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Ethnicity and involuntary hospitalisation: A study of intersectional effects
Get PDFPurpose: Studies have found that the Mental Health Act is used disproportionally among minoritised ethnicities. Yet, little research has been conducted to understand how the intersectionality of ethnicity with sociodemographic factors relates to involuntary admission. This study aimed to investigate whether an association between ethnicity and involuntary hospitalisation is altered by variations in service-users’ sociodemographic positions. Methods: A retrospective cohort study using records from the South London and Maudsley identified 18,569 service-users with a first episode of hospitalisation in a 13-year period. Logistic regression was used to calculate odds ratios for involuntary hospitalisation across ethnicities while adjusting for sociodemographic (age, gender, area-level deprivation, homelessness, and migration) and clinical factors (psychiatric diagnosis and HoNOS scores). Interaction analysis was conducted to identify intersectional effects between ethnicity and sociodemographic variables, potentially modifying the odds ratios of involuntary admission across ethnic groups. Results: Increased odds of involuntary hospitalisation compared to White British service-users were observed among 10 of the 14 ethnicities, with around, or just under twice the odds observed for Asian Chinese, Black African, and Black Caribbean. Women were found to have increased odds of involuntary admission. Significant interactions were present between ethnicity and age, area-level deprivation, homelessness, and migration in the unadjusted models. These effect modifications were not significant after adjustment for confounders. Conclusions: Ethnic inequalities were observed in involuntary hospitalisation among service-users on first admission. No evidence of intersectional effects was present when adjusting for sociodemographic and clinical factors. Further research needs to identify the mechanisms causing the inequalities
A perspective on 25 years of advances as reported in the Journal of Optics
No full textIn this perspective, the Editorial Board of the J. Opt. reflects on the past 25 years of the journal. The advances reported in journal have shaped the progress of diverse fields, from fundamental advances in optics to applications with optics as a key ingredient. The journal’s scope has seen it capture progress in several emergent fields, for instance, structured light covering orbital angular momentum, spatio-temporal solitons, topologies in light, singular optics and nonparaxial light. Reports include advances in optical devices, such as digital micromirror devices, metasurfaces and integrated photonics, as well as novel photonic materials based on nanophotonics. Application-based research includes super-resolution imaging, digital holography and nonlinear optics. We select key papers from across diverse disciplines to showcase the scope of the journal and the impact it has had on the wider community
Adrenal insufficiency in giant cell arteritis
Get PDFObjectives: To ascertain the frequency of adrenal insufficiency in patients with GCA treated using the Norwich prednisolone regimen. Methods: Consecutive patients diagnosed with GCA between 1 January 2012 and 31 May 2022 were included. All patients were treated with the Norwich prednisolone regimen, educated about the benefits and risks of long-term prednisolone use and followed up in dedicated vasculitis clinics. When patients contacted the advice line to report being unwell, tests for adrenal function were performed after ruling out relapsing vasculitis or polymyalgia rheumatica. A 9 a.m. serum cortisol was used, providing the daily dose of prednisolone was ≤5 mg, as a gateway to dynamic testing with full-form adrenocorticotrophic hormone (ACTH) stimulation. Results: A total of 353 consecutive patients with GCA were included. During the prescribed glucocorticoid tapering regimen, 76/353 had a 9 a.m. serum cortisol check after ruling out relapsing disease. Of these, 34/76 had a serum cortisol >350 nmol/l (our laboratory cut-off for adequacy of adrenal reserve); 7/76 had a serum cortisol 450 nmol/l at 30 min) and 8/35 had an inadequate result. A total of 15/353 patients required long-term steroids because of adrenal insufficiency and 11/15 patients with adrenal insufficiency were female. The median (IQR) cumulative prednisolone dose at the time of testing was 11.53 grams (7.74) and the median (IQR) duration of prednisolone was 121 weeks (97). Conclusion: This is the largest study studying the frequency of adrenal insufficiency in patients with GCA treated using the Norwich prednisolone regimen. Adrenal insufficiency requiring long-term steroid replacement therapy is uncommon. Sequential testing using 9 a.m. serum cortisol levels as a gateway to rationalizing the necessity for dynamic testing with standard-dose ACTH stimulation testing is an efficient strategy for this cohort of patients
ArnR binds a [4Fe-4S] cluster and indirectly senses anaerobicity in Corynebacteria
Get PDFCorynebacteria are commercially and medically important Gram-positive bacteria that can switch from aerobic to anaerobic respiration in response to low O2 and the availability of nitrate as an alternative electron acceptor. The narKGHJI operon encoding the respiratory nitrate reductase is under the control of a novel regulator, ArnR, which plays a major role in the aerobic/anaerobic respiratory switch. ArnR was previously shown to be an iron-sulfur cluster protein that modulates its DNA binding according to availability of O2. However, previous data suggest that it does not do this directly in response to O2, but instead by sensing nitric oxide (NO), which builds up only under low O2 through the activity of nitrate reductase. Here, we report spectroscopic and mass spectrometric studies of C. glutamicum ArnR and its reactions with O2 and NO. We demonstrate that ArnR is a dimer that binds a [4Fe-4S] cluster in each subunit, and this form of the protein binds tightly to DNA. The [4Fe-4S] cluster of AnrR degrades only very slowly in the presence of O2, consistent with the ability of ArnR to repress nar transcription under aerobic conditions. Reaction with NO results in the formation of mono- and di-nitrosylated forms of the [4Fe-4S] ArnR dimer, which exhibit altered DNA-binding characteristics such that the di-nitrosyl form no longer binds to promoter DNA; i.e. cluster degradation is not required in order to modulate DNA binding. These data are consistent with previous literature and lead us to propose a model for AnrR regulatory function
The iron-sulfur cluster of bacterioferritin-associated ferredoxin (Bfd): A "biological fuse" that prevents oxidative damage to cells?
