Showing papers by "Northampton Community College published in 2017"

Explaining interest in adopting residential solar photovoltaic systems in the United States: Toward an integration of behavioral theories

Abstract: Increased household adoption of solar photovoltaic systems has the potential to reduce greenhouse gas emissions associated with providing electricity. Although residential solar has recently become more affordable, market penetration in the U.S. remains relatively low. This study proposes a theoretical framework for investigating the psychological and social determinants of interest in residential solar drawn from three theories that may explain the decision to pursue it: diffusion of innovations theory, theory of planned behavior, and value-belief-norm theory. We test this framework using survey data from 904 non- adopter homeowners, with the aim of identifying potential levers for intervention. Overall, we find that consumers see solar electricity in multiple ways: as an environmental benefit, a consumer good, and an innovative technology. Notably, individuals who trust installers and believe solar will be personally beneficial are more likely to consider contacting an installer, as are individuals drawn to novel products. Proenvironmental personal norms indirectly increase interest through perceived personal benefits, suggesting that marketing efforts aimed at environmentally-concerned individuals may need to emphasize non-environmental benefits. The results also support leveraging trusted social networks to convey the benefits of solar. We conclude by discussing the value of the integrated framework along with implications for policymakers and marketers.

BIM-based deconstruction tool: Towards essential functionalities

Abstract: This study discusses the future directions of effective Design for Deconstruction (DfD) using BIM-based approach to design coordination. After a review of extant literatures on existing DfD practices and tools, it became evident that none of the tools is BIM compliant and that BIM implementation has been ignored for end-of-life activities. To understand how BIM could be employed for DfD and to identify essential functionalities for a BIM-based deconstruction tool, Focus Group Interviews (FGIs) were conducted with professionals who have utilised BIM on their projects. The interview transcripts of the FGIs were analysed using descriptive interpretive analysis to identify common themes based on the experiences of the participants. The themes highlight functionalities of BIM in driving effective DfD process, which include improved collaboration among stakeholders, visualisation of deconstruction process, identification of recoverable materials, deconstruction plan development, performance analysis and simulation of end-of-life alternatives, improved building lifecycle management, and interoperability with existing BIM software. The results provide the needed technological support for developing tools for BIM compliant DfD tools.

Learning from Lancashire: exploring the contours of the shale gas conflict in England

Abstract: This paper explores the conflict over shale gas exploration in Lancashire where the company Cuadrilla is preparing to horizontally drill and hydraulically fracture the first shale gas wells in England. At present, this is the only location in Europe where new commercial exploration for shale gas is underway, thus the outcome has wider significance. The initial planning applications were refused by Lancashire County Council in June 2015. The decisions were then appealed by Cuadrilla and there was a public enquiry in February and March of 2016. On 6 October 2016, the central Government over-turned the initial decisions at one site and gave Cuadrilla more time to address traffic concerns at the other. The paper uses the public enquiry to map the contours of the shale gas conflict. It is divided into three sections. The first explores public attitudes towards shale gas development in the UK and reveals growing public awareness and increasing opposition. The second presents the conceptual frame for the analysis, which includes both a critical assessment of the social licence to operate (SLO) and an introduction to a social, actuarial, and political risk and licensing model (SAP Model). The third deploys the SAP model to analyse the public enquiry. The model explains how Cuadrilla is able drill despite the absence of both a local political and social licence to operate. It is concluded that unless the industry and the government can address growing public concerns about shale gas development, continuing conflict could constrain commercial development.

The impact of CACNA1C gene, and its epistasis with ZNF804A, on white matter microstructure in health, schizophrenia and bipolar disorder1.

