Beyond City Living: Remaking the Inner Suburbs

This paper explores the emerging regeneration strategies for inner suburban areas. Drawing on evidence from Liverpool, Manchester and Leeds, the authors argue that regeneration of these inner areas can do more than upgrade housing and environments for existing residents; they can become more attractive to a wider range of households as convenient, accessible locations for larger, more affordable housing than is available in the city centre or the more recent suburbs. But care will be needed to create appealing, safe, walkable places; to define and deliver an attractive ‘offer’ for new residents, and to avoid displacement and tensions with existing residents. Here is a potential site for one version of ‘sustainable communities’ in the early twenty-first century, if it is approached sensitively and intelligently.cities; housing; economic development; regeneration; city centre living

Beyond City Living: Remaking the Inner Suburbs

This paper explores the emerging regeneration strategies for inner suburban areas. Drawing on evidence from Liverpool, Manchester and Leeds, the authors argue that regeneration of these inner areas can do more than upgrade housing and environments for existing residents; they can become more attractive to a wider range of households as convenient, accessible locations for larger, more affordable housing than is available in the city centre or the more recent suburbs. But care will be needed to create appealing, safe, walkable places; to define and deliver an attractive ‘offer’ for new residents, and to avoid displacement and tensions with existing residents. Here is a potential site for one version of ‘sustainable communities’ in the early twenty-first century, if it is approached sensitively and intelligently

Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia

Acknowledgements We wish to dedicate this work to the memory of Christian Osmer, a dedicated, caring doctor who was committed to achieving the best care for his patients and their relatives. He saw his contribution to this project as a way of advancing best care for surgical patients. We are very grateful for his valuable input to this work and the pleasure we had in working with him. We are grateful to Karen Hovhanisyan (former Trials Search Co-ordinator, Cochrane Anaesthesia, Critical and Emergency Care Group (ACE)) for carrying out the electronic database searches and to Jane Cracknell (Managing Editor, ACE) for her support throughout the review process. We would also like to thank W Alastair Chambers and Manjeet Shehmar for clinical advice relating to judgements about general anaesthesia usage, and Yvonne Cooper and Louise Pike who retrieved documents and screened papers as research assistants in earlier stages of the review. We are grateful to the following colleagues who helped us with foreign language papers - either by screening papers or by providing translation: Stefano Carrubba, Chuan Gao, Chen Ji, Kate Rhie, Reza Roudsari and Alena Vasianovich. We would like to thank Andy Smith (content editor), Nathan Pace (statistical editor), Michael Donnelly, Allan Cyna and Michael Wang (peer reviewers), and Shunjie Chua (consumer referee) for their help and editorial advice during the preparation of this systematic review. We would also like to thank Andrew Smith (content editor), Nathan Pace (statistical editor), Michael Wang and Allan Cyna (peer reviewers), and Lynda Lane (Cochrane Consumer Network representative) for their help and editorial advice during the preparation of the protocol (Powell 2010). Sources of support Internal sources Manchester Centre for Health Psychology, University of Manchester, UK. An award of £2000 was received to support research assistant costs. External sources British Academy, UK. We received a small research grant of £7480 to support research assistant costs.Peer reviewedPublisher PD

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

CLG Housing Markets and Planning Analysis Expert Panel Densities and Consumer Choice

The expert panel related to housing markets and planning enhances the CLG evidence base and facilitates the receipt of independent commentary from leading experts on issues relevant to policy formulation. The views expressed in this paper are the views of the authors and do not necessarily represent CLG views or policies

Making space for culture(s) in Boomtown. Some alternative futures for development, ownership and participation in leeds city centre

This paper looks at what kinds of spaces are emerging for cultures in Leeds, a city dubbed 'boomtown', due to an strong external appearance of a prosperous city on the move. What we suggest is that, while there is commitment to broad definitions of 'culture' as a way of life, on the ground, culture often equates to promoting property development and attracting mobile investment. We ask what are the barriers to doing cultures differently, and offer practical alternatives, in terms of development, ownership and participation, that could make space for different ideas and practices of cultures in boomtown Leeds.Culture, Leeds, regeneration, alternatives, participation,

Teaching Primary Students to Design Viewer Perspective and Interactive Meaning in Their Animation Stories

Meaning-making is at the heart of all literate practices. Teaching students how to make meaning through creating multimodal texts is increasingly important as digital, screen-based technologies extend everyday communication practices beyond traditional print literacy to incorporate complex new semiotic knowledge. This case study, undertaken in an Australian primary school, examines the implementation of a pedagogy for teaching primary students how to design visual meaning in creating animation stories to gain more authorial control over their storytelling. Positioned within a critical gap between the potential afforded by new communication technologies, and the scarcity of empirical evidence for supporting teachers to plan and deliver quality instruction in teaching meaning-making in different modes, this research is both significant and timely. Informed by systemic functional semiotics (SFS), this study identifies a systematic theorised account of the semiotic content knowledge teachers need to teach students to effectively design interactive meaning and viewer perspective in visual storytelling, using still and moving image semiotic resources. This specialised 'content knowledge' of what to teach was combined with teacher 'pedagogic knowledge' of how to best teach this as 'pedagogical content knowledge' (PCK). Three iterative pedagogical interventions were undertaken with different iterations of upper primary classes in the school over eighteen months, with informed, explicit, and scaffolded instruction around students creating their own animation stories. Evaluation of each intervention was based on the impact on student learning of the semiotic design content taught, judged through analysis of animation stories and interviews from a small sample of student exemplars identified for each intervention (ten in total). Based on these findings, the PCK was evaluated and refined across each of the interventions. Evidence from this small case study suggests that explicitly teaching students to design interactive meaning and viewer perspective in their moving image stories can provide students with greater creative mastery over their storytelling. By the second intervention, students in the small sample examined were able to make informed and creative semiotic choices to achieve particular effects on their viewer, and to talk about why they made these design choices. In this emergent area of inquiry, the semiotic design knowledge developed through this case study contributes to the development of urgently needed pedagogic guidance for teaching primary school students how to make meaning in composing moving image texts