The European Investment Bank to the rescue? COVID-related lending as incremental change

peer reviewedThe European Investment Bank (EIB) was officially part of a coordinated European Union (EU) strategy to address the impact of the COVID-19 pandemic. However, we argue that despite the worst socio-economic crisis to hit most European countries since the Second World War, the EIB failed to deviate from a set path that delimited acceptable forms of lending. We apply a historical institutionalist analysis to explain how and why the EIB continued to engage in principally low risk lending activities via the commercial banking sector, and failed to significantly increase lending to the public health sector.3. Good health and well-bein

A Phenomenological Study exploring Healthcare Workers‟ Experiences of Nutrition and Mealtimes in Hospitalised Older Patients

Background: A recent report from the Care Quality Commission showed that 20% of hospitals do not meet the required standards for dignity and nutrition whilst 35% need to make improvements (CQC, 2010). Older people are particularly at risk of malnutrition due to a natural decline in their physiological state and the influence of social and psychological factors. Malnutrition can have serious consequences for older people, often escalating existing health problems and has been linked to an increase in hospital stay and even death. Aim: To explore the attitudes, opinions and experiences of healthcare workers towards nutritional care of the older hospitalised patient. Method: An interpretive phenomenological approach was used. Therefore, the study was concerned with the „lived experiences‟ of the participants. The participants were healthcare workers from a healthcare of the older person ward. Data was collected using semi-structured interviews which were audio recorded and then transcribed. The interviews were analysed using thematic analysis in order to draw out themes. Findings: The healthcare workers showed a positive attitude towards nutritional care of the older person. They wanted to protect their patients from malnutrition which was indicated by the detailed description of their responsibilities at mealtimes and their use of nutritional tools such as nutritional assessment, red trays and protected mealtimes. However, they identified barriers which hindered them in protecting their patient; lack of education and training, busyness, hospital systems and bad press. Conclusion: The healthcare workers wanted to protect their patients from malnutrition but they were limited from doing this efficiently by specific barriers. Recommendations for practice were made on the basis of the findings. These were improving training, reducing conflicting pressures at mealtimes, ensuring adequate staffing levels and changing hospital systems for ordering food

Living with Water: Documenting Lived Experience and Social-Emotional Impacts of Chronic Flooding for Local Adaptation Planning

Coastal communities are threatened by extreme weather events in the form of storm surge and by frequent, chronic, or nuisance flooding. The physical damage of these events is vast and established in the literature; however, the social-emotional impacts are less well-documented. This pilot study sought to understand the impacts of tidal flooding on flood-prone communities in Queens, NY. Through in-depth, semi-structured interviews (n=9) with civic science participants, we document flooding impacts, identify adaptations to flooding, and examine sources of information about flooding--including local networks and relationship to government. We found that participants are knowledgeable about and engaged with the processes, rhythms, and impacts of tidal flooding. Qualitative methods can be used to surface experiences of living with flooding and therefore inform planning processes. This work demonstrates the need to attune methods and data collection to better capture and understand lived experience, local ecological knowledge, and civic engagement--as these are crucial building blocks for strengthening social resilience. Finally, by rooting the research in civic science and a co-production approach, this study provides a starting point for building shared knowledge across different stakeholders to inform collaborative adaptation planning. Ultimately, we seek to better engage local knowledge -- including rich, qualitative data capturing lived experience -- into adaptation and resilience planning

Photometric Observations of Three High Mass X-Ray Binaries and a Search for Variations Induced by Orbital Motion

We searched for long period variation in V-band, Ic-band and RXTE X-ray light curves of the High Mass X-ray Binaries (HMXBs) LS 1698 / RX J1037.5-5647, HD 110432 / 1H 1249-637 and HD 161103 / RX J1744.7-2713 in an attempt to discover orbitally induced variation. Data were obtained primarily from the ASAS database and were supplemented by shorter term observations made with the 24- and 40-inch ANU telescopes and one of the robotic PROMPT telescopes. Fourier periodograms suggested the existence of long period variation in the V-band light curves of all three HMXBs, however folding the data at those periods did not reveal convincing periodic variation. At this point we cannot rule out the existence of long term V-band variation for these three sources and hints of longer term variation may be seen in the higher precision PROMPT data. Long term V-band observations, on the order of several years, taken at a frequency of at least once per week and with a precision of 0.01 mag, therefore still have a chance of revealing long term variation in these three HMXBs.Comment: Accepted, RAA, May, 201

