Children's Children

Children's children by 'Simple Simon.' Typescript scanned from the original held in Rare Books & Special Collections. Transcription by Barbara Wall

The role of stress and health behaviour in linking weight discrimination and health: a secondary data analysis in England

Objective: To examine the role of stress and health-risk behaviours in relationships between weight discrimination and health and well-being.// Design: Secondary data analysis of an observational cohort study.// Setting: The English Longitudinal Study of Ageing.// Participants: Data were from 4341 adults (≥50 years) with overweight/obesity.// Primary outcome measures: We tested associations between perceived weight discrimination at baseline (2010/2011) and self-rated health, limiting long-standing illness, depressive symptoms, quality of life and life satisfaction over 4-year follow-up (2010/2011; 2014/2015). Potential mediation by stress exposure (hair cortisol) and health-risk behaviours (smoking, physical inactivity, alcohol consumption) was assessed.// Results: Cross-sectionally, perceived weight discrimination was associated with higher odds of fair/poor self-rated health (OR=2.05 (95% CI 1.49 to 2.82)), limiting long-standing illness (OR=1.76 (95% CI 1.29 to 2.41)) and depressive symptoms (OR=2.01 (95% CI 1.41 to 2.85)) and lower quality of life (B=−5.82 (95% CI −7.01 to −4.62)) and life satisfaction (B=−2.36 (95% CI −3.25 to −1.47)). Prospectively, weight discrimination was associated with higher odds of fair/poor self-rated health (OR=1.63 (95% CI 1.10 to 2.40)) and depressive symptoms (OR=2.37 (95% CI 1.57 to 3.60)) adjusting for baseline status. Those who reported discrimination had higher hair cortisol concentrations (B=0.14 (95% CI 0.03 to 0.25)) and higher odds of physical inactivity (OR=1.90 (95% CI 1.18 to 3.05)). These variables did not significantly mediate associations between discrimination and health outcomes.// Conclusions: Weight discrimination is associated with poor health and well-being. While this discrimination is associated with stress exposure and physical inactivity, these variables explain little of the association between discrimination and poorer outcomes

Reproduction, Embryonic Development, and Maternal Transfer of Contaminants in the Amphibian Gastrophryne carolinensis

Although many amphibian populations around the world are declining at alarming rates, the cause of most declines remains unknown. Environmental contamination is one of several factors implicated in declines and may have particularly important effects on sensitive developmental stages. Despite the severe effects of maternal transfer of contaminants on early development in other vertebrate lineages, no studies have examined the effects of maternal transfer of contaminants on reproduction or development in amphibians. We examined maternal transfer of contaminants in eastern narrow-mouth toads (Gastrophryne carolinensis) collected from a reference site and near a coal-burning power plant. Adult toads inhabiting the industrial area transferred significant quantities of selenium and strontium to their eggs, but Se concentrations were most notable (up to 100 μg/g dry mass). Compared with the reference site, hatching success was reduced by 11% in clutches from the contaminated site. In surviving larvae, the frequency of developmental abnormalities and abnormal swimming was 55–58% higher in the contaminated site relative to the reference site. Craniofacial abnormalities were nearly an order of magnitude more prevalent in hatchlings from the contaminated site. When all developmental criteria were considered collectively, offspring from the contaminated site experienced 19% lower viability. Although there was no statistical relationship between the concentration of Se or Sr transferred to eggs and any measure of offspring viability, our study demonstrates that maternal transfer may be an important route of contaminant exposure in amphibians that has been overlooked

Co-producing Justice : International Social Economy Network Programme Report

While the significance of employment to desistance (giving up crime) is well established, there are multifarious obstacles to people with convictions accessing and sustaining work. Social enterprises are businesses that trade for a social purpose, rather than for the enrichment of shareholders or owners. It has been shown that social enterprise and cooperative structures of employment can circumnavigate some of the systemic obstacles to employment, such as criminal records and employer discrimination that people routinely encounter. Yet, one in six people in the UK have a criminal conviction; a large proportion of people are, therefore, affected by the impacts that contact with the justice system has on access to employment and, relatedly, opportunities to move on from offending. The House of Commons Work and Pensions Committee (2016) recognise that employment significantly reduces reoffending and can lead to other outcomes that can reduce reoffending (e.g. financial security and stable accommodation). The Scottish Government (2016) has recently co-produced, with the social enterprise sector, a ten-year Strategy to encourage the further development of the sector and contribute to an overarching ‘inclusive growth’ agenda, demonstrating considerable appetite for an evidence-informed approach for this demographic. Despite this, not only are such structures providing paid work a rarity in the UK justice system, the potential of social enterprises and co-operatives in this context has hardly been explored. Recent research (Roy et al., 2017; Weaver 2016; forthcoming) provides important evidence to suggest their potential to support desistance, recovery and integration; this project sought to build on this by exploring approaches to their implementation, connecting a range of multi-disciplinary international and local experts who can differently contribute towards their realisation. By combining these largely disconnected strands of research, siloed within specific disciplines, our aim has been to advance a more coherent interdisciplinary theorizing and exploration of the interactions, synergies and distinctions in these disciplinary fields and to influence the direction of future research, policy and practice in justice contexts

