Economic modelling of antenatal screening and ultrasound scanning programmes for identification of fetal abnormalities

Objective Within the framework of a health technology assessment and using an economic model, to determine the most clinically and cost effective policy of scanning and screening for fetal abnormalities in early pregnancy. Design A discrete event simulation model of 50,000 singleton pregnancies. Setting Maternity services in Scotland. Population Women during the first 24 weeks of their pregnancy. Methods The mathematical model was populated with data on uptake of screening, prevalence, detection and false positive rates for eight fetal abnormalities and with costs for ultrasound scanning and serum screening. Inclusion of abnormalities was based on the relative prevalence and clinical importance of conditions and the availability of data. Six strategies for the identification of abnormalities prenatally including combinations of first and second trimester ultrasound scanning and first and second trimester screening for chromosomal abnormalities were compared. Main outcome measures The number of abnormalities detected and missed, the number of iatrogenic losses resulting from invasive tests, the total cost of strategies and the cost per abnormality detected were compared between strategies. Results First trimester screening for chromosomal abnormalities costs more than second trimester screening but results in fewer iatrogenic losses. Strategies which include a second trimester ultrasound scan result in more abnormalities being detected and have lower costs per anomaly detected. Conclusions The preferred strategy includes both first and second trimester ultrasound scans and a first trimester screening test for chromosomal abnormalities. It has been recommended that this policy is offered to all women in Scotland.

Instrumental and interpretive methods in evaluating urban programmes

The turn within urban policy to address increasingly complex social, economic and environmental problems has exposed some of the fragility of traditional measurement models and their reliance on the rational paradigm. This article looks at the experiences of the European Union (EU) Programme for Peace and Reconciliation in Northern Ireland and its particular attempt to construct new District Partnerships to deliver area-based regeneration programmes. It highlights the need to combine instrumental and interpretative evaluation methods in an attempt to explain the wider contribution of governance to conflict resolution and participatory practice in local development. It concludes by highlighting the value of conceptual approaches that deal with the politics of evaluation and the distributional effects of policy interventions designed to create new relationships within and between multiple stakeholders.

Analyzing the degree of conflict among belief functions.

The study of alternative combination rules in DS theory when evidence is in conflict has emerged again recently as an interesting topic, especially in data/information fusion applications. These studies have mainly focused on investigating which alternative would be appropriate for which conflicting situation, under the assumption that a conflict is identified. The issue of detection (or identification) of conflict among evidence has been ignored. In this paper, we formally define when two basic belief assignments are in conflict. This definition deploys quantitative measures of both the mass of the combined belief assigned to the emptyset before normalization and the distance between betting commitments of beliefs.We argue that only when both measures are high, it is safe to say the evidence is in conflict. This definition can be served as a prerequisite for selecting appropriate combination rules.

The general and specific effects of educational programmes aimed at promoting awareness of and respect for diversity among young children

This article reports the findings of a mixed-method evaluation of a pilot educational programme undertaken with 6-7 year olds in a sample of primary schools in England with the aim of increasing their awareness of and respect for diversity through theatre, workshops and related teacher-led classroom activities. The qualitative feedback from the teachers involved was extremely positive and encouraging and an analysis of the actual impact of the pilot programme on the children’s attitudes and awareness, using an experimental design, demonstrated some positive effects. In particular, the programme was found to increase the children’s general awareness of diversity and their ability to recognise instances of exclusion. While not a planned objective of the pilot programme, the evaluation also examined whether it had any effects on the children’s attitudes to specific differences, in this particular case racial differences. Interestingly, however, no evidence was found of any change in the children’s racial attitudes. With this in mind the article suggests that there is a need to distinguish between the general and specific effects of such educational programmes. The article considers the implications of this for future work in the area and also stresses the need to undertake more thorough and rigorous evaluations of such initiatives.

Public Participation in Area-based Urban Regeneration Programmes

This paper reports the findings of research into the representation of local interests in area-based urban regeneration programmes in Northern Ireland and the Republic of Ireland. The two case studies are contextualised by a review of the promotion of public participation in urban regeneration in both parts of Ireland and theorised as a site of interaction between state agencies and civil society. It is argued that the practice of public participation is a hegemonic project, which, within urban regeneration, is operationalised through partnership structures. The paper concludes that many factors from within and outside the case study programmes affected their consultation processes. Therefore the design and implementation of regeneration programmes should be undertaken in the context of an understanding of the relationship between the state and civil society in the empirical case.

The University Programmes for Senior Citizens and their contribution of lifelong learning

The study addresses the essential features of University Programmes for senior citizens (PUM). It committed to the lifelong education through the integration of the elderly in the University. Part of the base that is learned during the entire life cycle, there is no age, no specific space for education. Learning is constructed from knowledge, abilities, skills and aptitudes that are enriched continuously. It is necessary to ensure the elderly to age in a healthy way. It calls for active ageing, effective tool against isolation and social exclusion. The aim is to discover aspects of the UNED Senior training programme that contribute to lifelong learning and satisfaction produced. The PUM are ways for the promotion of aging along with other activities aimed to enhance a creative leisure, access to culture, facilitate training on topics of interest and create a means of participation in all spheres of society. In this research has resorted to a mixed methodology. Their wealth combines the methods of quantitative and qualitative allowing us to obtain information and contrast from different perspectives. The purpose is to verify the results of the investigation. The sample consists of 639 students, 57 teachers and 15 coordinators. The results indicate that the PUM of the UNED Senior is highly satisfactory for those involved, by the adequacy between interests and expectations. Fruit of this research are the conclusions and suggestions for improvement.

La valoración que los graduados tienen sobre su formación universitaria desde su situación laboral actual

En este artículo analizamos la valoración de los titulados universitarios sobre la formación recibida y su utilidad en la ocupación actual. El objetivo es analizar si existen diferencias por el nivel formativo de origen y el sexo de los estudiantes. A su vez, examinamos si las características de la situación laboral intervienen en estas relaciones afectando diferencialmente según las características sociodemográficas. Los resultados muestran la existencia de diferencias valorativas entre los jóvenes según su origen social y sexo, siendo las mujeres y los jóvenes de clase trabajadora los que valoran mejor su formación recibida. Finalmente, con la introducción de la situación laboral como variable de control constatamos que, en algunos casos, estas diferencias valorativas son debidas al contexto laboral actual de los graduados más que a diferencias sociodemográficas.

A new route to synthesize high degree polythiophene in a room temperature melt medium

Conducting polymers suffer from folds and kinks because of random nucleation and solvation of a free radical cation to yield a cross linked/disordered polymer and therefore a solvent free electrochemical polymerization in a room temperature melt medium is adopted to yield a high degree polymer with high electronic conductivity. Electropolymerization of thiophene was performed on platinum/ITO substrates using cyclic voltametry or galvenostatic mode in chloroaluminate room temperature melt medium to obtain a reddish brown free standing film which can be peeled off from the electrode surface after a minimum of 10 cycles. The conductivity was found to be around 102 S/cm. The degree of polymerization was calculated to be around 44 from IR studies. A layered structure supportive for high degree of polymerization was witnessed from potential step technique. From UV spectra the charge carriers were found to be bipolarons. The morphology of the film was found to be crystalline from SEM and XRD studies. Capacitative impedance properties for doped samples were interpreted from impedance spectroscopy.

Randomised controlled trial of home-based walking programmes at and below current recommended levels of exercise in sedentary adults

Objectives: To determine, using unsupervised walking programmes, the effects of exercise at a level lower than currently recommended to improve cardiovascular risk factors and functional capacity.