Guardians of public interest: the expectation and experience of non-executive directors in National Health Service commissioning boards in England.

Purpose: The purpose of the study is to examine how Non-Executive Directors (NEDs) in the English National Health Service (NHS) commissioning bodies experienced their role and contribution to governance. Design/methodology/approach: Semi-structured interviews were conducted with a purposive sample of 31 NEDs of Primary Care Trusts (PCTs) and 8 Clinical Commissioning Group (CCG) NEDs. Framework analysis was applied using a conceptualisation of governance developed by Newman, which has four models of governance: the hierarchy, self-governance, open systems and rational goal model. Findings: NEDs saw themselves as guardians of the public interest. NEDs' power is a product of the explicit levers set out in the constitution of the board, but also how they choose to use their knowledge and expertise to influence decisions for, as they see it, the public good. They contribute to governance by holding to account executive and professional colleagues, acting largely within the rational goal model. CCG NEDs felt less powerful than in those in PCTs, operating largely in conformance and representational roles, even though government policy appears to be moving towards a more networked, open systems model. Originality/value: This is the first in-depth study of NEDs in English NHS local commissioning bodies. It is of value in helping to inform how the NED role could be enhanced to make a wider contribution to healthcare leadership as new systems are established in the UK and beyond

Preparedness for use of the rapid result HIV self-test by gay men and other men who have sex with men (MSM): a mixed methods exploratory study among MSM and those involved in HIV prevention and care

Objectives: The aim of the study was to explore preparedness for the HIV self-test among men who have sex with men (MSM) and those involved in HIV prevention and care. Methods: A mixed methods exploratory research design was employed, detailing awareness and willingness to use the self-test and the perceived barriers and facilitators to implementation. Quantitative and qualitative data collection and analysis were completed in parallel. Descriptive and inferential analysis of cross-sectional bar-based survey data collected from MSM through a self-completed questionnaire and oral fluid specimen collection (n = 999) was combined with qualitative, thematic, analysis of data collected through 12 expert focus groups (n = 55) consisting of gay men, National Health Service (NHS) staff, community organizations, entrepreneurs and activists. Findings were subsequently combined and assessed for synergies. Results: Among MSM, self-test awareness was moderate (55%). Greater awareness was associated with increased educational attainment [adjusted odds ratio 1.51; 95% confidence interval (CI) 1.00–2.30; P = 0.05] and previous history of sexually transmitted infection (STI) testing (adjusted odds ratio 1.63; 95% CI 1.11–2.39; P = 0.01). Willingness to use the test was high (89%) and associated with meeting sexual partners online (unadjusted odds ratio 1.96; 95% CI 1.31–2.94; P < 0.001). Experts highlighted the overall acceptability of self-testing; it was understood as convenient, discreet, accessible, and with a low burden to services. However, some ambivalence towards self-testing was reported; it could reduce opportunities to engage with wider services, wider health issues and the determinants of risk. Conclusions: Self-testing represents an opportunity to reduce barriers to HIV testing and enhance prevention and access to care. Levels of awareness are moderate but willingness to use is high. Self-testing may amplify health inequalities

An evolutionarily-unique heterodimeric voltage-gated cation channel found in aphids

We describe the identification in aphids of a unique heterodimeric voltage-gated sodium channel which has an atypical ion selectivity filter and, unusually for insect channels, is highly insensitive to tetrodotoxin. We demonstrate that this channel has most likely arisen by adaptation (gene fission or duplication) of an invertebrate ancestral mono(hetero)meric channel. This is the only identifiable voltage-gated sodium channel homologue in the aphid genome(s), and the channel’s novel selectivity filter motif (DENS instead of the usual DEKA found in other eukaryotes) may result in a loss of sodium selectivity, as indicated experimentally in mutagenised Drosophila channels

Using Total Worker Health® implementation guidelines to design an organizational intervention for low-wage food service workers : the Workplace Organizational Health Study

