The labels and models used to describe problematic substance use impact discrete elements of stigma: A Registered Report

Objectives: Problematic substance use is one of the most stigmatised health conditions leading research to examine how the labels and models used to describe it influence public stigma. Two recent studies examine whether beliefs in a disease model of addiction influence public stigma but result in equivocal findings – in line with the mixed-blessings model, Kelly et al. (2021) found that whilst the label ‘chronically relapsing brain disease’ reduced blame attribution, it decreased prognostic optimism and increased perceived danger and need for continued care; however, Rundle et al. (2021) conclude absence of evidence. This study isolates the different factors used in these two studies to assess whether health condition (drug use vs. health concern), aetiological label (brain disease vs. problem), and attributional judgement (low vs. high treatment stability) influence public stigma towards problematic substance use. Methods: 1613 participants were assigned randomly to one of eight vignette conditions that manipulated these factors. They completed self-report measures of discrete and general public stigma and an indirect measure of discrimination. Results: Greater social distance, danger, and public stigma but lower blame were ascribed to drug use relative to a health concern. Greater (genetic) blame was reported when drug use was labelled as a ‘chronically relapsing brain disease’ relative to a ‘problem’. Findings for attributional judgement were either inconclusive or statistically equivalent. Discussion: The labels used to describe problematic substance use appear to impact discrete elements of stigma. We suggest that addiction is a functional attribution, which may explain the mixed literature on the impact of aetiological labels on stigma to date

The labels and models used to describe problematic substance use impact discrete elements of stigma: A registered report.

Objectives: Problematic substance use is one of the most stigmatized health conditions leading research to examine how the labels and models used to describe it influence public stigma. Two recent studies examine whether beliefs in a disease model of addiction influence public stigma but result in equivocal findings — in line with the mixed-blessings model, Kelly et al. (2021) found that while the label “chronically relapsing brain disease” reduced blame attribution, it decreased prognostic optimism and increased perceived danger and need for continued care; however,Rundle et al. (2021) conclude absence of evidence. This study isolates the different factors used in these two studies to assess whether health condition (drug use vs. health concern), etiological label (brain disease vs. problem), and attributional judgment (low vs. high treatment stability) influence public stigma toward problematic substance use. Method: Overall, 1,613 participants were assigned randomly to one of the eight vignette conditions that manipulated these factors. They completed self-report measures of discrete and general public stigma and an indirect measure of discrimination. Results: Greater social distance, danger, and public stigma but lower blame were ascribed to drug use relative to a health concern. Greater (genetic) blame was reported when drug use was labeled as a“chronically relapsing brain disease” relative to a “problem”. Findings for attributional judgment were either inconclusive or statistically equivalent. Discussion: The labels used to describe problematic substance use appear to impact discrete elements of stigma. We suggest that addiction is a functional attribution, which may explain the mixed literature on the impact of etiological labels on stigma to date

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Lasing from dye-doped icosahedral quasicrystals in dichromate gelatin emulsions

Lasing requires an active gain medium and a feedback mechanism. In conventional lasers the feedback is provided externally, e. g. by mirrors. An alternate approach is through Bloch waves in photonic crystals composed of periodic dielectric materials in which propagation of light in certain frequency ranges, known as photonic bandgaps, is forbidden. Compared to periodic crystals, quasicrystals have higher symmetry and are more favorable for the formation of photonic bandgaps. Hence quasicrystals are more efficient in providing the feedback mechanism for lasing. Here we report observation of lasing at visible wavelengths from dye-doped three-dimensional icosahedral quasicrystals fabricated in dichromate gelatin emulsions using a novel seven-beam optical interference holographic method. Multi-directional lasing exhibiting the icosahedral symmetry was observed. The lasing modes and pattern were explained by using the lasing condition expressed in the reciprocal lattice space of the icosahedral quasicrystal. (C) 2009 Optical Society of Americ

