452 research outputs found

    Measuring the productivity of residential long-term care in England: methods for quality adjustment and regional comparison

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    Productivity trend information is valuable in developing policy and for understanding changes in the ‘value for money’ of the care system. In this paper, we consider approaches to measuring productivity of adult social care (ASC), and particularly care home services. Productivity growth in the public sector is traditionally measured by comparing change in total output to change in total inputs, but has not accounted for changes in service quality and need. In this study, we propose a method to estimate ‘quality adjusted’ output based on indicators of the Adult Social Care Outcomes Toolkit (ASCOT), using data collected in the annual adult social care survey (ASCS). When combined with expenditure and activity data for 2010 to 2012, we found that this approach was feasible to implement with current data and that it altered the productivity results compared with non-adjusted productivity metrics. Overall, quality-adjusted productivity grew in most regions between 2010 and 2011 and remained unchanged for most regions from 2011 to 2012

    But a walking shadow: designing, performing and learning on the virtual stage

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    Representing elements of reality within a medium, or taking aspects from one medium and placing them in another is an act of remediation. The process of this act, however, is largely taken for granted. Despite the fact that available information enables a qualitative assessment of the history of multimedia and their influences on different fields of knowledge, there are still some areas that require more focused research attention. For example, the relationship between media evolution and new developments in scenographic practice is currently under investigation. This article explores the issue of immediacy as a condition of modern theatre in the context of digital reality. It discusses the opportunities and challenges that recent technologies present to contemporary practitioners and theatre design educators, creating a lot of scope to break with conventions. Here, we present two case studies that look into technology-mediated learning about scenography through the employment of novel computer visualization techniques. The first case study is concerned with new ways of researching and learning about theatre through creative exploration of design artefacts. The second case study investigates the role of the Immersive Virtual World Second Life™ (SL) in effective teaching of scenography, and in creating and experiencing theatrical performances

    Adapting data collection methods in the Australian life histories and health survey: a retrospective life course study

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    OBJECTIVE Ideally, life course data are collected prospectively through an ongoing longitudinal study. We report adaptive multimethod fieldwork procedures that gathered life history data by mail survey and telephone interview, comparable with the face-to-face methods employed in the English Longitudinal Study on Ageing (ELSA). DESIGN The Australian Life Histories and Health (LHH) Survey was a substudy of the Australian 45 and Up Study, with data collection methods modified from the ELSA Study. A self-complete questionnaire and life history calendar were completed by the participants, followed by a computer-assisted telephone interview recording key life events. RESULTS The LHH survey developed and tested procedures and instruments that gathered rich life history data within an ongoing Australian longitudinal survey on ageing. Data collection proved to be economical. The use of a self-complete questionnaire in conjunction with a life history calendar and coordinated computer-assisted telephone interview was successful in collecting retrospective life course information, in terms of being thorough, practical and efficient. This study has a diverse collection of data covering the life course, starting with early life experiences and continuing with socioeconomic and health exposures and outcomes during adult life. CONCLUSIONS Mail and telephone methodology can accurately and economically add a life history dimension to an ongoing longitudinal survey. The method is particularly valuable for surveying widely dispersed populations. The results will facilitate understanding of the social determinants of health by gathering data on earlier life exposures as well as comparative data across geographical and societal contexts.Supported by an Australian Research Council Grant (DP 1096778, “Socio-economic determinants and health inequalities over the life-course: Australian and English comparisons”) with investigators from the Universities of Sydney, Newcastle and Queensland (Australia) and the University of Manchester (UK)

    The role of adult social care in the prevention of intensive health and care needs: a scoping review

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    Context: Despite the strong emphasis on prevention in social care policy, there is a lack of evidence on the effectiveness of preventive social care interventions to delay escalation of intensive care needs. Objective(s): We reviewed the literature relating to the role of Adult Social Care to prevent escalation of care needs. We aimed to identify mechanisms in service delivery that prevent development of long-term care needs. Method(s): We used the PRISMA-ScR framework to review papers reporting the (cost)effectiveness of preventative services. Findings were qualitatively synthesised using elements of realist synthesis. Findings: Thirty-one papers were included covering: integrated care, intermediate care, rehabilitation, post-discharge services, community-based care, and domiciliary care. Overall, we found few studies with conclusive results to inform policy and practice. Moreover, the evidence was mostly concerned with the impact of social care on health care utilisation, with relatively few studies addressing the impact on social care utilisation. There was some preliminary evidence for the effectiveness of multi-faceted support set within the community, and improvements were observed for patients’ Quality of Life. Limitations: The variety of papers we included reflects the complexity of the social care landscape but prevents robust assessment of the impact of services to delay advancing care needs. Implications: Greater investment in research in this field will help policy makers and families target scarce resources and invest in the most effective prevention services. We emphasise the impact of prevention services can take several years to realise, which must be reflected in research design and social care funding

    Structural, magnetic and electrical properties of the hexagonal ferrites MFeO3 (M=Y, Yb, In)

