Birc2/Iap1 regulates endothelial cell integrity and blood vessel homeostasis.

none4noneM. SANTORO; TEMESGEN SAMUEL; TRACY MITCHEL; JOHN C. REED AND DIDIER Y. STAINIERSantoro, Massimo; Temesgen, Samuel; Tracy, Mitchel; JOHN C. REED AND DIDIER Y., Stainie

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

Quantity over quality: a political economy of ‘active labour market policy’ in the UK

This article offers a critical evaluation of recent ‘active labour market policy’ (ALMP) initiatives in the UK, focusing on the coalition government's Work Programme and its immediate antecedents. ALMP exemplifies a supply-side employment strategy, reorienting the state away from supporting labour demand and towards promoting the ‘employability’ of individuals within existing labour market structures. The article locates the rationale for this policy agenda within the wider politics of economic growth. Belying its status as a pioneer of ALMP, the UK spends very little on supply-side labour market interventions relative to other European countries. This can be explained with reference to the type of ALMP interventions prioritised in the UK, which in turn is explained by the growth model that ALMP is designed to sustain. The UK's growth model requires an abundance of low-paid jobs in the labour-intense and volatile services sector. Ostensibly, ALMP fulfils this requirement by ensuring that individuals are immediately available for work, marginalising concerns about pay and job quality. Moreover, ALMP also serves to inculcate the desirability of certain behaviours at the individual level. The coalition government's approach demonstrates an intensification rather than transformation of previous practice, indicative of its support for resurrecting the UK's pre-crisis growth model

Picnics, potlucks and cookbooks : farm women's clubs and the livelihood of community in twentieth century Southern Alberta

vi, 141 leaves ; 29 cm.This thesis examines the collective labour and resources utilized by farm women within the context of the farm women’s neighbourhood club in rural communities in twentieth century Southern Alberta. The ethnographic research explores the historic, cultural and political foundations of women’s labour on farms and in formal and informal farm organizations through interviews conducted with former members of two clubs that were actively involved in fundraising and philanthropic projects in their rural communities for more than forty-five years. The critical perspective argues farm women in rural clubs responded to the patriarchal farm discourse that gendered their labour by using their reproductive skills and resources to build and maintain friendships, social networks and mutuality, and do good works that ensured the livelihood of their rural communities

A mouse model for studying stroke induced impairments, recovery, and compensation in the motor cortex

viii, 115 leaves : ill. ; 29 cm.Stroke is the third leading cause of death and survivors suffer motor impairments. The rodent sensorimotor system is similar to the human's, making rodents a good model to study the effects of stroke. Transgenic technology makes the mouse a desirable stroke model, however, there are few behavioural tests to assess behavioural outcome. This thesis evaluates mice subjected to permanent or temporary occlusion focal motor cortex strokes in a skilled reaching task. The first experiment documents changes in skilled movements in mice with a permanent occlusion focal motor cortex stroke. The second experiment is identical but uses a temporary occlusion focal motor cortex stroke. The third experiment compares the two strokes. The results indicate permanent occlusion mice suffer great impairments, and a larger injury, than temporarily occluded animals. The mice with the largest insults were most impaired. Mice make an excellent behavioural and genetic model for studying motor system stroke

Developing and testing accelerated partner therapy for partner notification for people with genital Chlamydia trachomatis diagnosed in primary care: a pilot randomised controlled trial

Background Accelerated partner therapy (APT) is a promising partner notification (PN) intervention in specialist sexual health clinic attenders. To address its applicability in primary care, we undertook a pilot randomised controlled trial (RCT) of two APT models in community settings. Methods Three-arm pilot RCT of two adjunct APT interventions: APTHotline (telephone assessment of partner(s) plus standard PN) and APTPharmacy (community pharmacist assessment of partner(s) plus routine PN), versus standard PN alone (patient referral). Index patients were women diagnosed with genital chlamydia in 12 general practices and three community contraception and sexual health (CASH) services in London and south coast of England, randomised between 1 September 2011 and 31 July 2013. Results 199 women described 339 male partners, of whom 313 were reported by the index as contactable. The proportions of contactable partners considered treated within 6 weeks of index diagnosis were APTHotline 39/111 (35%), APTPharmacy 46/100 (46%), standard patient referral 46/102 (45%). Among treated partners, 8/39 (21%) in APTHotline arm were treated via hotline and 14/46 (30%) in APTPharmacy arm were treated via pharmacy. Conclusions The two novel primary care APT models were acceptable, feasible, compliant with regulations and capable of achieving acceptable outcomes within a pilot RCT but intervention uptake was low. Although addition of these interventions to standard PN did not result in a difference between arms, overall PN uptake was higher than previously reported in similar settings, probably as a result of introducing a formal evaluation. Recruitment to an individually randomised trial proved challenging and full evaluation will likely require service-level randomisation

