1,577 research outputs found
Can national policy blockages accelerate the development of polycentric governance? Evidence from climate change policy in the United Kingdom
Many factors can conspire to limit the scope for policy development at the national level. In this paper, we consider whether blockages in national policy processes â resulting for example from austerity or small state political philosophies â might be overcome by the development of more polycentric governance arrangements. Drawing on evidence from three stakeholder workshops and fifteen interviews, we address this question by exploring the United Kingdomâs recent retrenchment in the area of climate change policy, and the ways in which its policy community have responded. We identify two broad strategies based on polycentric principles: âworking with gatekeepersâ to unlock political capital and âcollaborate to innovateâ to develop policy outputs. We then empirically examine the advantages that these actions bring, analysing coordination across overlapping sites of authority, such as those associated with international regimes, devolved administrations and civic and private initiatives that operate in conjunction with, and sometimes independently of, the state. Despite constraining political and economic factors, which are by no means unique to the UK, we find that a polycentric climate policy network can create opportunities for overcoming central government blockages. However, we also argue that the ambiguous role of the state in empowering but also in constraining such a network will determine whether a polycentric approach to climate policy and governance is genuinely additional and innovative, or whether it is merely a temporary âsticking plasterâ for the retreat of the state and policy retrenchment during austere times
Optically Active Coordination Compounds. Part 50. 4-Fold Symmetry Axes in Optically Active Complex Ions from Natural Nicotine
The synthesis, characterization and circular dichroism under
varied conditions (notably pR) of trans-dichloro-tetrakis-(S)-(-)-
nicotiniumrhodium(III) salts are described, to illustrate the interplay
of chirality of the metal ion (D4) and at carbon centres (C1)
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COPe-support - a multi-component digital intervention for family carers for people affected by psychosis: study protocol for a randomized controlled trial.
BACKGROUND: Psychosis often causes significant distress and impacts not only in the individuals, but also those close to them. Many relatives and friends ('carers') provide long-term support and need resources to assist them. We have co-produced a digital mental health intervention called COPe-support (Carers fOr People with Psychosis e-support) to provide carers with flexible access to high quality psychoeducation and interactive support from experts and peers. This study evaluates the effectiveness of COPe-support to promote mental wellbeing and caregiving experiences in carers. METHODS: This study is a single-blind, parallel arm, individually randomized controlled trial (RCT) comparing COPe-support, with attention control. Both groups continue to receive usual care. COPe-support provides interactive web-based psychoeducation on psychosis-related issues, wellbeing-promotion and network support through forums. The attention-control is a non-interactive online information resource pack. Carers living in England are eligible if they provide at least weekly support to a family member or close friend affected by psychosis, and use internet communication (including emails) daily. All trial procedures are run online, including collection of outcome measurements which participants will directly input into our secure platform. Following baseline assessment, a web-based randomization system will be used to allocate 360 carers to either arm. Participants have unlimited access to the allocated condition for 40âweeks. Data collection is at three time points (10, 20, and 40âweeks after randomization). Analyses will be conducted by trial statisticians blinded to allocation. The primary outcome is mental wellbeing measured by Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), at 20âweeks. As well as an intention-to-treat analysis, a complier average causal effect (CACE) analysis will be conducted to estimate the intervention effect in participants who have accessed COPe-support content twice or more. The secondary objectives and analysis will examine other health and caregiving-related outcomes and explore mechanisms. In a process evaluation, we will interview 20% of the intervention arm participants regarding the acceptability of COPe-support. We will explore in detail participants' usage patterns. DISCUSSION: The results of this trial will provide valuable information about the effectiveness of COPe-support in promoting wellbeing and caregiving experiences in carers. TRIAL REGISTRATION: The RCT is registered with the Current Controlled Trials registration (ISRCTN 89563420, registration date: 02/03/2018)
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Peer support for discharge from inpatient to community mental health services: Study protocol clinical trial (SPIRIT Compliant).
INTRODUCTION: In the period shortly after discharge from inpatient to community mental health care, people are at increased risk of self-harm, suicide, and readmission to hospital. Discharge interventions including peer support have shown potential, and there is some evidence that community-based peer support reduces readmissions. However, systematic reviews of peer support in mental health services indicate poor trial quality and a lack of reporting of how peer support is distinctive from other mental health support. This study is designed to establish the clinical and cost effectiveness of a peer worker intervention to support discharge from inpatient to community mental health care, and to address issues of trial quality and clarity of reporting of peer support interventions. METHODS: This protocol describes an individually randomized controlled superiority trial, hypothesizing that people offered a peer worker discharge intervention in addition to usual follow-up care in the community are less likely to be readmitted in the 12 months post discharge than people receiving usual care alone. A total of 590 people will be recruited shortly before discharge from hospital and randomly allocated to care as usual plus the peer worker intervention or care as usual alone. Manualized peer support provided by trained peer workers begins in hospital and continues for 4 months in the community post discharge. Secondary psychosocial outcomes are assessed at 4 months post discharge, and service use and cost outcomes at 12 months post discharge, alongside a mixed methods process evaluation. DISCUSSION: Clearly specified procedures for sequencing participant allocation and for blinding assessors to allocation, plus full reporting of outcomes, should reduce risk of bias in trial findings and contribute to improved quality in the peer support evidence base. The involvement of members of the study team with direct experience of peer support, mental distress, and using mental health services, in coproducing the intervention and designing the trial, ensures that we theorize and clearly describe the peer worker intervention, and evaluate how peer support is related to any change in outcome. This is an important methodological contribution to the evidence base. TRIAL REGISTRATION: This study was prospectively registered as ISRCTN 10043328 on November 28, 2016
