Liveable urban forms: planning, self-organisation, and a third way (Isobenefit urbanism)

Urban development combines the forces of dispersal and agglomeration, often facilitated by free market forces, and this results in different patterns and self-organised ways, with both positive and negative outputs. Globally, over 6 billion people will live in cities by 2050, and this would require at least an additional 1.2 million km2 land to be built on. This huge expansion of the urban population and area requires construction at scale that avoids current urban problems such as urban heat island effects, carbon emissions, pollution, congestion, urban sprawl and excessive hard surfacing, while maintaining the physical and mental quality of life. Two basic approaches would be to let market forces freely shape our new urban areas or to impose a strong planning framework. This paper introduces a third way, Isobenefit urbanism that takes advantage of the two basic approaches to urban development. Isobenefit urbanism is a relatively recent urban development approach to shaping urban form, through an examination of centralities and localisation by a code whose implementation results in Isobenefit cities where one can walk to reach the closest centrality (where theatres, restaurant, schools, offices, promenades, shops…are located) and the closest access to green land regardless where one lives, and regardless the size of the city

Liveable urban forms:planning, self-organisation, and a third way (Isobenefit urbanism)

Urban development combines the forces of dispersal and agglomeration, often facilitated by free market forces, and this results in different patterns and self-organised ways, with both positive and negative outputs. Globally, over 6 billion people will live in cities by 2050, and this would require at least an additional 1.2 million km2 land to be built on. This huge expansion of the urban population and area requires construction at scale that avoids current urban problems such as urban heat island effects, carbon emissions, pollution, congestion, urban sprawl and excessive hard surfacing, while maintaining the physical and mental quality of life. Two basic approaches would be to let market forces freely shape our new urban areas or to impose a strong planning framework. This paper introduces a third way, Isobenefit urbanism that takes advantage of the two basic approaches to urban development. Isobenefit urbanism is a relatively recent urban development approach to shaping urban form, through an examination of centralities and localisation by a code whose implementation results in Isobenefit cities where one can walk to reach the closest centrality (where theatres, restaurant, schools, offices, promenades, shops…are located) and the closest access to green land regardless where one lives, and regardless the size of the city

‘Synthetic cannabis’: A dangerous misnomer

The term 'synthetic cannabis' has been widely used in public discourse to refer to a group of cannabinoid receptor agonists. In this paper we detail the characteristics of these drugs, and present the case that the term is a misnomer. We describe the pharmacodynamics of these drugs, their epidemiology, mechanisms of action, physiological effects and how these differ substantially from delta-9-tetrahydrocannabinol (THC). We argue that not only is the term a misnomer, but it is one with negative clinical and public health implications. Rather, the substances referred to as 'synthetic cannabis' in public discourse should instead be referred to consistently as synthetic cannabinoid receptor agonists (SCRAs), a drug class distinct from plant-derived cannabinoids. SCRAs have greater potency and efficacy, and psychostimulant-like properties. While such terminology may be used in the scientific community, it is not widely used amongst the media, general public, people who use these drugs or may potentially do so. A new terminology has the potential to reduce the confusion and harms that result from the misnomer ‘synthetic cannabis’. The constant evolution of this distinct drug class necessitates a range of distinct policy responses relating to terminology, harm reduction, epidemiology, treatment, and legal status

Supporting Worth Mapping with Sentence Completion

Expectations for design and evaluation approaches are set by the development practices within which they are used. Worth Centred Development (WCD) seeks to both shape and fit such practices. We report a study that combined two WCD approaches. Sentence completion gathered credible quantitative data on user values, which were used to identify relevant values and aversions of two player groups for an online gambling site. These values provided human value elements for a complementary WCD approach of worth mapping. Initial worth maps were extended in three workshops, which focused on outcomes and user experiences that could be better addressed in the current product and associated marketing materials. We describe how worth maps were prepared for, and presented in, workshops, and how product owners and associated business roles evaluated the combination of WCD approaches. Based on our experiences, we offer practical advice on this combinination

Derivation and validation of a novel risk score to predict need for haemostatic intervention in acute upper gastrointestinal bleeding (London Haemostat Score)

