Dyes as guests in ordered systems: current understanding and future directions

The optical properties of dyes dissolved in liquid crystals have led to their proposed use in a diverse range of practical applications. Such guest–host systems are typically required to fulfil a range of criteria relating to their absorption properties, degree of alignment and stability, but concurrently satisfying these requirements has proven a barrier to their widespread use. In this article, many of the proposed applications and their requirements are discussed, and an outline of some of the most prevalent classes of dye proposed in the context of guest–host systems is given, along with a summary of recent reports of dyes that exhibit thermotropic mesophases. Theoretical approaches to describing the alignment within guest–host systems are outlined, and possible strategies for the future rational design of guest–host systems are discussed

Sustainability and the common good: Catholic Social Teaching and ‘Integral Ecology’ as contributions to a framework of social values for sustainability transitions

It is widely acknowledged that the large-scale and long-term transitions needed to mitigate climate change and to implement policies for sustainable development within planetary boundaries require significant shifts in values and behaviours. Consequently, there is increasing interest in the processes through which major societal transitions for sustainability can occur through peaceful cooperation and widespread embrace of pro-environmental values, and the values associated with the broad concept of sustainability such as care for the interests of future generations and concern for the poor. This encompasses the search for compelling narratives to frame the process and goals of change and the need for the fostering of virtues and ethical frameworks of identity and practice that can underpin advocacy and change for sustainability. This requires drawing on richer sources of values and ethics. We suggest that important resources can be found in religious, as well as secular traditions of social values and ethical analysis. While major religions have begun to reflect environmental concerns and sustainability goals in their theology and praxis, with immense potential and actual influence over value and behaviours, little research has explored the impacts and implications of this development; nor indeed, the intellectual stimulus and social capabilities they can offer to secular thinkers and practitioners in sustainable development. In particular, we argue that there is a need to consider the affinities between secular sustainability frameworks for ethics and policy and the concepts of Catholic Social Teaching (CST) on the Common Good, recently updated by Pope Francis to integrate ecological concern and a call for universal ‘ecological conversion’ and cooperation. We outline the key features of CST and the Pope’s new ‘Integral Ecology’ framework and identify affinities, in particular, with Elinor Ostrom’s system of design principles for sustainable management of commons. We conclude with suggestions for research to investigate the interrelationships of the Integral Ecology reframing of CST with initiatives for transformational change in values and practices for sustainability

Impact of meningitis on intelligence and development: A systematic review and meta-analysis

BACKGROUND: We undertook a systematic review and meta-analysis to address the question "what is the impact of meningitis on IQ and development." METHODS: Search: conducted using standardized search terms across Medline, PsychInfo and EMBASE to 06/2014. Eligibility: human studies of any infectious aetiology of meningitis reporting IQ or infant developmental age or stage outcomes. Quality: Centre for Evidence Based Medicine, Oxford, quality tools. Analysis: random effects meta-analysis by organism. RESULTS: 39 studies were included in the review, 34 providing data on IQ (2015 subjects) and 12 on developmental delay (382 subjects). Across all bacterial organisms, meningitis survivors had a mean IQ 5.50 (95% CI: -7.19, -3.80; I2 = 47%, p = 0.02) points lower than controls. IQ was significantly lower than controls for Neisseria meningitides (NM: 5 points) and Haemophilus influenzae b (Hib: 6 points) but not in viral meningitis, with only single studies included for Streptococcus pneumoniae (SP) and group B streptococcus (GBS). The pooled relative risk (RR) for low IQ (IQ<70) in survivors of bacterial meningitis compared with controls was 4.99 (95% CI: 3.17, 7.86) with no significant heterogeneity (I2 = 49%, p = 0.07). Developmental delay of approximately 0.5SD was reported in studies of bacterial meningitis but no delay in the only study of viral meningitis. CONCLUSIONS: We found moderate evidence that surviving bacterial meningitis has a deleterious impact on IQ and development but no evidence that viral meningitis had meaningful cognitive impacts. Survivors of bacterial meningitis should be routinely offered screening for cognitive deficits and developmental delay in addition to hearing loss

Student evaluation of an OSCE in paediatrics at the University of the West Indies, Jamaica

BACKGROUND: The Faculty of Medical Sciences, University of the West Indies first implemented the Objective Structured Clinical Examination (OSCE) in the final MB Examination in Medicine and Therapeutics during the 2000–2001 academic year. Simultaneously, the Child Health Department initiated faculty and student training, and instituted the OSCE as an assessment instrument during the Child Health (Paediatric) clerkship in year 5. The study set out to explore student acceptance of the OSCE as part of an evaluation of the Child Health clerkship. METHODS: A self-administered questionnaire was completed by successive groups of students immediately after the OSCE at the end of each clerkship rotation. Main outcome measures were student perception of examination attributes, which included the quality of instructions and organisation, the quality of performance, authenticity and transparency of the process, and usefulness of the OSCE as an assessment instrument compared to other formats. RESULTS: There was overwhelming acceptance of the OSCE in Child Health with respect to the comprehensiveness (90%), transparency (87%), fairness (70%) and authenticity of the required tasks (58–78%). However, students felt that it was a strong anxiety-producing experience. And concerns were expressed regarding the ambiguity of some questions and inadequacy of time for expected tasks. CONCLUSION: Student feedback was invaluable in influencing faculty teaching, curriculum direction and appreciation of student opinion. Further psychometric evaluation will strengthen the development of the OSCE

Health-related quality of life associated with bullying and aggression: a cross-sectional study in English secondary schools.

