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Feasibility of regional center telehealth visits utilizing a rural research network in people with Parkinson’s disease
- Tuhin Virmani, Lakshmi Pillai, Veronica Smith, Aliyah Glover, Derek Abrams, Phillip Farmer, Shorabuddin Syed, Horace J. Spencer, Aaron Kemp, Kendall Barron, Tammaria Murray, Brenda Morris, Bendi Bowers, Angela Ward, Terri Imus, Linda J. Larson-Prior, Mitesh Lotia, Fred Prior
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- Journal:
- Journal of Clinical and Translational Science / Volume 8 / Issue 1 / 2024
- Published online by Cambridge University Press:
- 25 March 2024, e63
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Background:
Impaired motor and cognitive function can make travel cumbersome for People with Parkinson’s disease (PwPD). Over 50% of PwPD cared for at the University of Arkansas for Medical Sciences (UAMS) Movement Disorders Clinic reside over 30 miles from Little Rock. Improving access to clinical care for PwPD is needed.
Objective:To explore the feasibility of remote clinic-to-clinic telehealth research visits for evaluation of multi-modal function in PwPD.
Methods:PwPD residing within 30 miles of a UAMS Regional health center were enrolled and clinic-to-clinic telehealth visits were performed. Motor and non-motor disease assessments were administered and quantified. Results were compared to participants who performed at-home telehealth visits using the same protocols during the height of the COVID pandemic.
Results:Compared to the at-home telehealth visit group (n = 50), the participants from regional centers (n = 13) had similar age and disease duration, but greater disease severity with higher total Unified Parkinson’s disease rating scale scores (Z = −2.218, p = 0.027) and lower Montreal Cognitive Assessment scores (Z = −3.350, p < 0.001). Regional center participants had lower incomes (Pearson’s chi = 21.3, p < 0.001), higher costs to attend visits (Pearson’s chi = 16.1, p = 0.003), and lived in more socioeconomically disadvantaged neighborhoods (Z = −3.120, p = 0.002). Prior research participation was lower in the regional center group (Pearson’s chi = 4.5, p = 0.034) but both groups indicated interest in future research participation.
Conclusions:Regional center research visits in PwPD in medically underserved areas are feasible and could help improve access to care and research participation in these traditionally underrepresented populations.
Fermenting a place in history: The first outbreak of Escherichia coli O157 associated with kimchi in Canada
- Courtney R. Smith, Heather Bond, Ashley Kearney, Kelvin Chau, Linda Chui, Monica Gerrie, Lance Honish, Yves Oukouomi Lowé, Victor Mah, Anna J. W. Manore
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- Journal:
- Epidemiology & Infection / Volume 151 / 2023
- Published online by Cambridge University Press:
- 08 June 2023, e106
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A Canadian outbreak investigation was initiated in January 2022 after a cluster of cases of Shiga-toxin-producing Escherichia coli (STEC) O157 was identified through whole genome sequencing (WGS). Exposure information was collected through case interviews. Traceback investigations were conducted, and samples from case homes, retail, and the manufacturer were tested for STEC O157. Fourteen cases were identified in two provinces in Western Canada, with isolates related by 0–5 whole genome multi-locus sequence typing allele differences. Symptom onset dates ranged from 11 December 2021 to 7 January 2022. The median age of cases was 29.5 (range 0–61); 64% were female. No hospitalisations or deaths were reported. Of 11 cases with information available on fermented vegetable exposures, 91% (10/11) reported consuming Kimchi Brand A during their exposure period. The traceback investigation identified Manufacturer A in Western Canada as the producer. One open and one closed sample of Kimchi Brand A tested positive for STEC O157, with isolates considered genetically related by WGS to the outbreak strain. Napa cabbage within the kimchi product was hypothesised as the most likely source of contamination. This paper summarises the investigation into this STEC O157 outbreak associated with kimchi, the first reported outside of East Asia.
