A copolymer analysis approach to estimate the neutral sugar distribution of sugar beet pectin using size exclusion chromatography

Partially degraded sugar beet (Beta vulgaris) pectins were characterised in terms of galacturonic acid, neutral sugar and ferulic acids contents. It was shown that the total neutral sugar content is correlated with the ferulic acid content. One pectin (C) was further characterised by size exclusion chromatography coupled to refractive index and UV detectors (SEC-RI-UV). This gave the opportunity to estimate how the ferulic acid and neutral sugar contents changed with hydrodynamic radius. Pectin C was found to be heterogeneous in composition with neutral sugar-rich fractions of both high and low hydrodynamic radii. A neutral sugar-poor fraction was found at intermediate hydrodynamic radii

No Californian Left Behind: Clean and Affordable Transportation Options for All Through Vehicle Replacement

As California focuses in on new, high-tech, best-in-class transportation strategies, it risks leaving behind an important subset of households and communities who could most benefit from the transition to a cleaner, cheaper, and more sustainable transportation future. Hundreds of thousands of low-income Californians, particularly those in rural parts of the state, live with some of the worst air pollution in the U.S. They also often drive relatively old, inefficient, unsafe, and highly polluting vehicles, and struggle to cover the costs of their basic transportation needs. For these Californians, getting into a relatively more efficient vehicle is more realistic than getting into a new electric vehicle, which is expensive, or onto public transit, which is often ineffective in serving rural and non-urban households.The state has recognized this problem and attempted to address it by focusing on vehicle repair and retirement programs. However, by merely repairing and retiring vehicles and not replacing them with cleaner, more efficient ones, existing programs do not maximize long-term air benefits or lessen the financial burden these inefficient vehicles currently place on low-income Californians. To help address this issue, Senate Bill 459, signed by Governor Brown in September 2013, directs the California Air Resources Board (ARB) to rewrite the guidelines of California's Enhanced Fleet Modernization Program (EFMP). This program has been in place since 2010, and is designed to allow residents who own the highest-emitting vehicles in the state to retire and/or replace them.In this report, we discuss the contribution made by these highly polluting vehicles to the state's air quality problems; we also discuss the serious drag that driving these vehicles can have on household budgets. After outlining these problems, we discuss the state's current policies aimed at promoting vehicle retirement and replacement and offer some recommendations for improving those programs.California is already a leader in advanced and high-tech transportation and transit solutions. It is time we also became a leader in pragmatic solutions for a population that is sometimes left behind in these discussions: non-urban, low-income, car-dependent households. Bringing solutions to these communities will have a huge impact on our current air quality and family budgets; it will also widen the circle of Californians who play an active part in moving this state toward a cleaner, less oil-dependent future

Leading Communities: Community-led Development in England’s Small Towns: the Market Towns Initiative

The Market Towns Initiative (MTI), a UK community-led development programme, operated throughout rural England from 2000 until 2005/6. It was designed to help local people, with professional support, identify – and then capitalize on – the economic, environmental and social strengths and weaknesses of small country towns. This paper explains the origins and ways of working of the MTI. Examples of the topics explored and participants’ views are given, and conclusions drawn. The opportunity is also taken to explain how interest in the roles of England’s small country towns grew in the years following the Second World War, and how this led to the development of the MTI. Evidence suggests that the programme worked well. It demonstrated that local people have the enthusiasm, skills and knowledge to take a lead in the development of the places in which they live; something which, until local government reforms changed roles and structures, was largely taken for granted

5-Aminosalicylates to maintain remission in Crohn's disease: Interpreting conflicting systematic review evidence

5-Aminosalicylates are a class of anti-inflammatory agents that have been used for decades in inflammatory bowel disease. Whilst they are first line for induction and an option for maintenance of remission in ulcerative colitis, the picture in Crohn's disease is variable. For maintenance of remission, key Cochrane systematic reviews have found conflicting results between the medical and surgical induced contexts. In this piece, the possible reasons for this are considered. It is proposed that clinicians should consider 5-aminosalicylates agents an option to maintain remission post-surgery. Future primary research is needed in the medical induced remission setting which considers the length of remission on enrolment and endoscopic or histological disease scores. Additionally, secondary research to rank the various treatment options in the post-surgical setting could be achieved through the use of network meta-analysis and will guide policy makers in the future

Who cares about rural England's disadvantaged now? The implications of the closure of the Commission for Rural Communities for the disadvantaged people and places of rural England (preprint)

For more than 100 years, non-landed and non-Establishment interests in rural England were represented by a succession of three quasi-independent government bodies (quangos) whose roles embraced, to varying degrees, policy, practice, and advocacy. These were the Development/Rural Development Commission, the Countryside Agency, and the Commission for Rural Communities (CRC). In 2013 the British government closed the CRC, and absorbed aspects of its responsibilities into the civil service. This paper explores the implications of the change for the disadvantaged people and places of rural England whose interests the CRC was created to represent. First, by way of context, the histories of the three quangos and the main farming and landed sector membership groups are described. In order to inform the discussion the views of the latter were sought (unsuccessfully), together with the opinions of people involved in one or more of the quangos, and, or, the civil service successor unit. These are presented and discussed. Conclusions relating to consequential “gaps” in independent policy and research are drawn. The aim is to stimulate discussion about the implications for rural England of closing the CRC, for it is possible that the loss of this small organization may have unexpected long-term consequences. The eventual significance of this decision has yet to be determined

Who will look after England’s rural disadvantaged now?

