Ichnology and palaeobiology of Phoebichnus trochoides and Schaubcylindrichnus heberti comb. nov.

The three-dimensional reconstructions of Phoebichnus trochoides and Schaubcylindrichnus (Palaeophycus) heberti created as part of this thesis allow us to fully understand and characterize the three-dimensional morphology and palaeobiology of these common taxa. Three-dimensional reconstructions demonstrate that P. trochoides is a large stellate burrow composed of numerous long galleries produced by a deposit feeding organism. This study reports for the first time that the central zone is composed of stacked disk-shaped layers of highly bioturbated sediment, the radial burrows are composed of a sand-rich lining of pelleted annuli surrounding an active sand-rich fill, and the presence of subtle conical features above the radial galleries that are inferred to result from collapse cone feeding. Reconstructions of heberti demonstrate that the thick walled burrows are composed of sand-rich annular rings, are a broad U-shape, and may be either clustered or isolated. Our observations show that the morphology of heberti is inconsistent with the generic diagnosis of Palaeophycus, but is morphologically comparable to Schaubcylindrichnus, and is herein synonymised with Schaubcylindrichnus to create S. heberti comb. nov. The three-dimensional reconstructions have revealed a number of hitherto unknown morphological elements to both taxa which has facilitated new interpretations of the trace-makers behaviour. The data improves the taxonomic understanding of both P. trochoides and S. heberti which require significant taxonomic change and emendation of diagnoses at the species and genus level

Automorphism groups of countable algebraically closed graphs and endomorphisms of the random graph

We establish links between countable algebraically closed graphs and the endomorphisms of the countable universal graph $R$. As a consequence we show that, for any countable graph $\Gamma$, there are uncountably many maximal subgroups of the endomorphism monoid of $R$ isomorphic to the automorphism group of $\Gamma$. Further structural information about End $R$ is established including that Aut $\Gamma$ arises in uncountably many ways as a Sch\"{u}tzenberger group. Similar results are proved for the countable universal directed graph and the countable universal bipartite graph.Comment: Minor revision following referee's comments. 27 pages, 3 figure

Developing a National Design Scoreboard

Recognising the growing importance of design, this paper reports on the development of an approach to measuring design at a national level. A series of measures is proposed, that are based around a simplified model of design as a system at a national level. This model was developed though insights from literature and a workshop with government, industry and design sector representatives. Detailed data on design in the UK is presented to highlight the difficulties in collecting reliable and robust data. Evidence is compared with four countries (Spain, Canada, Korea and Sweden). This comparison highlights the inherent difficulties in comparing performance and a revised set of measures is proposed. Finally, an approach to capturing design spend at a firm level is proposed, based on insights from literature and case studies. Keywords: National Design System, Design Performance</p

San Salvador Community Garden Initiative

The San Salvador Community Garden Initiative is a project intended to address chronic disease prevalence and nutrition security on a San Salvador, Bahamas. This project contains data analysis, soil microbial analysis, and a project overview

Understanding determinants of acute stroke thrombolysis using the tailored implementation for chronic diseases framework: a qualitative study

Abstract Background The Tailored Implementation in Chronic Disease (TICD) framework is a comprehensive framework describing the determinants of implementation success that has been used extensively in primary care settings. We explored the utility of the TICD to identify determinants of practice in an acute setting, namely guideline concordant acute stroke thrombolysis in a low-resourced, predominately minority serving, large, Emergency Department (ED). Methods Through workshops and expert review, we developed an interview guide informed by the TICD framework. We then conducted semi-structured interviews with data collected through written transcripts, audio transcripts or interviewer notes based on participant availability. Three independent coders then performed a content analysis using template analysis, but open to new determinants that arose from the data, into the TICD framework. Results We performed a total of 15 semi-structured interviews with ED acute stroke providers including medical technicians, nurses, and physicians. We found that guideline factors, individual health professional factors, and patient factors domains were barriers to guideline concordant acute stroke thrombolysis. The domain professional interactions was a facilitator to treatment. We identified three determinants, healthcare professional burnout, health care professional turnover and surrogate decision making, that are not part of the TICD framework. Conclusions Most determinants of acute stroke thrombolysis are included within the TICD framework. Inclusion of healthcare professional burnout, healthcare professional turnover and surrogate decision making may assist in expanding the TICD to time-sensitive ED conditions. Further work is needed to confirm this finding and to establish whether the TICD is applicable for use in non-time sensitive ED conditions. Interventions that address guideline, individual health professional and patient factors may improve guideline concordant acute stroke thrombolysis.https://deepblue.lib.umich.edu/bitstream/2027.42/148315/1/12913_2019_Article_4012.pd

Delivery of a Mental Health First Aid training package and staff peer support service in secondary schools: a process evaluation of uptake and fidelity of the WISE intervention.

