Understanding Achievement in Numeracy Among Primary School Children in Ethiopia: Evidence from RISE Ethiopia Study

Ethiopia has succeeded in rapidly expanding access to primary education over the past two decades. However, learning outcomes remain low among primary school children and particularly among girls and children from disadvantaged backgrounds. Starting with a systematic review of quantitative studies on the determinants of learning outcomes among primary school children in Ethiopia, this study then examined key determinants of students’ numeracy achievement over the 2018-19 school year. The study focused on Grade 4 children (N= 3,353) who are part of an on-going longitudinal study. The two questions that guided this study are: what are the key determinants of numeracy achievement at Grade 4 in primary schools in Ethiopia, and how does our current empirical study contribute to understanding achievement differences in numeracy among primary school children in Ethiopia? We employed descriptive and inferential statistics to examine factors that determine differences in numeracy scores at the start and end of the school year, as well as determinants of numeracy scores at the end of the school year conditional on achievement at the start of the school year. We examined differences across gender, region, and rural-urban localities. We also used ordinary least squares and school ‘fixed effects’ approaches to estimate the key child, household and school characteristics that determine numeracy scores in Grade 4. The findings revealed that boys significantly outperformed girls in numeracy both at the start and end of the 2018/19 school year, but the progress in numeracy scores over the school year by boys was similar to that of girl

Cognitive training for people with mild to moderate dementia (protocol)

This is the final version of the article. Available from Cochrane Collaboration / Wiley via the DOI in this record.The review version is in ORE at: http://hdl.handle.net/10871/36870This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the effects of cognitive training on cognitive and non-cognitive outcomes for people with mild to moderate dementia and their caregivers. To compare the effects of cognitive training with those of other non-pharmacological interventions, including cognitive stimulation or rehabilitation. To identify and explore factors related to intervention and trial design that may be associated with the efficacy of cognitive training.Internal sources • Cochrane Incentive Award, UK. External sources • NIHR, UK. This protocol was supported by the National Institute for Health Research (NIHR), via Cochrane Incentive funding Cochrane to the Cochrane Dementia and Cognitive Improvement group. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, National Health Service or the Department of Health • National Health and Medical Research Council of Australia, Australi

Cognitive training for people with mild to moderate dementia (review)

