Physical activity assessment in practice: a mixed methods study of GPPAQ use in primary care

Background: Insufficient physical activity (PA) levels which increase the risk of chronic disease are reported by almost two-thirds of the population. More evidence is needed about how PA promotion can be effectively implemented in general practice (GP), particularly in socio-economically disadvantaged communities. One tool recommended for the assessment of PA in GP and supported by NICE (National Institute for Health and Care Excellence) is The General Practice Physical Activity Questionnaire (GPPAQ) but details of how it may be used and of its acceptability to practitioners and patients are limited. This study aims to examine aspects of GPPAQ administration in non-urgent patient contacts using different primary care electronic recording systems and to explore the views of health professionals regarding its use.

Methods: Four general practices, selected because of their location within socio-economically disadvantaged areas, were invited to administer GPPAQs to patients, aged 35-75 years, attending non-urgent consultations, over two-week periods. They used different methods of administration and different electronic medical record systems (EMIS, Premiere, Vision). Participants’ (general practitioners (GPs), nurses and receptionists) views regarding GPPAQ use were explored via questionnaires and focus groups.

Results: Of 2,154 eligible consultations, 192 (8.9%) completed GPPAQs; of these 83 (43%) were categorised as inactive. All practices were located within areas ranked as being in the tertile of greatest socio-economic deprivation in Northern Ireland. GPs/nurses in two practices invited completion of the GPPAQ, receptionists did so in two. One practice used an electronic template; three used paper copies of the questionnaires. End-of-study questionnaires, completed by 11 GPs, 3 nurses and 2 receptionists and two focus groups, with GPs (n = 8) and nurses (n = 4) indicated that practitioners considered the GPPAQ easy to use but not in every consultation. Its use extended consultation time, particularly for patients with complex problems who could potentially benefit from PA promotion.

Conclusions: GPs and nurses reported that the GPPAQ itself was an easy tool with which to assess PA levels in general practice and feasible to use in a range of electronic record systems but integration within routine practice is constrained by time and complex consultations. Further exploration of ways to facilitate PA promotion into practice is needed.

Electronic voting in the French legislative elections of 2012

This chapter presents an analysis of the unprecedented use of electronic voting by expatriates during the French 2012 legislative elections, when they elected their own representatives (referred to here as ‘deputies’), to the National Assembly in Paris for the first time, in 11 newly created overseas constituencies.
The study is presented within the broader perspective of electronic voting in France more generally, and in the historical context of extra-territorial voting by French expatriates. The authors discuss the main issues and controversies that arose during the 2012 elections, and in a final section analyse the results. The authors conclude by drawing attention to recent developments in electronic voting in France since the 2012 elections, which suggest that although there was much criticism expressed by experts of electronic voting as to the security and transparency of the system used, the official discourse that acclaimed the experience as a success, appears to have convinced its target audience.

Language and Power: A Resource Book for Students

Language and Power offers a comprehensive survey of the ways in which language intersects and connects with the social, cultural and political aspects of power; provides a comprehensive introduction to the history of the field, and covers all the major approaches, theoretical concepts and methods of analysis in this important and developing area of academic study; covers all the 'traditional' topics, such as race, gender and institutional power, but also incorporates newer material from forensic discourse analysis, the discourse of new capitalism and the study of humour as power; includes readings from works by seminal figures in the field, such as Roger Fowler, Deborah Cameron and Teun van Dijk; uses real texts and examples throughout, including advertisements from cosmetics companies; newspaper articles and headlines; websites and internet media; and spoken dialogues such as a transcription from the Obama and McCain presidential debate; and is accompanied by a supporting website that aims to challenge students at a more advanced level and features a complete four-unit chapter which includes activities, a reading and suggestions for further work.

Interview with Paul DeMarinis

Since the early 1970s, the American electronic media artist Paul DeMarinis (b. 1948, Cleveland, Ohio, USA) has created works that re-imagine modes of communication and reinvent the technologies that enable communication. His works (see Table 1) have taken shape as recordings, performances, electronic inventions, and site-specific and interactive installations; many are considered landmarks in the histories of electronic music and media art. Paul DeMarinis pioneered live performance with computers, collaborated on landmark works with artists like David Tudor and Robert Ashley, undertook several tours with the Merce Cunningham Dance Company, and brought to life obscure technologies such as the flame loudspeaker (featured in his 2004 sculpture Firebirds). His interactive installation The Music Room (1982), commissioned by Frank Oppenheimer for the Exploratorium in San Francisco, was the first automatic music work to reach a significant audience. His album Music As A Second Language (1991) marks one of the most extensive explorations of the synthesized voice and speech melodies to date. Installations like The Edison Effect (1989-1993), in which lasers scan ancient recordings to produce music, and The Messenger (1998/2005), in which electronic mail messages are displayed on alphabetic telegraph receivers, illustrate a creative process that Douglas Kahn (1994) has called "reinventing invention." [etc]

