Circulatory Disease in the NHS: Measuring Trends in Hospital Costs and Output

Following the publication of the Atkinson Review of the measurement of government outputs in the National Accounts, there has been great interest in measuring the productivity growth of the National Health Service. Such macro measures of productivity are important when deciding how much public money to devote to the NHS, and in holding the NHS to account. However, it is also important to gain an understanding of the productivity of individual programmes of care, so as to ensure that resources are allocated efficiently within the NHS. Hitherto, such information has not been available. This report is an exploratory study of the feasibility and usefulness of developing measures of growth in outputs, costs and productivity of a single programme of care within the NHS: hospital treatment of circulatory diseases.

Exploring the impact of public services on quality of life indicators

The fundamental aim of public services is to improve the quality of life of citizens. The main objective of this study was to investigate the influence of public service organisations (PSOs) on aspects of quality of life (broadly measured) of citizens at a local level. We assembled a rich database using 20 of the 45 quality of life measures developed by the Audit Commission. Those we selected covered broad areas of quality of life such as safety, housing, health, education, and transport and were available at ‘small area’ level. We used a range of advanced statistical methods to analyse the relationships between PSOs and quality of life measures at different hierarchical levels. The techniques were selected to be robust when making comparisons between levels and when looking at associations between quality of life measures. Our descriptive analyses (bivariate correlations, factor analysis and ANOVA) suggested overall some significant correlations between some of the quality of life variables. The SUR model results also indicated that the quality of life indicators are correlated, and therefore that we should look at these measures in a joint modelling approach such as MVML, as envisaged in the study objectives.

Localization and Function of GABA Transporters GAT-1 and GAT-3 in the Basal Ganglia

GABA transporter type 1 and 3 (GAT-1 and GAT-3, respectively) are the two main subtypes of GATs responsible for the regulation of extracellular GABA levels in the central nervous system. These transporters are widely expressed in neuronal (mainly GAT-1) and glial (mainly GAT-3) elements throughout the brain, but most data obtained so far relate to their role in the regulation of GABAA receptor-mediated postsynaptic tonic and phasic inhibition in the hippocampus, cerebral cortex and cerebellum. Taking into consideration the key role of GABAergic transmission within basal ganglia networks, and the importance for these systems to be properly balanced to mediate normal basal ganglia function, we analyzed in detail the localization and function of GAT-1 and GAT-3 in the globus pallidus of normal and Parkinsonian animals, in order to further understand the substrate and possible mechanisms by which GABA transporters may regulate basal ganglia outflow, and may become relevant targets for new therapeutic approaches for the treatment of basal ganglia-related disorders. In this review, we describe the general features of GATs in the basal ganglia, and give a detailed account of recent evidence that GAT-1 and GAT-3 regulation can have a major impact on the firing rate and pattern of basal ganglia neurons through pre- and post-synaptic GABAA- and GABAB-receptor-mediated effects

La eficiencia del uso del agua disminuye durante la senescencia de las hojas en otoño en tres especies de árboles de hoja caduca

During fall leaf senescence in deciduous species, photosynthesis nears completion due to chlorophyll breakdown and re-assimilation. However, several other processes such as leaf nutrient uptake, re-translocation, and storage, or tissue dehydration to avoid frost damage, may be important and dependent upon stomatal opening. We report here on measured changes in photosynthesis (A), leaf conductance to water vapor (g), and WUE (estimated by A/g) in three deciduous tree species (Acer saccharum, Cornus florida, and Ginkgo biloba) during the weeks of leaf senescence preceding abscission. Substantial decreases in A of 60 up to 80% were not matched quantitatively by similar declines in g (40 to 70%), resulting in corresponding decreases in WUE (estimated by A/g) from near 50% to over 300% among the three species. This shift to a lower WUE may reflect adaptive value in maintaining a higher g relative to A during the fall leaf senescence period

A Biological and Ethical Comparison of Birth Plans: Literature Review

The purpose of our study was to investigate the current literature surrounding birth methods and outcomes. This study compared the medical outcomes across different birth plans including physician-assisted in-hospital births, midwife-assisted births, and home births. The differences found among birth plans vary in risk profile across race and ethnicity. The studies used suggest non-white persons disproportionately experience birth complications, while their white counterparts are more likely to utilize midwife services and have lower rates of poor outcomes. This distinction can be due to the socioeconomic disadvantages met within gynecological resources available for persons of color, in addition to the financial burden associated with creating a birth plan. These facts are for research purposes only, and are not to advocate for or against different birthing methods

The Effects of Foam Rolling on Flexibility

Studies have conflicting research based on whether foam rolling shows a significant difference in flexibility with the lower extremities. PURPOSE: To determine if there will be a significant difference in flexibility when using a foam roller compared to a five minute walk. METHODS: On the initial visit 14 participants self-reported their age, weight, and height, and then had their baseline flexibility assessed. Treatment conditions consisted of: 1) using a foam roller on the hamstrings, quadriceps, calves, and lower back, and 2) walking on a treadmill for five minutes. After each session, participant’s flexibility was measured three times with the Sit and Reach test. SPSS(V23) was used to conduct a repeated measures ANOVA to explore the difference in flexibility between the trials. The alpha was set at .05. RESULTS: A Repeated Measures ANOVA indicated a significant difference existed among the three levels of flexibility, F(2, 14) = 15.6, p = .001. Pairwise comparisons indicate a significant increase in flexibility after foam rolling compared to walking (+2.29 cm, p = .003) and baseline (+3.81 cm, p = .001). CONCLUSION: This study suggests that foam rolling is a better means to acutely increase flexibility compared to walking, therefore the predicted hypothesis that there will be a significant difference in lower body flexibility when using foam rolling compared to a five minute walk was accepted

The mouse anterior chamber angle and trabecular meshwork develop without cell death

BACKGROUND: The iridocorneal angle forms in the mammalian eye from undifferentiated mesenchyme between the root of the iris and cornea. A major component is the trabecular meshwork, consisting of extracellular matrix organized into a network of beams, covered in trabecular endothelial cells. Between the beams, channels lead to Schlemm's canal for the drainage of aqueous humor from the eye into the blood stream. Abnormal development of the iridocorneal angle that interferes with ocular fluid drainage can lead to glaucoma in humans. Little is known about the precise mechanisms underlying angle development. There are two main hypotheses. The first proposes that morphogenesis involves mainly cell differentiation, matrix deposition and assembly of the originally continuous mesenchymal mass into beams, channels and Schlemm's canal. The second, based primarily on rat studies, proposes that cell death and macrophages play an important role in forming channels and beams. Mice provide a potentially useful model to understand the origin and development of angle structures and how defective development leads to glaucoma. Few studies have assessed the normal structure and development of the mouse angle. We used light and electron microscopy and a cell death assay to define the sequence of events underlying formation of the angle structures in mice. RESULTS: The mouse angle structures and developmental sequence are similar to those in humans. Cell death was not detectable during the period of trabecular channel and beam formation. CONCLUSIONS: These results support morphogenic mechanisms involving organization of cellular and extracellular matrix components without cell death or atrophy