Investigating local policy drivers for alcohol harm prevention: a comparative case study of two local authorities in England

AbstractBackground The recent transfer of public health teams to local authorities in England offers opportunities for new policy approaches to tackling alcohol harm. The new responsible authority status of directors of public health, for example with regard to licensing applications, raises the prospect of reducing excessive alcohol consumption through local availability measures. Local authorities are also responsible for the commissioning of community-based treatment services. We used a case study approach to identify the major drivers and characteristics of local alcohol policies and services in two contrasting local authorities. Methods The many sources used were semi-structured interviews with key informants, including two in public health, two in licensing and trading standards, one in the police, and one information specialist; documentary analysis, including two alcohol strategies; two statements of licensing policy; and field observation (attending a licensing committee hearing). Focusing on alcohol harm prevention programmes and their underlying objectives, we used storyboards and constant comparative methods to describe and explain differences in the alcohol policy landscape between the two local authorities. Ethics approval was obtained from the University of Sheffield Ethics Committee. Findings Substantial differences in the stated priorities of alcohol harm prevention strategies were shown in the contrasting policy responses of the two local authorities. Concern about how best to reduce high rates of alcohol-related hospital admissions in local authority 1 led to an emphasis on health-service approaches, such as screening and brief intervention, whereas a public disorder focus in local authority 2 resulted in policies aimed at reducing availability through licensing measures. Perceived tensions were apparent for local authority 1 between maintaining a supportive environment for local businesses at a time of economic recession and introducing policy measures with a regulatory focus. Field observations highlighted the underlying importance of well-functioning working relationships between licensees and all responsible authorities, for achieving acceptable implementation plans for novel policies. Resource constraints and a lack of clear policy champions were also barriers to more preventive measures in local authority 1. Interpretation Devolved responsibility for alcohol harm prevention clearly presents the potential for local authorities to tailor policies closely to their identified population needs. The exercising of responsible authority status in reducing availability through licensing approaches is best achieved however when fully integrated into the full spectrum of alcohol harm reduction activities, from prevention through to treatment-based interventions

Pregnancy incidence and correlates in a clinical trial preparedness study, North West Province South Africa.

INTRODUCTION: Women in HIV prevention trials often must typically agree to avoid pregnancy. Regardless, some become pregnant. Screening tools predicting pregnancy risk could maximize trial safety and efficiency. OBJECTIVES: We assessed incidence and correlates of pregnancy among women at high HIV risk. METHODS: We enrolled sexually-active, HIV-negative women into an observational cohort (2008-2011). At enrollment demographic, contraceptive, reproductive, pregnancy intention and behavioural data were collected. Women reported if one or both partners wanted or intended for the couple to become pregnant. We measured gender role beliefs using a locally validated eight-point index. We tested HIV and pregnancy, and inquired about sexually transmitted infection symptoms (STIs) at enrollment and monthly. HIV testing included behavioural counselling and condom provision, but did not specifically counsel women to avoid pregnancy. Cox proportional hazard modelling evaluated the associations with pregnancy. The multivariate model included the following variables "Recent pregnancy attempts", "Gender Roles Beliefs", "Self-reported STIs" and "Age". RESULTS: We screened 1068 women and excluded (24.6%, 263/1068) who did not report risk behaviour. Non-pregnant, non-sterilized women aged 18-35 (median = 21 years) enrolled (n = 438). Most women reported one partner (74.7%) and a prior live birth (84.6%). Median follow-up time was 6 months (range 0.7-15.5). Pregnancy incidence was 25.1 per 100 women-years (n = 57 pregnancies). Conservative beliefs on gender roles (Adjusted Hazard Ratio (aHR) 1.8; 95% confidence interval [CI] 1.1-2.9), recent pregnancy attempts (aHR 1.9; 95% CI 1.1-3.4) and baseline self-reported STI (aHR 2.5; 95% CI 1.4-4.4) were associated with increased incident pregnancy. Report of no pregnancy intention was associated with lowered pregnancy risk (aHR 0.3; 95% CI 0.1-0.7). CONCLUSIONS: We identified new and confirmed existing factors that can facilitate screening for pregnancy risk