Abstract: Genome-wide studies have identified allele A (adenine) of single nucleotide polymorphism (SNP) rs1006737 of the calcium-channel CACNA1C gene as a risk factor for both schizophrenia (SZ) and bipolar disorder (BD) as well as allele A for rs1344706 in the ZNF804A gene. These illnesses have also been associated with white matter abnormalities, reflected by reductions in fractional anisotropy (FA), measured using diffusion tensor imaging (DTI). We assessed the impact of the CACNA1C psychosis risk variant on FA in SZ, BD and health. 230 individuals (with existing ZNF804A rs1344706 genotype data) were genotyped for CACNA1C rs1006737 and underwent DTI. FA data was analysed with tract-based spatial statistics and threshold-free cluster enhancement significance correction (P < 0.05) to detect effects of CACNA1C genotype on FA, and its potential interaction with ZNF804A genotype and with diagnosis, on FA. There was no significant main effect of the CACNA1C genotype on FA, nor diagnosis by genotype(s) interactions. Nevertheless, when inspecting SZ in particular, risk allele carriers had significantly lower FA than the protective genotype individuals, in portions of the left middle occipital and parahippocampal gyri, right cerebellum, left optic radiation and left inferior and superior temporal gyri. Our data suggests a minor involvement of CACNA1C rs1006737 in psychosis via conferring susceptibility to white matter microstructural abnormalities in SZ. Put in perspective, ZNF804A rs1344706, not only had a significant main effect, but its SZ-specific effects were two orders of magnitude more widespread than that of CACNA1C rs1006737.

Live births after embryo selection using morphokinetics versus conventional morphology: a retrospective analysis

Abstract: The increasing corpus of clinical studies using time-lapse imaging for embryo selection demonstrates considerable variation in study protocols and only limited-sized study cohorts. Outcome measures are based on implantation or clinical pregnancy; some predict blastulation from early cleavage-stage data, and few have evaluated live birth. Erroneously, most studies treat the embryos as independent variables and do not include patient or treatment variables in the statistical analyses. In this study, cohort size was 14,793 patients and 23,762 cycles. The incidence of live birth (n = 973 deliveries) after embryo selection by objective morphokinetic algorithms was compared with conventional embryology selection parameters (n = 6948 deliveries). A 19% increase in the incidence of live birth was observed when morphokinetic data were used to select embryos for the patient cohort aged younger than 38 years (OR 1.19 with 95% CI 1.06 to 1.34) using their own eggs, and an increase of 37% for oocyte recipients aged over 37 years (OR 1.370; 95% Cl 0.763 to 2.450). This is the largest study of the prospective use of time-lapse imaging algorithms in IVF reporting on live birth outcome, although the nature of purely a closed system versus standard incubation could not be assessed.

Budget Impact of a Comprehensive Nutrition-Focused Quality Improvement Program for Malnourished Hospitalized Patients.

Abstract: Background Nutrition interventions can alleviate the burden of malnutrition by improving patient outcomes; however, evidence on the economic impact of medical nutrition intervention remains limited. A previously published nutrition-focused quality improvement program targeting malnourished hospitalized patients showed that screening patients with a validated screening tool at admission, rapidly administering oral nutritional supplements, and educating patients on supplement adherence result in significant reductions in 30-day unplanned readmissions and hospital length of stay. Objectives To assess the potential cost-savings associated with decreased 30-day readmissions and hospital length of stay in malnourished inpatients through a nutrition-focused quality improvement program using a web-based budget impact model, and to demonstrate the clinical and fiscal value of the intervention. Methods The reduction in readmission rate and length of stay for 1269 patients enrolled in the quality improvement program (between October 13, 2014, and April 2, 2015) were compared with the pre-quality improvement program baseline and validation cohorts (4611 patients vs 1319 patients, respectively) to calculate potential cost-savings as well as to inform the design of the budget impact model. Readmission rate and length-of-stay reductions were calculated by determining the change from baseline to post-quality improvement program as well as the difference between the validation cohort and the post-quality improvement program, respectively. Results As a result of improved health outcomes for the treated patients, the nutrition-focused quality improvement program led to a reduction in 30-day hospital readmissions and length of stay. The avoided hospital readmissions and reduced number of days in the hospital for the patients in the quality improvement program resulted in cost-savings of $1,902,933 versus the pre-quality improvement program baseline cohort, and $4,896,758 versus the pre-quality improvement program in the validation cohort. When these costs were assessed across the entire patient population enrolled in the quality improvement program, per-patient net savings of $1499 when using the baseline cohort as the comparator and savings per patient treated of $3858 when using the validated cohort as the comparator were achieved. Conclusion The nutrition-focused quality improvement program reduced the per-patient healthcare costs by avoiding 30-day readmissions and through reduced length of hospital stay. These clinical and economic outcomes provide a rationale for merging patient care and financial modeling to advance the delivery of value-based medicine in a malnourished hospitalized population. The use of a novel web-based budget impact model supports the integration of comparative effectiveness analytics and healthcare resource management in the hospital setting to provide optimal quality of care at a reduced overall cost.

