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‘A lack of cultural understanding and sometimes interest’: Towards half a century of anti-racist policy, practice and strategy within probation
Get PDFIn 2021, HM Inspectorate of Probation published a long awaited and highly critical report – Race equality in probation: the experience of black, Asian and minority ethnic probation service users and staff. The inspection upon which it was based was conducted in the Autumn of 2020 and was therefore set against the background of the death of George Floyd in the United States, the rise of the Black Lives Matter movement worldwide. The Black Lives Matter (BLM) movement laid down a challenge on many levels, stating that black, Asian and minority ethnic people must be accepted and respected as equal citizens and nowhere is this more urgently needed than within the operation of the criminal justice system. The article seeks to move beyond the conclusions and recommendations of the Inspection report using the lens of Critical Race Theory to engage in a discussion of systemic racism in society. To do this we have used three levels of analysis – macro, meso and micro – to situate contemporary probation within the wider structures of a post-colonial
society
TIC 184743498: The first tri-axial stellar pulsator
Get PDFWe have discovered a δ Scuti pulsator in a tight binary (P = 1.053 d) with nine pulsation modes whose frequencies are between 38 and 56 d−1. Each of these modes exhibits amplitude modulations and π-rad phase shifts twice per orbital cycle. Five of these modes exhibit amplitude and phase shifts that are readily explained by dipole pulsations along an axis that is aligned with the binary’s tidal axis. The novelty of the system lies in the remaining four pulsation modes, which we show are dipole pulsations along an axis that is perpendicular to both the tidal axis and the binary’s orbital angular momentum axis. There are additionally two pulsation modes whose amplitudes and phases do not change significantly with orbital phase; they are explained as dipole modes along an axis aligned with the orbital/rotation axis. Hence, we propose that TIC 184743498 is a tri-axial pulsator, the first of its kind
A qualitative analysis of free‑text patient satisfaction responses in Care Response, a database of patient‑reported outcome and experience measures
Get PDFBackground: Databases have become important tools in improving health care. Care Response is a database containing information on tens of thousands of chiropractic patients internationally. It has been collecting patient-reported outcomes and patient satisfaction information for more than 10 years. The purpose of this study was to contribute to the understanding of patient perceptions and priorities for chiropractic care by analysing free text entered into the patient reported experience measure (PREM) questionnaires within the Care Response system. Methods: There were two questions of interest on the PREM for this study. One requested information about “good points” patients perceived about patients’ care experience, and the other requested information on “improvements” that could make the experience better. We conducted a word frequency analysis using a word counting macro in Microsoft Word, then used those results as a starting point for a qualitative analysis. Data were collected on 30 May 2022. Results: The people who participated in the Care Response system often reported positive experiences with their chiropractors, including that they had reduced pain, improved function, and felt validated in their clinical condition. In addition, they appreciated having diagnostic and treatment procedures explained to them. They valued friendly, professional, and on-time service. The negative experiences were the opposite: being rushed through treatment, that the treatment was not worth the cost, or that they weren’t treated professionally, empathetically, or with respect for them as individuals. The most important themes that emerged under “good points” were satisfaction (with care), value (as a person), safety, comfort, and professionalism. Their opposites, dissatisfaction, lack of value, lack of safety, lack of comfort, and lack of professionalism emerged as the most important themes under “improvements”. We report some nuances of patient experience that have not previously been explored in the literature. Conclusions: Respondents seemed to value effective care provided in a safe, professional, friendly, and aesthetically pleasing environment. Chiropractors should note these priorities and engage with patients according to them. Education institutions should consider how good practice in these areas might be incorporated into curricula
‘I should do what?’ Addressing research misconduct through values alignment
