Evaluation of EPIM III: Emerging Insights From the Evaluation So Far

This report sets out some emerging insights from the ongoing evaluation of the European Programme for Integration and Migration (EPIM) 2012-2015 programme. The activities of EPIM and this evaluation lie at the very heart of EPIM's efforts to strengthen the capacity of NGOs active in migration and integration issues, to engage with and influence decision-making at EU and Member state levels, and to do so by drawing on a rigorous evidence base, and through a pragmatic approach. Founded in 2005 as an activity of the Network of European Foundations (NEF) in a unique effort to fund European migration and integration organisations, EPIM's activities include strategic grant-making as well as networking, capacity-building, supporting advocacy and policy work. The Programme has now disbursed over 3m to more than 24 grantee organisations. Drawing on experience and learning from previous phases, EPIM's current three core areas of focus are asylum seekers, undocumented migrants, and equality, integration and social inclusion of vulnerable migrants. Recognising the importance of the role played by civil society, one of EPIM's key goals is to strengthen the advocacy capacities of NGOs at the European level. This goal reflects the fact that over the past decade the EU has become an important actor in the field of immigration and asylum, as well as that the majority of countries face some challenges in this area

Formation routes and structural details of the CaF1 layer on Si(111) from high-resolution noncontact atomic force microscopy data

We investigate the CaF1/Si(111) interface using a combination of high-resolution scanning tunnelling and noncontact atomic force microscopy operated at cryogenic temperature as well as x-ray photoelectron spectroscopy. Submonolayer CaF1 films grown at substrate temperatures between 550 and 600 ◦C on Si(111) surfaces reveal the existence of two island types that are distinguished by their edge topology, nucleation position, measured height, and inner defect structure. Our data suggest a growth model where the two island types are the result of two reaction pathways during CaF1 interface formation. A key difference between these two pathways is identified to arise from the excess species during the growth process, which can be either fluorine or silicon. Structural details as a result of this difference are identified by means of high-resolution noncontact atomic force microscopy and add insights into the growth mode of this heteroepitaxial insulator-on-semiconductor system

Review of social housing archetypes to support EESSH2 review

This report reviews social housing archetypes in Scotland to enable identification of suitable energy efficiency and zero emissions heating systems

Antibiotic Bowel Decontamination in Gastrointestinal Surgery-A Single-Center 20 Years' Experience

Objective: Anastomotic leakage, surgical site infections, and other infectious complications are still common complications in gastrointestinal surgery. The concept of perioperative antibiotic bowel decontamination demonstrates beneficial effects in single randomized controlled trials (RCTs), but data from routine clinical use are still sparse. Our aim was to analyze the data from the routine clinical use of perioperative antibiotic bowel decontamination in gastrointestinal surgery. Methods: Based on 20 years' experience, we performed a retrospective analysis of all cases in oncologic gastrointestinal surgery with the use of antibiotic bowel decontamination in gastric, sigmoid, and rectal cancer. Clinical data and perioperative outcomes were analyzed, especially regarding anastomotic leakage, surgical site infections, and other infectious complications. Results: A total of n = 477 cases of gastrointestinal surgery in gastric cancer (n = 80), sigmoid cancer (n = 168), and rectal cancer (n = 229) using a perioperative regimen of antibiotic bowel decontamination could be included in this analysis. Overall, anastomotic leakage occurred in 4.4% (2.5% gastric cancer, 3.0% sigmoid cancer, 6.1% rectal cancer) and surgical site infections in 9.6% (6.3% gastric cancer, 9.5% sigmoid cancer, 10.9% rectal cancer). The incidence of all infectious complications was 13.6% (12.5% gastric cancer, 11.3% sigmoid cancer, 15.7% rectal cancer). Mortality was low, with an overall rate of 1.1% (1.3% gastric cancer, 1.8% sigmoid cancer, 0.4% rectal cancer). Antibiotic decontamination was completed in 98.5%. No adverse effects of antibiotic bowel decontamination could be observed. Conclusion: Overall, in this large cohort, we can report low rates of surgery-related serious morbidity and mortality when perioperative antibiotic bowel decontamination is performed. The rates are lower than other clinical reports. In our clinical experience, the use of perioperative antibiotic bowel decontamination appears to improve patient safety and surgical outcomes during gastrointestinal oncologic procedures in a routine clinical setting

Determination of thyroid volume in infants with suspected congenital hypothyroidism—the limitations of both subjective and objective evaluation