For more than 100 years, non-landed and non-Establishment interests in rural England were represented by a succession of three quasi-independent government bodies (quangos). These were the Development/Rural Development Commissions, the Countryside Agency, and the Commission for Rural Communities (CRC). Their roles embraced, to varying degrees, policy, practice, and advocacy. In 2013 the British government closed the CRC and absorbed aspects of its responsibilities into the civil service. The implications of this decision for the disadvantaged people and places of rural England are explored. The potential for land-related interest groups and traditional elites to increase their influence as a consequence, is considered. First, by way of context, the histories of the three quangos and the main interest groups are described. The views of the latter – and others with related interests - were sought (unsuccessfully), together with the opinions of people involved in one or more of the quangos, and, or, the civil service successor unit. These are presented and discussed. Conclusions relating to consequential ‘gaps’ in independent policy and research are drawn. The aim is to stimulate discussion about the implications for rural England of closing the CRC, for it is possible that the loss of this small organization may have unexpected long-term consequences. The eventual significance of this decision has yet to be determined

Non-technical skills learning in healthcare through simulation education: Integrating the SECTORS learning model and Complexity theory

Background: Recent works have reported the SECTORS model for non-technical skills learning in healthcare. The TINSELS programme applied this model, together with complexity theory, to guide the design and piloting of a non-technical skills based simulation training programme in the context of medicines safety. Methods: The SECTORS model defined learning outcomes. Complexity Theory led to a simulation intervention that employed authentic multi-professional learner teams, included planned and unplanned disturbances from the norm and used a staged debrief to encourage peer observation and learning. Assessment videos of non-technical skills in each learning outcome were produced and viewed as part of a Non-Technical Skills Observation Test (NOTSOT) both pre and post intervention. Learner observations were assessed by two researchers and statistical difference investigated using a student’s t-test Results: The resultant intervention is described and available from the authors. 18 participants were recruited from a range of inter-professional groups and were split into two cohorts. There was a statistically significant improvement (P=0.0314) between the Mean (SD) scores for the NOTSOT pre course 13.9 (2.32) and post course 16.42 (3.45). Conclusions: An original, theoretically underpinned, multi-professional, simulation based training programme has been produced by the integration of the SECTORS model for non-technical skills learning the complexity theory. This pilot work suggests the resultant intervention can enhance nontechnical skills

Physicians' Practice of Dispensing Medicines: A Qualitative Study

Objectives: The physical act of giving medication to patients to administer away from a health care setting, dispensing, is normally performed by pharmacists. Dispensing of medication by physicians is a neglected patient safety issue, and having observed considerable variation in practice, the lead author sought to explore this issue further. A literature review yielded zero articles pertaining to this, so an exploratory study was commenced. The qualitative arm, relating to junior physicians' experience of, and training in, dispensing, is reported here. Methods: Focus groups were conducted to explore the beliefs, ideas, and experiences of physicians-in-training pertaining to dispensing of medication. These were recorded and transcribed. The transcriptions were thematically analyzed using the grounded theory. Results: The emergency department was the most common site of dispensing. No formal training in dispensing had been received. Informal training was variable in content and utility. The physicians felt that dispensing was part of their role. Conclusions: Despite being expected to dispense, and the patient safety issues involved in giving drugs to patients to use at home, physicians do not feel that they have been trained to undertake this task. These findings from 1 hospital raise questions about thewider quality and safety of this practic

Are we talking the same paradigm? Considering methodological choices in health education systematic review

For the past two decades, there have been calls for medical education to become more evidence-based. Whilst previous works have described how to use such methods, there are no works discussing when or why to select different methods from either a conceptual or pragmatic perspective. This question is not to suggest the superiority of such methods, but that having a clear rationale to underpin such choices is key and should be communicated to the reader of such works. Our goal within this manuscript is to consider the philosophical alignment of these different review and synthesis modalities and how this impacts on their suitability to answer different systematic review questions within health education. The key characteristic of a systematic review that should impact the synthesis choice is discussed in detail. By clearly defining this and the related outcome expected from the review and for educators who will receive this outcome, the alignment will become apparent. This will then allow deployment of an appropriate methodology that is fit for purpose and will indeed justify the significant work needed to complete a systematic. Key items discussed are the positivist synthesis methods meta-analysis and content analysis to address questions in the form of ‘whether and what’ education is effective. These can be juxtaposed with the constructivist aligned thematic analysis and meta ethnography to address questions in the form of ‘why’. The concept of the realist review is also considered. It is proposed that authors of such work should describe their research alignment and the link between question, alignment and evidence synthesis method selected. The process of exploring the range of modalities and their alignment highlights gaps in the researcher’s arsenal. Future works are needed to explore the impact of such changes in writing from authors of medical education systematic review

Review – Reclaiming Local Democracy: A progressive future for local government

This is a book that needed to be written. First published in 2014, Ines Newman takes a timely, refreshing, and broad look at local government.  Although it relates mainly to the UK, colleagues throughout the Commonwealth will find this book both interesting and relevant.  Her thoughtful approach has, I think, optimism at its heart.  The work is an effective counterpoint to the prevailing neoliberal orthodoxy that “austerity”, with its consequential public sector cuts, is unavoidable. As Newman makes clear, “austerity” is a political choice.