Your money matters evaluation: money management for older people

The National Research and Development Centre for adult literacy and numeracy (NRDC) was commissioned by Help the Aged to evaluate Your Money Matters, a free, confidential and impartial money advice service for older people run by Help the Aged in partnership with Barclays. Your Money Matters was launched in 2006. The three-year funding partnership with Barclays ended in April 2009

Carbon loss by water erosion in drylands: Implications from a study of vegetation change in the south-west USA

Journal ArticleSoil organic carbon (SOC) is an important component of the global carbon cycle yet is rarely quantified adequately in terms of its spatial variability resulting from losses of SOC due to erosion by water. Furthermore, in drylands, little is known about the effect of widespread vegetation change on changes in SOC stores and the potential for water erosion to redistribute SOC around the landscape especially during high-magnitude run-off events (flash floods). This study assesses the change in SOC stores across a shrub-encroachment gradient in the Chihuahuan Desert of the south-west USA. A robust estimate of SOC storage in surface soils is presented, indicating that more SOC is stored beneath vegetation than in bare soil areas. In addition, the change in SOC storage over a shrub-encroachment gradient is shown to be nonlinear and highly variable within each vegetation type. Over the gradient of vegetation change, the heterogeneity of SOC increases, and newer carbon from C3 plants becomes dominant. This increase in the heterogeneity of SOC is related to an increase in water erosion and SOC loss from inter-shrub areas, which is self-reinforcing. Shrub-dominated drylands lose more than three times as much SOC as their grass counterparts. The implications of this study are twofold: (1) quantifying the effects of vegetation change on carbon loss via water erosion and the highly variable effects of land degradation on soil carbon stocks is critical. (2) If landscape-scale understanding of carbon loss by water erosion in drylands is required, studies must characterize the heterogeneity of ecosystem structure and its effects on ecosystem function across ecotones subject to vegetation change. © 2013 John Wiley & Sons, Ltd.NS

Biotic and abiotic changes in ecosystem structure over a shrub-encroachment gradient in the southwestern USA.

publication-status: Publishedtypes: Article© 2010 Springer Verlag. This is a post print version of the article. The final publication is available at link.springer.comIn this study, we investigate changes in ecosystem structure that occur over a gradient of land-degradation in the southwestern USA, where shrubs are encroaching into native grassland. We evaluate a conceptual model which posits that the development of biotic and abiotic structural connectivity is due to ecogeomorphic feedbacks. Three hypotheses are evaluated: 1. Over the shrub-encroachment gradient, the difference in soil properties under each surface-cover type will change non-linearly, becoming increasingly different; 2. There will be a reduction in vegetation cover and an increase in vegetation-patch size that is concurrent with an increase in the spatial heterogeneity of soil properties over the shrub-encroachment gradient; and 3. Over the shrub-encroachment gradient, the range at which soil properties are autocorrelated will progressively exceed the range at which vegetation is autocorrelated. Field-based monitoring of vegetation and soil properties was carried out over a shrub-encroachment gradient at the Sevilleta National Wildlife Refuge in New Mexico, USA. Results of this study show that vegetation cover decreases over the shrub-encroachment gradient, but vegetation-patch size increases, with a concurrent increase in the spatial heterogeneity of soil properties. Typically, there are significant differences in soil properties between non-vegetated and vegetated surfaces, but for grass and shrub patches, there are only significant differences for the biotic soil properties. Results suggest that it is the development of larger, well-connected, non-vegetated patches that is most important in driving the overall behavior of shrub-dominated sites. Results of this study support the hypothesis that feedbacks of functional connectivity reinforce the development of structural connectivity, which increases the resilience of the shrub-dominated state, and thus makes it harder for grasses to re-establish and reverse the vegetation change

Levonorgestrel-releasing intrauterine system vs. usual medical treatment for menorrhagia: An economic evaluation alongside a randomised controlled trial

