Partnerships: survey respondents' perceptions of inter-professional collaboration to address alcohol-related harms in England

Tackling alcohol-related harms crosses agency and professional boundaries, requiring collaboration between health, criminal justice, education and social welfare institutions. It is a key component of most multicomponent programmes in the United States, Australia and Europe. Partnership working, already embedded in service delivery structures, is a core mechanism for delivery of the new UK Government Alcohol Strategy. This article reports findings from a study of alcohol partnerships across England. The findings are based on a mix of open discussion interviews with key informants and on semi-structured telephone interviews with 90 professionals with roles in local alcohol partnerships. Interviewees reported the challenges of working within a complex network of interlinked partnerships, often within hierarchies under an umbrella partnership, some of them having a formal duty of partnership. The new alcohol strategy has emerged at a time of extensive reorganisation within health, social care and criminal justice structures. Further development of a partnership model for policy implementation would benefit from consideration of the incompatibility arising from required collaboration and from tensions between institutional and professional cultures. A clearer analysis of which aspects of partnership working provide ‘added value’ is needed

Characterization of two putative potassium channels in Plasmodium falciparum

<p>Abstract</p> <p>Background</p> <p>Potassium channels are essential for cell survival and participate in the regulation of cell membrane potential and electrochemical gradients. During its lifecycle, <it>Plasmodium falciparum </it>parasites must successfully traverse widely diverse environmental milieus, in which K⁺channel function is likely to be critical. Dramatically differing conditions will be presented to the parasite in the mosquito mid-gut, red blood cell (RBC) cytosol and the human circulatory system.</p> <p>Methods</p> <p><it>In silico </it>sequence analyses identified two open-reading frames in the <it>P. falciparum </it>genome that are predicted to encode for proteins with high homology to K⁺channels. To further analyse these putative channels, specific antisera were generated and used in immunoblot and immunofluorescence analyses of <it>P. falciparum</it>-infected RBCs. Recombinant genome methods in cultured <it>P. falciparum </it>were used to create genetic knock outs of each K⁺channel gene to asses the importance of their expression.</p> <p>Results</p> <p>Immunoblot and IFA analyses confirmed the expression of the two putative <it>P. falciparum </it>K⁺channels (PfK1 and PfK2). PfK1 is expressed in all asexual stage parasites, predominantly in late stages and localizes to the RBC membrane. Conversely, PfK2 is predominantly expressed in late schizont and merozoite stage parasites and remains primarily localized to the parasite. Repeated attempts to knockout PfK1 and PfK2 expression by targeted gene disruption proved unsuccessful despite evidence of recombinant gene integration, indicating that <it>pfk1 </it>and <it>pfk2 </it>are apparently refractory to genetic disruption.</p> <p>Conclusion</p> <p>Putative K⁺channel proteins PfK1 and PfK2 are expressed in cultured <it>P. falciparum </it>parasites with differing spatial and temporal patterns. Eventual functional characterization of these channels may reveal future pharmacological targets.</p

EquiFACS: the Equine Facial Action Coding System

Although previous studies of horses have investigated their facial expressions in specific contexts, e.g. pain, until now there has been no methodology available that documents all the possible facial movements of the horse and provides a way to record all potential facial configurations. This is essential for an objective description of horse facial expressions across a range of contexts that reflect different emotional states. Facial Action Coding Systems (FACS) provide a systematic methodology of identifying and coding facial expressions on the basis of underlying facial musculature and muscle movement. FACS are anatomically based and document all possible facial movements rather than a configuration of movements associated with a particular situation. Consequently, FACS can be applied as a tool for a wide range of research questions. We developed FACS for the domestic horse (Equus caballus) through anatomical investigation of the underlying musculature and subsequent analysis of naturally occurring behaviour captured on high quality video. Discrete facial movements were identified and described in terms of the underlying muscle contractions, in correspondence with previous FACS systems. The reliability of others to be able to learn this system (EquiFACS) and consistently code behavioural sequences was high—and this included people with no previous experience of horses. A wide range of facial movements were identified, including many that are also seen in primates and other domestic animals (dogs and cats). EquiFACS provides a method that can now be used to document the facial movements associated with different social contexts and thus to address questions relevant to understanding social cognition and comparative psychology, as well as informing current veterinary and animal welfare practices

Semiclassical States in Quantum Cosmology: Bianchi I Coherent States

We study coherent states for Bianchi type I cosmological models, as examples of semiclassical states for time-reparametrization invariant systems. This simple model allows us to study explicitly the relationship between exact semiclassical states in the kinematical Hilbert space and corresponding ones in the physical Hilbert space, which we construct here using the group averaging technique. We find that it is possible to construct good semiclassical physical states by such a procedure in this model; we also discuss the sense in which the original kinematical states may be a good approximation to the physical ones, and the situations in which this is the case. In addition, these models can be deparametrized in a natural way, and we study the effect of time evolution on an "intrinsic" coherent state in the reduced phase space, in order to estimate the time for this state to spread significantly.Comment: 21 pages, 1 figure; Version to be published in CQG; The discussion has been slightly reorganized, two references added, and some typos correcte

Identification of harmful cyanobacteria in the Sacramento-San Joaquin Delta and Clear Lake, California by DNA barcoding.

