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The CoACH Study - Policy Briefing
Get PDFExecutive Summary• In Hull, a significantly higher proportion of the population is dependent on alcohol (2.38%) compared to the national average (1.39%). • It is estimated that 1 in 10 hospital inpatients experience alcohol dependence. In Hull, there is a high rate of alcohol-related hospital readmissions, with 45% of people being admitted 3 or more times in a year.• Alcohol Assertive Outreach Treatment (AAOT) is a valuable care option for people with alcohol dependence and physical co-morbidities, who are frequently admitted and who often don’t engage with traditional alcohol support.• A mixed-methods evaluation of AAOT in Hull shows evidence of reductions in alcohol consumption, improvements to quality of life, and less hospital service use.• We estimate a net saving of £7765 per service-user in hospital costs in the first year.• Qualitative research consistently found high quality AAOT was effective in supporting individuals’ recovery, through assertive advocacy and cultivating hope.•The evaluation identified that AAOT can be successfully implemented with fidelity to the high-quality model
Redox-innocent scandium(III) as the sole catalyst in visible light photooxidations
Get PDFIn recent years, the catalytic activity of scandium triflate Sc(OTf)3 has attracted significant attention due to its robust Lewis acidity and the oxophilicity of Sc3+. These features have led to impressive progress in developing diverse organic reactions, including C-C bond formation. The Sc3+ also facilitates single electron transfer in photoinduced reactions either by coordination to an organophotoredox catalyst, which modifies its redox reactivity, or by the formation of a scandium–superoxide anion complex after electron transfer from a light-absorbing redox-active compound. The prior consideration of Sc3+ as a redox-inactive/innocent metal ion initially hampered the investigation of the possibility of using Sc(OTf)3 as a sole visible light photoredox catalyst. This work demonstrates the use of Sc(OTf)3 as a visible light photocatalyst capable of direct and mild aerobic oxidative C-H functionalisation of aromatic substrates by oxidation of the benzylic position and direct cyanation of the aromatic ring
Risk communication during treatment decision-making conversations with older people with advanced kidney disease
Get PDFObjective: Most older people with advanced kidney disease are medically ineligible for transplant, hence the treatments available are dialysis or conservative kidney management (CKM). Previous research indicates that in the information patients receive from clinicians, dialysis is often prioritised over CKM. However, there is evidence that for older people and those with other health issues, dialysis is not always more beneficial. The aim was to investigate whether and how risks and benefits are discussed in relation to these options in consultations, to convey CKM as a valid option. Methods: Outpatient consultations were recorded across four UK renal units purposively selected for variability of CKM rates amongst patients age 65+ with Chronic Kidney Disease. All data are British English. A total of 30 conversations were identified which concerned a decision between dialysis and CKM (22 led by doctors and 8 led by nurses). These included 20 conversations where options were listed to undecided patients, eight where a prior decision was revisited, and two where a recommendation was made against dialysis. Conversations were analysed using conversation analysis. Results: We found that CKM was only treated as a valid option by patients when the risks, burdens and limited benefits of dialysis were framed as significant in terms of quality and/or length of life. We found the following aspects of clinician communication enabled patients to respond in a way that treated CKM as a valid treatment option: 1) talking about the impact of dialysis to a person's quality of life, 2) conveying uncertainty regarding the potential benefit of dialysis to length of life, 3) conveying risk as being personally relevant to the patient's circumstances. Practice implications: Findings demonstrate how clinicians can convey information to patients about the risks of dialysis in advanced kidney disease to enable patients to recognise and consider CKM as a valid option
The Merging Galaxy Cluster Environment Affects the Morphology of Radio Active Galactic Nuclei
Get PDFIt has previously been found that the galaxy cluster environment can affect the fueling and evolution of active galactic nuclei (AGN). This work examines the effect of the merging cluster environment on the properties of radio AGN by comparing the radio morphology of cluster members in a sample of four merging and eight relaxed galaxy clusters at low redshift (z < 0.2). Using 144 MHz data from the LOFAR Two-meter Sky Survey and Zooniverse, we classify the radio morphology of the radio-detected cluster members using the following morphology classes: compact, compact extended, extended, jetted, and disturbed. We find that the merging cluster environment has a statistically significant, higher population proportion of disturbed (bent and head tail) sources, indicating that the merging environment can affect the morphology of cluster radio AGN. We also investigate the number of AGN that are detected in the radio data only and the number that are detected in both the radio and optical data in mergers and nonmergers. We find that the merging cluster environment has a higher population proportion of AGN that are identified only as radio AGN compared to AGN that are identified as both radio and optical AGN. Overall, we find that the merging environment affects certain radio AGN (disturbed and only radio-identified AGN), but not all
Cough frequency has a high daily variation in patients with chronic cough
