Are social inequalities in early childhood smoking initiation explained by exposure to adult smoking? Findings from the UK Millennium Cohort Study

INTRODUCTION: To assess the socio-economic gradient in early smoking initiation at age 11 years and the extent to which any inequality was explained after accounting for longitudinal exposure to adult smoking. METHODS: Analysis of the UK Millennium Cohort Study, based on 9, 609 children from ages 9 months to 11 years. The outcome was smoking initiation by age 11. Odds ratios (ORs) for smoking initiation were estimated using logistic regression, according to maternal education, whilst adjusting for baseline demographic factors. Longitudinal exposure to a regular smoker in the same room was assessed as potential mediator of the association between maternal education and early smoking, along with other socially patterned risk factors for early smoking initiation, such as parental separation and mental health. RESULTS: Overall 2.7% (95% CI: 2.3–3.1) of children had tried a cigarette by age eleven. Children of mothers with no qualifications were more than six times as likely to have tried a cigarette than children of mothers with degree level qualifications or higher (OR 6.0 [95%CI 3.5–10.1]), with clear social gradient. Controlling for potentially mediating variables, particularly exposure to a regular adult smoker reduced the OR smoking initiation in children of mothers with no qualifications by 63% (aOR 2.9 [95%CI 1.7 to 5.1]). CONCLUSIONS: Smoking initiation is more common in disadvantaged children, and this is largely explained by regular exposure to an adult smoker in the same room. Reducing adult smoking in front of children may reduce inequalities in smoking initiation in children by over a half

Shall we dance? Welfarist incorporation and the politics of state-labour NGO relations in China

State-labour NGOs relations in China have been particularly fraught. In 2012 these took an interesting twist, as some local governments made overtures to labour NGOs to co-operate in providing services to migrant workers. This article argues that this shift is part of a broader strategy of `welfarist incorporation’ to redraw the social contract between state and labour. There are two key elements to this: first, relaxation of the registration regulations for social organisations; second, governmental purchasing of services from social organisations. These overtures have both a state and market logic to maintain social control and stabilise relations of production

Habilitation provision for children and young people with vision impairment in the United Kingdom: A lack of clarity leading to inconsistencies

The key to empowering and supporting children and young people (CYP) with vision impairment (VI) to achieve their potential lies in the delivery of habilitation training. Evidence has revealed that provision of habilitation services across the United Kingdom was inconsistent, with CYP with VI not receiving services in some areas. This research explored the accessibility and quality of habilitation provision for CYP with VI via two studies: (1) 12 qualitative case studies of habilitation practice and (2) surveys of habilitation training experiences, with CYP with VI (n = 43) and with parents of CYP with VI (n = 68). Five themes were identified highlighting inconsistencies and variability in the delivery of habilitation training in recent years, a lack of focus on independent living skills training, on social inclusion and emotional well-being, a lack of support for parents and a lack of clarity with regard to the definition of habilitation, and who is responsible for providing training

Long-term variability of proglacial groundwater-fed hydrological systems in an area of glacier retreat, Skeioararsandur, Iceland

Proglacial groundwater‐fed features, such as seeps, substantially impact proglacial geomorphology, hydrology, and ecology. However, there is a paucity of research on the impacts of climate change and glacier retreat on the extent of these important features. This paper aims to investigate the impact of glacier retreat on proglacial groundwater levels and on the extent of groundwater‐fed seeps. Research has taken place in western Skeiðarársandur, the large proglacial outwash plain of Skeiðarárjökull, a retreating temperate glacier in southeast Iceland. Changes in the extent of proglacial groundwater seeps were mapped using historical aerial photographs from 1986, 1997, and 2012. Proglacial groundwater levels were monitored in shallow boreholes between 2000 and 2012. The western margin of Skeiðarárjökull has retreated approximately 1 km beyond its position in 1986. However, this retreat was punctuated by short periods of readvance. The geomorphology and groundwater systems at the site were substantially impacted by the November 1996 jökulhlaup, whose deposits altered approximately 18% of the area of groundwater seeps. The surface areas of groundwater seeps and lakes in the study area have declined by ~97% between 1986 and 2012. Most of the decline took place after 1997, when the mean annual rate of retreat increased three‐fold. Groundwater levels also declined substantially between 2000 and 2012, although this trend varies spatially. The paper provides a conceptual model of the controls on proglacial shallow groundwater systems. Direct impacts of glacier retreat are suggested as the main cause for the declines in proglacial groundwater levels and in the extent of groundwater seeps. These declines are expected to adversely impact sandur ecology

Designing an optimal infection prevention service: part 2

Background: The importance of infection prevention and control (IPC) services to prevent threats from healthcare-associated infections and improve the quality of healthcare delivery is undeniable. However, IPC services across the UK and Ireland have substantial variability in terms of team structures and delivery models. Aim: The aim of this study was to define an optimal IPC service in different contexts and settings within the United Kingdom and Ireland. Methods: This mixed methods study adopted discussion huddles with IPC teams to explore various components of IPC programmes and services. A Nominal Group technique was then undertaken to achieve a group consensus of what an optimal infection prevention service should look like. Results: Five discussion huddles were conducted which included 53 participants in total. Key themes arising were IPC Service Priorities, IPC Service Enablers for Success, and Necessary Skills and Expertise Required for Delivering an Effective IPC Service. For the nominal technique, 45 responses were identified which were determining the key priorities for an effective IPC service and 69 responses for establishing key enablers for success. Discussion: These findings supported the development of a conceptual model for designing an optimal infection prevention service, which can be used to develop IPC services at an international, national, regional and local level. A focus is required around implementation of these highlighted enablers, so are effectively embedded into infection prevention and control services, and wider healthcare settings.</p