Get PDFIron is in an essential micronutrient in living systems. However, it is also potentially toxic and so the concentration of chelatable iron within cells is tightly regulated to prevent catalytic formation of harmful reactive oxygen species (ROS). Ferritins play a key role in iron homeostasis by storing excess iron as an insoluble ferric mineral within the protein. When bacterial cells become iron deficient, this store may be accessed by reduction/solubilisation of the iron. Bacterioferritins utilise heme, bound at an inter-subunit site, to support electron transfer to the stored mineral. Electrons for heme reduction are shuttled from NADPH via Bfd, a [2Fe-2S] cluster-containing ferredoxin. This raises the paradox that the synthesis of an iron-dependent protein cofactor is required under conditions of iron-deficiency so that stored iron can be utilised. Here we show that exposure of Bfd to ROS suppresses the capacity of the protein to stimulate iron release from bacterioferritin. We propose that reliance of iron release on Bfd evolved to ensure that chelatable iron levels do not increase under oxidative stress conditions. Thus, the Bfd iron-sulfur cluster functions as a ‘biological fuse’ in providing a fail-safe that immediately halts iron release once ROS accumulate to damaging concentrations
Produce, Reduce, Recycle:Phonocenes of Citizenship
No full textThis chapter explores soundscapes as forms of citizenship and engagement. We start from the concept of a phonocene as proposed by Donna Haraway, focusing our attention on the sonic and audio dimensions of the Anthropocene. We explore what a posthumanist attention to sound means for the concept of citizenship by using 3 different vignettes to explore what it means to produce, reduce, and recycle sounds, and end by reflecting on what this shift in attention might mean for education. We start with an examination of the production of sound as citizenship, focusing on the ‘Clap for Our Carers’ phenomenon that occurred at the start of the COVID-19 pandemic in Europe and the UK. We examine the notion of a collective production of sound on a nation-wide level, often unheard by intended recipients, that became an obligation of a collective performance of sonic appreciation. We then move to explore the recycling of sound as a form of citizenship, focusing specifically on TikTok as a space of reusing and repurposing audio. We examine the ways that audio meme generation encourages the spread and copying of sounds, layering additional meanings and contexts onto existing audio. We use this to explore how the use of sound on TIkTok presents a new space of engagement in in a collective citizenship through repurposing sound (here comes the boy). In the final vignette we focus on the purposeful reduction of sound as a form of citizenship, explore the policing of reduced sound through the act of ‘taking of the knee’ as a protest to racism in sport. Here the absence of sound is used powerfully and pointedly as a form of engaged citizenship to highlight inequity. This act quickly became a contested form of citizenship, with a counter attempt emerging to control and negate the silence by drowning it out with sound. This was added to by a white hegemonic discourse that attempted to dictate what the form of protest should not only look like but sound like in order to be seen as acceptable citizenship. Through this contested act we focus on the redirection of sonic attention as a form of engaged and disputed citizenship. The chapter ends with a reflection on the important of the phonocene for education, and call for education to begin to embrace the concept of noise and sound beyond individuals in order to consider the boundaries and negotiation of sound as part of an actor-network of contested educational possibilities
Researching Digital Society:An Introduction
No full textInterested in digital technology and its impact on our everyday lives? This multidisciplinary book introduces you to the theories, concepts, and methods you need to research our digital society. Drawing on diverse case studies and examples it gives you everything you need to understand and choose from a range of research designs, and to utilise and critique digital data from a variety of sources. Learn more about: · How technology shapes our society and how online and offline spaces impact each other · Key methodologies and theories used to understand digital societies · Approaches for studying different voices and communities in online spaces, including digital inequalities. The perfect companion for students and researchers across the social sciences, this book is a fresh, practical introduction to research in the digital age
Sea ice controls net ocean uptake of carbon dioxide by regulating wintertime stratification
