Nuclear disasters and health: lessons learned, challenges, and proposals

Past nuclear disasters, such as the atomic bombings in 1945 and major accidents at nuclear power plants, have highlighted similarities in potential public health effects of radiation in both circumstances, including health issues unrelated to radiation exposure. Although the rarity of nuclear disasters limits opportunities to undertake rigorous research of evidence-based interventions and strategies, identification of lessons learned and development of an effective plan to protect the public, minimise negative effects, and protect emergency workers from exposure to high-dose radiation is important. Additionally, research is needed to help decision makers to avoid premature deaths among patients already in hospitals and other vulnerable groups during evacuation. Since nuclear disasters can affect hundreds of thousands of people, a substantial number of people are at risk of physical and mental harm in each disaster. During the recovery period after a nuclear disaster, physicians might need to screen for psychological burdens and provide general physical and mental health care for many affected residents who might experience long-term displacement. Reliable communication of personalised risks has emerged as a challenge for health-care professionals beyond the need to explain radiation protection. To overcome difficulties of risk communication and provide decision aids to protect workers, vulnerable people, and residents after a nuclear disaster, physicians should receive training in nuclear disaster response. This training should include evidence-based interventions, support decisions to balance potential harms and benefits, and take account of scientific uncertainty in provision of community health care. An open and joint learning process is essential to prepare for, and minimise the effects of, future nuclear disasters.

Socialized credit and the working-class family economy: a comparative history of Britain and France 1900-2000

This paper provides a comparative analysis of working class consumer credit in Britain and France from the early twentieth century through to the 1980s. It indicates a number of similarities between the two nations in the earlier part of the period: in particular, in the operation of doorstep credit systems. For the British case study, we explore consumer finance offered by credit drapers (sometimes known as tallymen) whilst in France the paper explores a similar system that functioned in the coalmining communities around the city of Lens. Both methods operated on highly socialised relationships that established the trust on which credit was offered and long-term creditor/borrower relationships established. In the second part of the paper, we analyse the different trajectories taken in post-war France and Britain in this area of working class credit. In France this form of socialized credit gradually dwindled due to factors such as ‘Bancarisation’, which saw the major banks emerge as modern bureaucratized providers of credit for workers and their families. In contrast, in Britain the tallymen (and other related forms of doorstep credit providers) were offered a new lease of life in the 1960s and 1970s. This was a period during which British credit providers utilised multiple methods to evade the hire purchase controls put in place by post-war governments. Thus, whilst the British experience was one of fragmented consumer loan types (including the continuation of doorstep credit), the French experience (like elsewhere in Europe) was one of greater consolidation. The paper concludes by reflecting on the role of these developments in the creation of differential experiences of credit inclusion/exclusion in the two nations and the impact of this on financial inequality.

Realistic evaluation of EWS and ALERT: factors enabling and constraining implementation.

