Valuing conservation benefits of an offshore marine protected area

Increasing anthropogenic pressure in the offshore marine environment highlights the need for improved management and conservation of offshore ecosystems. This study scrutinises the applicability of a discrete choice experiment to value the expected benefits arising from the conservation of an offshore sandbank in UK waters. The valuation scenario refers to the UK part of the Dogger Bank, in the southern North Sea, and is based on real-world management options for fisheries, wind farms and marine protection currently under discussion for the site. It is assessed to what extent the general public perceive and value conservation benefits arising from an offshore marine protected area. The survey reveals support for marine conservation measures despite the general public's limited prior knowledge of current marine planning. Results further show significant values for an increase in species diversity, the protection of certain charismatic species and a restriction in the spread of invasive species across the site. Implications for policy and management with respect to commercial fishing, wind farm construction and nature conservation are discussed

A pragmatic, multicentre, randomised controlled trial comparing stapled haemorrhoidopexy to traditional excisional surgery for haemorrhoidal disease (eTHoS): study protocol for a randomised controlled trial

Background: Current interventions for haemorrhoidal disease include traditional haemorrhoidectomy (TH) and stapled haemorrhoidopexy (SH) surgery. However, uncertainty remains as to how they compare from a clinical, quality of life (QoL) and economic perspective. The study is therefore designed to determine whether SH is more effective and more cost-effective, compared with TH. Methods/Design: eTHoS (either Traditional Haemorrhoidectomy or Stapled Haemorrhoidopexy for Haemorrhoidal Disease) is a pragmatic, multicentre, randomised controlled trial. Currently, 29 secondary care centres are open to recruitment. Patients, aged 18 year or older, with circumferential haemorrhoids grade II to IV, are eligible to take part. The primary clinical and economic outcomes are QoL profile (area under the curve derived from the EuroQol Group’s 5 Dimension Health Status Questionnaire (EQ-5D) at all assessment points) and incremental cost per quality adjusted life year (QALY) based on the responses to the EQ-5D at 24 months. The secondary outcomes include a comparison of the SF-36 scores, pain and symptoms sub-domains, disease recurrence, complication rates and direct and indirect costs to the National Health Service (NHS). A sample size of n =338 per group has been calculated to provide 90% power to detect a difference in the mean area under the curve (AUC) of 0.25 standard deviations derived from EQ-5D score measurements, with a two-sided significance level of 5%. Allowing for non-response, 400 participants will be randomised per group. Randomisation will utilise a minimisation algorithm that incorporates centre, grade of haemorrhoidal disease, baseline EQ-5D score and gender. Blinding of participants and outcome assessors is not attempted. Discussion: This is one of the largest trials of its kind. In the United Kingdom alone, 29,000 operations for haemorrhoidal disease are done annually. The trial is therefore designed to give robust evidence on which clinicians and health service managers can base management decisions and, more importantly, patients can make informed choices. Trial registration: Current Controlled Trials ISRCTN80061723 (assigned 8 March 2010

Consumer stated preferences for dairy products with carbon footprint labels in Italy

Abstract Carbon footprint (CF) labels on agri-food products represent one of the most important tools to convey information to consumers about the greenhouse gases emissions associated with their purchase behaviour. Together with the growing interest of consumers in CF labels, the subject has gained attention also in the scientific literature, and formal evaluations of consumer response to carbon labelling have been published. Studies in this area aim at analysing consumers' preferences for buying products with a lower CF label or their willingness to pay (WTP) for these products. The objective of this paper is twofold. First, the study proposes a review of the literature that so far has analysed consumer WTP for CF label, focusing on Italian consumers. Second, it uses the results of two surveys of consumers' attitudes towards dairy products with a lower CF label to analyse the factors determining a positive stated WTP. Results point out that a positive WTP for lower CF products is more likely to be declared by respondents who believe that buying products with less environmental impact can combat climate change. Conversely, highly price-sensitive consumers are less likely to be willing to pay more for CF-labelled products

Rural internship job preferences of final year medical students in South Africa: a discrete choice experiment

