Monkey’s Guide to Healthy Living and NHS Services An evaluation of the implementation of resources designed to support the learning of primary school aged children in England

A team of researchers from the Faculty of Education, Health and Community recently carried out a national evaluation project on behalf of the NHS Institute for Innovation and Improvement. Colleagues from across the faculty were involved in evaluating the impact of resources provided to every primary school in England. The resources were designed to enable teachers and health professionals to work together to help children learn about the NHS and the range of services they could access if they required acute of emergency care

The flux and provenance of dust delivered to the SW Pacific during the last glacial maximum

The funding for the TAN1106 voyage was from the Coasts and Oceans Physical Resources program awarded to the National Institute of Water and Atmospheric Research, New Zealand. This work was funded by NERC studentship NE/L002531/1 to R.S. and NERC grant NE/J021075/1 to G.L.F. R.G. and A.B. were supported by NERC grant NE/M004619/1 awarded to A.B.Atmospheric dust is a primary source of iron (Fe) to the open ocean, and its flux is particularly important in the high nutrient, low chlorophyll (HNLC) Southern Ocean where Fe currently limits productivity. Alleviation of this Fe limitation in the Subantarctic Zone of the Atlantic by increased dust-borne Fe supply during glacial periods has been shown to increase primary productivity. However, previous work has found no such increase in productivity in the Pacific sector. In order to constrain the relative importance of Southern Ocean Fe fertilization on glacial-interglacial carbon cycles, records of dust fluxes outside of the Atlantic sector of the Southern Ocean at the Last Glacial Maximum (LGM) are required. Here we use grain size and U-series analyses to reconstruct lithogenic and CaCO3 fluxes, and Nd, Sr and Pb isotopes to ascertain the provenance of terrigenous material delivered to four deep-water cores in the SW Pacific Ocean over the last ~30kyr. We find evidence for an increase in the relative proportion of fine-grained (0.5-12 ?m) terrigenous sediment and higher detrital fluxes during the LGM compared to the Holocene. The provenance of the LGM dust varied spatially, with an older, more "continental" signature (low εNd, high 87Sr/86Sr) sourced from Australia in the northern cores, and a younger, more volcanogenic source in the southern cores (high εNd, low 87Sr/86Sr), likely sourced locally from New Zealand. Given this increase in lithogenic flux to the HNLC subantarctic Pacific Southern Ocean during the LGM, factors besides Fe-supply must have regulated the biological productivity here.Publisher PDFPeer reviewe

How Do We Know Co-Created Solutions Work Effectively within the Real World of People Living with Dementia? Learning Methodological Lessons from a Co-Creation-to-Evaluation Case Study

Living Labs (LL) are a novel and potentially robust way of addressing real-life health challenges, especially within the dementia field. Generally, LLs focus on co-creating through implementing the quadruple helix partnership as a user-centric approach to co-creating. In the context of this paper, the users were people with dementia and their informal carers. LL are not necessarily environments that evaluate these co-created innovations within the real world. Considering this disconnect between co-creation and real-world evaluation, this paper, as a critical commentary, will reflect on the methodological lessons learnt during the development of an LL model aimed at addressing this discrepancy. The LL at Liverpool John Moores University (LJMU) was commissioned to co-create and then evaluate a new Dementia Reablement Service. The case study findings revealed that the Dementia Reablement Service had a positive impact on the quality of life of people with dementia, suggesting that the service is a catalyst for positive change. In addition, the critical learning from this case study highlights the potential role of LLs in seamlessly co-creating and then evaluating the co-created solution within the real world. A benefit of this way of working is that it provides opportunities for LLs to secure access to traditional research funding

