University of East Anglia

About: University of East Anglia is a education organization based out in Norwich, Norfolk, United Kingdom. It is known for research contribution in the topics: Population & Climate change. The organization has 13250 authors who have published 37504 publications receiving 1669060 citations. The organization is also known as: UEA.

Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial

Abstract: Objective To assess the effect of home based telehealth interventions on the use of secondary healthcare and mortality. Design Pragmatic, multisite, cluster randomised trial comparing telehealth with usual care, using data from routine administrative datasets. General practice was the unit of randomisation. We allocated practices using a minimisation algorithm, and did analyses by intention to treat. Setting 179 general practices in three areas in England. Participants 3230 people with diabetes, chronic obstructive pulmonary disease, or heart failure recruited from practices between May 2008 and November 2009. Interventions Telehealth involved remote exchange of data between patients and healthcare professionals as part of patients’ diagnosis and management. Usual care reflected the range of services available in the trial sites, excluding telehealth. Main outcome measure Proportion of patients admitted to hospital during 12 month trial period. Results Patient characteristics were similar at baseline. Compared with controls, the intervention group had a lower admission proportion within 12 month follow-up (odds ratio 0.82, 95% confidence interval 0.70 to 0.97, P=0.017). Mortality at 12 months was also lower for intervention patients than for controls (4.6% v 8.3%; odds ratio 0.54, 0.39 to 0.75, P Conclusions Telehealth is associated with lower mortality and emergency admission rates. The reasons for the short term increases in admissions for the control group are not clear, but the trial recruitment processes could have had an effect. Trial registration number International Standard Randomised Controlled Trial Number Register ISRCTN43002091.

Access and Property: A Question of Power and Authority

Abstract: In this introduction we argue that access and property regarding natural resources are intimately bound up with the exercise of power and authority. The process of seeking authorizations for property claims also has the effect of granting authority to the authorizing politico-legal institution. In consequence, struggles over natural resources in an institutionally pluralist context are processes of everyday state formation. Through the discussion of this theoretical proposition we point to legitimizing practices, territoriality and violence as offering particular insights into the recursively constituted relations between struggles over access and property regarding natural resources, contestations about power and authority, and state formation.

Interpretation of High Projections for Global-Mean Warming

Abstract: The Intergovernmental Panel on Climate Change (IPCC) has recently released its Third Assessment Report (TAR), in which new projections are given for global-mean warming in the absence of policies to limit climate change. The full warming range over 1990 to 2100, 1.4° to 5.8°C, is substantially higher than the range given previously in the IPCC Second Assessment Report. Here we interpret the new warming range in probabilistic terms, accounting for uncertainties in emissions, the climate sensitivity, the carbon cycle, ocean mixing, and aerosol forcing. We show that the probabilities of warming values at both the high and low ends of the TAR range are very low. In the absence of climate-mitigation policies, the 90% probability interval for 1990 to 2100 warming is 1.7° to 4.9°C.