‘Well, actually’: investigating mansplaining in the modern workplace
- Chelsie J. Smith, Linda Schweitzer, Katarina Lauch, Ashlyn Bird
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- Journal of Management & Organization , First View
- Published online by Cambridge University Press:
- 11 November 2022, pp. 1-19
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This mixed-method investigation examines the nature, prevalence, and correlates of mansplaining in modern workplaces. In Study 1, we scrape Twitter and conduct a thematic analysis of 2,312 tweets. These findings ground a comprehensive definition of mansplaining and propose six items for measurement. In Study 2, we quantitatively investigate mansplaining experiences at work (n = 499), finding that almost every participant had experienced mansplaining in the previous year. Expected gender differences emerged among mansplaining perpetrators and targets, yet men were not the only perpetrators, nor were women the only targets. Confirmatory factor analysis results support the possibility that mansplaining is a second factor of incivility. Further, mansplaining predicted significant variance in outcomes such as job satisfaction and turnover intentions above and beyond incivility. This research underscores that mansplaining is more than a social media phenomenon. Rather, it is a form of gendered mistreatment with implications for scholars and practitioners alike.
Antimicrobial use in Canadian acute-care hospitals: Findings from three national point-prevalence surveys between 2002 and 2017
- Jennifer J. Liang, Wallis Rudnick, Robyn Mitchell, James Brooks, Kathryn Bush, John Conly, Jennifer Ellison, Charles Frenette, Lynn Johnston, Christian Lavallée, Allison McGeer, Dominik Mertz, Linda Pelude, Michelle Science, Andrew Simor, Stephanie Smith, Paula Stagg, Kathryn N. Suh, Nisha Thampi, Daniel J.G. Thirion, Joseph Vayalumkal, Alice Wong, Geoffrey Taylor, for the Canadian Nosocomial Infection Surveillance Program
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 43 / Issue 11 / November 2022
- Published online by Cambridge University Press:
- 07 March 2022, pp. 1558-1564
- Print publication:
- November 2022
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Objectives:
The Canadian Nosocomial Infection Surveillance Program conducted point-prevalence surveys in acute-care hospitals in 2002, 2009, and 2017 to identify trends in antimicrobial use.
Methods:Eligible inpatients were identified from a 24-hour period in February of each survey year. Patients were eligible (1) if they were admitted for ≥48 hours or (2) if they had been admitted to the hospital within a month. Chart reviews were conducted. We calculated the prevalence of antimicrobial use as follows: patients receiving ≥1 antimicrobial during survey period per number of patients surveyed × 100%.
Results:In each survey, 28−47 hospitals participated. In 2002, 2,460 (36.5%; 95% CI, 35.3%−37.6%) of 6,747 surveyed patients received ≥1 antimicrobial. In 2009, 3,566 (40.1%, 95% CI, 39.0%−41.1%) of 8,902 patients received ≥1 antimicrobial. In 2017, 3,936 (39.6%, 95% CI, 38.7%−40.6%) of 9,929 patients received ≥1 antimicrobial. Among patients who received ≥1 antimicrobial, penicillin use increased 36.8% between 2002 and 2017, and third-generation cephalosporin use increased from 13.9% to 18.1% (P < .0001). Between 2002 and 2017, fluoroquinolone use decreased from 25.7% to 16.3% (P < .0001) and clindamycin use decreased from 25.7% to 16.3% (P < .0001) among patients who received ≥1 antimicrobial. Aminoglycoside use decreased from 8.8% to 2.4% (P < .0001) and metronidazole use decreased from 18.1% to 9.4% (P < .0001). Carbapenem use increased from 3.9% in 2002 to 6.1% in 2009 (P < .0001) and increased by 4.8% between 2009 and 2017 (P = .60).
Conclusions:The prevalence of antimicrobial use increased between 2002 and 2009 and then stabilized between 2009 and 2017. These data provide important information for antimicrobial stewardship programs.