A Focused Systematic Review of Pharmacological Treatment for Borderline Personality Disorder.

Abstract: Medicines are routinely prescribed to treat borderline personality disorder (BPD) despite a relative lack of high-quality evidence and in breach of some treatment guidelines. An earlier Cochrane review of pharmacotherapy in BPD underlined the lack of evidence, encouraged the replication of earlier studies, but also emphasised the pressing need for more randomised placebo-controlled trials, and for those studies to employ broadened inclusion criteria. The authors searched bibliographic databases, reference lists of articles and trials registers. Records were screened to identify those that met the inclusion criteria. Full-text articles were screened and assessed for eligibility. On-going trials of pharmacotherapy in BPD were also identified. Fifteen new studies of pharmacotherapy for BPD were identified since the earlier review. Eight of those examined second generation antipsychotics, two investigated mood stabilisers, three investigated antidepressants and two studied the effectiveness of opioid antagonists. Results for the effectiveness of antipsychotics appeared to be mixed. There has been little recent evidence to support the use of mood stabilisers. There is a lack of new placebo-controlled, randomised controlled trials investigating antidepressants and limited new evidence to support the use of opioid antagonists. The review revealed that there remains a dearth of high-quality research evidence to help patients, carers and clinicians make sound and safe evidence-based decisions about medicines to treat BPD.

Using Digital Badges for Developing High School Chemistry Laboratory Skills

Abstract: Digital badges are emerging as an approach to offer microaccreditation for student achievements obtained in ongoing course work. They act to offer a formal recognition and framework for multiple small components which together make a significant contribution to student learning. Badges are promoted as a way of highlighting these particular components. The process of awarding a badge relies on evidence, typically in digital form, such as video. In this article, we report on the implementation of digital badges in high school chemistry for the teaching and accrediting of achievement in laboratory skills. Pupils watched videos prior to the classroom to assist them in preparation for a demonstration activity. In the classroom, students demonstrated the laboratory technique to a peer while the peer videoed the demonstration on a mobile phone. This video was then used to review the demonstration by both peers and teacher, and once the technique was considered satisfactorily demonstrated, a badge was awarded. As...

Predictive factors of hospital stay in patients with odontogenic maxillofacial infections: the role of C-reactive protein.

Abstract: To investigate whether clinical or laboratory variables on admission of patients with odontogenic infections are associated with a severe clinical course and a prolonged hospital stay, we hypothesised that specific factors such as the serum concentration of C-reactive protein (CRP) may act as predictors of the duration of stay. We designed a prospective patient-oriented study that included all those treated for maxillofacial infections of odontogenic origin in the Oral and Maxillofacial Surgery Department of Northampton General Hospital between November 2013 and December 2014. A total of 71 were enrolled. We found that the concentration of CRP was a significant predictor of hospital stay (p=0.01). Its measurement on admission can predict the likely duration of stay of these patients and enable beds to be managed more efficiently.

