The effectiveness of public health interventions to reduce the health impact of climate change:a systematic review of systematic reviews

Climate change is likely to be one of the most important threats to public health in the coming years. Yet despite the large number of papers considering the health impact of climate change, few have considered what public health interventions may be of most value in reducing the disease burden. We aimed to evaluate the effectiveness of public health interventions to reduce the disease burden of high priority climate sensitive diseases

Enhanced relapse prevention for bipolar disorder – ERP trial. A cluster randomised controlled trial to assess the feasibility of training care coordinators to offer enhanced relapse prevention for bipolar disorder

BACKGROUND: Bipolar Disorder (BD) is a common and severe form of mental illness characterised by repeated relapses of mania or depression. Pharmacotherapy is the main treatment currently offered, but this has only limited effectiveness. A recent Cochrane review has reported that adding psycho-social interventions that train people to recognise and manage the early warning signs of their relapses is effective in increasing time to recurrence, improving social functioning and in reducing hospitalisations. However, the review also highlights the difficulties in offering these interventions within standard mental health services due to the need for highly trained therapists and extensive input of time. There is a need to explore the potential for developing Early Warning Sign (EWS) interventions in ways that will enhance dissemination. METHODS AND DESIGN: This article describes a cluster-randomised trial to assess the feasibility of training care coordinators (CCs) in community mental health teams (CMHTs) to offer Enhanced Relapse Prevention (ERP) to people with Bipolar Disorder. CMHTs in the North West of England are randomised to either receive training in ERP and to offer this to their clients, or to continue to offer treatment as usual (TAU). The main aims of the study are (1) to determine the acceptability of the intervention, training and outcome measures (2) to assess the feasibility of the design as measured by rates of recruitment, retention, attendance and direct feedback from participants (3) to estimate the design effect of clustering for key outcome variables (4) to estimate the effect size of the impact of the intervention on outcome. In this paper we provide a rationale for the study design, briefly outline the ERP intervention, and describe in detail the study protocol. DISCUSSION: This information will be useful to researchers attempting to carry out similar feasibility assessments of clinical effectiveness trials and in particular cluster randomised controlled trials

Valley splitting of single-electron Si MOS quantum dots

Silicon-based metal-oxide-semiconductor quantum dots are prominent candidates for high-fidelity, manufacturable qubits. Due to silicon's band structure, additional low-energy states persist in these devices, presenting both challenges and opportunities. Although the physics governing these valley states has been the subject of intense study, quantitative agreement between experiment and theory remains elusive. Here, we present data from an experiment probing the valley states of quantum dot devices and develop a theory that is in quantitative agreement with both this and a recently reported experiment. Through sampling millions of realistic cases of interface roughness, our method provides evidence that the valley physics between the two samples is essentially the same.J.K.G. gratefully acknowledges support from the Sandia National Laboratories Truman Fellowship Program, which is funded by the Laboratory Directed Research and Development (LDRD) program. This work was performed, in part, at the Center for Integrated Nanotechnologies, an Office of Science User Facility operated for the U.S. Department of Energy (DOE) Office of Science. C.H.Y. and A.S.D. acknowledge support from the Australian Research Council (CE11E0001017), the U.S. Army Research Office (W911NF-13-1-0024) and the NSW Node of the Australian National Fabrication Facility. A.R. acknowledges support from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie Grant Agreement No. 654712 (SINHOPSI)

Selective and low temperature transition metal intercalation in layered tellurides

Layered materials embrace rich intercalation reactions to accommodate high concentrations of foreign species within their structures, and find many applications spanning from energy storage, ion exchange to secondary batteries. Light alkali metals are generally most easily intercalated due to their light mass, high charge/volume ratio and in many cases strong reducing properties. An evolving area of materials chemistry, however, is to capture metals selectively, which is of technological and environmental significance but rather unexplored. Here we show that the layered telluride T2PTe2 (T=Ti, Zr) displays exclusive insertion of transition metals (for example, Cd, Zn) as opposed to alkali cations, with tetrahedral coordination preference to tellurium. Interestingly, the intercalation reactions proceed in solid state and at surprisingly low temperatures (for example, 80?°C for cadmium in Ti2PTe2). The current method of controlling selectivity provides opportunities in the search for new materials for various applications that used to be possible only in a liquid