Accurate identification of cyanobacteria using traditional morphological taxonomy is challenging due to the magnitude of phenotypic plasticity among natural algal assemblages. In this study, molecular approach was utilized to facilitate the accurate identification of cyanobacteria in the Sacramento-San Joaquin Delta and in Clear Lake in Northern California where recurring blooms have been observed over the past decades. Algal samples were collected from both water bodies in 2011 and the samples containing diverse cyanobacteria as identified by morphological taxonomy were chosen for the molecular analysis. The 16S ribosomal RNA genes (16S rDNA) and the adjacent internal transcribed spacer (ITS) regions were amplified by PCR from the mixed algal samples using cyanobacteria generic primers. The obtained sequences were analyzed by similarity search (BLASTN) and phylogenetic analysis (16S rDNA) to differentiate species sharing significantly similar sequences. A total of 185 plasmid clones were obtained of which 77 were successfully identified to the species level: Aphanizomenon flos-aquae, Dolichospermum lemmermannii (taxonomic synonym: Anabaena lemmermannii), Limnoraphis robusta (taxonomic synonym: Lyngbya hieronymusii f. robusta) and Microcystis aeruginosa. To date, Dolichospermum and Limnoraphis found in Clear Lake have only been identified to the genus lavel by microscopy. During the course of this study, morphological identification and DNA barcoding confirmed A. flos-aquae as the predominant cyanobacterium in the Sacramento-San Joaquin Delta indicating a shift from M. aeruginosa that have dominated the blooms in the past decade. Lastly, the species-specific identification of Limnoraphis robusta in Clear Lake is another significant finding as this cyanobacterium has, thus far, only been reported in Lake Atitlan blooms in Guatemala

Density anomaly in a competing interactions lattice gas model

We study a very simple model of a short-range attraction and an outer shell repulsion as a test system for demixing phase transition and density anomaly. The phase-diagram is obtained by applying mean field analysis and Monte Carlo simulations to a two dimensional lattice gas with nearest-neighbors attraction and next-nearest-neighbors repulsion (the outer shell). Two liquid phases and density anomaly are found. The coexistence line between these two liquid phases meets a critical line between the fluid and the low density liquid at a tricritical point. The line of maximum density emerges in the vicinity of the tricritical point, close to the demixing transition

A pragmatic effectiveness study of 10-session cognitive behavioural therapy (CBT-T) for eating disorders: Targeting barriers to treatment provision

Objective Ten‐session cognitive behavioural therapy (CBT‐T) for transdiagnostic eating disorders targets several barriers to treatment, including cost, therapist expertise, and lengthy wait lists. Method We used a case series design to investigate the effectiveness of CBT‐T delivered by trainee psychologists in a postgraduate training clinic. Participants were randomly allocated to commence treatment either immediately or after a 4‐week waitlist period. CBT‐T was delivered to 52 patients, by six different trainees under supervision. Measures of eating disorder cognitions and behaviours, quality of life, and general psychopathology were examined in completer and intention‐to‐treat analyses using multilevel modelling. Last observation carried forward was applied for abstinence, remission, and good outcome analyses to aid comparison with prior studies. Results Significant improvements, associated with medium to large effect sizes, were found for eating disorder cognitions, behaviours quality of life, and negative affect from baseline to posttreatment, and at 1‐ and 3‐month follow‐up. Attrition (38.5%) was comparable with other treatment studies. Conclusion Results provide evidence for the effectiveness of CBT‐T delivered by trainee psychologists for transdiagnostic eating disorder patients, thus tackling some important barriers for treatment. Longer follow‐up, randomised controlled trial designs, and moderator analyses will provide more robust evidence about which patients do best with a shorter therapy

Optimisation of variables for studying dilepton transverse momentum distributions at hadron colliders

In future measurements of the dilepton ($Z/\gamma^*$) transverse momentum, \Qt, at both the Tevatron and LHC, the achievable bin widths and the ultimate precision of the measurements will be limited by experimental resolution rather than by the available event statistics. In a recent paper the variable \at, which corresponds to the component of \Qt\ that is transverse to the dilepton thrust axis, has been studied in this regard. In the region, \Qt\ $<$ 30 GeV, \at\ has been shown to be less susceptible to experimental resolution and efficiency effects than the \Qt. Extending over all \Qt, we now demonstrate that dividing \at\ (or \Qt) by the measured dilepton invariant mass further improves the resolution. In addition, we propose a new variable, \phistarEta, that is determined exclusively from the measured lepton directions; this is even more precisely determined experimentally than the above variables and is similarly sensitive to the \Qt. The greater precision achievable using such variables will enable more stringent tests of QCD and tighter constraints on Monte Carlo event generator tunes.Comment: 8 pages, 5 figures, 2 table

Reasons for and consequences of missed appointments in general practice in the UK: questionnaire survey and prospective review of medical records

Background Missed appointments are a common occurrence in primary care in the UK, yet little is known about the reasons for them, or the consequences of missing an appointment. This paper aims to determine the reasons for missed appointments and whether patients who miss an appointment subsequently consult their general practitioner (GP). Secondary aims are to compare psychological morbidity, and the previous appointments with GPs between subjects and a comparison group. Methods Postal questionnaire survey and prospective medical notes review of adult patients missing an appointment and the comparison group who attended appointments over a three week period in seven general practices in West Yorkshire. Results Of the 386 who missed appointments 122 (32%) responded. Of the 386 in the comparison group 223 (58%) responded, resulting in 23 case-control matched pairs with complete data collection. Over 40% of individuals who missed an appointment and participated said that they forgot the appointment and a quarter said that they tried very hard to cancel the appointment or that it was at an inconvenient time. A fifth reported family commitments or being too ill to attend. Over 90% of the patients who missed an appointment subsequently consulted within three months and of these nearly 60% consulted for the stated problem that was going to be presented in the missed consultation. The odds of missing an appointment decreased with increasing age and were greater among those who had missed at least one appointment in the previous 12 months. However, estimates for comparisons between those who missed appointments and the comparison group were imprecise due to the low response rate. Conclusion Patients who miss appointments tend to cite practice factors and their own forgetfulness as the main reasons for doing so, and most attend within three months of a missed appointment. This study highlights a number of implications for future research. More work needs to be done to engage people who miss appointments into research in a meaningful way