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Sleep is vital for health and wellbeing across the lifecourse. Ethnic differences have been observed with regards to the prevalence and predictors of self-reported sleep problems. An understanding of sleep experiences with ageing and across ethnicities is required to better support older people. Open-ended interviews were conducted with 23 people living in Aotearoa/New Zealand aged 61–92 years (12 Māori and 11 non-Māori) concerning current sleep status, changes over their lifecourse and personal strategies for supporting good sleep. Participants typically expressed satisfaction with current sleep (usually pertaining to duration) or feelings that sleep was compromised (usually pertaining to waking function). Comparisons to a socially perceived ‘ideal’ sleep were common, with sleep transitions presented as a gradual and accepted part of ageing. Participants resisted medicalising sleep disruptions in older age. While participants were aware of ways to enhance their sleep, many acknowledged engaging in practices that undermined it. Unique insights from some Māori participants indicated that sleep disruptions were not so readily pathologised compared to Western views and that sleeplessness could provide opportunity for cultural or spiritual connection. Common narratives underpinning the themes were: ‘You don't need as much sleep when you're older’, ‘Sleep just fits in’ and ‘Having the time of my life’. Findings provide personal experiences and cultural interpretations relating to sleep and ageing. This provides the foundation for future participatory research to co-design sleep health messages which are meaningful for ageing well across ethnicities.
In recent decades, the use of conditionality backed by benefit sanctions for those claiming unemployment and related benefits has become widespread in the social security systems of high-income countries. Critics argue that sanctions may be ineffective in bringing people back to employment or indeed harmful in a range of ways. Existing reviews largely assess the labour market impacts of sanctions but our understanding of the wider impacts is more limited. We report results from a scoping review of the international quantitative research evidence on both labour market and wider impacts of benefit sanctions. Following systematic search and screening, we extract data for 94 studies reporting on 253 outcome measures. We provide a narrative summary, paying attention to the ability of the studies to support causal inference. Despite variation in the evidence base and study designs, we found that labour market studies, covering two thirds of our sample, consistently reported positive impacts for employment but negative impacts for job quality and stability in the longer term, along with increased transitions to non-employment or economic inactivity. Although largely relying on non-experimental designs, wider-outcome studies reported significant associations with increased material hardship and health problems. There was also some evidence that sanctions were associated with increased child maltreatment and poorer child well-being. Lastly, the review highlights the generally poor quality of the evidence base in this area, with few studies employing research methods designed to identify the causal impact of sanctions, especially in relation to wider impacts.
There is a paucity of knowledge and understanding of medical error in opioid substitution treatment programmes.
Objectives
To characterise patient safety incidents involving opioid-substitution treatment with methadone or buprenorphine in community-based care to identify the sources and nature of harm, describe and interpret themes and use this qualitative analysis to identify priorities to focus future improvement work.
Methods
We undertook a mixed-methods study examining incidents involving opioid substitution treatment with methadone or buprenorphine in community-based care submitted between 2005 and 2015 from the National Reporting and Learning System, a repository of incident reports from England and Wales. We analysed each report using four frameworks to identify incident type, contributory factors, incident outcome and severity of harm. Analysis involved detailed data coding and iterative generation of data summaries using descriptive statistical and thematic analysis.
Results
2,284 reports were identified. We found that most risks of harm came from failure in one of four processes of care delivery: prescribing opiate-substitution (n=151); supervised dispensing errors (n=248); non-supervised dispensing errors (n=318); and monitoring and communication activities (n=1544). Most incidents resulting in harm involved supervised or non-supervised dispensing (n=91/127, 72%). Staff- (e.g. mistakes, not following protocols) and organisation-related (e.g. poor working conditions or poor continuity of care between services) contributory factors were present for over half of incidents.
Conclusions
We have identified four processes of care delivery and associated contributory factors, which represent potential target areas for healthcare systems worldwide to develop interventions to improve the safe delivery of opioid substitution treatment.
Psychodermatology is an emerging field at the interface between psychiatry, psychology and dermatology. There is a strong bidirectional relationship between a number of dermatological disorders and psychiatric disorders. This article provides an overview of psychiatric disorders with dermatological symptoms, and dermatological disorders with secondary psychophysiological consequences. The principles of management and our insights into establishing a psychodermatology service in the UK are discussed.
