Systematic review investigating the reporting of comorbidities and medication in randomized controlled trials of people with dementia

Objectives: dementia is a debilitating condition characterised by global loss of cognitive and intellectual functioning, which reduces social and occupational performance. This population frequently presents with medical co-morbidities such as hypertension, cardiovascular disease and diabetes. The CONSORT statement outlines recommended guidance on reporting of participant characteristics in clinical trials. It is, however, unclear how much these are adhered to in trials assessing people with dementia. This paper assesses the reporting of medical co-morbidities and prescribed medications for people with dementia within randomised controlled trial (RCT) reports. Design: a systematic review of the published literature from the databases AMED, CINAHL, MEDLINE, EMBASE and the Cochrane Clinical Trial Registry from 1 January 1997 to 9 January 2014 was undertaken in order to identify RCTs detailing baseline medical co-morbidities and prescribed medications . Eligible studies were appraised using the Critical Appraisal Skills Programme (CASP) RCT appraisal tool, and descriptive statistical analyses were calculated to determine point prevalence. Results: nine trials, including 1474 people with dementia, were identified presenting medical co-morbidity data. These indicated neurological disorders ( prevalence 91%), vascular disorders (prevalence 91%), cardiac disorders ( prevalence 74%) and ischaemic cerebrovascular disease ( prevalence 53%) were most frequently seen. Conclusions: published RCTs poorly report medical co-morbidities and medications for people with dementia. Future trials should include the report of these items to allow interpretation of whether the results are generalisable to frailer older populations.

In defence of amateurism:on not professionalizing ethnic and racial studies

This piece suggests that the field of ethnic and racial studies is too diverse in theoretical and methodological approach and subject of study to constitute its own discipline. Instead, ethnic and racial studies remains a loosely defined space of interdisciplinary exchange. There is a sense of community among researchers in this field, but teaching continues to be organized to meet the imperatives of different home disciplines. This article argues that in these times of increasing bureaucracy, standardization and managerial intrusion into academic life, there is a positive benefit in retaining a relatively open space of inquiry where we can consider the construction of contemporary social boundaries.

Making Sense of Home and Homeland: Former-Soviet Greeks' Motivations and Strategies for a Transnational Migrant Circuit

Focusing on former-Soviet Greeks' experiences of cross-border movement to Greece, this paper sheds light on the impact of this migration on the social identities of Russian Greeks as a transnational community. It draws on informants’ narratives and ethnographic observations recorded among Greek migrants in their home communities in southern Russia, and shows how their motivation, in their transnational movement, is determined by the ‘push-and-pull’ forces of socio-economic and political transformations in post-Soviet space. In these conditions, Greek identity becomes a resource which facilitates the organisation of transnational migration. The cultural, social and economic differences between the former-Soviet Greek migrants and the native-born population of Greece result in the emergence of a Pontic-Greek cultural identity which emphasises migrants’ connections with the former USSR. The difficulties of economic and cultural adaptation for migrants to Greece are examined in relation to the Russian Greeks' economic strategies within their home communities and their perception of the ‘homeland’ as a constantly contested and relocated social construct.

Towards an integrative theory of religion and politics

In the social sciences, debate on the relationship between religion and politics is mainly the subject of analysis in the sociology of religion and the theory of international relations. While each of these fields promotes different approaches to study their interdependency. The individual's perception of religion and politics is neglected by current research. The faithful, who participates in religious ceremonies, listening and behaving according to specific religious teachings, actively engaging in the liturgical life of the institutional form of his religion, has a specific way of understanding the relationship between religion and politics. I argue that this aspect is under-researched and misrepresented in the literature of sociology and international relations. However, a more complex analysis is offered by the study of nationalism, and especially by its ethnosymbolic approach, which includes at the micro and macro societal level the presence of myths and symbols as part of the individual's and the nation's life. An integrative theory analysing the connection between religion and politics takes into account the role of myths and symbols from the perspectives of both individuals and ethnic communities.

The impact of board independence and ownership structure on the timeliness of corporate internet reporting of Irish-listed companies

Purpose – This study seeks to provide valuable new insight into the timeliness of corporate internet reporting (TCIR) by a sample of Irish-listed companies. Design/methodology/approach – The authors apply an updated version of Abdelsalam et al. TCIR index to assess the timeliness of corporate internet reporting. The index encompasses 13 criteria that are used to measure the TCIR for a sample of Irish-listed companies. In addition, the authors assess the timeliness of posting companies’ annual and interim reports to their web sites. Furthermore, the study examines the influence of board independence and ownership structure on the TCIR behaviour. Board composition is measured by the percentage of independent directors, chairman’s dual role and average tenure of directors. Ownership structure is represented by managerial ownership and blockholder ownership. Findings – It is found that Irish-listed companies, on average, satisfy only 46 per cent of the timeliness criteria assessed by the timeliness index. After controlling for size, audit fees and firm performance, evidence that TCIR is positively associated with board of director’s independence and chief executive officer (CEO) ownership is provided. Furthermore, it is found that large companies are faster in posting their annual reports to their web sites. The findings suggest that board composition and ownership structure influence a firm’s TCIR behaviour, presumably in response to the information asymmetry between management and investors and the resulting agency costs. Practical implications – The findings highlight the need for improvement in TCIR by Irish-listed companies in many areas, especially in regard to the regular updates of information provided on their web sites. Originality/value – This study represents one of the first comprehensive examinations of the important dimension of the TCIR in Irish-listed companies.

