Chair CHEAD Foreword Creative Graduates Creative Futures

CHEAD has a strong reputatin for its work in promoting UK art and design and in activity which examines contemporary issues affecting the HE curriculum and its implementation. It was with great pleasure that CHEAD agreed to be a key partner in the Creative Graudates Creative Futures research project

The Effectiveness of Aid to Kenya: A Case Study

SUMMARY This article reviews the effectiveness of official aid to Kenya. Major features include an increase in non?project aid in response to Kenya's economic difficulties of the early 1980s, and an associated intensification of policy?related conditions. Sector reviews (agriculture, transport, rural water, energy and population) show mixed results, with an overall decrease in aid effectiveness over the past decade. The article highlights the need for better aid coordination and for a continuing learning process. SOMMAIRE L'efficacité de l'aide au Kenya: un cas d'étude Cet article examine l'efficacité de l'aide officielle au Kenya, Parmi les facteurs déterminants on discerne une hausse de l'aide non?liée aux projets (au début des années 80s, lié aux difficultés économiques du Kenya), et une intensification associée des conditions de politique. Des examens sectoriels (de l'agriculture, du transport, de l'eau rurale, de l'énergie et de la population) produisent des résultats mixtes, avec une baisse générale de l'efficacité de l'aide au cours de la dernière décennie. L'article souligne le besoin d'une meilleure coordination de l'aide, et un processus continuel d'apprentissage. RESUMEN La efectividad de la ayuda a Kenya: un estudio de caso Este artículo examina la efectividad de la ayuda oficial a Kenya. Las principales características incluyen un aumento en la ayuda no asociada a proyectos en respuesta a las dificultades económicas del país a principios de la década de 1980, así como una intensificación de las condiciones políticamente relacionadas. El análisis sectorial (agricultura, transporte, agua rural, energía y población) evidencia resultados mixtos con una constante declinación de la efectividad de la ayuda en la década pasada. El artículo destaca la necesidad de una mejor coordinación en la ayuda y de un continuo proceso de aprendizaje

The management of type 2 diabetes with fixed‐ratio combination insulin degludec/liraglutide (IDegLira) versus basal‐bolus therapy (insulin glargine U100 plus insulin aspart): a short‐term cost‐effectiveness analysis in the UK setting

Aim: To evaluate the cost‐effectiveness of IDegLira versus basal‐bolus therapy (BBT) with insulin glargine U100 plus up to 4 times daily insulin aspart for the management of type 2 diabetes in the UK. Methods: A Microsoft Excel model was used to evaluate the cost‐utility of IDegLira versus BBT over a 1‐year time horizon. Clinical input data were taken from the treat‐to‐target DUAL VII trial, conducted in patients unable to achieve adequate glycaemic control (HbA1c <7.0%) with basal insulin, with IDegLira associated with lower rates of hypoglycaemia and reduced body mass index (BMI) in comparison with BBT, with similar HbA1c reductions. Costs (expressed in GBP) and event‐related disutilities were taken from published sources. Extensive sensitivity analyses were performed. Results: IDegLira was associated with an improvement of 0.05 quality‐adjusted life years (QALYs) versus BBT, due to reductions in non‐severe hypoglycaemic episodes and BMI with IDegLira. Costs were higher with IDegLira by GBP 303 per patient, leading to an incremental cost‐effectiveness ratio (ICER) of GBP 5924 per QALY gained for IDegLira versus BBT. ICERs remained below GBP 20 000 per QALY gained across a range of sensitivity analyses. Conclusions: IDegLira is a cost‐effective alternative to BBT with insulin glargine U100 plus insulin aspart, providing equivalent glycaemic control with a simpler treatment regimen for patients with type 2 diabetes inadequately controlled on basal insulin in the UK

CPA firm technology planning guide

https://egrove.olemiss.edu/aicpa_guides/1443/thumbnail.jp

Improving the psychological evaluation of exercise referral: psychometric properties of the Exercise Referral Quality of Life Scale

There is a growing need to assess the psychological outcomes of exercise referral and the National Institute of Health and Care Excellence has called for the routine assessment of life-quality. However, a quality of life scale specific to the requirements of exercise referral is currently unavailable. Therefore, the aim of this study was to produce a quality of life measure for this purpose. The Exercise Referral Quality of Life Scale is a 22-item measure comprising three domains: mental and physical health, injury pain and illness and physical activity facilitators. Exploratory factor analysis determined the initial factor structure and was subsequently confirmed by confirmatory factor analysis. Additional scale properties were also assessed. The scale contributes to the global need for improved consistent psychological outcome assessment of exercise referral

Aquatic microenvironments in bacterial ecology and diversity

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Civil and Environmental Engineering, 2008.Page 116 blank.Includes bibliographical references.Molecular surveys have revealed tremendous bacterial diversity in the world's oceans; yet how do these diverse bacteria with the same essential nutrient requirements co-exist in the same environment? This study examines the role of aquatic microenvironments in generating bacterial diversity: closely related organisms may co-exist in the same environment without competing for resources by a combination of habitat, metabolic, and behavioral differentiation. This hypothesis has been approached from several angles: (i) Within the bacterial family Vibrionaceae is there evidence for microenvironmental specialization or functional differentiation? (ii) Is there small scale clustering of bacteria around phytoplankton in the coastal ocean? Microdiverse clusters (< 1% 16S rRNA gene divergence) of Vibrionaceae were found to be differentially distributed between zooplankton-enriched, particulate, and planktonic water column microenvironments. However microhabitat preferences may not correspond to metabolic capabilities; chitin metabolism was observed to be a near ubiquitous metabolic characteristic of the Vibrionaceae, yet does not appear to be linked to colonization of chitinous zooplankton or particles. Finally, the microscale patchiness of bacterial cells was examined over an annual cycle, revealing seasonal variation and a positive correlation with eukaryotic cell number, suggesting that bacteria may cluster in the nutrient-rich microzones around algae in the environment. This study seeks to answer several fundamental questions about marine bacterial populations: how do closely related species co-exist in the same environment, do bacteria adapt to distinct microscale environments and how important are these microenvironments to bacterial productivity.by Dana E. Hunt..Ph.D

