Trafficking and Human Rights in Nepal: Community Perceptions and Policy and Program Responses

This report from the Population Council's Horizons program summarizes the policy analysis, documentation of current intervention models, and community-based study of trafficking in the context of an emerging HIV/AIDS epidemic in Nepal

Levonorgestrel-releasing intrauterine system vs. usual medical treatment for menorrhagia: An economic evaluation alongside a randomised controlled trial

Objective: To undertake an economic evaluation alongside the largest randomised controlled trial comparing Levonorgestrel-releasing intrauterine device ('LNG-IUS') and usual medical treatment for women with menorrhagia in primary care; and compare the cost-effectiveness findings using two alternative measures of quality of life. Methods: 571 women with menorrhagia from 63 UK centres were randomised between February 2005 and July 2009. Women were randomised to having a LNG-IUS fitted, or usual medical treatment, after discussing with their general practitioner their contraceptive needs or desire to avoid hormonal treatment. The treatment was specified prior to randomisation. For the economic evaluation we developed a state transition (Markov) model with a 24 month follow-up. The model structure was informed by the trial women's pathway and clinical experts. The economic evaluation adopted a UK National Health Service perspective and was based on an outcome of incremental cost per Quality Adjusted Life Year (QALY) estimated using both EQ-5D and SF-6D. Results: Using EQ-5D, LNG-IUS was the most cost-effective treatment for menorrhagia. LNG-IUS costs £100 more than usual medical treatment but generated 0.07 more QALYs. The incremental cost-effectiveness ratio for LNG-IUS compared to usual medical treatment was £1600 per additional QALY. Using SF-6D, usual medical treatment was the most cost-effective treatment. Usual medical treatment was both less costly (£100) and generated 0.002 more QALYs. Conclusion: Impact on quality of life is the primary indicator of treatment success in menorrhagia. However, the most costeffective treatment differs depending on the quality of life measure used to estimate the QALY. Under UK guidelines LNG-IUS would be the recommended treatment for menorrhagia. This study demonstrates that the appropriate valuation of outcomes in menorrhagia is crucial. Copyright: © 2014 Sanghera et al

Examining the effectiveness of technology use in classrooms: A tertiary meta-analysis

Identifying effective literacy instruction programs has been a focal point for governments, educators and parents over the last few decades (Ontario Ministry of Education, 2004, 2006; Council of Ontario Directors of Education, 2011). Given the increasing use of computer technologies in the classroom and in the home, a variety of information communication technology (ICT) interventions for learning have been introduced. Meta-analyses comparing the impact of these programs on learning, however, have yielded inconsistent findings (Andrews, Freeman, Hou, McGuinn, Robinson, & Zhu, 2007; Slavin, Cheung, Groff, & Lake, 2008; Slavin, Lake, Chambers, Cheung, & Davis, 2009; Torgerson & Zhu, 2003). The present tertiary meta-analytic review re-assesses outcomes presented in three previous meta-analyses. Four moderator variables assessed the impact of the systematic review from which they were retrieved, training and support, implementation fidelity and who delivered the intervention (teacher versus researcher). Significant results were found when training and support was entered as a moderator variable with the small overall effectiveness of the ICTs (ES = 0.18), similar to those found in previous research, increasing significantly (ES = 0.57). These findings indicate the importance of including implementation factors such as training and support, when considering the relative effectiveness of ICT interventions

General Practice in the Time of COVID-19: A Mixed-Methods Service Evaluation of a Primary Care COVID-19 Service

Primary care coronavirus disease 2019 (COVID-19) clinics were rapidly introduced across the UK to review potentially infectious patients. Evaluation of these services is needed to guide future implementation. This mixed-methods study evaluates patient demographics, clinical presentation, co-morbidities, service usage, and outcomes for the Islington COVID-19 service (London, UK) and from April to May 2020 and thematically analyses survey responses from 29 service clinicians and 41 GP referrers on their service experience. Of the 237 patients booked into the service, a significant number of referrals (n = 91; 38.6%) were made after the presumed infectious period of 14 days. Almost half of all adult referrals (49%) were dealt with remotely (via telephone/video consultation +/− remote oxygen saturation monitoring). The service was perceived to provide a safe way to see patients; it developed local expertise, learning, and empowerment; and it was a positive teamworking experience. These findings suggest that the management of many patients with COVID-19 symptoms is possible in routine general practice with minimal risk through the implementation of remote consultation methods and in patients who present after the post-infectious period. Additionally, the use of remote saturation monitoring and local GP COVID-19 “experts” can support practices to manage COVID-19 patients. Future primary care COVID-19 services should act as empowerment tools to assist GPs to safely manage their own patients and provide support for GPs in this process