Realistic Evaluation of EWS and ALERT: factors enabling and constraining implementation Background The implementation of EWS and ALERT in practice is essential to the success of Rapid Response Systems but is dependent upon nurses utilising EWS protocols and applying ALERT best practice guidelines. To date there is limited evidence on the effectiveness of EWS or ALERT as research has primarily focused on measuring patient outcomes (cardiac arrests, ICU admissions) following the implementation of a Rapid Response Team. Complex interventions in healthcare aimed at changing service delivery and related behaviour of health professionals require a different research approach to evaluate the evidence. To understand how and why EWS and ALERT work, or might not work, research needs to consider the social, cultural and organisational influences that will impact on successful implementation in practice. This requires a research approach that considers both the processes and outcomes of complex interventions, such as EWS and ALERT, implemented in practice. Realistic Evaluation is such an approach and was used to explain the factors that enable and constrain the implementation of EWS and ALERT in practice [1]. Aim The aim of this study was to evaluate factors that enabled and constrained the implementation and service delivery of early warnings systems (EWS) and ALERT in practice in order to provide direction for enabling their success and sustainability. Methods The research design was a multiple case study approach of four wards in two hospitals in Northern Ireland. It followed the principles of realist evaluation research which allowed empirical data to be gathered to test and refine RRS programme theory. This approach used a variety of mixed methods to test the programme theories including individual and focus group interviews, observation and documentary analysis in a two stage process. A purposive sample of 75 key informants participated in individual and focus group interviews. Observation and documentary analysis of EWS compliance data and ALERT training records provided further evidence to support or refute the interview findings. Data was analysed using NVIVO8 to categorise interview findings and SPSS for ALERT documentary data. These findings were further synthesised by undertaking a within and cross case comparison to explain the factors enabling and constraining EWS and ALERT. Results A cross case analysis highlighted similarities, differences and factors enabling or constraining successful implementation across the case study sites. Findings showed that personal (confidence; clinical judgement; personality), social (ward leadership; communication), organisational (workload and staffing issues; pressure from managers to complete EWS audit and targets), educational (constraints on training; no clinical educator on ward) and cultural (routine task delegated) influences impact on EWS and acute care training outcomes. There were also differences noted between medical and surgical wards across both case sites. Conclusions Realist Evaluation allows refinement and development of the RRS programme theory to explain the realities of practice. These refined RRS programme theories are capable of informing the planning of future service provision and provide direction for enabling their success and sustainability. References: 1. McGaughey J, Blackwood B, O’Halloran P, Trinder T. J. & Porter S. (2010) A realistic evaluation of Track and Trigger systems and acute care training for early recognition and management of deteriorating ward–based patients. Journal of Advanced Nursing 66 (4), 923-932. Type of submission: Concurrent session Source of funding: Sandra Ryan Fellowship funded by the School of Nursing & Midwifery, Queen’s University of Belfast

Towards a budget approach to Pleistocene terraces: preliminary studies using the River Exe in South West England, UK

This paper presents a first approach to using a sediment budget methodology for paired terrace staircase sediments in SW England. Although a budget approach has become firmly established in Holocene fluvial studies, it has not been used in Pleistocene sequences due to the problems of temporal resolution, catchment changes and downstream loss from the system. However, this paper uses a budget approach in a paired non-glaciated basin, primarily as a method of interrogating the terrace record concerning the degree of reworking and new sediment input required to produce the reconstructed terrace sequences. In order to apply a budget approach a number of assumptions have to be made and these are justified in the paper. The results suggest that the Exe system can most parsimoniously be explained principally by the reworking of a Middle Pleistocene floodplain system with relatively little input of new resistant clasts required and a cascade-type model in geomorphological terms. Whilst this maybe partially a result of the specific geology of the catchment, it is likely to be representative of many Pleistocene terrace systems in NW Europe due to their litho-tectonic similarities. This cascade-type model of terrace formation has archaeological implications and sets the context for the Palaeolithic terrace record in the UK. Future work will involve the testing of this and similar budget models using a combination of landscape modelling and chronometric dating. ?? 2009 The Geologists' Association.

Individual factors and perceived community characteristics in relation to mental health and mental well-being

Background
It has been argued that though correlated with mental health, mental well-being is a distinct entity. Despite the wealth of literature on mental health, less is known about mental well-being. Mental health is something experienced by individuals, whereas mental well-being can be assessed at the population level. Accordingly it is important to differentiate the individual and population level factors (environmental and social) that could be associated with mental health and well-being, and as people living in deprived areas have a higher prevalence of poor mental health, these relationships should be compared across different levels of neighbourhood deprivation.

Methods
A cross-sectional representative random sample of 1,209 adults from 62 Super Output Areas (SOAs) in Belfast, Northern Ireland (Feb 2010 – Jan 2011) were recruited in the PARC Study. Interview-administered questionnaires recorded data on socio-demographic characteristics, health-related behaviours, individual social capital, self-rated health, mental health (SF-8) and mental well-being (WEMWBS). Multi-variable linear regression analyses, with inclusion of clustering by SOAs, were used to explore the associations between individual and perceived community characteristics and mental health and mental well-being, and to investigate how these associations differed by the level of neighbourhood deprivation.

