Neo-Statecraft Theory, Historical Institutionalism and Institutional Change

This article provides a critical examination of the contribution that statecraft theory, which has been subject to recent revision and development, makes to the literature on institutional change. It articulates an emergent neo-statecraft approach that offers an agent-led form of historical institutionalism. This overcomes the common criticism that historical institutionalists underplay the creative role of actors. The article also argues that the approach brings back into focus the imperatives of electoral politics as a source of institutional change and provides a macro theory of change which is also commonly missing from historical institutionalist work. It can therefore identify previously unnoticed sources of stability and change, especially in states with strong executives and top-down political cultures

Liver segmentation using automatically defined patient specific B-Spline surface models

This paper presents a novel liver segmentation algorithm. This is a model-driven approach; however, unlike previous techniques which use a statistical model obtained from a training set, we initialize patient-specific models directly from their own pre-segmentation. As a result, the non-trivial problems such as landmark correspondences, model registration etc. can be avoided. Moreover, by dividing the liver region into three sub-regions, we convert the problem of building one complex shape model into constructing three much simpler models, which can be fitted independently, greatly improving the computation efficiency. A robust graph-based narrow band optimal surface fitting scheme is also presented. The proposed approach is evaluated on 35 CT images. Compared to contemporary approaches, our approach has no training requirement and requires significantly less processing time, with an RMS error of 2.440.53mm against manual segmentation

The prevalence of Type 2 diabetes and its associated health problems in a community-dwelling elderly population.

AIMS: Prevalence estimates of Type 2 diabetes and its associated health problems in elderly populations are rare, especially in the very elderly. METHODS: A sample of 15 095 community-dwelling older people aged > or = 75 years were assessed. Type 2 diabetes and associated health problems were identified using self-reporting, general practitioner records, drug histories, and blood and urine measurements. RESULTS: There were 1177 people identified as having Type 2 diabetes mellitus, giving an overall prevalence of 7.8% (95% confidence interval 7.1, 8.5), 9.4% (8.4, 10.5) for men and 6.8% (6.1, 7.6) for women. The age, sex and smoking adjusted odds ratios for various health problems, comparing people with and without diabetes were: low vision 1.6 (1.3, 1.9), proteinuria 1.7 (1.4, 2.1), chronic kidney disease stage 4 or 5 1.5 (1.0, 2.1), angina 1.3 (1.1, 1.6), myocardial infarction 1.5 (1.2, 1.8), cerebrovascular event 2.0 (1.8, 2.1) and foot ulceration 1.7 (1.2, 2.4). CONCLUSIONS: The prevalence of Type 2 diabetes is not high in community-dwelling older people, but diabetes was a contributory factor to a number of health problems

The MRC trial of assessment and management of older people in the community: objectives, design and interventions [ISRCTN23494848].

BACKGROUND: The benefit of regular multidimensional assessment of older people remains controversial. The majority of trials have been too small to produce adequate evidence to inform policy. Despite the lack of a firm evidence base, UK primary care practitioners (general practitioners) are required to offer an annual health check to patients aged 75 years and over. DESIGN: Cluster-randomised factorial trial in primary care comparing a package of assessments (i) universal versus targeted assessment and (ii) management by the primary care team (PC) or a multidisciplinary geriatric assessment team (GM). The unit of randomization is the general practice. METHODS: Older people aged 75 and over eligible for the over 75s health check and excluding those in nursing homes or terminally ill were invited to participate. All participants receive a brief assessment covering all areas of the over 75s check. In the universal arm all participants also receive a detailed health and social assessment by a study nurse while in the targeted arm only participants with a pre-determined number and range of problems at the brief assessment go on to have the detailed assessment. The study nurse follows a standard protocol based on results and responses in the detailed assessment to make referrals to (i) the randomised management team (PC or GM) (ii) other medical services, health care workers or agencies (iii) emergency referrals to the GP. The main outcomes are mortality, hospital and institutional admissions and quality of life. 106 practices and 33,000 older people have been recruited to the trial

Collaboration is the secret of success : strategies for integrating information services with learning, teaching and research

Working closely with teaching and research staff is critical to the success of libraries and information services. Indeed, the degree of integration with a University's academic work is one of the factors that distinguish a successful service from a poor one. This paper will consider the relationship between information services and how universities operate. Using the challenges facing institutions as a starting point - including the move towards a single European higher education market - the impact of information provision on institutional strategies will be explored. Information resources underpin all learning, teaching and research activities and the presentation will consider the professional practice which ensures that libraries and computing services are fully exploited. The focus on the experience of students is leading some institutions to integrate information services with a wide range of other activities and the paper will consider the opportunities and challenges which this brings, including the need to build working relationships with a broader range of professional groups

From Library to Learning Centre: the experience of UK universities

This paper considers the development of the Learning Centre as a new model to deliver services and stimulate educational development. Drawing on experience in the United Kingdom, the paper has four aims. First, to set the context by identifying the key changes which have affected higher education over the past ten years or so, and, second, to consider the impact of these changes on students and academic staff. The Learning Centre model is described, using experience at Sheffield Hallam University as a case study, and finally, a number of key issues for the role of librarians are identified

The changing landscape of teaching and research

cette intervention tente de dresser un portrait des changement survenus dans le paysage universitaire alors que ces dernières évoluent dans un marché de plus en plus compétitif, et que les ressources électroniques ont un fort impact en terme de collections et de services

Smoking, dementia and cognitive decline in the elderly, a systematic review.

Background. Nicotine may aid reaction time, learning and memory, but smoking increases cardiovascular risk. Cardiovascular risk factors have been linked to increased risk of dementia. A previous meta-analysis found that current smokers were at higher risk of subsequent dementia, Alzheimers disease, vascular dementia and cognitive decline. Methods. In order to update and examine this further a systematic review and meta-analysis was carried out using different search and inclusion criteria, database selection and more recent publications. Both reviews were restricted to those aged 65 and over. Results. The review reported here found a significantly increased risk of Alzheimers disease with current smoking and a likely but not significantly increased risk of vascular dementia, dementia unspecified and cognitive decline. Neither review found clear relationships with former smoking. Conclusion. Current smoking increases risk of Alzheimers disease and may increase risk of other dementias. This reinforces need for smoking cessation, particularly aged 65 and over. Nicotine alone needs further investigation. © 2008 Peters et al; licensee BioMed Central Ltd