BACKGROUND: Improving children and young people's provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The WISE intervention comprised a Mental Health First Aid (MHFA) training package delivered to at least 16% of staff, a short mental health awareness session to all teachers and development of a staff peer support service. Twenty-five schools were randomised to intervention or control arms. This paper reports findings regarding the extent of uptake and fidelity of the intervention. METHODS: Mixed methods data collection comprised researcher observations of training delivery, training participant evaluation forms, trainer and peer supporter interviews, peer supporter feedback meetings, logs of support provided, and teacher questionnaires. Quantitative data were summarised descriptively, while thematic analysis was applied to the qualitative data. RESULTS: In the 12 schools assigned to the intervention arm, 113 (8.6%) staff completed the 2-day standard MHFA training course, and a further 146 (11.1%) staff completed the 1-day MHFA for schools and colleges training. In seven (58.3%) schools, the required 8% of staff completed the MHFA training packages. A 1-h mental health awareness-raising session was attended by 666 (54.5%) staff. Delivery of the MHFA training package was achieved with high levels of fidelity and quality across schools. All schools set up the peer support service following training, with a majority adhering to most of the operational guidelines developed from the pilot study at the outset. Teachers reported limited use of the peer support service during follow-up. At the 1-year follow-up, only three (25.0%) schools indicated they had re-advertised the service and there was evidence of a reduction in support from senior leadership. CONCLUSION: The MHFA training package was delivered with reasonably high fidelity, and a staff peer support service was established with general, but not complete, adherence to guidelines. In some schools, insufficient staff received MHFA training and levels of delivery of the peer support service compromised intervention dose and reach. TRIAL REGISTRATION: ISRCTN 95909211 . Registered on 15 January 2016

Process evaluation protocol for a cluster randomised controlled trial of an intervention to improve the mental health support and training available to secondary school teachers– the Wellbeing in Secondary Education (WISE) project

Background: Secondary school teachers have low levels of wellbeing and high levels of depression compared with the general population. Teachers are in a key position to support students, but poor mental health may be a barrier to doing so effectively. The Wellbeing in Secondary Education (WISE) project is a cluster randomised controlled trial (RCT) of an intervention to improve the mental health support and training available to secondary school teachers through delivery of the training package Mental Health First Aid and a staff peer support service. We will conduct a process evaluation as part of the WISE trial to support the interpretation of trial outcomes and refine intervention theory. The domains assessed will be: the extent to which the hypothesised mechanisms of change are activated; system level influences on these mechanisms; programme differentiation and usual practice; intervention implementation, including any adaptations; intervention acceptability; and intervention sustainability. Methods: Research questions will be addressed via quantitative and qualitative methods. All study schools (n = 25) will provide process evaluation data, with more detailed focus group, interview and observation data being collected from a subsample of case study schools (4 intervention and 4 control). Mechanisms of change, as outlined in a logic model, will be measured via teacher and student surveys and focus groups. School context will be explored via audits of school practice that relate to mental health and wellbeing, combined with stakeholder interviews and focus groups. Implementation of the training and peer support service will be assessed via training observations, training participant evaluation forms, focus groups with participants, interviews with trainers and peer support service users, and peer supporter logs recording help provided. Acceptability and sustainability will be examined via interviews with funders, head teachers, trainers and peer support services users, and focus groups with training participants. Discussion: The process evaluation embedded within the WISE cluster RCT will illuminate how and why the intervention was effective, ineffective or conferred iatrogenic effects. It will contribute to the refinement of the theory underpinning the intervention, and will help to inform any future implementation. Trial registration: International Standard Randomised Controlled Trial Number: ISRCTN95909211 registered on 24 March 2016. Keywords: Mental health, Wellbeing, Schools, Children, Adolescents, Teachers, Process evaluation, Cluster Randomised Controlled Tria

An intervention to improve teacher well-being support and training to support students in UK high schools (the WISE study): A cluster randomised controlled trial.

