Community interventions for improving adult mental health: mapping local policy and practice in England.

BACKGROUND: Public mental health (PMH) aims to improve wellbeing and prevent poor mental health at the population level. It is a global challenge and a UK priority area for action. Communities play an important role in the provision of PMH interventions. However, the evidence base concerning community-based PMH interventions is limited, meaning it is challenging to compare service provision to need. Without this, the efficient and equitable provision of services is hindered. Here, we sought to map the current range of community-based interventions for improving mental health and wellbeing currently provided in England to inform priority areas for policy and service intervention. METHOD: We adopted an established mapping exercise methodology, comparing service provision with demographic and deprivation statistics. Five local authority areas of England were selected based on differing demographics, mental health needs and wider challenging circumstances (i.e. high deprivation). Community-based interventions were identified through: 1) desk-based research 2) established professional networks 3) chain-referral sampling of individuals involved in local mental health promotion and prevention and 4) peer researchers' insight. We included all community-based, non-clinical interventions aimed at adult residents operating between July 2019 and May 2020. RESULTS: 407 interventions were identified across the five areas addressing 16 risk/protective factors for PMH. Interventions for social isolation and loneliness were most prevalent, most commonly through social activities and/or befriending services. The most common subpopulations targeted were older adults and people from minority ethnic backgrounds. Interventions focusing on broader structural and environmental determinants were uncommon. There was some evidence of service provision being tailored to local need, though this was inconsistent, meaning some at-risk groups such as men or LGBTQ+ people from minority ethnic backgrounds were missed. Interventions were not consistently evaluated. CONCLUSIONS: There was evidence of partial responsiveness to national and local prioritising. Provision was geared mainly towards addressing social and individual determinants of PMH, suggesting more integration is needed to engage wider service providers and policy-makers in PMH strategy and delivery at the community level. The lack of comprehensive evaluation of services to improve PMH needs to be urgently addressed to determine the extent of their effectiveness in communities they serve.

Social inequalities in climate change-attributed impacts of Hurricane Harvey.

Climate change is already increasing the severity of extreme weather events such as with rainfall during hurricanes. But little research to date investigates if, and to what extent, there are social inequalities in climate change-attributed extreme weather event impacts. Here, we use climate change attribution science paired with hydrological flood models to estimate climate change-attributed flood depths and damages during Hurricane Harvey in Harris County, Texas. Using detailed land-parcel and census tract socio-economic data, we then describe the socio-spatial characteristics associated with these climate change-induced impacts. We show that 30 to 50% of the flooded properties would not have flooded without climate change. Climate change-attributed impacts were particularly felt in Latina/x/o neighborhoods, and especially so in Latina/x/o neighborhoods that were low-income and among those located outside of FEMA's 100-year floodplain. Our focus is thus on climate justice challenges that not only concern future climate change-induced risks, but are already affecting vulnerable populations disproportionately now.

Where next for the design, delivery, and evaluation of community-based physical activity prescription? Emerging lessons from the United Kingdom.

Despite widespread use, community-based physical activity prescription is controversial. Data limitations have resulted in a lack of clarity about what works, under what circumstances, and for whom, reflected in conservative policy recommendations. In this commentary we challenge a predominantly negative discourse, using contemporary research to highlight promising findings and "lessons learnt" for design, delivery, and evaluation. In doing so, we argue for the importance of a more nuanced approach to future commissioning and evaluation. Novelty: Amalgamating learning from multiple research teams to create recommendations for advancing physical activity prescription.

New insights into US flood vulnerability revealed from flood insurance big data.

Improvements in modelling power and input data have vastly improved the precision of physical flood models, but translation into economic outputs requires depth-damage functions that are inadequately verified. In particular, flood damage is widely assumed to increase monotonically with water depth. Here, we assess flood vulnerability in the US using >2 million claims from the National Flood Insurance Program (NFIP). NFIP claims data are messy, but the size of the dataset provides powerful empirical tests of damage patterns and modelling approaches. We show that current depth-damage functions consist of disparate relationships that match poorly with observations. Observed flood losses are not monotonic functions of depth, but instead better follow a beta function, with bimodal distributions for different water depths. Uncertainty in flood losses has been called the main bottleneck in flood risk studies, an obstacle that may be remedied using large-scale empirical flood damage data.

Growth of Aerobacter aerogenes on D-arabinose: origin of the enzyme activities.

