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Perspectives from early-onset colorectal cancer patients on their treatment experiences during a pandemic
No full textRapid response online comment on 'Data from a large Western centre exploring the impact of COVID-19 pandemic on endoscopy services and cancer diagnosis' Frontline Gastroenterology 2021; 12: 193-199
Poverty in Northern Ireland: from the local to the global
No full textExecutive SummaryThe terms of reference for this report centred around undertaking an evidence synthesis/systematic review of literature published in the period 1st January 2020 to 31st December 2024, on the topic of poverty in Northern Ireland. In addition, the terms of reference wanted an analysis of levels of poverty in Northern Ireland, compared to the rest of the UK, the Republic of Ireland and some international comparators from Europe and the rest of the world. The G12 countries, plus the Republic of Ireland, England, Scotland and Wales, were determined to make a suitable group to make comparisons with. The report that follows synthesises published research literature and reports and then sets poverty in Northern Ireland within a broader national and international context. This evidence is then used to make informed recommendations that could support effective anti-poverty policy interventions in Northern Ireland.This review provides an evidence synthesis of the literature on poverty in Northern Ireland since 2020. A systematic search across five major databases was undertaken: Scopus, Web of Science, Social Policy and Practice, PsycINFO, and Medline. A total of 622 studies were retrieved from academic, government, policy, and non-statutory sources. These studies were exported to Evidence for Policy and Practice Information Centre (EPPI) Reviewer (Version: 6.16.0.0) for screening and data extraction. After identifying and removing 350 duplicates, two reviewers conducted an initial screening of titles and abstracts, excluding 219 records based on inclusion criteria. Subsequently, 82 records underwent full-text screening, with 53 meeting the inclusion criteria and being incorporated into the evidence synthesis. The findings from these 53 studies are organised into eight key thematic areas: child poverty, health poverty, food poverty, energy poverty, educational outcomes, housing and homelessness, employment poverty, and the cost of living. International ComparisonsPoverty in Northern Ireland is contextualised by comparing it with the G12 countries and Republic of Ireland. Comparative analysis revealed that, in terms of income, Northern Ireland ranked 16th out of 17 countries. However, it ranks first in terms of low unemployment, demonstrating a strong labour market presence. Northern Ireland holds the 14th out of 17 countries for life expectancy, while for child poverty, it is ranked 7th out of 17. In educational outcomes, Northern Ireland’s reading scores place it 9th among the 17 comparator countries. These findings provide a nuanced understanding of the multifaceted nature of poverty in Northern Ireland and offer insights into its relative position on the global stage. RecommendationsThere is an urgent need to develop a comprehensive anti-poverty strategy in Northern Ireland with measurable targets. Department for Communities (2024) report that 349,000 people live in poverty in Northern Ireland. These strategies need to be resilient and robust in the face of a changing and sometimes unstable political climate in Northern Ireland. This means a cross-community, cross-party approach to poverty developed and approved by the Northern Ireland Assembly that develops long-term solutions to poverty by:• Developing a clear plan to eradicate poverty by the provision of financial aid packages to ensure all households have monthly income of greater than £373 per week (the figure set by the Government as being the threshold for living in poverty or not living in poverty).• Reform of welfare policies and a movement away from neoliberalism ideology underpinning these policies.• Addressing health inequalities with significant financial investment into life-changing interventions in the poorest areas of Northern Ireland, where health inequalities are greatest.• Addressing food poverty and ensuring that all families in Northern Ireland can live without food insecurity. • Undertaking historical and planned future high-quality analysis of Northern Ireland longitudinal data sets (e.g., health data, benefits data, school attainment data, population census data) to examine patterns of poverty and inequality, looking at how public policy and Government decisions have influenced outcomes, and make similar comparisons to England, Scotland, Wales, the Republic of Ireland and suitable international countries. • Investment in, and support for, affordable childcare to ensure parents (especially those who may be primary care givers) can take their place in the workforce and by being economically active increased their household income. This ultimately would lift many families out of poverty.• Improving the quality and availability of housing, ensuring affordable rental property was well insulated, energy efficient, and free from damp and mould. This would reduce poverty, improve health of the renting population and their children, and help Government meet targets on carbon emissions.• Improving access to all forms of education, especially for disadvantaged groups, where publicly funded schools should educate a representative section of the communities they serve. In essence, the Northern Ireland Assembly should set quotas for free school meal entry for grammar schools that are representative of the geographic areas in which they are situated.• Address transport and digital poverty, particularly in rural areas.<br/
