302 research outputs found
Persistence and change in interregional differences in entrepreneurship: England and Wales, 1921–2011
The paper explores time-persistence in interregional differences of self-employment rates in England and Wales in the 1921–2011 period by using census data. The results suggest a strong path-dependence in entrepreneurship as past self-employment rates have strong bearing on future ones. However, there is also some rank mobility reflected in the upward movements of London boroughs and downward movements of primarily coastal areas. Rank mobility relates to structural changes, changes in human capital, regional age structures and immigration
The impact of labour regulations : measuring the effectiveness of legal norms in a developing country.
Is group cognitive behaviour therapy for postnatal depression evidence-based practice? A systematic review
Background:
There is evidence that psychological therapies including cognitive behaviour therapy (CBT) may be effective in reducing postnatal depression (PND) when offered to individuals. In clinical practice, this is also implemented in a group therapy format, which, although not recommended in guidelines, is seen as a cost-effective alternative. To consider the extent to which group methods can be seen as evidence-based, we systematically review and synthesise the evidence for the efficacy of group CBT compared to currently used packages of care for women with PND, and we discuss further factors which may contribute to clinician confidence in implementing an intervention.
Methods:
Seventeen electronic databases were searched. All full papers were read by two reviewers and a third reviewer was consulted in the event of a disagreement on inclusion. Selected studies were quality assessed, using the Cochrane Risk of Bias Tool, were data extracted by two reviewers using a standardised data extraction form and statistically synthesised where appropriate using the fixed-effect inverse-variance method.
Results:
Seven studies met the inclusion criteria. Meta-analyses showed group CBT to be effective in reducing depression compared to routine primary care, usual care or waiting list groups. A pooled effect size of d = 0.57 (95% CI 0.34 to 0.80, p < 0.001) was observed at 10–13 weeks post-randomisation, reducing to d = 0.28 (95% CI 0.03 to 0.53, p = 0.025) at 6 months. The non-randomised comparisons against waiting list controls at 10–13 weeks was associated with a larger effect size of d = 0.94 (95% CI 0.42 to 1.47, p < 0.001). However due to the limitations of the available data, such as ill-specified definitions of the CBT component of the group programmes, these results should be interpreted with caution.
Conclusions:
Although the evidence available is limited, group CBT was shown to be effective. We argue, therefore, that there is sufficient evidence to implement group CBT, conditional upon routinely collected outcomes being benchmarked against those obtained in trials of individual CBT, and with other important factors such as patient preference, clinical experience, and information from the local context taken into account when making the treatment decision
The effect of starch-based biomaterials on leukocyte adhesion and activation in vitro
Leukocyte adhesion to biomaterials has long been recognised as a key element to
determine their inflammatory potential. Results regarding leukocyte adhesion and
activation are contradictory in some aspects of the material’s effect in determining these
events. It is clear that together with the wettability or hydrophilicity/hydrophobicity, the
roughness of a substrate has a major effect on leukocyte adhesion. Both the chemical and
physical properties of a material influence the adsorbed proteins layer which in turn
determines the adhesion of cells.
In this work polymorphonuclear (PMN) cells and a mixed population of
monocytes/macrophages and lymphocytes (mononuclear cells) were cultured separately
with a range of starch-based materials and composites with hydroxyapatite (HA). A
combination of both reflected light microscopy and scanning electron microscopy (SEM)
was used in order to study the leukocyte morphology. The quantification of the enzyme
lactate dehydrogenase (LDH) was used to determine the number of viable cells adhered to
the polymers. Cell adhesion and activation was characterised by immunocytochemistry
based on the expression of several adhesion molecules, crucial in the progress of an
inflammatory response.
This work supports previous in vitro studies with PMN and monocytes/macrophages,
which demonstrated that there are several properties of the materials that can influence
and determine their biological response. From our study, monocytes/macrophages and
lymphocytes adhere in similar amounts to more hydrophobic (SPCL) and to moderately
hydrophilic (SEVA-C) surfaces and do not preferentially adhere to rougher substrates
(SCA). Contrarily, more hydrophilic surfaces (SCA) induced higher PMN adhesion and
lower activation. In addition, the hydroxyapatite reinforcement induces changes in cell
behaviour for some materials but not for others.
