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Multilevel structural equation models for longitudinal data where predictors are measured more frequently than outcomes : an application to the effects of stress on the cognitive function of nurses

Funded by Chief Scientist Office, Scotland. Grant Number: CZH/4/394 Economic and Social Research Council grant as part of the National Centre for Research Methods. Grant Number: RES-576-25-0032

Women Lawyers and the Struggle for Change in Conflict and Transition

This article examines the particular experiences of female ‘cause lawyers’ in conflicted and transitional societies. Drawn from an ongoing comparative project which involved fieldwork in Cambodia, Chile, Israel, Palestine, Tunisia and South Africa, the paper looks at opportunities, obstacles and the obduracy required from such lawyers to ‘make a difference’ in these challenging contexts. Drawing upon the theoretical literature on the sociology of the legal profession, cause-lawyers, gender and transitional justice, and the structure/agency nexus, the article considers in turn the conflict\cause-lawyering intersection and the work of cause-lawyers in transitional contexts. It concludes by arguing that the case-study of cause-lawyers offers a rebuttal to the charge that transitional justice is just like ‘ordinary justice’. It also contends that, notwithstanding the durability of patriarchal power in transitional contexts, law remains a site of struggle, not acquiescence, and many of these cause-lawyers have and continue to exercise both agency and responsibility in ‘taking on’ that power.

Improving Patients’ Experience and Outcome of Total Joint Replacement: the RESTORE Programme

BACKGROUND: Total hip replacements (THRs) and total knee replacements (TKRs) are common elective procedures. In the REsearch STudies into the ORthopaedic Experience (RESTORE) programme, we explored the care and experiences of patients with osteoarthritis after being listed for THR and TKR up to the time when an optimal outcome should be expected. OBJECTIVE: To undertake a programme of research studies to work towards improving patient outcomes after THR and TKR. METHODS: We used methodologies appropriate to research questions: systematic reviews, qualitative studies, randomised controlled trials (RCTs), feasibility studies, cohort studies and a survey. Research was supported by patient and public involvement. RESULTS: Systematic review of longitudinal studies showed that moderate to severe long-term pain affects about 7–23% of patients after THR and 10–34% after TKR. In our cohort study, 10% of patients with hip replacement and 30% with knee replacement showed no clinically or statistically significant functional improvement. In our review of pain assessment few research studies used measures to capture the incidence, character and impact of long-term pain. Qualitative studies highlighted the importance of support by health and social professionals for patients at different stages of the joint replacement pathway. Our review of longitudinal studies suggested that patients with poorer psychological health, physical function or pain before surgery had poorer long-term outcomes and may benefit from pre-surgical interventions. However, uptake of a pre-operative pain management intervention was low. Although evidence relating to patient outcomes was limited, comorbidities are common and may lead to an increased risk of adverse events, suggesting the possible value of optimising pre-operative management. The evidence base on clinical effectiveness of pre-surgical interventions, occupational therapy and physiotherapy-based rehabilitation relied on small RCTs but suggested short-term benefit. Our feasibility studies showed that definitive trials of occupational therapy before surgery and post-discharge group-based physiotherapy exercise are feasible and acceptable to patients. Randomised trial results and systematic review suggest that patients with THR should receive local anaesthetic infiltration for the management of long-term pain, but in patients receiving TKR it may not provide additional benefit to femoral nerve block. From a NHS and Personal Social Services perspective, local anaesthetic infiltration was a cost-effective treatment in primary THR. In qualitative interviews, patients and health-care professionals recognised the importance of participating in the RCTs. To support future interventions and their evaluation, we conducted a study comparing outcome measures and analysed the RCTs as cohort studies. Analyses highlighted the importance of different methods in treating and assessing hip and knee osteoarthritis. There was an inverse association between radiographic severity of osteoarthritis and pain and function in patients waiting for TKR but no association in THR. Different pain characteristics predicted long-term pain in THR and TKR. Outcomes after joint replacement should be assessed with a patient-reported outcome and a functional test. CONCLUSIONS: The RESTORE programme provides important information to guide the development of interventions to improve long-term outcomes for patients with osteoarthritis receiving THR and TKR. Issues relating to their evaluation and the assessment of patient outcomes are highlighted. Potential interventions at key times in the patient pathway were identified and deserve further study, ultimately in the context of a complex intervention.

Comparación del ensamblaje de escarabajos necro-coprófagos (Coleoptera: Scarabaeidae: Scarabaeinae) en cuatro sitios con diferente grado de perturbación en el Parque Nacional el Imposible, Ahuachapán, El Salvador

El ecoturismo en esencia es una actividad responsable dentro de áreas protegidas o parques nacionales, es razonable suponer que el impacto generado en la vida silvestre sería el mínimo posible. Sin embargo es muy poca la información existente relacionada con la cuantificación del impacto generado por este en ecosistemas protegidos. En esta investigación, se analizó la variación en la composición del ensamblaje de escarabajos necro-coprófagos en cuatro sitios con diferente grado de perturbación (de menor a mayor paso de personas) producto del ecoturismo en el parque nacional El Imposible. Se realizaron seis muestreos entre los meses de junio a noviembre del 2013, utilizando 20 trampas de caída en cada sitio, 10 cebadas con excremento humano y 10 con carroña de pollo. Se capturaron 10, 500 individuos pertenecientes a 22 especies. El índice de similaridad fue alto (0.90), demostrando iguales niveles de dominancia, mientras que el índice de Jaccard fue capaz de separar los sitios con acceso turístico de los sitios sin acceso. Dos especies dominaron el ensamblaje: Onthophagus landolti (excremento) y Coprophanaeus corythus (carroña). A medida que aumentó el paso de personas la riqueza (F=4.376, p=0.0048) y la abundancia (F=6.4330, p=0.0032) tendieron a descender, mientras que la diversidad (F=3.3117, p=0.0230), equitatividad (F=3.5892, p=0.0220) y biomasa (F=1.9003, p=0.1435) tendieron a aumentar a medida que el disturbio lo hacía, aunque las diferencias en biomasa no fueron estadísticamente significativas. Diferentes estudios han propuesto que el número de personas que transitan por un lugar juega un papel muy leve al afectar la vida silvestre, por lo que esta investigación podría significar un aporte al conocimiento del impacto que puede generar esta variable, ya que se observaron variaciones significativas en la composición del ensamblaje de escarabajos.

PRESENTACIÓN

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El patrimonio bancario y artístico cultural vasco durante la guerra civil española. Incautaciones, evacuaciones, embargos y pleitos

399 p.

Hacia un enfoque territorial del desarrollo rural

Introducción Los temas relacionados con el desarrollo rural adquieren ímpetu renovado en la última década, debido en parte a la incapacidad del modelo económico vigente para resolver los serios problemas estructurales que aquejaban un gran número de países y si incompetencia para abortar de manera creativa el nuevo panorama rural de América Latina y el Caribe (ALC). La persistencia de la pobreza rural y la necesidad de enfoques innovadores para su abortaje, cambios en la concepción del rol de la agricultura y de los pequeños agricultores, la necesidad de un abordaje mas holístico de los temas rurales y de superar el Consenso de Washington sobre la agricultura, son algunos de los elementos que han marcado de manera importante este resurgimiento…

Adubação da mandioca em latosolo amarelo esgotado do estuário amazônico.

1968