Under the skin: Wearable technology futures

Artist statement – Artisan Gallery I have a confession to make… I don’t wear a FitBit, I don’t want an Apple Watch and I don’t like bling LED’s. But, what excites me is a future where ‘wearables’ are discreet, seamless and potentially one with our body. Burgeoning E-textiles research will provide the ability to inconspicuously communicate, measure and enhance human health and well-being. Alongside this, next generation wearables arguably will not be worn on the body, but rather within the body…under the skin. ‘Under the Skin’ is a polemic piece provoking debate on the future of wearables – a place where they are not overt, not auxiliary and perhaps not apparent. Indeed, a future where wearables are under the skin or one with our apparel. And, as underwear closets the skin and is the most intimate and cloaked apparel item we wear, this work unashamedly teases dialogue to explore how wearables can transcend from the overt to the unseen. Context Wearable Technology, also referred to as wearable computing or ‘wearables’, is an embryonic field that has the potential to unsettle conventional notions as to how technology can interact, enhance and augment the human body. Wearable technology is the next-generation for ubiquitous consumer electronics and ‘Wearables’ are, in essence, miniature electronic devices that are worn by a person, under clothing, embedded within clothing/textiles, on top of clothing, or as stand-alone accessories/devices. This wearables market is predicted to grow somewhere between $30-$50 billion in the next 5 years (Credit Suisse, 2013). The global ‘wearables’ market, which is emergent in phase, has forecasted predictions for vast consumer revenue with the potential to become a significant cross-disciplinary disruptive space for designers and entrepreneurs. For Fashion, the field of wearables is arguably at the intersection of the second and third generation for design innovation: the first phase being purely decorative with aspects such as LED lighting; the second phase consisting of an array of wearable devices, such as smart watches, to communicate areas such as health and fitness, the third phase involving smart electronics that are woven into the textile to perform a vast range of functions such as body cooling, fabric colour change or garment silhouette change; and the fourth phase where wearable devices are surgically implanted under the skin to augment, transform and enhance the human body. Whilst it is acknowledged the wearable phases are neither clear-cut nor discreet in progression and design innovation can still be achieved with first generation decorative approaches, the later generation of technology that is less overt and at times ‘under the skin’ provides a uniquely rich point for design innovation where the body and technology intersect as one. With this context in mind, the wearable provocation piece ‘Under the Skin’ provides a unique opportunity for the audience to question and challenge conventional notions that wearables need to be a: manifest in nature, b: worn on or next to the body, and c: purely functional. The piece ‘Under the Skin’ is informed by advances in the market place for wearable innovation, such as: the Australian based wearable design firm Catapult with their discreet textile biometric sports tracking innovation, French based Spinali Design with their UV app based textile senor to provide sunburn alerts, as well as opportunities for design technology innovation through UNICEF’s ‘Wearables for Good’ design challenge to improve the quality of life in disadvantaged communities. Exhibition As part of Artisan’s Wearnext exhibition, the work was on public display from 25 July to 7 November 2015 and received the following media coverage: WEARNEXT ONLINE LISTINGS AND MEDIA COVERAGE: http://indulgemagazine.net/wear-next/ http://www.weekendnotes.com/wear-next-exhibition-gallery-artisan/ http://concreteplayground.com/brisbane/event/wear-next_/ http://www.nationalcraftinitiative.com.au/news_and_events/event/48/wear-next http://bneart.com/whats-on/wear-next_/ http://creativelysould.tumblr.com/post/124899079611/creative-weekend-art-edition http://www.abc.net.au/radionational/programs/breakfast/smartly-dressed-the-future-of-wearable-technology/6744374 http://couriermail.newspaperdirect.com/epaper/viewer.aspx RADIO COVERAGE http://www.abc.net.au/radionational/programs/breakfast/wear-next-exhibition-whats-next-for-wearable-technology/6745986 TELEVISION COVERAGE http://www.abc.net.au/radionational/programs/breakfast/wear-next-exhibition-whats-next-for-wearable-technology/6745986 https://au.news.yahoo.com/video/watch/29439742/how-you-could-soon-be-wearing-smart-clothes/#page1

The Apparel Industry and Codes of Conduct: A Solution to the International Child Labor Problem?