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The Australia Telescope 20GHz (AT20G) Survey: analysis of the extragalactic source sample

The Australia Telescope 20 GHz (AT20G) survey is a blind survey of the whole Southern sky at 20 GHz with follow-up observations at 4.8, 8.6, and 20 GHz carried out with the Australia Telescope Compact Array (ATCA). In this paper we present an analysis of radio spectral properties in total intensity and polarisation, sizes, optical identifications, and redshifts of the sample of the 5808 extragalactic sources in the survey catalogue of confirmed sources over the whole Southern sky excluding the strip at Galactic latitude |b|<1.5deg. The sample has a flux density limit of 40 mJy. Completeness has been measured as a function of scan region and flux density. Averaging over the whole survey area the follow-up survey is 78% complete above 50mJy and 93% complete above 100mJy. 3332 sources with declination <-15deg have good quality almost simultaneous observations at 4.8, 8.6, and 20GHz. The spectral analysis shows that the sample is dominated by flat-spectrum sources. The fraction of flat-spectrum sources decreases from 81% for 20GHz flux densities S>500mJy, to 60% for S<100mJy. There is also a clear spectral steepening at higher frequencies with the median spectral index decreasing from -0.16 between 4.8 and 8.6GHz to -0.28 between 8.6 and 20GHz. Simultaneous observations in polarisation are available for all the sources at all the frequencies. 768 sources have a good quality detection of polarised flux density at 20GHz; 467 of them were also detected in polarisation at 4.8 and/or at 8.6GHz so that it has been possible to compare the spectral behaviour in total intensity and polarisation. We have found that the polarised fraction increases slightly with frequency and decreases with flux density. Cross matches and comparisons have been made with other catalogues at lower radio frequencies, and in the optical, X-ray and gamma-ray bands. Redshift estimates are available for 825 sources.Comment: 15 pages, 16 figures, accepted for publication in MNRA

Eligibility and subsequent burden of cardiovascular disease of four strategies for blood pressure-lowering treatment: a retrospective cohort study.

BACKGROUND: Worldwide treatment recommendations for lowering blood pressure continue to be guided predominantly by blood pressure thresholds, despite strong evidence that the benefits of blood pressure reduction are observed in patients across the blood pressure spectrum. In this study, we aimed to investigate the implications of alternative strategies for offering blood pressure treatment, using the UK as an illustrative example. METHODS: We did a retrospective cohort study in primary care patients aged 30-79 years without cardiovascular disease, using data from the UK's Clinical Practice Research Datalink linked to Hospital Episode Statistics and Office for National Statistics mortality. We assessed and compared four different strategies to determine eligibility for treatment: using 2011 UK National Institute for Health and Care Excellence (NICE) guideline, or proposed 2019 NICE guideline, or blood pressure alone (threshold ≥140/90 mm Hg), or predicted 10-year cardiovascular risk alone (QRISK2 score ≥10%). Patients were followed up until the earliest occurrence of a cardiovascular disease diagnosis, death, or end of follow-up period (March 31, 2016). For each strategy, we estimated the proportion of patients eligible for treatment and number of cardiovascular events that could be prevented with treatment. We then estimated eligibility and number of events that would occur during 10 years in the UK general population. FINDINGS: Between Jan 1, 2011, and March 31, 2016, 1 222 670 patients in the cohort were followed up for a median of 4·3 years (IQR 2·5-5·2). 271 963 (22·2%) patients were eligible for treatment under the 2011 NICE guideline, 327 429 (26·8%) under the proposed 2019 NICE guideline, 481 859 (39·4%) on the basis of a blood pressure threshold of 140/90 mm Hg or higher, and 357 840 (29·3%) on the basis of a QRISK2 threshold of 10% or higher. During follow-up, 32 183 patients were diagnosed with cardiovascular disease (overall rate 7·1 per 1000 person-years, 95% CI 7·0-7·2). Cardiovascular event rates in patients eligible for each strategy were 15·2 per 1000 person-years (95% CI 15·0-15·5) under the 2011 NICE guideline, 14·9 (14·7-15·1) under the proposed 2019 NICE guideline, 11·4 (11·3-11·6) with blood pressure threshold alone, and 16·9 (16·7-17·1) with QRISK2 threshold alone. Scaled to the UK population, we estimated that 233 152 events would be avoided under the 2011 NICE guideline (28 patients needed to treat for 10 years to avoid one event), 270 233 under the 2019 NICE guideline (29 patients), 301 523 using a blood pressure threshold (38 patients), and 322 921 using QRISK2 threshold (27 patients). INTERPRETATION: A cardiovascular risk-based strategy (QRISK2 ≥10%) could prevent over a third more cardiovascular disease events than the 2011 NICE guideline and a fifth more than the 2019 NICE guideline, with similar efficiency regarding number treated per event avoided. FUNDING: National Institute for Health Research