Applications of Satellite Remote Sensing for Archaeological Survey: A Case Study from the Sinis Archaeological Project, Sardinia
- Daniel Plekhov, Linda R. Gosner, Alexander J. Smith, Jessica Nowlin
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- Advances in Archaeological Practice / Volume 8 / Issue 2 / May 2020
- Published online by Cambridge University Press:
- 02 March 2020, pp. 192-205
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Satellite imagery has long been recognized as well suited for the regional and ecological questions of many archaeological surveys. One underexplored aspect of such data is their temporal resolution. It is now possible for areas to be imaged on an almost daily basis, and this resolution offers new opportunities for studying landscapes through remote sensing in parallel with ground-based survey. This article explores the applications of these data for visibility assessment and land-cover change detection in the context of the Sinis Archaeological Project, a regional archaeological survey of west-central Sardinia. We employ imagery provided by Planet, which has a spatial resolution of 3 m, in four spectral bands, and is collected daily. Using Normalized Difference Vegetation Index (NDVI) values calculated for each survey unit, we find that there is a relationship between NDVI values and field-reported visibility in general, though the strength of this correlation differs according to land-cover classes. We also find the data to be effective at tracking short-term changes in field conditions that allow us to differentiate fields of similar land cover and visibility. We consider limitations and potentials of these data and encourage further experimentation and development.
Shifting surgical site infection denominators and implications for National Health Safety Network reporting
- Jessica L. Seidelman, Becky Smith, Brittain Wood, Linda Adcock, Barry Shelton, Kirk Huslage, Art Baker, Ibukunoluwa C. Akinboyo, Deverick J. Anderson, Daniel J. Sexton, Sarah S. Lewis
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 40 / Issue 11 / November 2019
- Published online by Cambridge University Press:
- 02 September 2019, pp. 1316-1317
- Print publication:
- November 2019
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Diverse Rotations and Optimal Cultural Practices Control Wild Oat (Avena fatua)
- K. Neil Harker, John T. O'Donovan, T. Kelly Turkington, Robert E. Blackshaw, Newton Z. Lupwayi, Elwin G. Smith, Eric N. Johnson, Denis Pageau, Steven J. Shirtliffe, Robert H. Gulden, John Rowsell, Linda M. Hall, Christian J. Willenborg
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- Weed Science / Volume 64 / Issue 1 / March 2016
- Published online by Cambridge University Press:
- 20 January 2017, pp. 170-180
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In western Canada, more money is spent on wild oat herbicides than on any other weed species, and wild oat resistance to herbicides is the most widespread resistance issue. A direct-seeded field experiment was conducted from 2010 to 2014 at eight Canadian sites to determine crop life cycle, crop species, crop seeding rate, crop usage, and herbicide rate combination effects on wild oat management and canola yield. Combining 2× seeding rates of early-cut barley silage with 2× seeding rates of winter cereals and excluding wild oat herbicides for 3 of 5 yr (2011 to 2013) often led to similar wild oat density, aboveground wild oat biomass, wild oat seed density in the soil, and canola yield as a repeated canola–wheat rotation under a full wild oat herbicide rate regime. Wild oat was similarly well managed after 3 yr of perennial alfalfa without wild oat herbicides. Forgoing wild oat herbicides in only 2 of 5 yr from exclusively summer annual crop rotations resulted in higher wild oat density, biomass, and seed banks. Management systems that effectively combine diverse and optimal cultural practices against weeds, and limit herbicide use, reduce selection pressure for weed resistance to herbicides and prolong the utility of threatened herbicide tools.
The very massive star content of the nuclear star clusters in NGC 5253
- Linda J. Smith, Paul A. Crowther, Daniela Calzetti
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- Journal:
- Proceedings of the International Astronomical Union / Volume 12 / Issue S329 / November 2016
- Published online by Cambridge University Press:
- 28 July 2017, pp. 327-331
- Print publication:
- November 2016
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The blue compact dwarf galaxy NGC 5253 hosts a very young starburst containing twin nuclear star clusters. Calzetti et al. (2015) find that the two clusters have an age of 1 Myr, in contradiction to the age of 3–5 Myr inferred from the presence of Wolf-Rayet (W-R) spectral features. We use Hubble Space Telescope (HST) far-ultraviolet (FUV) and ground-based optical spectra to show that the cluster stellar features arise from very massive stars (VMS), with masses greater than 100 M⊙, at an age of 1–2 Myr. We discuss the implications of this and show that the very high ionizing flux can only be explained by VMS. We further discuss our findings in the context of VMS contributing to He ii λ1640 emission in high redshift galaxies, and emphasize that population synthesis models with upper mass cut-offs greater than 100 M⊙ are crucial for future studies of young massive clusters.