To achieve Sustainable Development Goal 3 in developing countries, Good health and wellbeing for all, the health workforce is vital however the unpopularity of rural medical practice results in widening healthcare inequalities between urban and rural areas. This study determined the heterogeneity in valuations for rural facility attributes by final year medical students at one South African public university to inform cost-effective recruitment policy recommendations. Focus groups conducted identified facility attributes, a D-efficient design was generated with 15 choice sets, each with two rural hospital alternatives and no opt-out option. An online, unlabelled discrete choice experiment (DCE) was conducted, the results effects coded, and mixed logit models applied. The final sample size was 193 (86,16% of the class), majority female 130 (66.33%), with urban origins 176 (89.80%), unmarried 183 (93.37%) and without children 193 (98.47%). Most had undergraduate rural medicine exposure 110 (56.12%) and intended to specialise 109 (55.61%). The main-effects mixed logit found advanced practical experience, hospital safety, correctly fitted personal protective equipment (PPE) and availability of basic resources the highest weighted attributes with their mean utilities increasing by 0.82, 0.64, 0.62 and 0.52 respectively (p=0.000). In contrast, increases in rural allowance and the provision of housing provided smaller mean utility increases of 0.001 (p<0.01) and 0.09 (p<0.05) respectively. The interaction terms; female, general practise and prior rural medicine exposure, were associated with higher weighting for hospital safety, mean utility increases 1.59, 1.82, 1.42 respectively (p=0.000). Participants were willing to pay ZAR 2636.45 monthly (95%CI: 1398.55;3874.355) to gain advanced practical experience (equivalent to 65.91% of current rural allowance). Medical students’ facility preferences have been found to be influenced by their gender, career aspirations and prior experienced with rural medicine. The policy recommendations derived from this research include publicising rural health facility “draw-cards” among medical graduates, such as the opportunity to gain practical experience, improving the physical and occupational safety at rural health facilities and providing greater transparency about rural facility attributes to medical graduates

Derivation of the required elements for a definition of the term middleware

Thirteen contemporary definitions of Middleware were analyzed. The definitions agree that any software that can do the following should be classified as Middleware (1) provide service that provides transparent application-to-application interaction across the network, (2) act as a service provider for distributed applications, and (3) provide services that are primarily used by distributed applications (e.g., RPCs, ORBs, Directories, name-resolution services, etc.) Most definitions agree that Middleware is that level of software required to achieve platform, location, and network transparency. There is some discrepancy about the OSI levels at which middleware operates. The majority of definitions limit it to levels 5, 6, and 7. Additionally, almost half of the definitions do not include database transparency as something achieved by Middleware, perhaps due to the ambiguous classification of ODBC and JDBC as software. Assuming that the number of times a service is mentioned, the majority of the definitions rank services associated with legal access to an application as core to Middleware, along with valid, standardized APIs for application development as core to the definition of middleware

Outcome Measures at a Private Outpatient Pediatric Occupational Therapy Clinic

My Doctoral Capstone Experience (DCE) focused on outcome measurements and better understanding business related elements within a private outpatient occupational therapy clinic. As described in the paper below, outcome measurements are important for a variety of reasons but can be difficult to implement in everyday practice for clinicians. Thus, I aimed to improve the ways that this clinic collected outcome measures so that it would be more manageable for the clinicians. For my DCE, I also sought to improve the physical environment at Sensory Systems Clinic West (SSCW) which was indicated as a barrier during the needs assessment by staff. During my DCE, I was able to address and learn many aspects of business management. To do this, one of the main objectives was to update the clinic’s policy and procedure manual, the orientation binder and creating a telehealth policy and procedure manual for the clinic. This led to many different projects to achieve this objective and allowed me to learn a great deal related to business management. Overall, I was able to grow as a clinician through this unique experience and improve upon the environment and its inner working systems

Text messaging and financial incentives to encourage weight loss in men with obesity: the Game of Stones feasibility RCT

Funding: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 11. See the NIHR Journals Library website for further project information.Peer reviewedPublisher PD

DATABASE SECURITY

Ensuring the security of databases is a complex issue. The more complex the databases are the more complex the security measures that are to be applied are. Network and Internet connections to databases may complicate things even further. Also, each and every additional internal user that would be added can create further serious security problems. The purpose of this paper is to highlight and identify the main methods and facets of attack on a database, as well as ways to deflect attacks, through focusing on the delicate issue of data inference.This paper will examine the different topics related to database security and see the adaption of the research to the changing environment