Principal Construction of Normative Frameworks: Improving Schooling for Students

Unless leadership candidates develop different normative frameworks on which they can ground their decisions, how can we expect schools to be different

Anomalous Pacific‐Antarctic Ridge volcanism precedes glacial Termination 2

We present results from a well‐dated sediment core on the Pacific‐Antarctic Ridge (PAR) that document a ∼15 cm thick layer of basaltic ash shards that precedes the penultimate deglaciation (Termination 2). The glasses have MORB composition consistent with an axial source and their morphologies are typical of pyroclastic deposits created by submarine volcanism. The ash layer was deposited ∼7 km from the PAR axis, a distance that implies buoyant plumes lofted debris high into the water column with subsequent fallout to the core location. We infer plume rise height using grain settling velocities, the water depth at the core site, and deep ocean current speeds from ARGO floats. Rise heights of 1.5 km or less require unrealistically large current speeds to transport grains to the core site. Instead, the data are consistent with a plume rise height of at least 2 km, implying that T2 was an interval of anomalous volcanism along this segment of the PAR. The timing and duration of the ash deposit is consistent with glacial‐interglacial modulation of ridge magmatism. Volcaniclastic records from additional locations will be necessary to assess whether the PAR record is a rare find or it is representative of mid‐ocean ridge volcanism during glacial terminations

Recombinant Incretin-Secreting Microbe Improves Metabolic Dysfunction in High-Fat Diet Fed Rodents

peer-reviewedThe gut hormone glucagon-like peptide (GLP)-1 and its analogues represent a new generation of anti-diabetic drugs, which have also demonstrated propensity to modulate host lipid metabolism. Despite this, drugs of this nature are currently limited to intramuscular administration routes due to intestinal degradation. The aim of this study was to design a recombinant microbial delivery vector for a GLP-1 analogue and assess the efficacy of the therapeutic in improving host glucose, lipid and cholesterol metabolism in diet induced obese rodents. Diet-induced obese animals received either Lactobacillus paracasei NFBC 338 transformed to express a long-acting analogue of GLP-1 or the isogenic control microbe which solely harbored the pNZ44 plasmid. Short-term GLP-1 microbe intervention in rats reduced serum low-density lipoprotein cholesterol, triglycerides and triglyceride-rich lipoprotein cholesterol substantially. Conversely, extended GLP-1 microbe intervention improved glucose-dependent insulin secretion, glucose metabolism and cholesterol metabolism, compared to the high-fat control group. Interestingly, the microbe significantly attenuated the adiposity associated with the model and altered the serum lipidome, independently of GLP-1 secretion. These data indicate that recombinant incretin-secreting microbes may offer a novel and safe means of managing cholesterol metabolism and diet induced dyslipidaemia, as well as insulin sensitivity in metabolic dysfunction

Anomalous Pacific‐Antarctic Ridge volcanism precedes glacial Termination 2

We present results from a well‐dated sediment core on the Pacific‐Antarctic Ridge (PAR) that document a ∼15 cm thick layer of basaltic ash shards that precedes the penultimate deglaciation (Termination 2). The glasses have MORB composition consistent with an axial source and their morphologies are typical of pyroclastic deposits created by submarine volcanism. The ash layer was deposited ∼7 km from the PAR axis, a distance that implies buoyant plumes lofted debris high into the water column with subsequent fallout to the core location. We infer plume rise height using grain settling velocities, the water depth at the core site, and deep ocean current speeds from ARGO floats. Rise heights of 1.5 km or less require unrealistically large current speeds to transport grains to the core site. Instead, the data are consistent with a plume rise height of at least 2 km, implying that T2 was an interval of anomalous volcanism along this segment of the PAR. The timing and duration of the ash deposit is consistent with glacial‐interglacial modulation of ridge magmatism. Volcaniclastic records from additional locations will be necessary to assess whether the PAR record is a rare find or it is representative of mid‐ocean ridge volcanism during glacial terminations

