Invisible Inequalities of Austerity: Everyday Life, Mothers and Health in Stockton-on-Tees

Austerity in the UK has been ongoing since 2010 and is contributing to widening health, economic, gender and social inequalities. There has been little contemporary qualitative research into the gendered inequalities of austerity in the context of health inequalities. This thesis presents findings from research with mothers in Stockton-on-Tees, a borough in the North East of England with wide health inequalities. The research focuses on the interplay between the macro and micro consequences of austerity for mothers – the impact of welfare retrenchment, public sector cuts and local labour market conditions, and how these effect everyday life in the context of unpaid care work and mothers experiences of depletion through social reproduction. This is contextualised through the lens of feminist political economy as an essential framework for diagnosing the symptoms of austerity and proposing productive alternatives. Qualitative longitudinal interviewing and ethnographic research are used to draw out the perspectives of respondents in relation to austerity and everyday life. The ‘intersectionality’ of inequality is emphasised – how gender interacts with age, class, place, ethnicity and disability to produce complex effects on health and wellbeing. Findings indicate that austerity is making Stockton-on-Tees a more uneven place - once-strong ties to communities are perceived to be deteriorating, and the socio-spatial distribution of inequality increasing. Mothers expressed a need for more space and time to care without the pressures of welfare reform and the associated risks. ‘Invisible inequalities’ are depleting the mental wellbeing of many mothers. This research provides a contribution to the growing body of evidence indicating that austerity is damaging to social equality, widening the health gap, contributing to worsening mental health, and intensifying intersecting inequalities for women. It is unique in its application of the concept of intersectionality to health inequalities in the context of austerity, and the novel contribution of a feminist political economy approach to the study of health and austerity

Freight Sequencing to Improve Hub Operations in the Less-Than-Truckload Freight Transportation Industry

In less-than-truckload freight transportation, hub operations affect the service levels that carriers are able to provide their customers. This paper focuses on improving the efficiency of hub operations by reducing freight handling time and cost. Specifically, the freight sequencing problem (FSP) is investigated to determine the freight unloading and loading sequence that minimizes the time for dock workers to transfer shipments from origin trailers to destination trailers. The FSP is modeled as a Rural Postman Problem (RPP) and three algorithms are compared: trailer-at-atime, nearest neighbor, and balance-and-connect. Using five industrial data sets, the results demonstrate the effectiveness, advantages, and disadvantages of the approaches

Mortality According to CD4 Count at Start of Combination Antiretroviral Therapy Among HIV-infected Patients Followed for up to 15 Years After Start of Treatment: Collaborative Cohort Study.

BACKGROUND: CD4 count at start of combination antiretroviral therapy (ART) is strongly associated with short-term survival, but its association with longer-term survival is less well characterized. METHODS: We estimated mortality rates (MRs) by time since start of ART (<0.5, 0.5-0.9, 1-2.9, 3-4.9, 5-9.9, and ≥10 years) among patients from 18 European and North American cohorts who started ART during 1996-2001. Piecewise exponential models stratified by cohort were used to estimate crude and adjusted (for sex, age, transmission risk, period of starting ART [1996-1997, 1998-1999, 2000-2001], and AIDS and human immunodeficiency virus type 1 RNA at baseline) mortality rate ratios (MRRs) by CD4 count at start of ART (0-49, 50-99, 100-199, 200-349, 350-499, ≥500 cells/µL) overall and separately according to time since start of ART. RESULTS: A total of 6344 of 37 496 patients died during 359 219 years of follow-up. The MR per 1000 person-years was 32.8 (95% confidence interval [CI], 30.2-35.5) during the first 6 months, declining to 16.0 (95% CI, 15.4-16.8) during 5-9.9 years and 14.2 (95% CI, 13.3-15.1) after 10 years' duration of ART. During the first year of ART, there was a strong inverse association of CD4 count at start of ART with mortality. This diminished over the next 4 years. The adjusted MRR per CD4 group was 0.97 (95% CI, .94-1.00; P = .054) and 1.02 (95% CI, .98-1.07; P = .32) among patients followed for 5-9.9 and ≥10 years, respectively. CONCLUSIONS: After surviving 5 years of ART, the mortality of patients who started ART with low baseline CD4 count converged with mortality of patients with intermediate and high baseline CD4 counts

Mortality according to CD4 count at start of combination antiretroviral therapy among HIV-infected patients followed for up to 15 years after start of treatment:collaborative cohort study

Background. CD4 count at start of combination antiretroviral therapy (ART) is strongly associated with short-term survival, but its association with longer-term survival is less well characterised. Methods. We estimated mortality rates (MR) by time since start of ART (&lt;0.5, 0.5-0.9, 1-2.9, 3-3.9, 5-9.9 and ≥10 years) among patients from 18 European and North American cohorts who started ART during 1996-2001. Piecewise exponential models stratified by cohort were used to estimate crude and adjusted (for sex, age, transmission risk, period of starting ART [1996-7, 1998-9, 2000-1], AIDS and HIV-1 RNA at baseline) mortality rate ratios (MRR) by CD4 count at start of ART (0-49, 50-99, 100-199, 200-349, 350-499, ≥500 cells/μL) overall and separately according to time since start of ART. Results. 6,344 of 37,496 patients died during 359,219 years of follow up. The MR per 1000 person-years was 32.8 (95% CI 30.2-35.5) during the first 6 months, declining to 16.0 (15.4, 16.8) during 5-9.9 years and 14.2 (13.3-15.1) after 10 years duration of ART. During the first year of ART there was a strong inverse association of CD4 count at start of ART with mortality. This diminished over the next 4 years. The adjusted MRR per CD4 group were 0.97 (0.94-1.00), p=0.054 and 1.02 (0.98-1.07), p=0.32 among patients followed for 5-9.9 and &gt;10 years respectively. Conclusions. After surviving five years of ART, the mortality of patients who started ART with low baseline CD4 count converged with mortality of patients with intermediate and high baseline CD4 counts. </p