This report is the third volume in ILAB’s international child labor series. It focuses on the use of child labor in the production of apparel for the U.S. market, and reviews the extent to which U.S. apparel importers have established and are implementing codes of conduct or other business guidelines prohibiting the use of child labor in the production of the clothing they sell. The report was mandated by the Omnibus Consolidated Rescissions and Appropriations Act of 1996, P.L. 104-134.

Design thinking using a collaborative model for skin cancer prevention

Physical activity is well recognised as a means to reduce cancer risk; however, outdoor activity can increase sun exposure and consequential skin cancer risk. It is proposed, one of the key potential solutions to promote active lifestyles whilst enhancing protection against skin cancer is design resolution for active apparel that considers Australia’s sub-tropical climate whilst maintaining comfort, aesthetic appeal and performance. Using a design thinking approach, facilitated through collaboration between an NGO and a university, student designers were tasked with developing apparel prototypes to explore this challenge. Through practical ideation of problems, potential design solutions were developed within a modest NGO budget and adherence to specific brand guidelines. This project is novel as it demonstrates a low cost yet effective way of collaboratively creating a product to meet multiple needs, rather than reactively assessing already manufactured sun protection products for endorsement. It is a nimble and unique stepping stone in integrating sun safety considerations into clothing that is appealing to the population and creating cross-industry understandings of how design can better contribute to human health and wellbeing. Outcomes to be shared include empirical insights for updating sun safe clothing guidelines, issues around the aesthetic nature of sun safe apparel, and the role of design education for sun safety.

Inter-seasonal population dynamics and pest status of Bemisia tabaci (Gennadius) biotype B in an Australian cropping system

Bemisia tabaci, biotype B, commonly known as the silverleaf whitefly (SLW) is an alien species that invaded Australia in the mid-90s. This paper reports on the invasion ecology of SLW and the factors that are likely to have contributed to the first outbreak of this major pest in an Australian cotton cropping system, population dynamics of SLW within whitefly-susceptible crop (cotton and cucurbit) and non-crop vegetation (sowthistle, Sonchus spp.) components of the cropping system were investigated over four consecutive growing seasons (September-June) 2001/02-2004/05 in the Emerald Irrigation Area (EIA) of Queensland, Australia. Based on fixed geo-referenced sampling sites, variation in spatial and temporal abundance of SLW within each system component was quantified to provide baseline data for the development of ecologically sustainable pest management strategies. Parasitism of large (3rd and 4th instars) SLW nymphs by native aphelinid wasps was quantified to determine the potential for natural control of SLW populations. Following the initial outbreak in 2001/02, SLW abundance declined and stabilised over the next three seasons. The population dynamics of SLW is characterised by inter-seasonal population cycling between the non-crop (weed) and cotton components of the EIA cropping system. Cotton was the largest sink for and source of SLW during the study period. Over-wintering populations dispersed from weed host plant sources to cotton in spring followed by a reverse dispersal in late summer and autumn to broad-leaved crops and weeds. A basic spatial source-sink analysis showed that SLW adult and nymph densities were higher in cotton fields that were closer to over-wintering weed sources throughout spring than in fields that were further away. Cucurbit fields were not significant sources of SLW and did not appear to contribute significantly to the regional population dynamics of the pest. Substantial parasitism of nymphal stages throughout the study period indicates that native parasitoid species and other natural enemies are important sources of SLW mortality in Australian cotton production systems. Weather conditions and use of broad-spectrum insecticides for pest control are implicated in the initial outbreak and on-going pest status of SLW in the region.

