Analysing trade-offs and synergies between SDGs for urban development, food security and poverty alleviation in rapidly changing peri-urban areas: a tool to support inclusive urban planning

Transitional peri-urban contexts are frontiers for sustainable development where land-use change involves negotiation and contestation between diverse interest groups. Multiple, complex trade-offs between outcomes emerge which have both negative and positive impacts on progress towards achieving Sustainable Development Goals (SDGs). These trade-offs are often overlooked in policy and planning processes which depend on top-down expert perspectives and rely on course grain aggregate data which does not reflect complex peri-urban dynamics or the rapid pace of change. Tools are required to address this gap, integrate data from diverse perspectives and inform more inclusive planning processes. In this paper, we draw on a reinterpretation of empirical data concerned with land-use change and multiple dimensions of food security from the city of Wuhan in China to illustrate some of the complex trade-offs between SDG goals that tend to be overlooked with current planning approaches. We then describe the development of an interactive web-based tool that implements deep learning methods for fine-grained land-use classification of high-resolution remote sensing imagery and integrates this with a flexible method for rapid trade-off analysis of land-use change scenarios. The development and potential use of the tool are illustrated using data from the Wuhan case study example. This tool has the potential to support participatory planning processes by providing a platform for multiple stakeholders to explore the implications of planning decisions and land-use policies. Used alongside other planning, engagement and ecosystem service mapping tools it can help to reveal invisible trade-offs and foreground the perspectives of diverse stakeholders. This is vital for building approaches which recognise how trade-offs between the achievement of SDGs can be influenced by development interventions

Adolescent dietary patterns are associated with lifestyle family psycho-social factors

Background/ Objectives: Dietary intake during adolescence contributes to lifelong eating habits and the development of early risk factors for disease in adulthood. Few studies have examined the dietary patterns of adolescents and the social and environmental factors that may affect them during this life stage. The present study describes dietary patterns in a cohort of adolescents and examines their associations with socioeconomic factors, as well as parental and adolescent risk factor behaviours. Design: A semi quantitative FFQ was used to assess study adolescents’ usual dietary intake over the previous year. Information was collected on family functioning and various socio economic and risk factor variables via questionnaire. Adolescents visited the clinic for anthropometric measurements. Setting: The Western Australian Pregnancy Cohort Study (Raine Study), Perth, Western Australia. Subjects: Adolescents (n 1631) aged 14 years from a pregnancy cohort study. Results: Factor analysis identified two distinct dietary patterns that differed predominantly in fat and sugar intakes. The ‘Western’ pattern consisted of high intakes of take away foods, soft drinks, confectionery, French fries, refined grains, full fat dairy products and processed meats. The ‘Healthy’’ pattern included high intakes of whole grains, fruit, vegetables, legumes and fish. ANOVA showed that the ‘Western’ dietary pattern was positively associated with greater television viewing and having a parent that smoked, and was inversely associated with family income. The ‘Healthy’’ pattern was positively associated with female gender, greater maternal education, better family functioning and being in a two parent family, and was inversely associated with television viewing. Conclusions: This study suggests that both lifestyle factors and family psycho social environment are related to eating patterns in Australian adolescents

Production and characterization of anti-human interferon γ receptor antibody fragments that inhibit cytokine binding to the receptor

Three single-chain antibody fragments that recognize the extracellular human interferon γ receptor α-chain (IFNγR), and inhibit the binding of human IFNγ, have been produced in Escherichia coli. These fragments are derived from murine anti-receptor monoclonal antibodies, and comprise the variable heavy (VH) domain linked to the variable light (VL) chain through a 15 amino acid linker [(GGGGS)3]. Using surface plasmon resonance technology (BIAcore), the soluble proteins were shown to retain a high affinity for recombinant IFNγR, and by radioimmunoassay to possess high inhibitory activity towards IFNγ-binding to human Raji cells. The antibody fragments most likely recognize epitopes that overlap the cytokine binding site on the receptor surface. Attempts to dissect further the antibodies to isolated VH- and VL-chains and to synthetic linear and cyclic peptides derived from the individual complementarity determining regions failed to afford fragments with significant IFNγR binding affinity. Nevertheless, these native-like variable region fragments and petidomimetics derived from them are of interest in the design of novel IFNγR antagonist

