An evaluation of the Psychosocial Impact of Assistive Devices Scale

The West Midlands Rehabilitation Centre (WMRC) is responsible for the National Health Service provision and maintenance of Environmental Control Equipment to patients across the West Midlands Region, England. It is important to measure outcome of provision using a paradigm that has meaning for those patients. The Psychosocial Impact of Assistive Devices Scale is a 26-item, self-rating questionnaire designed to measure user perceptions of how assistive devices affect quality of life. This outcome measure is being evaluated in the West Midland

Appropriate Perspectives for Health Care Decisions

NICE uses cost-effectiveness analysis to compare the health benefits expected to be gained by using a technology with the health that is likely to be forgone due to additional costs falling on the health care budget and displacing other activities that improve health. This approach to informing decisions will be appropriate if the social objective is to improve health, the measure of health is adequate and the budget for health care can reasonably be regarded as fixed. If NICE were to recommend a broader =societal perspective‘, wider effects impacting on other areas of the public sector and the wider economy would be formally incorporated into analyses and decisions. The problem for policy is that, in the face of budgets legitimately set by government, it is not clear how or whether a societal perspective can be implemented, particularly if transfers between sectors are not possible. It poses the question of how the trade-offs between health, consumption and other social arguments, as well as the valuation of market and non market activities, ought to be undertaken.Perspective. Cost-effectiveness analysis. Economic evaluation.

Mortality from infectious pneumonia in metal workers: a comparison with deaths from asthma in occupations exposed to respiratory sensitizers

Introduction: national analyses of mortality in England and Wales have repeatedly shown excess deaths from pneumonia in welders. During 1979-1990 the excess was attributable largely to deaths from lobar pneumonia and pneumonias other than bronchopneumonia, limited to working-aged men, and apparent in other metal fume-exposed occupations. We assessed findings for 1991-2000 and compared the mortality pattern with that from asthma in occupations exposed to known respiratory sensitizers.Methods: the Office of National Statistics supplied data on deaths by underlying cause among men aged 16-74 years in England and Wales during 1991-2000, including age and last held occupation. We abstracted data on pneumonia for occupations with exposure to metal fume and on asthma for occupations commonly reported to surveillance schemes as at risk of occupational asthma. We estimated expected numbers of deaths by applying age-specific proportions of deaths by cause in the population to the total deaths by age in each occupational group. Observed and expected numbers were compared for each cause of death.Results: among working-aged men in metal fume-exposed occupations we found excesses of mortality from pneumococcal and lobar pneumonia (54 deaths vs. 27.3 expected) and from pneumonias other than bronchopneumonia (71 vs. 52.4), but no excess from these causes at older ages, or from bronchopneumonia at any age. The attributable mortality from metal fume (45.3 excess deaths) compared with an estimated 62.6 deaths from occupational asthma.Conclusion: exposure to metal fume is a material cause of occupational mortality. The hazard deserves far more attention than it presently receive

Electroanalytical sensors using lipophilic cyclodextrins

Lipophilic dialkylated-a-, β- and γ-cyclodextrin derivatives were used as selective ionophores for a series of clinically relevant ammonium ions, and as enantioselective ionophores for both a- and β-aryl ammonium ions. Sensitive and selective potentiometric detection of the local anaesthetics lidocaine and bupivacaine was achieved by using 2,3,6 trioctyl-β-cyclodextrin as the ionophore, leading to micromolar detection limits. Interference studies showed that the simulated clinical electrolyte background caused minimal interference whereas organic interferents of similar size and charge caused some perturbation of the electrode response at a concentration of 10 mmol dm(^-3). An electrode comprising a plasticized biocompatible membrane matrix, TECOFLEX, with 2,6 didodecyl-β-cyclodextrin was incorporated in a flow injection analysis system and the response to lidocaine studied in the presence of human serum. Human serum caused no adverse effects to the electrochemical response of the electrode. These electrodes are, therefore, very suitable for on-line detection of local anaesthetics. Potentiometric detection of tricyclic antidepressants using didodecyl-a-, β- and γ- cyclodextrins as the ionophore, gave micromolar detection limits. Interference from simulated clinical electiolyte background and selected organic interferents gave similar results to those discussed above. In order to lower the detection limit to sub-nanomolar levels modified amperometric electrodes were assembled by depositing a membrane comprising plasticised TECOFLEX, 2,3,6 triethyl-β-cyclodextrin and TKB on the working electrode of a screen printed electrode. Lipophilic 2,6 didodecyl-a- and β-cyclodextrins exhibited enantiomeric discrimination in the binding of propranolol, ephedrine, amphetamine and methamphetamine. These results were confirmed using potentiometric and NMR techniques

Developing professionalism in new IT graduates? Who needs it?

