Patients Recording Clinical Encounters: A Path to Empowerment? Assessment by Mixed Methods

Objective: To examine the motivations of patients recording clinical encounters, covertly or otherwise, and why some do not wish to record encounters. Design: Mixed-methods analysis of survey data and nested semistructured interviews. Setting: Survey to UK audience, using social media and radio broadcast. Participants: 168 survey respondents, of whom 161 were 18 years of age or older (130 completions). Of the 56 participants who agreed to be contacted, we included data from 17 interviews

Network modelling for road-based fecal sludge management

Improvements in the collection and treatment of sewage are critical to reduce health and environmental hazards in rapidly urbanising informal settlements. Where sewerage infrastructure is not available, road-based faecal sludge management options are often the only alternative. However, the costs of faecal sludge transportation are often a barrier to its implementation and operation and thus it is desirable to optimise travel time from source to treatment to reduce costs. This paper presents a novel technique, employing spatial network analysis, to optimise the spatiotopological configuration of a road-based faecal sludge transportation network on the basis of travel time. Using crowd-sourced spatial data for the Kibera settlement and the surrounding city, Nairobi, a proof-of-concept network model was created simulating the transport of waste from the 158 public toilets within Kibera. The toilets are serviced by vacuum pump trucks which move faecal sludge to a transfer station, and from there a tanker transports waste to a treatment plant. The model was used to evaluate the efficiency of different network configurations, based on transportation time. The results show that the location of the transfer station is a critical factor in network optimisation, demonstrating the utility of network analysis as part of the sanitation planning process

Evaluation of Sova's Lincolnshire Offender Mentoring scheme

In January 2014 a team of researchers from the University of Lincoln undertook an evaluation of Sova’s Lincolnshire Offender Mentoring Programme (LOM). LOM is run in partnership with Lincolnshire Probation Trust. LOM works to address the multiple barriers faced by disadvantaged offenders. The project offers community mentoring and a range of intervention activities that aim to enable its participants to realise their full potential and reduce re-offending. The researchers interviewed 12 participants, which included 6 LPT staff, 2 Sova staff, 2 mentors and 2 offenders. Despite LOM being in its infancy, the research found that Sova and LPT had developed an effective inter-agency partnership with excellent levels of communication. The research also found the LOM is valued by both LPT staff and offenders and that it helped improve the service offered to offenders. Whilst the sample size of the research is relatively small there was evidence to suggest that LPT staff and offenders thought LOM had a positive impact on offenders’ behaviour. The research concludes that LOM should continue to be supported and further extended to other suitable offenders who would clearly benefit from the programme

Hilliard Seigler, M.D. and the origins of kidney transplantation and immunology at Duke

The contributions of Dr. Hilliard Seigler to the founding of the Duke kidney transplantation program were considerable in both surgery and immunology. Some of these highlights are summarized based upon interviews with Dr. Seigler by the authors

Transport Accessibility Analysis Using GIS: Assessing Sustainable Transport in London

Transport accessibility is an important driver of urban growth and key to the sustainable development of cities. This paper presents a simple GIS-based tool developed to allow the rapid analysis of accessibility by different transport modes. Designed to be flexible and use publicly-available data, this tool (built in ArcGIS) uses generalized cost to measure transport costs across networks including monetary and distance components. The utility of the tool is demonstrated on London, UK, showing the differing patterns of accessibility across the city by different modes. It is shown that these patterns can be examined spatially, by accessibility to particular destinations (e.g., employment locations), or as a global measure across a whole city system. A number of future infrastructure scenarios are tested, examining the potential for increasing the use of low-carbon forms of transport. It is shown that private car journeys are still the least cost mode choice in London, but that infrastructure investments can play a part in reducing the cost of more sustainable transport options. Document type: Articl

Assessing urban strategies for reducing the impacts of extreme weather on infrastructure networks

