3,004 research outputs found
Protocol for the economic evaluation of a complex intervention to improve the mental health of maltreated infants and children in foster care in the UK (The BeST? services trial)
Introduction: Children who have experienced abuse and neglect are at increased risk of mental and physical health problems throughout life. This places an enormous burden on individuals, families and society in terms of health services, education, social care and judiciary sectors. Evidence suggests that early intervention can mitigate the negative consequences of child maltreatment, exerting long-term positive effects on the health of maltreated children entering foster care. However, evidence on cost-effectiveness of such complex interventions is limited. This protocol describes the first economic evaluation of its kind in the UK.
Methods and analysis: An economic evaluation alongside the Best Services Trial (BeST?) has been prospectively designed to identify, measure and value key resource and outcome impacts arising from the New Orleans intervention model (NIM) (an infant mental health service) compared with case management (CM) (enhanced social work services as usual). A within-trial economic evaluation and long-term model from a National Health Service/Personal Social Service and a broader societal perspective will be undertaken alongside the National Institute for Health Research (NIHR)–Public Health Research Unit (PHRU)-funded randomised multicentre BeST?. BeST? aims to evaluate NIM compared with CM for maltreated children entering foster care in a UK context. Collection of Paediatric Quality of Life Inventory (PedsQL) and the recent mapping of PedsQL to EuroQol-5-Dimensions (EQ-5D) will facilitate the estimation of quality-adjusted life years specific to the infant population for a cost–utility analysis. Other effectiveness outcomes will be incorporated into a cost-effectiveness analysis (CEA) and cost-consequences analysis (CCA). A long-term economic model and multiple economic evaluation frameworks will provide decision-makers with a comprehensive, multiperspective guide regarding cost-effectiveness of NIM. The long-term population health economic model will be developed to synthesise trial data with routine linked data and key government sector parameters informed by literature. Methods guidance for population health economic evaluation will be adopted (lifetime horizon, 1.5% discount rate for costs and benefits, CCA framework, multisector perspective).
Ethics and dissemination: Ethics approval was obtained by the West of Scotland Ethics Committee. Results of the main trial and economic evaluation will be submitted for publication in a peer-reviewed journal as well as published in the peer-reviewed NIHR journals library (Public Health Research Programme).
Trial registration number: NCT02653716; Pre-results
A technique combining neurolept·analgesia with local analgesia for caesarean section
A technique of combining neurolept-analgesia and local anaesthesia for caesarean section is described, together with the necessary modifications in surgical technique. The results of a small series are analysed. This is found to be a safe and useful technique, and is regarded by the authors as being preferable to general anaesthesia where the services of a skilled anaesthetist are not always to hand
Growth, microstructure, and failure of crazes in glassy polymers
We report on an extensive study of craze formation in glassy polymers.
Molecular dynamics simulations of a coarse-grained bead-spring model were
employed to investigate the molecular level processes during craze nucleation,
widening, and breakdown for a wide range of temperature, polymer chain length
, entanglement length and strength of adhesive interactions between
polymer chains. Craze widening proceeds via a fibril-drawing process at
constant drawing stress. The extension ratio is determined by the entanglement
length, and the characteristic length of stretched chain segments in the
polymer craze is . In the craze, tension is mostly carried by the
covalent backbone bonds, and the force distribution develops an exponential
tail at large tensile forces. The failure mode of crazes changes from
disentanglement to scission for , and breakdown through scission
is governed by large stress fluctuations. The simulations also reveal
inconsistencies with previous theoretical models of craze widening that were
based on continuum level hydrodynamics
Generating socially appropriate tutorial dialog
Analysis of student-tutor coaching dialogs suggest that good human tutors attend to and attempt to influence the motivational state of learners. Moreover, they are sensitive to the social face of the learner, and seek to mitigate the potential face threat of their comments. This paper describes a dialog generator for pedagogical agents that takes motivation and face threat factors into account. This enables the agent to interact with learners in a socially appropriate fashion, and foster intrinsic motivation on the part of the learner, which in turn may lead to more positive learner affective states
Property for noncommutative universal lattices
We establish a new spectral criterion for Kazhdan's property which is
applicable to a large class of discrete groups defined by generators and
relations. As the main application, we prove property for the groups
, where and is an arbitrary finitely generated
associative ring. We also strengthen some of the results on property for
Kac-Moody groups from a paper of Dymara and Januszkiewicz (Invent. Math 150
(2002)).Comment: 47 pages; final versio
Avaliação do incremento em volume de madeira de Quassia amara L.- Simaroubaceae, em cultivo agroecológico no trópico úmido da Costa Rica.
Quassia amara é arbusto de 3 a 6 metros de altura, tendo sido retirado indiscriminadamente das florestas para extrair do caule as quassinas usadas na indústria farmacêutica e como inseticida em agricultura orgânica. Não se tem muita informação técnica acerca do crescimento desta espécie para subsidiar estratégias de manejo sustentado. Este trabalho tem como objetivo avaliar o crescimento de Q. amara L. em cultivo agroecológico na Costa Rica. O trabalho consistiu em realizar avaliações do desenvolvimento de indivíduos de Q. amara em parcelas permanentes de medições, instaladas em meio às plantações desta espécie em consórcio com essências arbóreas. Foram efetuadas medições de diâmetro do caule a 10 cm do solo e altura total. Foi observado que em função das taxas de crescimento vegetal e incrementos médio e corrente anuais (IMA e ICA), mesmo após cinco anos de plantio, a madeira de Quassia amara para extração de quassinas não está pronta para colheita
Analysing Lyapunov spectra of chaotic dynamical systems
It is shown that the asymptotic spectra of finite-time Lyapunov exponents of
a variety of fully chaotic dynamical systems can be understood in terms of a
statistical analysis. Using random matrix theory we derive numerical and in
particular analytical results which provide insights into the overall behaviour
of the Lyapunov exponents particularly for strange attractors. The
corresponding distributions for the unstable periodic orbits are investigated
for comparison.Comment: 4 pages, 4 figure
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