Get PDFSea-air exchange of carbon dioxide in the Southern Ocean is strongly seasonal, with ocean uptake in summer, which is partly offset by carbon dioxide outgassing in winter. This seasonal balance can shift due to sea ice conditions, inducing interannual variability in the Southern Ocean carbon sink. A decade (2010–2020) of unique, year-round marine carbonate chemistry observations from the Rothera Time Series (West Antarctic Peninsula) reveals that interannual variability in seawater fugacity of carbon dioxide depends on wintertime processes. Sea ice duration controls ocean stratification, which acts as a gateway to the carbon-rich ocean interior. Consequently, years with persistent sea ice cover and high mean winter stratification absorb, on average, 20% more carbon dioxide than years with less sea ice and weaker stratification in winter. Wintertime marine observations are therefore essential to resolve critical processes and reliably quantify interannual variability of the sea-air carbon dioxide flux in seasonally sea ice-covered regions
First steps to implement SOCONET-Tier 1 measurements and data delivery
Get PDFThis document describes the first operational steps to implement the reference-quality measurements of the Surface Ocean CO2 Observing Network (SOCONET-Tier 1). The network aims to coordinate groups making high-quality surface water fugacity1 of CO2 (fCO2w) and marine boundary dry mole fraction (xCO2) observations. SOCONET-Tier 1 will be the observational cornerstone for surface ocean fCO2w observations to quantify sea-air CO2 fluxes with sustained delivery of reference quality datasets in support of efforts such as the WMO Global Greenhouse Gas Watch (G3W). The requirements for SOCONET-Tier 1 are to perform high-quality observations with an accuracy of <2 µatm in fCO2w and <0.2 ppm (µmol mol-1) in mole fraction in dry air, xCO2a, and implementation of these measurements in a coordinated framework with benefits outlined in Table S1. This approach and these accuracies are necessary to constrain global annual sea-air CO2 fluxes to 0.2 Pg C (1015 g C) or uncertainties of less than 10% of the current annual global sea-air CO2 flux (Bender et al. 2002). Here we provide the practical considerations to establish uniform presentation, documentation, and (meta)data delivery. It incorporates ideas and common practices in place by established operators with the goal of providing a unified outward-facing presence of the entities providing high-quality measurements. Therefore, adoption of the steps by established groups is envisioned to be relatively straightforward. This document is focused on Tier 1 operations, but much of the practices will likely be adapted for non-Tier 1 measurements once experience is gained in incorporating the procedures by the established groups. This document is not an implementation plan for SOCONET, which would entail a holistic view of SOCONET and its role in a surface water CO2 observing system, including detailed network design and gap analysis of spatial and temporal coverage of measurements
Reimagining dementia care: A complex intervention systematic review on optimising social prescribing (SP) for people living with dementia (PLWD) in the United Kingdom
Get PDFIntroduction: Dementia is a complex medical condition that poses significant challenges to healthcare systems and support services. People living with dementia (PLWD) often face complex needs, exacerbated by social isolation and difficulty accessing support. Social prescribing (SP) has been increasingly integrated into the United Kingdom's National Health Service (NHS) as a means to connect individuals with non-clinical services to address these challenges. However, current research provides limited detail on specific SP interventions tailored to dementia care, leaving gaps in understanding the targeted needs, participation drivers, effectiveness and potential benefits for PLWD. Methods: A complex intervention systematic review of SP in dementia care was performed in the United Kingdom using an iterative logic model approach. Six databases and grey literature were searched, supplemented by hand searching for reference lists of included studies. Results were screened in a two-step process, followed by data extraction. Risk of bias was assessed using Gough's Evidence of Framework. Reporting was informed by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA-CI) extension statement and checklist. Results: Forty-nine studies, reporting on PLWD, met the inclusion criteria. Findings indicate that SP for PLWD in the United Kingdom is varied and lacks focus, reflecting the diverse demographics involved. Interventions encompass cognitive, educational, psychosocial, physical, community and complementary therapies, of inconsistent classification, with some being umbrella interventions and others standalone services. Provided by the NHS, charities and integrated services, SP involves a range of referrers and connectors. Finally, individual outcomes show benefits such as increased independence and improved mood, but challenges pertaining to suitability and logistical issues, whereas systemic outcomes include cost savings and better service delivery, despite high implementation costs. Conclusion: SP pathways for PLWD are varied, with success relying heavily on adequately resourced and trained connectors. While benefits extend beyond health improvements, further research is needed to assess long-term impacts, refine mechanisms and standardise evaluation metrics for SP effectiveness in dementia care. Patient and Public Contributions: A PPI advisory group, consisting of a person living with dementia and a caregiver, was actively involved throughout the review process, providing insights into the review questions, the logic model, emerging findings and interpretation of results