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Background 'Reducing the Strength' (RtS) is a public health initiative encouraging retailers to voluntarily stop selling cheap, strong beers/ciders (≥6.5% alcohol by volume). This study evaluates the impact of RtS initiatives on alcohol availability and purchasing in three English counties with a combined population of 3.62 million people. Methods We used a multiple baseline time-series design to examine retail data over 29 months from a supermarket chain that experienced a two-wave, area-based role out of RtS: initially 54 stores (W1), then another 77 stores (W2). We measured impacts on units of alcohol sold (primary outcome: beers/ciders; secondary outcome: all alcoholic products), economic impacts on alcohol sales and substitution effects. Results We observed a non-significant W1 increase (+3.7%, 95% CI: -11.2, 21.0) and W2 decrease (-6.8%, 95% CI: -20.5, 9.4) in the primary outcome. We observed a significant W2 decrease in units sold across all alcohol products (-10.5%, 95% CI: -19.2, -0.9). The direction of effect between waves was inconsistent for all outcomes, including alcohol sales, with no evidence of substitution effects. Conclusions In the UK, voluntary RtS initiatives appear to have little or no impact on reducing alcohol availability and purchase from the broader population of supermarket customers.

Unidirectional glass/epoxy prepreg with embedded microcapsules containing a liquid healing agent was developed for the fabrication of laminated self-healing fiber-reinforced polymer matrix composites (PMCs). Microcapsules containing a liquid healing agent were distributed throughout a prepreg fabric using a custom designed prepregger. The microcapsules of ca. 2.5 μm in diameter resided in the fiber interstitial spaces and remained intact during prepregging and subsequent hot-pressing of laminated composites. The prepreg fabric displayed uniform distribution of microcapsules within the fiber yarns and throughout the fabric. Laminated composites produced with the prepreg attained 0.56 fiber volume fraction with 0.063 microcapsule volume fraction distributed uniformly throughout the composite. Embedded microcapsules within the laminated composites lead to a small reduction in transverse storage modulus and glass transition temperature.

Marangoni forces drive a fluid to flow in response to positional differences in surface energy. In thin polymer films, a difference in surface energy between two coincident liquid polymers could offer a useful route to manufacture topographically patterned surfaces via the Marangoni effect. Previously, we have demonstrated a photochemical method using the Marangoni effect for patterning thin polystyrene films. To generalize the approach, a theoretical model that gives the underlying physics of this process was also developed, which further revealed that low viscosities, low diffusivities, and large surface energy gradients favor rapid evolution of large film thickness variations. However, as described by the Stokes−Einstein equation or the Rouse model, low viscosity is generally correlated with high diffusivity in a single-component system. Herein, we report a strategy to decouple film viscosity and diffusivity by co-casting a high molecular weight surface energy gradient creating copolymer (low diffusivi...

A recently developed flame retardant (FR) nanocoating of polydopamine (PDA) was applied to flexible polyurethane foam (PU) and thermogravimetrically analyzed (TGA). Thermal degradation kinetics were described by a simplified multi-component, Arrhenius expression coupled with a first-order reaction model. Kinetic parameters were then extracted via an optimization solver. By limiting the number of optimized parameters, a mesh adaptive direct search algorithm was employed to extract meaningful kinetic parameters that better simulate the TGA data compared to graphical methods. Through TGA, it was shown that the effect of the PDA nanocoating on PU degradation differs between oxidative (78 vol% nitrogen (N2) and 21 vol% oxygen) and inert (100% N2) environments. In nitrogen, the mass loss is delayed and diminished in the first PU reaction, which is the opposite effect of a traditional halophosphate FR. In an oxidative environment, the first reaction of PU is greatly delayed by the PDA coating, but once the reaction begins, it becomes accelerated.

The Marangoni effect describes fluid flow near an interface in response to a surface tension gradient. Here, we demonstrate that the Marangoni effect is the underlying mechanism for flow driven feature formation in an azobenzene-containing polymer film; features formed in azobenzene-containing polymers are often referred to as surface relief gratings or SRGs. An amorphous poly(4-(acryloyloxyhexyloxy)-4′-pentylazobenzene) was synthesized and studied as a model polymer. To isolate the surface tension driven flow from the surface tension pattern inscription step, the surface tension gradient was preprogrammed via photoisomerization of azobenzene in a glassy polymer film without forming topographical features. Subsequently, the latent image was developed in the absence of light by annealing above the glass transition temperature where the polymer is a liquid. The polymer flow direction was controlled with precision by inducing different surface tension changes in the exposed regions, in accordance with expect...

