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Background Informal carers are central in supporting patients at the end of life, but this has substantial negative impacts on carers’ own mental health. When carers are unable to cope, this may affect their ability to support the patient and increase the likelihood of patient hospital admissions. Further, demographic changes mean demands for care at and before end of life are increasing and existing services will struggle to meet these demands. It is important to recognise carers as a vital resource and prevent adverse health outcomes from caregiving (and thereby limit their consequences). Large individual variation in the level of psychological morbidity from end-of-life caregiving suggests there is scope for interventions to improve carer mental health if we can understand the underlying factors. Objectives This meta-synthesis of qualitative studies aims to identify factors reported by carers as important to their mental health. Data sources Searches of MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Social Science Citation Index, EMBASE, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and Cochrane Qualitative Reviews 1 January 2009 to 24 November 2019 for empirical publications from Organization for Economic Cooperation and Development countries in English/Scandinavian on factors affecting adult carer mental health during end-of-life caregiving in home settings. Review methods Systematic qualitative meta-synthesis in collaboration with a Public Patient Involvement carer Review Advisory Panel, included thematic synthesis, followed by a best-fit framework synthesis, informed by principles of meta-ethnography. Critical Appraisal Skills Programme Qualitative Studies Checklist was used. Results Thirty-three eligible studies identified six themes encompassing factors perceived by carers to affect their mental health during end-of-life caregiving. These were: (1) the patient condition (including patient decline); (2) impact of caring responsibilities (including exhaustion, lack of time for own needs, isolation); (3) relationships (including quality of the patient–carer relationship); (4) finances (including financial concerns, impact on work); (5) carers’ internal processes (including loss of autonomy, lack of confidence, coping strategies); and (6) support (including lack of informal support, inadequacies in formal support information and care provision, limited collaboration, disjointed care). Reported strategies to improve mental health were linked to the final two themes, with suggestions on how to manage carers’ internal processes and build appropriate support. Findings correspond with literature 1998–2008, indicating consistency in factors affecting carers and adding validity to findings. Limitations The review was limited to caregiving in the home setting and studies from Organization for Economic Cooperation and Development countries published in English and Scandinavian. Identified papers predominantly considered carers of people with cancer, with little research into ethnic-minority perspectives. The review may therefore not fully encompass factors affecting carers of people with longer-term conditions, or those within other care settings, countries and population groups. Conclusions and future work A wide range of both internal and contextual factors may lead to psychological morbidity when caring for someone at the end of life. Future work within practice therefore requires a broad-based rather than narrow approach to sustaining and improving carer mental health. Future work within research requires collaboration between researchers and stakeholders within policy, commissioning, practice and carer organisations to develop solutions and assess their effectiveness. Further, researchers need to develop better models for factors affecting carer mental health and their interaction, to build a stronger evidence base and better guide interventions. Study registration This study is registered as PROSPERO CRD42019130279. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number HSDR 18/01/01 and will be published in full in Health and Social Care Delivery Research. See the NIHR Journals Library website for further project information. Plain language summary Introduction Being a carer for a family member or friend at the end of their life can have an impact on the carer’s mental health. This includes depression, anxiety, stress and feeling overwhelmed. If carers feel unable to cope, they may be less able to look after their relative or friend. The mental health of carers must be a priority to help them feel better, cope, and support patients. This review summarises information from research into things that carers say are important for their mental health, to help us understand how we may be able to maintain or improve carers’ mental health. Methods We worked with six carers in a Review Advisory Panel to search for studies on carers’ experience published between 1 January 2009 and 24 November 2019 and identify common themes from identified studies. Themes were put into a table of themes and subthemes, assessed by the carers, and compared with other literature to identify factors that caused carers to have poor mental health, and ways to help carers feel better. Results We found six themes that indicate how caring for those at the end of life can affect mental health. These include: the impact of the patient condition and seeing the patient decline; the impact of caring responsibilities; carers’ relationship with the patient; finances; carers’ feelings and experiences such as lack of control or confidence when caring; and support from other family, friends and health-care professionals. Strategies to improve mental health were linked to the final two themes, including how to manage carers’ views and experiences of their situation and how to gain appropriate support. Conclusions This study describes factors that lead to poor mental health and ways to improve mental health when caring for someone at the end of life. Further work is needed to use this information to inform policy and service delivery.

Abstract We analysed corrosion from a copper bowl dating from the Roman period (43–410 AD) found in a farm in Kent, UK. Despite its relatively good condition, the interior and exterior surface of the object had areas of deterioration containing green and brown-coloured corrosion which were sampled for characterization by a multi-analytical protocol. Basic copper chlorides atacamite and paratacamite were identified in the context of mineral phases along with chlorobenzenes in the green corrosion. Chlorobenzenes are common soil contaminants in rural areas from the use of pesticides, many of which were banned more than 50 years ago. Here we show that their presence is associated with accelerated corrosion, and this provides a threat to the preservation of archaeological metal objects in the ground.

