Understanding the challenges of identifying, supporting, and signposting patients with alcohol use disorder in secondary care hospitals, post COVID-19: a qualitative analysis from the North East and North Cumbria, England

Abstract Background Alcohol-related mortality and morbidity increased during the COVID-19 pandemic in England, with people from lower-socioeconomic groups disproportionately affected. The North East and North Cumbria (NENC) region has high levels of deprivation and the highest rates of alcohol-related harm in England. Consequently, there is an urgent need for the implementation of evidence-based preventative approaches such as identifying people at risk of alcohol harm and providing them with appropriate support. Non-alcohol specialist secondary care clinicians could play a key role in delivering these interventions, but current implementation remains limited. In this study we aimed to explore current practices and challenges around identifying, supporting, and signposting patients with Alcohol Use Disorder (AUD) in secondary care hospitals in the NENC through the accounts of staff in the post COVID-19 context. Methods Semi-structured qualitative interviews were conducted with 30 non-alcohol specialist staff (10 doctors, 20 nurses) in eight secondary care hospitals across the NENC between June and October 2021. Data were analysed inductively and deductively to identify key codes and themes, with Normalisation Process Theory (NPT) then used to structure the findings. Results Findings were grouped using the NPT domains ‘implementation contexts’ and ‘implementation mechanisms’. The following implementation contexts were identified as key factors limiting the implementation of alcohol prevention work: poverty which has been exacerbated by COVID-19 and the prioritisation of acute presentations (negotiating capacity); structural stigma (strategic intentions); and relational stigma (reframing organisational logics). Implementation mechanisms identified as barriers were: workforce knowledge and skills (cognitive participation); the perception that other departments and roles were better placed to deliver this preventative work than their own (collective action); and the perceived futility and negative feedback cycle (reflexive monitoring). Conclusions COVID-19, has generated additional challenges to identifying, supporting, and signposting patients with AUD in secondary care hospitals in the NENC. Our interpretation suggests that implementation contexts, in particular structural stigma and growing economic disparity, are the greatest barriers to implementation of evidencebased care in this area. Thus, while some implementation mechanisms can be addressed at a local policy and practice level via improved training and support, system-wide action is needed to enable sustained delivery of preventative alcohol work in these settings

The Molonglo Reference Catalog 1-Jy radio source survey IV. Optical spectroscopy of a complete quasar sample

Optical spectroscopic data are presented here for quasars from the Molonglo Quasar Sample (MQS), which forms part of a complete survey of 1-Jy radio sources from the Molonglo Reference Catalogue. The combination of low-frequency selection and complete identifications means that the MQS is relatively free from the orientation biases which affect most other quasar samples. To date, the sample includes 105 quasars and 6 BL Lac objects, 106 of which have now been confirmed spectroscopically. This paper presents a homogenous set of low-resolution optical spectra for 79 MQS quasars, the majority of which have been obtained at the Anglo-Australian Telescope. Full observational details are given and redshifts, continuum and emission-line data tabulated for all confirmed quasars.Comment: 40 pages, ApJS in pres

Genetic Background Can Result in a Marked or Minimal Effect of Gene Knockout (GPR55 and CB2 Receptor) in Experimental Autoimmune Encephalomyelitis Models of Multiple Sclerosis

PMCID: PMC379391

The influence of fine-scale topography on the impacts of Holocene fire in a Tasmanian montane landscape

Copyright © 2019 John Wiley & Sons, Ltd. Tasmania's montane temperate rainforests contain some of Australia's most ancient and endemic flora. Recent landscape-scale fires have impacted a significant portion of these rainforest ecosystems. The complex and rugged topography of Tasmania results in a highly variable influence of fire across the landscape, rendering predictions of ecosystem response to fire difficult. We assess the role of topographic variation in buffering the influence of fire in these endemic rainforest communities. We developed a new 14000-year (14-ka) palaeoecological dataset from Lake Perry, southern Tasmania, and compared it to neighbouring Lake Osborne

Neuroprotection in a Novel Mouse Model of Multiple Sclerosis

The authors acknowledge the support of the Barts and the London Charity, the Multiple Sclerosis Society of Great Britain and Northern Ireland, the National Multiple Sclerosis Society, USA, notably the National Centre for the Replacement, Refinement & Reduction of Animals in Research, and the Wellcome Trust (grant no. 092539 to ZA). The siRNA was provided by Quark Pharmaceuticals. The funders and Quark Pharmaceuticals had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

An argument for pandemic risk management using a multidisciplinary One Health approach to governance: an Australian case study

The emergence of SARS-CoV-2 and the subsequent COVID-19 pandemic has resulted in significant global impact. However, COVID-19 is just one of several high-impact infectious diseases that emerged from wildlife and are linked to the human relationship with nature. The rate of emergence of new zoonoses (diseases of animal origin) is increasing, driven by human-induced environmental changes that threaten biodiversity on a global scale. This increase is directly linked to environmental drivers including biodiversity loss, climate change and unsustainable resource extraction. Australia is a biodiversity hotspot and is subject to sustained and significant environmental change, increasing the risk of it being a location for pandemic origin. Moreover, the global integration of markets means that consumption trends in Australia contributes to the risk of disease spill-over in our regional neighbours in Asia-Pacific, and beyond. Despite the clear causal link between anthropogenic pressures on the environment and increasing pandemic risks, Australia’s response to the COVID-19 pandemic, like most of the world, has centred largely on public health strategies, with a clear focus on reactive management. Yet, the span of expertise and evidence relevant to the governance of pandemic risk management is much wider than public health and epidemiology. It involves animal/wildlife health, biosecurity, conservation sciences, social sciences, behavioural psychology, law, policy and economic analyses to name just a few. The authors are a team of multidisciplinary practitioners and researchers who have worked together to analyse, synthesise, and harmonise the links between pandemic risk management approaches and issues in different disciplines to provide a holistic overview of current practice, and conclude the need for reform in Australia. We discuss the adoption of a comprehensive and interdisciplinary ‘One Health’ approach to pandemic risk management in Australia. A key goal of the One Health approach is to be proactive in countering threats of emerging infectious diseases and zoonoses through a recognition of the interdependence between human, animal, and environmental health. Developing ways to implement a One Health approach to pandemic prevention would not only reduce the risk of future pandemics emerging in or entering Australia, but also provide a model for prevention strategies around the world