Get PDFEvidence suggests that the incidence of research misconduct is not in decline despite efforts to improve awareness, education and governance mechanisms. Two responses to this problem are favoured: first, the promotion of an agent-centred ethics approach to enhance researchers’ personal responsibility and accountability, and second, a change in research culture to relieve perceived pressures to engage in misconduct. This article discusses the challenges for both responses and explains how normative coherence through values alignment might assist. We argue that research integrity and research ethics convey mixed messages, which are likely to contribute to a form of normative confusion. For the successful adoption of an agent-centred approach, normative coherence is needed between the two. To facilitate normative coherence, we propose that research ethics and research integrity be underpinned by a shared set of moral values that can be enacted via codes and guidelines and imbue research environments. Furthermore, to facilitate culture change, the same normative coherence is necessary at all levels of an institution. Only via values alignment between institutional aims, management, institutional practices and researchers can an ethical culture become truly embedded in research institutions
Disaccharide compositional analysis of chondroitin sulphate using WAX HILIC-MS with pre-column procainamide labelling; application to the placenta in pre-eclampsia
Get PDFChondroitin sulphate (CS) and dermatan sulphate are negatively charged linear heteropolysaccharides. These glycosaminoglycans (GAG) are involved in cellular signalling via binding to growth factors. CS is expressed in a range of tissue and biological fluids and is highly expressed in the placenta. There is evidence that decorin; a CS proteoglycan is significantly decreased in pre-eclampsia and fetal growth restriction. It is considered that GAG chain composition may influence cellular processes that are altered in pre-eclampsia. The goal of the present study was to develop an LC-MS method with precolumn procainamide labelling for the disaccharide compositional analysis of CS. The method was used to investigate whether the disaccharide composition of placenta-extracted CS is altered in pre-eclampsia. The study revealed differential disaccharide compositions of placental chondroitin sulphate between pre-eclampsia and other pregnancy conditions. This suggests that the method may have diagnostic potential for pregnancy disorders. Furthermore, the findings suggest that CS sulphation might play a significant role in maternal labour
The Environmental and Economic Importance of Mixed and Boundary Friction
Get PDFOne route to reducing global CO2 emissions is to improve the energy efficiency of machines. Even small improvements in efficiency can be valuable, especially in cases where an efficiency improvement can be realized over many millions of newly produced machines. For example, conventional passenger car combustion engines are being downsized (and also downspeeded). Increasingly, they are running on lower viscosity engine lubricants (such as SAE 0W-20 or lower viscosity grades) and often also have stop-start systems fitted (to prevent engine idling when the vehicle is stopped). Some of these changes result in higher levels of mixed and boundary friction, and so accurate estimation of mixed/boundary friction losses is becoming of increased importance, both for estimating friction losses and wear volumes. Traditional approaches to estimating mixed/boundary friction, which employ real area of contact modelling, and assumptions such as elastic deformation of asperities, are widely used, but recent experimental data suggests that some of these approaches underestimate mixed/boundary friction losses. In this paper, a discussion of the issues involved in reliably estimating mixed/boundary friction losses in machine elements is undertaken, highlighting where the key uncertainties lie. Mixed/boundary lubrication losses in passenger car and heavy-duty internal combustion engines are then estimated and compared with published data, and a detailed description of how friction is related to fuel consumption in these vehicles, on standard fuel economy driving cycles, is given. Knowing the amount of fuel needed to overcome mixed/boundary friction in these vehicles enables reliable estimates to be made of both the financial costs of mixed/boundary lubrication for today’s vehicles, and their associated CO2 emissions, and annual estimates are reported to be approximately $290 billion dollars with CO2 emissions of 480 million tonnes. This paper is an expanded version of a conference paper [1] that was originally delivered at the LUBMAT 2023 International Conference which took place in Preston, UK, in July 2023
Prevalence of symptoms of post stroke depression and anxiety in young adults: a systematic review and meta-analysis
Get PDFBackground
Young adults with stroke have distinct professional and social roles making them vulnerable to symptoms of post-stroke depression (PSD) and post-stroke anxiety (PSA). Prior reviews have examined the prevalence of anxiety and depression in stroke populations. However, there are a lack of studies that have focused on these conditions in young adults.