Undiagnosed dementia in primary care: A record linkage study

BackgroundThe number of people living with dementia is greater than the number with a diagnosis of dementia recorded in primary care. This suggests that a significant number are living with dementia that is undiagnosed. Little is known about this group and there is little quantitative evidence regarding the consequences of diagnosis for people with dementia.ObjectivesThe aims of this study were to (1) describe the population meeting the criteria for dementia but without diagnosis, (2) identify predictors of being diagnosed and (3) estimate the effect of diagnosis on mortality, move to residential care, social participation and well-being.DesignA record linkage study of a subsample of participants (n = 598) from the Cognitive Function and Ageing Study II (CFAS II) (n = 7796), an existing cohort study of the population of England aged ≥ 65 years, with standardised validated assessment of dementia and consent to access medical records.Data sourcesData on dementia diagnoses from each participant’s primary care record and covariate and outcome data from CFAS II.SettingA population-representative cohort of people aged ≥ 65 years from three regions of England between 2008 and 2011.ParticipantsA total of 598 CFAS II participants, which included all those with dementia who consented to medical record linkage (n = 449) and a stratified sample without dementia (n = 149).Main outcome measuresThe main outcome was presence of a diagnosis of dementia in each participant’s primary care record at the time of their CFAS II assessment(s). Other outcomes were date of death, cognitive performance scores, move to residential care, hospital stays and social participation.ResultsAmong people with dementia, the proportion with a diagnosis in primary care was 34% in 2008–11 and 44% in 2011–13. In both periods, a further 21% had a record of a concern or a referral but no diagnosis. The likelihood of having a recorded diagnosis increased with severity of impairment in memory and orientation, but not with other cognitive impairment. In multivariable analysis, those aged ≥ 90 years and those age

‘Shifting between the internal and external’: Psychoanalytic ways of working with children in local authority care

This thesis seeks to explore psychoanalytic ways of working with children in local authority care. Despite evidence suggesting psychoanalytic psychotherapy is used widely in routine clinical practice in the UK and may be helpful for children who experienced early attachment trauma, there is little research examining its use with these children. Study 1 aimed to identify current models of working with looked after and adopted children amongst UK psychoanalytic child psychotherapists. A survey of child psychotherapists (n=215) examined a range of activities, including assessment, therapy, work with foster carers/adoptive parents, and consultation to the professional network. Respondents placed emphasis on work with professionals and foster carers, seeing this as an area of development for services. Study 2 aimed to explore how child psychotherapists understood their work as consultant to the professional network, and what they saw as particular to the psychoanalytic approach. Thematic analysis of in-depth interviews (n=9) identified that participants experienced various tensions they held within themselves in their role, particularly around wanting to offer a network-led approach, when professionals often asked them to provide therapy. Study 3 aimed to understand how child psychotherapists function within a specialist children’s social care setting, including how they positioned themselves in a multi-disciplinary Child and Adolescent Mental Health Service (CAMHS) and a multi-agency setting. Grounded theory analysis of an ethnographic case study identified that the child psychotherapists balanced three elements of their professional identity in this role: a discipline-specific identity; CAMHS team identity; and professional network member identity. To be effective in their role, the child psychotherapists needed to integrate the elements of their professional identity. Collectively, the findings have implications for understanding the role of UK child psychotherapists working with children in local authority care; particularly the significance, but also complexity, of work with the professional network around the child

Accuracy of urine pH testing in a regional metabolic renal clinic: is the dipstick accurate enough?