Intraventricular Alpha Interferon Therapy for Rasmussen’s Syndrome
- L. Maria Bernard, M. Ringdahl Debbie, J. Parker Mickle, J. Smith Linda, D. Reuman Peter, L. Gilmore Robin, E. Drane Walter, G. Quisling Ronald
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- Canadian Journal of Neurological Sciences / Volume 20 / Issue 4 / November 1993
- Published online by Cambridge University Press:
- 18 September 2015, pp. 333-336
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A 4-year-old boy developed Rasmussen’s syndrome and was treated with alpha interferon intraventricularly. An improvement in the epileptic and neurologic syndrome was noted for several weeks following interferon. No adverse side effects were encountered. Since hemispherectomy is the only established therapy in Rasmussen’s Syndrome, further studies are needed to establish if intraventricular alpha interferon may halt the clinical progression of the syndrome.
Biographies of Contributors
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- By Cecile Aptel, Roberta Arnold, Sareta Ashraph, Mohamed A. Bangura, Ilias Bantekas, Linda E. Carter, Theresa M. Clark, Vivian Grosswald Curran, Margaret M. deGuzman, Amy E. DiBella, Viviane E. Dittrich, Jennifer Easterday, Stuart Ford, Micaela Frulli, Kenneth S. Gallant, Lansana Gberie, Annie Gell, Charles Chernor Jalloh, Wayne Jordash, Sara Kendall, Alhagi B. M. Marong, Scott Martin, Simon M. Meisenberg, Chacha Bhoke Murungu, Vincent O. Nmehielle, Noah Benjamin Novogrodsky, Valerie Oosterveld, Peter Penfold, René Provost, Stephen J. Rapp, Leila Nadya Sadat, Shakiratu Sanusi, Michael P. Scharf, Alpha Sesay, Sandesh Sivakumaran, Alison Smith, Sidney Thompson, Harmen van der Wilt
- Edited by Charles Chernor Jalloh
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- Book:
- The Sierra Leone Special Court and its Legacy
- Published online:
- 05 January 2014
- Print publication:
- 16 December 2013, pp xiii-xxiv
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Contributors
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- By Yohance M. Allette, Christophe Altier, Charles E. Argoff, Nadine Attal, Paul J. Austin, Didier Bouhassira, Ian Carroll, Kristine M. Chapman, Stephen Coleman, Lynn Kerene Cooper, Michael R. Due, Mary-Ann Fitzcharles, Robyn Flynn, Andrea D. Furlan, Vishal Gupta, Maija Haanpää, Jennifer Hah, Steven H. Horowitz, John Hughes, Mark R. Hutchinson, Scott Jarvis, Maan Kattan, Manpreet Kaur, Bradley J. Kerr, Krishna Kumar, Yuen Hei Kwok, Wojciech Leppert, Liang Liu, Angela Mailis-Gagnon, Gila Moalem-Taylor, Dwight E. Moulin, Harsha Nagaraja, Dontese Nicholson, Lauren Nicotra, Anne Louise Oaklander, John Xavier Pereira, Syed Rizvi, Stephan A. Schug, Michael Serpell, Amanda Sherwin, Howard S. Smith, Peter A. Smith, Pam Squire, Peter A. Ste-Marie, Patrick L. Stemkowski, Nicole M. Sumracki, Cory Toth, Krista van Steeg, Jan H. Vranken, Bharati Vyawahare, Mark A. Ware, Linda R. Watkins, C. Peter N. Watson, Fletcher A. White
- Edited by Cory Toth, Dwight E. Moulin
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- Book:
- Neuropathic Pain
- Published online:
- 05 December 2013
- Print publication:
- 07 November 2013, pp vii-x
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Notes on contributors