Semanttisen webin ontologisen tekstiilikäsitteistön kehittäminen ja liittäminen museoiden luettelointitietoihin

DEVELOPING A TEXTILE ONTOLOGY FOR THE SEMANTIC WEB AND CONNECTING IT TO MUSEUM CATALOGING DATA The goal of the Semantic Web is to share concept-based information in a versatile way on the Internet. This is achievable using formal data structures called ontologies. The goal of this re-search is to increase the usability of museum cataloging data in information retrieval. The work is interdisciplinary, involving craft science, terminology science, computer science, and museology. In the first part of the dissertation an ontology of concepts of textiles, garments, and accessories is developed for museum cataloging work. The ontology work was done with the help of thesauri, vocabularies, research reports, and standards. The basis of the ontology development was the Museoalan asiasanasto MASA, a thesaurus for museum cataloging work which has been enriched by other vocabularies. Concepts and terms concerning the research object, as well as the material names of textiles, costumes, and accessories, were focused on. The research method was terminological concept analysis complemented by an ontological view of the Semantic Web. The concept structure was based on the hierarchical generic relation. Attention was also paid to other relations between terms and concepts, and between concepts themselves. Altogether 977 concept classes were created. Issues including how to choose and name concepts for the ontology hierarchy and how deep and broad the hierarchy could be are discussed from the viewpoint of the ontology developer and museum cataloger. The second part of the dissertation analyzes why some of the cataloged terms did not match with the developed textile ontology. This problem is significant because it prevents automatic ontological content integration of the cataloged data on the Semantic Web. The research datasets, i.e. the cataloged museum data on textile collections, came from three museums: Espoo City Museum, Lahti City Museum and The National Museum of Finland. The data included 1803 textile, costume, and accessory objects. Unmatched object and textile material names were analyzed. In the case of the object names six categories (475 cases), and of the material names eight categories (423 cases), were found where automatic annotation was not possible. The most common explanation was that the cataloged field was filled with a long sentence comprised of many terms. Sometimes in the compound term, the object name and material, or the name and the way of usage, were combined. As well, numeric values in the material name cataloging field prevented annotation and so did the absence of a corresponding concept in the ontology. Ready-made drop-down lists of materials used in one cataloging system facilitated the annotation. In the case of naming objects and materials, one should use terms in basic form without attributes. The developed textile ontology has been applied in two cultural portals, MuseumFinland and Culturesampo, where one can search for and browse information based on cataloged data using integrated ontologies in an interoperable way. The textile ontology is also part of the national FinnONTO ontology infrastructure. Keywords: annotation, concept, concept analysis, cataloging, museum collection, ontology, Semantic Web, textile collection, textile material

Remote sensing applications for cotton.

This paper compares classified normalized difference vegetation index images of cotton crops derived from both low and high resolution satellite imagery to determine the most accurate and feasible option for Australian cotton growers. It also demonstrates a rapid automated processing and internet delivery system for distributing satellite SPOT-2 imagery. Also provided is the profile of two case studies conducted in the Darling Towns demonstrating the potential benefit of adopting this technology for improving in-season agronomic crop assessments and therefore enable improved management decisions to be made.

Verkkokurssilla : Opiskelijoiden kokemuksia toiminnasta yhteisöllisessä oppimisprosessissa Fle2-ympäristössä ja kokemusten näkyminen toimintaan osallistumisessa

