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Facilitating GP registrations among children by linking with Child Health Information Services (CHIS)
Get PDFBackground Lack of access to primary care services, by not being registered with a general practitioner (GP), is a source of health inequality.1 Unregistered children are at risk of missing healthcare activity, including routine vaccination.2 NHS England has emphasised the importance of ensuring no child misses out on vaccination invitations and has sought to explore solutions for those not registered with a GP. NHS South, Central and West (SCW) currently provides Child Health Information Services (CHIS) coverage for 32% of the 0–19-year-old population in England.3 Approximately 1% (n=8000) of those aged 0–6 years within the areas covered are not registered with a GP. SCW CHIS maintains health records for all children aged 0–19 years who live in, attend school in, or are registered with a GP within one of its areas. CHIS is notified when a baby is born or moves into the area, when they register with a GP, and about their vaccinations and screening. The aim of this pilot was to facilitate GP registrations among children aged 0–6 years resident in Bath and North-East Somerset, Swindon, Wiltshire and Gloucestershire, so that families could access childhood vaccination and other healthcare services. Methods CHIS worked with NHS England South-West commissioners to develop a letter reminding parents/carers of the importance of registering their child with a GP. The letter was in plain English, written at a level below the average adult reading age, and included symbols to support accessibility. It outlined how to register, emphasising the process was quick, free and did not require a fixed address or identification. In September 2024, the letter was sent to the households of 807 children aged 8 weeks to 6 years who were not registered with a GP and had one or more missing routine vaccinations. A second letter was sent out the following month to all households where the child was under the age of 1 year (n=89). Results Within 2 months of the initial mailout, 77 children (9.5%) were newly registered with a GP in the area and 52 (6.4%) became up to date with their age-appropriate vaccinations.2 The cost of postage (the most expensive item at £0.86 per letter) for both mailouts (896 letters in total) was £770.56, which equates to just over £10 per new registration or just under £15 per child catching up with their vaccinations. Discussion and conclusion In recent years, there has been a rise in vaccine-preventable diseases such as measles, alongside widening health inequalities. It is therefore more important than ever that children are registered with a GP. CHIS providers are well positioned to identify non-registered cohorts and send simple and low-cost mailouts, resulting in increased registrations and an associated increase in uptake of routine childhood vaccination. Future work A planned project will expand the area covered and will look to identify indicators associated with uptake, for example, ethnicity, index of multiple deprivation. Related projects will look at the optimum number of reminders for vaccination appointments, moving to digital-first invitations and making reminders more accessible
TiDES : The 4MOST Time Domain Extragalactic Survey
Get PDFThe Time Domain Extragalactic Survey (TiDES) conducted on the 4 m Multi-Object Spectroscopic Telescope will perform spectroscopic follow-up of extragalactic transients discovered in the era of the NSF-DOE Vera C. Rubin Observatory. TiDES will conduct a 5 yr survey, covering >14, 000squaredegrees , and use around 250,000 fibre hours to address three main science goals: (i) spectroscopic observations of >30,000 live transients, (ii) comprehensive follow-up of >200,000 host galaxies to obtain redshift measurements, and (iii) repeat spectroscopic observations of active galactic nuclei to enable reverberation mapping studies. The live spectra from TiDES will be used to reveal the diversity and astrophysics of both normal and exotic supernovae across the luminosity-timescale plane. The extensive host-galaxy redshift campaign will allow exploitation of the larger sample of supernovae and improve photometric classification, providing the largest-ever sample of SNe Ia, capable of a sub-2% measurement of the equation-of-state of dark energy. Finally, the TiDES reverberation mapping experiment of 700–1000 AGN will complement the SN Ia sample and extend the Hubble diagram to z ∼ 2.5
A search for dark matter produced in association with a dark Higgs boson decaying into a Higgs boson pair in 3b or 4b final states using pp collisions at TeV with the ATLAS detector