Get PDFOpening paragraph:Chronic cough (coughing lasting 8 weeks or longer) is a burdensome disease, causing low quality of life due to the disruption that frequent coughing causes to daily life. Its prevalence is estimated to be 10% of the global population. Chronic cough can be due to underlying conditions such as asthma and COPD, or can persist despite treatment (refractory chronic cough) or have unidentified origins (unexplained chronic cough). Due to its prevalence and lack of effective treatments, there is high interest in developing drugs for refractory and unexplained chronic cough. Cough frequency, represented as coughs per hour measured over 24 h or awake time, has been used as a key endpoint in multiple clinical drug trials
Reimagining Dementia Care: A Complex Intervention Systematic Review on Optimising Social Prescribing (SP) for People Living with Dementia (PLWD) in the UK
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
Editorial: Internal and external factors affecting polycystic ovary syndrome
Get PDFOpening paragraph:Polycystic ovary syndrome (PCOS) pathophysiology is modified by a multitude of internal and external factors that go far beyond the traditional stimulators and inhibitors of endocrine response and function. This Research Topic call was to specifically include state-of-the art methodologies and review articles, with the result that 21 manuscripts were published that could be broadly divided into mendelian randomisation studies (RMS), articles regarding lifestyle and PCOS pathophysiology, and fertility including in vitro fertilization studies, the overview of which is shown in Figure 1
Neoliberalism, City-Regionalism, Transit Planning, Regional Equity
Get PDFPublic transit service provision is fraught with contradictions and tensions, which today tend to converge around the city-regional scale of planning and governance. The promise of public transit is to promote economic development and improve regional accessibility, mobility, equity, and sustainability. However, these priorities can often conflict with each other, resulting in the splintering of the corresponding city-regional planning and governance structures set up to finance and deliver major transit infrastructure projects. Drawing upon a case study of transit-led city-regionalism in Denver, Colorado, USA, this article explores how the tensions and contradictions embedded within regional public transit service planning are exposed and exacerbated during times of financial austerity, such as during the COVID-19 pandemic. It examines how the neoliberal goals of promoting transit-oriented redevelopment in Denver alongside expanding service to Denver’s wealthier suburbs clash with the pandemic-induced expediency of targeting transit service for front-line workers and transit-dependent populations in core urban neighborhoods. The article demonstrates that in times of COVID-19-induced urban austerity the entrepreneurial city-regional approach to infrastructure provision originally developed for the FasTracks expansion program is increasingly at odds with regional objectives to use mass transit to foster equity and transport justice
Exploring the superior mild temperature performance of nickel-infused fibrous titania silica for enhanced dry reforming of methane
No full textCarbon (IV) oxide (CO2) and methane (CH4) contribute significantly to greenhouse gas emissions and global warming. One potential approach for reducing their environmental impact is transforming these gases into synthesis gas (CO + H2). This study illustrates the advancement of catalysts supported by fibrous titania silica (FTS), which have nickel loadings of 1%, 3%, and 5%. The FTS support, a modified variant of silica-titania, has a distinct fibrous structure and exhibits mesoporous material properties such as a type IV isotherm and an H1 hysteresis loop. After 72 h of operation, the 1Ni/FTS catalyst converted over 80% of CH4 and CO2 with low coke deposition, outperforming other catalysts. The bare FTS support had reduced CH4 conversion at 600 °C, CO2 conversion at 650 °C, and H2/CO ratio at 700 °C. However, the 5Ni/FTS and 3Ni/FTS catalysts showed consistent increases in CH4 conversion at 600 °C. The 1Ni/FTS catalyst, with a pore size of 7.39 nm, had strong metal-support interaction and moderate basicity sites, which helped with reactant dissociation and coke gasification. Despite the slightly higher CH4 conversion of the 3Ni/FTS catalyst and the high basicity of the 5Ni/FTS catalyst, the 1Ni/FTS catalyst demonstrated superior thermal stability and coking resistance, as evidenced by negligible weight loss during TGA analysis. Raman shifts revealed the presence of carbon synthesis and the buildup of disordered amorphous carbon. The Id/Ig ratios of FTS, 1Ni/FTS, 3Ni/FTS, and 5Ni/FTS were 1.01, 0.98, 1.01, and 1.01, respectively. The lower Id/Ig ratio of 1Ni/FTS suggests less disorder. The FTS support promises mild-temperature, carbon-neutral CH4 reforming with long-term catalytic applications. This study demonstrates the efficacy of FTS-supported catalysts in constructing long-term and efficient systems for converting greenhouse gasses
Maintaining Professional Face: Deceptive Impression Management in Community Sport Coaching
Get PDFThis article breaks new ground in the sociology of sports work through its novel exploration of workplace deception and the associated development of an original typology of deceptive impression management. Analysis of data collected from a two-phased research design, comprising online interviews and survey responses from 102 participants, revealed that community sport coaches employed deceptive impression management to display emotional control, an ideal practice of their work, and to feign expert knowledge. These types of deceptive impression management consisted of disguising disdain, flattering insincerely, camouflaging alternative approaches, covering-up mistakes, hiding a lack of expected knowledge, and reporting favourable metrics. Drawing on theories of dramaturgical analysis (Goffman, 1959, 1967, 1974) and emotional labour (Hochschild, 1979, 1983) as used in constructing a professional image, we examine how the coaches used deception to cope with challenging work circumstances that endanger projecting a professional appearance. The present article not only advances our sociological understanding of sports work but raises important questions for the preparation, development, and support of sports workers