Estimating the incidence, prevalence and true cost of asthma in the UK: secondary analysis of national stand-alone and linked databases in England, Northern Ireland, Scotland and Wales-a study protocol.

INTRODUCTION: Asthma is now one of the most common long-term conditions in the UK. It is therefore important to develop a comprehensive appreciation of the healthcare and societal costs in order to inform decisions on care provision and planning. We plan to build on our earlier estimates of national prevalence and costs from asthma by filling the data gaps previously identified in relation to healthcare and broadening the field of enquiry to include societal costs. This work will provide the first UK-wide estimates of the costs of asthma. In the context of asthma for the UK and its member countries (ie, England, Northern Ireland, Scotland and Wales), we seek to: (1) produce a detailed overview of estimates of incidence, prevalence and healthcare utilisation; (2) estimate health and societal costs; (3) identify any remaining information gaps and explore the feasibility of filling these and (4) provide insights into future research that has the potential to inform changes in policy leading to the provision of more cost-effective care. METHODS AND ANALYSIS: Secondary analyses of data from national health surveys, primary care, prescribing, emergency care, hospital, mortality and administrative data sources will be undertaken to estimate prevalence, healthcare utilisation and outcomes from asthma. Data linkages and economic modelling will be undertaken in an attempt to populate data gaps and estimate costs. Separate prevalence and cost estimates will be calculated for each of the UK-member countries and these will then be aggregated to generate UK-wide estimates. ETHICS AND DISSEMINATION: Approvals have been obtained from the NHS Scotland Information Services Division's Privacy Advisory Committee, the Secure Anonymised Information Linkage Collaboration Review System, the NHS South-East Scotland Research Ethics Service and The University of Edinburgh's Centre for Population Health Sciences Research Ethics Committee. We will produce a report for Asthma-UK, submit papers to peer-reviewed journals and construct an interactive map

Does digital video enhance student learning in field-based experiments and develop graduate attributes beyond the classroom?

This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Geography in Higher Education on 02/05/2016, available online: http://www.tandfonline.com/doi/full/10.1080/03098265.2016.1141186?src=recsysThe connection between fieldwork and development of graduate attributes is explored in this paper. Digital technologies present opportunities to potentially enhance the learning experience of students undertaking fieldwork, and develop core digital attributes and competencies required by Higher Education Institutions (HEIs) and employers. This paper reports the success of adopting digital video capture in technology-rich field experiments that form part of final year undergraduate courses in Physical Geography at an HEI in New Zealand. Student perceptions were obtained via a range of approaches. Results suggest that deployment of digital video reinforces student learning and connects with core graduate attributes

Revitalising audit and feedback to improve patient care

Healthcare systems face challenges in tackling variations in patient care and outcomes. Audit and feedback aim to improve patient care by reviewing clinical performance against explicit standards and directing action towards areas not meeting those standards. It is a widely used foundational component of quality improvement, included in around 60 national clinical audit programmes in the United Kingdom. Ironically, there is currently a gap between what audit and feedback can achieve and what they actually deliver, whether led locally or nationally. Several national audits have been successful in driving improvement and reducing variations in care, such as for stroke and lung cancer, but progress is also slower than hoped for in other aspects of care (table 1). Audit and feedback have a chequered past.6 Clinicians might feel threatened rather than supported by top-down feedback and rightly question whether rewards outweigh efforts invested in poorly designed audit. Healthcare organisations have limited resources to support and act on audit and feedback. Dysfunctional clinical and managerial relationships undermine effective responses to feedback, particularly when it is not clearly part of an integrated approach to quality assurance and improvement. Unsurprisingly, the full potential of audit and feedback has not been realised

Formal Modelling for Ada Implementations: Tasking Event-B

This paper describes a formal modelling approach, where Ada code is automatically generated from the modelling artefacts. We introduce an implementation-level specification, Tasking Event-B, which is an extension to Event-B. Event-B is a formal method, that can be used to model safety-, and business-critical systems. The work may be of interest to a section of the Ada community who are interested in applying formal modelling techniques in their development process, and automatically generating Ada code from the model. We describe a streamlined process, where the abstract modelling artefacts map easily to Ada language constructs. Initial modelling takes place at a high level of abstraction. We then use refinement, decomposition, and finally implementation-level annotations, to generate Ada code. We provide a brief introduction to Event-B, before illustrating the new approach using small examples taken from a larger case study

