A grassroots sustainable energy niche? Reflections on community energy in the UK

System-changing innovations for sustainability transitions are pro- posed to emerge in radical innovative niches. ‘Strategic Niche Management’ theory predicts that niche-level actors and networks will aggregate learning from local projects, disseminating best practice, and encouraging innovation diffusion. Grassroots inno- vations emerging from civil society are under-researched, and so we investigate the UK community energy sector to empirically test this model. Our analysis draws on qualitative case study research with local projects, and a study of how intermediary organisa- tions support local projects. We examine the extent and nature of interactions and resource flows between projects and intermediary actors in order to evaluate the utility of niche theories in the civil society context. While networking and intermediary organisations can effectively spread some types of learning necessary for diffu- sion, this is not sufficient: tacit knowledge, trust and confidence are essential to these projects’ success, but are more difficult to abstract and translate to new settings. We discuss the implications of our findings for niche theory, for community energy and other grass- roots practitioners aiming to build robust influential niches, and for policymakers

A grassroots sustainable energy niche? Reflections on community energy case studies

System changing innovations for sustainability transitions are proposed to emerge in radical innovative niches. ‘Strategic Niche Management’ theory predicts that niche level actors and networks will aggregate learning from local projects, distilling and disseminating best practice. This should lower the bar for new projects to form and establish, thereby encouraging the innovation to diffuse through replication. Within this literature, grassroots innovations emerging from civil society are an under researched site of sociotechnical innovation for sustainable energy transitions. We consider the emerging community energy sector in the UK, in order to empirically test this model. Community energy is a diverse grassroots led sector including both demand and supply side initiatives for sustainable energy such as community owned renewable energy generation, village hall refurbishments, behaviour change initiatives and energy efficiency projects. Our analysis draws on in depth qualitative case study research with twelve local projects, and a study of how intermediary organisations aim to support local projects and encourage replication. This rich data allows us to examine the extent and nature of interactions between projects and intermediary actors in order to evaluate the utility of niche theories in the civil society context. In particular, we investigate which types of knowledge, support and resources were needed by our case study projects to become established and thrive, and compare and contrast this with those offered by the emerging community energy niche. Our findings indicate that while networking and intermediary organisations can effectively collate and spread some types of learning and information necessary for replication, this is not sufficient: tacit knowledge, trust and confidence are essential to these projects’ success, but are more difficult to abstract and translate to new settings. We draw out the implications of our findings for niche theory, for community energy and other grassroots practitioners aiming to build robust influential niches, and for policymakers eager to harness civil society’s innovative potential for sustainability

A retrospective review of the risk factors associated with retinopathy of prematurity in three academic hospitals in Johannesburg, South Africa

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Ophthalmology Johannesburg, April 2017.Purpose: Retinopathy of prematurity (ROP) is a leading cause of preventable blindness worldwide. Numerous studies have attempted to identify the many risk factors for this condition. While risk factors have been identified in previous studies, there remains a lack of information specific to the South African population. The purpose of this study was to try and identify possible risk factors in an African population that may differ from studies done in other areas of the world. Secondarily by identifying important risk factors in South African population, screening could be further tailored to try and decrease the load on a very strained health system as well as aiming education for smaller hospitals to try and manage babies correctly to decrease the prevalence of this devastating disease. Methods: Medical information from an eight-year period for infants with proven ROP that required treatment and for their mothers was reviewed from three public sector hospitals in Gauteng. A matched control group of babies who did not present with ROP were compared to the ROP group. Results: There were 64 babies in the treatment group and 63 babies in the control group (no ROP). Results showed that babies with ROP were significantly smaller (mean birthweight of 1064g compared to 1210g), had a shorter gestational age (average of 28.3 weeks compared to 29.9 weeks) and were significantly more likely to receive a blood transfusion. Weaker evidence showed that the babies with ROP all received oxygen therapy, were more likely to undergo mechanical ventilation, receive nitric oxide and have neonatal sepsis. The treatment group also showed a trend towards having a higher likelihood of hypotension and hyperglycaemia (requiring insulin). The ethnicity of the babies did not differ between groups with most of the babies being African (96% and 94% respectively, ROP and control groups). The prevalence of HIV between and within groups could not be reliably established due to lack of available data. Conclusion: Well documented risk factors as well as some lesser established risk factors were shown to predict ROP in this population group. The lack of note keeping of important risk factors by attendant medical staff proved problematic and requires attention. The current ROP-screening guidelines in use in South Africa (screening babies of under 1500g) are acceptable and should not be reduced if economically possible, to the guidelines used in some first world countries (screening of babies under 1250g) as this would increase the chances of missing the diagnoses of ROP (7 out of 63 treated babies in this study’s treatment group would have been missed) in premature infants.LG201

Hierarchical Character-Word Models for Language Identification

Social media messages' brevity and unconventional spelling pose a challenge to language identification. We introduce a hierarchical model that learns character and contextualized word-level representations for language identification. Our method performs well against strong base- lines, and can also reveal code-switching

A Perplexing Case Of Episodic Abdominal Pain And The Role Of Mast Cells Gastroenteritis

