites (secondary bile acids, trimethylamine-N-oxide (TMAO), tryptophan derivatives and others) and their influence upon cognitive function and neurodegenerative disorders, with a particular interest in their less-explored role as risk factors of cognitive decline

Obsessive Compulsive Treatment Efficacy Trial (OCTET) comparing the clinical and cost effectiveness of self-managed therapies: study protocol for a randomised controlled trial

Background: UK National Institute of Health and Clinical Excellence guidelines for obsessive compulsive disorder (OCD) specify recommendations for the treatment and management of OCD using a stepped care approach. Steps three to six of this model recommend treatment options for people with OCD that range from low-intensity guided self-help (GSH) to more intensive psychological and pharmacological interventions. Cognitive behavioural therapy (CBT), including exposure and response prevention, is the recommended psychological treatment. However, whilst there is some preliminary evidence that self-managed therapy packages for OCD can be effective, a more robust evidence base of their clinical and cost effectiveness and acceptability is required. Methods/Design: Our proposed study will test two different self-help treatments for OCD: 1) computerised CBT (cCBT) using OCFighter, an internet-delivered OCD treatment package; and 2) GSH using a book. Both treatments will be accompanied by email or telephone support from a mental health professional. We will evaluate the effectiveness, cost and patient and health professional acceptability of the treatments. Discussion: This study will provide more robust evidence of efficacy, cost effectiveness and acceptability of self-help treatments for OCD. If cCBT and/or GSH prove effective, it will provide additional, more accessible treatment options for people with OCD