Mesoscopic Superconducting Disc with Short-Range Columnar Defects

Short-range columnar defects essentially influence the magnetic properties of a mesoscopic superconducting disc.They help the penetration of vortices into the sample, thereby decrease the sample magnetization and reduce the upper critical field. Even the presence of weak defects split a giant vortex state (usually appearing in a clean disc in the vicinity of the transition to a normal state) into a number of vortices with smaller topological charges. In a disc with a sufficient number of strong enough defects vortices are always placed onto defects. The presence of defects lead to the appearance of additional magnetization jumps related to the redistribution of vortices which are already present on the defects and not to the penetration of new vortices.Comment: 14 pgs. RevTex, typos and figures corrected. Submitted to Phys. Rev.

'Who do "they" cheer for?' Cricket, diaspora, hybridity and divided loyalties amongst British Asians

This article explores the relationship between British Asians' sense of nationhood, citizenship, ethnicity and some of their manifestations in relation to sports fandom: specifically in terms of how cricket is used as a means of articulating diasporic British Asian identities. Norman Tebbit's 'cricket test' is at the forefront of this article to tease out the complexities of being British Asian in terms of supporting the English national cricket team. The first part of the article locates Tebbit's 'cricket test' within the wider discourse of multiculturalism. The analysis then moves to focus on the discourse of sports fandom and the concept of 'home team advantage' arguing that sports venues represent significant sites for nationalist and cultural expression due to their connection with national history. The article highlights how supporting 'Anyone but England', thereby rejecting ethnically exclusive notions of 'Englishness' and 'Britishness', continues to be a definer of British Asians' cultural identities. The final section situates these trends within the discourse of hybridity and argues that sporting allegiances are often separate from considerations of national identity and citizenship. Rather than placing British Asians in an either/or situation, viewing British 'Asianness' in hybrid terms enables them to celebrate their traditions and histories, whilst also being proud of their British citizenship. © The Author(s) 2011

Potent Activity of the HIV-1 Maturation Inhibitor Bevirimat in SCID-hu Thy/Liv Mice

The HIV-1 maturation inhibitor, 3-O-(3',3'-dimethylsuccinyl) betulinic acid (bevirimat, PA-457) is a promising drug candidate with 10 nM in vitro antiviral activity against multiple wild-type (WT) and drug-resistant HIV-1 isolates. Bevirimat has a novel mechanism of action, specifically inhibiting cleavage of spacer peptide 1 (SP1) from the C-terminus of capsid which results in defective core condensation.Oral administration of bevirimat to HIV-1-infected SCID-hu Thy/Liv mice reduced viral RNA by >2 log(10) and protected immature and mature T cells from virus-mediated depletion. This activity was observed at plasma concentrations that are achievable in humans after oral dosing, and bevirimat was active up to 3 days after inoculation with both WT HIV-1 and an AZT-resistant HIV-1 clinical isolate. Consistent with its mechanism of action, bevirimat caused a dose-dependent inhibition of capsid-SP1 cleavage in HIV-1-infected human thymocytes obtained from these mice. HIV-1 NL4-3 with an alanine-to-valine substitution at the N-terminus of SP1 (SP1/A1V), which is resistant to bevirimat in vitro, was also resistant to bevirimat treatment in the mice, and SP1/AIV had replication and thymocyte kinetics similar to that of WT NL4-3 with no evidence of fitness impairment in in vivo competition assays. Interestingly, protease inhibitor-resistant HIV-1 with impaired capsid-SP1 cleavage was hypersensitive to bevirimat in vitro with a 50% inhibitory concentration 140 times lower than for WT HIV-1.These results support further clinical development of this first-in-class maturation inhibitor and confirm the usefulness of the SCID-hu Thy/Liv model for evaluation of in vivo antiretroviral efficacy, drug resistance, and viral fitness