Comparative studies of how living circumstances influence medication adherence in ≥ 65 year olds

Background Resources to help the older aged (≥65 year olds) manage their medicines should probably target those in greatest need. The older-aged have many different types of living circumstances. There are different locations (urban, rural), different types of housing (in the community or in retirement villages), different living arrangements (living alone or with others), and different socioeconomic status (SES) circumstances. However, there has been limited attention to whether these living circumstances affect adherence to medicines in the ≥65 year olds. Aim of the review The aim was to determine whether comparative studies, including logistic regression studies, show that living circumstances affect adherence to medicines by the ≥65 year olds. Methods A literature search of Medline, CINAHL and the Internet (Google) was undertaken. Results Four comparative studies have not shown differences in adherence to medicines between the ≥65 year olds living in rural and urban locations, but one study shows lower adherence to medicines for osteoporosis in rural areas compared to metropolitan, and another study shows greater adherence to antihypertensive medicines in rural than urban areas. There are no comparative studies of adherence to medicines in the older-aged living in indigenous communities compared to other communities. There is conflicting evidence as to whether living alone, being unmarried, or having a low income/worth is associated with nonadherence. Preliminary studies have suggested that the older-aged living in rental, low SES retirement villages or leasehold, middle SES retirement villages have a lower adherence to medicines than those living in freehold, high SES retirement villages. Conclusions The ≥65 year olds living in rural communities may need extra help with adherence to medicines for osteoporosis. The ≥65 year olds living in rental or leasehold retirement villages may require extra assistance/resources to adhere to their medicines. Further research is needed to clarify whether living under certain living circumstances (e.g. living alone, being unmarried, low income) has an effect on adherence, and to determine whether the ≥65 year olds living in indigenous communities need assistance to be adherent to prescribed medicines.

A comparative study of two design charrettes: Implications for codesign and participatory action research

The purpose of this paper is to explore how participatory prototyping, through the use of design charrettes, can advance participatory action research (PAR) approaches and contribute to codesign practices in organisational settings. This will be achieved through the comparison of two varying design charrette experiences from a PAR initiative to redesign spaces in the Auraria Library in Denver, Colorado. Each design charrette followed a three-stage sequence of information sharing, idea generation and prototyping, and prioritisation with each stage building upon the former, both in terms of design concepts and in building up elements of ‘making’. While both charrette structures were similar, leadership and execution varied considerably. Lessons learned from the two design charrette experiences are presented, including the value of participatory prototyping within PAR to support ‘research through design’ activities. In addition, it highlights the value of authentic design participation of ‘designing with’ rather than ‘designing for’ to encourage optimal design outcomes.

Plantar pressure in diabetic peripheral neuropathy patients with active foot ulceration, previous ulceration and no history of ulceration: A meta-analysis of observational studies

Aims Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. Methods Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP) and pressure time integral (PTI) were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310). Results Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290–0.811, p<0.001; and 0.762, 95% CI 0.303–1.221, p = 0.001, respectively). Sub-group analyses demonstrated no significant difference in MPP for those with neuropathy with active ulceration compared to those without ulcers. A significant difference in MPP was found for those with neuropathy with a past history of ulceration compared to those without ulcers; (0.467, 95% CI 0.181– 0.753, p = 0.001). Statistical heterogeneity between studies was moderate. Conclusions Plantar pressures appear to be significantly higher in patients with diabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic neuropathy without a history of ulceration. More homogenous data is needed to confirm these findings.

Street-level perceptions of procedural rights for young unemployed people - a comparative study between Sweden and Australia

Two types of welfare states are compared in this article. Differences in procedural rights for young unemployed at the level of service delivery are analyzed. In Australia, rights are regulated through a rigid procedural justice system. The young unemployed within the social assistance system in Sweden encounter staff with high discretionary powers, which makes the legal status weak for the unemployed but, on the other hand, the system is more flexible. Despite the differences, there is striking convergence in how the young unemployed describe how discretionary power among street-level staff affects their procedural rights. This result can be understood as a result of similar professional norms, work customs and occupational cultures of street-level staff, and that there is a basic logic of conditionality in all developed welfare states where procedural rights are tightly coupled with responsibilities.

