776 research outputs found

    Targeting Mr Average: Participation, gender equity and school sport partnerships

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    The School Sport Partnership Programme (SSPP) is one strand of the national strategy for physical education and school sport in England, the physical education and school sport Club Links Strategy (PESSCL). The SSPP aims to make links between school physical education (PE) and out of school sports participation, and has a particular remit to raise the participation levels of several identified under-represented groups, of which girls and young women are one. National evaluations of the SSPP show that it is beginning to have positive impacts on young people's activity levels by increasing the range and provision of extra curricular activities (Office for Standards in Education (OFSTED), 2003, 2004, 2005; Loughborough Partnership, 2005, 2006). This paper contributes to the developing picture of the phased implementation of the programme by providing qualitative insights into the work of one school sport partnership with a particular focus on gender equity. The paper explores the ways in which gender equity issues have been explicitly addressed within the 'official texts' of the SSPP; how these have shifted over time and how teachers are responding to and making sense of these in their daily practice. Using participation observation, interview and questionnaire data, the paper explores how the coordinators are addressing the challenge of increasing the participation of girls and young women. The paper draws on Walby's (2000) conceptualisation of different kinds of feminist praxis to highlight the limitations of the coordinators' work. Two key themes from the data and their implications are addressed: the dominance of competitive sport practices and the PE professionals' views of targeting as a strategy for increasing the participation of under-represented groups. The paper concludes that coordinators work within an equality or difference discourse with little evidence of the transformative praxis needed for the programme to be truly inclusive. © 2008 Taylor & Francis

    A comparison of transient elastography with acoustic radiation force impulse elastography for the assessment of liver health in patients with chronic hepatitis C: Baseline results from the TRACER study

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    BACKGROUND: Liver stiffness measurements can be used to assess liver fibrosis and can be acquired by transient elastography using FibroScan® and with Acoustic Radiation Force Impulse imaging. The study aimed to establish liver stiffness measurement scores using FibroScan® and Acoustic Radiation Force Impulse in a chronic hepatitis C cohort and to explore the correlation and agreement between the scores and the factors influencing agreement. METHODS: Patients had liver stiffness measurements acquired with FibroScan® (right lobe of liver) and Acoustic Radiation Force Impulse (right and left lobe of liver). We used Spearman’s correlation to explore the relationship between FibroScan® and Acoustic Radiation Force Impulse scores. A Bland–Altman plot was used to evaluate bias between the mean percentage differences of FibroScan® and Acoustic Radiation Force Impulse scores. Univariable and multivariable analyses were used to assess how factors such as body mass index, age and gender influenced the agreement between liver stiffness measurements. RESULTS: Bland-Altman showed the average (95% CI) percentage difference between FibroScan® and Acoustic Radiation Force Impulse scores was 27.5% (17.8, 37.2), p < 0.001. There was a negative correlation between the average and percentage difference of the FibroScan® and Acoustic Radiation Force Impulse scores (r (95% CI) = −0.41 (−0.57, −0.21), p < 0.001), thus showing that percentage difference gets smaller for greater FibroScan® and Acoustic Radiation Force Impulse scores. Body mass index was the biggest influencing factor on differences between FibroScan® and Acoustic Radiation Force Impulse (r = 0.12 (0.01, 0.23), p = 0.05). Acoustic Radiation Force Impulse scores at segment 5/8 and the left lobe showed good correlation (r (95% CI) = 0.83 (0.75, 0.89), p < 0.001). CONCLUSION: FibroScan® and Acoustic Radiation Force Impulse had similar predictive values for the assessment of liver stiffness in patients with chronic hepatitis C infection; however, the level of agreement varied across lower and higher scores

    IEA EBC Annex 57 ‘Evaluation of Embodied Energy and CO<sub>2eq</sub> for Building Construction'

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    The current regulations to reduce energy consumption and greenhouse gas emissions (GHG) from buildings have focused on operational energy consumption. Thus legislation excludes measurement and reduction of the embodied energy and embodied GHG emissions over the building life cycle. Embodied impacts are a significant and growing proportion and it is increasingly recognized that the focus on reducing operational energy consumption needs to be accompanied by a parallel focus on reducing embodied impacts. Over the last six years the Annex 57 has addressed this issue, with researchers from 15 countries working together to develop a detailed understanding of the multiple calculation methods and the interpretation of their results. Based on an analysis of 80 case studies, Annex 57 showed various inconsistencies in current methodological approaches, which inhibit comparisons of results and difficult development of robust reduction strategies. Reinterpreting the studies through an understanding of the methodological differences enabled the cases to be used to demonstrate a number of important strategies for the reduction of embodied impacts. Annex 57 has also produced clear recommendations for uniform definitions and templates which improve the description of system boundaries, completeness of inventory and quality of data, and consequently the transparency of embodied impact assessments

