Continuous Traumatic Stress: Examining the Experiences and Support Needs of Women After Separation From an Abusive Partner

Intimate partner violence causes significant, long-lasting harm to almost one-third (27%) of the world’s population of women. Even when women leave abusive relationships, some men continue to exercise control over their ex-partners through psychological control, threats, violence, stalking, and other forms of harassment. In this qualitative study, 52 purposively sampled women who self-identified as victims or survivors of intimate partner violence (IPV) from male partners were interviewed. Data were analyzed with a theoretically informed thematic analysis, supported by Nvivo® software. We found that leaving a violent relationship was a long-term process fraught with difficulty and ongoing risks of psychological harm. The concept of Continuous Traumatic Stress (CTS), first developed to understand the impact of state-sponsored violence and war, was found to be a particularly useful tool for the analysis of the impact of post-separation abuse. Additionally, CTS encourages researchers and practitioners to think anew about resilience-centered approaches to improving protection and access to justice for female victims

Lessons Learned During the Implementation of a Cold Gas Propulsion System for the SunRISE Mission

The SunRISE mission utilizes a two-phase cold gas propulsion system, which provides several advantages over other cold gas systems but experienced challenges during assembly and testing. Since 2020, Georgia Tech Research Corporation (GTRC), Utah State University Space Dynamics Laboratory (SDL), and the Jet Propulsion Laboratory (FPL) have implemented several improvements to the SunRISE propulsion system. The SunRISE propulsion system leverages an additively manufactured monolithic structure, commercial off-the-shelf (COTS) valves and transducers, and the benign working fluid R-236fa to provide a suitable propulsion system for the SunRise mission. While the GTRC propulsion system had been developed for other missions, the multi-organizational team found and corrected several previously undetected design issues, including filters with highly variable flow performance, solenoid valve drive circuit issues, and inconsistencies in the tank additive manufacturing process that impacted manufacturing yield, thrust consistency, and quality of seals. Leaks in metallic fittings were also identified, and process improvements were put in place to mitigate them. Solenoid valve stiction was the last issue which was mitigated through valve screening and drive circuit adjustments. In this paper, we present lessons learned from the SunRISE propulsion system effort to aid future teams in identifying and addressing similar issues

Accuracy of identifying incident stroke cases from linked healthcare data in UK Biobank

Objective In UK Biobank (UKB), a large population-based prospective study, cases of many diseases are ascertained through linkage to routinely collected, coded national health datasets. We assessed the accuracy of these for identifying incident strokes. Methods In a regional UKB subpopulation (n = 17,249), we identified all participants with ≥1 code signifying a first stroke after recruitment (incident stroke-coded cases) in linked hospital admission, primary care, or death record data. Stroke physicians reviewed their full electronic patient records (EPRs) and generated reference standard diagnoses. We evaluated the number and proportion of cases that were true-positives (i.e., positive predictive value [PPV]) for all codes combined and by code source and type. Results Of 232 incident stroke-coded cases, 97% had EPR information available. Data sources were 30% hospital admission only, 39% primary care only, 28% hospital and primary care, and 3% death records only. While 42% of cases were coded as unspecified stroke type, review of EPRs enabled a pathologic type to be assigned in >99%. PPVs (95% confidence intervals) were 79% (73%–84%) for any stroke (89% for hospital admission codes, 80% for primary care codes) and 83% (74%–90%) for ischemic stroke. PPVs for small numbers of death record and hemorrhagic stroke codes were low but imprecise. Conclusions Stroke and ischemic stroke cases in UKB can be ascertained through linked health datasets with sufficient accuracy for many research studies. Further work is needed to understand the accuracy of death record and hemorrhagic stroke codes and to develop scalable approaches for better identifying stroke types

Does high-density stocking affect perennial forbs in mesic grassland?

Livestock production is an appropriate land use for mainstreaming biodiversity conservation, but little is known about the impact of grazing strategies on forbs that contribute most species, in grasslands. This study compared the effects of high-density, short-duration stocking (HDG) with no grazing (control) on vegetation structure, composition and demography of selected perennial forbs in a South African mesic grassland in a three-year experiment in KwaZulu-Natal, South Africa. HDG resulted in four-fold more and deeper litter accumulation, which reduced irradiance. Cover of three forb species, including the alien Bidens pilosa, was promoted and cover of another three forb species was reduced under HDG. There were no short-term effects of HDG on diversity, evenness and species richness. Ninety percent of forb species were damaged by HDG; type of damage varied widely from leaves and stems grazed to tearing and shredding by the hooves of cattle. Study of demography revealed that HDG threatened future populations of the grazing-sensitive species Afroaster hispida, Agathisanthemum chlorophyllum and Gerbera ambigua through increased mortality or reduction in the recruitment of large from small individuals. This study has revealed that HDG potentially has negative direct and indirect effects on indigenous perennial forbs in a South African mesic grassland.Keywords: biodiversity conservation, population dynamics, short-duration grazin

What are the long-term effects of high-density, short-duration stocking on the soils and vegetation of mesic grassland in South Africa?

