Towards inclusive geographies? Young people, religion, race and migration

No abstract available

Towards inclusive geographies? Young people, religion, race and migration

No abstract available

Word frequency influences on the list length effect and associative memory in young and older adults

Many studies show that age deficits in memory are smaller for information supported by preexperimental experience. Many studies also find dissociations in memory tasks between words that occur with high and low frequencies in language, but the literature is mixed regarding the extent of word frequency effects in normal ageing. We examined whether age deficits in episodic memory could be influenced by manipulations of word frequency. In Experiment 1, young and older adults studied short and long lists of high- and low-frequency words for free recall. The list length effect (the drop in proportion recalled for longer lists) was larger in young compared to older adults and for high- compared to low-frequency words. In Experiment 2, young and older adults completed item and associative recognition memory tests with high- and low-frequency words. Age deficits were greater for associative memory than for item memory, demonstrating an age-related associative deficit. High-frequency words led to better associative memory performance whilst low-frequency words resulted in better item memory performance. In neither experiment was there any evidence for age deficits to be smaller for high- relative to low-frequency words, suggesting that word frequency effects on memory operate independently from effects due to cognitive ageing

Exploring the Use of Cost-Benefit Analysis to Compare Pharmaceutical Treatments for Menorrhagia

Background: The extra-welfarist theoretical framework tends to focus on health-related quality of life, whilst the welfarist framework captures a wider notion of well-being. EQ-5D and SF-6D are commonly used to value outcomes in chronic conditions with episodic symptoms, such as heavy menstrual bleeding (clinically termed menorrhagia). Because of their narrow-health focus and the condition’s periodic nature these measures may be unsuitable. A viable alternative measure is willingness to pay (WTP) from the welfarist framework. Objective: We explore the use of WTP in a preliminary cost-benefit analysis comparing pharmaceutical treatments for menorrhagia. Methods: A cost-benefit analysis was carried out based on an outcome of WTP. The analysis is based in the UK primary care setting over a 24-month time period, with a partial societal perspective. Ninety-nine women completed a WTP exercise from the ex-ante (pre-treatment/condition) perspective. Maximum average WTP values were elicited for two pharmaceutical treatments, levonorgestrel-releasing intrauterine system (LNG-IUS) and oral treatment. Cost data were offset against WTP and the net present value derived for treatment. Qualitative information explaining the WTP values was also collected. Results: Oral treatment was indicated to be the most cost-beneficial intervention costing £107 less than LNG-IUS and generating £7 more benefits. The mean incremental net present value for oral treatment compared with LNG-IUS was £113. The use of the WTP approach was acceptable as very few protests and non-responses were observed. Conclusion: The preliminary cost-benefit analysis results recommend oral treatment as the first-line treatment for menorrhagia. The WTP approach is a feasible alternative to the conventional EQ-5D/SF-6D approaches and offers advantages by capturing benefits beyond health, which is particularly relevant in menorrhagia

Thromboxane and neutrophil changes following intermittent claudication suggest ischaemia-reperfusion injury

Objectives:It has been postulated that ischaemia-reperfusion occurs in intermittent claudication resulting in neutrophil activation and release of soluble mediators, increasing systemic vascular permeability and enhancing atherogenesis.Methods:We measured neutrophil deformability, plasma thromboxane levels, and urinary microalbumin excretion in 30 male claudicants, and 10 age- and sex-matched controls, before and after exercise to maximum walking distance. Blood was taken from an antecubital vein.ResultsThere was an increase in urinary microalbumin excretion after exercise in claudicants. Statistically significant increases in the median and 90th percentile transit times (markers of neutrophil deformability) for isolated neutrophils from blood drawn 5 min after exercise in the claudicants were observed with no change in control subjects. Plasma thromboxane concentrations in claudicants increased within 10 min post-exercise. Plasma concentrations in controls were significantly lower throughout the study period. In the claudicant group, a positive correlation between the percentage change in the median transit time for neutrophils, and the percentage change in plasma thromboxane at 60 min post-exercise was found.Conclusions:The results lend further support to the concept of ischaemia-reperfusion events in patients with intermittent claudication, leading to a systemic increase in vascular permeability as a result of endothelial injury or dysfunction (a crucial step in atherogenesis), associated with thromboxane production and neutrophil activation. We suggest that the above changes may contribute to the increased mortality seen in such patients