Results
Thirty-eight and 30 % of variability in the measures of mental well-being and mental health, respectively, could be explained by individual factors and the perceived community characteristics. In the total sample and stratified by neighbourhood deprivation, age, marital status and self-rated health were associated with both mental health and well-being, with the ‘social connections’ and local area satisfaction elements of social capital also emerging as explanatory variables. An increase of +1 in EQ-5D-3 L was associated with +1SD of the population mean in both mental health and well-being. Similarly, a change from ‘very dissatisfied’ to ‘very satisfied’ for local area satisfaction would result in +8.75 for mental well-being, but only in the more affluent of areas.

Conclusions
Self-rated health was associated with both mental health and mental well-being. Of the individual social capital explanatory variables, ‘social connections’ was more important for mental well-being. Although similarities in the explanatory variables of mental health and mental well-being exist, socio-ecological interventions designed to improve them may not have equivalent impacts in rich and poor neighbourhoods.

Age-Related Macular Degeneration-Associated Genes in Alzheimer Disease

Objectives: Given the clinical and pathological similarities between age-relatedmacular degeneration (AMD) and Alzheimer disease (AD), to assess whether AMDassociatedsingle nucleotide polymorphisms (SNPs), including those from complementrelatedgenes, are associated with AD. 
Design: A case-control association study-typedesign. 
Setting: A UK tertiary care dementia clinic. 
Participants: 322 cognitivelynormal participants and 258 cases with a clinical diagnosis of AD.
Measurements:Polymorphisms in the following genes were studied: CFH, ARMS2, C2/CFB, C3, CFI/PLA2G12a, SERPING1, TLR3, TLR4, CRP, APOE, and TOMM40. Haplotypes were analysedfor CFH, TOMM40, and APOE. Univariate analysis was performed for each geneticchange and case-comparator status, and then correction for multiple testing performed. 
Results: The presence of an ε4 APOE allele was significantly associated with AD. Noassociation was evident between CFH SNPs or haplotypes, or other AMD-associated SNPstested, and AD. The exceptions were TOMM40 SNPs, which were associated with AD evenafter correction for multiple comparisons. The associations disappeared, however, whenentered into a regression model including APOE genotypes. 
Conclusions: The resultsfor most SNPs tested, as well as CFH haplotypes, are novel. The functional effects ofabnormal complement activity in AD’s pathogenesis may be contradictory, butmethodological reasons may underlie the lack of association—for example, geneticchanges other than SNPs being involved.

Retrieving Similar Discussion Forum Threads: A Structure based Approach

Online forums are becoming a popular way of finding useful
information on the web. Search over forums for existing discussion
threads so far is limited to keyword-based search due
to the minimal effort required on part of the users. However,
it is often not possible to capture all the relevant context in a
complex query using a small number of keywords. Examplebased
search that retrieves similar discussion threads given
one exemplary thread is an alternate approach that can help
the user provide richer context and vastly improve forum
search results. In this paper, we address the problem of
finding similar threads to a given thread. Towards this, we
propose a novel methodology to estimate similarity between
discussion threads. Our method exploits the thread structure
to decompose threads in to set of weighted overlapping
components. It then estimates pairwise thread similarities
by quantifying how well the information in the threads are
mutually contained within each other using lexical similarities
between their underlying components. We compare our
proposed methods on real datasets against state-of-the-art
thread retrieval mechanisms wherein we illustrate that our
techniques outperform others by large margins on popular
retrieval evaluation measures such as NDCG, MAP, Precision@k
and MRR. In particular, consistent improvements of
up to 10% are observed on all evaluation measures

A Brief Review to Integrated Energy System and Energy Internet 综合能源系统与能源互联网简述

Integrated energy system and Energy Internet are two hot topics in the field of energy. In this paper, these two concepts and their focuses are summarized and analyzed. Typical research in the areas of integrated energy system and Energy Internet is reviewed. The research concerns and technologies of these two concepts are then outlined respectively. The differences and similarities of these two concepts and their future development are discussed.