Reframing climate change assessments around risk: recommendations for the US National Climate Assessment

Abstract: Climate change is a risk management challenge for society, with uncertain but potentially severe outcomes affecting natural and human systems, across generations. Managing climate-related risks will be more difficult without a base of knowledge and practice aimed at identifying and evaluating specific risks, and their likelihood and consequences, as well as potential actions to promote resilience in the face of these risks. We suggest three improvements to the process of conducting climate change assessments to better characterize risk and inform risk management actions. Risk is a central concept in methods used to establish the objective significance of potentially damaging events (NRC 1983, Ruckelshaus 1983) or feelings associated with these threats to people and the things they value (Slovic et al 2004). It is widely accepted that risk is a function of three elements: the triggering event or hazard that could result in a potential loss, the magnitude of what stands to be lost, and judgments about the probability of the loss occurring—including the level of uncertainty bounding the probability estimate (NRC 1996). It is often the nature of the hazard and magnitude of the consequences that grab —or fail to grab—the attention of citizens and policymakers, although, as we discuss below, other factors also play a role in how risks are perceived. Climate change is increasingly being framed as a risk management problem, albeit a uniquely challenging one (King et al 2015, Sussman et al 2014). It is characterized by multiple intersecting and uncertain future hazards to natural and human systems, that are expected to unfold over a very large range of spatial and temporal scales, and whose probabilities may be difficult, or in some cases impossible, to quantify precisely (because of intrinsic and/or irreducible © 2017 The Author(s). Published by IOP Publishing Ltd uncertainties about the future). It is a risk multiplier that interacts with other stressors to create new or alter existing risks (DoD 2014). The overall risk of severe outcomes stemming from climate change increases over time as greenhouse gas concentrations continue to rise, with the potential to affect multiple human generations across the full spectrum of cultural and geographic boundaries (IPCC 2014). While effectively managing the long-term risks of climate change promises to be a difficult challenge, there are many risk-reduction actions that can be taken in the near term.We need, however, a knowledge base explicitly designed to support choosing and implementing the most appropriate and effective actions. Traditional climate change assessments are not optimally designed and constructed to deliver the kind of actionable information decision-makers need —and are asking for—to prioritize and manage climate change risks (Kirchhoff et al 2013, NAS 2016). From our collective experience as physical and social scientists working at the intersection of climate change and society, we argue it is time for a shift in the objectives and implementation of climate change assessments—frommaking what amounts to a general 11 www.federalregister.gov/documents/2016/03/31/2016-07208/uni ted-states-global-change-research-program; one of the paper Environ. Res. Lett. 12 (2017) 080201 C P Weaver et al case for ‘action,’ to characterizing specific risks to help people develop, select, carry out, and monitor specific actions that ultimately have greater benefits than costs. Society’s knowledge of current and future climate change has been established through decades of scientific research into the natural causes of past changes in climate, the buildup of anthropogenic greenhouse gases in the atmosphere, and the linked behavior of the oceans, atmosphere, ice, land, and biosphere. Social, political, and economic analyses of observed and projected climate impacts have provided further insights into how changes in the physical climate system can harm ecosystems, economic productivity, and human health and well-being. Climate change assessments are a key tool for organizing, summarizing, and communicating this science. An array of such assessments has been prepared under the auspices of international bodies such as the Intergovernmental Panel on Climate Change (IPCC), and in the United States through the US Global Change Research Program (USGCRP), established by a Presidential Initiative in 1989 and mandated by Congress in the Global Change Research Act (GCRA) of 1990. These assessments have synthesized and communicated a robust understanding of the causes and proximate impacts of natural and anthropogenic climate change. They have built collective understanding within and across diverse scientific