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    We thank EPSRC for funding, STFC for providing neutron facilities and Diamond Light Source for provision of synchrotron facilities. We thank Dr Chiu Tang for assistance at Diamond and Dr A. Kusmartseva (University of Edinburgh) for assistance with the SQUID measurements. FDM thanks the Royal Society for a Research Fellowship.The hexagonal ferrites MFeO3 (M=Y, Yb, In) have been studied using a combination of neutron and X-ray powder diffraction, magnetic susceptibility, dielectric measurements and 57Fe Mössbauer spectroscopy. This study confirms the previously reported crystal structure of InFeO3 (YAlO3 structure type, space group P63/mmc), but YFeO3 and YbFeO3 both show a lowering of symmetry to at most P63cm (ferrielectric YMnO3 structure type). However, Mössbauer spectroscopy shows at least two distinct Fe sites for both YFeO3 and YbFeO3 and we suggest that the best model to rationalise this involves phase separation into more than one similar hexagonal YMnO3-like phase. Rietveld analysis of the neutron diffraction data was carried out using two hexagonal phases as a simplest case scenario. In both YFeO3 and YbFeO3, distinct dielectric anomalies are observed near 130 K and 150 K, respectively. These are tentatively correlated with weak anomalies in magnetic susceptibility and lattice parameters, for YFeO3 and YbFeO3, respectively, which may suggest a weak magnetoelectric effect. Comparison of neutron and X-ray powder diffraction shows evidence of long-range magnetic order in both YFeO3 and YbFeO3 at low temperatures. Due to poor sample crystallinity, the compositional and structural effects underlying the phase separation and possible magnetoelectric phenomena cannot be ascertained.PostprintPeer reviewe

    Effects of different Papua New Guinea sweetpotato varieties on performance and level of enteric pathogens in chickens

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    Published: 23 April 2019In the last decade, research has targeted the evaluation of local feed ingredients for use in monogastric diets to alleviate the high cost of production of livestock at smallholder levels in Papua New Guinea (PNG). The PNG smallholder poultry production system involves many families who rear multiple batches of meat birds every year. This study was conducted to evaluate the levels of enteric pathogens in the caeca of broilers fed with sweetpotato diets with varying levels of non-starch polysaccharides (NSP). Selection of a sweetpotato variety for use in broiler diets should be based on the total NSP content. In particular, varieties with low soluble NSPs are economical to use as Apparent Metabolizable Energy (AME) values are within the desired range for poultry and there is minimal need to include enzymes to improve NSP digestibility. The use of varieties with a low total NSP is also advantageous as the numbers of Clostridium perfringens was lower in broilers fed with these sweetpotato varieties. The level of Campylobacter and Salmonella levels were high in the ceca of birds fed with the sweetpotato varieties with high total NSP. These levels can be reduced with the inclusion of enzymes. This information will assist in the efficient use of local varieties of sweetpotato in PNG by small holder poultry farmers for sustainable poultry production and the commercial industry.Janet Pandi, Phil Glatz, Rebecca Forder and Kapil Chousalka

    Do You Prefer Safety to Social Participation? Finnish Population-Based Preference Weights for the Adult Social Care Outcomes Toolkit (ASCOT) for Service Users

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    Introduction. The Adult Social Care Outcomes Toolkit (ASCOT) was developed in England to measure people’s social care–related quality of life (SCRQoL). Objectives. The aim of this article is to estimate preference weights for the Finnish ASCOT for service users (ASCOT). In addition, we tested for learning and fatigue effects in the choice experiment used to elicit the preference weights. Methods. The analysis data (n = 1000 individuals) were obtained from an online survey sample of the Finnish adult general population using gender, age, and region as quotas. The questionnaire included a best-worst scaling (BWS) experiment using ASCOT. Each respondent sequentially selected four alternatives (best, worst; second-best, second-worst) for eight BWS tasks (n = 32,000 choice observations). A scale multinomial logit model was used to estimate the preference parameters and to test for fatigue and learning. Results. The most and least preferred attribute-levels were “I have as much control over my daily life as I want” and “I have no control over my daily life.” The preference weights were not on a cardinal scale. The ordering effect was related to the second-best choices. Learning effect was in the last four tasks. Conclusions. This study has developed a set of preference weights for the ASCOT instrument in Finland, which can be used for investigating outcomes of social care interventions on adult populations. The learning effect calls for the development of study designs that reduce possible bias relating to preference uncertainty at the beginning of sequential BWS tasks. It also supports the adaptation of a modelling strategy in which the sequence of tasks is explicitly modelled as a scale factor

    Books

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    Valuing informal carers' quality of life using best-worst scaling-Finnish preference weights for the Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer)

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    This study developed Finnish preference weights for the seven-attribute Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer) and investigated survey fatigue and learning in best-worst scaling (BWS) experiments. An online survey that included a BWS experiment using the ASCOT-Carer was completed by a sample from the general population in Finland. A block of eight BWS profiles describing different states from the ASCOT-Carer were randomly assigned to each respondent, who consecutively made four choices (best, worst, second best and second worst) per profile. The analysis panel data had 32,160 choices made by 1005 respondents. A scale multinomial logit (S-MNL) model was used to estimate preference weights for 28 ASCOT-Carer attribute levels. Fatigue and learning effects were examined as scale heterogeneity. Several specifications of the generalised MNL model were employed to ensure the stability of the preference estimates. The most and least-valued states were the top and bottom levels of the control over daily life attribute. The preference weights were not on a cardinal scale. We observed the position effect of the attributes on preferences associated with the best or second-best choices. A learning effect was found. The established preference weights can be used in evaluations of the effects of long-term care services and interventions on the quality of life of service users and caregivers. The learning effect implies a need to develop study designs that ensure equal consideration to all profiles (choice tasks) in a sequential choice experiment
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