Tsukamurella: an unrecognized mimic of atypical mycobacterial keratitis? The first case report.

PURPOSE:

The purpose of this study was to report on Tsukamurella as a mimic of atypical mycobacterial infection.

METHODS:

We report a patient who had received repeated corneal grafts with culture-proven Tsukamurella keratitis.

RESULTS:

A slow-progressing corneal abscess that initially developed adjacent to a corneal stitch responded poorly to empiric antibiotic treatment. A preliminary culture report revealed fast-growing mycobacterial species. Treatment adjustments successfully controlled the disease. A final diagnosis of Tsukamurella was subsequently made on the basis of cultures.

CONCLUSIONS:

Tsukamurella exhibits laboratory similarities to mycobacteria and should be considered in the differential of atypical infection of the ocular surface.

Implication of modified molecular structure of lipid through heat-related process to fatty acids supply in Brassica carinata seed.

This study was conducted to explore the effect of different autoclave heating times (30, 60 and 90 min) on fatty acids supply and molecular stability in Brassica carinata seed. Multivariate spectral analyses and correlation analyses were also carried out in our study. The results showed that autoclaving treatments significantly decreased the total fatty acids content in a linear fashion in B. carinata seed as heating time increased. Reduced concentrations were also observed in C18:3n3, C20:1, C22:1n9, monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), omega 3 (ω-3) and 9 (ω-9) fatty acids. Correspondingly, the heated seeds showed dramatic reductions in all the peak intensities within lipid-related spectral regions. Results from agglomerative hierarchical cluster analysis (AHCA) and principal component analysis (PCA) indicated that the raw oilseed had completely different structural make-up from the autoclaved seeds in both CH3 and CH2 asymmetric and symmetric stretching region (ca. 2999–2800 cm−1) and lipid ester Cdouble bond; length as m-dashO carbonyl region (ca. 1787–1706 cm−1). However, the oilseeds heated for 30, 60 and 90 min were not grouped into separate classes or ellipses in all the lipid-related regions, indicating that there still exhibited similarities in lipid biopolymer conformations among autoclaved B. carinata seeds. Moreover, strong correlations between spectral information and fatty acid compositions observed in our study could imply that lipid-related spectral parameters might have a potential to predict some fatty acids content in oilseed samples, i.e. B. carinata. However, more data from large sample size and diverse range would be necessary and helpful to draw up a final conclusion.

A BRCA1 deficient, NFκB driven immune signal predicts good outcome in triple negative breast cancer

Triple negative (TNBCs) and the closely related Basal-like (BLBCs) breast cancers are a loosely defined collection of cancers with poor clinical outcomes. Both show strong similarities with BRCA1-mutant breast cancers and BRCA1 dysfunction, or 'BRCAness', is observed in a large proportion of sporadic BLBCs. BRCA1 expression and function has been shown in vitro to modulate responses to radiation and chemotherapy. Exploitation of this knowledge in the treatment of BRCA1-mutant patients has had varying degrees of success. This reflects the significant problem of accurately detecting those patients with BRCA1 dysfunction. Moreover, not all BRCA1 mutations/loss of function result in the same histology/pathology or indeed have similar effects in modulating therapeutic responses. Given the poor clinical outcomes and lack of targeted therapy for these subtypes, a better understanding of the biology underlying these diseases is required in order to develop novel therapeutic strategies.We have discovered a consistent NFκB hyperactivity associated with BRCA1 dysfunction as a consequence of increased Reactive Oxygen Species (ROS). This biology is found in a subset of BRCA1-mutant and triple negative breast cancer cases and confers good outcome. The increased NFκB signalling results in an anti-tumour microenvironment which may allow CD8+ cytotoxic T cells to suppress tumour progression. However, tumours lacking this NFκB-driven biology have a more tumour-promoting environment and so are associated with poorer prognosis. Tumour-derived gene expression data and cell line models imply that these tumours may benefit from alternative treatment strategies such as reprogramming the microenvironment and targeting the IGF and AR signalling pathways.