This is the final version. Available from Cochrane Collaboration / Wiley via the DOI in this recordThe protocol version is in ORE at: http://hdl.handle.net/10871/33809Background Cognitive impairment, a defining feature of dementia, plays an important role in the compromised functional independence that characterises the condition. Cognitive training (CT) is an approach that uses guided practice on structured tasks with the direct aim of improving or maintaining cognitive abilities. Objectives To assess effects of CT on cognitive and non-cognitive outcomes for people with mild to moderate dementia and their caregivers. To compare effects of CT with those of other non-pharmacological interventions, including cognitive stimulation or rehabilitation, for people with mild to moderate dementia and their caregivers. To identify and explore factors related to intervention and trial design that may be associated with the efficacy of CT for people with mild to moderate dementia and their caregivers. Search methods We searched ALOIS, the Cochrane Dementia and Cognitive ImprovementGroup Specialised Register, on 5 July 2018. ALOIS contains records of clinical trials identified through monthly searches of several major healthcare databases and numerous trial registries and grey literature sources. In addition to this, we searched MEDLINE, Embase, PsycINFO, CINAHL, LILACS, Web of Science Core Collection, ClinicalTrials.gov, and the World Health Organization's trials portal, ICTRP, to ensure that searches were comprehensive and up-to-date. Selection criteria We included randomised controlled trials (RCTs) that described interventions for peoplewithmild tomoderate dementia and compared CT versus a control or alternative intervention. Data collection and analysis We extracted relevant data from published manuscripts and through contact with trial authors if required.We assessed risk of bias using the Cochrane 'Risk of bias' tool.We divided comparison conditions into active or passive control conditions and alternative treatments. We used a large number of measures and data to evaluate 19 outcomes at end of treatment, as well as 16 outcomes at follow-up in the medium term; we pooled this information in meta-analyses. We calculated pooled estimates of treatment effect using a random-effects model, and we estimated statistical heterogeneity using a standard Chi statistic. We graded the evidence using GradePro. Main results The 33 included trials were published between 1988 and 2018 and were conducted in 12 countries; most were unregistered, parallelgroup, single-site RCTs, with samples ranging from 12 to 653 participants. Interventions were between two and 104 weeks long. We classified most experimental interventions as 'straight CT', but we classified some as 'augmented CT', and about two-thirds as multi-domain interventions. Researchers investigated 18 passive and 13 active control conditions, along with 15 alternative treatment conditions, including occupational therapy, mindfulness, reminiscence therapy, and others. The methodological quality of studies varied, but we rated nearly all studies as having high or unclear risk of selection bias due to lack of allocation concealment, and high or unclear risk of performance bias due to lack of blinding of participants and personnel. We used data from 32 studies in the meta-analysis of at least one outcome. Relative to a control condition, we found moderate-quality evidence showing a small to moderate effect of CT on our first primary outcome, composite measure of global cognition at end of treatment (standardised mean difference (SMD) 0.42, 95% confidence interval (CI) 0.23 to 0.62), and high-quality evidence showing a moderate effect on the secondary outcome of verbal semantic fluency (SMD 0.52, 95% CI 0.23 to 0.81) at end of treatment, with these gains retained in the medium term (3 to 12 months post treatment). In relation to many other outcomes, including our second primary outcome of clinical disease severity in the medium term, the quality of evidence was very low, so we were unable to determine whether CT was associated with any meaningful gains. When compared with an alternative treatment, we found that CT may have little to no effect on our first primary outcome of global cognition at end of treatment (SMD 0.21, 95% CI-0.23 to 0.64), but the quality of evidence was low. No evidence was available to assess our second primary outcome of clinical disease severity in the medium term.We found moderate-quality evidence showing that CT was associated with improved mood of the caregiver at end of treatment, but this was based on a single trial. The quality of evidence in relation to many other outcomes at end of treatment and in the medium term was too low for us to determine whether CT was associated with any gains, but we are moderately confident that CT did not lead to any gains in mood, behavioural and psychological symptoms, or capacity to perform activities of daily living. Authors' conclusions Relative to a control intervention, but not to a variety of alternative treatments, CT is probably associated with small to moderate positive effects on global cognition and verbal semantic fluency at end of treatment, and these benefits appear to be maintained in the medium term. Our certainty in relation to many of these findings is low or very low. Future studies should take stronger measures to mitigate well-established risks of bias, and should provide long-term follow-up to improve our understanding of the extent to which observed gains are retained. Future trials should also focus on direct comparison of CT versus alternative treatments rather than passive or active control conditions.National Institute for Health Research (NIHR)National Health and Medical Research Council of Australi

Introduction: Social Protection for Social Justice

The articles in this IDS Bulletin are drawn from a conference hosted by the Centre for Social Protection at the Institute of Development Studies (IDS), Brighton, UK, in April 2011. The conference brought together academics and practitioners who understand social protection to be more than a palliative agenda for alleviating poverty and vulnerability, believing instead that social protection should be fundamentally interested in realising economic and social rights for all. This alternative agenda is one grounded in social justice, and it opens space for understanding how issues of rights, governance, distribution and access are critical for breaking the production and reproduction of vulnerability over time. The selection of articles in this IDS Bulletin aims to elaborate the linkages between social protection and social justice, to identify opportunities for operationalising the ‘transformative’ aspects of social protection and to strengthen the case for integrating social protection into broader social policy

The inflammatory microenvironment in colorectal neoplasia

Peer reviewedPublisher PD

Colposcopy attendance and deprivation: A retrospective analysis of 27 193 women in the NHS Cervical Screening Programme