Urine pH is a useful marker for assessing treatment need and efficacy in patients with nephrolithiasis. Though the gold standard of measurement is with a pH electrode, dipsticks offer the convenience of cost, ease of use, and the possibility of patients measuring their own values outside the clinic. The aim of this study was to determine whether dipsticks offer the same accuracy as the electrode. Paired measurements of freshly voided urine pH with both electrode and dipstick were analysed in a multidisciplinary renal clinic. We found that although there was a high Pearson correlation between the samples (0.89, p = 0.001), urine dipstick measurements carried an approximately 1 in 4 risk of producing clinically significant differences (pH differences  > 0.5 pH unit) from meter values. We also found that at high and low urine pH, the dipstick tended to over- and underestimate true pH readings, respectively. Examining the values in the 98 patients where a need for pharmacological urinary pH manipulation was indicated by the true pH, we found 14 who would not have been appropriately treated, and 5 who would have been unnecessarily medicated, if the stick pH value had been used. We conclude that dipstick pH measurement is insufficiently reliable for guiding clinical decision-making

Changing non-participation in epidemiological studies of older people: evidence from the Cognitive Function and Ageing Study I and II.

BACKGROUND: non-participation in epidemiological studies threatens the generalisability of findings. OBJECTIVE: to investigate the change in non-participation between the Medical Research Council Cognitive Function and Ageing Study (CFAS) I and II. DESIGN: a comparison of two epidemiological studies of older people using identical methods. SETTING: three geographical areas of the United Kingdom. SUBJECTS: older people aged 65 years and over. METHODS: the two studies were conducted approximately two decades apart between 1989 and 1994 (CFAS I) and between 2008 and 2011 (CFAS II). Random samples were drawn from primary care lists. We compared demographic factors associated with non-participation. RESULTS: non-participation in CFAS II was higher than in CFAS I (45.3 versus 18.3%). After adjustment for confounders, in both CFAS I and CFAS II, women were more likely to decline to take part (CFAS I: odds ratio (OR) 1.3 95% confidence interval (CI) 1.2 to 1.4; CFAS II: 1.1 95% CI 1.1 to 1.2). Deprivation was associated with non-participation in both studies (highest versus lowest Townsend deprivation quintile, CFAS I: OR 1.4 95% CI 1.2 to 1.6; CFAS II: 2.0 95% CI 1.8 to 2.2). Age was not associated with non-participation in either study (CFAS I, P = 0.21; CFAS II, P = 0.47). CONCLUSIONS: non-participation in epidemiological studies of older people has increased substantially in the past two decades and public willingness to take part in studies of this kind would appear to be declining. As communities become more diverse and older people have increasing commitments on their time, new ways to engage prospective participants are urgently needed.This work was supported by the Department of Health; the Medical Research Council; The National Institute of Health Research comprehensive research networks in West Anglia and Trent and the dementias and neurodegenerative disease research networks in Newcastle (grant number G9901400, G0601022). F.E.M. is supported by the MRC U105292687. The funders had no role in the design, implementation, analysis or interpretation of the study.This is the final version. It is available from Oxford University Press via http://dx.doi.org/10.1093/ageing/afv10

Constitutionalising the Security Union: Effectiveness, Rule of Law and Rights on Countering Terrorism and Crime. CEPS Paperback, 21 November 2017

This collective volume offers a multidisciplinary examination of the critical issues and challenges associated with the EU’s initiative to build a Security Union, particularly in relation to common policies adopted at the member state level aimed at countering terrorism and crime. It delves into the EU’s efforts to support cross-border investigations, the exchange of information and international cooperation, taking stock of the effects on freedom and privacy. The various authors offer key research findings, which contributed to the European Commission’s 2017 Comprehensive Assessment of EU Security Policy. They identify and explore the main constitutional dilemmas facing the Security Union concerning EU standards enshrined in the Lisbon Treaty and the commitments undertaken in the context of the EU Better Regulation agenda. Hence, this timely examination of EU security policies sheds light on their effectiveness, proportionality, fundamental rights and societal implications