Cumulative effects on the change of residual value in PPP projects: A comparative case study

Public private partnerships (PPPs) have been adopted widely to provide public facilities and services. According to the PPP agreement, PPP projects would be transferred to the public sector. However, problems related to the subsequent management of ongoing PPP projects have not been studied thoroughly. Residual value risk (RVR) can occur if the public sector cannot obtain the project in the desired conditions as required in the agreement when a project is being transferred. RVR has been identified as an important risk in PPPs and has greatly influenced the outputs of the projects. In order to further observe the change of residual value (RV) during the process of PPP projects and to reveal the internal mechanism for reducing the RVR, a comparative case study of two PPP projects in mainland China and Hong Kong was conducted. Based on the case study, different factors leading to RVR and a series of key risk indicators (KRIs) were identified. The comparison demonstrates that RVR is an important risk that could influence the success of PPP projects. The cumulative effects during the concession period can play significant roles in the occurrence of RVR. Additionally, the cumulative effects in different cases can make the RVR different because of different stakeholders’ efforts on the projects and ways to treat RVR. Finally, alternatives for the public sector to treat RVR were proposed. The findings of this research can reduce RVR and improve the performance of PPP projects.

Physical activity cost in children following an acquired brain injury : a comparative study

Background: Alterations in energy expenditure during activity post head injury has not been investigated due primarily to the difficulty of measurement. Objective: The aim of this study was to compare energy expenditure during activity and body composition of children following acquired brain injury (ABI) with data from a group of normal controls. Design: Energy expenditure was measured using the Cosmed K4b2 in a group of 15 children with ABI and a group of 67 normal children during rest and when walking and running. Mean number of steps taken per 3 min run was also recorded and body composition was measured. Results: The energy expended during walking was not significantly different between both groups. A significant difference was found between the two groups in the energy expended during running and also for the number of steps taken as children with ABI took significantly less steps than the normal controls during a 3 min run. Conclusions: Children with ABI exert more energy per activity than healthy controls when controlled for velocity or distance. However, they expend less energy to walk and run when they are free to choose their own desirable, comfortable pace than normal controls. © 2003 Elsevier Ltd. All rights reserved.

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Methods Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk–outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990–2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. Findings All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8–58·5) of deaths and 41·6% (40·1–43·0) of DALYs. Risks quantified account for 87·9% (86·5–89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. Interpretation Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.

Comparative genomic analysis of human Chlamydia pneumoniae isolates from respiratory, brain and cardiac tissues

Chlamydia pneumoniae is an obligate intracellular bacterium implicated in a wide range of human diseases including atherosclerosis and Alzheimer's disease. Efforts to understand the relationships between C. pneumoniae detected in these diseases have been hindered by the availability of sequence data for non-respiratory strains. In this study, we sequenced the whole genomes for C. pneumoniae isolates from atherosclerosis and Alzheimer's disease, and compared these to previously published C. pneumoniae genomes. Phylogenetic analyses of these new C. pneumoniae strains indicate two sub-groups within human C. pneumoniae, and suggest that both recombination and mutation events have driven the evolution of human C. pneumoniae. Further fine-detailed analyses of these new C. pneumoniae sequences show several genetically variable loci. This suggests that similar strains of C. pneumoniae are found in the brain, lungs and cardiovascular system and that only minor genetic differences may contribute to the adaptation of particular strains in human disease.

Perceptions of the prevalence of self-organising amongst Australian road safety stakeholders: A comparative perspective

The Australian road traffic fatality rate is slowing down at a much lower rate than that of comparable high income countries. This slow rate of reduction may be attributable to a wide range of causes such as deficits in coordination and low community engagement. However, it may also be due to the absence of understanding of systems thinking in road safety in Australia. This exploratory study aimed to investigate the perceptions of Australian stakeholders about the prevalence of a principle of the Dynamic Systems Theory, namely: self-organising. The results pointed to a need to decentralize the road traffic injury prevention efforts in Australia through a range of self-organising principles and the adoption of emergent rather than deliberate strategies.

Child-centered teaching, redemption, and educational identities: A history of the present

Child-centeredness runs a familiar route in educational narratives. From Rousseau to Pestalozzi to Froebel to present day systems of childcare and schooling, childcenteredness is thought to have shifted the treatment of children into closer harmony with their true nature and hence into more sensitive and civilized forms of rearing. The celebratory air surrounding its deployment in education has been pervasive and difficult to contest partly because of the emotive alliances that have been drawn between child-centeredness and progressivism. That is, child-centeredness has been positioned as superseding a harsh, medieval ignorance of children while preventing present-day authoritarian strategies of domination. Child-centeredness is thus presently constituted as a soft space, as a deeply sensitive middle ground, between ignoring children and dominating them completely.