Funder: Public Health WalesFunder: Bristol City CouncilFunder: Public Health EnglandBACKGROUND: Teachers are at heightened risk of poor mental health and well-being, which is likely to impact on the support they provide to students, and student outcomes. We conducted a cluster randomised controlled trial, to test whether an intervention to improve mental health support and training for high school teachers led to improved mental health and well-being for teachers and students, compared to usual practice. We also conducted a cost evaluation of the intervention. METHODS AND FINDINGS: The intervention comprised (i) Mental Health First Aid training for teachers to support students; (ii) a mental health awareness session; and (iii) a confidential staff peer support service. In total 25 mainstream, non-fee-paying secondary schools stratified by geographical area and free school meal entitlement were randomly allocated to intervention (n = 12) or control group (n = 13) after collection of baseline measures. We analysed data using mixed-effects repeated measures models in the intention-to-treat population, adjusted for stratification variables, sex, and years of experience. The primary outcome was teacher well-being (Warwick-Edinburgh Mental Well-being Scale). Secondary outcomes were teacher depression, absence, and presenteeism, and student well-being, mental health difficulties, attendance, and attainment. Follow-up was at months 12 (T1) and 24 (T2). We collected process data to test the logic model underpinning the intervention, to aid interpretation of the findings. A total of 1,722 teachers were included in the primary analysis. Teacher well-being did not differ between groups at T2 (intervention mean well-being score 47.5, control group mean well-being score 48.4, adjusted mean difference -0.90, 95% CI -2.07 to 0.27, p = 0.130). The only effect on secondary outcomes was higher teacher-reported absence among the intervention group at T2 (intervention group median number of days absent 0, control group median number of days absent 0, ratio of geometric means 1.04, 95% CI 1.00 to 1.09, p = 0.042). Process measures indicated little change in perceived mental health support, quality of relationships, and work-related stress. The average cost of the intervention was £9,103 per school. The study's main limitations were a lack of blinding of research participants and the self-report nature of the outcome measures. CONCLUSIONS: In this study, we observed no improvements to teacher or student mental health following the intervention, possibly due to a lack of impact on key drivers of poor mental health within the school environment. Future research should focus on structural and cultural changes to the school environment, which may be more effective at improving teacher and student mental health and well-being. TRIAL REGISTRATION: www.isrctn.com ISRCTN95909211

Evaluation of a brief anti-stigma campaign in Cambridge: do short-term campaigns work?

<p>Abstract</p> <p>Background</p> <p>In view of the high costs of mass-media campaigns, it is important to understand whether it is possible for a media campaign to have significant population effects over a short period of time. This paper explores this question specifically in reference to stigma and discrimination against people with mental health problems using the <it>Time to Change </it>Cambridge anti-stigma campaign as an example.</p> <p>Methods</p> <p>410 face-to-face interviews were performed pre, during and post campaign activity to assess campaign awareness and mental health-related knowledge, attitudes and behaviours.</p> <p>Results</p> <p>Although campaign awareness was not sustained following campaign activity, significant and sustained shifts occurred for mental health-related knowledge items. Specifically, there was a 24% (p < 0.001) increase in persons agreeing with the statement: <it>If a friend had a mental health problem, I know what advice to give them to get professional help</it>, following the campaign. Additionally, for the statement: <it>Medication can be an effective treatment for people with mental health problems</it>, there was a 10% rise (p = 0.05) in the proportion of interviewees responding 'agree' or 'strongly agree' following the campaign. These changes, however, were not evident for attitudinal or behaviour related questions.</p> <p>Conclusions</p> <p>Although these results only reflect the impact of one small scale campaign, these preliminary findings suggest several considerations for mass-media campaign development and evaluation strategies such as: (1) Aiming to influence outcomes pertaining to knowledge in the short term; (2) Planning realistic and targeted outcomes over the short, medium and long term during sustained campaigns; and (3) Monitoring indirect campaign effects such as social discourse or other social networking/contact in the evaluation.</p