An efficient, environmentally friendly, and water-applied flame retardant surface nanocoating based on polydopamine (PDA) was developed for foamed materials such as polyurethane (PU). The PDA nanocoating, deposited by simple dip-coating in an aqueous dopamine solution, consists of a planar sublayer and a secondary granular layer structure that evolve together, eventually turning into a dense, uniform, and conformal layer on all foam surfaces. In contrast to flexible PU foams that are known to be highly flammable without flame retardant additives, micro combustion calorimetry (MCC) and thermogravimetric analysis (TGA) confirm that the neat PDA is relatively inflammable with a strong tendency to form carbonaceous, porous char that is highly advantageous for flame retardancy. By depositing nanocoatings of PDA onto flexible PU foams, the flammability of the PU foam was significantly reduced with increasing coating thickness. For the thickest coating (3 days of PDA deposition), the foam quickly self-extinguish...

A thermoplastic resin poly(bisphenol A-co-epichlorohydrin) (PBAE) is blended with a high glass transition temperature (Tg) epoxy matrix to serve as both a toughening additive and a healing agent in combination with an encapsulated solvent. Microcapsules are coated with poly(dopamine) (PDA) to improve the thermal stability and retain the core solvent during curing at 180 °C. The fracture toughness of the high Tg epoxy (EPON 828: diamino diphenyl sulfone) is doubled by the addition of 20 wt % PBAE alone and tripled by the addition of both microcapsules and the thermoplastic phase. Self-healing is achieved with up to 57% recovery of virgin fracture toughness of the toughened epoxy. Healing performance and fracture toughness of the self-healing system remain stable after aging 30 days. The relative amount of thermoplastic phase and the presence of solvent-filled microcapsules influence the storage modulus, Tg, and healing performance of the polymer.

A maximum of 91% recovery of interfacial shear strength (IFSS) is achieved for carbon fiber/epoxy interfaces functionalized with capsules containing reactive epoxy resin and ethyl phenyl acetate (EPA). We find a binder is necessary to improve the retention of capsules on the carbon fiber surface. Two different methods for applying the binder to the carbon fiber surface are investigated. Healing efficiency is assessed by recovery of IFSS of a single functionalized fiber embedded in a microdroplet of epoxy. Debonding of the fiber/matrix interface ruptures the capsules, releasing resin and EPA solvent into the crack plane. The solvent swells the matrix, initiating transport of residual amine functionality from the matrix for further curing with the epoxy resin delivered to the crack plane. The two binder protocols produce comparable results, both yielding higher recovery of IFSS than samples prepared without a binder.

Robust microcapsules are prepared with carbon black suspensions high in solids loading (up to 0.2 g/mL) for electrical conductivity restoration. Oxidized carbon black is rendered more hydrophobic through surface functionalization with octadecylamine by two different methods. Functionalization significantly improves dispersability and suspension stability of carbon black in hydrophobic solvents such as o-dichlorobenzene (o-DCB), enabling encapsulation by in situ emulsion polymerization. Upon crushing, microcapsules containing functionalized carbon black (FCB) suspensions exhibit significant particle release relative to microcapsules filled with unfunctionalized carbon black. Release of carbon black is further enhanced by the addition of two types of core thickeners, epoxy resin or poly 3-hexylthiophene (P3HT). Full conductivity restoration (100% restoration efficiency) of damaged silicon anodes is achieved by crushing microcapsules containing FCB suspensions with P3HT. Hydrophobic surface functionalization of carbon black and the addition of core thickeners are both critical for achieving stable microcapsules capable of significant particle release and efficient conductivity restoration.

Summary Shoulder problems are a common musculoskeletal complaint, which present a difficult diagnostic challenge. Many orthopaedic tests for the shoulder are not specific for any one pathological condition and two or more conditions often co-exist, therefore, it is not surprising that clinicians are often unable to accurately diagnose shoulder joint pathology. Once shoulder pain due to conditions such as tumour, infection, trauma, systemic inflammatory disorders and referred pain from elsewhere has been ruled out, a more global and functional approach to diagnosis and management of non-specific shoulder pain is advocated. This paper presents an alternative diagnostic and therapeutic approach used to manage non-specific shoulder pain illustrated by three cases.