Total Worker Health® (TWH) interventions that utilize integrated approaches to advance worker safety, health, and well-being can be challenging to design and implement in practice. This may be especially true for the food service industry, characterized by high levels of injury and turnover. This paper illustrates how we used TWH Implementation Guidelines to develop and implement an organizational intervention to improve pain, injury, and well-being among low-wage food service workers. We used the Guidelines to develop the intervention in two main ways: first, we used the six key characteristics of an integrated approach (leadership commitment; participation; positive working conditions; collaborative strategies; adherence; data-driven change) to create the foundation of the intervention; second, we used the four stages to guide integrated intervention planning. For each stage (engaging collaborators; planning; implementing; evaluating for improvement), the Guidelines provided a flexible and iterative process to plan the intervention to improve safety and ergonomics, work intensity, and job enrichment. This paper provides a real-world example of how the Guidelines can be used to develop a complex TWH intervention for food service workers that is responsive to organizational context and addresses targeted working conditions. Application of the Guidelines is likely transferable to other industries

Unveiling the binding and orientation of the antimicrobial peptide Plantaricin 149 in zwitterionic and negatively charged membranes

Antimicrobial peptides are a large group of natural compounds which present promising properties for the pharmaceutical and food industries, such as broad-spectrum activity, potential for use as natural preservatives, and reduced propensity for development of bacterial resistance. Plantaricin 149 (Pln149), isolated from Lactobacillus plantarum NRIC 149, is a peptide with the ability to inhibit bacteria from the Listeria and Staphylococcus genera, which is capable of promoting inhibition and disruption of yeast cells. In this study, the interactions of Pln149 with model membranes composed of zwitterionic and/or anionic phospholipids were investigated using a range of biophysical techniques, including isothermal titration calorimetry, surface tension measurements, synchrotron radiation circular dichroism spectroscopy, oriented circular dichroism spectroscopy, and optical microscopy, in order to elucidate their mode of interactions and provide insight into their functional roles. In anionic model membranes, the binding of Pln149 to lipid bilayers is an endothermic process and induces a helical secondary structure in the peptide. The helices bind parallel to the surfaces of lipid bilayers and can promote vesicle disruption, depending on peptide concentration. Although Pln149 has relatively low affinity for zwitterionic liposomes, it is able to adsorb at their lipid interfaces, disturbing the lipid packing, assuming a similar parallel helix structure with a surface-bound orientation, and promoting an increase in the membrane surface area. Such findings can explain the intriguing inhibitory action of Pln149 in yeast cells whose cell membranes have a significant zwitterionic lipid composition

Klein tunneling in graphene: optics with massless electrons

This article provides a pedagogical review on Klein tunneling in graphene, i.e. the peculiar tunneling properties of two-dimensional massless Dirac electrons. We consider two simple situations in detail: a massless Dirac electron incident either on a potential step or on a potential barrier and use elementary quantum wave mechanics to obtain the transmission probability. We emphasize the connection to related phenomena in optics, such as the Snell-Descartes law of refraction, total internal reflection, Fabry-P\'erot resonances, negative refraction index materials (the so called meta-materials), etc. We also stress that Klein tunneling is not a genuine quantum tunneling effect as it does not necessarily involve passing through a classically forbidden region via evanescent waves. A crucial role in Klein tunneling is played by the conservation of (sublattice) pseudo-spin, which is discussed in detail. A major consequence is the absence of backscattering at normal incidence, of which we give a new shorten proof. The current experimental status is also thoroughly reviewed. The appendix contains the discussion of a one-dimensional toy model that clearly illustrates the difference in Klein tunneling between mono- and bi-layer graphene.Comment: short review article, 18 pages, 14 figures; v3: references added, several figures slightly modifie

Detailed electronic structure studies on superconducting MgB2_2 and related compounds