Evaluation of arthroscopy and macroscopic scoring

INTRODUCTION: Arthroscopy is a minimally invasive technique for retrieving synovial biopsies in rheumatology during the past 20 years. Vital for its use is continual evaluation of its safety and efficacy. Important for sampling is the fact of intraarticular variation for synovial markers. For microscopic measurements scoring systems have been developed and validated, but for macroscopic evaluations there is a need for further comprehensive description and validation of equivalent scoring systems. METHODS: We studied the complication rate and yield of arthroscopies performed at our clinic between 1998 and 2005. We also created and evaluated a macroscopic score set of instructions for synovitis. RESULTS: Of 408 procedures, we had two major and one minor complication; two haemarthrosis and one wound infection, respectively. Pain was most often not a problem, but 12 procedures had to be prematurely ended due to pain. Yield of biopsies adequate for histology were 83% over all, 94% for knee joints and 34% for smaller joints. Video printer photographs of synovium taken during arthroscopy were jointly and individually reviewed by seven raters in several settings, and intra and inter rater variation was calculated. A macroscopic synovial scoring system for arthroscopy was created (Macro-score), based upon hypertrophy, vascularity and global synovitis. These written instructions were evaluated by five control-raters, and when evaluated individual parameters were without greater intra or inter rater variability, indicating that the score is reliable and easy to use. CONCLUSIONS: In our hands rheumatologic arthroscopy is a safe method with very few complications. For knee joints it is a reliable method to retrieve representative tissue in clinical longitudinal studies. We also created an easy to use macroscopic score, that needs to be validated against other methodologies. We hope it will be of value in further developing international standards in this area

In Situ X-ray Absorption Spectroscopy of LaFeO₃ and LaFeO₃/LaNiO₃ Thin Films in the Electrocatalytic Oxygen Evolution Reaction

We study the electrocatalytic oxygen evolution reaction using in situ X-ray absorption spectroscopy (XAS) to track the dynamics of the valence state and the covalence of the metal ions of LaFeO3 and LaFeO3/LaNiO3 thin films. The active materials are 8 unit cells grown epitaxially on 100 nm conductive La0.67Sr0.33MnO3 layers using pulsed laser deposition (PLD). The perovskite layers are supported on monolayer Ca2Nb3O10 nanosheet-buffered 100 nm SiNx membranes. The in situ Fe and Ni K-edges XAS spectra were measured from the backside of the SiNx membrane using fluorescence yield detection under electrocatalytic reaction conditions. The XAS spectra show significant spectral changes, which indicate that (1) the metal (co)valencies increase, and (2) the number of 3d electrons remains constant with applied potential. We find that the whole 8 unit cells react to the potential changes, including the buried LaNiO3 film.</p

Association between individual level characteristics and take-up of a Minimum Income Guarantee for pensioners : panel data analysis using data from the British Household Panel survey 1999–2002

A Minimum Income Guarantee (MIG) ensures people have a minimum amount of income for essentials such as healthy food, housing, health care, social and digital networks to support health and well-being. MIGs could be a useful tool to reduce inequalities. A MIG will only be effective if those who are eligible take it up. The aim of this paper is to explore how individual characteristics were associated with take-up of a MIG for pensioners (aged 60+ for women and aged 65+ for men) in England. The data used is from the British Household Panel Survey including 9430 observations from 1893 people, from 1999 to 2002. We estimated a random effects logistic regression. Results show that women were less likely to claim than men (OR ranging from 0.17 [95% CI 0.10–0.29]-0.73 [95% CI 0.40–1.34]), and couples were less likely to claim (OR ranging from 0.04 [95% CI 0.03–0.06]-0.01 [95%CI 0.01–0.02]) than single person households. People with better mental health (OR 1.05 95% CI 1.02–1.08), older pensioners (75+) (OR ranging from 1.98 [95% CI 1.52–2.59]-2.81 [95%CI 2.16–3.67]), those who were registered disabled (OR 4.03 95% CI 2.50–6.52), and those with no formal qualification (OR ranging from 1.74 [95%CI 0.93–3.26]-2.07 [95% CI 1.22–3.51]) were more likely to claim. Understanding who is likely to claim MIGs is important to avoid social security policy inadvertently increasing inequalities

DNA methylation-based classification of central nervous system tumours.