communities and focused attention on established findings and key areas for new research to address outstanding uncertainties. An important stated goal of these assessments is to raise awareness among the public and policymakers of the existence, causes, and potential magnitude of human-induced climate change and its impacts. To a certain extent this has been successful: in the United States, for example, climate change is now recognized as a top risk to Federal government assets (GAO 2015), national security (DoD 2014, 2015), and business interests (Risky Business Project 2014, see also WEF 2016). Despite their technical sophistication and reach, however, major climate assessments have focused primarily on summarizing scientific understanding of, and scientific uncertainties about, expected changes in the physical climate system resulting from continued greenhouse gas emissions. Decision-makers, by contrast, need to understand how climate change may interfere with their plans and compromise their objectives, so they can adapt existing policies and adopt new strategies to stay on track—whether to protect life, health, and well-being, sustain economic growth, preserve natural resources, ensure continued performance of critical infrastructure, or maintain national security. The improved general understanding created by past assessments has led many decision-makers to demand that the next 10 Public Law 101–606(11/16/90) 104 Stat. 3096–3104, signed into law by President George H.W. Bush. 2 generation of assessments address new questions more relevant to their specific needs, which center on how climate change may intersect with their own unique decision imperatives; this embeds climate change within a larger environmental and socioeconomic context as one among many stressors (IPCC 2012, Weaver et al 2014, USGCRP 2016). At the international level of the IPCC assessments, there have been increasing calls for changes in assessment focus, process, and structure, in recognition of this mismatch between demand and supply of information (Arvai et al 2006, Mach et al 2016, Hallegatte and Mach 2016, Kennel et al 2016). The need for change is arguably even more important for national assessments, which generally focus on climate change and impacts at national and sub-national scales, the scales of governance with primary decisionmaking authority for most response actions. One of the largest nationally-led assessments is the US National Climate Assessment (NCA), the most recent version of which, the Third NCA, was released in May 2014 (Melillo et al 2014). These NCAs are charged with integrating, evaluating, and interpreting the existing body of climate research, so as to assess current and projected trends in climate change and its impacts on US regions and sectors. Development of the Fourth NCA by the US government is underway, building on the success of, and lessons learned from, the Third NCA. Furthermore, the United States has recently committed to a long-term ‘sustained’ process of climate change assessment over multiple NCA cycles (USGCRP 2012, Buizer et al 2015), with a new Federal Advisory Committee dedicated to this sustained process. Federal agencies, state and local governments, and businesses have begun preparing for adverse impacts of climate change on the basis of past assessments, but these actors need information more relevant to their planning and decision-making processes, which are fundamentally aimed at ensuring long-term resilience in the face of climate risks. Retooling US climate assessments around key societal risks would be a big step in that direction, and the time is right to do so. While our focus here is on national assessments, and in the United States in particular, the project of improving such assessments is an international one, with parallel efforts in other countries or regions (e.g. UKCommittee on Climate Change 2017, California’s four Climate Change Assessments); the need for peer learning between respective efforts is critical and often overlooked. Adapting core principles of risk assessment to climate: To date, the approach of climate change assessmentshasprimarilybeenrootedincommunicating authors, RHM, serves as the Chair of this Federal Advisory Committee. 12 http://climatechange.ca.gov/climate_action_team/reports/clima te_assessments.html. Text box on core principles of risk assessment (adapted from King et al 2015) Define what we value (what is ‘at risk’); make this transparent and put these things (people, human systems, valued natural systems and services) front and center in the assessment. Risk analysis inevitably involves definitions of valued outcomes that reflect particular ethical or political interests. Open deliberation is required to define relevant values that are acceptable to all stakeholders

