The Evolution of Public Health Education and Training in the United Kingdom

The United Kingdom has a long and evolving history of public health education. From the initiation of formal standardised training for Medical Officers for Health in the early 1900s, to the current national public health training programme, public health education has adapted to the changing contexts of public health practice. Whilst the profession was originally only a medical specialty, subsequent re­­cognition of the skills and contribution of the wider public health workforce has led to changes in professional specialist training for public health, which is now open to non-medical applicants. This well-established professional training scheme allows the formal accreditation of competence in a broad range of public health skills. The academic component of public health training is provided by a rapidly growing number of postgraduate courses. Once confined to the UK’s first school of public health, the London School of Hygiene and Tropical Medicine and a handful of British Universities, the current 60 or so courses across the country are found in diverse university settings. Quality and standards in higher education are monitored by the Quality Assurance Agency for Higher Education but there are no other professional accreditation schemes for postgraduate courses in public health nationally. Public health education and training continues to face challenges in the UK, notably the current government plans for major restructuring of the National Health Service (NHS) which threatens the loss of traditional NHS training placements and has created uncertainty around how professional training might be structured in the future. Whilst the long established tradition of public health education and more recent adoption of competency-based approaches to training gives some flexibility to meet these challenges, insight and innovative responses are required to ensure that public health education and training are not destabilised by these challenges. Revisions of the curricula of postgraduate courses and the competencies required for professional accreditation along with provision of experience in the new locations where public health is to be practiced in the future will be key to ensuring that public health professionals are ready to tackle the key issues that confront them

Predictive validity of preschool screening tools for language and behavioural difficulties:A PRISMA systematic review

Background: Preschool screening for developmental difficulties is increasingly becoming part of routine health service provision and yet the scope and validity of tools used within these screening assessments is variable. The aim of this review is to report on the predictive validity of preschool screening tools for language and behaviour difficulties used in a community setting. Methods: Studies reporting the predictive validity of language or behaviour screening tools in the preschool years were identified through literature searches of Ovid Medline, Embase, EBSCO CINAHL, PsycInfo and ERIC. We selected peer-reviewed journal articles reporting the use of a screening tool for language or behaviour in a population-based sample of children aged 2–6 years of age, including a validated comparison diagnostic assessment and follow-up assessment for calculation of predictive validity. Results: A total of eleven eligible studies was identified. Six studies reported language screening tools, two reported behaviour screening tools and three reported combined language & behaviour screening tools. The Language Development Survey (LDS) administered at age 2 years achieved the best predictive validity performance of the language screening tools (sens 67%, spec 94%, NPV 88% and PPV 80%). The Strengths and Difficulties Questionnaire (SDQ) administered at age 4 years achieved the best predictive validity compared to other behaviour screening tools (Sens 31%, spec 93%, NPV 84% and PPV 52%). The SDQ and Sure Start Language Measure (SSLM) administered at 2.5 years achieved the best predictive validity of the combined language & behaviour assessments (sens 87%, spec 64%, NPV 97% and PPV 31). Predictive validity data and diagnostic odds ratios identified language screening tools as more effective and achieving higher sensitivity and positive predictive value than either behaviour or combined screening tools. Screening tools with combined behaviour and language assessments were more specific and achieved higher negative predictive value than individual language or behaviour screening tools. Parent-report screening tools for language achieved higher sensitivity, specificity and negative predictive value than direct child assessment. Conclusions: Universal screening tools for language and behaviour concerns in preschool aged children used in a community setting can demonstrate excellent predictive validity, particularly when they utilise a parent-report assessment. Incorporating these tools into routine child health surveillance could improve the rate of early identification of language and behavioural difficulties, enabling more informed referrals to specialist services and facilitating access to early intervention

Preschool developmental concerns and adjustment in the early school years:Evidence from a Scottish birth cohort

Funding Information Scottish Chief Scientist Office. Grant Number: MR/K023209/1 Medical Research Council. Grant Number: MR/K023209/1 Farr Institute at Scotland. Grant Number: MR/K007017/1Peer reviewedPublisher PD

Prospects of direct detection of 48^{48}V gamma-rays from thermonuclear supernovae