Zebrafish mesonephric renin cells are functionally conserved and comprise of two distinct morphological populations

Zebrafish provide an excellent model in which to assess the role of the renin-angiotensin system in renal development, injury and repair. In contrast to mammals, zebrafish kidney organogenesis terminates with the mesonephros. Despite this, the basic functional structure of the nephron is conserved across vertebrates. The relevance of teleosts for studies relating to the regulation of the renin-angiotensin system was established by assessing the phenotype and functional regulation of renin-expressing cells in zebrafish. Transgenic fluorescent reporters for renin (ren), smooth muscle actin (acta2), and platelet derived growth factor receptor beta (pdgfrb) were studied to determine the phenotype and secretory ultrastructure of perivascular renin-expressing cells. Whole-kidney ren transcription responded to altered salinity, pharmacological renin-angiotensin system inhibition, and renal injury. Mesonephric ren-expressing cells occupied niches at the pre-glomerular arteries and afferent arterioles, forming intermittent epithelioid-like multi-cellular clusters exhibiting a granular secretory ultrastructure. In contrast, renin cells of the efferent arterioles were thin-bodied and lacked secretory granules. Renin cells expressed the perivascular cell markers acta2 and pdgfrb. Transcriptional responses of ren to physiological challenge support the presence of a functional renin-angiotensin system and are consistent with the production of active renin. The reparative capability of the zebrafish kidney was harnessed to demonstrate that ren transcription is a marker for renal injury and repair. Our studies demonstrate substantive conservation of renin regulation across vertebrates and ultrastructural studies of renin cells reveal at least two distinct morphologies of mesonephric perivascular ren-expressing cells

Roadmap Report and Executive Summary

Women’s Aid Federation England (WAFE) and SafeLives (SL) collaborated over five years (2016-21) to develop and implement the Roadmap Programme which aimed to transform the lives of women and girls through systemic change to policy, practice and commissioning by promoting early intervention and reducing the prevalence, impact and tolerance of domestic violence and abuse (DVA). Funded by the Big Lottery’s Women and Girls Initiative, WAFE and SL collaborated with DVA survivors and expert partners in specialist frontline services to develop and implement two contrasting interventions in five different sites in England. Both organisations were committed to making DVA services more accessible and responsive to survivors’ needs and both aimed to achieve wider system change in the sites where the programmes were delivered. However, the two organisations chose different but complementary routes by which to reach these broad goals:WAFE’s Change That Lasts (CtL) Programme1 aimed at developing a ‘whole community response’ that would increase responsiveness to DVA services at three levels: i) the community ii) frontline professionals in organisations that were not specialist DVA organisations and iii) services delivered by DVA specialist organisations. The programme comprised three interventions targeted on these three different audiences and delivered in three sites – Sunderland, Nottingham and Nottinghamshire (Nottingham/shire) and Surrey. Ask Me aimed to address cultural and attitudinal barriers to change through training and supporting Community Ambassadors who volunteered toincrease awareness and responsiveness to DVA in their local communities. Trusted Professionalcombined training with organisational development to improve expertise and responsiveness among frontline professionals. The VOICES intervention was designed to re-connect specialist DVA services to a strengths-based, needs-led, trauma-informed approach centred on the survivor for practitioners in specialist DVA organisations. The SafeLives Programme, designed by SafeLives, alongside Pioneers (survivors and experts by experience) and specialist frontline DVA partners, comprised an integrated suite of multiple interventions that would allow survivors and their families to access five different interventions within the same organisation. Two independent services, in Norwich and West Sussex (Worthing, Adur, and Crawley), were commissioned to deliver the interventions, hereafter referred to as the SafeLives Co-Designed Pilots (SLCDPs). These interventions were tailored to the needs of different groups so that survivors and their families could move between and through them on their journey to recovery. The intervention aimed to break down silos between services and deliver a ‘whole family’ service informed by DVA survivors’ views. The SLCDPs were targeted at those assessed as at medium risk of harm; people who wanted to remain in their relationships; those with complex needs; survivors recovering from abuse and children and young people. A wide range of individual and group interventions was utilised and training and skills development were provided to partner agencies

