866 research outputs found
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<sup>-4 </sup>in 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
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