No full textA search is performed for dark matter particles produced in association with a resonant pair of Higgs bosons using 140 fb −1 of proton-proton collisions at a centre-of-mass energy of 13 TeV recorded by the ATLAS detector at the Large Hadron Collider. This signature is expected in some extensions of the Standard Model predicting the production of dark matter particles, and is interpreted in terms of a dark Higgs model containing a Z′ mediator in which the dark Higgs boson s decays into a pair of Higgs bosons. The dark Higgs boson is reconstructed through final states with at least three b-tagged jets, produced by the pair of Higgs boson decays, in events with significant missing transverse momentum consistent with the presence of dark matter. The observed data are found to be in good agreement with Standard Model predictions, constraining scenarios with dark Higgs boson masses within the range of 250 to 400 GeV and Z′ mediators up to 2.3 TeV
Smart Office for Everyone : Real-Time Adaptation to promote Inclusion and Well-Being
No full textIntelligent office solutions increasingly rely on the Internet of Things (IoT) and Artificial Intelligence (AI) to optimize efficiency and comfort [1]. However, these solutions often neglect the needs of different generations, such as the tech-savvy Generation Z, work-life balance-conscious Millennials, and experienced Generation X employees [L3, L7]. To address this, a cloud-based IoT prototype integrating adaptive environmental control with generation-specific workplace strategies was created [3], demonstrating its potential to promote inclusion and productivity for all age groups in modern workplaces [2]. The approach improves comfort and inclusivity by incorporating generation-specific adaptations, positively impacting well-being and productivity
Transitions in the SEND system: collective research planning through action learning (AoP 1)
Get PDFThis paper tells the story of how a small group of academics and practitioners worked together using action learning to produce a collectively planned research proposal aimed at addressing challenges in the English special educational needs and disabilities (SEND) system. A genuine attempt to try something new, the paper reflects on the pros and cons of taking an approach which tries to balance doing action learning with engaging in research planning. After describing some of the challenges the SEND system faces, the paper focuses on the topic of transitions which emerged as a common theme in the action learning set we established. The paper summarises some of the problems brought to the set by its members, the asynchronous action learning process which evolved over email, the analysis of the textual threads contained in the emails and the emerging research focus on the importance of strategic documents which aim to introduce change. The paper concludes by reflecting on what we have learned from the process focusing especially on the tensions between research and practice
Predictors of short-term outcomes after post-operative periprosthetic femoral fracture : a UK linked data analysis
No full textAims Postoperative periprosthetic femoral fractures (POPFFs) following hip and knee arthroplasty are increasing. They often have poor outcomes. We have limited understanding of the predictors of these outcomes, which this study addresses. Methods We extracted administrative hospital data for patients aged 18 years and above with admissions to NHS hospitals in England with a primary diagnosis of POPFF between April 2016 and December 2022, including demographic characteristics, comorbidities, surgery for POPFF, admission source, outpatient department (OPD) appointments, and pre-POPFF admissions. Data were linked to the national death register. The most relevant available hospital-level key performance indicators (KPIs) were taken from the National Hip Fracture Database (NHFD). We used multilevel models with random intercepts for hospitals to predict in-hospital death, 30-day death, length of stay (LOS) above the upper quartile, and 30-day emergency readmission. Results A total of 33,728 patients were included, with a median age of 82 years (IQR 73 to 88); 65.9% were female. In total, 1,510 deaths occurred within 30 days of admission. In multiple regression models, age was associated with higher mortality and longer LOS. Females showed lower odds of mortality and 30-day readmission. Congestive heart failure and liver disease were more strongly linked to all adverse outcomes than were other comorbidities. Fixation (odds ratio (OR) 0.72, 95% CI 0.64 to 0.81) and revision (OR 0.78, 95% CI 0.68 to 0.91) were associated with lower 30-day mortality but longer hospital stays than having neither procedure. Previous hip fracture was associated with 30-day readmission and longer LOS but not with mortality. Admission from a care home was associated with higher 30-day mortality (OR 1.70, 95% CI 1.31 to 2.39), but shorter LOS. Previous any-cause emergency admissions and missed outpatient appointments were associated with worse outcomes. Hospital-level NHFD KPIs for POPFF and admission numbers for POPFF were not associated with any outcome. Conclusion We identified several patient factors, but no hospital factors, associated with adverse short-term outcomes following POPFF admission