The study examines one case of students' experiences from the activity in a collaborative learning process in a networked learning environment, and explores whether or not the experiences explain the participation or lack of participation in the activities. As a research task the students' experiences in the database of the networked learning environment, participating in its construction, and the ways of working needed to build the database, were examined. To contrast the students' experiences, their actual participation in the building of the database was clarified. Based on actual participation, groups more active and more passive than average were separated, and their experiences were compared to each other. The research material was collected from the course Cognitive and Creative Processes, which was offered to studentsof the Department of Textile Teacher Education in University of Helsinki, and students of the Departments of Teacher Education Units giving textile education in Turku, Rauma and Savonlinna in the beginning of 2001. In this course, creativity was examined from a psychological and sosiocultural context with the aim of realizing a collaborative progressive inquiry process. The course was held in a network-based Future Learning Environment (Fle 2) except for the starting lecture and training the use of the learning environment. This study analyzed the learning diaries that the students had sent to the tutor once a week for four weeks, and the final thoughts written into the database of the learning environment. Content analysis was applied as the research method. The case was enriched from another point of view by examining the messages the students had written into the learning environment with the social network analysis. The theoretical base of the study looks at the research of computer-supported collaborative learning, the conceptions of learning as a process of participation and knowledge building, and the possibilities and limitations of network-based learning environments. The research results show, that both using the network-based learning environment and collaborative ways of studying were new to the students. The students were positively surprised by the feedback and support provided by the community. On the other hand, they also experienced problems with facelessness and managing the information in the learning environment. The active students seemed to be more ready for a progressive inquiry process. It can be seen from their attitudes and actions that they have strived to participate actively and invested into the process both from their own and the community's point of view. The more passive students reported their actions to get credits and they had a harder time of perceiving the thoughts presented in the net as common progression. When arranging similar courses in the future, attention should be paid to how to get the students to act in ways necessary for knowledge building, and different from more traditional ways of studying. The difficulties of students used to traditional studying methods to adapt to collaborative knowledge building were evident on the course Cognitive and Creative Processes. Keywords: computer supported collaborative learning, knowledge building, progressive Inquiry, participation

Yhteinen käsityö peruskoulun 7. luokalla : Opettajien kokemuksia yhteisen käsityön opetuksesta ja organisoinnista

Finnish education politics presume that basic education should be equal to all students. While organising craft education equality can be understood as similarity or as possibility to choose. The possibility to be able to choose whether textile or technical craft despite of one´s gender has been the aim of laws and curriculums already over 30 years. In practice it´s almost impossible to students to ignore feminine and masculine roles that go deep into our culture. Choosing craft has been divided by gender, which is the reason why possibility to choose has not been good enough to educationalists of equality. The latest guidelines for the National core curriculum for bacis education were issued in 2004. According to curriculum craft education consists parts of both technical and textile craft. All students should take part in both sectors of crafts. Furthermore, one can be given a possibility to consentrate his studies in whether textile or technical craft. The curriculum does not set the rules how the education should be organised, which means that it can be organised in many ways depending on city, school or teacher. Teachers and other specialists have contradictory feelings towards shared craft education, because traditional way to see craft in Finland is to separate textile craft from technical craft. Both crafts have some common features that are introduced in curriculum. Besides there is many equal things in craft theories that bind textile and technical craft to each other. The main purpose of this research was to find out, how shared craft education has been organised at the 7.th grade in Finnish comprehensive school, and which things affect in the settlements. Second goal was to describe and compare teachers´ experiences in teaching shared craft education. Third aim of this study was how shared craft has changed craft education. I collected the research material in May 2006 by interviewing both textile and technical craft teachers who teach shared craft. The material consists of fourteen theme interviews. In the analysis of the material I used theoretic bounded document analysis. According to the research there are three different ways to organise shared craft education: 50 50-arrangement, exchanging period and project week. In the schools that carried out 50 50-arrangement teaching was realised mainly in heterogenous groups. Principals had usual a lot of authorization on how to arrange craft education, which means that their views on equality, laws and curriculum affected in the settlemets more than teachers´ opinions. Teachers´ attitudes to shared craft were mainly positive. The changing of craft education can be divided in two parts: the aims and the containings of the curriculum have changed, as well as the meaning of the craft as core subject. Teachers have been forced to decrease the containings of both textile and technical crafts. Despite of eliminations both crafts still have comprehensive containings. Teachers decided what to teach by these argumets: Students should learn some basic things or produce a certain product. Usually teachers had also a lot of experience and special intrests in crafts. According to this research there is four significant meanings for shared craft education: 1) developing readiness for doing things, 2) developing skills of thinking, 3) delight of doing things and 4) teaching attitude.