Needs analysis report following the sexual exploitation of children in Rotherham

It has been an immense honour to listen to the experiences of the people of Rotherham. The project team received a warm welcome and felt humbled at the extraordinary courage of victims, survivors and their families. We wish to express our heartfelt thanks to everyone who took part in the study. The knowledge and opinions shared by our participants are the foundation of this report. No-one wants to think about what child sexual abuse and exploitation really means. Recognising that children have been humiliated, raped and tortured is extremely distressing. As such, it is no surprise that many felt anger and rage when they understood that those with authority failed to protect vulnerable children and young people. There is a need to face the awful reality that child sexual abuse has always happened. However, in the age of the internet, the number of children at risk of sexual abuse has increased. Those who sexually abuse children are mostly, but not always, men. Not discounting the vast number of boys who have suffered abuse, most of the known victims of sexual abuse are girls. Both victims and perpetrators come from every walk of life. The threat is such that we all have a responsibility to consider what we can do to protect every child in our family and communities. The public criticism of Rotherham Metropolitan Borough Council (RMBC) and South Yorkshire Police, following Professor Jay’s report was right and inevitable. Positively, there have been several examples of how RMBC and South Yorkshire Police have responded to criticism and improved the way they respond to victims and survivors. However, there have also been negative consequences of public scrutiny, with many people in the study reporting that they want to regain pride in their hometown. Those who took part in this study did not shy away from exploring the difficulties they face. Naturally, participants continue to talk about issues of trust, as past mistakes created a sense of vulnerability. However, there is also evidence that healing is taking place. Many participants made suggestions of how they and RMBC could and should collaborate to strengthen, individuals, families and their communities Indeed, there is a determination to meet current and future needs with a sense of collective rigour. Some of these tasks involve developing internal structures, such as communication and the provision of appropriate resources. Rotherham, like many other towns and cities in Britain, is also faced with external threats which can exacerbate internal challenges. An example of this is how recognition of the involvement of some men of Asian Pakistani heritage, in the abuse of children in Rotherham, led some political groups to capitalise on fears. However, it is clear that children are best protected in resilient families and communities. Thankfully, Rotherham and its people continue to demonstrate resilience. In addition, there is also a strong sense of realism, no-one in Rotherham expects perfection, but they do expect to do everything possible to protect children and young people. One woman made the distinction between surviving and thriving: “…I don’t want to survive, I want to thrive…” We hope this report contributes to that aim and welcome your views on the findings from data collected between April and June 2015. We recognise that the data is reflective of views expressed at that time and that RMBC and the people of Rotherham, have continued to respond to needs throughout the course of this analysis process

FIRST-based survey of Compact Steep Spectrum sources I. MERLIN images of arc-second scale objects

Compact Steep Spectrum (CSS) sources are powerful extragalactic radio sources with angular dimensions of the order of a few arcseconds or less. Such a compactness is apparently linked to the youth of these objects. The majority of CSSs investigated so far have been known since the early 1980s. This paper is the first in a series where we report the results of an observational campaign targeted on a completely new sample of CSSs which are significantly weaker than those investigated before. The ultimate goal of that campaign is to find out how ``weak'' CSSs compare to ``strong'', classical ones, especially with regard to the morphologies. Here we present an analysis of morphological and physical properties of five relatively large sources based on MERLIN observations at 1.6 and 5 GHz.Comment: 8 pages, 7 figures, A&A in pres

Variants in KCNQ1 increase type II diabetes susceptibility in South Asians: A study of 3,310 subjects from India and the US

<p>Abstract</p> <p>Background</p> <p>Polymorphisms in intron 15 of potassium voltage-gated channel, KQT-like subfamily member 1 (<it>KCNQ1</it>) gene have been associated with type II diabetes (T2D) in Japanese genome-wide association studies (GWAS). More recently a meta-analysis of European GWAS has detected a new independent signal associated with T2D in intron 11 of the <it>KCNQ1 </it>gene. The purpose of this investigation is to examine the role of these variants with T2D in populations of Asian Indian descent from India and the US.</p> <p>Methods</p> <p>We examined the association between four variants in the <it>KCNQ1 </it>gene with T2D and related quantitative traits in a total of 3,310 Asian Indian participants from two different cohorts comprising 2,431 individuals of the Punjabi case-control cohort from the Sikh Diabetes Study and 879 migrant Asian Indians living in the US.</p> <p>Results</p> <p>Our data confirmed the association of a new signal at the <it>KCNQ1 </it>locus (rs231362) with T2D showing an allelic odds ratio (OR) of 1.24 95%CI [1.08-1.43], p = 0.002 in the Punjabi cohort. A moderate association with T2D was also seen for rs2237895 in the Punjabi (OR 1.14; p = 0.036) and combined cohorts (meta-analysis OR 1.14; p = 0.018). Three-site haplotype analysis of rs231362, rs2237892, rs2237895 exhibited considerably stronger evidence of association of the GCC haplotype with T2D showing OR of 1.24 95%CI [1.00-1.53], p = 0.001, permutation p = 8 × 10^-4in combined cohorts. The 'C' risk allele carriers of rs2237895 had significantly reduced measures of HOMA-B in the US cohort (p = 0.008) as well as in combined cohort in meta-analysis (p = 0.009).</p> <p>Conclusions</p> <p>Our investigation has confirmed that the variation within the <it>KCNQ1 </it>locus confers a significant risk to T2D among Asian Indians. Haplotype analysis further suggested that the T2D risk associated with <it>KCNQ1 </it>SNPs may be derived from 'G' allele of rs231362 and 'C' allele of rs2237895 and this appears to be mediated through β cell function.</p

Data for 'Something in the way she moves': the functional significance of flexibility in the multiple roles of protein disulfide isomerase (PDI)

Protein disulfide isomerase (PDI) has diverse functions in the endoplasmic reticulum as catalyst of redox transfer, disulfide isomerization and oxidative protein folding, as molecular chaperone and in multi-subunit complexes. It interacts with an extraordinarily wide range of substrate and partner proteins, but there is only limited structural information on these interactions. Extensive evidence on the flexibility of PDI in solution is not matched by any detailed picture of the scope of its motion. A new rapid method for simulating the motion of large proteins provides detailed molecular trajectories for PDI demonstrating extensive changes in the relative orientation of its four domains, great variation in the distances between key sites and internal motion within the core ligand-binding domain. The review shows that these simulations are consistent with experimental evidence and provide insight into the functional capabilities conferred by the extensive flexible motion of PDI

Randomised feasibility study to compare the use of Therabite® with wooden spatulas to relieve and prevent trismus in patients with cancer of the head and neck.

201809 bcrcpublished_fina