Food fraud and consumers' choices in the wake of the horsemeat scandal

Purpose – In 2012, the European food industry was hit by a food fraud: horsemeat was found in
pre-prepared foods, without any declaration on the package. This is commonly referred to as the
“horsemeat scandal”. The purpose of this paper is to investigate consumers’ preferences across
Europe for a selected ready meal, ready to heat (RTH) fresh lasagne, to consider whether the effects of
potential food frauds on consumers’ choices can be mitigated by introducing enhanced standards of
RTH products.
Design/methodology/approach – An online survey was administered to 4,598 consumers of RTH
lasagne in six European countries (Republic of Ireland, France, Italy, Spain, Germany and Norway),
applying discrete choice experiments to estimate consumers’ willingness to pay for enhanced food
safety standards and highlight differences between countries.
Findings – Many similarities across countries emerged, as well as some differences. Consumers in
Europe are highly concerned with the authenticity of the meat in ready meals and strongly prefer to
know that ingredients are nationally sourced. Strong regional differences in price premiums exist for
enhanced food safety standards.
Originality/value – This research adds relevant insights in the analysis of consumers’ reaction to
food fraud, providing practical guidelines on the most appropriate practices that producers should
adopt and on the information to reduce food risk perception among consumers. This would prove
beneficial for the food processing industry and the European Union. The survey is based on a
representative sample of European consumers making this the largest cross-country study of this kind.

Linking Family Engagement with a Rights Perspective: Macro Factors Influencing Practice

While child welfare practitioners in many countries are struggling to develop methods of effective family engagement, they operate within different national and cultural contexts which influence, both positively and negatively, the ability to engage with families. Increasingly, international comparisons are necessary to further understanding of the development of social work practice. This is particularly necessary because most countries utilize international frameworks (such as the United National Convention on the Rights of the Child) to provide guidance in the development of policies, programs, and interventions. Each country (and locality) struggles to advance practice to be more effective and humane. Our paper offers a comparative analysis focused on family-oriented and rights-based frameworks of different countries. Based on a review of current national policies and a review of the literature regarding family based practices, we examine similarities and differences among four countries: the United Kingdom, Sweden, the United States, and South Korea. These countries were selected because they have some similarities (advanced industrialized democracies, professional social work, formal child protection systems) but have some differences in their social welfare systems (policies, specific practices, socio-cultural context). These differences can be utilized to advance understanding regarding the promise and potential for family engagement strategies. We then discuss the utility of this comparison for theory-building in the arena of child care practice and conclude by identifying the challenges and limitations of this work.

Implications of divergences in Adult Protection legislation

Purpose – The purpose of this paper is to explore the similarities and differences of legal responses to older adults who may be at risk of harm or abuse in the UK, Ireland, Australia and the USA.
Design/methodology/approach – The authors draw upon a review of elder abuse and adult protection undertaken on behalf of the commissioner for older people in Northern Ireland. This paper focusses on the desk top mapping of the different legal approaches and draws upon wider literature to frame the discussion of the relative strengths and weaknesses of the different legal responses.
Findings – Arguments exist both for and against each legal approach. Differences in defining the scope and powers of adult protection legislation in the UK and internationally are highlighted.
Research limitations/implications – This review was undertaken in late 2013; while the authors have updated the mapping to take account of subsequent changes, some statutory guidance is not yet available. While the expertise of a group of experienced professionals in the field of adult safeguarding was utilized,
it was not feasible to employ a formal survey or consensus model.
Practical implications – Some countries have already introduced APL and others are considering doing so. The potential advantages and challenges of introducing APL are highlighted.
Social implications – The introduction of legislation may give professionals increased powers to prevent and reduce abuse of adults, but this would also change the dynamic of relationships within families and between families and professionals.
Originality/value – This paper provides an accessible discussion of APL across the UK and internationally
which to date has been lacking from the literature.