823 research outputs found
Exploring the Use of Cost-Benefit Analysis to Compare Pharmaceutical Treatments for Menorrhagia
Background: The extra-welfarist theoretical framework tends to focus on health-related quality of life, whilst the welfarist framework captures a wider notion of well-being. EQ-5D and SF-6D are commonly used to value outcomes in chronic conditions with episodic symptoms, such as heavy menstrual bleeding (clinically termed menorrhagia). Because of their narrow-health focus and the condition’s periodic nature these measures may be unsuitable. A viable alternative measure is willingness to pay (WTP) from the welfarist framework. Objective: We explore the use of WTP in a preliminary cost-benefit analysis comparing pharmaceutical treatments for menorrhagia.
Methods: A cost-benefit analysis was carried out based on an outcome of WTP. The analysis is based in the UK primary care setting over a 24-month time period, with a partial societal perspective. Ninety-nine women completed a WTP exercise from the ex-ante (pre-treatment/condition) perspective. Maximum average WTP values were elicited for two pharmaceutical treatments, levonorgestrel-releasing intrauterine system (LNG-IUS) and oral treatment. Cost data were offset against WTP and the net present value derived for treatment. Qualitative information explaining the WTP values was also collected.
Results: Oral treatment was indicated to be the most cost-beneficial intervention costing £107 less than LNG-IUS and generating £7 more benefits. The mean incremental net present value for oral treatment compared with LNG-IUS was £113. The use of the WTP approach was acceptable as very few protests and non-responses were observed. Conclusion: The preliminary cost-benefit analysis results recommend oral treatment as the first-line treatment for menorrhagia. The WTP approach is a feasible alternative to the conventional EQ-5D/SF-6D approaches and offers advantages by capturing benefits beyond health, which is particularly relevant in menorrhagia
The Indian family on UK reality television: Convivial culture in salient contexts
This is the author's accepted manuscript. The final published article is available from the link below, copyright 2012 @ the author.This article demonstrates how The Family (2009), a fly-on-the wall UK reality series about a British Indian family, facilitates both current public service broadcasting requirements and mass audience appeal. From a critical cultural studies perspective, the author examines the journalistic and viewer responses to the series where authenticity, universality, and comedy emerge as major themes. Textual analysis of the racialized screen representations also helps locate the series within the contexts of contested multiculturalism, genre developments in reality television and public service broadcasting. Paul Gilroy’s concept of convivial culture is used as a frame in understanding how meanings of the series are produced within a South Asian popular representational space. The author suggests that the social comedy taxonomy is a prerequisite for the making of this particular observational documentary. Further, the popular (comedic) mode of conviviality on which the series depends is both expedient and necessary within the various sociopolitical contexts outlined
Maternally expressed, paternally imprinted, embryonic non-coding RNA are expressed in osteosarcoma, Ewing sarcoma and spindle cell sarcoma
In a human embryo it takes 8 weeks after fertilisation for the skeleton to begin to form, one of the last organs to develop before becoming a foetus. Mesenchymal progenitors, derived from neural crest cells, differentiate into chondrocytes where the skeleton is generated as a mostly cartilage template. Other mesenchymal progenitors envelop the template, activate runt related transcription factor 2 (RUNX2) and bone morphogenetic protein 2 (BMP2) and differentiate into osteoblasts, where an osteoid matrix is secreted and subsequently mineralised to become bone.1 During development and up to late adolescence, cellular proliferation enabling skeletal growth is restricted to the metaphysis and epiphyseal line or “growth plate”. It is in the growth plate of long bones where most bone cancers develop, hence the predominantly childhood incidence of the cancer. Primitive mesenchymal cells undergo transformation to form a heterogeneous group of bone malignancies. The most common type of bone cancer in children is osteosarcoma, mostly initiated by tumour protein p53 (TP53) mutations. The second most common type of bone cancer in children is Ewing sarcoma, mostly initiated by a EWS RNA binding protein 1-Fli-1 proto-oncogene, ETS transcription factor (EWSR1-FLI1) fusion. There are an average of 160 and 55 new cases of osteosarcoma and Ewing sarcoma, respectively, every year in the UK. Five-year survival for both cancer types is 50% when diagnosed early. Five-year survival is 15% when lung metastases are present at diagnosis. Treatment progress for bone cancer is poor when compared to other cancers such as breast where there is a twenty-year survival of 70%. Bone cancer requires extensive and sometimes disabling multimodal treatment. Chemotherapy for osteosarcoma includes methotrexate, cisplatin and doxorubicin, which were developed in the 1940’s and 1970’s. Chemotherapy for Ewing sarcoma includes vincristine, ifosfamide and etoposide, which were developed in the 1960’s and 1980’s. If the tumour responds well to chemotherapy and radiotherapy, wide area resection or amputation is performed. New understanding of bone cancer biology leading to better diagnosis and better treatments is required
Optimizing countershading camouflage
Countershading, the widespread tendency of animals to be darker on the side that receives strongest illumination, has classically been explained as an adaptation for camouflage: obliterating cues to 3D shape and enhancing background matching. However, there have only been two quantitative tests of whether the patterns observed in different species match the optimal shading to obliterate 3D cues, and no tests of whether optimal countershading actually improves concealment or survival. We use a mathematical model of the light field to predict the optimal countershading for concealment that is specific to the light environment and then test this prediction with correspondingly patterned model “caterpillars” exposed to avian predation in the field. We show that the optimal countershading is strongly illumination-dependent. A relatively sharp transition in surface patterning from dark to light is only optimal under direct solar illumination; if there is diffuse illumination from cloudy skies or shade, the pattern provides no advantage over homogeneous background-matching coloration. Conversely, a smoother gradation between dark and light is optimal under cloudy skies or shade. The demonstration of these illumination-dependent effects of different countershading patterns on predation risk strongly supports the comparative evidence showing that the type of countershading varies with light environment
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
VLBA polarimetric observations of the CSS quasar 3C147
Aims. We report new VLBA polarimetric observations of the compact
steep-spectrum (CSS) quasar 3C147 (B0538+498) at 5 and 8.4GHz.
Methods. By using multifrequency VLBA observations, we derived
milliarcsecond-resolution images of the total intensity, polarisation, and
rotation measure distributions, by combining our new observations with archival
data.
Results. The source shows a one-sided structure, with a compact region, and a
component extending about 200 mas to the south-west. The compact region is
resolved into two main components with polarised emission, a complex rotation
measure distribution, and a magnetic field dominated by components
perpendicular to the source axis.
Conclusions. By considering all the available data, we examine the possible
location of the core component, and discuss two possible interpretations of the
observed structure of this source: core-jet and lobe-hot spot. Further
observations to unambiguously determine the location of the core would help
distinguish between the two possibilities discussed here.Comment: 11 pages, 12 figure
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