HCV activates somatic L1 retrotransposition–A potential hepatocarcinogenesis pathway

Hepatitis C virus (HCV) is a common cause of hepatocellular carcinoma (HCC). The activation and mutagenic consequences of L1 retrotransposons in virus-associated-HCC have been documented. However, the direct influence of HCV upon L1 elements is unclear, and is the focus of the present study. L1 transcript expression was evaluated in a publicly available liver tissue RNA-seq dataset from patients with chronic HCV hepatitis (CHC), as well as healthy controls. L1 transcript expression was significantly higher in CHC than in controls. L1orf1p (a L1 encoded protein) expression was observed in six out of 11 CHC livers by immunohistochemistry. To evaluate the influence of HCV on retrotransposition efficiency, in vitro engineered-L1 retrotransposition assays were employed in Huh7 cells in the presence and absence of an HCV replicon. An increased retrotransposition rate was observed in the presence of replicating HCV RNA, and persisted in cells after viral clearance due to sofosbuvir (PSI7977) treatment. Increased retrotransposition could be due to dysregulation of the DNA-damage repair response, including homologous recombination, due to HCV infection. Altogether these data suggest that L1 expression can be activated before oncogenic transformation in CHC patients, with HCV-upregulated retrotransposition potentially contributing to HCC genomic instability and a risk of transformation that persists post-viral clearance

Challenges, solutions and future directions in the evaluation of service innovations in health care and public health

HeadlineEvaluating service innovations in health care and public health requires flexibility, collaboration and pragmatism; this collection identifies robust, innovative and mixed methods to inform such evaluations.This is the final version of the article. It first appeared from the National Institute for Helath Research via http://dx.doi.org/10.3310/hsdr0416

Collaborative futures:discursive realignments in austere times

This paper explores the future of collaboration in an era of austerity. Boundary object theory provides a framework to examine the significance and role of four key discourses in collaboration – efficiency, effectiveness, responsiveness and cultural performance. Crisis provides a way of examining how and in what ways discourses realign. The exploration of discourses aids critical analysis of collaboration across sectoral, geographical and disciplinary boundaries, highlighting the importance of understanding the contextual roots of collaboration theory and practice, and the implications of local/global dynamics

Impact of retrotransposon protein L1 ORF1p expression on oncogenic pathways in hepatocellular carcinoma: the role of cytoplasmic PIN1 upregulation

BACKGROUND: Molecular characterisation of hepatocellular carcinoma (HCC) is central to the development of novel therapeutic strategies for the disease. We have previously demonstrated mutagenic consequences of Long-Interspersed Nuclear Element-1 (LINE1s/L1) retrotransposition. However, the role of L1 in HCC, besides somatic mutagenesis, is not well understood. METHODS: We analysed L1 expression in the TCGA-HCC RNAseq dataset (n = 372) and explored potential relationships between L1 expression and clinical features. The findings were confirmed by immunohistochemical (IHC) analysis of an independent human HCC cohort (n = 48) and functional mechanisms explored using in vitro and in vivo model systems. RESULTS: We observed positive associations between L1 and activated TGFβ-signalling, TP53 mutation, alpha-fetoprotein and tumour invasion. IHC confirmed a positive association between pSMAD3, a surrogate for TGFβ-signalling status, and L1 ORF1p (P < 0.0001, n = 32). Experimental modulation of L1 ORF1p levels revealed an influence of L1 ORF1p on key hepatocarcinogenesis-related pathways. Reduction in cell migration and invasive capacity was observed upon L1 ORF1 knockdown, both in vitro and in vivo. In particular, L1 ORF1p increased PIN1 cytoplasmic localisation. Blocking PIN1 activity abrogated L1 ORF1p-induced NF-κB-mediated inflammatory response genes while further activated TGFβ-signalling confirming differential alteration of PIN1 activity in cellular compartments by L1 ORF1p. DISCUSSION: Our data demonstrate a causal link between L1 ORF1p and key oncogenic pathways mediated by PIN1, presenting a novel therapeutic avenue