Associations between adolescent health-related quality of life (HRQoL), bullying, and aggression are not well understood. We used baseline data from a large-cluster randomized school trial to study the relationship between HRQoL, bullying experience, and other demographic factors. Cross-sectional self-reported questionnaires collected pre-randomization from the on-going INCLUSIVE trial. The questionnaires were completed in the classroom. The Gatehouse Bullying Scale measured bullying victimization and the Edinburgh Study of Youth Transitions and Crime school misbehavior subscale (ESYTC) measured aggressive behaviors. HRQoL was assessed using the Child Health Utility 9 Dimensions (CHU-9D) and general quality of life using the Pediatric Quality of Life Inventory (PedsQL). Participants were a cohort of year 7 students (age 11-12 years) from 40 state secondary schools in England. Descriptive statistics for the CHU-9D and PedsQL were calculated using standard methods with tests for differences in median scores by sex assessed using quantile regression. Correlation between HRQoL measures was conducted using Spearman's rank correlation coefficients. Predictors of HRQoL were identified using univariate and multiple regressions. A total of 6667 students filled out the questionnaire. The CHU-9D was correlated with the PedsQL (0.63, p &lt; 0.001). The multivariable regression results suggest that if students were bullied frequently and upset it resulted in a decrement in CHU-9D scores of (-0.108) and fall in PedsQL score of (-16.2). The impact of the antisocial/aggressive behavior on the ESYTC scale resulted in a utility decrement of -0.004 and fall of -.5 on the PedsQL. Adolescents' involvement in bullying and aggression is a strong correlate of HRQoL. These data have important implications for the potential cost-effectiveness of reducing bullying and aggression in schools

Cost-effectiveness of a community-delivered multicomponent intervention compared with enhanced standard care of obese adolescents: cost-utility analysis alongside a randomised controlled trial (the HELP trial)

OBJECTIVE: To undertake a cost-utility analysis of a motivational multicomponent lifestyle-modification intervention in a community setting (the Healthy Eating Lifestyle Programme (HELP)) compared with enhanced standard care. DESIGN: Cost-utility analysis alongside a randomised controlled trial. SETTING: Community settings in Greater London, England. PARTICIPANTS: 174 young people with obesity aged 12-19 years. INTERVENTIONS: Intervention participants received 12 one-to-one sessions across 6 months, addressing lifestyle behaviours and focusing on motivation to change and self-esteem rather than weight change, delivered by trained graduate health workers in community settings. Control participants received a single 1-hour one-to-one nurse-delivered session providing didactic weight-management advice. MAIN OUTCOME MEASURES: Mean costs and quality-adjusted life years (QALYs) per participant over a 1-year period using resource use data and utility values collected during the trial. Incremental cost-effectiveness ratio (ICER) was calculated and non-parametric bootstrapping was conducted to generate a cost-effectiveness acceptability curve (CEAC). RESULTS: Mean intervention costs per participant were £918 for HELP and £68 for enhanced standard care. There were no significant differences between the two groups in mean resource use per participant for any type of healthcare contact. Adjusted costs were significantly higher in the intervention group (mean incremental costs for HELP vs enhanced standard care £1003 (95% CI £837 to £1168)). There were no differences in adjusted QALYs between groups (mean QALYs gained 0.008 (95% CI -0.031 to 0.046)). The ICER of the HELP versus enhanced standard care was £120 630 per QALY gained. The CEAC shows that the probability that HELP was cost-effective relative to the enhanced standard care was 0.002 or 0.046, at a threshold of £20 000 or £30 000 per QALY gained. CONCLUSIONS: We did not find evidence that HELP was more effective than a single educational session in improving quality of life in a sample of adolescents with obesity. HELP was associated with higher costs, mainly due to the extra costs of delivering the intervention and therefore is not cost-effective. TRIAL REGISTRATION NUMBER: ISRCTN9984011

Tailoring the Surface Chemistry of PEDOT:PSS to Promote Supported Lipid Bilayer Formation

This communication reports on a versatile and substrate-agnostic method to tune the surface chemistry of conducting polymers with the aim of bridging the chemical mismatch between bioelectronic devices and biological systems. As a proof of concept, the surface of poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) is grafted with a short-chain oligoethylene glycol monolayer to favor the formation of cell-derived supported lipid bilayers (SLBs). This method is tuned to optimize the affinity between the supported lipid bilayer and the conducting polymer, leading to significant improvements in bilayer quality and therefore electronic readouts. To validate the impact of surface functionalization on the system's ability to transduce biological phenomena into quantifiable electronic signals, the activity of a virus commonly used as a surrogate for SARS-CoV-2 (mouse hepatitis virus) is monitored with and without surface treatment. The functionalized devices exhibit significant improvements in electronic output, stemming from the improved SLB quality, therefore strengthening the case for the use of such an approach in membrane-on-a-chip systems