Field experiments were conducted in 2017 and 2018 at two locations in Indiana to evaluate the influence of cover crop species, termination timing, and herbicide treatment on winter and summer annual weed suppression and corn yield. Cereal rye and canola cover crops were terminated early or late (2 wk before or after corn planting) with a glyphosate- or glufosinate-based herbicide program. Canola and cereal rye reduced total weed biomass collected at termination by up to 74% and 91%, in comparison to fallow, respectively. Canola reduced horseweed density by up to 56% at termination and 57% at POST application compared to fallow. Cereal rye reduced horseweed density by up to 59% at termination and 87% at POST application compared to fallow. Canola did not reduce giant ragweed density at termination in comparison to fallow. Cereal rye reduced giant ragweed density by up to 66% at termination and 62% at POST application. Termination timing had little to no effect on weed biomass and density reduction in comparison to the effect of cover crop species. Cereal rye reduced corn grain yield at both locations in comparison to fallow, especially for the late-termination timing. Corn grain yield reduction up to 49% (4,770 kg ha–1) was recorded for cereal rye terminated late in comparison to fallow terminated late. Canola did not reduce corn grain yield in comparison to fallow within termination timing; however, late-terminated canola reduced corn grain yield by up to 21% (2,980 kg ha–1) in comparison to early-terminated fallow. Cereal rye can suppress giant ragweed emergence, whereas canola is not as effective at suppressing large-seeded broadleaves such as giant ragweed. These results also indicate that early-terminated cover crops can often result in higher corn grain yields than late-terminated cover crops in an integrated weed management program.
In 1964 (Solar Cycle 20; SC 20), Patrick McIntosh began creating hand-drawn synoptic maps of solar magnetic features, based on Hα images. These synoptic maps were unique in that they traced magnetic polarity inversion lines, and connected widely separated filaments, fibril patterns, and plage corridors to reveal the large-scale organization of the solar magnetic field. Coronal hole boundaries were later added to the maps, which were produced, more or less continuously, into 2009 (i.e., the start of SC 24). The result was a record of ~45 years (~570 Carrington rotations), or nearly four complete solar cycles of synoptic maps. We are currently scanning, digitizing and archiving these maps, with the final, searchable versions publicly available at NOAA's National Centers for Environmental Information. In this paper we present preliminary scientific studies using the archived maps from SC 23. We show the global evolution of closed magnetic structures (e.g., sunspots, plage, and filaments) in relation to open magnetic structures (e.g., coronal holes), and examine how both relate to the shifting patterns of large-scale positive and negative polarity regions.
Using John Trusler's unpublished memoirs, this article seeks to reconsider his trade in printed sermons using imitation manuscript print, which clergy could pass off as their own. While the trade smacks of corruption and dishonesty, and attracted considerable scorn for Trusler, it was in some respects a reflection of late eighteenth-century sermon culture. Trusler's defence to Bishop Terrick of London of trading in imitation manuscript sermons suggests that he was not embarrassed by the enterprise. Trusler's talents as a preacher were considerable, but Victorian Britain came to regard his commerce as reprehensible.
Greenhouse experiments were conducted in 2011 to evaluate the effect of mowing frequency and mowing height on four summer annual weed species (large crabgrass, barnyardgrass, giant ragweed, and common lambsquarters). Plants were clipped at three heights (5, 10, or 20 cm) and at two frequencies (single clipping or repeated clippings at the same height) to simulate mowing. A nonclipped control was also grown for each species. When clipped once, large crabgrass, barnyardgrass, and giant ragweed produced at least 90% of the total dry weight (DW) of the nonclipped plants, and common lambsquarters produced at least 75%. A single cut was generally not sufficient to prevent weed seed production or kill any of the weeds in this study. Repeated clipping reduced large crabgrass, giant ragweed, and common lambsquarters reproductive DW to 46, 27, and 10% respectively, of the nonclipped control. Barnyardgrass plants that were repeatedly clipped produced between 0 and 8% of the seed DW of nonclipped plants, depending on clipping height. Repeated clipping reduced weed total DW to below 40% for all species compared to nonclipped plants. Our results suggest that, unless combined with other weed management practices, repeated mowing may be necessary to limit the growth and seed production of these weed species.