Objective: To compare two methods of assessing gland size on thyroid ultrasound in newborn infants with suspected congenital hypothyroidism (CH). Methods: Images from infants with eutopic glands referred between 2007 and 2013 were evaluated blind by two sets of observers. Subjective gland size was categorised as small, borderline-small, normal, borderline-large and large. Objective gland volume, calculated as the sum of each lobe using the prolate ellipsoid formula (length x width x depth x π/6), was put into corresponding categories: <0.8, 0.81–1.0, 1.1– <2.2, 2.2–2.4 and >2.4 ml, derived from normative Scottish data. Results: Of 36 infants, permanent CH was present in 17, transient CH in 17, status uncertain in 2. Mean (SD) intraobserver error for thyroid volume measurement was 0.11 (0.23) ml [8.3%]. Subjective assessment by two observers was discordant in only four (10.8%) infants. However, subjective vs objective evaluation was discordant in 14 (39%). Eight (three permanent, five transient CH) had large glands subjectively but normal glands objectively; and six (four transient CH) had normal glands subjectively but small glands objectively. The former infants all showed a single flattened curve to the anterior thyroid margin, giving an impression of bulkiness. Gland shape was normal in the latter infants. Conclusion: Neither subjective nor objective evaluation predicts permanent vs transient CH. Altered gland shape may confound both methods, and undermine use of the conventional formula for measuring lobe volume. Advances in knowledge: Until more refined methods are available for assessing thyroid size, both subjective and objective evaluation are recommended in CH

SIL1 deficiency causes degenerative changes of peripheral nerves and neuromuscular junctions in fish, mice and human.

BACKGROUND: Marinesco-Sjögren Syndrome (MSS) is a rare neuromuscular condition caused by recessive mutations in the SIL1 gene resulting in the absence of functional SIL1 protein, a co-chaperone for the major ER chaperone, BiP. As BiP is decisive for proper protein processing, loss of SIL1 results in the accumulation of misshaped proteins. This accumulation likely damages and destroys cells in vulnerable tissues, leading to congenital cataracts, cerebellar ataxia, vacuolar myopathy and other MSS phenotypes. Whether the peripheral nervous system (PNS) is affected in MSS has not been conclusively shown. METHODS: To study PNS vulnerability in MSS, intramuscular nerves fibres from MSS patients and from SIL1-deficient mice (woozy) as well as sciatic nerves and neuromuscular junctions (NMJ) from these mice have been investigated via transmission electron microscopic and immunofluorescence studies accompanied by transcript studies and unbiased proteomic profiling. In addition, PNS and NMJ integrity were analyzed via immunofluorescence studies in an MSS-zebrafish model which has been generated for that purpose. RESULTS: Electron microscopy revealed morphological changes indicative of impaired autophagy and mitochondrial maintenance in distal axons and in Schwann cells. Moreover, changes of the morphology of NMJs as well as of transcripts encoding proteins important for NMJ function were detected in woozy mice. These findings were in line with a grossly abnormal structure of NMJs in SIL1-deficient zebrafish embryos. Proteome profiling of sciatic nerve specimens from woozy mice revealed altered levels of proteins implicated in neuronal maintenance suggesting the activation of compensatory mechanisms. CONCLUSION: Taken together, our combined data expand the spectrum of tissues affected by SIL1-loss and suggest that impaired neuromuscular transmission might be part of MSS pathophysiology

Voice hearers’ experiences of the Making Sense of Voices in an NHS setting

The Making Sense of Voices (MsV) approach (Romme & Escher, 2000) has become established within large sections of the voice hearing community, as well as being adopted by some professional mental health workers. However, there has been limited research to assess this intervention. A recent case series using the MsV approach (Steel et al., 2019) reported promising results across a number of standardised outcome measures. The current study reports on the voice hearers’ experience of having received the MsV intervention, through the use of ‘exit interviews’ conducted as part of the case series. Individual participants’ experiences indicated a range of reactions to the intervention. Positive outcomes appeared to relate to a better understanding of voice hearing experiences and a greater sense of control over voices. Not all participants reported a positive experience of communicating with their voices. Outcomes are discussed within the context of potential common and distinct ‘ingredients’ of the MsV approach, compared to other approaches to working with distressing voices

Making sense of voices: a case series

The current evidence-base for the psychological treatment of distressing voices indicates the need for further clinical development. The Maastricht approach (also known as Making Sense of Voices) is popular within sections of the Hearing Voices Movement, but its clinical effectiveness has not been systematically evaluated. The aim of the approach is to develop a better understanding of the role of the voice, in part through opening a dialogue between the voice hearer and the voice. The current study was a (N=15) case series adopting a concurrent multiple baseline design. The Maastricht approach was offered for up to 9-months. The main outcome, weekly voice-related distress ratings, was not statistically significant during intervention or follow-up, although the effect size was in the moderate range. The PSYRATS Hallucination scale was associated with a large effect size both at the end of treatment, and after a 3-month follow-up period, although again the effect did not reach statistical significance. The results suggest further evaluation of the approach is warranted. However, given the large variance in individual participant outcome, it may be that a better understanding of response profiles is required before conducting a definitive randomised controlled trial