3,745 research outputs found

    'A light in a very dark place' : The role of a voluntary organisation providing support for those affected by encephalitis

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    Voluntary organisations are seen as contributing to the ‘democratisation’ of health and social care. Little, however, is written about their role and this paper, by focusing on the work of The Encephalitis Society, provides insights into the challenges facing voluntary organisations as they manage twin roles as service providers and advocates, of people with neurological disorders. Two studies are presented: a review conducted by the Society, focusing on patient’s experiences of neurological services; and an external evaluation of the Society’s current provision. The first, based on a postal survey of its members affected by encephalitis (n = 339), illustrates the Society’s advocacy role. The survey provided support for the Association of British Neurologists’ recommendation for nationally agreed standards of care. The second study, a postal survey of recent contacts (n = 76) and in-depth telephone interviews (n = 22), illustrates the Society’s value role as a service provider and supports its role in helping rehabilitate affected individuals and their families. These studies provided the Society with information for policy and service development. Importantly, providing the basis of informed action and partnership with stakeholders and informing the organisation’s sense of purpose, in the changing context of welfare provision in the UK

    The case of 'Yummy Yummy' - a replication of an intervention program

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    Androsterone glucuronide to dehydroepiandrosterone sulphate ratio is discriminatory for obese Caucasian women with polycystic ovary syndrome

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    BACKGROUND: Androsterone glucuronide (ADTG) concentrations have been suggested as a marker of the effects of androgens at the target tissue level. As the mechanism for hyperandrogenemia in obese and nonobese polycystic ovary syndrome (PCOS) may differ, this study compared the different androgen parameters in non-obese compared to obese women with PCOS, and in normal subjects. METHODS: Eleven non-obese and 14 obese women with PCOS were recruited and compared to 11 control women without PCOS. Total testosterone, dehydroepiandrosterone sulphate (DHEAS), ADTG, and androstenedione were analysed using gold standard tandem mass spectrometry, and the free androgen index (FAI) was calculated. RESULTS: Total testosterone, ADTG and androstendione levels did not differ between non-obese (body mass index (BMI) ≤25 kg/m2) and obese PCOS (BMI >25 kg/m2) but all were significantly higher than for controls (p < 0.01). The ADTG to DHEAS ratio was significantly elevated 39 ± 6 (p < 0.01) in obese PCOS in comparison to non-obese PCOS and controls (28 ± 5 and 29 ± 4, respectively). The free androgen index (FAI) and insulin resistance (HOMA-IR) were significantly higher in obese PCOS compared to non-obese PCOS and controls (p < 0.01). DHEAS was significantly higher in the non-obese versus obese PCOS (p < 0.01). All androgen parameters were significantly lower and sex hormone binding globulin (SHBG) significantly higher in normal subjects compared to those with obese and non-obese PCOS. CONCLUSIONS: The ADTG:DHEAS ratio was significantly elevated in obese PCOS compared to non-obese PCOS and controls suggesting that this may be a novel biomarker discriminatory for obese PCOS subjects, perhaps being driven by higher hepatic 5α reductase activity increasing ADTG formation in these women

    Lessons from building an automated pre-departure sequencer for airports

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    Commercial airports are under increasing pressure to comply with the Eurocontrol collaborative decision making (CDM) initiative, to ensure that information is passed between stakeholders, integrate automated decision support or make predictions. These systems can also aid effective operations beyond the airport by communicating scheduling decisions to other relevant parties, such as Eurocontrol, for passing on to downstream airports and enabling overall airspace improvements. One of the major CDM components is aimed at producing the target take-off times and target startup-approval times, i.e. scheduling when the aircraft should push back from the gates and start their engines and when they will take off. For medium-sized airports, a common choice for this is a “pre-departure sequencer” (PDS). In this paper, we describe the design and requirements challenges which arose during our development of a PDS system for medium sized international airports. Firstly, the scheduling problem is highly dynamic and event driven. Secondly, it is important to end-users that the system be predictable and, as far as possible, transparent in its operation, with decisions that can be explained. Thirdly, users can override decisions, and this information has to be taken into account. Finally, it is important that the system is as fair as possible for all users of the airport, and the interpretation of this is considered here. Together, these factors have influenced the design of the PDS system which has been built to work within an existing large system which is being used at many airport
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