The politicization of indigenous identities in Peru

Until now, scholars have argued that, unlike other Latin American countries with sizable indigenous populations, indigenous politics are largely unimportant in Peru because indigenous-based parties or national-level movements are absent. Rather than focusing solely on the emergence of indigenous parties or movements, which ignores the larger consequence of individuals' indigenous identifications for electoral politics, we argue that it is more important to examine the emergence of indigenous political divisions and their effects on indigenous representation. Using data from the World Values Survey across the presidential elections of 1995, 2001, and 2006, we show that, as indigenous identity has become more carefully defined, indigenous voting divisions have emerged in Peru, and concomitantly, parties have begun to recognize and respond to these divisions.

Verification of Key Generation from Individual OFDM Subcarrier's Channel Response

This paper presents a key generation system derived from the channel response of individual subcarrier in orthogonal frequency-division multiplexing (OFDM) systems. Practical aspects of the security were investigated by implementing our key generation scheme on a wireless open-access research platform (WARP), which enables us to obtain channel estimation of individual OFDM subcarriers, a feature not currently available in most commercial wireless interface cards. Channel response of individual OFDM subcarrier is usually a wide sense stationary random process, which allows us to find the optimal probing period and maximize the key generation rate. The implementation requires cross layer design as it involves interaction between physical and MAC layer. We have experimentally verified the feasibility and principles of key generation, and also evaluated the performance of our system in terms of randomness, key generation rate and key disagreement rate, which proves that OFDM subcarrier's channel responses are valid for key generation.

Content and methodology of predoctoral Geriatric Dentistry teaching in Europe

Objectives: To explore the content and methodology of predoctoral Geriatric Dentistry teaching amongst European dental schools.
Methods: The study was conducted by the European College of Gerodontology (ECG) Education Committee. Αn electronic questionnaire has been developed with close and open-ended items, including information on the prevalence and institutional anchorage of Gerodontology programs, the educators, the content and the methodology of teaching. An electronic mail, including a hyperlink to the questionnaire, was sent to 216 dental schools in 39 European countries (Winter/ Spring 2016). The Deans were asked to either answer themselves, or forward the link to faculty members with knowledge on Gerodontology teaching at their respective schools. Repeated reminders or telephone calls were used for non-respondents and personal networks were exploited to identify potential contact persons.
Results: Until August 2016, 121 dental schools from 29 countries responded to the survey (response rate 56%, EU response rate: 60%). Gerodontology was included in the predoctoral curricula of 86% of the respondents and was compulsory in 68%. The course was mainly offered in senior students and was interdisciplinary in 30% of the schools, delivered mainly by dentists (79%), physicians (21%), psychologists (10%), and nurses (5%). It was conducted as an independent lecture series in 40% of the schools and a course director was assigned in 44% of the respondents. When embedded in other disciplines, these were mainly Prosthodontics (31%). The content included a large number of items, such as epidemiology of oral health, medical problems in old age, prosthodontic management, xerostomia, and caries risk assessment. Lectures were the most common teaching format (69%), followed by small group seminars (27%). The most common types of educational material used were scientific articles (48%), printed textbooks (44%), lecture notes (40%) and e-learning material (21%). Clinical training was offered by 64% of the respondents, within the dental school clinics (49%) and/or in outreach locations (40%).
Conclusion: Amongst the respondent European dental schools (66%) there is an increasing number that teach Gerodontology at a pre-doctoral level with significant variations in content and methodology. Official guidelines and the dissemination of the ECG pre-doctoral curriculum guidelines might help to increase the prevalence and improve the status of Gerodontology teaching in Europe.

Optimal basis set for electronic structure calculations in periodic systems

An efficient method for calculating the electronic structure of systems that need a very fine sampling of the Brillouin zone is presented. The method is based on the variational optimization of a single (i.e., common to all points in the Brillouin zone) basis set for the expansion of the electronic orbitals. Considerations from k.p-approximation theory help to understand the efficiency of the method. The accuracy and the convergence properties of the method as a function of the optimal basis set size are analyzed for a test calculation on a 16-atom Na supercell.

