‘Adults at Risk’: ‘Vulnerability’ by Any Other Name?

Purpose The purpose of this paper is to explore and critique the conceptual and terminological shift – particularly from ‘vulnerability’ to ‘adult at risk’ - in adult safeguarding under the Care Act 2014 and the Social Services and Well-being (Wales) Act 2014. Design/methodology/approach The paper compares the notion of the vulnerable adult in safeguarding, with the notion of an adult at risk under the Care Act 2014 and the Social Services and Well-being (Wales) Act 2014 and questions to what extent such a shift addresses existing criticisms of ‘vulnerability’. Findings The paper criticises the notion of the 'vulnerable adult' for perpetuating the stigma associated with an impairment or disability, and for the types of legal and policy responses deemed appropriate under such an understanding of vulnerability. While efforts to replace the term ‘vulnerable adult’ with ‘adult at risk’ are, to some extent, to be welcomed, ‘adult at risk’ under the legislation relies on the same characteristics for which the ‘vulnerable adult’ has been criticised. Nevertheless, the safeguarding provisions under the two Acts have made some strides forward in comparison to their legal and policy predecessors and the notion of the ‘vulnerable adult’. Originality/value This paper’s originality and value lie in its scrutiny of the notion of ‘vulnerability’ in adult safeguarding, in comparison to the newer terminology of an ‘adult at risk,’ whilst also suggesting that in important respects – in relation to the interventions deemed appropriate where an adult is perceived to be at risk – the two pieces of legislation are a marked improvement on their predecessors. It also offers some thoughts as to how criticisms of the new legislation may be overcome

Parabolic oblique derivative problem in generalized Morrey spaces

We study the regularity of the solutions of the oblique derivative problem for linear uniformly parabolic equations with VMO coefficients. We show that if the right-hand side of the parabolic equation belongs to certain generalized Morrey space than the strong solution belongs to the corresponding generalized Sobolev-Morrey space

Stochastic programming approach for optimal day-ahead market bidding curves of a microgrid

The deregulation of electricity markets has driven the need to optimise market bidding strategies, e.g. when and how much electricity to buy or sell, in order to gain an economic advantage in a competitive market environment. The present work aims to determine optimal day-ahead market bidding curves for a microgrid comprised of a battery, power generator, photovoltaic (PV) system and an electricity load from a commercial building. Existing day-ahead market bidding models heuristically fix price values for each allowed bidding curve point prior to the optimisation problem or relax limitations set by market rules on the number of price–quantity points per curve. In contrast, this work integrates the optimal selection of prices for the construction of day-ahead market bidding curves into the optimisation of the energy system schedule; aiming to further enhance the bidding curve accuracy while remaining feasible under present market rules. The examined optimisation problem is formulated as a mixed integer linear programming (MILP) model, embedded in a two-stage stochastic programming approach. Uncertainty is considered in the electricity price and the PV power. First stage decisions are day-ahead market bidding curves, while the overall objective is to minimise the expected operational cost of the microgrid. The bidding strategy derived is then examined through Monte Carlo simulations by comparing it against a deterministic approach and two alternative stochastic bidding approaches from literature

Measuring Energy Expenditure in Sub-Adult and Hatchling Sea Turtles via Accelerometry

Measuring the metabolic of sea turtles is fundamental to understanding their ecology yet the presently available methods are limited. Accelerometry is a relatively new technique for estimating metabolic rate that has shown promise with a number of species but its utility with air-breathing divers is not yet established. The present study undertakes laboratory experiments to investigate whether rate of oxygen uptake (o2) at the surface in active sub-adult green turtles Chelonia mydas and hatchling loggerhead turtles Caretta caretta correlates with overall dynamic body acceleration (ODBA), a derivative of acceleration used as a proxy for metabolic rate. Six green turtles (25–44 kg) and two loggerhead turtles (20 g) were instrumented with tri-axial acceleration logging devices and placed singly into a respirometry chamber. The green turtles were able to submerge freely within a 1.5 m deep tank and the loggerhead turtles were tethered in water 16 cm deep so that they swam at the surface. A significant prediction equation for mean o2 over an hour in a green turtle from measures of ODBA and mean flipper length (R2 = 0.56) returned a mean estimate error across turtles of 8.0%. The range of temperatures used in the green turtle experiments (22–30°C) had only a small effect on o2. A o2-ODBA equation for the loggerhead hatchling data was also significant (R2 = 0.67). Together these data indicate the potential of the accelerometry technique for estimating energy expenditure in sea turtles, which may have important applications in sea turtle diving ecology, and also in conservation such as assessing turtle survival times when trapped underwater in fishing nets