Objective: To undertake an economic evaluation alongside the largest randomised controlled trial comparing Levonorgestrel-releasing intrauterine device ('LNG-IUS') and usual medical treatment for women with menorrhagia in primary care; and compare the cost-effectiveness findings using two alternative measures of quality of life. Methods: 571 women with menorrhagia from 63 UK centres were randomised between February 2005 and July 2009. Women were randomised to having a LNG-IUS fitted, or usual medical treatment, after discussing with their general practitioner their contraceptive needs or desire to avoid hormonal treatment. The treatment was specified prior to randomisation. For the economic evaluation we developed a state transition (Markov) model with a 24 month follow-up. The model structure was informed by the trial women's pathway and clinical experts. The economic evaluation adopted a UK National Health Service perspective and was based on an outcome of incremental cost per Quality Adjusted Life Year (QALY) estimated using both EQ-5D and SF-6D. Results: Using EQ-5D, LNG-IUS was the most cost-effective treatment for menorrhagia. LNG-IUS costs £100 more than usual medical treatment but generated 0.07 more QALYs. The incremental cost-effectiveness ratio for LNG-IUS compared to usual medical treatment was £1600 per additional QALY. Using SF-6D, usual medical treatment was the most cost-effective treatment. Usual medical treatment was both less costly (£100) and generated 0.002 more QALYs. Conclusion: Impact on quality of life is the primary indicator of treatment success in menorrhagia. However, the most costeffective treatment differs depending on the quality of life measure used to estimate the QALY. Under UK guidelines LNG-IUS would be the recommended treatment for menorrhagia. This study demonstrates that the appropriate valuation of outcomes in menorrhagia is crucial. Copyright: © 2014 Sanghera et al

Measuring the effect of intimate partner violence on health-related quality of life: a qualitative focus group study

Abstract Background Health related quality of life (HRQOL) can be measured by a wide range of instruments, many of which have been designed for specific conditions or uses. Preference-based measures assess the value individuals place on health, and are included in economic evaluations of treatments and interventions (such as cost effectiveness analysis). As economic evaluation becomes more common, it is important to assess the applicability of preference-based health related quality of life (HRQOL) measures to public health issues. This study investigated the usefulness of such instruments in the context of intimate partner violence (IPV), a public health concern that that can seriously affect quality of life. Methods The study consisted of focus groups with abused women to determine the aspects of life affected by IPV, and an analysis of existing HRQOL measures. Eight focus groups (n = 40) were conducted in which participants discussed the domains of health affected by IPV. Results were content analyzed and compared with the domains of health included in four commonly-used, preference-based HRQOL measures. Results The average focus group participant was 43 years old, unemployed, African American, with 3 children. Domains of health reported to be affected by IPV included physical functioning, emotional and psychological functioning, social functioning and children\u27s functioning. Psychological health was the most severely affected domain. The Short Form 36, the Health Utilities Index, the EuroQol 5D, and the Quality of Well-being Scale were found to vary in the degree to which they include domains of health important in IPV. Psychological health is included to a limited extent, and the spill-over effect of a condition on other family members, including children, is not included at all. Conclusion Emotional and psychological health plays an important role in the overall HRQOL of abused women but is relatively underemphasized in preference-based HRQOL measures. This may lead to an underestimation of the impact of partner violence on HRQOL when using these measures and in economic evaluations that rely thereon. Holistic measurement approaches or expanded measures that capture the far-reaching effects of IPV on HRQOL may be needed to accurately measure the effect of this condition on women\u27s health

The NANOGrav 15 yr Data Set: Constraints on Supermassive Black Hole Binaries from the Gravitational-wave Background

