A realist approach to understanding alliancing within Local Government public health and social care service provision.

BACKGROUND: Within the current context of continued austerity and post-pandemic recovery, it remains important that Local Government services address the increasing needs of residents as cost-effectively as possible. Alliancing, whereby services work collaboratively focusing on the 'whole-system', has gained popularity as a tool with the potential to support collaborative whole systems approaches. This synthesis aims to identify how alliancing can be successfully operationalised in the commissioning of public health, wider National Health Service (NHS) and social care-related services. METHODS: A realist literature synthesis was undertaken in order to identify underlying generative mechanisms associated with alliancing, the contextual conditions surrounding the implementation and operationalisation of the alliancing approach mechanisms, and the outcomes produced as a result. An iterative approach was taken, using a recent systematic review of the effectiveness of Alliancing, online database searches, and grey literature searches. RESULTS: Three mechanistic components were identified within the data as being core to the successful implementation of alliances in public health and social care-related services within Local Government: (i) Achieving a system-level approach; (ii) placing local populations at the heart of the system; and (iii) creating a cultural shift. Programme theories were postulated within these components. CONCLUSIONS: The alliancing approach offers an opportunity to achieve system-level change with the potential to benefit local populations. The realist synthesis approach taken within this study has provided insights into the necessary contextual and mechanistic factors of the Alliancing approach, above and beyond effectiveness outcomes typically collected through more conventional evaluation methodologies.

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.

An extreme magneto-ionic environment associated with the fast radio burst source FRB 121102.

Fast radio bursts are millisecond-duration, extragalactic radio flashes of unknown physical origin. The only known repeating fast radio burst source-FRB 121102-has been localized to a star-forming region in a dwarf galaxy at redshift 0.193 and is spatially coincident with a compact, persistent radio source. The origin of the bursts, the nature of the persistent source and the properties of the local environment are still unclear. Here we report observations of FRB 121102 that show almost 100 per cent linearly polarized emission at a very high and variable Faraday rotation measure in the source frame (varying from +1.46 × 105 radians per square metre to +1.33 × 105 radians per square metre at epochs separated by seven months) and narrow (below 30 microseconds) temporal structure. The large and variable rotation measure demonstrates that FRB 121102 is in an extreme and dynamic magneto-ionic environment, and the short durations of the bursts suggest a neutron star origin. Such large rotation measures have hitherto been observed only in the vicinities of massive black holes (larger than about 10,000 solar masses). Indeed, the properties of the persistent radio source are compatible with those of a low-luminosity, accreting massive black hole. The bursts may therefore come from a neutron star in such an environment or could be explained by other models, such as a highly magnetized wind nebula or supernova remnant surrounding a young neutron star.

Urban growth and water access in sub-Saharan Africa: Progress, challenges, and emerging research directions.

For the next decade, the global water crisis remains the risk of highest concern, and ranks ahead of climate change, extreme weather events, food crises and social instability. Across the globe, nearly one in ten people is without access to an improved drinking water source. Least Developed Countries (LDCs) especially in sub-Saharan Africa (SSA) are the most affected, having disproportionately more of the global population without access to clean water than other major regions. Population growth, changing lifestyles, increasing pollution and accelerating urbanization will continue to widen the gap between the demand for water and available supply especially in urban areas, and disproportionately affect informal settlements, where the majority of SSA's urban population resides. Distribution and allocation of water will be affected by climate-induced water stresses, poor institutions, ineffective governance, and weak political will to address scarcity and mediate uncertainties in future supply. While attempts have been made by many scientists to examine different dimensions of water scarcity and urban population dynamics, there are few comprehensive reviews, especially focused on the particular situation in Sub-Saharan Africa. This paper contributes to interdisciplinary understanding of urban water supply by distilling and integrating relevant empirical knowledge on urban dynamics and water issues in SSA, focusing on progress made and associated challenges. It then points out future research directions including the need to understand how alternatives to centralized water policies may help deliver sustainable water supply to cities and informal settlements in the region.

Short communication: Ultrasonographic assessment of lung consolidation postweaning and survival to the first lactation in dairy heifers.