A new graduate may require a period of ‘acclimatisation’ through a process of ‘developing their professionalism’ to fit into their work environment. The e-Skills UK Technology Counts Insights 2010 report suggests that 110,500 new entrants a year are required to fill IT & Telecoms professional job roles, with 20,800 coming from education (predominantly graduate level and higher). However, 43% of recruiters were reporting a lack of suitable candidates for IT & Telecoms posts where growing importance will be placed on relationship management, business process analysis and design, project and programme management. IT & Telecoms professionals are increasingly expected to be multi-skilled, with sophisticated business and interpersonal skills as well as technical competence. As the report also says: ‘UK growth will continue to be primarily in high-value roles with an increasing need for customer and business-oriented skills as well as sophisticated technical competencies.’ The diverse needs and requirements of the IT sector, as specified by various employer groups and professional bodies including BCS, IET, eSkills, the CBI and the SFIA Foundation, are discussed. According to the CBI, ‘62% of entrants to the IT sector need to draw on managerial and professional business skills almost immediately.’ For organisations to succeed, their IT graduate recruits must supplement their IT skills with managerial and professional business skills. Well considered CPD will ensure that recent graduates can enhance their ‘academic’ skills with the necessary work-based skills for the benefit of both themselves and their new employer. The focus of the improvement will balance the student-centred needs for development and the engaging employer’s commercial needs

Session E8: Can We Measure Cumulative Effects of Hydro-Power on Migratory Fish? Development of a Cumulative Effects Model Framework

Abstract: The Environment Agency provides guidance for run-of-river hydropower schemes in England, but concerns about small effects from multiple single schemes led to a project to determine how these can be assessed and to test an approach on migratory fish populations. We developed a model to assess the impact of multiple hydropower schemes. The model forecasts catchment-scale cumulative effects using three elements: hydropower scheme, spatial fish population and fish life cycle. The scheme element includes effects that are important to migratory fish and those that can be quantified. These are: 1) impediment to up- and downstream migration; 2) alleviation of up- and downstream impediment (e.g. fish pass installation); 3) impingement and entrainment; 4) habitat loss to freshwater stages (via a depleted reach). The model can be modified to include other effects if new research is able to provide better quantification, for example on migration delay causes by barriers. The spatial population element was developed by applying reference juvenile density values to the wetted area of the river network using Atlantic salmon as a demonstration species. The scheme effects element was then applied to the spatial population element, enabling the salmon population upstream of the scheme, and (via the life-cycle element) returning adults to be quantified and associated scheme benefits / dis-benefits to be applied. The sequential evaluation of multiple schemes in this way allowed assessment of cumulative effects. A number of hypothetical scenarios confirm that cumulative effects (positive, neutral or negative) were possible. The extent of effects was dependant on scheme location, the combined net benefit / dis-benefit of all schemes and the population status. The model results are sensitive to the precision and accuracy with which we are able to quantify barrier passability to fish and fish pass efficiencies, both of which can be hard to quantify with confidence

A technique for constructing a DNA library encoding a structurally diverse repertoire of constrained peptides

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN024344 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Family history of prostate and colorectal cancer and risk of colorectal cancer in the Women's health initiative.

BackgroundEvidence suggests that risk of colorectal and prostate cancer is increased among those with a family history of the same disease, particularly among first-degree relatives. However, the aggregation of colorectal and prostate cancer within families has not been well investigated.MethodsAnalyses were conducted among participants of the Women's Health Initiative (WHI) observational cohort, free of cancer at the baseline examination. Subjects were followed for colorectal cancer through August 31st, 2009. A Cox-proportional hazards regression modeling approach was used to estimate risk of colorectal cancer associated with a family history of prostate cancer, colorectal cancer and both cancers among first-degree relatives of all participants and stratified by race (African American vs. White).ResultsOf 75,999 eligible participants, there were 1122 colorectal cancer cases diagnosed over the study period. A family history of prostate cancer alone was not associated with an increase in colorectal cancer risk after adjustment for confounders (aHR =0.94; 95% CI =0.76, 1.15). Separate analysis examining the joint impact, a family history of both colorectal and prostate cancer was associated with an almost 50% increase in colorectal cancer risk (aHR = 1.48; 95% CI = 1.04, 2.10), but similar to those with a family history of colorectal cancer only (95% CI = 1.31; 95% CI = 1.11, 1.54).ConclusionsOur findings suggest risk of colorectal cancer is increased similarly among women with colorectal cancer only and among those with both colorectal and prostate cancer diagnosed among first-degree family members. Future studies are needed to determine the relative contribution of genes and shared environment to the risk of both cancers