Käsityön sukupuolirajat ja rajojen rikkojat

Gender-specific division of crafts is significant in Finnish culture. The aim of craft education in comprehensive schools has been to unify education for both girls and boys during the thirty years of modern comprehensive education, but in reality crafts has diverged into two different subjects for girls and boys. Craft education has taught different things: girls have been taught things that are feminine and included in private life, while the boys’ education has been mostly directed at public and working life. At the same time girls and boys have been educated and socialized towards a certain womanhood and manhood. Craft as a hobby is also very gender divided but there are some clues that tell of the changing positions on the border areas. The starting point of this study has been the assumption that gender structures within crafts can be transformed. But it is important to know the background that creates and maintains these constructions and the expedients for dismantling the structures. The main purpose of this study is to find out how the gender-specific crafts are changing and how they are still maintained. My study analyses why men and woman have chosen untypical hobbies and through that I shall discuss how gendered structures can be dismantled. In the autumn of 2008 I interviewed borderline breakers within crafts: men who had an interest in textile crafts and women who had an interest in technical work. Informants of this study were 20-31 years old and they studied behavioural sciences. The data was collected in 12 theme interviews and document analysis was used to study the results. The dismantling of the gender divide in crafts is slow, but new borders are drawn all the time. The informants have started textile and technical handicrafts soon after comprehensive school or during their studies at university. A main motivation for the new hobby has been the possibility to study for a teacher’s degree with technology or textile studies as a main or a secondary subject. Gender-specific division of crafts is constructed early in childhood as different skills are taught to girls and boys. School teaches gender specific skills and the different skills of girls and boys have not been taken into account. Instead, it has been assumed through comprehensive school that both girls and boys share certain basic skills, and attention has not been paid to the differences between genders. At university the same assumption has still thrived. Skill levels between men and women are substantial and that may have hindered a move by women to technical studies and by men to textile studies. Hence an assumption of naturally gendered crafts has been developed.

Tekstiilityötä ja matematiikkaa yhdistävän oppimateriaalin käyttökelpoisuus perusopetuksen yläluokilla

In this study the researcher wanted to show the observed connection of mathematics and textile work. To carry this out the researcher designed a textbook by herself for the upper secondary school in Tietoteollisuuden Naiset TiNA project at Helsinki University of Technology (URL:http://tina.tkk.fi/). The assignments were designed as additional teaching material to enhance and reinforce female students confidence in mathematics and in the management of their textile work. The research strategy applied action research, out of which two cycles two have been carried out. The first cycle consists of establishing the textbook and in the second cycle its usability is investigated. The third cycle is not included in this report. In the second cycle of the action research the data was collected from 15 teachers, five textile teachers, four mathematics teachers and six teachers of both subjects. They all got familiar with the textbook assignments and answered a questionnaire on the basis of their own teaching experience. The questionnaire was established by applying the theories of usability and teaching material assessment study. The data consisted of qualitative and quantitative information, which was analysed by content analysis with computer assisted table program to either qualitative or statistical description. According to the research results, the textbook assignments seamed to be applied better to mathematics lessons than textile work. The assignments pointed out, however, the clear interconnectedness of textile work and mathematics. Most of the assignments could be applied as such or as applications in the upper secondary school textile work and mathematics lessons. The textbook assignments were also applicable in different stages of the teaching process, e.g. as introduction, repetition or to support individual work or as group projects. In principle the textbook assignments were in well placed and designed in the correct level of difficulty. Negative findings concerned some too difficult assignments, lack of pupil motivation and unfamiliar form of task for the teacher. More clarity for some assignments was wished for and there was especially expressed a need for easy tasks and assignments in geometry. Assignments leading to the independent thinking of the pupil were additionally asked for. Two important improvements concerning the textbook attainability would be to get the assignments in html format over the Internet and to add a handicraft reference book.