The aim of this prospective cohort study was to assess the association of systematic thoracic ultrasonography findings postweaning on calves' survivability to the first lactation. Three-month-old Jersey heifers (n=250) returning from a custom heifer grower were scanned by thoracic ultrasonography and lungs assessed using a scoring system with a scale from 1 to 4. A score of 1 was attributed to calves with no abnormality. A score of 2 was assigned if multiple comet tails or B-lines (coalescence of multiple comet tails) were observed. A score of 3 was assigned to calves with ≥1 location of lung consolidation ≥1 cm but <6 cm. Calves with extensive consolidation (≥6 cm in one or more locations) or evidence of abscessation or pleural effusion (>1 cm) were assigned a score of 4. Calves with a score of 4 had greater risk of dying or being culled [26% (95% credibility interval: 13-47%)] than calves with a score of 1 [1% (0-6%)], 2 [3% (1-9%)], or 3 [5% (1-17%)]. We found no association between age of first calving in the remaining calves and lung score. Thus, lung lesion severity assessed by thoracic ultrasound is associated with a long-term production outcome.

Effect of neodymium: YAG laser on sodium hyaluronate in vitro as a model for postcapsulotomy intraocular pressure change.

PURPOSE: To define one possible etiology for the rise in intraocular pressure (IOP) after neodymium: YAG (Nd:YAG) laser capsulotomy and provide information for the continued investigation of this process. SETTING: Laser Center, Eye and Ear Institute, Pittsburgh, Pennsylvania. METHODS: Samples of 1% sodium hyaluronate or balanced salt solution (BSS) (control) were placed in a closed system and exposed to varying amounts of Nd:YAG energy delivered by a Coherent YAG laser. This system was hydrostatically coupled to a pressure monitor, and changes in pressure were recorded as a function of time. RESULTS: Average pressure increase was 0.140 mm Hg/mJ of YAG energy in the sodium hyaluronate samples and 0.017 mm Hg/mJ in BSS (P < .01). The relationship between total energy delivered and maximum pressure recorded for both substances was nearly linear. Further analysis of treated sodium hyaluronate samples showed that Nd:YAG energy can produce structural alterations. CONCLUSIONS: Neodymium:YAG laser energy has a pronounced effect on sodium hyaluronate that exceeds the thermal effect seen with BSS when the pressure is monitored in a closed system. These structural changes might contribute to the IOP rise seen clinically.

Robots in food systems: a review and assessment of potential uses.

Management personnel in foodservice, food processing, and robot industries were surveyed to evaluate potential job functions for robots in the food industry. The survey instrument listed 64 different food-related job functions that participants were asked to assess as appropriate or not appropriate for robotic implementation. Demographic data were collected from each participant to determine any positive or negative influence on job function responses. The survey responses were statistically evaluated using frequencies and the chi-square test of significance. Sixteen of the 64 job functions were identified as appropriate for robot implementation in food industries by both robot manufacturing and food managers. The study indicated, first, that food managers lack knowledge about robots and robot manufacturing managers lack knowledge about food industries. Second, robots are not currently being used to any extent in the food industry. Third, analysis of the demographic data in relation to the 16 identified job functions showed no significant differences in responses.

Metabolites of phenanthridine formed by rat liver homogenate.

The ethyl acetate-extractable metabolites of phenanthridine as formed in vitro with Aroclor-induced rat liver homogenate were isolated and structurally identified. The relative amounts of these metabolites were determined using [6-14C]phenanthridine. The major metabolites of phenanthridine formed under these incubation conditions were identified as phenanthridine-N-oxide, 1,2-dihydroxy-1,2-dihydrophenanthridine, and 9,10-dihydroxy-9,10-dihydrophenanthridine. Phenanthridone and 2-hydroxyphenanthridine were identified as minor metabolites. These data were obtained using an identical incubation mixture as employed in mutagenicity assays. It is suggested that metabolites in addition to phenanthridone are likely to contribute to mutagenicity of phenanthridine observed in assays performed with metabolic activation.

Tumor-initiating activity of quinoline and methylated quinolines on the skin of SENCAR mice.

Quinoline and all 7 positional isomers of methylquinoline were assayed for tumor-initiating activity on the skin of SENCAR female mice with promotion by tetradecanoyl phorbol acetate. The total initiation dose of either quinoline or the isomeric methylquinolines was 7.5 mg per mouse. Quinoline induced tumors in 53% of the mice (0.73 tumors per animal). While 2-, 3-, 5- and 7-methylquinoline did not exhibit significant tumorigenic activity in this assay, 4-methylquinoline induced tumors in 45% of the mice (0.90 tumors per animal). 8-Methylquinoline induced tumors in 45% of the mice (0.66 tumors per animal).

Identification of the metabolites of benzo[f]quinoline and benzo[h]quinoline formed by rat liver homogenate.

