Reduced street lighting at night and health: A rapid appraisal of public views in England and Wales.

Financial and carbon reduction incentives have prompted many local authorities to reduce street lighting at night. Debate on the public health implications has centred on road accidents, fear of crime and putative health gains from reduced exposure to artificial light. However, little is known about public views of the relationship between reduced street lighting and health. We undertook a rapid appraisal in eight areas of England and Wales using ethnographic data, a household survey and documentary sources. Public concern focused on road safety, fear of crime, mobility and seeing the night sky but, for the majority in areas with interventions, reductions went unnoticed. However, more private concerns tapped into deep-seated anxieties about darkness, modernity 'going backwards', and local governance. Pathways linking lighting reductions and health are mediated by place, expectations of how localities should be lit, and trust in local authorities to act in the best interests of local communities

Building Future Capacity of School Psychologists to Address the Demand for Inclusive Evidence-Based Consultation: Moving Beyond K-12 to Include School Readiness Frameworks

There is high demand for future school psychologists to address the need for continuous evidence-based consultation that moves beyond K-12 settings, and includes evidence-based consultation to promote school readiness for infants and toddlers with and at risk for developmental disabilities. While there exists a demand for school psychologists in infant and toddler settings, the primary focus of training programs is preparing graduates to work in school-based settings. Currently, a gap exists in graduate training opportunities in evidence-based consultation practices that support school readiness for infants and toddlers with and at risk for disabilities served through Part C services. While school psychologists typically are trained on evidence-based consultation mechanisms that have largely been utilized in K-12 contexts, they rarely receive consultation training with families of infants and toddlers. Therefore, expansion of training is necessary to support infants and toddlers through evidence-based consultation models. To underscore the importance of continuity in application of evidence-based consultation models, the current manuscript compares an evidence-based consultation model validated in K-12 settings and a consultation model for promoting infant and toddler developmental competencies. An illustration of the application of evidence-based consultation frameworks within multi-tiered systems of support and recommendations for graduate training, to better prepare school psychologists for work in birth-to-three settings, is provided

Predicting hedgehog mortality risks on British roads using habitat suitability modelling

Road vehicle collisions are likely to be an important contributory factor in the decline of the European hedgehog (Erinaceus europaeus) in Britain. Here, a collaborative roadkill dataset collected from multiple projects across Britain was used to assess when, where and why hedgehog roadkill are more likely to occur. Seasonal trends were assessed using a Generalized Additive Model. There were few casualties in winter—the hibernation season for hedgehogs—with a gradual increase from February that reached a peak in July before declining thereafter. A sequential multi-level Habitat Suitability Modelling (HSM) framework was then used to identify areas showing a high probability of hedgehog roadkill occurrence throughout the entire British road network (∼400,000 km) based on multi-scale environmental determinants. The HSM predicted that grassland and urban habitat coverage were important in predicting the probability of roadkill at a national scale. Probabilities peaked at approximately 50% urban cover at a one km scale and increased linearly with grassland cover (improved and rough grassland). Areas predicted to experience high probabilities of hedgehog roadkill occurrence were therefore in urban and suburban environments, that is, where a mix of urban and grassland habitats occur. These areas covered 9% of the total British road network. In combination with information on the frequency with which particular locations have hedgehog road casualties, the framework can help to identify priority areas for mitigation measures

The effect of reduced street lighting on road casualties and crime in England and Wales: controlled interrupted time series analysis.