Tekstiilikulttuurisen lukutaidon edistäminen museoissa

Purpose: The study focuses on the question, how to advance textile cultural interpretation skills in museum. The theme was actual, because there have been many workshops in different kind of museums, which have raised textile into important role of their museum pedagogy. The knowing of nature of textile materials was highlighted in former studies as the most crucial thing in craft. That is reason for choosing textile to study. The theoretical approach of study was particularized to the meanings which have been given to craft during recent ten years. Furthermore the composition of textile culture and transmitting textile cultural heritage were examined throug the theory. The finnish museum as a place for learning, as well as the contens of museum pedagogy, were analyzed. The fundamental approach to study was cultural research and art education. Methods: The methodological approach was theory-based theme interview. Before interviewing informants the charting was made by using literature, interviews and observation, to find out the most important themes within subject. Specialists were interviewed personally and results were sent to them by e-mail for further comments. There were 8 informants and they were chosen with intentional sampling from different kind of museums, from teacher education and among craft teachers. Research material was analyzed with content analysis by using deductive reasoning. Conclusions: The study revealed that there are three strategies in advancing textile cultural interpretation. The most remarkable strategies are 1) making acquaintance of materials and working with them, 2) getting exiting events with posibilities to use one s whole body and 3) getting textile cultural knowledge by using for example discovery - style learning. In practice those strategies were mixed, which also was considered advisable. Another conclusion the study revealed, is the desirable, acceptable attitude not only to the craft with creative, free beginning but also to the craft made like its model in museum. Learning from model can be felt as a very moving experience, like a journey in time. The side result of the study was the importance of collaboration of museums and schools in advancing textile cultural interpretation skills as well as significance of using internet in collaboration and relations.

Expression of functional GABAc receptors in the brain

γ-aminobutyric acid (GABA) is the main inhibitory transmitter in the nervous system and acts via three distinct receptor classes: A, B, and C. GABAC receptors are ionotropic receptors comprising ρ subunits. In this work, we aimed to elucidate the expression of ρ subunits in the postnatal brain, the characteristics of ρ2 homo-oligomeric receptors, and the function of GABAC receptors in the hippocampus. In situ hybridization on rat brain slices showed ρ2 mRNA expression from the newborn in the superficial grey layer of the superior colliculus, from the first postnatal week in the hippocampal CA1 region and the pretectal nucleus of the optic tract, and in the adult dorsal lateral geniculate nucleus. Quantitative RT-PCR revealed expression of all three ρ subunits in the hippocampus and superior colliculus from the first postnatal day. In the hippocampus, ρ2 mRNA expression clearly dominated over ρ1 and ρ3. GABAC receptor protein expression was confirmed in the adult hippocampus, superior colliculus, and dorsal lateral geniculate nucleus by immunohistochemistry. From the selective distribution of ρ subunits, GABAC receptors may be hypothesized to be specifically involved in aspects of visual image motion processing in the rat brain. Although previous data had indicated a much higher expression level for ρ2 subunit transcripts than for ρ1 or ρ3 in the brain, previous work done on Xenopus oocytes had suggested that rat ρ2 subunits do not form functional homo-oligomeric GABAC receptors but need ρ1 or ρ3 subunits to form hetero-oligomers. Our results demonstrated, for the first time, that HEK 293 cells transfected with ρ2 cDNA displayed currents in whole-cell patch-clamp recordings. Homomeric rat ρ2 receptors had a decreased sensitivity to, but a high affinity for picrotoxin and a marked sensitivity to the GABAC receptor agonist CACA. Our results suggest that ρ2 subunits may contribute to brain function, also in areas not expressing other ρ subunits. Using extracellular electrophysiological recordings, we aimed to study the effects of the GABAC receptor agonists and antagonists on responses of the hippocampal neurons to electrical stimulation. Activation of GABAC receptors with CACA suppressed postsynaptic excitability and the GABAC receptor antagonist TPMPA inhibited the effects of CACA. Next, we aimed to display the activation of the GABAC receptors by synaptically released GABA using intracellular recordings. GABA-mediated long-lasting depolarizing responses evoked by high-frequency stimulation were prolonged by TPMPA. For weaker stimulation, the effect of TPMPA was enhanced after GABA uptake was inhibited. Our data demonstrate that GABAC receptors can be activated by endogenous synaptic transmitter release following strong stimulation or under conditions of reduced GABA uptake. The lack of GABAC receptor activation by less intensive stimulation under control conditions suggests that these receptors are extrasynaptic and activated via spillover of synaptically released GABA. Taken together with the restricted expression pattern of GABAC receptors in the brain and their distinctive pharmacological and biophysical properties, our findings supporting extrasynaptic localization of these receptors raise interesting possibilities for novel pharmacological therapies in the treatment of, for example, epilepsy and sleep disorders.