‘As a woman…’; ‘As a Muslim…’: Subjects, positions and counter-terrorism powers in the United Kingdom

This article presents findings from original focus group research on the importance of identity claims within public understandings of counter-terrorism across the UK. Following a review of existing literature on the terrorism/counter-terrorism/identity nexus, the article introduces four prominent subject positions inhabited within public articulations of counter-terrorism powers: the ‘Muslim’, the ‘target’, the ‘woman’ and the ‘unaffected’. Positions such as these, we argue, both enable and inhibit particular normative, political and anecdotal claims about counter-terrorism frameworks and their impact upon the body politic. This, we suggest, is demonstrative of the co-constitutive role between counter-terrorism and identity claims. Thus, on the one hand, counter-terrorism initiatives work to position individuals socially, politically, and culturally: (re)producing various religious, ethnic and other identities. Yet, at the same time, specific subject positions are integral to the articulation of people’s attitudes toward developments in counter-terrorism. The article concludes by thinking through some of the implications of this, including for resistance toward securitising moves and for citizenship more generally

Reduction in Phencyclidine Induced Sensorimotor Gating Deficits in the Rat Following Increased System Xc − Activity in the Medial Prefrontal Cortex

Rationale: Aspects of schizophrenia, including deficits in sensorimotor gating, have been linked to glutamate dysfunction and/or oxidative stress in the prefrontal cortex. System xc −, a cystine–glutamate antiporter, is a poorly understood mechanism that contributes to both cellular antioxidant capacity and glutamate homeostasis. Objectives: Our goal was to determine whether increased system xc − activity within the prefrontal cortex would normalize a rodent measure of sensorimotor gating. Methods: In situ hybridization was used to map messenger RNA (mRNA) expression of xCT, the active subunit of system xc −, in the prefrontal cortex. Prepulse inhibition was used to measure sensorimotor gating; deficits in prepulse inhibition were produced using phencyclidine (0.3–3 mg/kg, sc). N-Acetylcysteine (10–100 μM) and the system xc − inhibitor (S)-4-carboxyphenylglycine (CPG, 0.5 μM) were used to increase and decrease system xc − activity, respectively. The uptake of 14C-cystine into tissue punches obtained from the prefrontal cortex was used to assay system xc − activity. Results: The expression of xCT mRNA in the prefrontal cortex was most prominent in a lateral band spanning primarily the prelimbic cortex. Although phencyclidine did not alter the uptake of 14C-cystine in prefrontal cortical tissue punches, intraprefrontal cortical infusion of N-acetylcysteine (10–100 μM) significantly reduced phencyclidine- (1.5 mg/kg, sc) induced deficits in prepulse inhibition. N-Acetylcysteine was without effect when coinfused with CPG (0.5 μM), indicating an involvement of system xc −. Conclusions: These results indicate that phencyclidine disrupts sensorimotor gating through system xc − independent mechanisms, but that increasing cystine–glutamate exchange in the prefrontal cortex is sufficient to reduce behavioral deficits produced by phencyclidine

Editors' introduction: neoliberalism and/as terror

The articles in this special issue are drawn from papers presented at a conference entitled “Neoliberalism and/as Terror”, held at the Nottingham Conference Centre at Nottingham Trent University by the Critical Terrorism Studies BISA Working Group (CSTWG) on 15-16 September 2014. The conference was supported by both a BISA workshop grant and supplementary funds from Nottingham Trent University’s Politics and International Relations Department and the Critical Studies on Terrorism journal. Papers presented at the conference aimed to extend research into the diverse linkages between neoliberalism and terrorism, including but extending beyond the contextualisation of pre-emptive counterterrorism technologies and privatised securities within relevant economic and ideological contexts. Thus, the conference sought also to stimulate research into the ways that neoliberalism could itself be understood as terrorism, asking - amongst other questions - whether populations are themselves terrorised by neoliberal policy. The articles presented in this special issue reflect the conference aims in bringing together research on the neoliberalisation of counterterrorism and on the terror of neoliberalism

Polarimetry and Unification of Low-Redshift Radio Galaxies

We have made high-quality measurements of the polarization spectra of 13 FR II radio galaxies and taken polarization images for 11 of these with the Keck telescopes. Seven of the eight narrow-line radio galaxies (NLRG) are polarized, and six of the seven show prominent broad Balmer lines in polarized light. The broad lines are also weakly visible in total flux. Some of the NLRG show bipolar regions with roughly circumferential polarization vectors, revealing a large reflection nebula illuminated by a central source. Our observations powerfully support the hidden quasar hypothesis for some NLRG. Classification as NLRG, broad-line radio galaxy (BLRG), or quasar therefore depends on orientation. However, not all objects fit into this unification scheme. Our sample is biased towards objects known in advance to be polarized, but the combination of our results with those of Hill, Goodrich and DePoy (1996) show that at least 6 out of a complete, volume and flux-limited sample of 9 FR II NLRG have broad lines, seen either in polarization or P_alpha.Comment: To appear in November 1999 Astronomical Journal. 49 pages, 13 figure