Evaluation of homelessness services to adults in the secure estate

This evaluation aimed to assess how changes to legislative duties towards those leaving custody since 2015 had been implemented by local authorities, prisons and probation providers; what impact the changes had on housing prison leavers; and to identify areas of good practice in meeting the housing needs of prison leavers. Chapter 1 provide some understanding the policy context for the development and implementation of the National Pathway for Homelessness Services to Adults in the Secure Estate. Chapter 2 briefly covers the existing delivery arrangements for the pathway. A background paper accompanies this report and provides more in depth exploration of both these issues. Chapter 3 describes the methodology adopted to undertake the evaluation. In turn thereafter, chapters 4, 5 and 6 respectively present the findings in relation to the operation of the National Pathway at the reception, prerelease and community stages of a prisoner’s journey into and out of custody. In Chapter 7, better practices in relation to implementing the National Pathway are discussed. Finally in chapter 8 the evaluation findings are summarised and recommendations for improving practices are identified

Antagonistic Mixing in Micelles of Amphiphilic Polyoxometalates and Hexaethylene Glycol Monododecyl Ether

International audienceHypothesis: Polyoxometalates (POMs) are metal oxygen clusters with a range of interesting magnetic and catalytic properties. POMs with attached hydrocarbon chains show amphiphilic behaviour so we hypothesised that mixtures of a nonionic surfactant and anionic surfactants with a polyoxometalate cluster as headgroup would form mixed micelles, giving control of the POM density in the micelle, and which would differ in size and shape from micelles formed by the individual surfactants. Due to the high charge and large size of the POM, we suggested that these would be nonideal mixtures due to the complex interactions between the two types of surfactants. The nonideality and the micellar composition may be quantified using regular solution theory. With supplementary information provided by small-angle neutron scattering (SANS), an understanding of this unusual binary surfactant system can be established.Experiments: A systematic study was performed on mixed surfactant systems containing polyoxometalate-headed amphiphiles (K10[P2W17O61OSi2(CnH(2n+1))2], abbreviated as P2W17-2Cn, where n = 12, 14 or 16) and hexaethylene glycol monododecyl ether (C12EO6). Critical micelle concentrations (CMCs) of these mixtures were measured and used to calculate the interaction parameters based on regular solution theory, enabling prediction of micellar composition. Predictions were compared to micelle structures obtained from SANS. A phase diagram was also established.Findings: The CMCs of these mixtures suggest unusual unfavourable interactions between the two species despite formation of mixed micelles. Micellar compositions obtained from SANS concurred with those calculated using the averaged interaction parameters for P2W17-2Cn/C12EO6 (n = 12 and 14). We attribute the unfavourable interactions to a combination of different phenomena: counterion-mediated interactions between P2W17 units and the unfolding of the ethylene oxide headgroups of the nonionic surfactant, yet micelles still form in these systems due to the hydrophobic interactions between surfactant tails

Synthesis of small silver nanocubes in a hydrophobic solvent by introducing oxidative etching with Fe(III) species

The role of oxidative etching in the synthesis of noble-metal nanocrystals with a hydrophilic solvent (in particular, ethylene glycol) has been explored in our previous work. In this paper, we demonstrate that the mechanism of oxidative etching could be extended to the synthesis of single-crystal Ag nanocrystals in a hydrophobic solvent such as isoamyl ether. In this case, Fe(III) species in the form of FeCl3 or Fe(acac)(3) had to be introduced into the hydrophobic system as an effective etching agent. The final product contained single-crystal Ag nanocubes (slightly truncated) with an edge length as small as similar to 13.5 nm, a size that has been difficult to achieve using a hydrophilic system. The role of oxidative etching in the synthesis of noble-metal nanocrystals with a hydrophilic solvent (in particular, ethylene glycol) has been explored in our previous work. In this paper, we demonstrate that the mechanism of oxidative etching could be extended to the synthesis of single-crystal Ag nanocrystals in a hydrophobic solvent such as isoamyl ether. In this case, Fe(III) species in the form of FeCl3 or Fe(acac)(3) had to be introduced into the hydrophobic system as an effective etching agent. The final product contained single-crystal Ag nanocubes (slightly truncated) with an edge length as small as similar to 13.5 nm, a size that has been difficult to achieve using a hydrophilic system.NSF [DMR-0804088, ECS-0335765]; NIH [DP1 OD000798]; China Scholarship Counci