Evidence-based perspective on CP rehabilitation : Reviews on physiotherapy, physiotherapy-related motor-based interventions and orthotic devices

This thesis utilises an evidence-based approach to critically evaluate and summarize effectiveness research on physiotherapy, physiotherapy-related motor-based interventions and orthotic devices in children and adolescents with cerebral palsy (CP). It aims to assess the methodological challenges of the systematic reviews and trials, to evaluate the effectiveness of interventions in current use, and to make suggestions for future trials Methods: Systematic reviews were searched from computerized bibliographic databases up to August 2007 for physiotherapy and physiotherapy-related interventions, and up to May 2003 for orthotic devices. Two reviewers independently identified, selected, and assessed the quality of the reviews using the Overview Quality Assessment Questionnaire complemented with decision rules. From a sample of 14 randomized controlled trials (RCT) published between January 1990 and June 2003 we analysed the methods of sampling, recruitment, and comparability of groups; defined the components of a complex intervention; identified outcome measures based on the International Classification of Functioning, Disability and Health (ICF); analysed the clinical interpretation of score changes; and analysed trial reporting using a modified 33-item CONSORT (Consolidated Standards of Reporting Trials) checklist. The effectiveness of physiotherapy and physiotherapy-related interventions in children with diagnosed CP was evaluated in a systematic review of randomised controlled trials that were searched from computerized databases from January 1990 up to February 2007. Two reviewers independently assessed the methodological quality, extracted the data, classified the outcomes using the ICF, and considered the level of evidence according to van Tulder et al. (2003). Results: We identified 21 reviews on physiotherapy and physiotherapy-related interventions and five on orthotic devices. These reviews summarized 23 or 5 randomised controlled trials and 104 or 27 observational studies, respectively. Only six reviews were of high quality. These found some evidence supporting strength training, constraint-induced movement therapy or hippotherapy, and insufficient evidence on comprehensive interventions. Based on the original studies included in the reviews on orthotic devices we found some short-term effects of lower limb casting on passive range of movement, and of ankle-foot orthoses on equinus walk. Long term effects of lower limb orthoses have not been studied. Evidence of upper limb casting or orthoses is conflicting. In the sample of 14 RCTs, most trials used simple randomisation, complemented with matching or stratification, but only three specified the concealed allocation. Numerous studies provided sufficient details on the components of a complex intervention, but the overlap of outcome measures across studies was poor and the clinical interpretation of observed score changes was mostly missing. Almost half (48%) of the applicable CONSORT-based items (range 28 32) were reported adequately. Most reporting inadequacies were in outcome measures, sample size determination, details of the sequence generation, allocation concealment and implementation of the randomization, success of assessor blinding, recruitment and follow-up dates, intention-to-treat analysis, precision of the effect size, co-interventions, and adverse events. The systematic review identified 22 trials on eight intervention categories. Four trials were of high quality. Moderate evidence of effectiveness was established for upper extremity treatments on attained goals, active supination and developmental status, and of constraint-induced therapy on the amount and quality of hand use and new emerging behaviours. Moderate evidence of ineffectiveness was found for strength training's effect on walking speed and stride length. Conflicting evidence was found for strength training's effect on gross motor function. For the other intervention categories the evidence was limited due to the low methodological quality and the statistically insignificant results of the studies. Conclusions: The high-quality reviews provide both supportive and insufficient evidence on some physiotherapy interventions. The poor quality of most reviews calls for caution, although most reviews drew no conclusions on effectiveness due to the poor quality of the primary studies. A considerable number of RCTs of good to fair methodological and reporting quality indicate that informative and well-reported RCTs on complex interventions in children and adolescents with CP are feasible. Nevertheless, methodological improvement is needed in certain areas of the trial design and performance, and the trial authors are encouraged to follow the CONSORT criteria. Based on RCTs we established moderate evidence for some effectiveness of upper extremity training. Due to limitations in methodological quality and variations in population, interventions and outcomes, mostly limited evidence on the effectiveness of most physiotherapy interventions is available to guide clinical practice. Well-designed trials are needed, especially for focused physiotherapy interventions.