Novltex: a new class of antibiotics with potent activity against multidrug-resistant bacterial pathogens─design, synthesis, and biological evaluation
No full textIncreasing spread of multidrug-resistant (MDR) bacteria demands antibiotics that combine potent activity with scalable synthesis. Novo29 (clovibactin) is promising but suffers from low yield (1%), dependence on costly and noncommercial d-hydroxy-asparagine (d-Hyn5), and lengthy syntheses. We report “Novltex”, a novel class of antibiotic that fuses the Leu10-teixobactin macrocycle to the Novo29 N-terminus tail, replacing d-Hyn5with inexpensive threonine. Our efficient synthesis delivers 30% yield with faster coupling cycles (∼10 min), enabling rapid and low-cost scale-up. A 16-member analogue library systematically probing amino-acid configuration identified analogue 4 (d-Leu2) as the initial lead, informing the rational design of analogue 12 (d-cyclohexylalanine2). Analogue 12 displays potent antibacterial activity (minimum inhibitory concentration (MIC) 0.12–0.5 μg/mL) against World Health Organization (WHO)-priority pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus faecium, surpassing several licensed antibiotics while maintaining an excellent safety profile. Lipid II-binding assays confirm the conservation of the parent mechanism. Novltex, therefore, offers a practical, high-yielding, and cost-efficient platform for the development of next-generation antibiotics targeting MDR infections.</p
Cultural models within general practice training: a scoping review
No full textBACKGROUND: Doctors training to become general practitioners (GPs) are increasingly working in cross cultural consultations. Cultural models have been developed as frameworks to better equip medical professionals towards more culturally appropriate health care, with potential to improve equity in healthcare systems.AIM: To map evidence on models of cultural competence, cultural safety, cultural humility and transcultural care within GP training worldwide.DESIGN & SETTING: Scoping review using Arksey and O'Malley's framework.METHOD: Searches were conducted across three databases, extending to grey literature such as curricula. Articles were extracted, reviewed and analysed according to inclusion criteria.RESULTS: Nineteen articles met inclusion criteria. Publications ranged from 2008-2024, with 10 articles from Australia, 5 from USA, 2 Sweden, 1 Canada and 1 the Netherlands. Three themes were generated: Unlearning, Informal Learning, and Informed Learning. The literature illustrates that there are gaps in knowledge of what the models are and how best to practise and teach them within GP education.CONCLUSION: Cultural models advocate for cultural awareness, examine power imbalances, and encourage self-reflexivity and learning. Integrating cultural models into healthcare can better serve all patients, with potential to reduce health inequities. There also needs to be an adaptation to learning in traditional GP consultations with a focus on how our own biases impact the care that we provide, and a more formal learning of cultural models best delivered by GP trainers in partnership with cultural mentors.</p
Working conditions of artists: an interdisciplinary study of space for dance on the island of Ireland
No full textThis chapter builds on existing research in cultural policy studies and dance scholarship regarding the experience of work in the cultural sector by drawing attention to considerations of space in working conditions for dance. Space refers to both the location or environment, as well as the expanse (material and conceptual), in which work happens. We argue that dance workers’ development and practice is impacted by, and occurs within, space that is physical, temporal, social and conceptual. Grounding the discussion in experiences of a particular socio-cultural context – the two-polity space of the island of Ireland – this chapter discusses findings from two cross-border studies mixing dance practice-as-research and social science methods to explore the working conditions and experiences of dance practitioners: i) the ‘Dance Counts’ survey 2021 and ii) ‘Dance Conversations’. These studies were designed by, and involved collaboration between, two social science researchers (Durrer and Campbell) and a dance scholar (McGrath). The discussion of dance workers’ experience of space considers (i) physical space and (ii) social and collective space, and how they relate to, and impact, dancers’ experiences of space for dance. In its approach, this chapter furthers the case for the potential of interdisciplinary approaches to build understanding of the lived experiences of artistic, creative and cultural practice
The experiences of bedside nurses delivering an intensive care sedation study: a process evaluation within the A2B trial
No full textBackground:This process evaluation explored delivery of a complex sedation intervention within the Alpha-2 Agonists for Sedation to Produce Better Outcomes from Critical Illness (A2B) trial, which compared dexmedetomidine- and clonidine-based sedation with propofol (usual care). All groups targeted lighter sedation levels. The objective was to understand bedside nurses’ experiences delivering the interventions and identify factors influencing protocol adherence and implementation.Methods:A qualitative study using semi-structured interviews was conducted with intensive care unit (ICU) staff (consultants, bedside and research nurses) from A2B trial sites. Thematic analysis explored how participants experienced and delivered trial interventions, with particular focus on bedside nurses’ abilities to manage sedation in line with the protocol.Results:Nurses with greater ICU experience described more confidence and adaptability in using alpha-2 agonists, while less experienced staff required