Objective
We performed a systematic review and meta-analysis of observational studies that reported on symptoms of PSD, PSA and comorbid PSD/PSA in young adults aged 18 to 55 years of age.
Methods
MEDLINE, EMBASE, SCOPUS and PsycINFO were searched for studies reporting the prevalence of symptoms of PSD and/or PSA in young adults with stroke from inception until June 23, 2023. We included studies that evaluated depression and/or anxiety symptoms with screening tools or interviews following ischemic or hemorrhagic stroke. Validated methods were employed to evaluate risk of bias.
Results
4,748 patients from twenty eligible studies were included. Among them, 2,420 were also evaluated for symptoms of PSA while 847 participants were evaluated for both PSD and PSA symptoms. Sixteen studies were included in the random effects meta-analysis for PSD symptoms, with a pooled prevalence of 31% (95% CI 24-38%). Pooled PSA symptom prevalence was 39% (95% CI 30-48%) and comorbid PSD with PSA symptom prevalence was 25% (95% CI 12-39%). Varying definitions of ‘young adult’, combinations of stroke subtypes, and methods to assess PSD and PSA contributed to high heterogeneity amongst studies.
Conclusions
We identified high heterogeneity in studies investigating the prevalence of symptoms of PSD and PSA in young adults, emphasizing the importance of standardized approaches in future research to gain insight into the outcomes and prognosis of PSD and PSA symptoms following stroke in young adults. Larger longitudinal epidemiological studies as well as studies on tailored interventions are required to address the mental health needs of this important population.
Funding
None
Designing Community Services for People With Borderline Personality Disorder to Reduce Hospitalizations
Get PDFPrevious evaluations of interventions for borderline personality disorder have focused on psychotherapies. This study (N=42 patients), conducted in Liverpool, United Kingdom, reviewed the effect on out-of-area treatments (OATs) and hospital admissions of establishing a local case management team and a combined day and crisis service for patients who are too dysregulated to access typical office-based psychotherapy. Data from 12, 24 and 36 months postintervention were compared with baseline data. All patients in OATs were repatriated. No new patients were sent to OATs. Hospital admissions decreased statistically significantly (at 24 months, 64%; at 36 months, 74%), achieving savings. Moderate increases in the use and costs of some other services were observed
ERS International Congress 2023: highlights from the Clinical Techniques, Imaging and Endoscopy Assembly.
Get PDFThe Clinical Techniques, Imaging and Endoscopy Assembly is involved in the diagnosis and treatment of several pulmonary diseases, as demonstrated at the 2023 European Respiratory Society (ERS) International Congress in Milan, Italy. From interventional pulmonology, the congress included several exciting results for the use of bronchoscopy in lung cancer, including augmented fluoroscopy, robotic-assisted bronchoscopy and cryobiopsies. In obstructive lung disease, the latest results on bronchoscopic treatment of emphysema with hyperinflation and chronic bronchitis were presented. Research on using cryobiopsies to diagnose interstitial lung disease was further explored, with the aims of elevating diagnostic yield and minimising risk. For imaging, the latest updates in using artificial intelligence to overcome the increased workload of radiologists were of great interest. Novel imaging in sarcoidosis explored the use of magnetic resonance imaging, photon-counting computed tomography and positron emission tomography/computed tomography in the diagnostic work-up. Lung cancer screening is still a hot topic and new results were presented regarding incorporation of biomarkers, identifying knowledge gaps and improving screening programmes. The use of ultrasound in respiratory medicine is an expanding field, which was demonstrated by the large variety in studies presented at the 2023 ERS Congress. Ultrasound of the diaphragm in patients with amyotrophic lateral sclerosis and myasthenia gravis was used to assess movements and predict respiratory fatigue. Furthermore, studies using ultrasound to diagnose or monitor pulmonary disease were presented. The congress also included studies regarding the training and assessment of competencies as an important part of implementing ultrasound in clinical practice