In order to understand the unexpected superconducting behavior of MgB$_2$ compound we have made electronic structure calculations for MgB$_2$ and closely related systems. Our calculated Debye temperature from the elastic properties indicate that the average phonon frequency is very large in MgB$_2$ compared with other superconducting intermetallics and the exceptionally high $T_c$ in this material can be explained through BCS mechanism only if phonon softening occurs or the phonon modes are highly anisotropic. We identified a doubly-degenerate quasi-two dimensional key-energy band in the vicinity of $E_{F}$ along $\Gamma$-A direction of BZ which play an important role in deciding the superconducting behavior of this material. Based on this result, we have searched for similar kinds of electronic feature in a series of isoelectronic compounds such as BeB$_2$, CaB$_2$, SrB$_2$, LiBC and MgB$_2$C$_2$ and found that MgB$_2$C$_2$ is one potential material from the superconductivity point of view. There are contradictory experimental results regarding the anisotropy in the elastic properties of MgB$_2$ ranging from isotropic, moderately anisotropic to highly anisotropic. In order to settle this issue we have calculated the single crystal elastic constants for MgB$_2$ by the accurate full-potential method and derived the directional dependent linear compressibility, Young's modulus, shear modulus and relevant elastic properties. We have observed large anisotropy in the elastic properties. Our calculated polarized optical dielectric tensor shows highly anisotropic behavior even though it possesses isotropic transport property. MgB$_2$ possesses a mixed bonding character and this has been verified from density of states, charge density and crystal orbital Hamiltonian population analyses

A large mid-Holocene estuary was not present in the lower River Murray, Australia

Recent research has suggested that during the mid-Holocene (c. 8500 to 5000 cal yr BP) a large estuary occupied the lower River Murray and its terminal lakes (Lakes Alexandrina and Albert: herein the Lower Lakes) in South Australia. This research has questioned both reconstructions of past River Murray discharge and contemporary environmental water provisions aimed at maintaining the freshwater state of the Lower Lakes. We show that (1) a large mid-Holocene estuary extending into the lower River Murray was not physically possible, and (2) that the River Murray and Lower Lakes were predominantly fresh during the mid-Holocene. Sea level was well below present at the time of purported initiation of estuarine sedimentation and, therefore, could not have allowed formation of an estuary. Holocene human occupation of the lower River Murray valley, that was reliant on freshwater resources, negates the existence of a large estuary in the valley. A variety of freshwater indicators in sediments from in, and around, the Lower Lakes negate the notion of significant marine incursion. Hence, current management of the Lower Lakes as freshwater ecosystems is consistent with their Holocene history.J. Tibby, B. Bourman, C. Wilson, L. M. Mosley, A. P. Belperio, D. D. Ryan ... et al

Massive stars as thermonuclear reactors and their explosions following core collapse

Nuclear reactions transform atomic nuclei inside stars. This is the process of stellar nucleosynthesis. The basic concepts of determining nuclear reaction rates inside stars are reviewed. How stars manage to burn their fuel so slowly most of the time are also considered. Stellar thermonuclear reactions involving protons in hydrostatic burning are discussed first. Then I discuss triple alpha reactions in the helium burning stage. Carbon and oxygen survive in red giant stars because of the nuclear structure of oxygen and neon. Further nuclear burning of carbon, neon, oxygen and silicon in quiescent conditions are discussed next. In the subsequent core-collapse phase, neutronization due to electron capture from the top of the Fermi sea in a degenerate core takes place. The expected signal of neutrinos from a nearby supernova is calculated. The supernova often explodes inside a dense circumstellar medium, which is established due to the progenitor star losing its outermost envelope in a stellar wind or mass transfer in a binary system. The nature of the circumstellar medium and the ejecta of the supernova and their dynamics are revealed by observations in the optical, IR, radio, and X-ray bands, and I discuss some of these observations and their interpretations.Comment: To be published in " Principles and Perspectives in Cosmochemistry" Lecture Notes on Kodai School on Synthesis of Elements in Stars; ed. by Aruna Goswami & Eswar Reddy, Springer Verlag, 2009. Contains 21 figure