Doing research in non-specialist mental health services for children and young people:lessons learnt from a process evaluation of the ICALM (Interpersonal Counselling for Adolescent Low Mood) feasibility randomised controlled trial

BACKGROUND: The rising prevalence of adolescent mild depression in the UK and the paucity of evidence-based interventions in non-specialist sectors where most cases present, creates an urgent need for early psychological interventions. Randomised controlled trials (RCTs) are considered the gold standard for obtaining unbiased estimates of intervention effectiveness. However, the complexity of mental health settings poses great challenges for effectiveness evaluations. This paper reports learning from an embedded process evaluation of the ICALM RCT which tested the feasibility of delivering Interpersonal Counselling for Adolescents (IPC-A) plus Treatment as Usual (TAU) versus TAU only for adolescent (age 12-18) mild depression by non-qualified mental health professionals in non-specialist sectors.METHODS: A qualitative mixed methods process evaluation, drawing on Bronfenbrenner's socioecological model to investigate key influences on trial delivery across macro-(e.g. policy), meso-(e.g. service characteristics) and micro-(e.g. on-site trial processes) contextual levels. Data collection methods included 9 site questionnaires, 4 observations of team meetings, policy documents, and 18 interviews with stakeholders including therapists, heads of service and managers. Thematic analysis focused on understanding how contextual features shaped trial implementation.RESULTS: The ICALM trial concluded in 2022 having only randomised 14 out of the target 60 young people. At a macro-level, trial delivery was impacted by the COVID-19 pandemic, with services reporting a sharp increase in cases of (social) anxiety over low mood, and backlogs at central referral points which prolonged waiting times for mild cases (e.g. low mood). An interaction between high demand and lack of capacity at a meso-service level led to low prioritisation of trial activities at a micro-level. Unfamiliarity with research processes (e.g. randomisation) and variation in TAU support also accentuated the complexities of conducting an RCT in this setting.CONCLUSIONS: Conducting a RCT of IPC-A in non-specialist services is not feasible in the current context. Failure to conduct effectiveness trials in this setting has clinical implications, potentially resulting in escalation of mild mental health problems. Research done in this setting should adopt pragmatic and innovative recruitment and engagement approaches (e.g. creating new referral pathways) and consider alternative trial designs, e.g. cluster, stepped-wedge or non-controlled studies using complex systems approaches to embrace contextual complexity.TRIAL REGISTRATION: ISRCTN registry, ISRCTN82180413. Registered on 31 December 2019.</p

Hydrothermal scavenging of ^(230)Th on the Southern East Pacific Rise during the last deglaciation

Thorium-230 (^(230)Th) is a fundamental tool for estimating sediment fluxes in the open ocean. Because ^(230)Th is rapidly scavenged by particles falling through the water column, the flux of ^(230)Th to underlying sediments is typically equal to its water column production rate. However, recent surveys suggest hydrothermal plumes are unusually efficient scavengers of ^(230)Th. Here we show that hydrothermal scavenging on the Southern East Pacific Rise (SEPR) resulted in ^(230)Th fluxes several times higher than the water column production rate during the last deglaciation. Elevated fluxes likely require diffusive transport of dissolved ^(230)Th from the ridge flanks towards the ridge crest. Depending on the length-scale of ^(230)Th transport, the resulting deficits in ^(230)Th may yield overestimates of sediment flux to ridge flank sediments. We also show that Fe fluxes at 19°S on the SEPR lag those at 11°S and 6°S by several thousand years, inconsistent with a signal driven by changes in deep water pH and oxygen levels. Instead, variable hydrothermal activity is the simplest explanation of the observed signals in the Pacific, Indian, and Atlantic basins