Arachidonic acid, a fatty acid component of neuronal cell membranes, forms the backbone of endogenous ligands of the endocannabinoid system. The lipid nature of this system may make it particularly susceptible to changes in fat content of the diet, which may, in turn, affect endocannabinoid tone and subsequent changes in receptor expression or activity. The latter would also be expected to affect responses to exogenous cannabinoids. The purpose of the present study was to determine the effects of a high-fat diet on sensitivity to the pharmacological effects of Δ 9 -tetrahydrocannabinol (Δ 9 -THC). Male and female Long-Evans rats were fed either a diet of standard rodent chow or chow enhanced with corn oil. Subsequently, they were repeatedly assessed for Δ 9 -THC-induced hypomobility, catalepsy and hypothermia. Female rats that received the high-fat diet beginning in adolescence or in adulthood became significantly less sensitive to the effects of Δ 9 -THC on motor behavior, but not its hypothermic effects, with faster development of decreased sensitivity in female rats that began the high-fat diet as adults. In contrast, diet-induced differences either did not occur, or were less pronounced, in male rats of both ages. After acute injection, brain and blood levels of Δ 9 -THC and its two primary metabolites were similar regardless of diet. Combined with the fact that diet differentially affected only some of the measures, these results suggest that pharmacokinetic differences cannot fully account for the effects of the high-fat diet on response to Δ 9 -THC. Further, these results suggest that dietary fat content may represent an important consideration in predicting the effects of marijuana in females.

Evidence-based medicine (EBM) is described as ‘‘. . . the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine requires the integration of individual clinical expertise with the best available external clinical evidence from systematic research.’’ More recently, this definition has been updated to incorporate patient values in the decision process. These key elements of evidencebased clinical decisions are depicted in Fig. 1. The overall aim of EBM is to provide the best possible care for the individual patient. The integration of best research evidence, clinical expertise and patient values, allows clinicians and patients to form a ‘‘diagnostic and therapeutic alliance’’ to optimise clinical outcomes and quality of life. As professionals, we should constantly question clinical practice how and why we practice in the way we do and whether we are providing the most effective care for our patients. To do less is to practice as a technician and not as a professional. The need for evidence-based practice has arisen from the rapid advances in medical knowledge and the large number of clinical papers being published. Traditional sources of information such as textbooks rapidly become out of date. Consequently, a disparity develops between diagnostic skills and clinical judgement that increases with experience and dating of academic knowledge resulting in a decline in clinical performance over time. EBM was developed to help bridge this gap between research and practice. Recent advances in database searching and secondary sources of evidence, as well as improved access to them, have made the practice of EBM a more viable option.

Microcapsules containing a liquid metal alloy core of gallium-indium (Ga-In) are prepared via in situ urea-formaldehyde (UF) microencapsulation. The capsule size, shape, thermal properties, and shell wall thickness are investigated. We prepare ellipsoidal capsules with major and minor diameter aspect ratios ranging from 1.64 to 1.08 and with major diameters ranging from 245 µm to 3 µm. We observe that as the capsule major diameter decreases, the aspect ratio approaches 1. The thermal properties of the prepared microcapsules are investigated by thermogravimetric (TGA) and differential scanning calorimetry (DSC). Microcapsules are shown to survive incorporation into an epoxy matrix and to trigger via mechanical damage to the cured matrix. Microcapsules containing liquid metal cores may have diverse applications ranging from self-healing to contrast enhancement or the demonstration of mechano-adaptive circuitry.

Adhesion phenomena are essential to many biological processes and to synthetic adhesives and manufactured coatings and composites. Supramolecular interactions are often implicated in various adhesion mechanisms. Recently, supramolecular building blocks, such as synthetic DNA base-pair mimics, have drawn attention in the context of molecular recognition, self-assembly, and supramolecular polymers. These reversible, hydrogen-bonding interactions have been studied extensively for their adhesive capabilities at the nano- and microscale, however, much less is known about their utility for practical adhesion in macroscopic systems. Herein, we report the preparation and evaluation of supramolecular coupling agents based on high-affinity, high-fidelity quadruple hydrogen-bonding units (e.g., DAN·DeUG, Kassoc = 10(8) M(-1) in chloroform). Macroscopic adhesion between polystyrene films and glass surfaces modified with 2,7-diamidonaphthyridine (DAN) and ureido-7-deazaguanine (DeUG) units was evaluated by mechanical testing. Structure-property relationships indicate that the designed supramolecular interaction at the nanoscale plays a key role in the observed macroscopic adhesive response. Experiments probing reversible adhesion or self-healing properties of bulk samples indicate that significant recovery of initial strength can be realized after failure but that the designed noncovalent interaction does not lead to healing during the process of adhesion loss.

