THE MANAGEMENT OF PATIENTS WITH DEPRESSION IN PRIMARY CARE: AN AUDIT REVIEW

Aims and methods: The IAPT scheme was introduced in 2007 to implement the recommendations from NICE guidelines regarding psychological therapy for depression. This retrospective audit carried out across two General Practice Surgeries evaluates the care being given in relation to the standards of NICE guidelines. Results: Initial audit found variable concordance, however after discussion of this at a local audit meeting and the displaying of posters and leaflets detailing the IAPT scheme this was improved on re-audit. Clinical implications: Training should be provided to General Practitioners regarding the standards of care for patients with low mood or depression. In this training there should be an emphasis on the role of psychological therapy and details given of local resources. Posters and leaflets should be clearly displayed to allow patients to self-refer to IAPT. A close watch must be given to waiting times for the IAPT service as demands increase

Studies on ovine interferon-gamma

Interferons have been recognized as important mediators of cellular communication for many years. There are two types of interferon: Type I interferons have antiviral functions, but Type II interferon (IFN-g) is more important as an immunomodulating molecule. Type II interferon has effects on cellular MHC class II expression, immunoglobulin class-switching, macrophage activation, cellular proliferation and a number of other functions. The role of IFN-g during in vivo immune responses has not been studied in great detail, but the sheep is an ideal species in which to study these phenomena by using the efferent lymphatic vessel cannulation model. This allows access to cells and tissue fluid for cytokine analysis using antibody and genetic probes for the detection of IFN-g.Bovine IFN-g peptides (amino-terminus, carboxy-terminus and central) were used to generate antibodies in rabbits. None of the antipeptide sera reacted with denatured ovine or bovine IFN-g, nor neutralized their antiviral effect. Rabbit antibodies to bovine recombinant IFN-g neutralized ovine IFN-g and detected IFN-g in a sandwich ELISA when used in combination with a monoclonal antibody against a human IFN-g carboxy-terminal peptide. The sensitivity of detection was only 125ng/ml, insufficient for use with efferent lymph fluid samples.The expression of MHC class II molecules on cell surfaces is increased by IFN-g on many cell types. This has been used previously to measure biologically active IFN-g concentrations in fluids. Measurement of ovine class II by slot blot was assessed as a method of adapting this to ovine IFN-g measurement, but the technique proved to be too problematic for regular use. The expression of class II on T lymphocytes is influenced by IFN-g in the surrounding fluid. Analysis by FACS of resting ovine T lymphocytes shows them to express class II, a situation different to that in the human. Incubation of efferent lymph cells with IFN-g enhances the expression of ovine DR-like class II molecules especially on CD8⁺ cells, but also on CD4⁺ cells. The expression of ovine DQ-like class II molecules was much less influenced by IFN-g. This differential expression has been seen previously in human cells. It is likely that such differences are due to variation in transcriptional control between the two types of molecule.The IFN-g genes of many species have been cloned, including bovine IFN-g. Nucleotide primers for the cloning of ovine IFN-g by polymerase chain reaction were chosen from the bovine sequence. Cloning of the central 300bp of the gene revealed 98% identity between ovine and bovine IFN-g at the amino acid level. Subsequent cloning of ovine IFN-g by other groups showed that allelic variation of the gene occurs with no alteration in the amino acid structure. This feature is not found in human IFN-g, but is described in other ruminant cytokines. Attempts to isolate a lambda clone expressing an IFN-g fusion protein using the rabbit anti-bovine rIFN-g sera were unsuccessful.The immune response may be analysed by studying cells and fluid delivered by the cannulation of an efferent lymphatic vessel. A secondary response to ovalbumin was induced in a sheep by inoculation of a dependent area. The lymphocytes collected were isolated into CD4⁺ and CD8⁺ cells by a magnetic separation technique (MACS). Their mRNA was isolated, and cDNA generated from it was subjected to IFN-g-specific PCR. This revealed that both CD4⁺ and CD8⁺ cells contribute to the synthesis of IFN-g during the secondary immune response to a protein antigen in the sheep

Regulation of mature mRNA levels by RNA processing efficiency

Transcription and co-transcriptional processes, including pre-mRNA splicing and mRNA cleavage and polyadenylation, regulate the production of mature mRNAs. The carboxyl terminal domain (CTD) of RNA polymerase (pol) II, which comprises 52 repeats of the Tyr1Ser2Pro3Thr4Ser5Pro6Ser7 peptide, is involved in the coordination of transcription with co-transcriptional processes. The pol II CTD is dynamically modified by protein phosphorylation, which regulates recruitment of transcription and co-transcriptional factors. We have investigated whether mature mRNA levels from intron-containing protein-coding genes are related to pol II CTD phosphorylation, RNA stability, and pre-mRNA splicing and mRNA cleavage and polyadenylation efficiency. We find that genes that produce a low level of mature mRNAs are associated with relatively high phosphorylation of the pol II CTD Thr4 residue, poor RNA processing, increased chromatin association of transcripts, and shorter RNA half-life. While these poorly-processed transcripts are degraded by the nuclear RNA exosome, our results indicate that in addition to RNA half-life, chromatin association due to a low RNA processing efficiency also plays an important role in the regulation of mature mRNA levels

Chilean Voices: Activists Describe their Experiences of the Popular Unity Period

Each interview focuses on the field in which the speaker was most active. The number of interviews in each field reflects its relative importance: three for industry, two for the country side and one each for the shantytowns and the universities. In the case of industry, anything less could scarcely have conveyed the range of views on its key issues, such as workers’ participation: hence the three selected are from the Communist Party, the MAPU and the Socialist Party

Permacultures of transformation: steps to a cultural ecology of environmental action

