Description and predictors of hospital costs of oesophageal cancer during the first year following diagnosis in Northern Ireland

The cost-effectiveness of novel interventions in the treatment of cancer is well researched; however, relatively little attention is paid to the cost of many aspects of routine care. Oesophageal cancer is the ninth most common cancer in the UK and sixth most common cause of cancer death. It usually presents late and has a poor prognosis. The hospital costs incurred by oesophageal cancer patients diagnosed in Northern Ireland in 2005 (n = 198) were determined by review of medical records. The average cost of hospital care per patient in the 12 months from presentation was £7847. Variations in total hospital costs by age at diagnosis, gender, cancer stage, histological type, mortality at 1 year, co-morbidity count and socio-economic status were analysed using multiple regression analyses. Higher costs were associated with earlier stages of cancer and cancer stage remained a significant predictor of costs after controlling for cancer type, patient age and mortality at 1 year. Thus, although early detection of cancer usually improves survival, this would mean increased costs in the first year. Deprivation achieved borderline significance with those from more deprived areas having lower resource consumption relative to the more affluent. © 2013 John Wiley & Sons Ltd.

Detection of an outburst one year prior to the explosion of SN 2011ht

Using imaging from the Pan-STARRS1 survey, we identify a precursor outburst at epochs 287 and 170 days prior to the reported explosion of the purported Type IIn supernova (SN) 2011ht. In the Pan-STARRS data, a source coincident with SN 2011ht is detected exclusively in the \zps\ and \yps-bands. An absolute magnitude of M$_z\simeq$-11.8 suggests that this was an outburst of the progenitor star. Unfiltered, archival Catalina Real Time Transient survey images also reveal a coincident source from at least 258 to 138 days before the main event. We suggest that the outburst is likely to be an intrinsically red eruption, although we cannot conclusively exclude a series of erratic outbursts which were observed only in the redder bands by chance. This is only the fourth detection of an outburst prior to a claimed SN, and lends credence to the possibility that many more interacting transients have pre-explosion outbursts, which have been missed by current surveys.

A 1300-year multi-proxy, high-resolution record from a rich fen in northern Poland:Reconstructing hydrology, land use and climate change

Here we present the first high-resolution multi-proxy analysis of a rich fen in the central-eastern European lowlands. The fen is located in the young glacial landscape of the Sta{ogonek}zki river valley. We investigated the fen's development pathways, asking three main questions: (i) what was the pattern and timing of the peatland's vegetation succession, (ii) how did land use and climate affect the succession in the fen ecosystem, and (iii) to what degree does the reconstructed hydrology for this site correlate with those of other sites in the region in terms of past climate change? Several stages of fen history were determined, beginning with the lake-to-fen transition ca. AD 700. Brown mosses dominated the sampling site from this period to the present. No human impact was found to have occurred until ca. AD 1700, when the first forest cutting began. Around AD 1890 a more significant disturbance took place-this date marks the clear cutting of forests and dramatic landscape openness. Deforestation changed the hydrology and chemistry of the mire, which was revealed by a shift in local plant and testate amoebae communities. We also compared a potential climatic signal recorded in the peat profile before AD 1700 with other sites from the region. © 2013 John Wiley & Sons, Ltd.

A high resolution 15,600-year pollen and microcharcoal record from the Cederberg Mountains, South Africa

The Cederberg Mountains (Western Cape Province, South Africa) are located within the Fynbos Biome, which exhibits some of the highest levels of species richness and endemism in the world. The region's post-glacial vegetation history, however, remains largely unknown. Presented here are high resolution pollen and microcharcoal records spanning the last 15,600 years obtained from the De Rif rock hyrax midden from the Driehoek Valley of the central Cederberg. In this region, previous pollen studies have shown muted variability in vegetation community composition during periods of globally marked climatic variability (e.g. the last glacial-interglacial transition). In our record, however, significant changes in vegetation composition are apparent. Most notably, they indicate a shift from ericaceous/restioid fynbos (present from 15,600 to 13,300 cal yr BP) to a brief, but prominent, development of proteoid fynbos at the beginning of the Holocene around 11,200 cal yr BP. This vegetation shift is associated with increased moisture at the site, and coincides with reduced fire frequency as indicated by the microcharcoal record. At 10,400 cal yr BP, there is a marked reduction in Protea-type pollen, which is replaced by thicket, characterised by Dodonaea, which became the dominant arboreal pollen type. This shift was likely the result of a long relatively fire-free period coupled with warmer and wetter climates spanning much of the early Holocene. A brief but marked decrease in water availability around 8500-8000 cal yr BP resulted in the strong decrease of Dodonaea pollen. The vegetation of the mid- to late Holocene is characterised by the increased occurrence of Asteraceae and succulent taxa, suggesting substantially drier conditions. These data give unprecedented insight into the vegetation dynamics across a period of substantial, rapid climate change, and while they confirm the presence of fynbos elements throughout the last 15,600 years, the results highlight significant fluctuations in the vegetation that were triggered by changes in both climate and fire regimes. (C) 2013 Elsevier B.V. All rights reserved.

External validation of the OHTS-EGPS model for predicting the 5-year risk of open-angle glaucoma in ocular hypertensives

To independently evaluate and compare the performance of the Ocular Hypertension Treatment Study-European Glaucoma Prevention Study (OHTS-EGPS) prediction equation for estimating the 5-year risk of open-angle glaucoma (OAG) in four cohorts of adults with ocular hypertension.