El conjunto de datos de 15 años de NANOGrav muestra evidencias de la presencia de un fondo de ondas gravitacionales (GWB) de baja frecuencia. Aunque muchos procesos físicos pueden originar estas ondas gravitacionales de baja frecuencia, aquí analizamos la señal como procedente de una población de agujeros negros binarios supermasivos (SMBH) distribuidos por todo el Universo. Demostramos que los modelos astrofísicos de poblaciones binarias SMBH son capaces de reproducir tanto la amplitud como la forma del espectro de ondas gravitacionales de baja frecuencia observado. Aunque múltiples variaciones del modelo son capaces de reproducir el espectro GWB con nuestra precisión de medida actual, nuestros resultados subrayan la importancia de modelar con precisión la evolución binaria para producir espectros GWB realistas. Además, aunque unos parámetros razonables son capaces de reproducir las observaciones de 15 años, la amplitud implícita del GWB requiere que un gran número de parámetros se sitúen en los límites de los valores esperados o que un pequeño número de parámetros difieran notablemente de las expectativas estándar. Aunque todavía no somos capaces de establecer definitivamente el origen de la señal GWB inferida, la consistencia de la señal con las expectativas astrofísicas ofrece una perspectiva tentadora para confirmar que las binarias SMBH son capaces de formarse, alcanzar separaciones de sub-segundos y finalmente unirse. A medida que la importancia aumente con el tiempo, las características de orden superior del espectro del GWB determinarán definitivamente la naturaleza del GWB y permitirán nuevas restricciones sobre las poblaciones de SMBH. © 2023The NANOGrav 15 yr data set shows evidence for the presence of a low-frequency gravitational-wave background (GWB). While many physical processes can source such low-frequency gravitational waves, here we analyze the signal as coming from a population of supermassive black hole (SMBH) binaries distributed throughout the Universe. We show that astrophysically motivated models of SMBH binary populations are able to reproduce both the amplitude and shape of the observed low-frequency gravitational-wave spectrum. While multiple model variations are able to reproduce the GWB spectrum at our current measurement precision, our results highlight the importance of accurately modeling binary evolution for producing realistic GWB spectra. Additionally, while reasonable parameters are able to reproduce the 15 yr observations, the implied GWB amplitude necessitates either a large number of parameters to be at the edges of expected values or a small number of parameters to be notably different from standard expectations. While we are not yet able to definitively establish the origin of the inferred GWB signal, the consistency of the signal with astrophysical expectations offers a tantalizing prospect for confirming that SMBH binaries are able to form, reach subparsec separations, and eventually coalesce. As the significance grows over time, higher-order features of the GWB spectrum will definitively determine the nature of the GWB and allow for novel constraints on SMBH populations. © 2023. The Author(s). Published by the American Astronomical Society

Assessing the construct validity of the Italian version of the EQ-5D: preliminary results from a cross-sectional study in North Italy

BACKGROUND: Information on health related quality of life (HR-QOL) can be integrated with other classical health status indicators and be used to assist policy makers in resource allocation decisions. For this reason instruments such as the SF-12 and EQ-5D have been widely proposed as assessment tools to monitor changes in HR-QOL in general populations and very recently in general practice settings as well AIM: The primary goal of our study was to assess the construct validity of the Italian version of the EQ-5D in a general population of North Italy using socio-demographic factors and diagnostic sub-groups. Our secondary goal was to assess the concurrent validity of the EQ-5D and SF-12. METHODS: The SF-12, the EQ-5D plus an additional questionnaire on socio-demographic characteristics, clinical conditions and symptoms were completed by 1,622 adults, randomly selected from the Registry of the Health Authorities of the city of Bologna, Italy. The primary care physician of each subject was contacted to report on the subject's health status. RESULTS: Our findings indicate that the Italian version of the EQ-5D is well accepted by the general population (91% response rate), has good reliability (Cronbach's alpha 0.73), and shows evidence of construct validity. CONCLUSION: Our data provide a basis for further research to be conducted to assess the validity of the EQ-5D in Italy. In particular future studies should focus on assessing its ability to detect a clinically important change in health related quality of life over time (responsiveness)