This study is funded by a grant from the UK Department of Health (no. 106/0001). ED and NM are supported by the Policy Research Unit in Cancer Awareness, Screening, and Early Diagnosis. The Policy Research Unit receives funding for a research programme from the Department of Health Policy Research Programme. It is a collaboration between researchers from seven institutions (Queen Mary University of London, University College London, King’s College London, London School of Hygiene and Tropical Medicine, Hull York Medical School, Durham University and Peninsula Medical School)

Blood pressure and cholesterol level checks as dynamic interrelated screening examinations

This study analysed the determinants of screening uptake for blood pressure and cholesterol level checks. Furthermore, it investigated the presence of possible spillover effects from one type of cardiovascular screening to another type of cardiovascular screening. A dynamic random effects bivariate panel probit model with initial conditions (Wooldridge-type estimator) was adopted for the estimation. The outcome variables were the participation in blood pressure and cholesterol level checks by individuals in a given year. The balanced panel sample of 21,138 observations was constructed from 1,626 individuals from the British Household Panel Survey (BHPS) between 1996 and 2008. The analysis showed the significance of past screening behaviour for both cardiovascular screening examinations. For both cardiovascular screening examinations state dependence exist. The study also shows a significant spillover effect of the cholesterol level check on the blood pressure check and vice versa. Also a poorer health status led to a higher uptake for both types of screening examinations. Changes in recommendations have to consider the fact that taking part in one type of cardiovascular screening examination can influence the decision to take part in the other type of cardiovascular screening examination

Predicting the recipients of social work support and its impact on emotional and behavioural problems in early childhood

This paper examines the recipients of social work support in the Millennium Cohort Study. Using panel analysis and fixed effects models it investigates the factors that lead to the receipt of any type of social work support for individuals with young children, and the effects of this support on changes in the prevalence of emotional and behavioural problems in these children. We find that divorce or separation, and episodes of homelessness are two important factors that lead to the receipt of social work support. Mothers with male children are also more likely to receive social work support. However, we find no clear evidence that social work support has any effect on changes in children’s emotional and behavioural problems over time. The implications of these findings for social work research, and for practice and policy are discussed

Discovery and Validation of Molecular Biomarkers for Colorectal Adenomas and Cancer with Application to Blood Testing

BACKGROUND & AIMS: Colorectal cancer incidence and deaths are reduced by the detection and removal of early-stage, treatable neoplasia but we lack proven biomarkers sensitive for both cancer and pre-invasive adenomas. The aims of this study were to determine if adenomas and cancers exhibit characteristic patterns of biomarker expression and to explore whether a tissue-discovered (and validated) biomarker is differentially expressed in the plasma of patients with colorectal adenomas or cancer. METHODS: Candidate RNA biomarkers were identified by oligonucleotide microarray analysis of colorectal specimens (222 normal, 29 adenoma, 161 adenocarcinoma and 50 colitis) and validated in a previously untested cohort of 68 colorectal specimens using a custom-designed oligonucleotide microarray. One validated biomarker, KIAA1199, was assayed using qRT-PCR on plasma extracted RNA from 20 colonoscopy-confirmed healthy controls, 20 patients with adenoma, and 20 with cancer. RESULTS: Genome-wide analysis uncovered reproducible gene expression signatures for both adenomas and cancers compared to controls. 386/489 (79%) of the adenoma and 439/529 (83%) of the adenocarcinoma biomarkers were validated in independent tissues. We also identified genes differentially expressed in adenomas compared to cancer. KIAA1199 was selected for further analysis based on consistent up-regulation in neoplasia, previous studies and its interest as an uncharacterized gene. Plasma KIAA1199 RNA levels were significantly higher in patients with either cancer or adenoma (31/40) compared to neoplasia-free controls (6/20). CONCLUSIONS: Colorectal neoplasia exhibits characteristic patterns of gene expression. KIAA1199 is differentially expressed in neoplastic tissues and KIAA1199 transcripts are more abundant in the plasma of patients with either cancer or adenoma compared to controls