Contested Places: A Typology for Responding to Place-based Harms

In response to historic and ongoing devaluation of certain people, and concurrently, the places they live, many communities are grappling with how to respond to place-based harms. This has produced a wide range of responses, such as calls for “Land Back,” reparations programs, arts-based neighborhood regeneration, and local history initiatives. This paper explores the potential roles community practitioners can play in these contested places. Drawing on a review of the literature, this paper offers an emerging typology for responding to place-based harms

Thermal Stability of Thin Au Films Deposited on Salt Whiskers

Thin metal films deposited on patterned or rough substrates play an increasing role in microelectronics, sensing, catalysis, and other areas of nanotechnology. However, the thermal stability and solid state dewetting of thin metal films with complex three-dimensional architecture is still poorly understood. In this work we employed a model system of nanocrystalline Au thin films deposited on prismatic single crystalline KCl whiskers to study the solid state dewetting of thin films in a three-dimensional setting. The arrays of KCl whiskers were grown on porous substrates under well-defined humidity and temperature conditions. Single crystalline prismatic KCl whiskers with a very high aspect ratio, [001] axis and {100} side facets were obtained. The whiskers were coated with thin conformal Au films of 20-30 nm in thickness. The annealing of these core-shell whiskers at the temperature of 350oC resulted in solid state dewetting of the Au film, with the dewetting processes occurring much faster along the whisker edges than on the side facets. The orientation relationships between Au and KCl were determined by employing similarly prepared thin Au films deposited on the flat KCl (100) substrates. Inspired by our experimental results, we developed a numerical model describing the curvature-gradient driven and surface diffusion-controlled growth of a hole in the thin film deposited on a curved substrate. The model predicted the growth of anisotropic elliptical holes elongated along the whisker axis. We discuss the experimental results in terms of the proposed model, indicating the importance of the change in orientation relationship between the Au grains and KCl whisker along the whisker edges

Thermal Stability of Thin Au Films Deposited on Salt Whiskers

Thin metal films deposited on patterned or rough substrates play an increasing role in microelectronics, sensing, catalysis, and other areas of nanotechnology. However, the thermal stability and solid state dewetting of thin metal films with complex three-dimensional architecture is still poorly understood. In this work we employed a model system of nanocrystalline Au thin films deposited on prismatic single crystalline KCl whiskers to study the solid state dewetting of thin films in a three-dimensional setting. The arrays of KCl whiskers were grown on porous substrates under well-defined humidity and temperature conditions. Single crystalline prismatic KCl whiskers with a very high aspect ratio, [001] axis and {100} side facets were obtained. The whiskers were coated with thin conformal Au films of 20-30 nm in thickness. The annealing of these core-shell whiskers at the temperature of 350oC resulted in solid state dewetting of the Au film, with the dewetting processes occurring much faster along the whisker edges than on the side facets. The orientation relationships between Au and KCl were determined by employing similarly prepared thin Au films deposited on the flat KCl (100) substrates. Inspired by our experimental results, we developed a numerical model describing the curvature-gradient driven and surface diffusion-controlled growth of a hole in the thin film deposited on a curved substrate. The model predicted the growth of anisotropic elliptical holes elongated along the whisker axis. We discuss the experimental results in terms of the proposed model, indicating the importance of the change in orientation relationship between the Au grains and KCl whisker along the whisker edges

Optimal Pandemic Influenza Vaccine Allocation Strategies for the Canadian Population

BACKGROUND: The world is currently confronting the first influenza pandemic of the 21(st) century. Influenza vaccination is an effective preventive measure, but the unique epidemiological features of swine-origin influenza A (H1N1) (pH1N1) introduce uncertainty as to the best strategy for prioritization of vaccine allocation. We sought to determine optimal prioritization of vaccine distribution among different age and risk groups within the Canadian population, to minimize influenza-attributable morbidity and mortality. METHODOLOGY/PRINCIPAL FINDINGS: We developed a deterministic, age-structured compartmental model of influenza transmission, with key parameter values estimated from data collected during the initial phase of the epidemic in Ontario, Canada. We examined the effect of different vaccination strategies on attack rates, hospitalizations, intensive care unit admissions, and mortality. In all scenarios, prioritization of high-risk individuals (those with underlying chronic conditions and pregnant women), regardless of age, markedly decreased the frequency of severe outcomes. When individuals with underlying medical conditions were not prioritized and an age group-based approach was used, preferential vaccination of age groups at increased risk of severe outcomes following infection generally resulted in decreased mortality compared to targeting vaccine to age groups with higher transmission, at a cost of higher population-level attack rates. All simulations were sensitive to the timing of the epidemic peak in relation to vaccine availability, with vaccination having the greatest impact when it was implemented well in advance of the epidemic peak. CONCLUSIONS/SIGNIFICANCE: Our model simulations suggest that vaccine should be allocated to high-risk groups, regardless of age, followed by age groups at increased risk of severe outcomes. Vaccination may significantly reduce influenza-attributable morbidity and mortality, but the benefits are dependent on epidemic dynamics, time for program roll-out, and vaccine uptake