    Defining Potential Therapeutic Targets in Coronavirus Disease 2019: A Cross-Sectional Analysis of a Single-Center Cohort

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    OBJECTIVES: Multiple mechanisms have been proposed to explain disease severity in coronavirus disease 2019. Therapeutic approaches need to be underpinned by sound biological rationale. We evaluated whether serum levels of a range of proposed coronavirus disease 2019 therapeutic targets discriminated between patients with mild or severe disease. DESIGN: A search of ClinicalTrials.gov identified coronavirus disease 2019 immunological drug targets. We subsequently conducted a retrospective observational cohort study investigating the association of serum biomarkers within the first 5 days of hospital admission relating to putative therapeutic biomarkers with illness severity and outcome. SETTING: University College London, a tertiary academic medical center in the United Kingdom. PATIENTS: Patients admitted to hospital with a diagnosis of coronavirus disease 2019. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eighty-six patients were recruited, 44 (51%) with mild disease and 42 (49%) with severe disease. We measured levels of 10 cytokines/signaling proteins related to the most common therapeutic targets (granulocyte-macrophage colony-stimulating factor, interferon-α2a, interferon-β, interferon-γ, interleukin-1β, interleukin-1 receptor antagonist, interleukin-6, interleukin-7, interleukin-8, tumor necrosis factor-α), immunoglobulin G antibodies directed against either coronavirus disease 2019 spike protein or nucleocapsid protein, and neutralization titers of antibodies. Four-hundred seventy-seven randomized trials, including 168 different therapies against 83 different pathways, were identified. Six of the 10 markers (interleukin-6, interleukin-7, interleukin-8, interferon-α2a, interferon-β, interleukin-1 receptor antagonist) discriminated between patients with mild and severe disease, although most were similar or only modestly raised above that seen in healthy volunteers. A similar proportion of patients with mild or severe disease had detectable spike protein or nucleocapsid protein immunoglobulin G antibodies with equivalent levels between groups. Neutralization titers were higher among patients with severe disease. CONCLUSIONS: Some therapeutic and prognostic biomarkers may be useful in identifying coronavirus disease 2019 patients who may benefit from specific immunomodulatory therapies, particularly interleukin-6. However, biomarker absolute values often did not discriminate between patients with mild and severe disease or death, implying that these immunomodulatory treatments may be of limited benefit

    An investigation of factors associated with the health and well-being of HIV-infected or HIV-affected older people in rural South Africa

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    BackgroundDespite the severe impact of HIV in sub-Saharan Africa, the health of older people aged 50+ is often overlooked owing to the dearth of data on the direct and indirect effects of HIV on older people's health status and well-being. The aim of this study was to examine correlates of health and well-being of HIV-infected older people relative to HIV-affected people in rural South Africa, defined as participants with an HIV-infected or death of an adult child due to HIV-related cause. MethodsData were collected within the Africa Centre surveillance area using instruments adapted from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE). A stratified random sample of 422 people aged 50+ participated. We compared the health correlates of HIV-infected to HIV-affected participants using ordered logistic regressions. Health status was measured using three instruments: disability index, quality of life and composite health score. ResultsMedian age of the sample was 60 years (range 50-94). Women HIV-infected (aOR 0.15, 95% confidence interval (CI) 0.08-0.29) and HIV-affected (aOR 0.20, 95% CI 0.08-0.50), were significantly less likely than men to be in good functional ability. Women's adjusted odds of being in good overall health state were similarly lower than men's; while income and household wealth status were stronger correlates of quality of life. HIV-infected participants reported better functional ability, quality of life and overall health state than HIV-affected participants. Discussion and Conclusions The enhanced healthcare received as part of anti-retroviral treatment as well as the considerable resources devoted to HIV care appear to benefit the overall well-being of HIV-infected older people; whereas similar resources have not been devoted to the general health needs of HIV uninfected older people. Given increasing numbers of older people, policy and programme interventions are urgently needed to holistically meet the health and well-being needs of older people beyond the HIV-related care system. <br/
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