Mechanisms of urban change: Regeneration companies or development corporations?

This article is an early assessment of the role and performance of URCs, benchmarked against the UDC model. It identified weaknesses and vulnerability of URCs in relation to control over land

A strategic needs assessment for Nottinghamshire

Peter Murphy, Kirsten Greenhalgh and Craig Parkin from Nottingham Trent University, University of Nottingham and Nottinghamshire Fire and Rescue Service, report on their joint project

Fire and rescue service reconfiguration: a case study in Nottinghamshire

The Fire Cover Review in Nottinghamshire arises out of the Integrated Risk Management Planning process introduced in the UK by the Fire and Rescue 2004 Act,. It is intended to provide the evidence and analysis for the reconfiguration of services and the future deployment of resources in in the short, medium and long terms. Any future reconfigurations of services must be based on contemporary and comprehensive risk assessments of the areas affected.(ODPM 2004). The need to undertake the review pre-dated the current financial crises, the general election and the need for significant reductions in public expenditure in the UK, although these circumstances made the review more challenging and politically sensitive. This paper evaluates the practical implementation of the Integrated Risk Management Planning process and the Fire Cover Review in Nottinghamshire to identify good practice and to generate recommendations for improving the process and its implementation

Risk models and scores for type 2 diabetes: Systematic review

This article is published under a Creative Commons Attribution Non Commercial (CC BY-NC 3.0) licence that allows reuse subject only to the use being non-commercial and to the article being fully attributed (http://creativecommons.org/licenses/by-nc/3.0).Objective - To evaluate current risk models and scores for type 2 diabetes and inform selection and implementation of these in practice. Design - Systematic review using standard (quantitative) and realist (mainly qualitative) methodology. Inclusion - criteria Papers in any language describing the development or external validation, or both, of models and scores to predict the risk of an adult developing type 2 diabetes. Data sources - Medline, PreMedline, Embase, and Cochrane databases were searched. Included studies were citation tracked in Google Scholar to identify follow-on studies of usability or impact. Data extraction - Data were extracted on statistical properties of models, details of internal or external validation, and use of risk scores beyond the studies that developed them. Quantitative data were tabulated to compare model components and statistical properties. Qualitative data were analysed thematically to identify mechanisms by which use of the risk model or score might improve patient outcomes. Results - 8864 titles were scanned, 115 full text papers considered, and 43 papers included in the final sample. These described the prospective development or validation, or both, of 145 risk prediction models and scores, 94 of which were studied in detail here. They had been tested on 6.88 million participants followed for up to 28 years. Heterogeneity of primary studies precluded meta-analysis. Some but not all risk models or scores had robust statistical properties (for example, good discrimination and calibration) and had been externally validated on a different population. Genetic markers added nothing to models over clinical and sociodemographic factors. Most authors described their score as “simple” or “easily implemented,” although few were specific about the intended users and under what circumstances. Ten mechanisms were identified by which measuring diabetes risk might improve outcomes. Follow-on studies that applied a risk score as part of an intervention aimed at reducing actual risk in people were sparse. Conclusion - Much work has been done to develop diabetes risk models and scores, but most are rarely used because they require tests not routinely available or they were developed without a specific user or clear use in mind. Encouragingly, recent research has begun to tackle usability and the impact of diabetes risk scores. Two promising areas for further research are interventions that prompt lay people to check their own diabetes risk and use of risk scores on population datasets to identify high risk “hotspots” for targeted public health interventions.Tower Hamlets, Newham, and City and Hackney primary care trusts and National Institute of Health Research

How Vending Machines can Conquer Access to Better Quality Convenience Food

As the food system has evolved it has been forced to include convenience. Changing life styles and big food companies have dictated a switch in expectations from our food. They have made it so that time and energy can be saved when it comes to producing, cooking or eating food. Technology has evolved beside convenience food, to sell or manufacture it and make it more convenient. One of these invention is vending machines. Automated food vending began with the Automat, which served fresh and healthy dishes but has come to dispense food that is mostly considered unhealthy. Vending machines are tools that can changed to increase the amount of healthy food rather than unhealthy food. This project’s research is based around how vending machines can make healthy food more accessible by making it more convenient and abundant

