Rationale, design and methods for a community-based study of clustering and cumulative effects on chronic disease process and their effects on ageing: the Busselton healthy ageing study

Background: The global trend of increased life expectancy and increased prevalence of chronic and degenerative diseases will impact on health systems. To identify effective intervention and prevention strategies, greater understanding of the risk factors for and cumulative effects of chronic disease processes and their effects on function and quality of life is needed. The Busselton Healthy Ageing Study aims to enhance understanding of ageing by relating the clustering and interactions of common chronic conditions in adults to function. Longitudinal (3–5 yearly) follow-up is planned. Methods/design: Phase I (recruitment) is a cross-sectional community-based prospective cohort study involving up to 4,000 ‘Baby Boomers’ (born from 1946 to 1964) living in the Busselton Shire, Western Australia. The study protocol involves a detailed, self-administered health and risk factor questionnaire and a range of physical assessments including body composition and bone density measurements, cardiovascular profiling (blood pressure, ECG and brachial pulse wave velocity), retinal photography, tonometry, auto-refraction, spirometry and bronchodilator responsiveness, skin allergy prick tests, sleep apnoea screening, tympanometry and audiometry, grip strength, mobility, balance and leg extensor strength. Cognitive function and reserve, semantic memory, and pre-morbid intelligence are assessed. Participants provide a fasting blood sample for assessment of lipids, blood glucose, C-reactive protein and renal and liver function, and RNA, DNA and serum are stored. Clinically relevant results are provided to all participants. The prevalence of risk factors, symptoms and diagnosed illness will be calculated and the burden of illness will be estimated based on the observed relationships and clustering of symptoms and illness within individuals. Risk factors for combinations of illness will be compared with those for single illnesses and the relation of combinations of illness and symptoms to cognitive and physical function will be estimated. Discussion: This study will enable a thorough characterization of multiple disease processes and their risk factors within a community-based sample of individuals to determine their singular, interactive and cumulative effects on ageing. The project will provide novel cross-sectional data and establish a cohort that will be used for longitudinal analyses of the genetic, lifestyle and environmental factors that determine whether an individual ages well or with impairment

Flipped learning: research report

This small-scale study, undertaken by NFER and NESTA, revealed both benefits and challenges of implementing a flipped learning approach to mathematics teaching. Flipped learning involves the use of digital technology, such as video, to provide direct instruction on new concepts outside of the classroom. Students come to lessons already having a preliminary understanding of the topic, freeing up class time for the teacher to focus on other beneficial learning activities. Nine case-study schools across England and Scotland piloted a flipped learning approach for around 4-6 weeks during 2014-2015. Each case study visit involved lesson observations, teacher interviews, student focus groups and teacher and student questionnaires with both a class using flipped learning and a comparison class. Detailed and specific guides to implementing flipped learning accompany the research report. Key Findings: Where flipped learning was reported to work effectively, there was more time in class for active learning activities, such as: practising and applying mathematical knowledge; individualised coaching support provided by the teacher; collaborative learning; and whole-class discussion Flipped learning encouraged students to take responsibility for their learning, to learn at their own pace, to deepen their knowledge and understanding and to make faster progress than would otherwise have been the case Enabling factors and challenges included access to technology, homework culture, appropriateness of online resources to the age and ability level of students and teachers’ openness to the approach and capacity to implement it Most teachers in the study intended to continue using flipped learning, or aspects of it, as part of a varied repertoire of teaching strategies and to develop its potential further

Climate policy conflict in the U.S. states: a critical review and way forward

Abstract Many U.S. states have taken significant action on climate change in recent years, demonstrating their commitment despite federal policy gridlock and rollbacks. Yet, there is still much we do not know about the agents, discourses, and strategies of those seeking to delay or obstruct state-level climate action. We first ask, what are the obstacles to strong and effective climate policy within U.S. states? We review the political structures and interest groups that slow action, and we examine emerging tensions between climate justice and the technocratic and/or market-oriented approaches traditionally taken by many mainstream environmental groups. Second, what are potential solutions for overcoming these obstacles? We suggest strategies for overcoming opposition to climate action that may advance more effective and inclusive state policy, focusing on political strategies, media framing, collaboration, and leveraging the efforts of ambitious local governments