Implementation and sustainment of diverse practices in a large integrated health system: a mixed methods study

Background: One goal of health systems seeking to evolve into learning health systems is to accelerate the implementation and sustainment of evidence-based practices (EBPs). As part of this evolution, the Veterans Health Administration (VHA) developed the Innovation Ecosystem, which includes the Diffusion of Excellence (DoE), a program that identifies and diffuses Gold Status Practices (GSPs) across facilities. The DoE hosts an annual Shark Tank competition in which leaders bid on the opportunity to implement a GSP with 6 months of implementation support. Over 750 diverse practices were submitted in cohorts 2 and 3 of Shark Tank; 23 were designated GSPs and were implemented in 31 VA networks or facilities. As part of a national evaluation of the DoE, we identified factors contributing to GSP implementation and sustainment. Methods: Our sequential mixed methods evaluation of cohorts 2 and 3 of Shark Tank included semi-structured interviews with at least one representative from 30/31 implementing teams (N = 78/105 people invited) and survey responses from 29/31 teams (N = 39/47 invited). Interviews focused on factors influencing implementation and future sustainment. Surveys focused on sustainment 1.5-2 years after implementation. The Consolidated Framework for Implementation Research (CFIR) informed data collection and directed content analysis. Ordinal scales were developed inductively to rank implementation and sustainment outcomes. Results: Over 50% of teams (17/30) successfully implemented their GSP within the 6-month implementation period. Despite extensive implementation support, significant barriers related to centralized decision-making, staffing, and resources led to partial (n = 6) or no (n = 7) implementation for the remaining teams. While 12/17 initially successful implementation teams reported sustained use of their GSP, over half of the initially unsuccessful teams (n = 7/13) also reported sustained GSP use 1.5 years after the initial implementation period. When asked at 6 months, 18/27 teams with complete data accurately anticipated their future sustainability based on reported sustainment an average of 1.5 years later. Conclusions: Most teams implemented within 6 months and/or sustained their GSP 1.5 years later. High levels of implementation and sustainment across diverse practices and teams suggest that VHA\u27s DoE is a successful large-scale model of diffusion. Team predictions about sustainability after the first 6 months of implementation provide a promising early assessment and point of intervention to increase sustainability

The Australia Telescope 20 GHz (AT20G) Survey: The Bright Source Sample

The Australia Telescope 20 GHz (AT20G) Survey is a blind survey of the whole Southern sky at 20 GHz (with follow-up observations at 4.8 and 8.6 GHz) carried out with the Australia Telescope Compact Array (ATCA) from 2004 to 2007. The Bright Source Sample (BSS) is a complete flux-limited subsample of the AT20G Survey catalogue comprising 320 extragalactic (|b|>1.5 deg) radio sources south of dec = -15 deg with S(20 GHz) > 0.50 Jy. Of these, 218 have near simultaneous observations at 8 and 5 GHz. In this paper we present an analysis of radio spectral properties in total intensity and polarisation, size, optical identifications and redshift distribution of the BSS sources. The analysis of the spectral behaviour shows spectral curvature in most sources with spectral steepening that increases at higher frequencies (the median spectral index \alpha, assuming S\propto \nu^\alpha, decreases from \alpha_{4.8}^{8.6}=0.11 between 4.8 and 8.6 GHz to \alpha_{8.6}^{20}=-0.16 between 8.6 and 20 GHz), even if the sample is dominated by flat spectra sources (85 per cent of the sample has \alpha_{8.6}^{20}>-0.5). The almost simultaneous spectra in total intensity and polarisation allowed us a comparison of the polarised and total intensity spectra: polarised fraction slightly increases with frequency, but the shapes of the spectra have little correlation. Optical identifications provided an estimation of redshift for 186 sources with a median value of 1.20 and 0.13 respectively for QSO and galaxies.Comment: 34 pages, 19 figures, tables of data included, replaced with version published in MNRA