Towards Explainable AI Modelling on Brain Ageing
Get PDFMachine learning, when combined with advanced neuroimaging such as three-dimensional Magnetic Resonance Imaging (MRI), has opened new possibilities for understanding brain health and disease. Among MRI modalities—structural MRI (sMRI), functional MRI (fMRI), and Diffusion Tensor Imaging (DTI)—sMRI is most widely applied in machine learning research, as it provides detailed measures of cortical thickness, gray matter volume, and subcortical anatomy. Despite significant progress, existing brain age estimation methods face three persistent challenges: limited predictive accuracy across diverse age groups, insufficient interpretability of model predictions, and a lack of fairness in mitigating demographic biases such as agerelated bias. These gaps restrict the utility of brain age as a reliable biomarker in both research and clinical settings. This thesis addresses these limitations by developing new approaches for brain age estimation from sMRI, aiming to improve accuracy, enhance interpretability, and incorporate fairness. To this end, I compiled several large-scale sMRI datasets and proposed three models: the Nonlinear Age-Adaptive Ensemble (nl-AAE), the Triamese Vision Transformer (Triamese-ViT), and the Democratic AI framework (u-DemAI). The nl-AAE improves predictive accuracy by dynamically weighting multiple base learners according to age groups, achieving a mean absolute error (MAE) of 3.19 years (r = 0.95). The Triamese-ViT leverages three orthogonal MRI views and integrates built-in interpretability, meaning that its attention mechanisms generate explanatory maps directly during the prediction process. These intrinsic explanations, validated against conventional explainable AI (XAI) techniques, highlight age-related and ASD-related brain regions consistent with established clinical findings. The u-DemAI framework extends beyond predictive performance by incorporating user personalization into the framework, enabling community-driven model updates and explicitly addressing fairness—particularly reducing age-related bias (ageism) in predictions. Taken together, these contributions advance the state of the art in brain age estimation by combining accuracy, interpretability, and fairness. More broadly, this work demonstrates how democratic principles can be embedded into machine learning frameworks to promote equitable, transparent, and socially responsible applications in neuroscience and clinical practice
Biopolymer-based freeze-dried emulsion and bigel composites with Sambucus nigra-loaded chitosan microparticles : novel multifunctional systems for enhanced skin performance
Get PDFFusobacterium in the microbiome : from health to disease across the oral–gut axis and beyond
Get PDFFusobacterium functions as both commensal and pathogen, linking the oral–gut axis to diverse diseases, including cancer. Evidence shows it modulates microbial balance, promotes dysbiosis, and contributes to carcinogenesis by driving inflammation, proliferation, invasion, and immune evasion. This review integrates ecological, molecular, and clinical insights, highlighting its roles in oral and systemic disease and discussing therapeutic potential, underscoring Fusobacterium’s dualistic nature and implications for microbiome-targeted interventions
Orchard Expansion May Diminish Groundwater Replenishment While Amplifying Nitrate Pollution in a Cultivated Loess Critical Zone
Get PDFPlain Language Summary: Agricultural land‐use and management changes significantly alter vadose zone hydrology and nitrate (NO3−) transport within the Earth's Critical Zone (CZ). In this study, we built a model that uses many vertical soil columns to represent the soil. We used this model to estimate how much water reaches the groundwater and how much NO3− moves downward under two land use systems: traditional cropland and orchards. We also tested how differences in soil hydraulic properties affect the results. These differences create large uncertainties in the predicted amount of water recharge and NO3− leakage, especially in orchards. In the central and eastern parts of the region, groundwater is more susceptible to NO3− pollution. Converting cropland to orchards reduces the amount of water reaching the groundwater but increases the amount of NO3− moving downward, raising the risk of groundwater pollution. Future large‐scale shifts from croplands to orchards require caution, particularly in regions with shallow soil and coarse texture