ARITMETIČKA SREDINA I STANDARDNA DEVIJACIJA

Over the course of the Neogene, the Earth underwent profound climatic shifts from the sustained warmth of the middle Miocene to the development of Plio-Pleistocene glacial–interglacial cycles. Major perturbations in the global carbon cycle have occurred alongside these shifts, however the lack of long-term carbonate system reconstructions currently limits our understanding of the link between changes in CO2, carbon cycling, and climate over this time interval. Here we reconstruct continuous surface ocean pH, CO2, and surface ocean aragonite saturation state using boron isotopes from the planktonic foraminifer Trilobatus trilobus and we perform a sensitivity analysis of the key variables in our calculations (e.g. Bsw, [Ca]sw, CCD). We show that the choice of sw influences both seawater pH and CO2 while [Ca]sw reconstructed dissolved inorganic carbon exerts a significant influence only on CO2. Over the last 22 Myr, the lowest pH levels occurred in the Middle Miocene Climate Optimum (MMCO; 17–14 Myr ago) reaching units in all our scenarios. The extended warmth of the MMCO corresponds to mean CO2 and aragonite saturation state levels of 470–630 ppm and 2.7–3.5, respectively. Despite a general correspondence between our CO2 record and climate, all CO2 scenarios show a peak at ∼9 Ma not matched by corresponding changes in climate reconstructions. This may suggest decoupling (i.e. significant CO2 change without a discernible climate response) for a limited interval in the Late Miocene (11.6–8.5 Ma), although further refinement of our understanding of the temporal evolution of the boron isotopic composition of seawater is necessary to fully evaluate the nature of the relationship between CO2 and climate. Nonetheless, from our long-term view it is clear that low-latitude open ocean marine ecosystems are unlikely to have experienced sustained surface pH and saturation levels below 7.7 and 1.7, respectively, during the past 14 millio

Real-World Validation of Health Innovation: a systematic review

b. Aim of review Real-World Data (RWD) and Real-World Evidence (RWE) are playing an increasing role in health care decisions. Electronic health records, the use of computers, mobile devices, wearables and other biosensors to gather and store huge amounts of health-related data has been rapidly accelerating. This data holds the potential to allow us to better design and conduct studies in the health care setting. Furthermore, Randomized Controlled Trials (RCT), the gold standard in the context of clinical guidelines, are time and resource-intensive, lack of generalizability and typically restricted to evaluating specific interventions one at a time. RCTs are being challenged by health care providers since they are looking for (RWE) to validate innovative interventions. This systematic review and meta-analysis will assess the literature to establishing a clearer definition and terminology of Real World Validation (RWV) including a better understanding of the associated methods, determining in how and in which contexts RWV has been used. c. Search and review methodology A systematic search of Cochrane Library, PubMed, MedLine (EBSCO), Web-of-Science (BIOSIS Citation Index, BIOSIS Previews, KCI-Korean journal database, Russian Science Citation Index, SciELO Citation Index), SCOPUS, and grey literature was performed independently by two reviewers using predefined criteria. d. Findings (Findings must be included and be relevant to the aims and/or objectives.) 1,153 records were identified, 254 titles and abstracted were scanned after the duplicates removed, 62 studies met the selection criteria and were considered for full-text review. e. Conclusions and implication The data collected suggested that Real-world Validation (RWV) is a cost-effective, relevant and adaptable mix-method user-inclusive methodology to assess the impact and benefits to patients, staff and the health economy, in a non-controlled environment by using RWD and RWE, of an innovation that has already undergone a pilot process. RWV generates insight, foresight, and explorative findings to bring a product to the healthcare market and to ensure its significance in clinical practice, grasping up with the principles of health economics and outcome research, thereby exhibiting the value of real‑world insights in healthcare decisio

Models of “Real World” health research: A critical review

Background The increasing call for real world evidence has resulted in a diverse range of studies being conducted using the broad “real world” descriptor. We conducted a critical review of how researchers are incorporating the real world in their evaluation of health innovations. Our aim was to develop a framework to categorise existing research approaches and to establish a more precise lexicon for real world health research models. Methods Five electronic databases were searched in July 2021 (PubMed, MEDLINE, Web-of-Science databases, Cochrane library and SCOPUS) for primary research articles presenting validations, evaluations, evidence or data drawn from real world, pragmatic or realist studies for health related innovations. 1762 records were identified. Two authors independently screened papers by title and abstract (n = 291), followed by a full-text screening (n = 104). 33 included studies were critically reviewed to determine the nature of the “real world” elements used in each of the research studies. Results It was shown that whilst authors used a wide variety of terms to describe their studies, they could be grouped into three categories according to the aim of the study. Two of the categories, the pragmatic study and the proof of concept study were derived from current published definitions. We identify the need for a category that provides evidence on the population using an innovation, rather than as an evaluation of the innovation itself. Conclusions We propose a fourth category – real world validation – and explain why it should be reserved for evidence meeting very specific criteria