BACKGROUND: Many local authorities in England and Wales have reduced street lighting at night to save money and reduce carbon emissions. There is no evidence to date on whether these reductions impact on public health. We quantified the effect of 4 street lighting adaptation strategies (switch off, part-night lighting, dimming and white light) on casualties and crime in England and Wales. METHODS: Observational study based on analysis of geographically coded police data on road traffic collisions and crime in 62 local authorities. Conditional Poisson models were used to analyse longitudinal changes in the counts of night-time collisions occurring on affected roads during 2000-2013, and crime within census Middle Super Output Areas during 2010-2013. Effect estimates were adjusted for regional temporal trends in casualties and crime. RESULTS: There was no evidence that any street lighting adaptation strategy was associated with a change in collisions at night. There was significant statistical heterogeneity in the effects on crime estimated at police force level. Overall, there was no evidence for an association between the aggregate count of crime and switch off (RR 0.11; 95% CI 0.01 to 2.75) or part-night lighting (RR 0.96; 95% CI 0.86 to 1.06). There was weak evidence for a reduction in the aggregate count of crime and dimming (RR 0.84; 95% CI 0.70 to 1.02) and white light (RR 0.89; 95% CI 0.77 to 1.03). CONCLUSIONS: This study found little evidence of harmful effects of switch off, part-night lighting, dimming, or changes to white light/LEDs on road collisions or crime in England and Wales

Personal security alarms for the prevention of assaults against healthcare staff

Background: Personal security alarms have been used to try to reduce violence against healthcare staff, some of whose members face relatively high risks of assault. This systematic review focused on the effect of alarms in reducing the incidence and/or severity of assaults. Methods: Electronic databases, including Cochrane Library, Ovid MEDLINE(R); CINAHL Plus (EBSCO); PubMed; PsycINFO (OvidSP) PsycEXTRA; Applied Social Sciences Index and Abstracts (ProQuest) (1987 to current); Criminal Justice Abstracts (EBSCOhost); Psychology and Behavioural Science Collection (EBSCOhost); Social Policy and Practice (OvidSP) Sociological Abstracts; ProQuest theses and dissertations, were searched. Study designs eligible for inclusion were randomised controlled trials, interrupted time series and controlled before-after studies that assessed the impact of personal security alarms on assaults. Searches were undertaken for studies of healthcare staff in all settings (i.e. including staff working in confined spaces such as hospitals and also field personnel such as community health workers). Workplace violence between colleagues (lateral violence and bullying) and other uses of personal alarms (e.g. fall alarms for the elderly, domestic violence prevention) were excluded. Search results were screened by title, abstracts and keywords for possible inclusion. Full text reports for all potentially relevant studies were obtained and independently assessed for final inclusion. The primary outcome was physical assaults (recorded or self-reported). Secondary outcomes included increased confidence or self-efficacy in violence prevention (recorded or self-reported). Main results: No studies were found that met all inclusion criteria. Four reported associations of personal alarms (and other variables) with risks of assault in healthcare settings. These were described narratively. Conclusions: Healthcare workers in emergency departments, psychiatric units and geriatric facilities face much higher risks of assault than those in other healthcare settings. Alarm systems vary widely. Alarm systems form one of a range of measures, which may interact with one another, that are used to reduce the risks of assault. Given this complexity and diversity, prior to field trials EMMIE orientated efficacy trials are recommended to try to establish whether alarms can be introduced and operated in ways that can contribute to reducing assaults in specific high-risk settings. In relation to findings relating to any given intervention, EMMIE refers to effects produced, mechanisms activated to produce the effects, moderators or contexts relevant to the activation of mechanisms, implementation issues that arise, and economic costs and benefits

Absence of street lighting may prevent vehicle crime, but spatial and temporal displacement remains a concern

Objectives This paper estimates the effect of changes in street lighting at night on levels of crime at street-level. Analyses investigate spatial and temporal displacement of crime into adjacent streets. Methods Offense data (burglaries, robberies, theft of and theft from vehicles, and violent crime) were obtained from Thames Valley Police, UK. Street lighting data (switching lights off at midnight, dimming, and white light) were obtained from local authorities. Monthly counts of crime at street-level were analyzed using a conditional fixed-effects Poisson regression model, adjusting for seasonal and temporal variation. Two sets of models analyzed: (1) changes in night-time crimes adjusting for changes in day-time crimes and (2) changes in crimes at all times of the day. Results Switching lights off at midnight was strongly associated with a reduction in night-time theft from vehicles relative to daytime (rate ratio RR 0.56; 0.41–0.78). Adjusted for changes in daytime, night-time theft from vehicles increased (RR 1.55; 1.14–2.11) in adjacent roads where street lighting remained unchanged. Conclusion Theft from vehicle offenses reduced in streets where street lighting was switched off at midnight but may have been displaced to better-lit adjacent streets. Relative to daytime, night-time theft from vehicle offenses reduced in streets with dimming while theft from vehicles at all times of the day increased, thus suggesting temporal displacement. These findings suggest that the absence of street lighting may prevent theft from vehicles, but there is a danger of offenses being temporally or spatially displaced

Whole-body and adipose tissue-specific mechanisms underlying the metabolic effects of fibroblast growth factor 21 in the Siberian hamster.