This article examines a trend over the past two decades towards more explicit politicization in some areas of the ecovillage movement, particularly where covillages engage with related grassroots movements for environmental and social change. It does so using an expanded political ecology framework, also drawing upon 'Multi-level Perspective on Sustainability Transitions' and Gregory Bateson's Ecology of Mind. It argues that apparently apolitical focii on lifestyle change and personal development have in some cases given way to overt recognition of the need for global political change. It attributes this to the global political economy of sustainability becoming more evident and critiques of dominant social, political and economic regimes more compelling and widely accepted

The Effects of Brand Portfolio Management on Brand Choice Behaviour

Double Jeopardy (DJ) says brands with lower market share have far fewer buyers, and these buyers are slightly less loyal (Sharp, 2010). The Dirichlet Model has generally been used to analyse brand buying behaviour for individual brands to reveal levels of brand loyalty and switching. The long and varied pursuit of such analysis led to empirical generalizations such as the Double Jeopardy (DJ) pattern, which can be seen in brand performance metrics (BPM) like repeat buying, SCR and sole brand loyalty. These BPMs are typically viewed at an individual brand level, but this research takes the analysis a step further by analysing BPMs for corporate brand portfolios (all the brands owned by a particular company within a product category) to explore how the common strategy of having several brands within a company portfolio affects core BPMs both within and between company portfolios. The main finding from this initial research on DJ effects is that it is a useful framework for analysing corporate level portfolio performance. The main new finding is that there are indications of raised sharing of customers within portfolios compared to between portfolios

Rethinking the sustainable development goals : learning with and from community-led initiatives

Unidad de excelencia María de Maeztu CEX2019-000940-MAjuts: we are grateful to Frank Biermann and Tim O'Riordan for their stimulating critical comments on a previous version of this manuscript. Work on this paper was partially supported by various awards from the Portuguese Fundação para a Ciência e a Tecnologia, whose support is gratefully acknowledged: Bolsa IF/00940/2015 (Penha-Lopes, Henfrey), Bolsa SFRH/BPD/94495/2013 (Esteves) and project grant PTDC/SOC-SOC/2061/2020 (Esteves, Henfrey).This paper explores the actual and potential contributions of community-led initiatives (CLIs) to the Sustainable Development Goals (SDGs). As examples of self-determined practical action for sustainability and social justice, CLIs prefigure many of the intended outcomes of the SDGs. Existing evidence shows that CLIs are already contributing, at local scale, to almost all of the SDGs, and achieving particular success in bringing different goals into synergy. However, these achievements are based on ethics, guiding philosophies, issue framings, practical goals and ways of organising that differ significantly from those behind the formulation and delivery of the SDGs. Embracing those differences, and with them greater plurality and ongoing critical self-reflection, would allow the SDGs to transcend certain self-limiting contradictions, particularly concerning the role of economic growth. Such a shift in orientation is essential if the SDGs are to move from reinforcing to challenging the root causes of unsustainability and injustice

Sustainable entrepreneurship and the Sustainable Development Goals:Community-led initiatives, the social solidarity economy and commons ecologies

The social solidarity economy is an approach to the production and consumption of goods, services and knowledge that promises to address contemporary economic, social and environmental crises more effectively than business as usual. The paper employs the concept of commons ecologies to examine the practices, relationships and interactions among actors and organisations in the social solidarity economy, as well as between them and the mainstream economy, which shape the field and its degree of autonomy in relation to capitalism, through a process defined as boundary commoning. Such process shapes both local and regional commons ecologies, as well as the participation of local and regional actors in wider networks at national, international and global levels. The paper takes a case study-based approach to identify practices, relationships and interactions of commons ecologies in relation to selected community-led initiatives in the UK, Portugal, Brazil and Senegal. Each case study illuminates different qualities of local/regional commons ecologies and their forms of engagement with wider networks. Further, the paper shows that these cases demonstrate how the social solidarity economy may facilitate delivery of the Sustainable Development Goals in a distinctive way. In each case, SSE acts as a vehicle for expressing participants' values and principles consistent with those underlying the SDGs. Local implementation of SDGs is thus an in-built feature of these commons ecologies. The participation of community-led initiatives in international and global networks offers opportunities to learn from local level experiences and successes, potentially strengthening SDG implementation more generally.</p

Towards a necessary regenerative urban planning: Insights from community-led initiatives for ecocity transformation

This article suggests that to adequately tackle climate breakdown, urban planning needs to move beyond sustainability to incorporate regenerative development frameworks. Key to this is activating and increasing citizen participation in a fractal-like, multi scaled, community-led, bottom up planning process, where active citizens design, construct and are part of the futures they desire for their territories. 2019’s declarations of climate emergency show that decades of sustainable development have not worked. The Sustainable Development Goals are a positive step, but sustainability’s dependence on economic growth is problematic. Recognising Earth’s limits, this article builds on degrowth ideas and doughnut economic frameworks to examine the role of community-led urban transitions in catalysing a regenerative world, where ecocities are the normative goal of contemporary cities. Challenges in scaling the Global Ecovillage Network’s process to large cities are identified and some radical governance experiments examined. Attempting to bridge activism and academia, a transdisciplinary participative action research method is used to develop a Communities of Practice ecosystem to support an eco-social just transition. This work contributes to the European Network for Community-Led Initiatives on Climate Change and Sustainability, ECOLISE, the Horizon 2020 project UrbanA investigating Sustainable and Just Cities, and the Communities for Future action platform enabling translocal communities to connect, co-create a knowledge commons and help shape policy. Insights from Lisbon are examined with three community-led initiatives; Bela Flor, Ajuda and Marvila. These processes are still at the margins, but could soon become core activities of regenerative urban planning. Re-Making our cities is everyone’s business.info:eu-repo/semantics/publishedVersio