How explicable are differences between reviews that appear to address a similar research question? A review of reviews of physical activity interventions

Background Systematic reviews are promoted as being important to inform decision-making. However, when presented with a set of reviews in a complex area, how easy is it to understand how and why they may differ from one another? Methods An analysis of eight reviews reporting evidence on effectiveness of community interventions to promote physical activity. We assessed review quality and investigated overlap of included studies, citation of relevant reviews, consistency in reporting, and reasons why specific studies may be excluded. Results There were 28 included studies. The majority (n = 22; 79%) were included only in one review. There was little cross-citation between reviews (n = 4/28 possible citations; 14%). Where studies appeared in multiple reviews, results were consistently reported except for complex studies with multiple publications. Review conclusions were similar. For most reviews (n = 6/8; 75%), we could explain why primary data were not included; this was usually due to the scope of the reviews. Most reviews tended to be narrow in focus, making it difficult to gain an understanding of the field as a whole. Conclusions In areas where evaluating impact is known to be difficult, review findings often relate to uncertainty of data and methodologies, rather than providing substantive findings for policy and practice. Systematic ‘maps’ of research can help identify where existing research is robust enough for multiple in-depth syntheses and also show where new reviews are needed. To ensure quality and fidelity, review authors should systematically search for all publications from complex studies. Other relevant reviews should be searched for and cited to facilitate knowledge-building

Unbearable wearables

As wearable devices play an increasing role in the management of health and disease, adverse skin reactions to wearables have become more common. However, the management of allergic contact dermatitis is challenging and new treatment options more compatible with wearable devices are needed. In a 40-year-old woman with contact dermatitis to a continuous glucose monitoring device, topical clobetasol propionate 0.05% spray proved to be an effective treatment that was compatible with the application of adhesive wearables. This case demonstrates that spray formulations of topical steroids are a good option for the treatment of dermatitis under wearable devices such as continuous glucose monitors or ostomy appliance

Families and Communities Against Child Sexual Exploitation (FCASE) : final evaluation report

This is the final evaluation report for the Barnardo’s Families and Communities Against Sexual Exploitation project (FCASE), produced by the International Centre, researching Child Sexual Exploitation, Violence and Trafficking at the University of Bedfordshire. The programme was launched in April 2013, funded by the Department for Education (DfE) and concluded in March 2015. The evaluation was undertaken during the same period. The FCASE model has been piloted in three sites, which for the purposes of this report have been anonymised and will be referred to using pseudonyms. It consists of the following elements: a structured programme of six to eight weeks direct work with young people and families where a risk of child sexual exploitation (CSE) has been identified; delivery of CSE training with professionals; and undertaking community awareness raising. The evaluation has been informed by a range of qualitative data. The report identifies the elements that work well and some of the challenges in its implementation. This had been done in order to determine good practice in supporting families and communities and embed more effective practice on protecting children and young people, including those in foster care, from sexual exploitation, harnessing the protective factors within a child’s family and/or foster home. The learning from the project is intended to help other agencies to implement the FCASE model. An on-line learning resource is to be produced in order to facilitate this process

Optimal operation of combined heat and power systems: an optimization-based control strategy

The use of decentralized Combined Heat and Power (CHP) plants is increasing since the high levels of efficiency they can achieve. Thus, to determine the optimal operation of these systems in dynamic energy-market scenarios, operational constraints and the time-varying price profiles for both electricity and the required resources should be taken into account. In order to maximize the profit during the operation of the CHP plant, this paper proposes an optimization-based controller designed according to the Economic Model Predictive Control (EMPC) approach, which uses a non-constant time step along the prediction horizon to get a shorter step size at the beginning of that horizon while a lower resolution for the far instants. Besides, a softening of related constraints to meet the market requirements related to the sale of electric power to the grid point is proposed. Simulation results show that the computational burden to solve optimization problems in real time is reduced while minimizing operational costs and satisfying the market constraints. The proposed controller is developed based on a real CHP plant installed at the ETA research factory in Darmstadt, Germany.Peer ReviewedPostprint (author's final draft

Economic model predictive control for optimal operation of combined heat and power systems