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- By Christine Alexander, Simon Avery, Michael Baumber, Birgitta Berglund, Dinah Birch, Miriam Elizabeth Burstein, Janis McLarren Caldwell, Edward Chitham, Stephen Colclough, Ann Dinsdale, Bob Duckett, Maria Frawley, Barbara T. Gates, Janet Gezari, Dudley Green, David Jasper, Drew Lamonica Arms, Elizabeth Langland, Alexandra Lewis, Sara J. Lodge, Sue Lonoff, Jill L. Matus, Victor A. Neufeldt, Linda H. Peterson, Stephen Prickett, Lyn Pykett, Herbert Rosengarten, Jane Sellars, Joanne Shattock, Margaret Smith, Patsy Stoneman, Marianne Thormählen, Ian Ward, Stephen Whitehead, T. J. Winnifrith, Steven Wood
- Edited by Marianne Thormählen, Lunds Universitet, Sweden
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- Book:
- The Brontës in Context
- Published online:
- 05 December 2012
- Print publication:
- 01 November 2012, pp xi-xvii
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Contributors
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- By Blair C. Armstrong, David A. Balota, Lawrence W. Barsalou, Jos J. A. Van Berkum, Lera Boroditsky, Gregory A. Bryant, Cristina Cacciari, Joana Cholin, Morten H. Christiansen, Stella Christie, Eve V. Clark, Herbert H. Clark, Eliana Colunga, John F. Connolly, Michael J. Cortese, Seana Coulson, George S. Cree, Christopher M. Crew, Gary S. Dell, Kevin Diependaele, Judit Druks, Thomas A. Farmer, Anne Fernald, Kelly Forbes, Carol A. Fowler, Michael Frank, Stephen J. Frost, Dedre Gentner, Raymond W. Gibbs, Monica Gonzalez-Marquez, Arthur C. Graesser, Jonathan Grainger, Zenzi M. Griffin, Mary Hare, Harlan D. Harris, Marc F. Joanisse, Leonard Katz, Albert Kim, Gina R. Kuperberg, Nicole Landi, Birte Loenneker-Rodman, Danielle S. MacNamara, James S. Magnuson, Ken McRae, W. Einar Mencl, Daniel Mirman, Jennifer B. Misyak, Srini Narayanan, Kate Nation, Randy L. Newman, Lee Osterhout, Roberto Padovani, Karalyn Patterson, Kenneth R. Pugh, Terry Regier, Douglas Roland, Jay G. Rueckl, Vasile Rus, Jenny R. Saffran, Sarah D. Sahni, Arthur G. Samuel, Rebecca Sandak, Dominiek Sandra, Sophie Scott, Mark S. Seidenberg, Linda B. Smith, Michael J. Spivey, Meghan Sumner, Daniel Tranel, Gabriella Vigliocco, Nicole L. Wilson, Anna Woollams
- Edited by Michael Spivey, Ken McRae, University of Western Ontario, Marc Joanisse, University of Western Ontario
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- Book:
- The Cambridge Handbook of Psycholinguistics
- Published online:
- 05 November 2012
- Print publication:
- 20 August 2012, pp xi-xiv
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Colostrum avoidance, prelacteal feeding and late breast-feeding initiation in rural Northern Ethiopia
- Nikki L Rogers, Jemilla Abdi, Dennis Moore, Sarah Nd'iangui, Linda J Smith, Andrew J Carlson, Dennis Carlson
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- Journal:
- Public Health Nutrition / Volume 14 / Issue 11 / November 2011
- Published online by Cambridge University Press:
- 21 April 2011, pp. 2029-2036
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Objective
To identify specific cultural and behavioural factors that might be influenced to increase colostrum feeding in a rural village in Northern Ethiopia to improve infant health.
DesignBackground interviews were conducted with six community health workers and two traditional birth attendants. A semi-structured tape-recorded interview was conducted with twenty mothers, most with children under the age of 5 years. Variables were: parental age and education; mother's ethnicity; number of live births and children's age; breast-feeding from birth through to weaning; availability and use of formula; and descriptions of colostrum v. other stages of breast milk. Participant interviews were conducted in Amharic and translated into English.