Valuing beyond economics : a pluralistic evaluation framework for participatory policymaking

The sustainability challenges facing societies call for policies and governance systems that are attuned to the diversity of goods that support and enrich human life via ecological, technical and other kinds of systems, and to the plurality of values that people hold across diverse cultures and belief systems. A pluralistic evaluation framework (PEF) is here presented as a tool for considering diverse kinds of goodness as perceived by diverse stakeholders in the design and evaluation of policies or projects. It arises from considering a suite of aspects of meaning (biotic, economic, aesthetic, etc.) at each of three stages, namely: identifying relevant stakeholders, mapping real-world systems and assessing modes of valuing. This framework, drawing on the philosophical work of Herman Dooyeweerd and Dirk Vollenhoven, offers a joined-up, participatory approach to policymaking. We report pilot trials of the PEF with groups of policymakers at a series of workshops, demonstrating that it provides additional perspectives and unification of core issues and can be used in a wide range of areas of policymaking and project assessment. We also illustrate its potential application to a controversial environmental project and outline how a pluralistic evaluation framework can be used in tandem with existing frameworks

Objectively measured physical activity and sedentary behaviour in obese adolescents, and their relationship with fatness and metabolic outcomes

PURPOSE: To describe the physical activity (PA) and sedentary behaviour (SB) levels of obese adolescents (12-19 year-olds), and investigate the association of SB and moderate-to-vigorous PA (MVPA) with fatness and metabolic outcomes. METHODS: Baseline measurements were obtained from 102 obese (body mass index (BMI)>95th centile UK1990 reference) adolescents participating in a multicomponent obesity treatment trial- the Healthy Eating and Lifestyle Programme. PA/SB were measured with ActiGraph accelerometers (15-second epochs), time spent in SB, PA and MVPA was derived using Evenson et al’s (2007) cut-points, and participants were included for analyses if providing ≥3 valid days (≥10hours wear-time). Total, low- and high density lipoprotein cholesterol, triglycerides, insulin and glucose were obtained from fasting blood samples. Height, weight and waist circumference were measured by trained staff, fat mass (FM) and fat-free mass (FFM) were determined from bio-impedance analyses, and BMI and FM Index (FM/height2) were derived. Sex differences were assessed with chi-square or Mann-Whitney U tests, and associations of MVPA and SB with fatness and metabolic outcomes were assessed with univariable and multivariable linear regression. RESULTS: Adolescents spent a median of 4.5 hours/day in PA (including 38.5 min/day MVPA) and 12.7 hours/day in SB, with 86% spending over two thirds of their day in SB. Boys spent more time in MVPA than girls (median: 48.6min versus 35.9min; p=0.004), and were more likely to meet guidelines of ≥60 min/day in MVPA (24.3% versus 9.2%; p=0.04). Univariable regressions showed significant associations of MVPA with FM Index (B= -0.05), FM (B= -0.11) and FFM (B=0.14), and SB with Insulin (B=-0.02; all p<0.05). After including MVPA and SB in the same model and adjusting for age, sex, and wear-time, only MVPA remained significantly associated with FM Index (B= -0.05; p=0.04) and FFM (B= 0.13; p=0.008). CONCLUSIONS: Most adolescents did not meet current UK PA guidelines, and spent a worryingly high proportion of their day in SB. Although causality cannot be inferred, results highlight theimportance of promoting MVPA to improve the body composition profiles of obese adolescents

Adolescent experiences of anti-obesity drugs

Only two anti-obesity drugs (AODs) are frequently prescribed in paediatric obesity, orlistat and metformin. Meta-analyses show modest benefit in clinical trials, yet analyses of prescribing databases show high levels of discontinuation in routine clinical practice. Increased understanding of young people's experiences taking AOD could result in improved prescribing and outcomes. Semi-structured interviews were conducted with young people aged 13-18 years and their parents from three specialist obesity clinics, analysed using a general thematic coding methodology. Theme saturation was achieved after interviews with 15 young people and 14 parents (13 parent-child dyads). Three models were developed. Model 1 explored factors influencing commencement of AOD. Six themes emerged: medication as a way out of obesity, enthusiasm and relief at the prospect of pharmaceutical treatment, last ditch attempt for some but not all, passive acceptance of medication, fear as a motivating factor, and unique treatments needed for unique individuals. Model 2 described the inter-relationship between dosing and side effects; side effects were a significant experience for many young people, and few adhered to prescribed regimens, independently changing lifestyle and dosage to tolerate medications. Model 3 described the patient-led decision process regarding drug continuation, influenced primarily by side effects and efficacy. Use of AODs is challenging for many adolescents. Multiple factors were identified that could be targeted to improve concordance and maximize efficacy