Childhood Brain Tumours: Associations With Parental Occupational Exposure to Solvents

Background: Parental occupational exposures have been associated with childhood brain tumours (CBT), but results are inconsistent. Few studies have studied CBT risk and parental solvent exposure, suggesting a possible association. We examined the association between CBT and parental occupational exposure to solvents in a case–control study.Methods: Parents of 306 cases and 950 controls completed detailed occupational histories. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for both maternal and paternal exposure to benzene, other aromatics, aliphatics and chlorinated solvents in key time periods relative to the birth of their child. Adjustments were made for matching variables (child’s age, sex and state of residence), best parental education and occupational exposure to diesel exhaust.Results: An increased risk of CBT was observed with maternal occupational exposures to chlorinated solvents (OR=8.59, 95% CI 0.94–78.9) any time before birth. Paternal exposure to solvents in the year before conception was associated with an increased CBT risk: OR=1.55 (95% CI 0.99–2.43). This increased risk appeared to be mainly attributable to exposure to aromatic solvents: OR=2.72 (95% CI 0.94–7.86) for benzene and OR=1.76 (95% CI 1.10–2.82) for other aromatics.Conclusions: Our results indicate that parental occupational exposures to solvents may be related to an increased risk of CBT

Ocean carbon storage across the middle Miocene: A new interpretation for the Monterey Event

The Miocene Climatic Optimum (MCO, 14–17 Ma) was ~3–4 °C warmer than present, similar to estimates for 2100. Coincident with the MCO is the Monterey positive carbon isotope (δ13C) excursion, with oceans more depleted in 12C relative to 13C than any time in the past 50 Myrs. The long-standing Monterey Hypothesis uses this excursion to invoke massive marine organic carbon burial and draw-down of atmospheric CO2 as a cause for the subsequent Miocene Climate Transition and Antarctic glaciation. However, this hypothesis cannot explain the multi-Myr lag between the δ13C excursion and global cooling. We use planktic foraminiferal B/Ca, δ11B, δ13C, and Mg/Ca to reconstruct surface ocean carbonate chemistry and temperature. We propose that the MCO was associated with elevated oceanic dissolved inorganic carbon caused by volcanic degassing, global warming, and sea-level rise. A key negative feedback of this warm climate was the organic carbon burial on drowned continental shelves

Meta-analysis reveals that pollinator functional diversity and abundance enhance crop pollination and yield

How insects promote crop pollination remains poorly understood in terms of the contribution of functional trait differences between species. We used meta-analyses to test for correlations between community abundance, species richness and functional trait metrics with oilseed rape yield, a globally important crop. While overall abundance is consistently important in predicting yield, functional divergence between species traits also showed a positive correlation. This result supports the complementarity hypothesis that pollination function is maintained by non-overlapping trait distributions. In artificially constructed communities (mesocosms), species richness is positively correlated with yield, although this effect is not seen under field conditions. As traits of the dominant species do not predict yield above that attributed to the effect of abundance alone, we find no evidence in support of the mass ratio hypothesis. Management practices increasing not just pollinator abundance, but also functional divergence, could benefit oilseed rape agriculture.This study was funded by the Natural Environment Research Council (NERC) under research programme NE/N018125/1 ASSIST–Achieving Sustainable Agricultural Systems www.assist.ceh.ac.uk. ASSIST is an initiative jointly supported by NERC and the Biotechnology and Biological Sciences Research Council (BBSRC). Additional funding for field studies was from the Wessex Biodiversity Ecosystem Services Sustainability (NE/J014680/1) project within the NERC BESS programme. Other data sets were generated from research funded by: (a) the Insect Pollinators Initiative programme funded by BBSRC, Defra, NERC, the Scottish Government and the Wellcome Trust, under the Living with Environmental Change Partnership; (b) Defra project BD5005: Provision of Ecosystem services in the ES scheme; and (c) Irish Government under the National Development Plan 2007–2013 administered by the Irish EPA