Background: Acute Upper Gastrointestinal Bleeding (AUGIB) is a common medical emergency which takes up considerable healthcare resources. However, only approximately 20-30% of bleeds require urgent haemostatic intervention. Current standard of care is for all patients admitted to hospital to undergo endoscopy within 24 hours for risk stratification, but this is difficult to achieve in practice, invasive and costly. Aim To develop a novel non-endoscopic risk stratification tool for AUGIB to predict the need for haemostatic intervention by endoscopic, radiological or surgical treatments. We compared this with the Glasgow-Blatchford Score (GBS). Design: Model development was carried out using a derivation (n=466) and prospectively collected validation cohort (n=404) of patients who were admitted with AUGIB to three large hospitals in London, UK (2015-2020). Univariable and multivariable logistic regression analysis was used to identify variables that were associated with increased or decreased chances of requiring haemostatic intervention. This model was converted into a risk scoring system, the London Haemostat Score (LHS). Results: The LHS was more accurate at predicting need for haemostatic intervention than the GBS, in the derivation cohort (Area Under the Receiver Operating Curve [AUROC] 0.82; 95% Confidence Interval (CI), 0.78-0.86 vs 0.72; 95% CI, 0.67-0.77; p<0.001) and validation cohort (AUROC 0.80; 95% CI, 0.75-0.85 vs 0.72; 95% CI, 0.67-0.78; p<0.001). At cut-off scores at which LHS and GBS identified patients who required haemostatic intervention with 98% sensitivity, the specificity of the LHS was 41% vs 18% with the GBS (p<0.001). This could translate to 32% of inpatient endoscopies for AUGIB being avoided at a cost of only a 0.5% false negative rate. Conclusions: The London Haemostat score is accurate at predicting the need for haemostatic intervention in AUGIB and could be used identify a proportion of low-risk patients who can undergo delayed or outpatient endoscopy. Validation in other geographical settings is required before routine clinical use

Inequality, poverty and the privatization of essential services: A "systems of provision" study of water, energy and local buses in the UK

This paper is concerned with the distributional effects of the deregulation and privatization of essential services in Britain since the 1980s, based on a cross-sector study of water, energy and local bus transport. Our approach locates end users within the structures and processes, and prevailing narratives that underpin both production and consumption. This framework highlights the ways that the provisioning of these vital services is contested, contradictory and underpinned by power relations. We show that, at one end, investors in these sectors have made generous returns on their investments but their methods of profit maximization are often not in the public interest. Meanwhile these profits are financed by end users’ payments of bills and fares. Many lower-income households face challenges in terms of affording, and even accessing, these essential services. Regulation has failed to provide adequate social protection. We argue that adverse social outcomes emerge from systemic factors embedded in these modes of provision. A narrative of politically-neutral, technocratic solutions belies the underlying contested nature of privatized monopolistic shared essential services. Moreover, a policy preoccupation with markets and competition obscures the inequality embedded in the underlying structures and processes and undermines more collective and equitable forms of provisioning

Comparative evaluation of three TSPO PET radiotracers in a LPS-induced model of mild neuroinflammation in rats.

