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

Making votes-at-16 work in Wales: lessons for the future

The 2021 Senedd election was the first election in which young people aged 16 and 17 were enfranchised to vote in Wales. The election came with a range of unique challenges, not the least because of the coronavirus pandemic. Given these challenges, how did young people experience the election and what worked to mobilise 16- and 17-year-olds to vote? Based on large-scale qualitative research with 16- and 17- year-olds across Wales and with stakeholders involved in youth work and youth democratic engagement, this report provides a comprehensive look into how the pioneering generation enfranchised to vote at age 16 in Wales experienced the 2021 Senedd election and analyses what can be learnt for young people’s engagement in future elections and youth political engagement in Wales. The findings highlight that young people in Wales faced a range of barriers to turning out to vote in the 2021 Senedd election – some exacerbated by the coronavirus pandemic, others that would have materialised regardless of the pandemic. Some young people were better placed than others to overcome these barriers, and experiences of engagement with the election varied considerably among young people from different social groups and different parts of Wales

Characterization of Ribosomal Frameshifting in Theiler's Murine Encephalomyelitis Virus.

Theiler's murine encephalomyelitis virus (TMEV) is a member of the genus Cardiovirus in the Picornaviridae, a family of positive-sense single-stranded RNA viruses. Previously, we demonstrated that in the related cardiovirus, Encephalomyocarditis virus, a programmed-1 ribosomal frameshift (1 PRF) occurs at a conserved G_GUU_UUU sequence within the 2B-encoding region of the polyprotein open reading frame (ORF). Here we show that-1 PRF occurs at a similar site during translation of the TMEV genome. In addition, we demonstrate that a predicted 3= RNA stem-loop structure at a noncanonical spacing downstream of the shift site is required for efficient frameshifting in TMEV and that frameshifting also requires virus infection. Mutating the G_GUU_UUU shift site to inhibit frameshifting results in an attenuated virus with reduced growth kinetics and a small-plaque phenotype. Frameshifting in the virus context was found to be extremely efficient at 74 to 82%, which, to our knowledge, is the highest frameshifting efficiency recorded to date for any virus. We propose that highly efficient-1 PRF in TMEV provides a mechanism to escape the confines of equimolar expression normally inherent in the single-polyprotein expression strategy of picornaviruses.Work in the A.E.F. lab is supported by the Wellcome Trust [088789], [106207]; and the Biotechnology and Biological Sciences Research Council [BB/J007072/1]. L.F. is supported by a Biotechnology and Biological Sciences Research Council PhD studentship.This is the final published version. It first appeared at http://jvi.highwire.org/content/early/2015/06/05/JVI.01043-15.abstract

The use of learner-generated drawings in the development of music students’ teacher identities

Identity development is a continuous process framed within changing social contexts, and is particularly problematic for musicians and other artists whose work contradicts the mythologized image of the artist. The purpose of this article is to examine the professional growth of music students in relation to developing teacher identities. The article reports on the use of learner-generated drawings and journal reflections produced by music performance and education majors; in particular, the article probes students’ perceptions of teaching within a traditional career hierarchy that favours performance and artistic creation above all else. Whilst initial student drawings illustrated traditional images of the teacher as knowledge giver, these gave way to student-centred images in which students appeared to identify with teaching in new ways. The combination of textual and non-textual data provided insights that would not otherwise have been evident, and the consideration of ‘possible selves’ became a useful tool in the explorations of identity and career

Observation of vortex dynamics in arrays of nanomagnets

Vortex dynamics within arrays of square ferromagnetic nanoelements have been studied by time-resolved scanningKerr microscopy (TRSKM),while x-ray photoemission electronmicroscopy has been used to investigate the equilibrium magnetic state of the arrays. An alternating field demagnetization process was found to initialize a distribution of equilibrium states within the individual elements of the array, including quasiuniform states and vortex states of different chirality and core polarization. Repeated initialization revealed some evidence of stochastic behavior during the formation of the equilibrium state. TRSKM with a spatial resolution of ∼300 nm was used to detect vortex gyration within arrays of square nanoelements of 250-nm lateral size. Two arrays were studied consisting of a 9 × 9 and 5 × 5 arrangement of nanoelements with 50- and 500-nm element edge-to-edge separation to encourage strong and negligible dipolar interactions, respectively. In the 5 × 5 element array, TRSKM images, acquired at a fixed phase of the driving microwave magnetic field, revealed differences in the gyrotropic phase within individual elements. While some phase variation is attributed to the dispersion in the size and shape of elements, the vortex chirality and core polarization are also shown to influence the phase. In the 9 × 9 array, strong magneto-optical response due to vortex gyration was observed across regions with length equal to either one or two elements. Micromagnetic simulations performed for 2 × 2 arrays of elements suggest that particular combinations of vortex chirality and polarization in neighboring elements are required to generate the observed magneto-optical contrast.Engineering and Physical Sciences Research Council (EPSRC

Complete intersections: Moduli, Torelli, and good reduction

We study the arithmetic of complete intersections in projective space over number fields. Our main results include arithmetic Torelli theorems and versions of the Shafarevich conjecture, as proved for curves and abelian varieties by Faltings. For example, we prove an analogue of the Shafarevich conjecture for cubic and quartic threefolds and intersections of two quadrics.Comment: 37 pages. Typo's fixed. Expanded Section 2.

The Grizzly, December 3, 1982

Graterford Prisoners Counseled • Phi Psi Sponsors Santa • Chem Society Rated Outstanding • Renowned Professor Dies • Steinbright Scholarships Offered • News Briefs: Sigma Pi Sigma Inducts New Members; Operation Native Talent; New Evening School Class; Winterfest II Schedules Events; Going for Baroque • Commuters Don\u27t Get No Respect! • Letters to the Editor • Is Tuition Increase Justified? • Recent Thefts and Attacks Prompt Security Questions • Cheating at Ursinus? • A Last Squeeze Before Departing • The Missionary: A Blessing • Roving Reporter: How Do You Feel About the New Security System in the Quad? • Challenge Yourself at Outward Bound • The Perfect Man • UC Faculty Not Burnt Out • Sports Profile: Mullahy and Bazow, Football Captains • Women\u27s Basketball Tops Aggies in Opener: Jankauskas Scoring and Rebounding Was Key • UC Making a Contribution to Olympic Efforthttps://digitalcommons.ursinus.edu/grizzlynews/1090/thumbnail.jp

Default Risk and Equity Returns: A Comparison of the Bank-Based German and the U.S. Financial System

In this paper, we address the question whether the impact of default risk on equity returns depends on the financial system firms operate in. Using an implementation of Merton's option-pricing model for the value of equity to estimate firms' default risk, we construct a factor that measures the excess return of firms with low default risk over firms with high default risk. We then compare results from asset pricing tests for the German and the U.S. stock markets. Since Germany is the prime example of a bank-based financial system, where debt is supposedly a major instrument of corporate governance, we expect that a systematic default risk effect on equity returns should be more pronounced for German rather than U.S. firms. Our evidence suggests that a higher firm default risk systematically leads to lower returns in both capital markets. This contradicts some previous results for the U.S. by Vassalou/Xing (2004), but we show that their default risk factor looses its explanatory power if one includes a default risk factor measured as a factor mimicking portfolio. It further turns out that the composition of corporate debt affects equity returns in Germany. Firms' default risk sensitivities are attenuated the more a firm depends on bank debt financing