The combined diabetes and renal control trial (C-DIRECT) - a feasibility randomised controlled trial to evaluate outcomes in multi-morbid patients with diabetes and on dialysis using a mixed methods approach

Background: This cluster randomised controlled trial set out to investigate the feasibility and acceptability of the “Combined Diabetes and Renal Control Trial” (C-DIRECT) intervention, a nurse-led intervention based on motivational interviewing and self-management in patients with coexisting end stage renal diseases and diabetes mellitus (DM ESRD). Its efficacy to improve glycaemic control, as well as psychosocial and self-care outcomes were also evaluated as secondary outcomes. Methods: An assessor-blinded, clustered randomised-controlled trial was conducted with 44 haemodialysis patients with DM ESRD and ≥ 8% glycated haemoglobin (HbA1c), in dialysis centres across Singapore. Patients were randomised according to dialysis shifts. 20 patients were assigned to intervention and 24 were in usual care. The C-DIRECT intervention consisted of three weekly chair-side sessions delivered by diabetes specialist nurses. Data on recruitment, randomisation, and retention, and secondary outcomes such as clinical endpoints, emotional distress, adherence, and self-management skills measures were obtained at baseline and at 12 weeks follow-up. A qualitative evaluation using interviews was conducted at the end of the trial. Results: Of the 44 recruited at baseline, 42 patients were evaluated at follow-up. One patient died, and one discontinued the study due to deteriorating health. Recruitment, retention, and acceptability rates of C-DIRECT were generally satisfactory HbA1c levels decreased in both groups, but C-DIRECT had more participants with HbA1c < 8% at follow up compared to usual care. Significant improvements in role limitations due to physical health were noted for C-DIRECT whereas levels remained stable in usual care. No statistically significant differences between groups were observed for other clinical markers and other patient-reported outcomes. There were no adverse effects. Conclusions: The trial demonstrated satisfactory feasibility. A brief intervention delivered on bedside as part of routine dialysis care showed some benefits in glycaemic control and on QOL domain compared with usual care, although no effect was observed in other secondary outcomes. Further research is needed to design and assess interventions to promote diabetes self-management in socially vulnerable patients

Clinical trial of laronidase in Hurler syndrome after hematopoietic cell transplantation.

BackgroundMucopolysaccharidosis I (MPS IH) is a lysosomal storage disease treated with hematopoietic cell transplantation (HCT) because it stabilizes cognitive deterioration, but is insufficient to alleviate all somatic manifestations. Intravenous laronidase improves somatic burden in attenuated MPS I. It is unknown whether laronidase can improve somatic disease following HCT in MPS IH. The objective of this study was to evaluate the effects of laronidase on somatic outcomes of patients with MPS IH previously treated with HCT.MethodsThis 2-year open-label pilot study of laronidase included ten patients (age 5-13 years) who were at least 2 years post-HCT and donor engrafted. Outcomes were assessed semi-annually and compared to historic controls.ResultsThe two youngest participants had a statistically significant improvement in growth compared to controls. Development of persistent high-titer anti-drug antibodies (ADA) was associated with poorer 6-min walk test (6MWT) performance; when patients with high ADA titers were excluded, there was a significant improvement in the 6MWT in the remaining seven patients.ConclusionsLaronidase seemed to improve growth in participants &lt;8 years old, and 6MWT performance in participants without ADA. Given the small number of patients treated in this pilot study, additional study is needed before definitive conclusions can be made

Valuation of ecosystem services to inform management of multiple-use landscapes

Public agencies worldwide are increasingly adopting an ecosystem service framework to manage lands serving multiple uses. Yet, reliable, practical, and well-tailored methods remain a major limitation in moving from conceptual to actionable approaches. Together with one of the largest federal land managing agencies, we co-develop and co-demonstrate an ecosystem services approach tailored to specific decisions, through a process with potentially widespread relevance. With the U.S. Department of Defense (DoD), we focus on balancing military training with biodiversity and resource conservation under both budgetary and land-use pressures at a representative installation. In an iterative process of co-design and application, we define, map, and quantify multiple ecosystem services under realistic management options. Resource management budget emerges as a major determinant of the degree to which managers can sustain both necessary training environments – a DoD-specific ecosystem service – and a prairie ecosystem with species of conservation concern. We also found clear tradeoffs between training intensity and forest-related services. Our co-developed approach brings otherwise hidden values and tradeoffs to the fore in a balanced way that can help public agencies safeguard priority services under potentially conflicting uses and budget limitations