High-density, short-duration stocking (HDG) is gaining popularity amongst farmers in the South African mesic grasslands, but little is known about its potential impact on natural resources. Using a fence-line contrast approach, this study compared the long-term effects of HDG with those of other rotational grazing systems at lower densities (LDG) on soil properties and vegetation composition at two sites. Soils at Kokstad and Cedarville were 31% and 19% more compacted under HDG than LDG, respectively, but did not differ in total nitrogen, total carbon, available phosphorus or pH. At Kokstad, HDG had promoted unpalatable grass species at the expense of palatable grass species. Forb species composition differed substantially between HDG and LDG, with HDG having 13 and LDG having 16 unique species. A radical prostrate forb growth habit was favoured over a cauline erect habit under HDG. At Cedarville, few grass or forb species showed differences between HDG and LDG, possibly because of an overriding influence of the absence of burning in both grazing systems. These results suggest that HDG potentially has negative impacts on soil health and vegetation composition of South African mesic grassland.Keywords: biodiversity, forbs, grazing management system

Variations and value improvement in back pain care in one area of England

Abstract The pursuit of value and equity have been put on a legal footing in the NHS with the arrival of the legal duty for all in the NHS to improve health and well-being of the population served, to provide fair access to high quality healthcare, and to use resources sustainably and efficiently. Recognising this we used analysis of variation to help us understand the degree to which we were fulfilling our new duty for people with back pain in Mid-Nottinghamshire and where there might be opportunities for value improvement. MSK Together is a group of clinical and managerial representatives from providers, purchasers, local government, and patients who work collectively to optimise the use of resources for people with MSK conditions in Mid-Nottinghamshire. Back pain is the third largest burden of disease in the locality, and the largest cause of disability, so it is of strategic importance to MSK Together—we wanted to know about, and act on, opportunities for value improvement across the population of people with back pain. In 2019/20, after adjusting for age and sex, we found a greater than three-fold variation among general practices in age-sex standardised rates of all hospital service usage for back pain conditions. When looking at a four-year period (2016/17–2019/20), the observed variation increased to eight-fold for (with narrow 95% confidence intervals). When looking at procedures (e.g., surgery or injections), the standardised variation among general practices was six-fold in 2019/20. The deprivation score of the general practice (a heterogenous measure given the mixed neighbourhoods many general practices serve) showed little correlation to the rates observed and did not appear to justify the variation. When we looked at the deprivation of the neighbourhood from which the individuals receiving back pain procedures came, there appeared to be a weak correlation in terms of lower rates of intervention in the least-deprived compared with the most-deprived communities. This correlation was not tested statistically. People receiving hospital services for back pain appeared to receive the first episode of care most often in their 40s (working age), compared with people from the least-deprived areas who received care most commonly in their 60s (approaching retirement). When we looked at the interventions provided in Mid-Nottinghamshire for back pain, 29 interventions were provided to 17,225 people. Using a recent NICE evaluation of cost-effectiveness of back pain interventions, we established that, of these 29 interventions, 16 have evidence of improving the quality of life, for nine there was no evidence of benefit or harm, for three there was evidence that they do not provide an improvement in quality of life, and for one there was possible evidence of harm. The total cost of interventions was estimated at £4.5 million and, using the evidence from the NICE review, the total quality adjusted life year (QALY) gain to the treated population of people with back pain was calculated to be 4,571 QALYs. After discussions among the MSK Together group, it was agreed that some interventions could be stopped or scaled down, and new interventions introduced (in particular, in more-deprived neighbourhoods). Within the same estimated cost envelope of £4.5 million, the QALY gain was predicted to increase to 7702 QALYs and, by targeting QALY-related interventions to people from deprived neighbourhoods, reduce inequity (and therefore health inequalities). Using variation helped us identify areas for improvement and generated a momentum for change among the MSK Together group. By examining what we were doing, the associated costs, and the likely QALY benefits (from research evidence), we identified lower value interventions to stop or reduce and new interventions to introduce, achieving greater health gain for people with back pain with no additional resource requirements

Guest Editorial: Montane rangelands in a changing world

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Optimizing conditions for the development of a composite film from seaweed hydrocolloids and pectin derived from a fruit waste, gac pulp

Recently, edible films and coatings have received more attention instead of plastic packaging. Pectin prepared from gac pulp, a waste generated from gac oil production, was used to prepare edible films combined with seaweed hydrocolloids. This study aimed to investigate the impact of sodium alginate (SA), kappa-carrageenan (KC), and gac pulp pectin (GPP) on the physical, barrier, and mechanical properties of the resultant films. The optimum formula with the best characteristics was identified using Response Surface Methodology (RSM). Results revealed that most of the film properties were significantly influenced by seaweed hydrocolloids, while GPP significantly affected color properties. Besides, the interaction between GPP and seaweed hydrocolloids affected the water vapor permeability and mechanical properties. The optimum formula was SA of 1.28% w/v, KC of 0.58% w/v, and GPP of 0.25% w/v. The result suggests that this formula has the potential as an edible film for further applications in foods. Novelty impact statement: A composite edible film with great physical and mechanical properties can be developed from an optimal formulation of sodium alginate, kappa-carrageenan, and gac pulp pectin, derived from a waste of the oil production. This film is potentially applied for coating and preservation of foods to improve their properties and shelf-life