Walking for recreation and transport by geographic remoteness in South Australian adults

Objective: To determine differences in walking for recreation and transport between Accessibility/Remoteness Index of Australia (ARIA) categories, in South Australian adults.  Design: Cross-sectional self-reported data from adult telephone survey respondents between April and May in 2012 and 2013.  Setting: Population of South Australia.  Participants: A total of 4004 adults (aged over 18 years) participated: n = 1956 men and n = 2048 women. Area of residence was categorised using ARIA (major city, inner regional, outer regional and remote/very remote).  Main outcome measure(s): Self-reported participation in walking for transport and recreation/exercise as the number of times and minutes per week. Data were analysed using Kruskal–Wallis test for median minutes and negative binomial regression for times walked with adjustment for socioeconomic status, age and body mass index.  Results: Average age was 47.8 ± 18.5 years, 51.1% were women, 70.9% lived in the major cities, 14.6% in inner regional, 10.8% in outer regional and 3.6% in remote/very remote areas. Relative to major city, times walked for recreation was lower for only remote/very remote residents (incidence rate ratio (IRR) 0.74 (95%CI 0.59–0.92), P = 0.008). This difference was only observed for men (IRR 0.54 (95%CI 0.39–0.73), P < 0.001). Relative to major city, times walked for transport was less for inner regional (IRR 0.74 (95%CI 0.67–0.85), P < 0.001) and outer regional (IRR 0.64 (95%CI 0.56–0.74), P < 0.001) only. This difference in transport walking was seen in both men and women.  Conclusion: Frequency of walking varied by purpose, level of remoteness and sex. As walking is the focus of population-level health promotion, more detailed understanding of the aetiology of regular walking is needed

Breast cancer in lesbians and bisexual women: Systematic review of incidence, prevalence and risk studies

This article is made available through the Brunel Open Access Publishing Fund. © 2013 Meads and Moore; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: The UK Parliamentary Enquiry and USA Institute of Medicine state that lesbians may be at a higher risk of breast cancer but there is insufficient information. Lesbians and bisexual (LB) women have behavioural risk-factors at higher rates compared to heterosexuals such as increased alcohol intake and higher stress levels. Conversely, breast cancer rates are higher in more affluent women yet income levels in LB women are relatively low. This systematic review investigated all evidence on whether there is, or likely to be, higher rates of breast cancer in LB women. Methods: Cochrane library (CDSR, CENTRAL, HTA, DARE, NHSEED), MEDLINE, EMBASE, PsychINFO, CAB abstracts, Web of Science (SCI, SSCI), SIGLE and Social Care Online databases were searched to October 2013. Unpublished research and specific lesbian, gay and bisexual websites were checked, as were citation lists of relevant papers. Included were studies in LB populations reporting breast cancer incidence or prevalence rates, risk model results or risk-factor estimates. Inclusions, data-extraction and quality assessment were by two reviewers with disagreements resolved by discussion. Results: Searches found 198 references. No incidence rates were found. Nine studies gave prevalence estimates - two showed higher, four showed no differences, one showed mixed results depending on definitions, one had no comparison group and one gave no sample size. All studies were small with poor methodological and/or reporting quality. One incidence modelling study suggested a higher rate. Four risk modelling studies were found, one Rosner-Colditz and three Gail models. Three suggested higher and one lower rate in LB compared to heterosexual women. Six risk-factor estimates suggested higher risk and one no difference between LB and heterosexual women. Conclusions: The only realistic way to establish rates in LB women would be to collect sexual orientation within routine statistics, including cancer registry data, or from large cohort studies

Securing recruitment and obtaining informed consent in minority ethnic groups in the UK

Background: Previous health research has often explicitly excluded individuals from minority ethnic backgrounds due to perceived cultural and communication difficulties, including studies where there might be language/literacy problems in obtaining informed consent. This study addressed these difficulties by developing audio-recorded methods of obtaining informed consent and recording data. This report outlines 1) our experiences with securing recruitment to a qualitative study investigating alternative methods of data collection, and 2) the development of a standardised process for obtaining informed consent from individuals from minority ethnic backgrounds whose main language does not have an agreed written form. Methods: Two researchers from South Asian backgrounds recruited adults with Type 2 diabetes whose main language was spoken and not written, to attend a series of focus groups. A screening tool was used at recruitment in order to assess literacy skills in potential participants. Informed consent was obtained using audio-recordings of the patient information and recording patients' verbal consent. Participants' perceptions of this method of obtaining consent were recorded. Results: Recruitment rates were improved by using telephone compared to face-to-face methods. The screening tool was found to be acceptable by all potential participants. Audio-recorded methods of obtaining informed consent were easy to implement and accepted by all participants. Attrition rates differed according to ethnic group. Snowballing techniques only partly improved participation rates. Conclusion: Audio-recorded methods of obtaining informed consent are an acceptable alternative to written consent in study populations where literacy skills are variable. Further exploration of issues relating to attrition is required, and a range of methods may be necessary in order to maximise response and participation