"Action at a distance":accounting inscriptions and the reporting of episodes of clinical care

This paper reports on an aspect of the implementation of a sophisticated system of Casemix Budgeting within a large public hospital in New Zealand. The paper examines the role of accounting inscription in supporting a system of “remote” management control effected through the Finance function at the hospital. The paper provides detailed description and analysis of part of the casemix technology in use at the research site. The implementation of clinical budgeting through the Transition casemix system will be examined by describing an aspect of the casemix system in detail. The design and use of management reporting is described. Reporting to different levels of management and for differing parts of the organisation are discussed with particular emphasis on the adoption of traditional analysis of costs using standard costing and variance analysis techniques.

The application of artificial neural networks to the interpretation and classification of freshwater benthic invertebrate communities

This thesis presents a thorough and principled investigation into the application of artificial neural networks to the biological monitoring of freshwater. It contains original ideas on the classification and interpretation of benthic macroinvertebrates, and aims to demonstrate their superiority over the biotic systems currently used in the UK to report river water quality. The conceptual basis of a new biological classification system is described, and a full review and analysis of a number of river data sets is presented. The biological classification is compared to the common biotic systems using data from the Upper Trent catchment. This data contained 292 expertly classified invertebrate samples identified to mixed taxonomic levels. The neural network experimental work concentrates on the classification of the invertebrate samples into biological class, where only a subset of the sample is used to form the classification. Other experimentation is conducted into the identification of novel input samples, the classification of samples from different biotopes and the use of prior information in the neural network models. The biological classification is shown to provide an intuitive interpretation of a graphical representation, generated without reference to the class labels, of the Upper Trent data. The selection of key indicator taxa is considered using three different approaches; one novel, one from information theory and one from classical statistical methods. Good indicators of quality class based on these analyses are found to be in good agreement with those chosen by a domain expert. The change in information associated with different levels of identification and enumeration of taxa is quantified. The feasibility of using neural network classifiers and predictors to develop numeric criteria for the biological assessment of sediment contamination in the Great Lakes is also investigated.

Comparative risk of microalbuminuria and proteinuria in UK residents of south Asian and white European ethnic background with type 2 diabetes:a report from UKADS

Objective - This study investigated and compared the prevalence of microalbuminuria and overt proteinuria and their determinants in a cohort of UK resident patients of white European or south Asian ethnicity with type 2 diabetes mellitus. Research design and methods - A total of 1978 patients, comprising 1486 of south Asian and 492 of white European ethnicity, in 25 general practices in Coventry and Birmingham inner city areas in England were studied in a cross-sectional study. Demographic and risk factor data were collected and presence of microalbuminuria and overt proteinuria assessed. Main outcome measures - Prevalences of microalbuminuria and overt proteinuria. Results - Urinary albumin:creatinine measurements were available for 1852 (94%) patients. The south Asian group had a lower prevalence of microalbuminuria, 19% vs. 23% and a higher prevalence of overt proteinuria, 8% vs. 3%, X2?=?15.85, 2df, P?=?0.0004. In multiple logistic regression models, adjusted for confounding factors, significantly increased risk for the south Asian vs. white European patients for overt proteinuria was shown; OR (95% CI) 2.17 (1.05, 4.49), P?=?0.0365. For microalbuminuria, an interaction effect for ethnicity and duration of diabetes suggested that risk for south Asian patients was lower in early years following diagnosis; OR for SA vs. WH at durations 0 and 1 year were 0.56 (0.37, 0.86) and 0.59 (0.39, 0.89) respectively. After 20 years’ duration, OR?=?1.40 (0.63, 3.08). Limitations - Comparability of ethnicity defined groups; statistical methods controlled for differences between groups, but residual confounding may remain. Analyses are based on a single measure of albumin:creatinine ratio. Conclusions - There were significant differences between ethnicity groups in risk factor profiles and microalbuminuria and overt proteinuria outcomes. Whilst south Asian patients had no excess risk of microalbuminuria, the risk of overt proteinuria was elevated significantly, which might be explained by faster progression of renal dysfunction in patients of south Asian ethnicity.