Household Disposal of Pharmaceuticals as a Pathway for Aquatic Contamination in the United Kingdom

Pharmaceuticals are produced and used in increasingly large volumes every year. With this growth comes concern about the fate and effects of these compounds in the environment. The discovery of pharmaceuticals in the aquatic environment has stimulated research in the last decade. A wide range of pharmaceuticals has been found in fresh and marine waters, and it has recently been shown that even in small quantities, some of these compounds have the potential to cause harm to aquatic life. The primary pathway into the environment is the use and disposal of medicines; although much of the research in the area currently focuses on the removal of pharmaceuticals during sewage treatment processes, disposal via household waste might be a significant pathway requiring further research. To investigate the household disposal of unused and expired pharmaceuticals as a source of pharmaceutical compounds in the environment, we carried out a survey and interviewed members of 400 households, predominantly from southeastern England. We used the information on when and how they disposed of unfinished pharmaceuticals to construct a conceptual model to assess the pathways of human pharmaceuticals into the environment. The model demonstrated that disposal of unused pharmaceuticals, either by household waste or via the sink or toilet, may be a prominent route that requires greater attention

New insights into atypical Alzheimer's disease in the era of biomarkers

Most patients with Alzheimer's disease present with amnestic problems; however, a substantial proportion, over-represented in young-onset cases, have atypical phenotypes including predominant visual, language, executive, behavioural, or motor dysfunction. In the past, these individuals often received a late diagnosis; however, availability of CSF and PET biomarkers of Alzheimer's disease pathologies and incorporation of atypical forms of Alzheimer's disease into new diagnostic criteria increasingly allows them to be more confidently diagnosed early in their illness. This early diagnosis in turn allows patients to be offered tailored information, appropriate care and support, and individualised treatment plans. These advances will provide improved access to clinical trials, which often exclude atypical phenotypes. Research into atypical Alzheimer's disease has revealed previously unrecognised neuropathological heterogeneity across the Alzheimer's disease spectrum. Neuroimaging, genetic, biomarker, and basic science studies are providing key insights into the factors that might drive selective vulnerability of differing brain networks, with potential mechanistic implications for understanding typical late-onset Alzheimer's disease

Endothelin-1 directs airway remodeling and hyper-reactivity in a murine asthma model

BACKGROUND: The current paradigm describing asthma pathogenesis recognizes the central role of abnormal epithelial function in the generation and maintenance of the disease. However, the mechanisms responsible for the initiation of airway remodeling, which contributes to decreased lung function, remain elusive. Therefore, we aimed to determine the role of altered pulmonary gene expression in disease inception and identify proremodeling mediators. METHODS: Using an adenoviral vector, we generated mice overexpressing smad2, a TGF-β and activin A signaling molecule, in the lung. Animals were exposed to intranasal ovalbumin (OVA) without systemic sensitization. RESULTS: Control mice exposed to inhaled OVA showed no evidence of pulmonary inflammation, indices of remodeling, or airway hyper-reactivity. In contrast, local smad2 overexpression provoked airway hyper-reactivity in OVA-treated mice, concomitant with increased airway smooth muscle mass and peribronchial collagen deposition. Pulmonary eosinophilic inflammation was not evident, and there was no change in serum IgE or IgG1 levels. The profound remodeling changes were not mediated by classical pro-inflammatory Th2 cytokines. However, uric acid and interleukin-1β levels in the lung were increased. Epithelial-derived endothelin-1 and fibroblast growth factor were also augmented in smad2-expressing mice. Blocking endothelin-1 prevented these phenotypic changes. CONCLUSIONS: Innate epithelial-derived mediators are sufficient to drive airway hyper-reactivity and remodeling in response to environmental insults in the absence of overt Th2-type inflammation in a model of noneosinophilic, noninflammed types of asthma. Targeting potential asthma therapies to epithelial cell function and modulation of locally released mediators may represent an effective avenue for therapeutic design