Critical infrastructure networks, including transport, are crucial to the social and economic function of urban areas but are at increasing risk from natural hazards. Minimizing disruption to these networks should form part of a strategy to increase urban resilience. A framework for assessing the disruption from flood events to transport systems is presented that couples a high-resolution urban flood model with transport modelling and network analytics to assess the impacts of extreme rainfall events, and to quantify the resilience value of different adaptation options. A case study in Newcastle upon Tyne in the UK shows that both green roof infrastructure and traditional engineering interventions such as culverts or flood walls can reduce transport disruption from flooding. The magnitude of these benefits depends on the flood event and adaptation strategy, but for the scenarios considered here 3–22% improvements in city-wide travel times are achieved. The network metric of betweenness centrality, weighted by travel time, is shown to provide a rapid approach to identify and prioritize the most critical locations for flood risk management intervention. Protecting just the top ranked critical location from flooding provides an 11% reduction in person delays. A city-wide deployment of green roofs achieves a 26% reduction, and although key routes still flood, the benefits of this strategy are more evenly distributed across the transport network as flood depths are reduced across the model domain. Both options should form part of an urban flood risk management strategy, but this method can be used to optimize investment and target limited resources at critical locations, enabling green infrastructure strategies to be gradually implemented over the longer term to provide city-wide benefits. This framework provides a means of prioritizing limited financial resources to improve resilience. This is particularly important as flood management investments must typically exceed a far higher benefit–cost threshold than transport infrastructure investments. By capturing the value to the transport network from flood management interventions, it is possible to create new business models that provide benefits to, and enhance the resilience of, both transport and flood risk management infrastructures. Further work will develop the framework to consider other hazards and infrastructure networks

Elucidation of the Cellular Interactome of Ebola Virus Nucleoprotein and Identification of Therapeutic Targets

Ebola virus (EBOV) infection results in severe disease and in some cases lethal haemorrhagic fever. The infection is directed by seven viral genes that encode nine viral proteins. By definition viruses are obligate intracellular parasites and require aspects of host cell biology in order to replicate their genetic material, assemble new virus particles and subvert host cell anti-viral responses. Currently licenced antivirals are targeted against viral proteins to inhibit their function. However, experience with treating HIV and influenza virus demonstrates that resistant viruses are soon selected. An emerging area in virology is to transiently target host cell proteins that play critical proviral roles in virus biology, especially for acute infections. This has the advantage that the protein being targeted is evolutionary removed from the genome of the virus. Proteomics can aid in discovery biology and identify cellular proteins that may be utilised by the virus to facilitate infection. This work focused on defining the interactome of the EBOV nucleoprotein and identified that cellular chaperones, including HSP70, associate with this protein to promote stability. Utilisation of a mini-genome replication system based on a recent Makona isolate demonstrated that disrupting the stability of NP had an adverse effect on viral RNA synthesis

“Am I able? Is it worth it?” Adolescent girls’ motivational predispositions to school physical education: Associations with health-enhancing physical activity

The study purpose was to investigate predictive associations between adolescent girls&rsquo; motivational predispositions to physical education (PE) and habitual physical activity. Two hundred girls (age 13.1 &plusmn; 0.6 years) completed the Physical Education Predisposition Scale and the Physical Activity Questionnaire for Older Children. ANCOVAs revealed that girls with the highest Perceived PE Worth and Perceived PE Ability scores were the most habitually active groups (p &lt; .0001). Significant predictors of physical activity identified by hierarchical regression were Perceived PE Ability and body mass index, which accounted for 17% and 3% of variance, respectively. As Perceived PE Ability was strongly associated with physical activity, the correlates of this construct should be further established to inform future school and PE-based interventions. <br /

SUSY GUTs with Yukawa unification: a go/no-go study using FCNC processes

We address the viability of exact Yukawa unification in the context of general SUSY GUTs with universal soft-breaking sfermion and gaugino mass terms at the GUT scale. We find that this possibility is challenged, unless the squark spectrum is pushed well above the limits allowed by naturalness. This conclusion is assessed through a global fit using electroweak observables and quark flavour-changing neutral current (FCNC) processes. The problem is mostly the impossibility of accommodating simultaneously the bottom mass and the BR(B --> Xs gamma), after the stringent CDF upper bound on the decay Bs --> mu^+ mu^- is taken into account, and under the basic assumption that the b --> s gamma amplitude have like sign with respect to the Standard Model one, as indicated by the B --> Xs l^+ l^- data. With the same strategy, we also consider the possibility of relaxing Yukawa unification to b - tau Yukawa unification. We find that with small departures from the condition tan beta ~= 50, holding when Yukawa unification is exact, the mentioned tension is substantially relieved. We emphasize that in the region where fits are successful the lightest part of the SUSY spectrum is basically fixed by the requirements of b - tau unification and the applied FCNC constraints. As such, it is easily falsifiable once the LHC turns on.Comment: 10 pages, 1 figure, 5 tables. v3: A few textual modifications. Conclusions unchanged. Matches journal versio