Morphology, fluid Motion and Predation by the Scyphomedusa Aurelia Aurita

Although medusan predators play demonstrably important roles in a variety of marine ecosystems, the mechanics of prey capture and, hence, prey selection, have remained poorly defined. A review of the literature describing the commonly studied medusa Aurelia aurita (Linnaeus 1758) reveals no distinct patterns of prey selectivity and suggests that A. aurita is a generalist and feeds unselectively upon available zooplankton. We examined the mechanics of prey capture by A. aurita using video methods to record body and fluid motions. Medusae were collected between February and June in 1990 and 1991 from Woods Hole, Massachusetts and Narragansett Bay, Rhode Island, USA. Tentaculate A. aurita create fluid motions during swimming which entrain prey and bring them into contact with tentacles. We suggest that this mechanism dominates prey selection by A. aurita. In this case, we predict that medusae of a specific diameter will positively select prey with escape speeds slower than the flow velocities at their bell margins. Negatively selected prey escape faster than the medusan flow velocity draws them to capture surfaces. Faster prey will be captured by larger medusac because flow field velocity is a function of bell diameter. On the basis of prey escape velocities and flow field velocities of A. aurita with diameters of 0.8 to 7.1 cm, we predict that A. aurita will select zooplankton such as barnacle nauplii and some slow swimming hydromedusae, while faster copepods will be negatively selected

Barriers to colorectal cancer screening in community health centers: A qualitative study

<p>Abstract</p> <p>Background</p> <p>Colorectal cancer screening rates are low among disadvantaged patients; few studies have explored barriers to screening in community health centers. The purpose of this study was to describe barriers to/facilitators of colorectal cancer screening among diverse patients served by community health centers.</p> <p>Methods</p> <p>We identified twenty-three outpatients who were eligible for colorectal cancer screening and their 10 primary care physicians. Using in-depth semi-structured interviews, we asked patients to describe factors influencing their screening decisions. For each unscreened patient, we asked his or her physician to describe barriers to screening. We conducted patient interviews in English (n = 8), Spanish (n = 2), Portuguese (n = 5), Portuguese Creole (n = 1), and Haitian Creole (n = 7). We audiotaped and transcribed the interviews, and then identified major themes in the interviews.</p> <p>Results</p> <p>Four themes emerged: 1) Unscreened patients cited lack of trust in doctors as a barrier to screening whereas few physicians identified this barrier; 2) Unscreened patients identified lack of symptoms as the reason they had not been screened; 3) A doctor's recommendation, or lack thereof, significantly influenced patients' decisions to be screened; 4) Patients, but not their physicians, cited fatalistic views about cancer as a barrier. Conversely, physicians identified competing priorities, such as psychosocial stressors or comorbid medical illness, as barriers to screening. In this culturally diverse group of patients seen at community health centers, similar barriers to screening were reported by patients of different backgrounds, but physicians perceived other factors as more important.</p> <p>Conclusion</p> <p>Further study of these barriers is warranted.</p

Syrian hamster dermal cell immortalization is not enhanced by power line frequency electromagnetic field exposure

Several epidemiological studies have suggested associations between exposure to residential power line frequency electromagnetic fields and childhood leukaemia, and between occupational exposure and adult leukaemia. A variety of in vitro studies have provided limited supporting evidence for the role of such exposures in cancer induction in the form of acknowledged cellular end points, such as enhanced mutation rate and cell proliferation, though the former is seen only with extremely high flux density exposure or with co-exposure to ionizing radiation. However, in vitro experiments on a scale large enough to detect rare cancer-initiating events, such as primary cell immortalization following residential level exposures, have not thus far been reported. In this study, large cultures of primary Syrian hamster dermal cells were continuously exposed to power line frequency electromagnetic fields of 10 100 and 1000 μT for 60 h, with and without prior exposure to a threshold (1.5 Gy), or sub-threshold (0.5 Gy), immortalizing dose of ionizing radiation. Electromagnetic field exposure alone did not immortalize these cells at a detectable frequency (≥ 1 × 10−7); furthermore, such exposure did not enhance the frequency of ionizing radiation-induced immortalization. © 1999 Cancer Research Campaig

A review of data mining in knowledge management: applications/findings for transportation of small and medium enterprises

A core subfeld of knowledge management (KM) and data mining (DM) constitutes an integral part of the knowledge discovery in database process. With the explosion of information in the new digital age, research studies in the DM and KM continue to heighten up in the business organisations, especially so, for the small and medium enterprises (SMEs). DM is crucial in supporting the KM application as it processes the data to useful knowledge and KM role next, is to manage these knowledge assets within the organisation systematically. At the comprehensive appraisal of the large enterprise in the transportation sector and the SMEs across various industries—it was gathered that there is limited research case study conducted on the application of DM–KM on the transportation SMEs in specifc. From the extensive review of the case studies, it was uncovered that majority of the organisations are not leveraging on the use of tacit knowledge and that the SMEs are adopting a more traditional use of ICTs to its KM approach. In addition, despite DM–KM is being widely implemented—the case studies analysis reveals that there is a limitation in the presence of an integrated DM–KM assessment to evaluate the outcome of the DM–KM application. This paper concludes that there is a critical need for a novel DM–KM assessment plan template to evaluate and ensure that the knowledge created and implemented are usable and relevant, specifcally for the SMEs in the transportation sector. Therefore, this research paper aims to carry out an in-depth review of data mining in knowledge management for SMEs in the transportation industry