Here we present a case of chronic intractable vomiting and diarrhea of unknown cause, and introduce the relatively new entity of mast cell gastroenteritis. Our patient is a 38-year old female with PMH of seronegative rheumatoid arthritis, mixed connective tissue disorder, and several recent hospitalizations over the past 4 months at outside hospitals for suspected colitis with associated vomiting and diarrhea. Current symptoms include 4 days of nausea with intractable vomiting, and 2 days of rectal fullness with mucoid rectal discharge. Previous workup at outside hospitals included multiple abdominal CT scans, flexible sigmoidoscopy, colonoscopy, and exploratory laparotomy. Prior to admission no definitive diagnosis were identified for her symptoms, despite extensive workup. Possible causes considered include inflammatory bowel disease, irritable bowel disease, hereditary angioedema, and small vessel vasculitis. On admission, our physical exam showed no abnormalities including normal rectal exam. CT scan showed inflammation in the colon particularly in the rectum. A flexible sigmoidoscopy showed only edematous appearance of the colon without bleeding, ulcerations, or erythema. Biopsies were obtained, and initial pathology was non-specific. Special stains of the rectal tissue showed increased CD117+ cells at the lamina propria suggesting mast cell gastroenteritis (MCG) as the cause of her symptoms. She was treated with IV steroids until she could tolerate oral budesonide on discharge. MCG is defined as the abundance of mast cells at the lamina propria along the GI tract. Release of inflammatory mediators by these cells cause gastrointestinal mucosal inflammation leading to symptoms of nausea, vomiting, diarrhea, and abdominal pain. The relatively new and evolving diagnosis of MCG can be part of a larger systemic process or as the patient’s primary problem. Treatments include antihistamines, cromolyn, and steroids. Knowing when to test for MCG and how to interpret the results given a clinical scenario can be helpful in understanding the cause of a patient’s symptoms. In the setting of this case we can better understand this clinical reasoning behind MCG and more effectively treat our patient and her underlying GI mastocytosis.https://digitalcommons.psjhealth.org/ppmc_internal/1008/thumbnail.jp

Predictors of Increases in Alcohol Problems and Alcohol Use Disorders in Offspring in the San Diego Prospective Study.

BackgroundThe 35-year-long San Diego Prospective Study documented 2-fold increases in alcohol problems and alcohol use disorders (AUDs) in young-adult drinking offspring compared to rates in their fathers, the original probands. The current analyses use the same interviews and questionnaires at about the same age in members of the 2 generations to explore multiple potential contributors to the generational differences in adverse alcohol outcomes.MethodsUsing data from recent offspring interviews, multiple cross-generation differences in characteristics potentially related to alcohol problems were evaluated in 3 steps: first through direct comparisons across probands and offspring at about age 30; second by backward linear regression analyses of predictors of alcohol problems within each generation; and finally third through R-based bootstrapped linear regressions of differences in alcohol problems in randomly matched probands and offspring.ResultsThe analyses across the analytical approaches revealed 3 consistent predictors of higher alcohol problems in the second generation. These included the following: (i) a more robust relationship to alcohol problems for offspring with a low level of response to alcohol; (ii) higher offspring values for alcohol expectancies; and (iii) higher offspring impulsivity.ConclusionsThe availability of data across generations offered a unique perspective for studying characteristics that may have contributed to a general finding in the literature of substantial increases in alcohol problems and AUDs in recent generations. If replicated, these results could suggest approaches to be used by parents, healthcare workers, insurance companies, and industry in their efforts to mitigate the increasing rates of alcohol problems in younger generations

LITHIUM MUTAGENICITY

ESCOLA PAULISTA MED,RUA BOTUCATU 740-3,BR-04023900 São Paulo,BRAZILESCOLA PAULISTA MED,RUA BOTUCATU 740-3,BR-04023900 São Paulo,BRAZILWeb of Scienc

The relationship of individual comorbid chronic conditions to diabetes care quality.

ObjectiveMultimorbidity affects 26 million persons with diabetes, and care for comorbid chronic conditions may impact diabetes care quality. The aim of this study was to determine which chronic conditions were related to lack of achievement or achievement of diabetes care quality goals to determine potential targets for future interventions.Research design and methodsThis is an exploratory retrospective analysis of electronic health record data for 23 430 adults, aged 18-75, with diabetes who were seen at seven Midwestern US health systems. The main outcome measures were achievement of six diabetes quality metrics in the reporting year, 2011 (glycated haemoglobin (HbA1c) control and testing, low-density lipoprotein control and testing, blood pressure control, kidney testing). Explanatory variables were 62 chronic condition indicators. Analyses were adjusted for baseline patient sociodemographic and healthcare utilization factors.ResultsThe 62 chronic conditions varied in their relationships to diabetes care goal achievement for specific care goals. Congestive heart failure was related to lack of achievement of cholesterol management goals. Obesity was related to lack of HbA1c and BP control. Mental health conditions were related to both lack of achievement and achievement of different care goals. Three conditions were related to lack of cholesterol testing, including congestive heart failure and substance-use disorders. Of 17 conditions related to achieving control goals, 16 were related to achieving HbA1c control. One-half of the comorbid conditions did not predict diabetes care quality.ConclusionsFuture interventions could target patients at risk for not achieving diabetes care for specific care goals based on their individual comorbidities

Multimodal agent interfaces and system architectures for health and fitness companions

Multimodal conversational spoken dialogues using physical and virtual agents provide a potential interface to motivate and support users in the domain of health and fitness. In this paper we present how such multimodal conversational Companions can be implemented to support their owners in various pervasive and mobile settings. In particular, we focus on different forms of multimodality and system architectures for such interfaces