PURPOSE: Over the past 20 years, neuroinflammation (NI) has increasingly been recognised as having an important role in  many neurodegenerative diseases, including Alzheimer's disease. As such, being able to image NI non-invasively in patients is critical to monitor pathological processes and potential therapies targeting neuroinflammation. The translocator protein (TSPO) has proven a reliable NI biomarker for positron emission tomography (PET) imaging. However, if TSPO imaging in acute conditions such as stroke provides strong and reliable signals, TSPO imaging in neurodegenerative diseases has proven more challenging. Here, we report results comparing the recently developed TSPO tracers [(18)F]GE-180 and [(18)F]DPA-714 with (R)-[(11)C]PK11195 in a rodent model of subtle focal inflammation. PROCEDURES: Adult male Wistar rats were stereotactically injected with 1 μg lipopolysaccharide in the right striatum. Three days later, animals underwent a 60-min PET scan with (R)-[(11)C]PK11195 and [(18)F]GE-180 (n = 6) or [(18)F]DPA-714 (n = 6). Ten animals were scanned with either [(18)F]GE-180 (n = 5) or [(18)F]DPA-714 (n = 5) only. Kinetic analysis of PET data was performed using the simplified reference tissue model (SRTM) with a contralateral reference region or a novel data-driven input to estimate binding potential BPND. Autoradiography and immunohistochemistry were performed to confirm in vivo results. RESULTS: At 40-60 min post-injection, [(18)F]GE-180 dual-scanned animals showed a significantly increased core/contralateral uptake ratio vs. the same animals scanned with (R)-[(11)C]PK11195 (3.41 ± 1.09 vs. 2.43 ± 0.39, p = 0.03); [(18)]DPA-714 did not (2.80 ± 0.69 vs. 2.26 ± 0.41). Kinetic modelling with a contralateral reference region identified significantly higher binding potential (BPND) in the core of the LPS injection site with [(18)F]GE-180 but not with [(18)F]DPA-714 vs. (R)-[(11)C]PK11195. A cerebellar reference region and novel data-driven input to the SRTM were unable to distinguish differences in tracer BPND. CONCLUSIONS: Second-generation TSPO-PET tracers are able to accurately detect mild-level NI. In this model, [(18)F]GE-180 shows a higher core/contralateral ratio and BPND when compared to (R)-[(11)C]PK11195, while [(18)F]DPA-714 did not

Amplified ambivalence: having a sibling with juvenile idiopathic arthritis

Despite increased awareness of family responses to chronic illness and disability, there is still a need to understand experiences of well siblings. We begin to address this by asking “What is it like to have a sibling with juvenile idiopathic arthritis?” (JIA).Eight families with an adolescent diagnosed with JIA participated. Four members of each family, including one healthy sibling, were interviewed and transcripts analyzed using grounded theory. Analysis suggests healthy siblings see their family as different to ‘normal’ families, forfeit time with peers, share vicariously adverse experiences of their ill sibling, and feel inadequately informed. Such experiences amplify the ambivalent nature of sibling relationships and are possibly felt most strongly during late childhood and early adolescence. Support from extended family can reduce these negative experiences and facilitate social and emotional adjustment which also occurs over time as the children mature. These findings have implications for healthcare professionals and voluntary organizations

Absence of Staphylococcus aureus in wild populations of fish supports a spillover hypothesis

Staphylococcus aureus is a human commensal and opportunistic pathogen that also infects other animals. In humans and livestock, where S. aureus is most studied, strains are specialized for different host species. Recent studies have also found S. aureus in diverse wild animals. However, it remains unclear whether these isolates are also specialized for their hosts or whether their presence is due to repeated spillovers from source populations. This study focuses on S. aureus in fish, testing the spillover hypothesis in two ways. First, we examined 12 S. aureus isolates obtained from the internal and external organs of a farmed fish. While all isolates were from clonal complex 45, genomic diversity indicates repeated acquisition. The presence of a φSa3 prophage containing human immune evasion genes suggests that the source was originally human. Second, we tested for S. aureus in wild fish that were isolated from likely sources. In particular, we sampled 123 brown trout and their environment at 16 sites in the remote Scottish Highlands with variable levels of exposure to humans, birds, and livestock. This screen found no S. aureus infection in any of the wild populations or their environment. Together, these results support that the presence of S. aureus in fish and aquaculture is due to spillover from humans rather than specialization. Given the trends of increasing fish consumption, a better understanding of the dynamics of S. aureus spillover in aquaculture will mitigate future risks to fish and human health

Recognition without identification, erroneous familiarity, and déjà vu

Déjà vu is characterized by the recognition of a situation concurrent with the awareness that this recognition is inappropriate. Although forms of déjà vu resolve in favor of the inappropriate recognition and therefore have behavioral consequences, typical déjà vu experiences resolve in favor of the awareness that the sensation of recognition is inappropriate. The resultant lack of behavioral modification associated with typical déjà vu means that clinicians and experimenters rely heavily on self-report when observing the experience. In this review, we focus on recent déjà vu research. We consider issues facing neuropsychological, neuroscientific, and cognitive experimental frameworks attempting to explore and experimentally generate the experience. In doing this, we suggest the need for more experimentation and amore cautious interpretation of research findings, particularly as many techniques being used to explore déjà vu are in the early stages of development.PostprintPeer reviewe