Photoproduction of pi0-mesons off neutrons in the nucleon resonance region

Precise angular distributions have been measured for the first time for the photoproduction of $\pi^{0}$-mesons off neutrons bound in the deuteron. The effects from nuclear Fermi motion have been eliminated by a complete kinematic reconstruction of the final state. The influence of final-state-interaction effects has been estimated by a comparison of the reaction cross section for quasi-free protons bound in the deuteron to the results for free protons and then applied as a correction to the quasi-free neutron data. The experiment was performed at the tagged photon facility of the Mainz Microtron MAMI with the Crystal Ball and TAPS detector setup for incident photon energies between $0.45$~GeV and $1.4$~GeV. The results are compared to the predictions from reaction models and partial-wave analyses based on data from other isospin channels. The model predictions show large discrepancies among each other and the present data will provide much tighter constraints. This is demonstrated by the results of a new analysis in the framework of the Bonn-Gatchina coupled-channel analysis which included the present data.Comment: accepted for publication in Phys; Rev. Let

Photoproduction of π0-pairs off protons and off neutrons

Total cross sections, angular distributions, and invariant-mass distributions have been measured for the photoproduction of π0π0 pairs off free protons and off nucleons bound in the deuteron. The experiments were performed at the MAMI accelerator facility in Mainz using the Glasgow photon tagging spectrometer and the Crystal Ball/TAPS detector. The accelerator delivered electron beams of 1508 and 1557MeV, which produced bremsstrahlung in thin radiator foils. The tagged photon beam covered energies up to 1400MeV. The data from the free proton target are in good agreement with previous measurements and were only used to test the analysis procedures. The results for differential cross sections (angular distributions and invariant-mass distributions) for free and quasi-free protons are almost identical in shape, but differ in absolute magnitude up to 15%. Thus, moderate final-state interaction effects are present. The data for quasi-free neutrons are similar to the proton data in the second resonance region (final-state invariant masses up to ≈1550 MeV), where both reactions are dominated by the N(1520)3/2−→Δ(1232)3/2+π decay. At higher energies, angular and invariant-mass distributions are different. A simple analysis of the shapes of the invariant-mass distributions in the third resonance region is consistent with strong contributions of an N⋆→Nσ decay for the proton, while the reaction is dominated by a sequential decay via a Δπ intermediate state for the neutron. The data are compared to predictions from the Two-Pion-MAID model and the Bonn-Gatchina coupled-channel analysis

Quasifree photoproduction of η\eta mesons off protons and neutrons

Differential and total cross sections for the quasifree reactions $\gamma p\rightarrow\eta p$ and $\gamma n\rightarrow\eta n$ have been determined at the MAMI-C electron accelerator using a liquid deuterium target. Photons were produced via bremsstrahlung from the 1.5 GeV incident electron beam and energy-tagged with the Glasgow photon tagger. Decay photons of the neutral decay modes $\eta\rightarrow 2\gamma$ and $\eta\rightarrow 3\pi^0 \rightarrow 6\gamma$ and coincident recoil nucleons were detected in a combined setup of the Crystal Ball and the TAPS calorimeters. The $\eta$-production cross sections were measured in coincidence with recoil protons, recoil neutrons, and in an inclusive mode without a condition on recoil nucleons, which allowed a check of the internal consistency of the data. The effects from nuclear Fermi motion were removed by a kinematic reconstruction of the final-state invariant mass and possible nuclear effects on the quasifree cross section were investigated by a comparison of free and quasifree proton data. The results, which represent a significant improvement in statistical quality compared to previous measurements, agree with the known neutron-to-proton cross-section ratio in the peak of the $S_{11}(1535)$ resonance and confirm a peak in the neutron cross section, which is absent for the proton, at a center-of-mass energy $W = (1670\pm 5)$ MeV with an intrinsic width of $\Gamma\approx 30$ MeV

A comparison of the nationally important infection prevention and control documents in NHS England and NHS Scotland

Background: The devolution of health to Scotland in 1999, led for the first time in the NHS to different priorities and success indicators for infection prevention and control (IPC). This project sought to understand, compare and evaluate the national IPC priorities and available indicators of success. Aim: To identify the national infection prevention and control priorities alongside national indicators of success. Methods: Critical analysis of nationally produced documents and publicly available infection related data up to March 2018. Findings: For both NHS Scotland and England the local and national infection prevention and control priorities are evidenced by: a) People being cared for in an IPC safe environment, b) Staff following IPC safe procedures and c) organisations continuously striving not just to attain standards, but to improve on them. If national agencies that produce data were also charged with using a Continuous Quality Improvement (CQI) model, then there would be further opportunities to detect and improve on successes

Measurements of 12C(&#8594;γ,pp) photon asymmetries for Eγ= 200–450 MeV

The 12C (&#8594;γ ,pp) reaction has been studied in the photon energy range 200-450 MeV at the Mainz microtron MAMI-C, where linearly polarised photons were energy-tagged using the Glasgow-Mainz Tagged Photon Spectrometer and protons were detected in the Crystal Ball detector. The photon asymmetry Σ has been measured over a wider Eγ range than previous measurements. The strongest asymmetries were found at low missing energies where direct emission of nucleon pairs is expected. Cuts on the difference in azimuthal angles of the two ejected protons increased the magnitude of the observed asymmetries. At low missing energies the Σ data exhibit a strong angular dependence, similar to deuteron photodisintegration