Background One of the debates regarding the role of chiropractors is whether or not they should be considered as primary healthcare practitioners. Primary care is often used to describe chiropractic but without any definition of what is meant by the term. Primary healthcare itself has many definitions and this adds to the problem. Existing research literature, based mostly in the USA, suggests that the use of the title "primary healthcare professional" by chiropractors is central to the identity of the profession. It has also been suggested that the concept of primary care is misused by chiropractors because they have not examined the concept in detail and thus do not understand it. For the sake of quality of patient care and for the legitimacy of the profession, chiropractors in the UK need to agree on their healthcare role. This study aimed to examine the opinions of chiropractors towards the use of the term primary healthcare when applied to chiropractic practice within the UK. Methods A sequential study of exploratory design was used; this model is characterised by an initial phase of qualitative data collection and analysis that precedes and informs the quantitative phase of data collection and analysis. In this study, interviews with members of chiropractic teaching faculty were used to inform the development of a questionnaire used to survey the opinions of chiropractors in the UK. Results There was a general consensus of opinion that chiropractors are primary contact practitioners, who work in a primary healthcare setting and that to be able to fulfil this healthcare role, chiropractors must be able to diagnose patients and refer when required. Participants did not feel that chiropractors are able to treat all of the most common medical conditions that present in a primary healthcare setting. Conclusions The findings of this study suggest that chiropractors in the UK view their role as one of a primary contact healthcare practitioner and that this view is held irrespective of the country in which they were educated or the length of time in practice. Further research needs to be developed to evaluate the findings of the current study within a wider healthcare context. In particular the opinions of other healthcare professionals towards the role of chiropractors in healthcare, need to be examined in more detail.

Protection of Earth's ecosystems requires identification of geographical areas of greatest biodiversity. Assessment of biodiversity begins with knowledge of the evolutionary histories of species in a geographic area. Multiple phylogenetic diversity (PD) metrics have been developed to describe biodiversity beyond species counts, but sufficient empirical studies, particularly at fine phylogenetic scales, have not been conducted to provide conservation planners with evidence for incorporating PD metrics into selection of priority regions. We review notable studies that are contributing to a growing database of empirical results, we report on the effect of using high-throughput sequencing to estimate the phylogenies used to calculate PD metrics, and we discuss difficulties in selecting appropriate diversity indices. We focused on two of the most speciose angiosperm families in prairies—Asteraceae and Fabaceae—and compared 12 PD metrics and four traditional measures of biodiversity between three North American...

Background Retailers routinely collect data about people's purchasing behaviours and access to consumer products associated with health and wellbeing. Here we discuss how retail data can be used in public health research and consider potential strengths and limitations to such research. To illustrate the discussion we refer to an evaluation of an intervention called Reducing the Strength, whereby off-licence shops and supermarkets voluntarily stopped selling inexpensive superstrength (≥6·5% alcohol by volume) beers and ciders. Methods Monthly data from a large retail chain (East of England Co-operative Society) were obtained for three UK counties (141 stores). In one county the intervention started 12 months earlier than the others, allowing for a pre–post study design with a delayed implementation comparator. Difference-in-differences analysis of unit alcohol sales controlled for socioenvironmental confounders and shop-level characteristics including shop size, parking facilities, cash machines, opening hours, and other factors. Findings The retail data detailed shop-level characteristics and sales data such as prices, quantities, product brands, alcohol content, sales, and factors affecting sales. The wide geographical coverage, shop-level data, including data for potential confounding factors, and frequent timepoints made the retail data well-suited for a quasi-experimental evaluation capitalising on temporal and spatial variations in intervention exposure. Limitations of this study include a lack of longitudinal data for individual customers, and shops that are not covered by the data. Qualitative interviews with shop workers and customers, and triangulation using alternative data sources can help to address limitations. Alternative sources of retail data such as private sector consultants who specialise in collecting shop-level and sales data for a range of companies might also address some limitations; however, there are potential barriers of expense, accessibility, and coverage associated with the use of such consultants. Interpretation Increasingly, researchers recognise the potential of retail data for evaluating interventions affecting social determinants of health and inequalities, such as local access to alcohol. However, shop-level data have frequently proved difficult for researchers to obtain. By obtaining such data we have been able to assess, using a quasi-experimental design, the effects of removing strong, cheap beers and ciders from shops. We have also been able to explore in more detail how to optimise the strengths and address some limitations of the data in ways that could potentially assist others planning to use this important data source in their research. Funding The study is funded as part of the School of Public Health Research by NHS National Institute of Health Research. AJ, SA, and JW contributed as employees of Public Health Suffolk, Suffolk County Council.