In vivo dosimetry in UK external beam radiotherapy: current and future usage.

Abstract: Objective:Towards Safer Radiotherapy recommended that radiotherapy (RT) centres should have protocols in place for in vivo dosimetry (IVD) monitoring at the beginning of patient treatment courses (Donaldson S. Towards safer radiotherapy. R Coll Radiol 2008). This report determines IVD implementation in the UK in 2014, the methods used and makes recommendations on future use.Methods:Evidence from peer-reviewed journals was used in conjunction with the first survey of UK RT centre IVD practice since the publication of Towards Safer Radiotherapy. In March 2014, profession-specific questionnaires were sent to radiographer, clinical oncologist and physics staff groups in each of the 66 UK RT centres.Results:Response rates from each group were 74%, 45% and 74%, respectively. 73% of RT centres indicated that they performed IVD. Diodes are the most popular IVD device. Thermoluminescent dosimeter (TLD) is still in use in a number of centres but not as a sole modality, being used in conjunction with diodes and/or e...

Comparing preferences for outcomes of psoriasis treatments among patients and dermatologists in the U.K.: results from a discrete‐choice experiment

Abstract: Background Plaque psoriasis can have a significant negative effect on patient quality of life, and treatments can result in serious toxicities. Although there have been several studies of patients’ and physicians’ relative preferences for the benefits and risks of psoriasis treatments, it is unclear how and whether patients’ and physicians’ preferences for the outcomes of psoriasis treatments differ. Objectives The objective of this study is to quantify patient and dermatologist preferences for improvements in psoriasis symptoms as well as for increases in the risk of treatment-related serious adverse events. Methods Members of the United Kingdom (UK) Psoriasis Association and UK dermatologists with experience prescribing biologics completed a web-enabled discrete-choice experiment survey in which they evaluated efficacy and safety features of biological treatments for psoriasis. Choices between hypothetical treatment options were used to estimate preference weights indicating respondents’ relative trade-off preferences among treatment outcomes. These outcomes included improvements in the severity and coverage of psoriatic plaques and treatment-related risks of tuberculosis, serious infections, and lymphoma. Preference estimates were used to derive the maximum level of side-effect risks that respondents would accept for improvements in psoriasis symptoms. Results Results showed that respondents’ tolerance for side-effect risks varied with side-effect severity and location of plaques, and that risk tolerance for serious side effects was greater for patients than for dermatologists. Conclusions Estimates of patients’ risk tolerance for serious side effects indicate that patients valued psoriasis-symptom control highly and suggest that psoriasis symptoms have a significant effect on patients’ quality of life. In light of research showing increased treatment satisfaction and improved treatment adherence among patients who receive therapies that are consistent with their preferences, our findings suggest that greater communication between dermatologists and patients about risk tolerance could help improve patient care. This article is protected by copyright. All rights reserved.

Limiting climate change: what’s most worth doing?

Abstract: Wynes and Nicholas (2017 Environ. Res. Lett. 12 074024) claim that some of the most important actions individuals can take to mitigate climate change have been overlooked, particularly in educational messages for adolescents, and estimate the potential impact of some of these, including having fewer children and living car free. These estimates raise questions that deserve serious analysis, but they are based only on the technical potential of the actions and do not consider the plasticity of the behaviors and the feasibility of policies to support them. The actions identified as having the greatest potential are lifestyle changes that accrue benefits over a lifetime or longer, so are not realistic alternatives to actions that can be enacted immediately. But presenting lifestyle choices and the relative impacts of different actions as discussion starters for adolescents could be promising, especially if the discussions highlight issues of behavioral plasticity, policy plasticity, and time scale. Research has identified design principles for interventions to achieve the strongest emissions reductions at time scales up to the decadal. Design principles for achieving longer-lasting changes deserve careful analytic attention, as well as a stronger focus in adolescent textbooks and messages to the general population. Both adolescents and researchers would do well to think carefully about what could promote the generational changes needed to reach a climate change target such as 'well below 2 °C'.

Role of HIV-specific CD8+ T cells in pediatric HIV cure strategies after widespread early viral escape.

Abstract: Wellcome Trust WT 104748MA; 098051; 093768/Z/15/X; Clarendon Fund; National Institute for Health Research; University of Oxford; Mochida Memorial Foundation for Medical and Pharmaceutical Research.

Prevalence and breed predisposition for thoracolumbar intervertebral disc disease in cats.

