East Midlands FRESA targets project

Reviewed employment and skills targets in use by organisations in the East Midlands in order to inform the development of targets for the East Midlands Framework for Employment and Skills action (FRESA). Established target development process later adopted by emda for 2006 RES. Developed criteria for applying to future selection of economic performance monitoring metrics - especially for skills, based on extant best practice, such as the Treasury's 'Green Book'

Enteral Disorders of Childhood

The main object of the thesis is to clear up the uncertainty of classification of the various forms of enteritis of childhood which, of course, is a reflection of the great difficulty in diagnosis. However, while the subjects of classification and diagnosis were being investigated many other points of interest emerged which were followed up to a certain extent and some conclusions drawn. A short historical review from the time of Hippocrates to the nineteenth century is given. This is designed to show how certain basic facts such as the relationship between diarrhoea and teething, hot weather, artificial feeding and overcrowding came to be recognised. There then follows a discussion of the various classifications based upon clinical, pathological, bacteriological and biochemical findings and which have not proved to be very satisfactory. General etiological factors of enteritis of childhood then come under discussion with special emphasis upon the value of progressive public health legislation in causing a reduction in the death rate from enteritis as a whole. The suggestion is then made that one of the reasons for the difficulty in classification lies in the fact that the clinical basis which forms the foundation of every investigation is at fault. This, it is suggested, might he due to the true state of affairs being lost in a maze of biochemistry and bacteriology. CHAPTER I, deals with the non-infective forms of enteritis and shows that this group is not of great importance. The dyspeptic form of enteritis is shown to he easily treated. The mechanical form may include certain serious conditions such as hypertrophic pyloric stenosis and intussusception hut is rare. The symtomatic form is discussed at length and it is suggested that swallowed sputum and excretion of toxin through the intestinal wall might well he the two most likely causes. The association of enteritis with otitis media is noted and discussed fully. The conclusion is reached that undue importance has been attached to the symptomatic form of enteritis. An analysis of 492 cases of measles is used to support this view. CHAPTER II discusses the subject of infective enteritis of known etiology hut is confused mainly to Sonne dysentery. Seasonal incidence, incubation period, mode of spread, clinical features and complications are touched upon and finally the subject of diagnosis. Here I try to show that the only reliable method of diagnosis is by serum agglutination and figures are produced in support of this. This leads up to a discussion on the best routine method of dealing with a ward outbreak of some dysentery and the finding of mild cases and carriers. Treatment and pathology are also mentioned. Infective enteritis of uncertain etiology is then discussed and the division into two types- (1) Acute Toxic Enteritis and (2) Acute Choleraic Enteritis upon clinical and pathological grounds justified. Both types are fully discussed and theories advanced as to their etiology. It is suggested that the acute toxic type is a virus infection and that the choleraic form is of bacterial origin. Seasonal incidence, clinical picture, complications, pathology, diagnosis and treatment are dealt with fully. The question of the value of the various forms of treatment is gone into and personal experience of certain of these noted. CHAPTER III includes the unclassifiable forms of enteritis. These are probably mild forms of the dysentery group and of the dyspeptic group. CHAPTER IV deals with the routine investigation of cases of enteritis and makes certain suggestions which are in the main that serological examination must be carried out, clinical examina-tion must include examination of ears and urine together with a most thorough investigation of the respiratory tract. CHAPTER V describes briefly the enteritis unit at the Eastern Hospital in which the work recorded was carried out

Drug cue reactivity involves hierarchical instrumental learning: evidence from a biconditional Pavlovian to instrumental transfer task

This is the final version of the article. Available from Springer Verlag via the DOI in this record.RATIONALE: Drug cue reactivity plays a crucial role in addiction, yet the underlying mechanisms are poorly understood. According to the binary associative account, drug stimuli retrieve an expectation of the drug outcome, which, in turn, elicits the associated drug-seeking response (S-O-R). By contrast, according to the hierarchical account, drug stimuli retrieve an expectation that the contingency between the drug-seeking response and the drug outcome is currently more effective, promoting performance of the drug-seeking response (S:R-O). METHODS: The current study discriminated between these two accounts using a biconditional Pavlovian-to-instrumental transfer (PIT) task with 128 alcohol drinkers. A biconditional discrimination was first trained in which two responses produced alcohol and food outcomes, respectively, and these response-outcome contingencies were reversed across two discriminative stimuli (SDs). In the PIT test, alcohol and food cues were compounded with the two SDs to examine their impact on percent alcohol choice in extinction. RESULTS: It was found that alcohol and food cues selectively primed choice of the response that earned that outcome in each SD (p < .001), and this effect was associated with participants' belief that cues signalled greater effectiveness of that response (p < .0001). CONCLUSIONS: The alcohol stimulus could not have selectively primed the alcohol-seeking response through binary S-O-R associations because the drug outcome was equally associated with both responses. Rather, the alcohol stimulus must have retrieved an expectation that the response-alcohol contingency available in the current context was more likely to be effective (S:R-O), which primed performance of the alcohol-seeking response.The work was supported by an ESRC PhD scholarship to Lorna Hardy

Evidence for ACTN3 as a genetic modifier of Duchenne muscular dystrophy

Duchenne muscular dystrophy (DMD) is characterized by muscle degeneration and progressive weakness. There is considerable inter-patient variability in disease onset and progression, which can confound the results of clinical trials. Here we show that a common null polymorphism (R577X) in ACTN3 results in significantly reduced muscle strength and a longer 10\u2009m walk test time in young, ambulant patients with DMD; both of which are primary outcome measures in clinical trials. We have developed a double knockout mouse model, which also shows reduced muscle strength, but is protected from stretch-induced eccentric damage with age. This suggests that \u3b1-actinin-3 deficiency reduces muscle performance at baseline, but ameliorates the progression of dystrophic pathology. Mechanistically, we show that \u3b1-actinin-3 deficiency triggers an increase in oxidative muscle metabolism through activation of calcineurin, which likely confers the protective effect. Our studies suggest that ACTN3 R577X genotype is a modifier of clinical phenotype in DMD patients

Risk, ambiguity and quantum decision theory

In the present article we use the quantum formalism to describe the effects of risk and ambiguity in decision theory. The main idea is that the probabilities in the classic theory of expected utility are estimated probabilities, and thus do not follow the classic laws of probability theory. In particular, we show that it is possible to use consistently the classic expected utility formula, where the probability associated to the events are computed with the equation of quantum interference. Thus we show that the correct utility of a lottery can be simply computed by adding to the classic expected utility a new corrective term, the uncertainty utility, directly connected with the quantum interference term.Comment: 1 figur