Accurate pathological diagnosis is crucial for optimal management of patients with cancer. For the approximately 100 known tumour types of the central nervous system, standardization of the diagnostic process has been shown to be particularly challenging-with substantial inter-observer variability in the histopathological diagnosis of many tumour types. Here we present a comprehensive approach for the DNA methylation-based classification of central nervous system tumours across all entities and age groups, and demonstrate its application in a routine diagnostic setting. We show that the availability of this method may have a substantial impact on diagnostic precision compared to standard methods, resulting in a change of diagnosis in up to 12% of prospective cases. For broader accessibility, we have designed a free online classifier tool, the use of which does not require any additional onsite data processing. Our results provide a blueprint for the generation of machine-learning-based tumour classifiers across other cancer entities, with the potential to fundamentally transform tumour pathology

Ground water and climate change

As the world’s largest distributed store of fresh water, ground water plays a central part in sustaining ecosystems and enabling human adaptation to climate variability and change. The strategic importance of ground water for global water and food security will probably intensify under climate change as more frequent and intense climate extremes (droughts and floods) increase variability in precipitation, soil moisture and surface water. Here we critically review recent research assessing the impacts of climate on ground water through natural and human-induced processes as well as through groundwater-driven feedbacks on the climate system. Furthermore, we examine the possible opportunities and challenges of using and sustaining groundwater resources in climate adaptation strategies, and highlight the lack of groundwater observations, which, at present, limits our understanding of the dynamic relationship between ground water and climate

Alkylamine-Functionalized Carbon Supports to Enhance the Silver Nanoparticles Electrocatalytic Reduction of CO2 to CO

Silver electrocatalysts enable the conversion of CO2 to CO, thereby facilitating the transition to a carbon neutral society. To lower the cost of the expensive metal, silver nanostructures are often supported on carbon. This substrate offers great electrical conductivity, but it enhances the selectivity towards the competing hydrogen evolution reaction. In this work, carbon supports were functionalized with linear alkylamines of different chain lengths, to understand its effect on electrochemical performance. Alkylamines interact with the carbon surface and confer hydrophobic properties to the carbon support as well as making the local environment less acidic. These properties led not only to a suppression of the hydrogen evolution, but also to a remarkable enhancement in CO production. Despite the low silver weight loading (0.0016 mgAg cm−2), hexylamine-functionalized carbon-based catalysts achieved a CO to H2 ratio of 2.0, while the same material without the alkylamine functionalization only reached a ratio of 0.3, at −1.3 V vs RHE. This demonstrates the potential of hydrophobic functionalization for enhancing the CO selectivity of carbon-supported catalysts

Performance of the MALTA Telescope

MALTA is part of the Depleted Monolithic Active Pixel sensors designed in Tower 180nm CMOS imaging technology. A custom telescope with six MALTA planes has been developed for test beam campaigns at SPS, CERN, with the ability to host several devices under test. The telescope system has a dedicated custom readout, online monitoring integrated into DAQ with realtime hit map, time distribution and event hit multiplicity. It hosts a dedicated fully configurable trigger system enabling to trigger on coincidence between telescope planes and timing reference from a scintillator. The excellent time resolution performance allows for fast track reconstruction, due to the possibility to retain a low hit multiplicity per event which reduces the combinatorics. This paper reviews the architecture of the system and its performance during the 2021 and 2022 test beam campaign at the SPS North Area