Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: Systematic review and meta-analysis

This is an open access article - Copyright @ 2011 BMJObjective: To assess the impact of exercise referral schemes on physical activity and health outcomes. Design: Systematic review and meta-analysis. Data sources Medline, Embase, PsycINFO, Cochrane Library, ISI Web of Science, SPORTDiscus, and ongoing trial registries up to October 2009. We also checked study references. Study selection Design: randomised controlled trials or non-randomised controlled (cluster or individual) studies published in peer review journals. Population: sedentary individuals with or without medical diagnosis. Exercise referral schemes defined as: clear referrals by primary care professionals to third party service providers to increase physical activity or exercise, physical activity or exercise programmes tailored to individuals, and initial assessment and monitoring throughout programmes. Comparators: usual care, no intervention, or alternative exercise referral schemes. Results Eight randomised controlled trials met the inclusion criteria, comparing exercise referral schemes with usual care (six trials), alternative physical activity intervention (two), and an exercise referral scheme plus a self determination theory intervention (one). Compared with usual care, follow-up data for exercise referral schemes showed an increased number of participants who achieved 90-150 minutes of physical activity of at least moderate intensity per week (pooled relative risk 1.16, 95% confidence intervals 1.03 to 1.30) and a reduced level of depression (pooled standardised mean difference −0.82, −1.28 to −0.35). Evidence of a between group difference in physical activity of moderate or vigorous intensity or in other health outcomes was inconsistent at follow-up. We did not find any difference in outcomes between exercise referral schemes and the other two comparator groups. None of the included trials separately reported outcomes in individuals with specific medical diagnoses. Substantial heterogeneity in the quality and nature of the exercise referral schemes across studies might have contributed to the inconsistency in outcome findings. Conclusions Considerable uncertainty remains as to the effectiveness of exercise referral schemes for increasing physical activity, fitness, or health indicators, or whether they are an efficient use of resources for sedentary people with or without a medical diagnosis.This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme (project number 08/72/01) (www.hta.ac.uk/)

Regulatory Threat in Vertically Related Markets; The Case of German Electricity

Regulatory Threat in Vertically Related Markets; The Case of German Electricit

Counterfactual Explanations without Opening the Black Box: Automated Decisions and the GDPR

There has been much discussion of the right to explanation in the EU General Data Protection Regulation, and its existence, merits, and disadvantages. Implementing a right to explanation that opens the black box of algorithmic decision-making faces major legal and technical barriers. Explaining the functionality of complex algorithmic decision-making systems and their rationale in specific cases is a technically challenging problem. Some explanations may offer little meaningful information to data subjects, raising questions around their value. Explanations of automated decisions need not hinge on the general public understanding how algorithmic systems function. Even though such interpretability is of great importance and should be pursued, explanations can, in principle, be offered without opening the black box. Looking at explanations as a means to help a data subject act rather than merely understand, one could gauge the scope and content of explanations according to the specific goal or action they are intended to support. From the perspective of individuals affected by automated decision-making, we propose three aims for explanations: (1) to inform and help the individual understand why a particular decision was reached, (2) to provide grounds to contest the decision if the outcome is undesired, and (3) to understand what would need to change in order to receive a desired result in the future, based on the current decision-making model. We assess how each of these goals finds support in the GDPR. We suggest data controllers should offer a particular type of explanation, unconditional counterfactual explanations, to support these three aims. These counterfactual explanations describe the smallest change to the world that can be made to obtain a desirable outcome, or to arrive at the closest possible world, without needing to explain the internal logic of the system

Socio-economic status and physical health outcomes : the need for change in theoretical formulations : thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University

The Black Report (Department of Health and Social Security, 1980) , which was a seminal publication in the field of health inequality, proposed several possible theoretical explanations for the phenomenon of socio-economic health inequality. To date the models proposed in the Black Report have yet to be improved on, or developed greatly. While research in the field of socio-economic health inequality has been substantial, the state of theoretical formulation which attempts to explain such inequality has remained static. The phenomenon of socio- economic health inequality will be established by producing evidence for how socio-economic status impacts on health from many countries, but especially from the United Kingdom, North America, Australasia, and Europe. Potential pathways for socio-economic status to impact on health outcomes will be assessed, and an illustration of potential pathways will be provided with an application. The theoretical approaches of the Black Report, along with a more recent conceptualisation, will be discussed. The potential contribution of psychological factors to socio-economic health inequality will be considered following the establishment of the relationship, proposal of potential pathways, and theoretical formulation discussions to demonstrate how such factors are involved in socio-economic health inequality. From these first four sections it can be deduced that current theoretical formulations to explain socio-economic health inequality are deficient. To contend with this deficiency it is proposed that a more holistic approach, which includes psychological factors, is necessary. Future research should seek to empirically validate links within the confines of a more holistic framework if our understanding of the relation between socio-economic status and physical health outcomes is to improve

