37,807 research outputs found

    Incentives for breastfeeding and for smoking cessation in pregnancy: An exploration of types and meanings

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    Financial or tangible incentives are a strategy for improving health behaviours. The mechanisms of action of incentives are complex and debated. Using a multidisciplinary integrated mixed methods study, with service-user collaboration throughout, we developed a typology of incentives and their meanings for initiating and sustaining smoking cessation in pregnancy and breastfeeding. The ultimate aim was to inform incentive intervention design by providing insights into incentive acceptability and mechanisms of action. Systematic evidence syntheses of incentive intervention studies for smoking cessation in pregnancy or breastfeeding identified incentive characteristics, which were developed into initial categories. Little published qualitative data on user perspectives and acceptability was available. Qualitative interviews and focus groups conducted in three UK regions with a diverse socio-demographic sample of 88 women and significant others from the target population, 53 service providers, 24 experts/decision makers, and conference attendees identified new potential incentives and providers, with and without experience of incentives. Identified incentives (published and emergent) were classified into eight categories: cash and shopping vouchers, maternal wellbeing, baby and pregnancy-related, behaviour-related, health-related, general utility, awards and certificates, and experiences. A typology was refined iteratively through concurrent data collection and thematic analysis to explore participants' understandings of ‘incentives’ and to compare and contrast meanings across types. Our typology can be understood in three dimensions: the degree of restriction, the extent to which each is hedonic and/or utilitarian, and whether each has solely monetary value versus monetary with added social value. The layers of autonomy, meanings and the social value of incentive types influence their acceptability and interact with structural, social, and personal factors. Dimensions of incentive meaning that go beyond the simple incentive description should inform incentive programme design and are likely to influence outcomes

    Prevalence and clinical characteristics of left ventricular dysfunction among elderly patients in general practice setting: cross sectional survey

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    Objective: To assess the prevalence and clinical characteristics of left ventricular dysfunction among elderly patients in the general practice setting by echocardiographic assessment of ventricular function. Design: Cross sectional survey. Setting: Four centre general practice in Poole, Dorset. Subjects: 817 elderly patients aged 70-84 years. Main outcomes: Echocardiographic assessment of left ventricular systolic function including measurement of ejection fraction by biplane summation method where possible, clinical symptoms, and signs of left ventricular dysfunction. Results: The overall prevalence of left ventricular systolic dysfunction was 7.5% (95% confidence interval 5.8% to 9.5%); mild dysfunction (5.0%) was considerably more prevalent than moderate (1.6%) or severe dysfunction (0.7%). Measurement of ejection fraction was possible in 82% of patients (n=667): in patients categorised as having mild, moderate, or severe dysfunction, the mean ejection fraction was 48% (SD 12.0), 38% (8.1), and 26% (7.9) respectively. At all ages the prevalence was much higher in men than in women (odds ratio 5.1, 95% confidence interval 2.6 to 10.1). No clinical symptom or sign was both sensitive and specific. In around half the patients with ventricular dysfunction (52%, 32/61) heart failure had not been previously diagnosed. Conclusions: Unrecognised left ventricular dysfunction is a common problem in elderly patients in the general practice setting. Appropriate treatment with angiotensin converting enzyme inhibitors has the potential to reduce hospitalisation and mortality in these patients, but diagnosis should not be based on clinical history and examination alone. Screening is feasible in general practice, but it should not be implemented until the optimum method of identifying left ventricular dysfunction is clarified, and the cost effectiveness of screening has been shown

    Secondary electron background produced by heavy nuclei in a multiwire proportional counter hodoscope

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    The secondary electron background produced by heavy nuclei in a multiwire proportional counter hodoscope is calculated using both a simplified and a more complete Monte Carlo model. These results are compared with experimental data from a small multiwire proportional counter hodoscope operated in a 530 MeV/nucleon accelerator beam of nitrogen nuclei. Estimates of the secondary electron background produced by heavy relativistic nuclei are presented along with the detailed results from calculations of energy deposition in the hodoscope counter cells

    Pathways to "opportunity and excellence": collaborative curriculum innovation in South Yorkshire

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    This paper reports on two aspects of a large-scale curriculum project currently taking place in four LEAs in South Yorkshire. The first of these is concerned with the positive and negative influences on effective curriculum innovation and is addressed from the perspective of the LEA project managers who are managing the delivery of the project in the region's schools. The second aspect considers what the pupils (Year 10, age 14-15) think about the new learning opportunities. The project is set in the context of regional regeneration. The paper concludes that the extremely positive responses from the sample of pupils in all three strands of the programme indicate that the greater emphasis on vocational work and work experience in schools is having a strong motivational effect on pupils who are responding with improved attendance, behaviour and achievement.</p

    The provision of distance education within the HE sector - some areas for concern

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    This paper presents a summary of the findings of a recent survey of the way in which UK higher education institutions (HEIs) are offering distance education (DE) courses, the types of courses being offered, and their modes of delivery. From analysis of the findings of this survey, it is apparent that the emphasis of HEIs is very much on the exploitation of available teaching technology in the delivery of DE courses. However, teaching at a distance is quite different from face-toface teaching, and the evidence suggests that many HEIs fail to implement any meaningful academic staff training for the new role of DE tutor. The authors consider the difficulties this presents to academic staff who are required to move from face-to-face teaching to online facilitating. The paper concludes with an examination of the current provision of staff development and training within UK HEIs and suggests the type of academic staff training required if DE courses are to become truly core activities

    Production of Millisecond Dips in Sco X-1 Count Rates by Dead Time Effects

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    Chang et al. (2006) reported millisecond duration dips in the X-ray intensity of Sco X-1 and attributed them to occultations of the source by small trans-Neptunian objects (TNOs). We have found multiple lines of evidence that these dips are not astronomical in origin, but rather the result of high-energy charged particle events in the RXTE PCA detectors. Our analysis of the RXTE data indicates that at most 10% of the observed dips in Sco X-1 could be due to occultations by TNOs, and, furthermore, we find no positive or supporting evidence for any of them being due to TNOs. We therefore believe that it is a mistake to conclude that any TNOs have been detected via occultation of Sco X-1.Comment: Submitted to ApJ; uses emulateapj.cls, 8 pages with 8 figure

    Results of correlations for transition location on a clean-up glove installed on an F-14 aircraft and design studies for a laminar glove for the X-29 aircraft accounting for spanwise pressure gradient

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    Results of correlative and design studies for transition location, laminar and turbulent boundary-layer parameters, and wake drag for forward swept and aft swept wings are presented. These studies were performed with the use of an improved integral-type boundary-layer and transition-prediction methods. Theoretical predictions were compared with flight measurements at subsonic and transonic flow conditions for the variable aft swept wing F-14 aircraft for which experimental pressure distributions, transition locations, and turbulent boundary-layer velocity profiles were measured. Flight data were available at three spanwise stations for several values of sweep, freestream unit Reynolds number, Mach numbers, and lift coefficients. Theory/experiment correlations indicate excellent agreement for both transition location and turbulent boundary-layer parameters. The results of parametric studies performed during the design of a laminar glove for the forward swept wing X-29 aircraft are also presented. These studies include the effects of a spanwise pressure gradient on transition location and wake drag for several values of freestream Reynolds numbers at a freestream Mach number of 0.9
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