Over 1200 drugs-related deaths and 190,000 opiate-user-years of follow-up : relative risks by sex and age-group

Heroin users/injectors' risk of drugs-related death by sex and current age is weakly estimated both in individual cohorts of under 1000 clients, 5000 person-years or 50 drugs-related deaths and when using cross-sectional data. A workshop in Cambridge analysed six cohorts who were recruited according to a common European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) protocol from drug treatment agencies in Barcelona, Denmark, Dublin, Lisbon, Rome and Vienna in the 1990s; and, as external reference, opiate-user arrestees in France and hepatitis C diagnosed ever-injectors in Scotland in 1993-2001, both followed by database linkage to December 2001. EMCDDA cohorts recorded approximately equal numbers of drugs-related deaths (864) and deaths from other non-HIV causes (865) during 106,152 person-years of follow-up. External cohorts contributed 376 drugs-related deaths (Scotland 195, France 181) and 418 deaths from non-HIV causes (Scotland 221, France 197) during 86,417 person-years of follow-up (Scotland 22,670, France 63,747). EMCDDA cohorts reported 707 drugs-related deaths in 81,367 man-years {8.7 per 1000 person-years, 95% CI: 8.1 to 9.4} but only 157 in 24,785 person-years for females {6.3 per 1000 person-years, 95% CI: 5.4 to 7.4}. Except in external cohorts, relative risks by current age-group were not particularly strong, and more modest in Poisson regression than in cross-sectional analyses: relative risk was 1.2 (95% CI: 1.0-1.4) for 35-44 year olds compared to 15-24 year 3 olds, but 1.4 for males (95%CI: 1.2-1.6), and dramatically lower at 0.44 after the first year of follow-up (95% CI: 0.37-0.52)

Advocacy in the tail: Exploring the implications of ‘climategate’ for science journalism and public debate in the digital age

This paper explores the evolving practices of science journalism and public debate in the digital age. The vehicle for this study is the release of digitally stored email correspondence, data and documents from the Climatic Research Unit at the University of East Anglia in the weeks immediately prior to the United Nations Copenhagen Summit (COP-15) in December 2009. Described using the journalistic shorthand of ‘climategate’, and initially promoted through socio-technical networks of bloggers, this episode became a global news story and the subject of several formal reviews. ‘Climategate’ illustrates that media literate critics of anthropogenic explanations of climate change used digital tools to support their cause, making visible selected, newsworthy aspects of scientific information and the practices of scientists. In conclusion, I argue that ‘climategate’ may have profound implications for the production and distribution of science news, and how climate science is represented and debated in the digitally-mediated public sphere

Shall I tell my mentor? Exploring the mentor-student relationship and its impact on students’ raising concerns on clinical placement

Aims To explore student nurses' and nurse mentors' perceptions and experiences of raising concerns on clinical placement and the influence (if any) of their relationship on this process. A secondary aim is to consider the above, from a regulatory perspective in light of current literature and policy developments. Background Raising concerns whilst on clinical placement has been shown to be challenging for student nurses internationally. Registered nurses in the UK (in this case called “nurse mentors”) facilitate learning and assessment in practice. However, limited research exists on the influence of the relationship between the nurse mentor and student nurse on the raising concerns process. Design A qualitative approach was used to undertake secondary thematic analysis of interview data. The primary data set was generated during a PhD study, focusing on the mentor–student dynamic and the possible influence of this relationship on students' raising concerns. Methods 30 individual semi‐structured interviews were subjected to concurrent and thematic analysis. Interviews were undertaken with student nurses (n = 16) and nurse mentors (n = 14) between April 2016–January 2018. The COREQ 32‐item checklist was used during the preparation of this article. Findings The following three interrelated analytical themes were generated from the data, “developing a mentor‐student relationship," “keeping your mentor sweet” and “the mentor role in the raising concerns process.” Conclusion Our analysis of participants' experiences and perceptions offers an original contribution to understanding the factors associated with student nurses raising concerns in practice. Student nurses and most mentors believed that students should be encouraged and supported to raise concerns, but students' decisions were strongly influenced by their perceptions of the immediate interpersonal and educational context. Similar barriers to raising concerns have been shown to exist regardless of geographical boundaries, therefore the findings of this study are nationally and internationally relevant

Reviewing research evidence and the case of participation in sport and physical recreation by black and minority ethnic communities

The paper addresses the implications of using the process of systematic review in the many areas of leisure where there is a dearth of material that would be admitted into conventional Cochrane Reviews. This raises important questions about what constitutes legitimate knowledge, questions that are of critical import not just to leisure scholars, but to the formulation of policy. The search for certainty in an area that lacks conceptual consensus results in an epistemological imperialism that takes a geocentric form. While clearly, there is a need for good research design whatever the style of research, we contend that the wholesale rejection of insightful research is profligate and foolhardy. A mechanism has to be found to capitalise on good quality research of whatever form. In that search, we draw upon our experience of conducting a review of the material available on participation in sport and physical recreation by people from Black and minority ethnic groups. The paper concludes with a proposal for a more productive review process that makes better use of the full panoply of good quality research available. © 2012 © 2012 Taylor & Francis

Critical evaluation of starch-based antibacterial nanocomposites as agricultural mulch films: Study on their interactions with water and light