A Taste of Two Worlds: Stories and Recipes from Greenland and Maine

The Arctic Education Alliance Cookbook Project is a collaboration between the Inuili Food College in Narsaq, Greenland; Wabanaki Public Health and Wellness in Bangor, Maine, USA; and the Tourism and Hospitality program of the University of Southern Maine in Portland, Maine, USA. The brainchild of Jacob Hansen, Uddannelseschef / Head of Education at Inuili, the cookbook and its theme, “Taste of Two Worlds,” is intended to illustrate the connections and dichotomies between the cuisine of two North Atlantic regions, such as in the preparation and consumption of fish. However, the book does more than encapsulate recipes from Maine and Greenland: It hints at a past in which the Western European world came in contact with the Indigenous people. Within each country, there are youth who straddle these worlds, with one foot in a traditional culture sustained by a balanced natural resource usage and the other foot in a modern society that tends to be driven by consumerism. Some argue we have lost the connection between food and the ways it is raised, grown, harvested, and processed. But cooking can reestablish that vital connection. “Being immersed in the kitchen with Indigenous people from two continents sparked excitement and joy. Being able to experience the rare opportunity to help create recipes using Indigenous foods which are then shared with the world is unmatched,” said Andrea Sockabasin, Co-Senior Director of Wabanaki Public Health, an Indigenous public health organization that provides community-driven public health services to all Wabanaki communities while honoring our cultural knowledge and cultivating innovation and collaboration...https://digitalcommons.usm.maine.edu/facbooks/1689/thumbnail.jp

The SPORTSMART study: a pilot randomised controlled trial of sexually transmitted infection screening interventions targeting men in football club settings

Background: Uptake of chlamydia screening by men in England has been substantially lower than by women. Non-traditional settings such as sports clubs offer opportunities to widen access. Involving people who are not medically trained to promote screening could optimise acceptability. Methods: We developed two interventions to explore the acceptability and feasibility of urine-based sexually transmitted infection (STI) screening interventions targeting men in football clubs. We tested these interventions in a pilot cluster randomised control trial. Six clubs were randomly allocated, two to each of three trial arms: team captain-led and poster STI screening promotion; sexual health adviser-led and poster STI screening promotion; and poster-only STI screening promotion (control/comparator). Primary outcome was test uptake. Results: Across the three arms, 153 men participated in the trial and 90 accepted the offer of screening (59%, 95% CI 35% to 79%). Acceptance rates were broadly comparable across the arms: captain-led: 28/56 (50%); health professional-led: 31/46 (67%); and control: 31/51 (61%). However, rates varied appreciably by club, precluding formal comparison of arms. No infections were identified. Process evaluation confirmed that interventions were delivered in a standardised way but the control arm was unintentionally ‘enhanced’ by some team captains actively publicising screening events. Conclusions: Compared with other UK-based community screening models, uptake was high but gaining access to clubs was not always easy. Use of sexual health advisers and team captains to promote screening did not appear to confer additional benefit over a poster-promoted approach. Although the interventions show potential, the broader implications of this strategy for UK male STI screening policy require further investigation

Service configuration, unit characteristics and variation in intervention rates in a national sample of obstetric units in England: an exploratory analysis

Objectives: To explore whether service configuration and obstetric unit (OU) characteristics explain variation in OU intervention rates in "low-risk" women. Design: Ecological study using funnel plots to explore unit-level variations in adjusted intervention rates and simple linear regression, stratified by parity, to investigate possible associations between unit characteristics/configuration and adjusted intervention rates in planned OU births. Characteristics considered: OU size, presence of an alongside midwifery unit (AMU), proportion of births in the National Health Service (NHS) trust planned in midwifery units or at home and midwifery "under" staffing. Setting: 36 OUs in England. Participants: "Low-risk" women with a "term" pregnancy planning vaginal birth in a stratified, random sample of 36 OUs. Main outcome measures: Adjusted rates of intrapartum caesarean section, instrumental delivery and two composite measures capturing birth without intervention ("straightforward"and "normal" birth). Results: Funnel plots showed unexplained variation in adjusted intervention rates. In NHS trusts where proportionately more non-OU births were planned, adjusted intrapartum caesarean section rates in the planned OU births were significantly higher (nulliparous: R2=31.8%, coefficient=0.31, p=0.02; multiparous: R2=43.2%, coefficient=0.23, p=0.01), and for multiparous women, rates of "straightforward" (R2=26.3%, coefficient=-0.22, p=0.01) and "normal" birth (R2=17.5%, coefficient=0.24, p=0.01) were lower. The size of the OU (number of births), midwifery "under" staffing levels (the proportion of shifts where there were more women than midwives) and the presence of an AMU were associated with significant variation in some interventions. Conclusions: Trusts with greater provision of non-OU intrapartum care may have higher intervention rates in planned "low-risk" OU births, but at a trust level this is likely to be more than offset by lower intervention rates in planned non-OU births. Further research using high quality data on unit characteristics and outcomes in a larger sample of OUs and trusts is required