Optimizing countershading camouflage

Countershading, the widespread tendency of animals to be darker on the side that receives strongest illumination, has classically been explained as an adaptation for camouflage: obliterating cues to 3D shape and enhancing background matching. However, there have only been two quantitative tests of whether the patterns observed in different species match the optimal shading to obliterate 3D cues, and no tests of whether optimal countershading actually improves concealment or survival. We use a mathematical model of the light field to predict the optimal countershading for concealment that is specific to the light environment and then test this prediction with correspondingly patterned model “caterpillars” exposed to avian predation in the field. We show that the optimal countershading is strongly illumination-dependent. A relatively sharp transition in surface patterning from dark to light is only optimal under direct solar illumination; if there is diffuse illumination from cloudy skies or shade, the pattern provides no advantage over homogeneous background-matching coloration. Conversely, a smoother gradation between dark and light is optimal under cloudy skies or shade. The demonstration of these illumination-dependent effects of different countershading patterns on predation risk strongly supports the comparative evidence showing that the type of countershading varies with light environment

General Practice in the Time of COVID-19: A Mixed-Methods Service Evaluation of a Primary Care COVID-19 Service

Primary care coronavirus disease 2019 (COVID-19) clinics were rapidly introduced across the UK to review potentially infectious patients. Evaluation of these services is needed to guide future implementation. This mixed-methods study evaluates patient demographics, clinical presentation, co-morbidities, service usage, and outcomes for the Islington COVID-19 service (London, UK) and from April to May 2020 and thematically analyses survey responses from 29 service clinicians and 41 GP referrers on their service experience. Of the 237 patients booked into the service, a significant number of referrals (n = 91; 38.6%) were made after the presumed infectious period of 14 days. Almost half of all adult referrals (49%) were dealt with remotely (via telephone/video consultation +/− remote oxygen saturation monitoring). The service was perceived to provide a safe way to see patients; it developed local expertise, learning, and empowerment; and it was a positive teamworking experience. These findings suggest that the management of many patients with COVID-19 symptoms is possible in routine general practice with minimal risk through the implementation of remote consultation methods and in patients who present after the post-infectious period. Additionally, the use of remote saturation monitoring and local GP COVID-19 “experts” can support practices to manage COVID-19 patients. Future primary care COVID-19 services should act as empowerment tools to assist GPs to safely manage their own patients and provide support for GPs in this process

Needs analysis report following the sexual exploitation of children in Rotherham

It has been an immense honour to listen to the experiences of the people of Rotherham. The project team received a warm welcome and felt humbled at the extraordinary courage of victims, survivors and their families. We wish to express our heartfelt thanks to everyone who took part in the study. The knowledge and opinions shared by our participants are the foundation of this report. No-one wants to think about what child sexual abuse and exploitation really means. Recognising that children have been humiliated, raped and tortured is extremely distressing. As such, it is no surprise that many felt anger and rage when they understood that those with authority failed to protect vulnerable children and young people. There is a need to face the awful reality that child sexual abuse has always happened. However, in the age of the internet, the number of children at risk of sexual abuse has increased. Those who sexually abuse children are mostly, but not always, men. Not discounting the vast number of boys who have suffered abuse, most of the known victims of sexual abuse are girls. Both victims and perpetrators come from every walk of life. The threat is such that we all have a responsibility to consider what we can do to protect every child in our family and communities. The public criticism of Rotherham Metropolitan Borough Council (RMBC) and South Yorkshire Police, following Professor Jay’s report was right and inevitable. Positively, there have been several examples of how RMBC and South Yorkshire Police have responded to criticism and improved the way they respond to victims and survivors. However, there have also been negative consequences of public scrutiny, with many people in the study reporting that they want to regain pride in their hometown. Those who took part in this study did not shy away from exploring the difficulties they face. Naturally, participants continue to talk about issues of trust, as past mistakes created a sense of vulnerability. However, there is also evidence that healing is taking place. Many participants made suggestions of how they and RMBC could and should collaborate to strengthen, individuals, families and their communities Indeed, there is a determination to meet current and future needs with a sense of collective rigour. Some of these tasks involve developing internal structures, such as communication and the provision of appropriate resources. Rotherham, like many other towns and cities in Britain, is also faced with external threats which can exacerbate internal challenges. An example of this is how recognition of the involvement of some men of Asian Pakistani heritage, in the abuse of children in Rotherham, led some political groups to capitalise on fears. However, it is clear that children are best protected in resilient families and communities. Thankfully, Rotherham and its people continue to demonstrate resilience. In addition, there is also a strong sense of realism, no-one in Rotherham expects perfection, but they do expect to do everything possible to protect children and young people. One woman made the distinction between surviving and thriving: “…I don’t want to survive, I want to thrive…” We hope this report contributes to that aim and welcome your views on the findings from data collected between April and June 2015. We recognise that the data is reflective of views expressed at that time and that RMBC and the people of Rotherham, have continued to respond to needs throughout the course of this analysis process