Abstract: Objectives The objective was to evaluate the prevalence and possible breed predilections for thoracolumbar intervertebral disc disease (IVDD) in cats. Methods Medical records and imaging studies of cats diagnosed with thoracolumbar IVDD between January 2008 and August 2014 were retrospectively reviewed and compared with the general hospital population. The association between type of IVDD (ie, intervertebral disc extrusion [IVDE] or intervertebral disc protrusion [IVDP]) and breed, age, sex, and duration and severity of clinical signs was also evaluated. Results Of 12,900 cats presented during the study period, 31 (0.24%) were diagnosed with IVDD, including 17 purebred and 14 non-purebred cats. Of all presented purebred cats, 0.52% were diagnosed with thoracolumbar IVDD. More specifically, 1.29% of all British Shorthairs and 1.83% of all presented Persians were diagnosed with IVDD. Compared with the general hospital population, purebred cats ( P = 0.0001), British Shorthairs ( P <0.0001) and Persians ( P = 0.0006) were significantly overrepresented with thoracolumbar IVDD. Affected purebred cats were younger than affected non-purebred cats ( P = 0.02). Of 31 cats with IVDD, 19 were diagnosed with IVDE and 12 with IVDP. Cats with IVDE had a significantly shorter duration of clinical signs ( P = 0.0002) and demonstrated more severe neurological deficits ( P = 0.04) than cats with IVDP. Conclusions and relevance Although thoracolumbar IVDD is an uncommon condition in cats, purebred cats, British Shorthairs and Persians, were overrepresented. It is currently unclear if this represents a true breed predisposition or a higher likelihood of owners of purebred cats seeking referral for advanced diagnostic imaging procedures.

GamTest : Psychometric Evaluation and the Role of Emotions in an Online Self-Test for Gambling Behavior

Abstract: Recent increases in the number of online gambling sites have made gambling more available, which may contribute to an increase in gambling problems. At the same time, online gambling provides oppor ...

A qualitative study on becoming cared for in Alzheimer's disease: the effects to women's sense of identity

Abstract: Objective: To explore the lived experience of becoming cared for and the impact this has on the identity and sense of self of women with Alzheimer's disease.Method: Eight women with mild-to-moderate Alzheimer's disease were interviewed in Northamptonshire, England, on two separate occasions about their experiences relating to needing assistance with instrumental activities of daily living (IADL) tasks. Interpretative phenomenological analysis was the approach used to underpin this research.Results: Changes in the women's identity affected by the increased need for assistance with IADL tasks were expressed in terms of: who I am; unhappy being me; fighting to remain me; I'm not the same, but it doesn't worry me; and acceptance and contentment.Conclusion: This study offers an alternative perspective to the view that all women with Alzheimer's disease experience becoming cared for as a negative event in their lives. Some factors universally perceived as being a result of Alzheimer's disease may be a n...

Editorial: Student voice. Listening to students to improve education through digital technologies

Abstract: Over the past 20 years, the student voice pedagogical movement has been gaining momentum worldwide (Czerniawski & Kidd, 2011). Inspired by the need to enhance student engagement and participation in education (Cook-Sather, 2002), the movement seeks to bolster the position and role of students inside school and other academic contexts. In this light, students’ views on teaching and learning represent valuable input, informing the actions of teachers and policymakers alike (Fielding, 2001). The movement’s initial efforts were mostly focused on capturing the perspectives of school children and young students and on fostering their co-participation in teaching and learning practices (Flutter & Rudduck, 2004). More recently, major changes in higher education have resulted in the legitimisation of student voice at university level too (Cook-Sather, Bovil, & Felten, 2014). The student voice is now seen as a central component in the transformation of higher education and its alignment with students’ experience and expectations. It also contributes towards students’ experience and expectations as learners, and career aspirations as future contributors to the economy and society.

Notes on the use of randomised controlled trials to evaluate complex interventions: Community treatment orders as an illustrative case.

Abstract: Over the past seven decades, randomised controlled trials (RCTs) have revolutionised clinical research and achieved a gold standard status. However, extending their use to evaluate complex interventions is problematic. In this paper we will demonstrate that complex intervention RCTs violate the necessary premises that govern the RCTs logic and underpin their rigour. The lack of blinding, heterogeneity of participants, as well as poor treatment standardisation and difficulty of controlling for confounders, which characterise complex intervention RCTs, can potentially be profoundly detrimental to their integrity. Proponents of this approach argue that matching “real world” circumstances, while maintaining the randomised design, enhances external validity. We counter this argument by pointing out that an inverted U relation exists between internal and external validity, and thus relaxing the experimental conditions beyond a certain threshold can potentially paradoxically render the RCT externally invalid, i.e. its results cannot be used anywhere. We shall illustrate the inappropriate use of RCTs to evaluate community treatment orders and propose an alternative epistemic model that is based on mechanistic reasoning and Cartwright's capacity concept.