The observed response to starch-based biodegradable polymers was not significantly
different from the control materials. Thus, the results reported herein indicate the low
potential of the starch-based biodegradable polymers to induce inflammation especially
the HA reinforced composite materials
Setback distances as a conservation tool in wildlife-human interactions : testing their efficacy for birds affected by vehicles on open-coast sandy beaches
In some wilderness areas, wildlife encounter vehicles disrupt their behaviour and habitat use. Changing driver behaviour has been proposed where bans on vehicle use are politically unpalatable, but the efficacy of vehicle setbacks and reduced speeds remains largely untested. We characterised bird-vehicle encounters in terms of driver behaviour and the disturbance caused to birds, and tested whether spatial buffers or lower speeds reduced bird escape responses on open beaches. Focal observations showed that: i) most drivers did not create sizeable buffers between their vehicles and birds; ii) bird disturbance was frequent; and iii) predictors of probability of flushing (escape) were setback distance and vehicle type (buses flushed birds at higher rates than cars). Experiments demonstrated that substantial reductions in bird escape responses required buffers to be wide (> 25 m) and vehicle speeds to be slow (< 30 km h-1). Setback distances can reduce impacts on wildlife, provided that they are carefully designed and derived from empirical evidence. No speed or distance combination we tested, however, eliminated bird responses. Thus, while buffers reduce response rates, they are likely to be much less effective than vehicle-free zones (i.e. beach closures), and rely on changes to current driver behaviou
Setback distances as a conservation tool in wildlife-human interactions : testing their efficacy for birds affected by vehicles on open-coast sandy beaches
In some wilderness areas, wildlife encounter vehicles disrupt their behaviour and habitat use. Changing driver behaviour has been proposed where bans on vehicle use are politically unpalatable, but the efficacy of vehicle setbacks and reduced speeds remains largely untested. We characterised bird-vehicle encounters in terms of driver behaviour and the disturbance caused to birds, and tested whether spatial buffers or lower speeds reduced bird escape responses on open beaches. Focal observations showed that: i) most drivers did not create sizeable buffers between their vehicles and birds; ii) bird disturbance was frequent; and iii) predictors of probability of flushing (escape) were setback distance and vehicle type (buses flushed birds at higher rates than cars). Experiments demonstrated that substantial reductions in bird escape responses required buffers to be wide (> 25 m) and vehicle speeds to be slow (< 30 km h-1). Setback distances can reduce impacts on wildlife, provided that they are carefully designed and derived from empirical evidence. No speed or distance combination we tested, however, eliminated bird responses. Thus, while buffers reduce response rates, they are likely to be much less effective than vehicle-free zones (i.e. beach closures), and rely on changes to current driver behaviou
Preventing and Treating Women’s Postpartum Depression: A Qualitative Systematic Review on Partner-Inclusive Interventions
Partner-related factors associated with the occurrence of Postpartum Depression (PPD) may justify the partner’s inclusion in preventive and treatment approaches. The aim of this qualitative systematic review was to synthesize the literature on partner-inclusive interventions designed to prevent or treat postpartum depression (PPD) in women. In accordance with the PRISMA guidelines, the systematic search of studies published between 1967 and May 2015 in PsycINFO and PubMed identified 26 studies that met the inclusion criteria, which reported on 24 interventions. The following partner parameters were analyzed: participation type, session content, mental health assessment, attendance assessment, and the effects of partner’s participation on the women’s response to the interventions. Total participation by the partner was mostly reported in the prevention studies, whereas partial participation was reported in the treatment studies. The session content was mostly based on psychoeducation about PPD and parenthood, coping strategies to facilitate the transition to parenthood such as the partner’s emotional and instrumental support, and problem-solving and communication skills. Some benefits perceived by the couples underscore the relevance of the partner’s inclusion in PPD interventions. However, the scarce information about the partner’s attendance and the associated effects on the women’s intervention outcomes, along with methodological limitations of the studies, made it difficult to determine if the partner’s participation was associated with the intervention’s efficacy. Conclusions about the clinical value of including partners in PPD interventions are still limited. More research is warranted to better inform health policy strategies
Impaired innate interferon induction in severe therapy resistant atopic asthmatic children
Deficient type I interferon-β and type III interferon-λ induction by rhinoviruses has previously been reported in mild/moderate atopic asthmatic adults. No studies have yet investigated if this occurs in severe therapy resistant asthma (STRA). Here, we show that compared with non-allergic healthy control children, bronchial epithelial cells cultured ex vivo from severe therapy resistant atopic asthmatic children have profoundly impaired interferon-β and interferon-λ mRNA and protein in response to rhinovirus (RV) and polyIC stimulation. Severe treatment resistant asthmatics also exhibited increased virus load, which negatively correlated with interferon mRNA levels. Furthermore, uninfected cells from severe therapy resistant asthmatic children showed lower levels of Toll-like receptor-3 mRNA and reduced retinoic acid inducible gene and melanoma differentiation-associated gene 5 mRNA after RV stimulation. These data expand on the original work, suggesting that the innate anti-viral response to RVs is impaired in asthmatic tissues and demonstrate that this is a feature of STRA
Using candidacy theory to explore unemployed over-50s perceptions of suitability of a welfare to work programme: a longitudinal qualitative study
Welfare to work interventions seek to move out‐of‐work individuals from claiming unemployment benefits towards paid work. However, previous research has highlighted that for over‐50s, particularly those with chronic health conditions, participation in such activities are less likely to result in a return to work. Using longitudinal semi‐structured interviews, we followed 26 over‐50s during their experience of a mandated welfare to work intervention (the Work Programme) in the United Kingdom. Focusing on their perception of suitability, we utilise and adapt Candidacy Theory to explore how previous experiences of work, health, and interaction with staff (both in the intervention, and with healthcare practitioners) influence these perceptions. Despite many participants acknowledging the benefit of work, many described a pessimism regarding their own ability to return to work in the future, and therefore their lack of suitability for this intervention. This was particularly felt by those with chronic health conditions, who reflected on difficulties with managing their conditions (e.g., attending appointments, adhering to treatment regimens). By adapting Candidacy Theory, we highlighted the ways that mandatory intervention was navigated by all the participants, and how some discussed attempts to remove themselves from this intervention. We also discuss the role played by decision makers such as employment‐support staff and healthcare practitioners in supporting or contesting these feelings. Findings suggest that greater effort is required by policy makers to understand the lived experience of chronic illness in terms of ability to RTW, and the importance of inter‐agency work in shaping perceptions of those involved
Work Programme Evaluation : the participant experience report
This report brings together and summarises the key evidence available from the different strands of the Work Programme evaluation relating to the experience of participants. In particular, it presents analyses from two waves of a large scale longitudinal survey of participants and a multi-wave (partly cross-section, partly longitudinal) programme of in-depth qualitative fieldwork with participants. The evaluation tracks the Work Programme over several years from its launch in 2011
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