SettingKossoye, a rural Amhara village with high prevalence rates of stunting: inappropriate neonatal feeding is thought to be a factor.
SubjectsWomen (20–60 years of age) reporting at least one live birth (range: 1–8, mean: ∼4).
ResultsColostrum (inger) and breast milk (yetut wotet) were seen as different substances. Colostrum was said to cause abdominal problems, but discarding a portion was sufficient to mitigate this effect. Almost all (nineteen of twenty) women breast-fed and twelve (63 %) reported ritual prelacteal feeding. A majority (fifteen of nineteen, 79 %) reported discarding colostrum and breast-feeding within 24 h of birth. Prelacteal feeding emerged as an additional factor to be targeted through educational intervention.
ConclusionsTo maximize neonatal health and growth, we recommend culturally tailored education delivered by community health advocates and traditional health practitioners that promotes immediate colostrum feeding and discourages prelacteal feeding.
The science of EChO
- Giovanna Tinetti, James Y-K. Cho, Caitlin A. Griffith, Olivier Grasset, Lee Grenfell, Tristan Guillot, Tommi T. Koskinen, Julianne I. Moses, David Pinfield, Jonathan Tennyson, Marcell Tessenyi, Robin Wordsworth, Alan Aylward, Roy van Boekel, Angioletta Coradini, Therese Encrenaz, Ignas Snellen, Maria R. Zapatero-Osorio, Jeroen Bouwman, Vincent Coudé du Foresto, Mercedes Lopez-Morales, Ingo Mueller-Wodarg, Enric Pallé, Franck Selsis, Alessandro Sozzetti, Jean-Philippe Beaulieu, Thomas Henning, Michael Meyer, Giuseppina Micela, Ignasi Ribas, Daphne Stam, Mark Swain, Oliver Krause, Marc Ollivier, Emanuele Pace, Bruce Swinyard, Peter A.R. Ade, Nick Achilleos, Alberto Adriani, Craig B. Agnor, Cristina Afonso, Carlos Allende Prieto, Gaspar Bakos, Robert J. Barber, Michael Barlow, Peter Bernath, Bruno Bézard, Pascal Bordé, Linda R. Brown, Arnaud Cassan, Céline Cavarroc, Angela Ciaravella, Charles Cockell, Athéna Coustenis, Camilla Danielski, Leen Decin, Remco De Kok, Olivier Demangeon, Pieter Deroo, Peter Doel, Pierre Drossart, Leigh N. Fletcher, Matteo Focardi, Francois Forget, Steve Fossey, Pascal Fouqué, James Frith, Marina Galand, Patrick Gaulme, Jonay I. González Hernández, Davide Grassi, Matt J. Griffin, Ulrich Grözinger, Manuel Guedel, Pactrick Guio, Olivier Hainaut, Robert Hargreaves, Peter H. Hauschildt, Kevin Heng, David Heyrovsky, Ricardo Hueso, Pat Irwin, Lisa Kaltenegger, Patrick Kervella, David Kipping, Geza Kovacs, Antonino La Barbera, Helmut Lammer, Emmanuel Lellouch, Giuseppe Leto, Mercedes Lopez Morales, Miguel A. Lopez Valverde, Manuel Lopez-Puertas, Christophe Lovi, Antonio Maggio, Jean-Pierre Maillard, Jesus Maldonado Prado, Jean-Baptiste Marquette, Francisco J. Martin-Torres, Pierre Maxted, Steve Miller, Sergio Molinari, David Montes, Amaya Moro-Martin, Olivier Mousis, Napoléon Nguyen Tuong, Richard Nelson, Glenn S. Orton, Eric Pantin, Enzo Pascale, Stefano Pezzuto, Ennio Poretti, Raman Prinja, Loredana Prisinzano, Jean-Michel Réess, Ansgar Reiners, Benjamin Samuel, Jorge Sanz Forcada, Dimitar Sasselov, Giorgio Savini, Bruno Sicardy, Alan Smith, Lars Stixrude, Giovanni Strazzulla, Gautam Vasisht, Sandrine Vinatier, Serena Viti, Ingo Waldmann, Glenn J. White, Thomas Widemann, Roger Yelle, Yuk Yung, Sergey Yurchenko
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- Journal:
- Proceedings of the International Astronomical Union / Volume 6 / Issue S276 / October 2010
- Published online by Cambridge University Press:
- 10 November 2011, pp. 359-370
- Print publication:
- October 2010
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The science of extra-solar planets is one of the most rapidly changing areas of astrophysics and since 1995 the number of planets known has increased by almost two orders of magnitude. A combination of ground-based surveys and dedicated space missions has resulted in 560-plus planets being detected, and over 1200 that await confirmation. NASA's Kepler mission has opened up the possibility of discovering Earth-like planets in the habitable zone around some of the 100,000 stars it is surveying during its 3 to 4-year lifetime. The new ESA's Gaia mission is expected to discover thousands of new planets around stars within 200 parsecs of the Sun. The key challenge now is moving on from discovery, important though that remains, to characterisation: what are these planets actually like, and why are they as they are?