Representational predicaments at three Hong Kong sites

Representational predicaments arise when a job incumbent believes that attributions and images assumed by dominant authorities unfavourably ignore, or disproportionately and unfavourably emphasize, aspects of the incumbent\u27s own work and social identity. This is likely to happen when the incumbent does not have a close relationship with a dominant authority, and when power asymmetries give the former relatively little control over which aspects of their work and social identity are made visible or invisible to the latter. We draw on critical incident interviews from three organizations to illustrate a typology of six types of representational predicament: invasive spotlighting, idiosyncratic spotlighting, embedded background work, paradoxical social visibility, standardization of work processes, and standardization of work outputs. We analyse responses to representational predicaments according to whether they entailed exit, voice, loyalty, or neglect. Incumbents tended to respond with loyalty if they felt able and willing to accommodate their work behaviour and/or social identity to the dominant representations, and if there were sufficient compensatory factors, such as intrinsic rewards from the work or solidarity with colleagues. Exit or neglect appeared to reflect the belief that it was impossible to accommodate. Power asymmetries appeared to deter voice. Individual employees with a close and cordial working relationship with a member of a dominant authority group, or who were relationally networked to one, appeared not to experience representational predicaments

What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care

<p>Abstract</p> <p>Background</p> <p>Out-of-hours care in the primary care setting is rapidly changing and evolving towards general practitioner 'cooperatives' (GPC). GPCs already exist in the Netherlands, the United Kingdom and Scandinavia, all countries with strong general practice, including gatekeepers' role. This intervention study reports the use and caseload of out-of-hours care before and after implementation of a GPC in a well subscribed region in a country with an open access health care system and no gatekeepers' role for general practice.</p> <p>Methods</p> <p>We used a prospective before/after interventional study design. The intervention was the implementation of a GPC.</p> <p>Results</p> <p>One year after the implementation of a GPC, the number of patient contacts in the intervention region significantly increased at the GPC (OR: 1.645; 95% CI: 1.439-1.880), while there were no significant changes in patient contacts at the Emergency Department (ED) or in other regions where a simultaneous registration was performed. Although home visits decreased in all general practitioner registrations, the difference was more pronounced in the intervention region (intervention region: OR: 0.515; 95% CI: 0.411-0.646, other regions: OR: 0.743; 95% CI: 0.608-0.908). At the ED we observed a decrease in the number of trauma cases (OR: 0.789; 95% CI: 0.648-0.960) and of patients who came to hospital by ambulance (OR: 0.687; 95% CI: 0.565-0.836).</p> <p>Conclusions</p> <p>One year after its implementation more people seek help at the GPC, while the number of contacts at the ED remains the same. The most prominent changes in caseload are found in the trauma cases. Establishing a GPC in an open health care system, might redirect some patients with particular medical problems to primary care. This could lead to a lowering of costs or a more cost-effective out of hours care, but further research should focus on effective usage to divert patient flows and on quality and outcome of care.</p

Uganda Genome Resource Enables Insights into Population History and Genomic Discovery in Africa.

Genomic studies in African populations provide unique opportunities to understand disease etiology, human diversity, and population history. In the largest study of its kind, comprising genome-wide data from 6,400 individuals and whole-genome sequences from 1,978 individuals from rural Uganda, we find evidence of geographically correlated fine-scale population substructure. Historically, the ancestry of modern Ugandans was best represented by a mixture of ancient East African pastoralists. We demonstrate the value of the largest sequence panel from Africa to date as an imputation resource. Examining 34 cardiometabolic traits, we show systematic differences in trait heritability between European and African populations, probably reflecting the differential impact of genes and environment. In a multi-trait pan-African GWAS of up to 14,126 individuals, we identify novel loci associated with anthropometric, hematological, lipid, and glycemic traits. We find that several functionally important signals are driven by Africa-specific variants, highlighting the value of studying diverse populations across the region.Main funding: This work was funded by the Wellcome Trust, The Wellcome Sanger Institute (WT098051), the U.K. Medical Research Council (G0901213-92157, G0801566, and MR/K013491/1), and the Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS core funding