Towards a new wave in internationalization of innovation? The rise of China's innovative MNEs, strategic coupling, and global economic organization

Abstract: This paper examines the changes in the internationalisation of innovation created by the recent surge of Chinese innovative firms and the resultant effects on global economic organisation. Drawing insights from the international business, economic geography and development studies literatures, it investigates the rise and internationalisation of Chinese innovative firms from the perspective of strategic coupling, decoupling and recoupling. This novel approach provides a first glimpse into the potential impact of the Chinese innovative firms on global business leadership, power relationships in global value chains and ultimately into global economic organisation.

A survey of recent contributions on low power NoC architectures

Abstract: The Network-on-Chip (NoC) paradigm has been herald as the solution to the communication limitation that System-On-Chip (SoC) poses. However, power Consumption is one of its major defects. To ensure that a high performance architecture is constructed, analyzing how power can be reduced in each area of the network is essential. Power dissipation can be reduced by making adjustments to the elements in routers. The architecture itself and the Links. This paper will entail a survey conducted on recent contributions on NoC. As well as the techniques employed by researchers towards the reduction of power in the router architecture, network architecture and the links.

Not 'just' a GP: a call for action.

Abstract: > ‘ The fault, dear Brutus, is not in our stars, But in ourselves, that we are underlings. ’1 One of the most commonly heard anecdotes on the plight of general practice in medical schools is the description of the packed lecture theatre in the first week. The lecturer asks the students, ‘ How many of you want to become general practitioners?’ Only three raise their hands, enabling the lecturer to comment disparagingly, ‘ Well tough, half of you will “end up” as GPs.’ This is a response that sadly embeds the belief that one ‘ends up’ in general practice instead of ‘arriving’ by choice. At the same time within the NHS we face a view, entrenched from its launch, that the consultant’s career pathway is ‘ a ladder off which, if unsuccessful, one falls to become a GP’ .2,3 How often does one still hear the comment reflective of this hierarchical assumption that, ‘ I am just a GP’ ? This problem was highlighted by Denis Pereira Gray more than 35 years ago,4 yet such comments are still heard far too often. This is a call for action to bridge the primary care/secondary care ‘fault line’2 and cling to the ladder to achieve equal status. The lecturer should be expounding the view to students that, ‘Unfortunately only half of you will feel you have the intellectual ability and personal attributes to become a GP.’ As a profession we must declare that current and future primary care demands some of the brightest and best students to deliver what must now be one of the most difficult and intellectually challenging careers. As the recent report from …

New horizons: forensic mental health services for older people

Abstract: Although the older adult population makes up only a small percentage of mentally disordered offenders, there is a clear need for forensic mental health services for older people. However, these services to date have developed ad hoc and with no coordination. In this article we discuss the evolution, current provision, future direction and therapeutic implications of such services. Although the epidemiology, criminology and clinical characteristics of older people are sufficiently different from those of younger people to warrant such service specificity, we suggest that the provision of care should be geared to services based on older people’s multiple and complex needs, rather than on arbitrary age cut-offs.

CRISPR as a strong gene editing tool.

Abstract: Clustered regularly-interspaced short palindromic repeats (CRISPR) is a new and effective genetic editing tool. CRISPR was initially found in bacteria to protect it from virus invasions. In the first step, specific DNA strands of virus are identified by guide RNA that is composed of crRNA and tracrRNA. Then RNAse III is required for producing crRNA from pre-crRNA. In The second step, a crRNA:tracrRNA:Cas9 complex guides RNase III to cleave target DNA. After cleavage of DNA by CRISPR-Cas9, DNA can be fixed by Non- Homologous End Joining (NHEJ) and Homology Directed Repair (HDR). Whereas NHEJ is simple and random, HDR is much more complex and accurate. Gene editing by CRISPR is able to be applied to various biological field such as agriculture and treating genetic diseases in human. [BMB Reports 2017; 50(1): 20-24].