Benzo[f]quinoline and benzo[h]quinoline are widespread environmental pollutants which have been found to be mutagenic. The metabolism of benzo[f]quinoline and benzo[h]quinoline was investigated using a liver homogenate from Aroclor-pretreated rats. The metabolites of benzo[f]quinoline which were identified were 7,8-dihydroxy-7,8-dihydrobenzo[f]quinoline, 9,10-dihydroxy-9,10-dihydrobenzo[f]quinoline, 7-hydroxybenzo[f]quinoline, and benzo[f]quinoline-N-oxide. Metabolism studies on benzo[f]quinoline performed in the presence of the epoxide hydratase inhibitor, 3,3,3-trichloropropylene oxide, demonstrated that the formation of both of these dihydrodiols can be inhibited. The major metabolites of benzo[h]quinoline were identified as 5,6-dihydroxy-5,6-dihydrobenzo[h]quinoline and 7,8-dihydroxy-7,8-dihydrobenzo[h]quinoline. Benzo[h]quinoline-N-oxide was not detected as a metabolite. In the presence of an epoxide hydratase inhibitor, the major metabolites of benzo[h]quinoline were 5,6-epoxybenzo[h]quinoline and 7-hydroxybenzo[h]quinoline. The difference in the metabolism to N-oxides observed between benzo[h]quinoline and benzo[f]quinoline is consistent with previous observations in which sterically hindered aromatic ring nitrogen compounds such as benzo[h]quinoline are more resistant to N-oxide formation. The nitrogen atom of these aza-arenes with its lone pair of electrons has a significant influence on sites at which dihydrodiols are formed. The data suggest that the aromatic ring nitrogen of these azaphenanthrenes has an effect similar to that of a methyl substituent in directing their metabolic oxidation.

On the metabolism of quinoline and isoquinoline: possible molecular basis for differences in biological activities.

Quinoline is a hepatocarcinogen in mice and rats, a mutagen in Salmonella typhimurium, and induces unscheduled DNA synthesis in primary cultures of rat hepatocytes. In contrast, isoquinoline has not been shown to be genotoxic. The metabolites of quinoline and isoquinoline, as formed in vitro with rat liver homogenate, were identified to investigate possible molecular bases for the differences in their biological activity. The ethyl acetate extractable metabolites of quinoline and isoquinoline were analyzed directly by high pressure liquid chromatography and, after silylation, by capillary gas chromatography. The major metabolite of quinoline was 5,6-dihydroxy-5,6-dihydroquinoline. Lesser amounts of 2- and 3-hydroxyquinoline and quinoline-N-oxide were also identified as metabolites. 1-, 4- and 5-Hydroxyiso-quinoline and isoquinoline-N-oxide were detected as metabolites of isoquinoline. 5,6-Dihydroxy-5,6-dihydroiso-quinoline was detected as only a minor metabolite. This difference in the extent to which these isomers are ultimately metabolized to dihydrodiols may be associated with their differences in biological activity. Quinoline, 4-methylquinoline and 7-methylquinoline were bioassayed as tumor initiators on the skin of Sencar mice. While 4-methylquinoline was at least as potent a tumor initiator as quinoline, 7-methylquinoline was not significantly tumorigenic in this assay. These data are consistent with the hypothesis that formation of the 5,6-epoxide of quinoline is associated with its metabolic activation to a tumorigen.

Chromosome polymorphism and banding patterns in the owl monkey (Aotus).

Diploid numbers, chromosome morphology, G- and C-banding characterisitics and pelage phenotypes were studied in 330 owl monkeys (Aotus) captured and exported from several parts of South America. Among these animals, seven distinctive karyotypes were recognized by the number of chromosomes and their individual identification by G- and C-banding methods. These seven karyotypes were distributed among four distinctive phenotypes differentiated by color patterns in the pelage. These specific phenotypes were designated in this study with capital letters (A through D) and the karyotypes by Roman numerals (I-VII), followed in parentheses by their diploid number. Specimens with phenotype A originated from Brazil and their karyotypes all conformed to a type designated karyotype I (2n=54). Animals classified as having phenotype B were exported from Colombia and their karyotypes were designated as karyotypes II (2n=54), III (2n=53), IV (2n=52), and V (2n=46). Monkeys received from Peru were designated as phenotype C and karyotype VII (2n=52). A group of owl monkeys received from Bolivia were designated as having karyotype VI (2n=50 male; 2n=49 female). Their distinctive phenotype was labeled D. All males in this sample had a diploid number of 49 and the Y-chromosome was translocated to an autosome.