Moving on (part 2): Power and the child in curriculum history

This paper is the second in a two-part series that maps continuities and ruptures in conceptions of power and traces their effects in educational discourse on 'the child'. It delineates two post-Newtonian intellectual trajectories through which concepts of 'power' arrived at the theorization of 'the child': the paradoxical bio-physical inscriptions of human-ness that accompanied mechanistic worldviews and the explanations for social motion in political philosophy. The intersection of pedagogical theories with 'the child' and 'power' is further traced from the latter 1800s to the present, where a Foucaultian analytics of power-as-effects is reconsidered in regard to histories of motion. The analysis culminates in an examination of post-Newtonian (dis)continuities in the theorization of power, suggesting some productive paradoxes that inhabit turn of the 21st-century conceptualizations of the social.

Moving on (part 1): The physics of power and curriculum history

This is the first of two papers that map (dis)continuities in notions of power from Aristotle to Newton to Foucault. They trace the ways in which bio-physical conceptions of power became paraphrased in social science and deployed in educational discourse on the child and curriculum from post-Newtonian times to the present. The analyses suggest that, amid ruptures in the definition, role, location and meaning given 'power' historically in various 'physical' and 'social' cosmologies, the naming of 'power' has been dependent on 'physics', on the theorization of motion across 'Western' sciences. This first paper examines some (dis)continuities in regard to histories of motion and power from Aristotelian 'natural science' to Newtonian mechanics.

In Perpetual Motion: Theories of Power, Educational History, and the Child

"In Perpetual Motion is an "historical choreography" of power, pedagogy, and the child from the 1600s to the early 1900s. It breaks new ground by historicizing the analytics of power and motion that have interpenetrated renditions of the young. Through a detailed examination of the works of John Locke, Jean-Jacques Rousseau, Johann Herbart, and G. Stanley Hall, this book maps the discursive shifts through which the child was given a unique nature, inscribed in relation to reason, imbued with an effectible interiority, and subjected to theories of power and motion. The book illustrates how developmentalist visions took hold in U.S. public school debates. It documents how particular theories of power became submerged and taken for granted as essences inside the human subject. In Perpetual Motion studiously challenges views of power as in or of the gaze, tracing how different analytics of power have been used to theorize what gazing could notice."--BOOK JACKET.

The functional liminality of the not-dead-yet students, or, how public schooling became compulsory: A glancing history

This paper redefines the focus for narrating histories of education in the USA through a ‘glancing history’. It highlights the important role played by ‘not-dead-yet students’ who occupied a liminal place on the scale of life in late nineteenth- and early twentieth-century. Traditional histories of education have been more singularly focused on the advent and dynamics of public schooling, ignoring the functionality of such child subjects to public schooling’s existence. This paper argues that public schools as historical objects cannot be understood outside of a broader trinary system of prior institutions that were established for ‘delinquent’ and ‘special’ children. These prior institutions facilitated the formation of ‘the public’ in public schooling less in opposition to ‘the private’ and more in consonance with ‘the human’. The existence of prior institutions enabled the enforcement of compulsory attendance legislation. Compulsory attendance legislation, in place across all existing states by 1918, was concerned more with the conditions for exclusion and exemption than with compelling attendance. Thus, at the most immediate level, this paper historicizes some of the discursive and hence institutional events that linked an array of tutelary complexes by the early 1900s, and which enabled such legislation. This part of the argument extends the notion of institution to consider broader places of confinement and systematicity. It examines the prior practice of reservation and slavery systems, and the efficacy they lent to further institutionalized segregation in the USA. At a second level, the narrative reflects on how such a narration has become possible. It considers how histories of education can currently be rethought and rewritten around the notion of dis/ability, historicizing the formation of dis/ability as identity categories made noticeable in part (and circularly) through the crystallization of a segregated but linked common schooling system. The paper thus provides a counter-memory against dominant economic foundationalist and psychomedical accounts of schooling’s past. It documents both ‘external’ conditions of possibility for public schooling’s emergence and ‘internal’ effects that emerged through the experiences of confinement

Animal magnetism and curriculum history

This article elaborates the impact that crises of authority provoked by animal magnetism, mesmerism, and hypnosis in the 19th century had for field formation in American education. Four layers of analysis elucidate how curriculum history’s repetitive focus on public school policy and classroom practice became possible. First, the article surveys external conditions of possibility for the enactment of compulsory public schooling. Second, “internal” conditions of possibility for the formation of educational objects (e.g., types of children) are documented via the processes of différance that were generated from within the experiences of confinement. Third, the article maps how these were interpenetrated by animal magnetic debates that were lustered and planished in education’s emerging field, including impact upon behavior management practices, the contouring of expertise and authority, the role of Will in intelligence testing and child development theories, and the redefinition of public and private. Last, the article examines implications for curriculum history, whether policy- or practice-oriented, especially around the question of influence, the theorization of child mind, and philosophies of Being.