support due to limited familiarity with lighter sedation. Hesitancy to up-titrate alpha-2 agonists was common, driven by concerns about bradycardia and hypotension. Reluctance to down-titrate propofol was shaped by fears of agitation and self-extubation. Deep sedation norms, especially amongst nurses trained during the COVID-19 pandemic, further hindered protocol adherence. Research nurses were instrumental in supporting implementation and bridging knowledge gaps.Conclusion:Despite all three trial groups targeting lighter sedation, nurse confidence, safety concerns, and ingrained cultural practices limited adherence to alpha-2 agonist-based protocols. Addressing these barriers through training, support, and cultural change will be essential for future trials and practice shifts involving lighter sedation strategies in ICU.Trial registration number:ClinicalTrials.gov NCT03653832 https://clinicaltrials.gov/study/NCT03653832<br/
Efficient parameter estimation and communication path identification in ISAC
No full textAs demand for spectrum efficiency and multi-functional systems grows, dual-function radar-communication (DFRC) systems within integrated sensing and communication (ISAC) networks present a compelling solution by combining radar and communication tasks. Extracting essential parameters from received signals, as well as accurately identifying communication paths, are among the most important practical aspects of these systems. However, existing approaches often suffer from low accuracy and resolution in estimation and index ambiguity problems when modeling communication paths. To address these issues, this paper presents an efficient approach for parameter estimation and path identification in DFRC systems. We introduce a fourth-order statistics (FOS)-based technique to enhance angle estimation accuracy and resolution. Also, the corresponding Cramér-Rao bound (CRB) is extracted to assess the theoretical limits of the angle estimation performance. Additionally, we propose an improved matched-filtering algorithm for delay and Doppler estimations, minimizing interference. For scattering coefficient estimation, an adapted angle and phase estimation technique is applied, offering significant accuracy improvements. Besides, by identifying the problem of index ambiguity mathematically, we introduce an effective solution to solve it. Extensive simulation results validate the superiority of the proposed approach over existing methods in estimating angle, delay, Doppler and scattering parameters, without requiring excessively high computational resources.<br/
A lightweight and hardware-efficient NTT FPGA accelerator for FHE applications
No full textThe Number Theoretic Transform (NTT) and its inverse (INTT) are pivotal operations in Fully Homomorphic Encryption (FHE) schemes to facilitate efficient polynomial multiplication over modular rings. We propose a compact and hardware-efficient NTT/INTT architecture for FHE systems with a novel twiddle factor generator (TFG) for Radix-2 multi-path delay commutator (MDC) designs, saving up to 97.2% of on-chip memory by storing the twiddle factors (TF) for the initial 11 stages (for log2(N) = 15 to 17) and only the TF bases for on-the-fly generation in the remaining stages. DSP-efficient multipliers via non-standard tiling are designed to reduce DSP utilization as compared to standard tiling, without sacrificing performance. Benchmarking on comparable Xilinx FPGAs reveals that our design is the most compact, along with a significant efficiency advantage with up to 2.72× reduction in average area-time product (ATP) and up to 2.57× increase in throughput-per-equivalent-LUT (TPE) compared to state-of-the-art NTT designs. In various configurations, the architecture maintains lower BRAM and DSP utilization, and better overall efficiency, making it a scalable and efficient solution for real-world FHE deployments.<br/
The changing food allergen landscape in Europe calls for harmonised food allergen monitoring: position paper
No full textWith the changing food allergen landscape in Europe, there is an increasing need for the monitoring of (non-)prepacked food products to improve the protection of consumers with food allergies. Although food allergy is a condition affecting up to 10 % of the consumers worldwide, a European harmonised approach for the management of precautionary allergen labelling, allergen reference doses, analytical methods or food product monitoring is not in place. This leads to limited food choices for consumers with food allergies but can also result in the occurrence of serious allergic incidents. The current state of non-harmonised and unregulated food allergen monitoring in Europe means risks and considerable costs for the individual consumer, but also for society in general. In this position paper, we argue for the introduction of harmonised guidelines for food allergen monitoring on the European level based on a discussion of the wide-ranging implications their lacking entails. We believe that there is a pressing need to update the European legislation on food allergens, including the introduction of harmonised monitoring programmes, which will lead to improved overall food safety, and better protection and options for consumers with food allergies.<br/
The challenges of performing exome sequencing in structurally normal fetuses
No full textWhat’s already known about this topic?•Exome sequencing in structurally normal fetuses is not currently representatative of wider routine clinical practice internationallyWhat does this study add?•This summates recent evidence regarding studies assessing the clinical utility of prenatal exome sequencing in structurally normal fetuses•This highlights the interpretational and ethical challenges posed by performing prenatal sequencing in this scenario<br/