© 2019. ElsevierThe use of decentralized Combined Heat and Power (CHP) plants is increasing since the high levels of efficiency they can achieve. Hence, to determine the optimal operation of these systems in the changing energy market, the time-varying price profiles for both electricity as well as the required resources and the energy-market constraints should be considered into the design of the control strategies. To solve these issues and maximize the profit during the operation of the CHP plant, this paper proposes an optimization-based controller, which will be designed according to the Economic Model Predictive Control (EMPC) approach. The proposed controller is designed considering a non-constant time step to get a high sampling frequency for the near instants and a lower resolution for the far instants. Besides, a soft constraint to met the market constraints for the sale of electric power is proposed. The proposed controller is developed based on a real CHP plant installed in the ETA research factory in Darmstadt, Germany. Simulation results show that lower computational time can be achieved if a non-constant step time is implemented while the market constraints are satisfied.Peer ReviewedPostprint (author's final draft

Childhood obesity and educational attainment : A systematic review

Background This report describes the findings and methods of a systematic review of research which explores the relationship between obesity and educational attainment. It has been conducted at a time of great concern about levels of obesity in the UK, and the negative physical, psychological and social impacts of obesity. Current research suggests that there may be a relationship between obesity and poor educational attainment. It is likely that obesity and poor school performance are elements of a broader picture of inequalities in health and education, whereby disadvantaged socio-economic groups tend to have poorer health and lower levels of education. However, it is possible that other factors influence obesity and attainment, such as gender, discrimination and poor mental and emotional well-being. This systematic review was therefore commissioned to address the question: What do we know about the relationship between childhood obesity and educational attainment, from the research literature? In order that our review might be informed by those closest to observing any interaction between obesity and attainment, we sought the perspectives of teachers and young people to identify the causal pathways that seemed most pertinent to them. Findings Is there a statistical association between obesity and educational attainment? While often conflicting, an overall pattern emerges from the research evidence suggesting that there is a weak negative association between obesity and educational attainment in children and young people; i.e. that higher weight is associated with lower educational attainment. Obesity is also associated with other variables, such as socio-economic status, and when these other variables are taken into consideration, the association between obesity and attainment becomes still weaker, and often loses statistical significance. To what extent does the research evidence explore the influence of the broader determinants of health, and in particular socio-economic position, in explaining any link between obesity and attainment? Place of residence, ethnicity, occupation, gender, religion, education, socio-economic status (SES) and social capital were all explored as potential moderating variables in the included research. Twenty-three of 29 studies used a measure of socio-economic status as a moderating variable. Various factors appear to contribute to low educational attainment to some extent, although given the variation in definitions, analyses and quality of data, it is impossible to point to any causative or definite risk factors. Authors of the included studies have posited theories suggesting that the link between obesity and educational attainment is moderated by individual and societal factors. Does the research evidence support or refute these? Most studies explored the influence of obesity upon attainment. Only two studies examined the influence of attainment upon obesity. Many authors suggested multiple causal pathways, many of which remained untested in their studies. The moderating variables used in statistical analyses of the relationship between obesity and attainment were not consistent with the causal pathways proposed, which is probably a reflection of the constraints imposed upon authors conducting secondary analyses of pre-existing datasets (i.e. they made use of existing variables, rather than collecting their own, tailored data). The most frequently cited factors resulting from obesity and impacting upon educational attainment were poor mental health, stigmatisation and discrimination, disordered sleep, decreased time spent in physical activity and socialising, and absenteeism. Different perspectives on obesity and attainment Few young people initially thought that obesity and educational attainment were associated. However, they considered obesity and educational attainment to be of importance to young people. Young people considered parental influence and circumstances, including family income and poverty, and bullying and emotional health to be the most important factors which might explain an association between obesity and educational attainment. Most teachers said that there was an association between obesity and educational attainment. Bullying, low self-esteem and emotional well-being, poverty and poor diet, and physical activity were commonly cited by teachers as being the most important and credible mediating variables in this association. Teachers also considered gender, ethnicity and parental influence to be important factors. While researchers, teachers and young people identified causal pathways whereby low academic attainment resulted from poor mental and emotional health among obese children and young people, only four studies adjusted for mental and emotional health variables. This may represent a significant divergence in the perspectives of researchers and stakeholders. Alternatively, it may be that in the 23 studies which conducted a secondary analysis of an existing dataset, such data were not available to the authors. Another divergence concerns the impact of reduced participation in sports and social activities. While teachers and young people located this within a broader framework of isolation and lower socialisation suffered by obese children – and thus felt reduced sports participation would result in lower attainment – three studies in the included research proposed a causal pathway in which reduced participation in sports and social activities might lead to increased time spent studying and hence higher attainment