Evaluation of a partnership between primary and secondary care providing an accessible Level 1 sexual health service in the community

Comprehensive testing for asymptomatic sexually transmitted infections in Northern Ireland has traditionally been provided by genitourinary medicine clinics. As patient demand for services has increased while budgets have remained limited, there has been increasing difficulty in accommodating this demand. In May 2013, the newly commissioned specialist Sexual Health service in the South Eastern Trust sought to pilot a new model of care working alongside a GP partnership of 12 practices. A training programme to enable GPs and practice nurses to deliver Level 1 sexual health care to heterosexual patients aged >16 years, in accordance with the standards of BASHH, was developed. A comprehensive care pathway and dedicated community health advisor supported this new model with close liaison between primary and secondary care. Testing for Chlamydia, gonorrhoea, HIV and syphilis was offered. The aims of the pilot were achieved, namely to provide accessible, cost-effective sexual health care within a framework of robust clinical governance. Furthermore, it uncovered a high positivity rate for Chlamydia, especially in young men attending their general practice, and demonstrated a high level of patient satisfaction. Moreover the capacity of secondary care to deliver Levels 2 and 3 services was increased.

Investigations into the Control of Biofilm Damage with Relevance to Built Heritage (BIODAM)

This publication describes the results of a 3 year EC-funded R&D project (BIODAM) which investigated the effects of biological colonisation on heritage surfaces and evaluated of novel, low toxicity treatments for their ability to control of biofilms and for their compatibility with conservation products.

Investigation into the potential of using micro gas turbines in plug-in hybrid electric vehicles

The transport sector is considered to be one of the most dependent sectors on fossil fuels. Meeting ecological, social and economic demands throughout the sector has got increasingly important in recent times. A passenger vehicle with a more environmentally friendly propulsion system is the hybrid electric vehicle. Combining an internal combustion engine and an electric motor offers the potential to reduce carbon dioxide emissions. The overall objective of this research is to provide an appraisal of the use of a micro gas turbine as the range extender in a plug-in hybrid electric vehicle. In this application, the gas turbine can always operate at its most efficient operating point as its only requirement is to recharge the battery. For this reason, it is highly suitable for this purpose. Gas turbines offer many benefits over traditional internal combustion engines which are traditionally used in this application. They offer a high power-to-weight ratio, multi-fuel capability and relatively low emission levels due to continuous combustion.

The community trigger for anti-social behaviour: protecting victims or raising unrealistic expectations?

In October 2014, a statutory remedy for victims of anti-social behaviour became available called the community trigger. It affords complainants a right to request a review of their case if they consider that the response from local agencies has been inadequate. The Government has hailed the reform as “putting victims first”. This article first explores the context behind this reform. This includes a number of high profile cases involving the deaths of complainants after systematic failures led to prolonged exposure to anti-social behaviour. The article then examines the provisions and how they are likely to operate in practice. It argues that whilst much will depend upon implementation, the community trigger has the potential to improve the level of service offered to vulnerable complainants without necessarily impacting adversely on the rights of alleged perpetrators. As such, the community trigger may provide a model from which other areas of the criminal justice system may draw.

Insights into the Staggered Nature of Hydrogenation Reactivity over the 4d Transition Metals

Hydrogenation reactions at transition metal surfaces comprise a key set of reactions in heterogeneous catalysis. In this paper, density functional theory methods are employed to take an in-depth look at this fundamental reaction type. The energetics of hydrogenation of atomic C, N, and O have been studied in some detail over low index Zr, Nb, Mo, Tc, Ru, Rh, and Pd surfaces. Detailed bonding analysis has also been employed to track carefully the chemical changes taking place during reaction. A number of interesting horizontal and vertical trends have been uncovered relating to reactant valency and metal d-band filling. A general correlation has also been found between the reaction barriers and the reaction potential energies. Moreover, when each reaction is considered independently, correlation has been found to improve with decreasing reactant valency. Bonding analysis has pointed to this being related to the relative position of the transition state along the reaction coordinate and has shown that as reactant valency decreases, the transition states become progressively later.

New insights into the causes of human illness due to consumption of azaspiracid contaminated shellfish

Azaspiracid (AZA) poisoning was unknown until 1995 when shellfish harvested in Ireland caused illness manifesting by vomiting and diarrhoea. Further in vivo/vitro studies showed neurotoxicity linked with AZA exposure. However, the biological target of the toxin which will help explain such potent neurological activity is still unknown. A region of Irish coastline was selected and shellfish were sampled and tested for AZA using mass spectrometry. An outbreak was identified in 2010 and samples collected before and after the contamination episode were compared for their metabolite profile using high resolution mass spectrometry. Twenty eight ions were identified at higher concentration in the contaminated samples. Stringent bioinformatic analysis revealed putative identifications for seven compounds including, glutarylcarnitine, a glutaric acid metabolite. Glutaric acid, the parent compound linked with human neurological manifestations was subjected to toxicological investigations but was found to have no specific effect on the sodium channel (as was the case with AZA). However in combination, glutaric acid (1mM) and azaspiracid (50nM) inhibited the activity of the sodium channel by over 50%. Glutaric acid was subsequently detected in all shellfish employed in the study. For the first time a viable mechanism for how AZA manifests itself as a toxin is presented.

An investigation into the factors influencing tooth brushing behaviour amongst school children living in Northern Ireland: An application of the Theory of Planned Behaviour.