OBJECTIVE: Fibroblast growth factor 21 (FGF21) has been shown to rapidly lower body weight in the Siberian hamster, a preclinical model of adiposity. This induced negative energy balance mediated by FGF21 is associated with both lowered caloric intake and increased energy expenditure. Previous research demonstrated that adipose tissue (AT) is one of the primary sites of FGF21 action and may be responsible for its ability to increase the whole-body metabolic rate. The present study sought to determine the relative importance of white (subcutaneous AT [sWAT] and visceral AT [vWAT]), and brown (interscapular brown AT [iBAT]) in governing FGF21-mediated metabolic improvements using the tissue-specific uptake of glucose and lipids as a proxy for metabolic activity. METHODS: We used positron emission tomography-computed tomography (PET-CT) imaging in combination with both glucose (18F-fluorodeoxyglucose) and lipid (18F-4-thiapalmitate) tracers to assess the effect of FGF21 on the tissue-specific uptake of these metabolites and compared responses to a control group pair-fed to match the food intake of the FGF21-treated group. In vivo imaging was combined with ex vivo tissue-specific functional, biochemical, and molecular analyses of the nutrient uptake and signaling pathways. RESULTS: Consistent with previous findings, FGF21 reduced body weight via reduced caloric intake and increased energy expenditure in the Siberian hamster. PET-CT studies demonstrated that FGF21 increased the uptake of glucose in BAT and WAT independently of reduced food intake and body weight as demonstrated by imaging of the pair-fed group. Furthermore, FGF21 increased glucose uptake in the primary adipocytes, confirming that these in vivo effects may be due to a direct action of FGF21 at the level of the adipocytes. Mechanistically, the effects of FGF21 are associated with activation of the ERK signaling pathway and upregulation of GLUT4 protein content in all fat depots. In response to treatment with FGF21, we observed an increase in the markers of lipolysis and lipogenesis in both the subcutaneous and visceral WAT depots. In contrast, FGF21 was only able to directly increase the uptake of lipid into BAT. CONCLUSIONS: These data identify brown and white fat depots as primary peripheral sites of action of FGF21 in promoting glucose uptake and also indicate that FGF21 selectively stimulates lipid uptake in brown fat, which may fuel thermogenesis

Route of drug administration in out-of-hospital cardiac arrest: A protocol for a randomised controlled trial (PARAMEDIC-3)

© 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).AIMS: The PARAMEDIC-3 trial evaluates the clinical and cost-effectiveness of an intraosseous first strategy, compared with an intravenous first strategy, for drug administration in adults who have sustained an out-of-hospital cardiac arrest. METHODS: PARAMEDIC-3 is a pragmatic, allocation concealed, open-label, multi-centre, superiority randomised controlled trial. It will recruit 15,000 patients across English and Welsh ambulance services. Adults who have sustained an out-of-hospital cardiac arrest are individually randomised to an intraosseous access first strategy or intravenous access first strategy in a 1:1 ratio through an opaque, sealed envelope system. The randomised allocation determines the route used for the first two attempts at vascular access. Participants are initially enrolled under a deferred consent model.The primary clinical-effectiveness outcome is survival at 30-days. Secondary outcomes include return of spontaneous circulation, neurological functional outcome, and health-related quality of life. Participants are followed-up to six-months following cardiac arrest. The primary health economic outcome is incremental cost per quality-adjusted life year gained. CONCLUSION: The PARAMEDIC-3 trial will provide key information on the clinical and cost-effectiveness of drug route in out-of-hospital cardiac arrest.Trial registration: ISRCTN14223494, registered 16/08/2021, prospectively registered.Peer reviewe

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy