Give and Let Give: Building a Culture of Philanthropy in the Financial Services Industry

A review of the potential for partnering between the third sector and business, more specifically the financial services sector in the UK

The landforms of the Christchurch lowland : |b a dissertation submitted in partial requirement for the Diploma of Landscape Architecture in the University of Canterbury [Lincoln College]

Long before European occupation, the main landforms of the Christchurch lowland were coastal sandhills, swamps, river fans and terraces. These landforms were all part of a broad flood plain formed by the Waimakariri as the flow of this river to the sea was blocked by the volcanic island that now forms Banks Peninsula. In this flat swampy lowland the English settlers chose to build their new town. This study is about those landforms and their subsequent modification. When I started looking at the landforms of Christchurch I realised that the lowland in which it lies has a very special foundation. In order to explain many of the present day topographical features, we have to go back to its geological past. Chapter one gives a brief overview of this geological past and how it was responsible for the formation of the plains and the lowland of Christchurch. Chapter two is a description of the specific landforms, their formation and natural state. Most of these landforms are interdependent, both in formation and evolution. However, for ease of study these landforms are discussed in separate sections. Chapter three relates the story of human occupation, the first impressions of these settlers, the problems they encountered and the factors which determined where they settled. Chapter four describes how the landforms were used, managed and what modifications were made. The main sections in this chapter discuss the drainage of swamps, by individual effort and public authorities, the modification and management of rivers, estuary, the Waimakariri, sandhills, and roading. Chapter five discusses the landforms that remain, their present state and possible future

Social commerce Open Innovation in healthcare management: an exploration from a novel technology transfer approach

This paper presents an Open Innovation approach, AgorIP, for commercialisation of opportunities within Health & Social Care and Life Sciences, piloted in south-west Wales. This approach, supported by Welsh Government, NHS Wales, universities and private sector aims to develop new markets and innovations, where all opportunities are rigorously assessed for existing and/or new market potential. In parallel, the empowerment of citizens to manage their personal and collective health, and to access information and services has become an important driver, becoming a disruptive development within the state-centric integrated health economy. This paper examines the relevant policy context and emerging portfolio of innovations within AgorIP to explore emergence of social commerce innovation in Health care management. Findings reflect the above dynamics and constraints, with innovations showing segmentation across geographic, demographic and disease-sufferer groups. The authors therefore offer the AgorIP initiative as an interesting space to observe the potential for Open Innovation of social commerce within the health sector

Developmental Regulation of Mitochondrial Function in Ovine Fetal Skeletal Muscle

Skeletal muscle is a highly metabolically active tissue, both in the adult and the fetus. Mitochondria are essential in providing energy in the form of ATP from the oxidative metabolism of carbohydrates, fats and amino acids. Mitochondrial function is influenced by the abundance and activity of the complexes comprising the electron transfer system (ETS) and the balance between mitochondrial fusion and fission. Any factors which affect the development of skeletal muscle, and mitochondria in particular, may have an impact not only on neonatal health but also on the metabolic health of the adult offspring. However, the normal developmental profile of skeletal muscle mitochondrial function as the fetus prepares for the increased metabolic challenges associated with extrauterine life, is not well characterised. The hormones, cortisol and triiodothyronine (T3) are known to be crucial in the maturation of several physiological processes during late gestation. Further, their role in regulating adult metabolism is well-documented. However, whether they play a role in regulating fetal mitochondrial function is unknown. Using fetal sheep, the aims of this project were twofold: 1) to determine any changes in skeletal muscle mitochondrial function which occur over the last third of gestation and in the first two days of neonatal life and 2) to determine any regulatory roles of cortisol and T3 in these developmental changes. Mixed fibre-type skeletal muscle was collected from fetuses at 3 time points over late gestation and from newborn lambs. In addition, skeletal muscle samples were taken from fetuses which had been thyroidectomised (TX) and fetuses infused with either T3 or cortisol. Respirometry, enzyme assays, qRT-PCR and western blotting were carried out on the skeletal muscle samples in order to assess mitochondrial parameters. Mitochondrial activity, as measured by carbohydrate- and fat- stimulated ADP-coupled oxygen uptake, increased with age in a thyroid hormone dependent manner, rising predominantly postnatally. Mitochondrial density, abundance of ETS complexes I-IV and ATP-synthase and expression of the adenine nucleotide transferase 1 and mitofusin 2 were all positively influenced by age, with the natural prepartum rise being prevented in the thyroidectomised fetuses. However, T3 infusion alone was insufficient to raise any of these factors prematurely. Cortisol infusion resulted in an increase in some aspects of mitochondrial oxidative capacity in a muscle-specific manner. Overall, the data presented shows that there are developmental changes in skeletal muscle mitochondria during the perinatal period. They also suggest that these changes are regulated by both cortisol and thyroid hormones in preparation for birth, although neither hormone alone was sufficient to induce all the functional changes.Wellcome Trus

Quantifying rates of glacier recession in the Peruvian Andes since the Little Ice Age

Peru hosts 92% of the total glacierised area of the tropics, and those glaciers are losing mass at an unprecedented rate with ongoing climate change. This glacier mass loss delivers meltwater that has the potential to have dramatic and dangerous impacts on the local – and larger-scale – surroundings via meltwater release. This study uses extensive geomorphological evidence detected within high resolution digital elevation models and satellite imagery, together with GIS reconstructions, to determine glacier area and volumetric changes since the Little Ice Age (LIA) maximum (1579 to 1728). These data show a reduction in glacierised area of 45% and a reduction in volume of 40% (almost 75 km3) when aggregated across all Peruvian Cordilleras. Using the median date for the LIA maximum, this volume loss equates to 6.34 x 10-5 km3 yr-1 km-2, with a mass balance of -0.3 ± 0.09 m w.e. yr-1 and sea level equivalent of 0.17 mm, or 0.0005 mm yr-1, between 1644 and 2003. When six of Peru’s Cordilleras are compared, no significant difference between rates of recession is observed, which indicates that the response of these glaciers to long-term climate change is driven by large-scale climatic controls. Overall, this study contributes to the improved understanding of spatial and temporal rates of glacier melt in Peru by providing novel long-term data over a broad area, and provides a literature analysis to contextualise the rapid rates of contemporary glacier recession within a long-term record

Barriers and enablers to the effective implementation of robotic assisted surgery

Acknowledgements We thank the participants - specialty leads, surgeons, scrub nurses, the anaesthetist, policy makers/commissioners and industry representatives - for their time, energy and invaluable insight to assist this research. We also thank Jared Torkington, Arul Immanuel, and Richard Kerr for providing a clinical review of the work prior to submission. Funding: MKC and DB were funded via an unrestricted grant (https://www.intuitive.com/en-gb) awarded by Intuitive Surgical (European Research Board). The funder had no role in the conception, design, conduct, analysis, or interpretation of the study.Peer reviewedPublisher PD

Life Sciences and Health in South West Wales: A Sub-regional Innovation Ecosystem

This chapter describes how efforts to develop the Life Sciences sector in south Wales have been undertaken through structured efforts of Understanding, Acting and Measuring, resulting in new ventures formed through spin-outs to commercialise research output and collaboration with other enterprises. Building upon concepts of clustering and regional innovation systems, the approach demonstrates the harnessing of a long-term strategy involving smart specialisation resulting in emerging and meaningful economic impact. Networking and knowledge exchange are shown as core components of a system reaching across wider sectors involving a diversity of skills

Cost-effectiveness of telehealth for patients with depression: Evidence from the Healthlines randomised controlled trial

BACKGROUND: Depression is a prevalent long-term condition that is associated with substantial resource use. Telehealth may offer a cost-effective means of supporting the management of people with depression. AIMS: To investigate the cost-effectiveness of a telehealth intervention ('Healthlines') for patients with depression. METHOD: A prospective patient-level economic evaluation conducted alongside a randomised controlled trial. Patients were recruited through primary care, and the intervention was delivered via a telehealth service. Participants with a confirmed diagnosis of depression and PHQ-9 score ≥10 were recruited from 43 English general practices. A series of up to 10 scripted, theory-led, telephone encounters with health information advisers supported participants to effect a behaviour change, use online resources, optimise medication and improve adherence. The intervention was delivered alongside usual care and was designed to support rather than duplicate primary care. Cost-effectiveness from a combined health and social care perspective was measured by net monetary benefit at the end of 12 months of follow-up, calculated from incremental cost and incremental quality-adjusted life years (QALYs). Cost-consequence analysis included cost of lost productivity, participant out-of-pocket expenditure and the clinical outcome. RESULTS: A total of 609 participants were randomised - 307 to receive the Healthlines intervention plus usual care and 302 to receive usual care alone. Forty-five per cent of participants had missing quality of life data, 41% had missing cost data and 51% of participants had missing data on either cost or utility, or both. Multiple imputation was used for the base-case analysis. The intervention was associated with incremental mean per-patient National Health Service/personal social services cost of £168 (95% CI £43 to £294) and an incremental QALY gain of 0.001 (95% CI -0.023 to 0.026). The incremental cost-effectiveness ratio was £132 630. Net monetary benefit at a cost-effectiveness threshold of £20 000 was -£143 (95% CI -£164 to -£122) and the probability of the intervention being cost-effective at this threshold value was 0.30. Productivity costs were higher in the intervention arm, but out-of-pocket expenses were lower. CONCLUSIONS: The Healthlines service was acceptable to patients as a means of condition management, and response to treatment after 4 months was higher for participants randomised to the intervention. However, the positive average intervention effect size was modest, and incremental costs were high relative to a small incremental QALY gain at 12 months. The intervention is not likely to be cost-effective in its current form. DECLARATION OF INTEREST: None. COPYRIGHT AND USAGE: © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence

Current issues and future considerations for the wider implementation of robotic-assisted surgery : a qualitative study

Acknowledgments We thank the participants for their time, energy and invaluable insight to assist this research. Thanks to Clare Robertson for facilitating the public focus group. Funding This work was supported by Intuitive Surgical (European Research Board) via an unrestricted grant.Peer reviewedPublisher PD

Changes in physical activity behaviour and physical function after bariatric surgery: A systematic review and meta-analysis

© 2016 World Obesity. Although physical activity performed after bariatric surgery is associated with enhanced weight loss outcomes, there is limited information on patients' physical activity behaviour in this context. This systematic review and meta-analysis assessed pre-operative to post-operative changes in physical activity and physical function outcomes among obese adults undergoing bariatric surgery. A total of 50 studies met inclusion criteria with 26 papers reporting data for meta-analysis. Increases in both objectively recorded and self-reported physical activity at 12months were demonstrated. Studies indicated that there was a shift towards a greater amount of active time, but of a lower intensity within the first 6months of bariatric surgery, suggested by a reduction in moderate to vigorous physical activity but an increase in step count. A standardized mean difference (SMD) of 1.53 (95% CI: 1.02-2.04) based on nine studies indicated improved walking performance at 12months. Similarly, analysis of five studies demonstrated increased musculoskeletal function at 3-6months (SMD: 1.51; 95% CI: 0.60-2.42). No relationship was identified between changes in weight and walking performance post-surgery. More studies assessing physical activity, physical function and weight loss would help understand the role of physical activity in optimizing post-operative weight and functional outcomes