Background: Northern Ireland has the worst oral health in the UK and its children have among the highest levels of tooth decay in Europe (DHSSPS, 2007).
Aim: The aim of this study is to investigate the factors influencing tooth brushing behaviour among Year 6 primary schoolchildren using the Theory of Planned Behaviour (TPB).
Method: Seven semi-structured focus groups involving 56 children were conducted during which children were asked questions about the factors that influence whether or not they brush their teeth. Thematic analysis was used with the purpose of eliciting the belief-based measures for all the TPB constructs.
Results: The findings suggest that children are knowledgeable about their teeth and are aware of the importance of maintaining good oral health; although a number of barriers to consistent tooth brushing exist.
Discussion: The findings will be used to inform stage 2 of the research project; questionnaire development to identify the factors influencing young people’s motivations to improve their tooth brushing behaviour and to assess their relative importance.

Demand response to improved walking infrastructure: A study into the economics of walking and health behaviour change

Walking is the most common form of moderate‐intensity physical activity among adults, is widely accessible and especially appealing to obese people. Most often policy makers are interested in valuing the effect on walking of changes in some characteristics of a neighbourhood, the demand response for walking, of infrastructure changes. A positive demand response to improvements in the walking environment could help meet the public health target of 150 minutes of at least moderate‐intensity physical activity per week. We model walking in an individual’s local neighbourhood as a ‘weak complement’ to the characteristics of the neighbourhood itself. Walking is affected by neighbourhood
characteristics, substitutes, and individual’s characteristics, including their opportunity cost of time.  Using compensating variation, we assess the economic benefits of walking and how walking behaviour is affected by improvements to the neighbourhood.  Using a sample of 1,209 respondents surveyed over a 12 month period (Feb 2010‐Jan 2011) in East Belfast, United Kingdom, we find that a policy that increased walkability and people’s perception of access to shops and facilities  would lead to an increase in walking of about 36 minutes/person/week, valued at £13.65/person/week. When focusing on inactive residents, a policy that improved the walkability of the area would lead to guidelines for physical activity being reached by only 12.8% of the population who are currently inactive. Additional interventions would therefore be needed to encourage inactive residents to
achieve the recommended levels of physical activity, as it appears that interventions that improve the walkability of an area are particularly effective in increasing walking among already active citizens, and, among the inactive ones, the best response is found among healthier, younger and wealthier citizens.

An Investigation into the Role of Polymeric Carriers on Crystal Growth within Amorphous Solid Dispersion Systems

Using phase diagrams derived from Flory–Huggins theory, we defined the thermodynamic state of amorphous felodipine within three different polymeric carriers. Variation in the solubility and miscibility of felodipine within different polymeric materials (using F–H theory) has been identified and used to select the most suitable polymeric carriers for the production of amorphous drug–polymer solid dispersions. With this information, amorphous felodipine solid dispersions were manufactured using three different polymeric materials (HPMCAS-HF, Soluplus, and PVPK15) at predefined drug loadings, and the crystal growth rates of felodipine from these solid dispersions were investigated. Crystallization of amorphous felodipine was studied using Raman spectral imaging and polarized light microscopy. Using this data, we examined the correlation among several characteristics of solid dispersions to the crystal growth rate of felodipine. An exponential relationship was found to exist between drug loading and crystal growth rate. Moreover, crystal growth within all selected amorphous drug–polymer solid dispersion systems were viscosity dependent (η–ξ). The exponent, ξ, was estimated to be 1.36 at a temperature of 80 °C. Values of ξ exceeding 1 may indicate strong viscosity dependent crystal growth in the amorphous drug–polymer solid dispersion systems. We argue that the elevated exponent value (ξ > 1) is a result of drug–polymer mixing which leads to a less fragile amorphous drug–polymer solid dispersion system. All systems investigated displayed an upper critical solution temperature, and the solid–liquid boundary was always higher than the spinodal decomposition curve. Furthermore, for PVP–FD amorphous dispersions at drug loadings exceeding 0.6 volume ratio, the mechanism of phase separation within the metastable zone was found to be driven by nucleation and growth rather than liquid–liquid separation.

Investigation into the effect of molybdenum-site substitution on the performance of Sr2Fe1.5Mo0.5O6-δ for intermediate temperature solid oxide fuel cells

In this paper, niobium doping is evaluated as a means of enhancing the electrochemical performance of a Sr₂Fe_1.5Mo_0.5O_6-δ (SFM) perovskite structure cathode material for intermediate temperature solid oxide fuel cells (IT-SOFCs) applications. As the radius of Nb approximates that of Mo and exhibits +4/+5 mixed valences, its substitution is expected to improve material performance. A series of Sr₂Fe_1.5Mo_0.5-xNb_xO_6-δ (x = 0.05, 0.10, 0.15, 0.20) cathode materials are prepared and the phase structure, chemical compatibility, microstructure, electrical conductivity, polarization resistance and power generation are systematically characterized. Among the series of samples, Sr₂Fe_1.5Mo_0.4Nb_0.10O_6-δ (SFMNb_0.10) exhibits the highest conductivity value of 30 S cm^-1 at 550°C, and the lowest area specific resistance of 0.068 Ω cm² at 800°C. Furthermore, an anode-supported single cell incorporating a SFMNb_0.10 cathode presents a maximum power density of 1102 mW cm^-2 at 800°C. Furthermore no obvious performance degradation is observed over 15 h at 750°C with wet H₂(3% H₂O) as fuel and ambient air as the oxidant. These results demonstrate that SFMNb shows great promise as a novel cathode material for IT-SOFCs.