Multi-Dimensional Deprivation in Ireland Among 9-Year-Olds in Ireland:An Analysis of the Growing Up in Ireland Survey’

In this paper we make use of the 9-year old wave of the Growing Up in Ireland study to analyse multidimensional deprivation in Ireland. The Alkire and Foster adjusted head count ratio approach (AHCR; 2007, 2011a, 2011b) applied here constitutes a significant improvement on union and intersection approaches and allows for the decomposition of multidimensional poverty in terms of dimensions and sub-groups. The approach involves a censoring of data such that deprivations count only for those above the specified multidimensional threshold leading to a stronger set of interrelationships between deprivation dimensions. Our analysis shows that the composition of the adjusted head ratio is influenced by a range of socio-economic factors. For less-favoured socio-economic groups dimensions relating to material deprivation are disproportionately represented while for the more advantaged groups, those relating to behavioral and emotional issues and social interaction play a greater role. Notwithstanding such variation in composition, our analysis showed that the AHCR varied systematically across categories of household type, and the social class, education and age group of the primary care giver. Furthermore, these variables combined in a cumulative manner. The most systematic variation was in relation to the head count of those above the multidimensional threshold rather than intensity, conditional on being above that cut-off point. Without seeking to arbitrate on the relative value of composite indices versus disaggregated profiles, our analysis demonstrates that there is much to be gained from adopting an approach with clearly understood axiomatic properties. Doing so allows one to evaluate the consequences of the measurement strategy employed for the understanding of levels of multidimensional deprivation, the nature of such deprivation profiles and socio-economic risk patterns. Ultimately it permits an informed assessment of the strengths and weaknesses of the particular choices made.

A cluster randomised controlled trial of “Bookstart+”: a book gifting programme

Purpose – The purpose of this paper is to evaluate the effectiveness of a free book gifting programme, called “Bookstart+”, in improving family reading outcomes.

Design/methodology/approach – Bookstart+ consists of a pack of books and reading materials provided to families at their two-year-old child's statutory health visit. The pack is accompanied by a short priming demonstration, delivered by the health visitor, on shared reading. The evaluation took the form of a randomised controlled trial (RCT) with 460 families from the client lists of 115 health visitors.

Findings – The study found evidence of: a positive significant effect on parents’ attitudes to reading and books (Cohen's d=+0.192, p=0.034); no significant effect on parental attitudes to their child reading (d=+0.085, p=0.279); and a negative effect, approaching significance, on public library usage (d=-0.160, p=0.055).

Research limitations/implications – The attrition rate was high, with only 43.9 per cent of the target families completing all of the research. However, this level of attrition did not lead to any significant differences between the control and intervention groups on their pre-test measures.

Practical implications – The study provides recommendations for free book gifting service provision in relation to pack contents and delivery.

Originality/value – This paper contributes to the limited international RCT evidence on free book gifting programmes.

Outcomes and process in reading tutoring

Background: Large-scale randomised controlled trials are relatively rare in education. The present study approximates to, but is not exactly, a randomised controlled trial. It was an attempt to scale up previous small peer tutoring projects, while investing only modestly in continuing professional development for teachers.Purpose: A two-year study of peer tutoring in reading was undertaken in one local education authority in Scotland. The relative effectiveness of cross-age versus same-age tutoring, light versus intensive intervention, and reading versus reading and mathematics tutoring were investigated.Programme description (if relevant): The intervention was Paired Reading, a freely available cross-ability tutoring method applied to books of the pupils' choice but above the tutee's independent readability level. It involves Reading Together and Reading Alone, and switching from one to the other according to need.Sample: Eighty-seven primary schools of overall average socio-economic status, ability and gender in one council in Scotland. There were few ethnic minority students. Proportions of students with special needs were low. Children were eight and 10 years old as the intervention started. Macro-evaluation n = 3520. Micro-evaluation Year 1 15 schools n = 592, Year 2 a different 15 schools n = 591, compared with a comparison group of five schools n = 240.Design and methods: Almost all the primary schools in the local authority participated and were randomly allocated to condition. A macro-evaluation tested and retested over a two-year period using Performance Indicators in Primary Schools. A micro-evaluation tested and retested within each year using norm-referenced tests of reading comprehension. Macro-evaluation was with multi-level modelling, micro-evaluation with descriptive statistics and effect sizes, analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA).Results: Macro-evaluation yielded significant pre-post gains in reading attainment for cross-age tutoring over both years. No other differences were significant. Micro-evaluation yielded pre-post changes in Year 1 (selected) and Year 2 (random) greater than controls, with no difference between same-age and cross-age tutoring. Light and intensive tutoring were equally effective. Tutoring reading and mathematics together was more effective than only tutoring reading. Lower socio-economic and lower reading ability students did better. Girls did better than boys. Regarding observed implementation quality, some factors were high and others low. Few implementation variables correlated with attainment gain.Conclusions: Paired Reading tutoring does lead to better reading attainment compared with students not participating. This is true in the long term (macro-evaluation) for cross-age tutoring, and in the short term (micro-evaluation) for both cross-age and same-age tutoring. Tutors and tutees benefited. Intensity had no effect but dual tutoring did have an effect. Low-socio-economic status, low-ability and female students did better. The results of the different forms of evaluation were indeed different. There are implications for practice and for future research. © 2012 Copyright Taylor and Francis Group, LLC.