Detection of gamma-rays emitted by radioactive isotopes synthesized in stellar explosions can give important insights into the processes that power transients such as supernovae, as well as providing a detailed census of the abundance of different isotope species relevant to the chemical evolution of the Universe. Observations of nearby supernovae have yielded observational proof that $^{57}$Co powered the late-time evolution of SN1987A's lightcurve, and conclusive evidence that $^{56}$Ni and its daughter nuclei power the light curves of Type Ia supernovae. In this paper we describe the prospects for detecting nuclear decay lines associated with the decay of $^{48}$V, the daughter nucleus of $^{48}$Cr, which is expected to be synthesised in large quantities - $M_{\mathrm{Cr}}\sim1.9\times10^{-2}\,\mathrm{M_\odot}$ - in transients initiated by explosive helium burning ($\alpha$-capture) of a thick helium shell. We calculate emergent gamma-ray line fluxes for a simulated explosion model of a thermonuclear explosion of carbon-oxygen white dwarf core of mass $0.45\,M_{\odot}$ surrounded by a thick helium layer of mass $0.21\,M_{\odot}$. We present observational limits on the presence of $^{48}$V in nearby SNe Ia 2014J using the \textit{INTEGRAL} space telescope, excluding a $^{48}$Cr production on the surface of more than $0.1\,\mathrm{M_{\odot}}$. We find that the future gamma-ray mission AMEGO will have an approximately 5 per cent chance of observing $^{48}$V gamma-rays from such events during the currently-planned operational lifetime, based on our birthrate predictions of faint thermonuclear transients. We describe the conditions for a $3\sigma$ detection by the gamma-ray telescopes \textit{INTEGRAL}/SPI, COSI and AMEGO.Comment: 9 pages, 3 figures, submitted to MNRAS, minor revisions Sept 202

Diffuse Galactic antimatter from faint thermonuclear supernovae in old stellar populations

Our Galaxy hosts the annihilation of a few $\times 10^{43}$ low-energy positrons every second. Radioactive isotopes capable of supplying such positrons are synthesised in stars, stellar remnants, and supernovae. For decades, however, there has been no positive identification of a main stellar positron source leading to suggestions that many positrons originate from exotic sources like the Galaxy's central super-massive black hole or dark matter annihilation. %, but such sources would not explain the recently-detected positron signal from the extended Galactic disk. Here we show that a single type of transient source, deriving from stellar populations of age 3-6 Gyr and yielding ~0.03 $M_\odot$ of the positron emitter $^{44}$Ti, can simultaneously explain the strength and morphology of the Galactic positron annihilation signal and the solar system abundance of the $^{44}$Ti decay product $^{44}$Ca. This transient is likely the merger of two low-mass white dwarfs, observed in external galaxies as the sub-luminous, thermonuclear supernova known as SN1991bg-like.Comment: 28 pages main text with 4 figures in preprint style; 26 pages of Supplementary Informatio

Association of a missense mutation in the bovine leptin gene with carcass fat content and leptin mRNA levels

Previously, we have shown that alleles of the BM1500 microsatellite, located 3.6 kb downstream of the leptin gene in cattle, were associated with carcass fat measures in a population of 154 unrelated beef bulls. Subsequently, a cytosine (C) to thymine (T) transition that encoded an amino acid change of an arginine to a cysteine was identified in exon 2 of the leptin gene. A PCR-RFLP was designed and allele frequencies in four beef breeds were correlated with levels of carcass fat. The T allele was associated with fatter carcasses and the C allele with leaner carcasses. The frequencies of the SNP alleles among breeds indicated that British breeds have a higher frequency of the T allele whereas the continental breeds have a higher occurrence of the C allele. A ribonuclease protection assay was developed to quantify leptin mRNA in a separate group of animals selected by genotype. Animals homozygous for thymine expressed higher levels of leptin mRNA. This may suggest that the T allele, which adds an extra cysteine to the protein, imparts a partial loss of biological function and hence could be the causative mutation

Understanding chromium behaviour in COPR-impacted sediments in the Polmadie Burn, Glasgow.

From ~1830-1968, one of the world’s largest Cr chemical factories operated in Rutherglen, SE Glasgow, Scotland. During this time ~2.5 million tonnes of chromite ore processing residue (COPR) was produced and used mainly as landfill, leading to widespread contamination of nearby land, surface water and groundwater. Hexavalent chromium (Cr(VI)) is highly toxic and carcinogenic and is present in COPR at ~1% w/w. Although some of the contaminated sites have been remediated, Cr(VI) is still readily detected in burn-side soils, sediments and surface waters of the Polmadie Burn, which flows into the River Clyde, Glasgow. This project seeks to determine the biogeochemical and environmental factors that influence the preservation of Cr(VI), its transport and its bioaccessibility