Vanishing Preons in the Fifth Dimension
We examine supersymmetric solutions of N=2, D=5 gauged supergravity coupled
to an arbitrary number of abelian vector multiplets using the spinorial
geometry method. By making use of methods developed in hep-th/0606049 to
analyse preons in type IIB supergravity, we show that there are no solutions
preserving exactly 3/4 of the supersymmetry.Comment: 19 pages, latex. Reference added, and further modification to the
introductio
Stochastic dynamics of Francisella tularensis infection and replication
We study the pathogenesis of Francisella tularensis infection with an experimental mouse model, agent-based computation and mathematical analysis. Following inhalational exposure to Francisella tularensis SCHU S4, a small initial number of bacteria enter lung host cells and proliferate inside them, eventually destroying the host cell and releasing numerous copies that infect other cells. Our analysis of disease progression is based on a stochastic model of a population of infectious agents inside one host cell, extending the birth-and-death process by the occurrence of catastrophes: cell rupture events that affect all bacteria in a cell simultaneously. Closed expressions are obtained for the survival function of an infected cell, the number of bacteria released as a function of time after infection, and the total bacterial load. We compare our mathematical analysis with the results of agent-based computation and, making use of approximate Bayesian statistical inference, with experimental measurements carried out after murine aerosol infection with the virulent SCHU S4 strain of the bacterium Francisella tularensis, that infects alveolar macrophages. The posterior distribution of the rate of replication of intracellular bacteria is consistent with the estimate that the time between rounds of bacterial division is less than 6 hours in vivo
Kappa symmetry, generalized calibrations and spinorial geometry
We extend the spinorial geometry techniques developed for the solution of
supergravity Killing spinor equations to the kappa symmetry condition for
supersymmetric brane probe configurations in any supergravity background. In
particular, we construct the linear systems associated with the kappa symmetry
projector of M- and type II branes acting on any Killing spinor. As an example,
we show that static supersymmetric M2-brane configurations which admit a
Killing spinor representing the SU(5) orbit of are generalized
almost hermitian calibrations and the embedding map is pseudo-holomorphic. We
also present a bound for the Euclidean action of M- and type II branes embedded
in a supersymmetric background with non-vanishing fluxes. This leads to an
extension of the definition of generalized calibrations which allows for the
presence of non-trivial Born-Infeld type of fields in the brane actions.Comment: 9 pages, latex, references added and minor change
The Impact of Phase Equilibrium Cloud Models on GCM Simulations of GJ~1214b
We investigate the impact of clouds on the atmosphere of GJ~1214b using the
radiatively-coupled, phase-equilibrium cloud model {\sc EddySed} coupled to the
{\sc Unified Model} general circulation model. We find that, consistent with
previous investigations, high metallicity ( solar) and clouds with
large vertical extents (a sedimentation factor of ) are
required to best match the observations, although metallicities even higher
than those investigated here may be required to improve agreement further. We
additionally find that in our case which best matches the observations
(), the velocity structures change relative to the clear
sky case with the formation of a superrotating jet being suppressed, although
further investigation is required to understand the cause of the suppression.
The increase in cloud extent with results in a cooler planet
due to a higher albedo, causing the atmosphere to contract. This also results
in a reduced day-night contrast seen in the phase curves, although the
introduction of cloud still results in a reduction of the phase offset. We
additionally investigate the impact the the {\sc Unified Model}'s
pseudo-spherical irradiation scheme on the calculation of heating rates,
finding that the introduction of nightside shortwave heating results in slower
mid-latitude jets compared to the plane parallel irradiation scheme used in
previous works. We also consider the impact of a gamma distribution, as opposed
to a log-normal distribution, for the distribution of cloud particle radii and
find the impact to be relatively minor.Comment: Accepted to MNRA
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Role of biomechanical forces in the natural history of coronary atherosclerosis.
Atherosclerosis remains a major cause of morbidity and mortality worldwide, and a thorough understanding of the underlying pathophysiological mechanisms is crucial for the development of new therapeutic strategies. Although atherosclerosis is a systemic inflammatory disease, coronary atherosclerotic plaques are not uniformly distributed in the vascular tree. Experimental and clinical data highlight that biomechanical forces, including wall shear stress (WSS) and plaque structural stress (PSS), have an important role in the natural history of coronary atherosclerosis. Endothelial cell function is heavily influenced by changes in WSS, and longitudinal animal and human studies have shown that coronary regions with low WSS undergo increased plaque growth compared with high WSS regions. Local alterations in WSS might also promote transformation of stable to unstable plaque subtypes. Plaque rupture is determined by the balance between PSS and material strength, with plaque composition having a profound effect on PSS. Prospective clinical studies are required to ascertain whether integrating mechanical parameters with medical imaging can improve our ability to identify patients at highest risk of rapid disease progression or sudden cardiac events.This work was supported by the British Heart Foundation (FS/13/33/30168), Heart Research UK (RG2638/14/16), the Cambridge NIHR Biomedical Research Centre, and the BHF Cambridge Centre for Research Excellence.This is the author accepted manuscript. The final version is available from Nature Publishing Group at http://dx.doi.org/10.1038/nrcardio.2015.203
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Emergency endovascular management of peripheral artery aneurysms and pseudoaneurysms - a review.
Endovascular stenting has been successfully employed in the management of aortic aneurysms; however, its use in managing peripheral arterial conditions remains questionable. We review the utility of endovascular technique in the management of peripheral arterial conditions like aneurysms, pseudoaneurysms and arterio-venous fistulas in the emergency setting. Though long term data about graft patency rates is not yet available, the endovascular approach appears to be a useful minimally invasive technique in situations where open repair is either difficult or not feasible.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are
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