While China’s experience of using special economic zones (SEZs) for advancing economic development is a model increasingly adopted in other developing countries, the processes involved in replicating this model elsewhere and the outcomes of such replication remain little understood. This review article’s nested examination of three relevant strands of literature and two case studies of India and Ethiopia indicates that successful replication of China’s SEZ-led development would involve deliberate processes of adaptation from the original model. Replication must be “smart,” by taking into account the temporal, systemic, and other discrepancies between the Chinese model and the replicating country; replicating the benefits of China’s approach whilst avoiding the drawbacks; and maximising the positive effects of direct Chinese involvement and investments while reducing negative repercussions.

This paper presents the results of excavations at Glover Drive, Edmonton, at a site located on the west side of the Lea Valley. In the past the valley comprised a spread of shifting channels, most of which are now silted and buried. Excavations within the floodplain revealed a sequence of deposits relating to former channels. These provided evidence for the past environment, anthropogenic activities and management of the landscape from the Mesolithic period to the present. An unusual timber platform and two roundwood stake-built structures, dated by dendrochronology to shortly after AD 472, were found within a small channel on the edge of a sand bank in a backwater fen area. A series of ditches on the higher ground to the west of the structures were also tentatively dated to the Early Saxon period. The timber structures were probably short-lived as the site became inundated, leading to the wooden structures and ditches being buried beneath thick alluvial clay. The Early Saxon wooden platform is the first of its kind to be excavated, recorded and dated in England and the article discusses its possible function, placing it into its temporal and spatial context. [ABSTRACT FROM AUTHOR]

This article explores two examples of worker housing in India, and compares these with China's 'dormitory labour regime', arguing that these methods of labour accommodation are part of a broader, increasingly global, workplace-residence regime aimed at migrant labour control for the purposes of value extraction. Contrary to previous studies, it argues that China's system is not unique, but part of the political economy of contemporary global capitalism. Although there exist historical and contextual variations between the two Indian case studies, drawn from the Delhi National Capital Region (NCR) garment sector and the Andhra Pradesh electronics industry, as well as between the Indian and Chinese contexts, the aims and many of the outcomes are similar. Moving beyond a focus on the country- and space-specific 'dormitory labour regime' facilitates a broader understanding of the crucial role contemporary workplace-residence systems play in enhancing control of migrant labour for the benefit of global accumulation networks. [ABSTRACT FROM AUTHOR]

Background: T2* mapping can characterize tumor hypoxia, which may be associated with resistance to therapy. Acquiring T2* maps during MR‐guided radiotherapy could inform treatment adaptation by, for example, escalating the dose to resistant sub‐volumes. Purpose: The purpose of this work is to demonstrate the feasibility of the accelerated T2* mapping technique using model‐based image reconstruction with integrated trajectory auto‐correction (TrACR) for MR‐guided radiotherapy on an MR‐Linear accelerator (MR‐Linac). Materials and methods: The proposed method was validated in a numerical phantom, where two T2* mapping approaches (sequential and joint) were compared for different noise levels (0,0.1,0.5,1) and gradient delays ([1, ‐1] and [1, ‐2] in units of dwell time for x‐ and y‐axis, respectively). Fully sampled k‐space was retrospectively undersampled using two different undersampling patterns. Root mean square errors (RMSEs) were calculated between reconstructed T2* maps and ground truth. In vivo data was acquired twice weekly in one prostate and one head and neck cancer patient undergoing treatment on a 1.5 T MR‐Linac. Data were retrospectively undersampled and T2* maps reconstructed, with and without trajectory corrections were compared. Results: Numerical simulations demonstrated that, for all noise levels, T2* maps reconstructed with a joint approach demonstrated less error compared to an uncorrected and sequential approach. For a noise level of 0.1, uniform undersampling and gradient delay [1, ‐1] (in units of dwell time for x‐ and y‐axis, respectively), RMSEs for sequential and joint approaches were 13.01 and 9.32 ms, respectively, which reduced to 10.92 and 5.89 ms for a gradient delay of [1, 2]. Similarly, for alternate undersampling and gradient delay [1, ‐1], RMSEs for sequential and joint approaches were 9.80 and 8.90 ms, respectively, which reduced to 9.10 and 5.40 ms for gradient delay [1, 2]. For in vivo data, T2* maps reconstructed with our proposed approach resulted in less artifacts and improved visual appearance compared to the uncorrected approach. For both prostate and head and neck cancer patients, T2* maps reconstructed from different treatment fractions showed changes within the planning target volume (PTV). Conclusion: Using the proposed approach, a retrospective data‐driven gradient delay correction can be performed, which is particularly relevant for hybrid devices, where full information on the machine configuration is not available for image reconstruction. T2* maps were acquired in under 5 min and can be integrated into MR‐guided radiotherapy treatment workflows, which minimizes patient burden and leaves time for additional imaging for online adaptive radiotherapy on an MR‐Linac. [ABSTRACT FROM AUTHOR]