Outreach and Early Warning Systems (EWS) for the prevention of intensive care admission and death of critically ill adult patients on general hospital wards

BACKGROUND: Despite the fact that outreach and early warning systems (EWS) are an integral part of a hospital wide systems approach to improve the early identification and management of deteriorating patients on general hospital wards, the widespread implementation of these interventions in practice is not based on robust research evidence. OBJECTIVES: The primary objective was to determine the impact of critical care outreach services on hospital mortality rates. Secondary objectives included determining the effect of outreach services on intensive care unit (ICU) admission patterns, length of hospital stay and adverse events. SEARCH STRATEGY: The review authors searched the following electronic databases: EPOC Specialised Register, The Cochrane Central Register of Controlled Trials (CENTRAL) and other Cochrane databases (all on The Cochrane Library 2006, Issue 3), MEDLINE (1996-June week 3 2006), EMBASE (1974-week 26 2006), CINAHL (1982-July week 5 2006), First Search (1992-2005) and CAB Health (1990-July 2006); also reference lists of relevant articles, conference abstracts, and made contact with experts and critical care organisations for further information. SELECTION CRITERIA: Randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series designs (ITS) which measured hospital mortality, unanticipated ICU admissions, ICU readmissions, length of hospital stay and adverse events following implementation of outreach and EWS in a general hospital ward to identify deteriorating adult patients versus general hospital ward setting without outreach and EWS were included in the review. DATA COLLECTION AND ANALYSIS: Three review authors independently extracted data and two review authors assessed the methodological quality of the included studies. Meta-analysis was not possible due to heterogeneity. Summary statistics and descriptive summaries of primary and secondary outcomes are presented for each study. MAIN RESULTS: Two cluster-randomised control trials were included: one randomised at hospital level (23 hospitals in Australia) and one at ward level (16 wards in the UK). The primary outcome in the Australian trial (a composite score comprising incidence of unexpected cardiac arrests, unexpected deaths and unplanned ICU admissions) showed no statistical significant difference between control and medical emergency team (MET) hospitals (adjusted P value 0.640; adjusted odds ratio (OR) 0.98; 95% confidence interval (CI) 0.83 to 1.16). The UK-based trial found that outreach reduced in-hospital mortality (adjusted OR 0.52; 95% CI 0.32 to 0.85) compared with the control group. AUTHORS' CONCLUSIONS: The evidence from this review highlights the diversity and poor methodological quality of most studies investigating outreach. The results of the two included studies showed either no evidence of the effectiveness of outreach or a reduction in overall mortality in patients receiving outreach. The lack of evidence on outreach requires further multi-site RCT's to determine potential effectiveness.

The determinants of performance appraisal systems: A note (Do Brown and Heywood's results for Australia hold up for Britain?)

This article offers a replication for Britain of Brown and Heywood's analysis of the determinants of performance appraisal in Australia. Although there are some important limiting differences between our two datasets - the Australia Workplace Industrial Relations Survey (AWIRS) and the Workplace Employment Relations Survey (WERS) - we reach one central point of agreement and one intriguing shared insight. First, performance appraisal is negatively associated with tenure: where employers cannot rely on the carrot of deferred pay or the stick of dismissal to motivate workers, they will tend to rely more on monitoring, ceteris paribus. Second, employer monitoring and performance pay may be complementary. However, consonant with the disparate results from the wider literature, there is more modest agreement on the contribution of specific human resource management practices, and still less on the role of job control.

The Governance of Sexual Offending Across Europe: Penal Policies, Political Economies and the Institutionalization of Risk

This article examines why England and Wales have comparatively one of the most stringent systems for the governance of sexual offending within Western Europe. While England and Wales, like the USA, have adopted broadly exclusionary, managerialist penal policies based around incapacitation and targeted surveillance, many other Western European countries have opted for more inclusionary therapeutic interventions. Divergences in state approaches to sex offender risk, particularly in relation to notification and vetting schemes, are initially examined with reference to the respective theoretical frameworks of ‘policy transfer’ and differing political economies. Chiefly, however, differences in penal policies are attributed to the social and political construction of risk and its control. There may be multiple expressions of risk relating to expert, lay, moral or emotive aspects. It is argued, however, that it is the particular convergence and alignment of these dimensions on the part of the various stakeholders in the UK – government, media, public and professional – that leads to risk becoming institutionalized in the form of punitive regulatory policies for managing the dangerous.