Km4City Ontology Building vs Data Harvesting and Cleaning for Smart-city Services

Presently, a very large number of public and private data sets are available from local governments. In most cases, they are not semantically interoperable and a huge human effort would be needed to create integrated ontologies and knowledge base for smart city. Smart City ontology is not yet standardized, and a lot of research work is needed to identify models that can easily support the data reconciliation, the management of the complexity, to allow the data reasoning. In this paper, a system for data ingestion and reconciliation of smart cities related aspects as road graph, services available on the roads, traffic sensors etc., is proposed. The system allows managing a big data volume of data coming from a variety of sources considering both static and dynamic data. These data are mapped to a smart-city ontology, called KM4City (Knowledge Model for City), and stored into an RDF-Store where they are available for applications via SPARQL queries to provide new services to the users via specific applications of public administration and enterprises. The paper presents the process adopted to produce the ontology and the big data architecture for the knowledge base feeding on the basis of open and private data, and the mechanisms adopted for the data verification, reconciliation and validation. Some examples about the possible usage of the coherent big data knowledge base produced are also offered and are accessible from the RDF-Store and related services. The article also presented the work performed about reconciliation algorithms and their comparative assessment and selection

Estimating Position Bias without Intrusive Interventions

Presentation bias is one of the key challenges when learning from implicit feedback in search engines, as it confounds the relevance signal. While it was recently shown how counterfactual learning-to-rank (LTR) approaches \cite{Joachims/etal/17a} can provably overcome presentation bias when observation propensities are known, it remains to show how to effectively estimate these propensities. In this paper, we propose the first method for producing consistent propensity estimates without manual relevance judgments, disruptive interventions, or restrictive relevance modeling assumptions. First, we show how to harvest a specific type of intervention data from historic feedback logs of multiple different ranking functions, and show that this data is sufficient for consistent propensity estimation in the position-based model. Second, we propose a new extremum estimator that makes effective use of this data. In an empirical evaluation, we find that the new estimator provides superior propensity estimates in two real-world systems -- Arxiv Full-text Search and Google Drive Search. Beyond these two points, we find that the method is robust to a wide range of settings in simulation studies

Regulatory Threat in Vertically Related Markets; The Case of German Electricity

This paper applies the concept of regulatory threat to analyse the electricity supply industry in Germany, where in contrast to other European member states, there is no ex-ante regulation of network access charges. Instead, network access relies on industrial self-regulation and ex-post control by the Cartel Office. The paper modifies the concept of regulatory threat to vertically related markets, stressing the balance between the level of the network access charges and (non-price) discrimination against their parties. The conceptual framework appears to explain developments in the German electricity sector accurately and thus provides a useful tool for policy analysis.regulation, discrimination, network industries, electricity

Policing in nonhuman primates: partial interventions serve a prosocial conflict management function in rhesus macaques.

Studies of prosocial policing in nonhuman societies traditionally focus on impartial interventions because of an underlying assumption that partial support implies a direct benefit to the intervener, thereby negating the potential for being prosocial in maintaining social stability for the benefit of the group. However, certain types of partial interventions have significant potential to be prosocial in controlling conflict, e.g. support of non-kin subordinates. Here, we propose a policing support hypothesis that some types of agonistic support serve a prosocial policing function that maintains group stability. Using seven large captive groups of rhesus macaques, we investigated the relationship between intervention type and group-level costs and benefits (rates of trauma, severe aggression, social relocation) and individual level costs and benefits (preferential sex-dyad targeting, dominance ambiguity reduction, access to mates, and return aggression). Our results show that impartial interventions and support of subordinate non-kin represent prosocial policing as both (1) were negatively associated with group-level rates of trauma and severe aggression, respectively, (2) showed no potential to confer individual dominance benefits, (3) when performed outside the mating season, they did not increase chances of mating with the beneficiary, and (4) were low-cost for the highest-ranking interveners. We recommend expanding the definition of 'policing' in nonhumans to include these 'policing support interventions'