Precommercial thinning (PCT) is used to increase tree size and shorten harvest rotation time. Short-term results from PCT studies often show a trade-off between individual-tree growth and net stand yield, while longer-term effects of PCT on tree growth and stand yield are less well documented. We used a 54-year-old PCT study to test long-term effects of forest density and thinning schedules on stand yield and tree-level characteristics in even-aged western larch (Larix occidentalis Nutt.) stands. The study has three target densities (494, 890, and 1680 trees * [ha.sup.-1]) crossed with three thinning schedules (target density achieved through one, two, or four entries). Analysis of variance (ANOVA) and linear contrasts were used to test the effects of density and number of entries on tree-and stand-level attributes. Thinning before stand age 10 years leads to long-term constant yield (219.0-269.5 [m.sup.3] * [ha.sup.-1]; P > 0.05) across the tested densities. We also found constant volume growth across stand densities during the most recent measurement interval (5.42-6.41 [m.sup.3] * [ha.sup.-1] * [year.sup.-1]; P > 0.05). Number of entries did not affect any tree- or stand-level attribute. The primary effect of early PCT is to control whether wood volume and growth are concentrated on few large, stable trees or spread over many small, unstable trees. Key words: density management, stand density, competition, stand dynamics, growth and yield. L'eclaircie precommerciale (EPC) est utilisee pour augmenter la taille des arbres et devancer l'age de la recolte du peuplement. A court terme, les resultats de l'EPC montrent souvent un compromis entre la croissance des arbres individuels et la production nette du peuplement, alors que les effets a long terme de l'EPC sur la croissance des arbres et la production des peuplements sont moins bien documentes. Nous avons utilise une etude sur l'EPC, vieille de 54 ans, pour evaluer les effets a long terme de la densite des peuplements et du calendrier des eclaircies sur la production des peuplements et les caracteristiques des arbres dans des peuplements equiennes de meleze occidental (Larix occidentalis Nutt.). L'etude comprenait trois densites cibles du peuplement (494, 890 et 1680 arbres-ha-1) et trois calendriers des eclaircies (densite cible atteinte apres un, deux ou quatre interventions). Nous avons utilise des analyses de variance et des contrastes lineaires pour tester les effets de la densite du peuplement et du nombre d'interventions sur les caracteristiques des arbres et des peuplements. Une eclaircie realisee avant l'age de 10 ans a mene a une production constante a long terme (de 219,0 a 269,5 [m.sup.3] * [ha.sup.-1]; P > 0,05) pour l'ensemble des densites testees. Nous avons aussi trouve une croissance en volume constante entre les densites de peuplement au cours du plus recent intervalle de mesures (5,42 a 6,41 [m.sup.3] * [ha.sup.-1] * [an.sup.-1]; P > 0,05). Le nombre d'interventions n'a influence aucune caracteristique des arbres et des peuplements. L'effet principal d'une EPC precoce est de determiner si le volume et la croissance du bois sont concentres sur un nombre limite de gros arbres stables ou repartis sur de nombreux petits arbres instables. [Traduit par la Redaction] Mots-cles : gestion de la densite, densite du peuplement, competition, dynamique du peuplement, croissance et production., 1. Introduction Forest stand density affects the timing and intensity of competitive interactions between neighboring trees (Oliver and Larson 1996; Long et al. 2004; Harrington et al. 2009). In high-density [...]

Background: Although nausea and vomiting are very common in pregnancy, their pathogenesis is poorly understood. We tested the hypothesis that circulating growth and differentiation factor 15 (GDF15) concentrations in early pregnancy, whose gene is implicated in hyperemesis gravidarum, are associated with nausea and vomiting. Methods: Blood samples for the measurement of GDF15 and human chorionic gonadotrophin (hCG) concentrations were obtained early in the second trimester (median 15.1 (interquartile range 14.4-15.7) weeks) of pregnancy from 791 women from the Cambridge Baby Growth Study, a prospective pregnancy and birth cohort. During each trimester participants completed a questionnaire which included questions about nausea, vomiting and antiemetic use. Associations with pre-pregnancy body mass indexes (BMI) were validated in 231 pregnant NIPTeR Study participants. Results: Circulating GDF15 concentrations were higher in women reporting vomiting in the second trimester than in women reporting no pregnancy nausea or vomiting: 11,581 (10,977-12,219) (n=175) vs. 10,593 (10,066-11,147) (n=193) pg/mL, p=0.02). In women who took antiemetic drugs during pregnancy (n=11) the GDF15 levels were also raised 13,157 (10,558-16,394) pg/mL (p =0.04). Serum GFD15 concentrations were strongly positively correlated with hCG levels but were inversely correlated with maternal BMIs, a finding replicated in the NIPTeR Study. Conclusions: Week 15 serum GDF15 concentrations are positively associated with second trimester vomiting and maternal antiemetic use in pregnancy. Given GDF15’s site of action in the chemoreceptor trigger zone of the brainstem and its genetic associations with hyperemesis gravidarum, these data support the concept that GDF15 may be playing a pathogenic role in pregnancy-associated vomiting.