Mutants of Aerobacter aerogenes can be selected which are capable of utilizing d-arabinose as a sole source of carbon and energy for growth. Mutants can also be selected which are capable of using l-xylose. The mutational event permitting the utilization of d-arabinose results in the constitutive synthesis of certain enzymes of the l-fucose catabolic pathway. l-Fucose isomerase catalyzes the first reaction in the degradation of d-arabinose: the isomerization of d-arabinose to d-ribulose. No other type of mutation appears to be required to initiate growth on d-arabinose, and wild-type cells induced for the enzymes of the l-fucose catabolic pathway are capable of growth on d-arabinose. The first reaction in the catabolism of l-xylose, the isomerization of l-xylose to l-xylulose, also appears to be catalyzed by constitutively synthesized l-fucose isomerase.

Metabolism of D-arabinose by Aerobacter aerogenes: purification of the isomerase.

In Aerobacter aerogenes, the mutational event permitting the utilization of d-arabinose as a source of carbon and energy is a regulatory mutation resulting in the constitutive synthesis of certain enzymes of the l-fucose catabolic pathway. l-Fucose isomerase catalyzes the isomerization of d-arabinose to d-ribulose. This enzyme was purified to homogeneity as indicated by a single band in disc-gel electrophoretic columns and single peaks with column chromatography and ultracentrifugation from the wild-type PRL-R3 strain, induced with l-fucose and two constitutive mutants, 502 and 510. The ratios of the activities of this isomerase on d-arabinose and l-fucose remained constant throughout all purifications. The apparent K(m) of the isomerase from the wild-type strain induced with l-fucose and from the constitutive mutant strains was 5.0 x 10(-2)m for l-fucose and 1.5 x 10(-1)m for d-arabinose. A strain 531 possessing an apparent alteration in the isomerase was isolated from the strain 502. This altered isomerase exhibited a lowered K(m) for d-arabinose.

Regulation of pentitol metabolism by aerobacter aerogenes. II. Induction of the ribitol pathway.

The incubation of Aerobacter aerogenes PRL-R3 with ribitol resulted in the induction of ribitol dehydrogenase and d-ribulokinase, coordinately controlled enzymes of the pathway of ribitol catabolism. A dehydrogenase-negative mutant was unable to induce d-ribulokinase activity following incubation with ribitol. Similar experiments using a kinase-negative mutant resulted in normal induction of ribitol dehydrogenase, as compared to the wild-type PRL-R3 strain. Constitutive or induced cells for l-fucose isomerase were capable of catalyzing the isomerization of d-arabinose to d-ribulose. In contrast to the experiments using ribitol as the substrate, the isomerization of d-arabinose resulted in the induction of d-ribulokinase with dehydrogenase-negative cells. These data indicated that d-ribulose, rather than ribitol, acts as the inducer of the enzymes for ribitol degradation.

Career goals and expectations of men and women pharmacy residents.

Personal and professional characteristics of men and women hospital pharmacy residents were studied to identify differences that could affect future hospital pharmacy practice. Residents in 111 ASHP-accredited pharmacy residency programs received a survey containing questions on demographic information, reasons for selecting a residency, areas of professional interest, postresidency career goals, responsibilities to home and family, and advantages and disadvantages associated with gender. Of 286 residents receiving questionnaires, 226 responded; the percentages of men and women responding corresponded to the ratio of men and women in hospital pharmacy residencies. While men and women expressed educational goals that were not significantly different, more men than women had earned or were in the process of earning advanced degrees. No significant differences were evident between men's and women's plans for marriage and children, but 73% of the women indicated that they would take time out from their practice to raise children, compared with only 9% of the men. The majority of residents did not think their gender affected them in their residency programs, but in professional interactions more men saw gender as an advantage and more women as a disadvantage. Significantly more than women aspired to be hospital pharmacy directors. The results suggest that men are obtaining advanced training closer to the time they graduate from pharmacy school and that in the future women competing for promotions may be older than men competing for comparable positions. Those planning pharmacy staffing should consider the needs of women, and men, who expect to take time out from their careers for family responsibilities and possibly seek part-time positions when they return to the work force.

Measurement of one-bond 1H-13C, couplings in backbone-labelled proteins.

NMR dipole-dipole couplings between protein backbone nuclei (1H(alpha), 13C(alpha), 15N, 1H(N), 13C') offer enormous scope for the rapid determination of protein global folds. Here, we show that measurement of one-bond splittings in the protein backbone is facilitated by use of protein that is selectively isotopically enriched only in the backbone atoms. In particular, 1H(alpha)-13C(alpha) couplings can be measured simply and with high sensitivity by use of conventional heteronuclear single quantum correlation (HSQC) techniques.