Effect of Different Calcination Duration on Physicochemical Properties of Vanadium Phosphate Catalysts

Vanadium phosphate catalysts have been prepared by calcining VOHPO44·0.5H2O which were prepared via two methods i.e. organic (VPO method) and dihydrate (VPD method) routes for different duration under anaerobic atmosphere. Increasing the calcinations duration led to a decrease in total surface area. It is also promote the formation of V5+ phase in the catalysts. Scanning electron microscopy clearly revealed that the morphologies of all catalysts composed of plate-like crystallites that were arranged into the characteristic of rosette cluster. However, by increasing the pretreatment duration in an inert environment, the rosette-shape of the clusters which normally obtained in reaction condition was collapsed. Prolong the duration of N2 calcination also resulted in an increment in the amount of oxygen desorbed (from O2-TPD) and removed (obtained from H2-TPR)

Lasing from Dye-doped Photonic Crystals with Graded Layers in Dichromate Gelatin Emulsions

We report on optically pumped lasing from dye-doped, graded-spacing layer structures of dichromate gelatin emulsions fabricated using two-beam holographic interference. The graded layers exhibited deep and wide photonic band gaps. Multimode lasing with both a low threshold and a high quality factor was observed at the band edge of the photonic band gap. We modeled the emissions from the dye-doped graded layer system using a finite difference time domain technique and achieved good agreement with experimental results. (C) 2008 American Institute of Physics

Preliminary Techno–Environment–Economic Evaluation of an Innovative Hybrid Renewable Energy Harvester System for Residential Application

A technical, environmental, and economic feasibility study for a patented hybrid renewable energy harvester system for residential application is conducted in this paper. This system can be mounted on top of an existing residential building to provide electricity from renewable sources. The system is characterized by its V-shaped roof guide vane (VRGV) that directs and augments airflow into the wind turbine, to enhance the rotational and power generation performance of the wind turbines in low wind speed areas. Furthermore, the VRGV increases the installation area for the solar photovoltaic panels and expand the rainwater collection area for the building, and facilitates natural ventilation and prevents excessive solar radiation into the room. The environment-economic evaluation of the system is conducted based on the life-cycle cost (LCC) in terms of low carbon and economic cost-effectiveness. The evaluation of the system with dimensions of 15 m (L) × 16 m (W) × 17.05 m (H) showed that the annual energy generated is 21.130 MWh. Annual low-carbon benefit of the system is estimated to be 11.894 t. The cumulative net present value (NPV) of the system in the life cycle time (20 years) is $52,207.247, with the consideration of a discount rate of 8%; also, the cash flow breakeven occurs in the 11th year. It is important to note that the carbon payback period (CPP) of the system is five years. © 2019 by the authors

Preliminary Performance Tests and Simulation of a V-Shape Roof Guide Vane Mounted on an Eco-Roof System

The technical and economic features of a patented V-shape roof guide vane (VRGV) with a solar and wind power generation system mounted on an eco-roof system are presented in this paper. Moreover, this innovative VRGV was investigated on for the purpose of improving the performance of a vertical axis wind turbine (VAWT), which was installed on an eco-roof system to solve the low-efficiency power generation problem of the wind turbines under the condition of a low wind speed. This paper proposes a preliminary study for the performance of the VAWT with the VRGV on a building. This research used a mock-up building with a double slope roof, where a five straight-bladed VAWT was mounted and tested under two conditions, with and without the VRGV. From the comparative experiments, the self-starting performance and rotational speed of the VAWT mounted above a double slope roof with the VRGV have been significantly improved compared to the VAWT without the VRGV. Further, the power coefficient (Cp) of the VAWT can be augmented to about 71.2% increment due to the VRGV design. In addition, numerical simulations by computational fluid dynamics (CFD) were proposed to verify the augmented effect of the Cp of the VAWT under the influence of the VRGV in the experiment. Besides, economic estimation of the VRGV was conducted