Supporting ethnographic studies of ubiquitous computing in the wild

Ethnography has become a staple feature of IT research over the last twenty years, shaping our understanding of the social character of computing systems and informing their design in a wide variety of settings. The emergence of ubiquitous computing raises new challenges for ethnography however, distributing interaction across a burgeoning array of small, mobile devices and online environments which exploit invisible sensing systems. Understanding interaction requires ethnographers to reconcile interactions that are, for example, distributed across devices on the street with online interactions in order to assemble coherent understandings of the social character and purchase of ubiquitous computing systems. We draw upon four recent studies to show how ethnographers are replaying system recordings of interaction alongside existing resources such as video recordings to do this and identify key challenges that need to be met to support ethnographic study of ubiquitous computing in the wild

Fos co-operation with PTEN loss elicits keratoacanthoma not carcinoma due to p53/p21^WAF-induced differentiation triggered by GSK3b inactivation and reduced AKT activity

To investigate gene synergism in multistage skin carcinogenesis, the RU486-inducible cre/lox system was employed to ablate PTEN function [K14.cre/D5PTENflx] in mouse epidermis expressing activated v-fos [HK1.fos]. RU486-treated HK1.fos/D5PTENflx mice exhibited hyperplasia, hyperkeratosis and tumours that progressed to highly differentiated keratoacanthomas rather than carcinomas, due to re-expression of high p53 and p21WAF levels. Despite elevated MAP kinase activity, cyclin D1/E2 over expression and increased AKT activity forming areas of highly proliferative, papillomatous keratinocytes, increasing levels of GSK3b inactivation exceeded a threshold that induced p53/p21WAF expression to halt proliferation and accelerate differentiation, giving the hallmark keratosis of keratoacanthomas. A pivotal facet to this GSK3b-triggered mechanism centred on increasing p53 expression in basal layer keratinocytes. This reduced activated AKT expression and released inhibition of p21WAF, which accelerated keratinocyte differentiation, as indicated by unique basal layer expression of differentiation-specific keratin K1, alongside premature filaggrin and loricrin expression. Thus, fos synergism with PTEN loss elicited a benign tumour context where GSK3b-induced, p53/p21WAF expression continually switched AKT-associated proliferation into one of differentiation, preventing further progression. This putative compensatory mechanism required the critical availability of normal p53 and/or p21WAF otherwise deregulated fos, Akt and GSK3b associate with malignant progression

Computer templates in chronic disease management: ethnographic case study in general practice

This work was funded by a research grant from the UK Medical Research Council (Healthcare Electronic Records in Organisations, 07/133) and a National Institute for Health Research Doctoral Fellowship Award (RDA/03/07/076) for D

Designing assisted living technologies 'in the wild' : preliminary experiences with cultural probe methodology

Background There is growing interest in assisted living technologies to support independence at home. Such technologies should ideally be designed ‘in the wild’ i.e. taking account of how real people live in real homes and communities. The ATHENE (Assistive Technologies for Healthy Living in Elders: Needs Assessment by Ethnography) project seeks to illuminate the living needs of older people and facilitate the co-production with older people of technologies and services. This paper describes the development of a cultural probe tool produced as part of the ATHENE project and how it was used to support home visit interviews with elders with a range of ethnic and social backgrounds, family circumstances, health conditions and assisted living needs. Method Thirty one people aged 60 to 98 were visited in their homes on three occasions. Following an initial interview, participants were given a set of cultural probe materials, including a digital camera and the ‘Home and Life Scrapbook’ to complete in their own time for one week. Activities within the Home and Life Scrapbook included maps (indicating their relationships to people, places and objects), lists (e.g. likes, dislikes, things they were concerned about, things they were comfortable with), wishes (things they wanted to change or improve), body outline (indicating symptoms or impairments), home plan (room layouts of their homes to indicate spaces and objects used) and a diary. After one week, the researcher and participant reviewed any digital photos taken and the content of the Home and Life Scrapbook as part of the home visit interview. Findings The cultural probe facilitated collection of visual, narrative and material data by older people, and appeared to generate high levels of engagement from some participants. However, others used the probe minimally or not at all for various reasons including limited literacy, physical problems (e.g. holding a pen), lack of time or energy, limited emotional or psychological resources, life events, and acute illness. Discussions between researchers and participants about the materials collected (and sometimes about what had prevented them completing the tasks) helped elicit further information relevant to assisted living technology design. The probe materials were particularly helpful when having conversations with non-English speaking participants through an interpreter. Conclusions Cultural probe methods can help build a rich picture of the lives and experiences of older people to facilitate the co-production of assisted living technologies. But their application may be constrained by the participant’s physical, mental and emotional capacity. They are most effective when used as a tool to facilitate communication and development of a deeper understanding of older people’s needs