In order to evaluate the potentiality of novel formulations based on starch to be used as agricultural mulch films, native and oxidized corn starch nanocomposites were prepared by extrusion using natural (Bent) and chitosan-modified bentonite (Bent-CS) fillers. The nanocomposite interactions with water were studied by means of moisture content (MC) determination, water solubility (WS), water vapor permeability (WVP), and contact angle (CA). The light transmission spectra were analyzed in order to determine the transparency and radiometric properties of films. Mechanical properties are also included and related with the cryo-fractured surface morphology observed by scanning electron microscopy (SEM). Finally, the antimicrobial action of developed nanocomposites was investigated against the phytopathogen bacterium Pseudomonas syringae pv tomato DC3000 (Psy). Results suggest that starch oxidation leads to a reduction in polarity and transparency. The incorporation of nanoclays improved water resistance but did not produce a significant effect in WVP and mechanical properties, and new strategies are required to improve the nanocomposite performance. However, the incorporation of Bent-CS exerted antibacterial activity on nanocomposites, which is an encouraging result.Fil: Merino, Danila. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; ArgentinaFil: Gutiérrez Carmona, Tomy José. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; ArgentinaFil: Mansilla, Andrea Yamila. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Biológicas. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Biológicas; ArgentinaFil: Casalongue, Claudia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Biológicas. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Biológicas; ArgentinaFil: Alvarez, Vera Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; Argentin

Conservation Performance of Tropical Protected Areas: How Important is Management?

Increasing the coverage of effectively managed protected areas (PAs) is a key focus of the 2020 Aichi biodiversity targets. PA management has received considerable attention, often based on the widely-held, but rarely examined, assumption that positive conservation outcomes will result from increased PA management inputs. To shed light on this assumption, we integrated data on PA management factors with 2006-2011 avoided forest degradation and deforestation across the Peruvian Amazon, using a counterfactual approach, combined with interviews and ranking exercises. We show that while increasing PA management input to Amazonian PAs tended to reduce likelihoods of forest degradation and deforestation, the associations were weak. Key challenges facing PAs ranked by PA managers included wider law enforcement, corruption and land title issues, rather than local management factors. We therefore encourage the post-2020 conservation targets to adopt holistic approaches beyond PA management, incorporating political, institutional and governance contexts across scales.This work was supported by the Economic and Social Research Council (grant number ES/I019650/1); Cambridge Political Economy Society; Cambridge Philosophical Society; St John’s College; and the Department of Geography, University of Cambridge

Learning in the chaos: A political economy analysis of education in Afghanistan

© 2018, The Author(s) 2018. Afghanistan is often characterised as a ‘failed’ or ‘fragile’ state in terms of state ‘functionality’, lacking in capacity to provide security and wellbeing to its citizens and failing to prevent violent conflict and terrorism. Since 2001, education has become a major victim of Afghanistan’s protracted crisis that involves international military interventions, fragile democracy and growing radicalisation. Drawing upon qualitative interviews with educational officials and practitioners in Afghanistan and critically examining the literature in education and conflict, we argue that Afghanistan’s education is caught in the nexus between deteriorating security conditions, weak governance and widespread corruption, resulting in rebel capture of educational spaces for radicalisation and violent extremism. More broadly, we contend that education faces the risk of capture for radicalisation in contexts where state fragility and fundamentalism intersect. Finally, we highlight some critical issues relating to educational programming in conflict-affected contexts

A grounded theory study of the narrative behind Indian physiotherapists global migration

It is estimated that an additional 6.4 million allied health professionals are required to address India's health challenges. Physiotherapy is amongst the largest of these professions. Over the last decade, thousands of Indian physiotherapists have sought to study and work overseas. In this study, 19 physiotherapists from across India were interviewed. Data were collected and analysed using construct+ivist grounded theory methods. The findings indicate that the Indian physiotherapy profession faces many political and clinical hierarchical challenges within the Indian healthcare infrastructure. The profession's education provision has developed, and the private clinical sector has grown, but there are significant disparities in quality and standards across the sector. The profession in India has variable autonomy, is not nationally regulated, is poorly paid, and the leadership has been divided. The political, educational, and clinical context in Indian physiotherapy impacts upon physiotherapists' ability to practise effectively to their professional satisfaction. Individual physiotherapists are frustrated by their workplace and travel overseas where they hear that the physiotherapy profession and practice is different. Whilst the disjunctures influencing these factors continue, and overseas physiotherapy practice is perceived as different and superior, Indian physiotherapists will continue to seek to migrate overseas, and facilitating their return will be challenging

Treatment of hypertension in rural Cambodia: results of a 6-year programme

This study was aimed to describe the outcomes of a hypertension treatment programme in two outpatient clinics in Cambodia. We determined proportions of patients who met the optimal targets for blood pressure (BP) control and assessed the evolution of mean systolic and diastolic BP (SBP/DBP) over time. Multivariate analyses were used to identify predictors of BP decrease and risk factors for LTFU. A total of 2858 patients were enrolled between March 2002 and June 2008 of whom 69.2% were female, 30.5% were aged >/=64years and 32.6% were diabetic. The median follow-up time was 600 days. By the end of 2008, 1642 (57.4%) were alive-in-care, 8 (0.3%) had died and 1208 (42.3%) were lost to follow-up. On admission, mean SBP and DBP were 162 and 94 mm Hg, respectively. Among the patients treated, a significant SBP reduction of 26.8 mm Hg (95% CI: 28.4-25.3) was observed at 6 months. Overall, 36.5% of patients reached the BP targets at 24 months. The number of young adults, non-overweight patients and non-diabetics reaching the BP targets was more. Older age (>64 years), uncontrolled DBP (>/=90 mm Hg) on last consultation and coming late for the last consultation were associated with LTFU, whereas non-diabetic patients were 1.5 times more likely to default than diabetics (95% CI: 1.3-1.7). Although the definite magnitude of the BP decrease due to antihypertension medication over time cannot be assessed definitely without a control group, our results suggest that BP reduction can be obtained with essential hypertension treatment in a large-scale programme in a resource-limited setting

Clinicians' caseload management behaviours as explanatory factors in patients' length of time on caseloads : a predictive multilevel study in paediatric community occupational therapy

Peer reviewedPublisher PD