In the past ten years, we have learned how to obtain the first spectra of exoplanets using transit transmission and emission spectroscopy. With the high stability of Spitzer, Hubble, and large ground-based telescopes the spectra of bright close-in massive planets can be obtained and species like water vapour, methane, carbon monoxide and dioxide have been detected. With transit science came the first tangible remote sensing of these planetary bodies and so one can start to extrapolate from what has been learnt from Solar System probes to what one might plan to learn about their faraway siblings. As we learn more about the atmospheres, surfaces and near-surfaces of these remote bodies, we will begin to build up a clearer picture of their construction, history and suitability for life.
The Exoplanet Characterisation Observatory, EChO, will be the first dedicated mission to investigate the physics and chemistry of Exoplanetary Atmospheres. By characterising spectroscopically more bodies in different environments we will take detailed planetology out of the Solar System and into the Galaxy as a whole.
EChO has now been selected by the European Space Agency to be assessed as one of four M3 mission candidates.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. 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Acknowledgements
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five - Current issues in the public health system in England
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Summary
The last two chapters described the changing public health landscape in England between 1974 and 1997 and post-1997 respectively, noting the key policy and other milestones in this journey as far as these have shaped and impacted on the direction of policy and the composition and configuration of the public health workforce. Such a period of intense activity, especially since 1997, has inevitably resulted in a range of issues and themes that remain alive and largely unresolved. They are explored further in this chapter and are all matters that are influencing an evolving public health system in one form or other, ultimately determining its ability to deliver. The issues on which we focus in this chapter are as follows:
• the nature of policy formation relating to the health of the public;
• markets, competition and choice;
• commissioning for health and wellbeing;
• public health through partnership;
• public involvement.
The remainder of the chapter is structured around these issues and we draw on our interview material to illustrate each as appropriate.
The nature of policy formation relating to the health of the public
A key tension to emerge from our review of the state of the public health system in England is the lack of certainty and agreement about what the thrust of public health policy is, where responsibility for promoting the health of the public across the wider public health system lies and how much importance is attributed to the impact on health of policies in other sectors.
One means of ensuring policy makers from a wide variety of sectors are sufficiently aware of the health consequences of their policies, currently being promoted by the WHO (2008d), is health impact assessment (HIA). It is a key component of the Health in All Policies (HiAP) strategy adopted by the EU to inform its health strategy (see Chapter Two). The intention of those advocating for HIA to be undertaken across government in the UK is that it provides a means of ensuring potential health impacts are taken into account in all policy decisions, not merely those emanating from the Department of Health. Theoretically, this could help ensure central government provides a more coherent policy steer on public health issues. However, concerns have been raised about whether HIA, which was originally developed to assess local health impacts, can be effectively adapted to national policy-making levels (Hübel and Hedin, 2003; Davenport et al, 2006).