Routine Measurement of Health-Related Quality of Life in Assessing Cost-Effectiveness in Secondary Health Care

Aims: The aims of this study were 1) to identify and describe health economic studies that have used quality-adjusted life years (QALYs) based on actual measurements of patients' health-related quality of life (HRQoL); 2) to test the feasibility of routine collection of health-related quality of life (HRQoL) data as an indicator of effectiveness of secondary health care; and 3) to establish and compare the cost-utility of three large-volume surgical procedures in a real-world setting in the Helsinki University Central Hospital, a large referral hospital providing secondary and tertiary health-care services for a population of approximately 1.4 million. Patients and methods: So as to identify studies that have used QALYs as an outcome measure, a systematic search of the literature was performed using the Medline, Embase, CINAHL, SCI and Cochrane Library electronic databases. Initial screening of the identified articles involved two reviewers independently reading the abstracts; the full-text articles were also evaluated independently by two reviewers, with a third reviewer used in cases where the two reviewers could not agree a consensus on which articles should be included. The feasibility of routinely evaluating the cost-effectiveness of secondary health care was tested by setting up a system for collecting HRQoL data on approximately 4 900 patients' HRQoL before and after operative treatments performed in the hospital. The HRQoL data used as an indicator of treatment effectiveness was combined with diagnostic and financial indicators routinely collected in the hospital. To compare the cost-effectiveness of three surgical interventions, 712 patients admitted for routine operative treatment completed the 15D HRQoL questionnaire before and also 3-12 months after the operation. QALYs were calculated using the obtained utility data and expected remaining life years of the patients. Direct hospital costs were obtained from the clinical patient administration database of the hospital and a cost-utility analysis was performed from the perspective of the provider of secondary health care services. Main results: The systematic review (Study I) showed that although QALYs gained are considered an important measure of the effectiveness of health care, the number of studies in which QALYs are based on actual measurements of patients' HRQoL is still fairly limited. Of the reviewed full-text articles, only 70 reported QALYs based on actual before after measurements using a valid HRQoL instrument. Collection of simple cost-effectiveness data in secondary health care is feasible and could easily be expanded and performed on a routine basis (Study II). It allows meaningful comparisons between various treatments and provides a means for allocating limited health care resources. The cost per QALY gained was 2 770 for cervical operations and 1 740 for lumbar operations. In cases where surgery was delayed the cost per QALY was doubled (Study III). The cost per QALY ranges between subgroups in cataract surgery (Study IV). The cost per QALY gained was 5 130 for patients having both eyes operated on and 8 210 for patients with only one eye operated on during the 6-month follow-up. In patients whose first eye had been operated on previous to the study period, the mean HRQoL deteriorated after surgery, thus precluding the establishment of the cost per QALY. In arthroplasty patients (Study V) the mean cost per QALY gained in a one-year period was 6 710 for primary hip replacement, 52 270 for revision hip replacement, and 14 000 for primary knee replacement. Conclusions: Although the importance of cost-utility analyses has during recent years been stressed, there are only a limited number of studies in which the evaluation is based on patients own assessment of the treatment effectiveness. Most of the cost-effectiveness and cost-utility analyses are based on modeling that employs expert opinion regarding the outcome of treatment, not on patient-derived assessments. Routine collection of effectiveness information from patients entering treatment in secondary health care turned out to be easy enough and did not, for instance, require additional personnel on the wards in which the study was executed. The mean patient response rate was more than 70 %, suggesting that patients were happy to participate and appreciated the fact that the hospital showed an interest in their well-being even after the actual treatment episode had ended. Spinal surgery leads to a statistically significant and clinically important improvement in HRQoL. The cost per QALY gained was reasonable, at less than half of that observed for instance for hip replacement surgery. However, prolonged waiting for an operation approximately doubled the cost per QALY gained from the surgical intervention. The mean utility gain following routine cataract surgery in a real world setting was relatively small and confined mostly to patients who had had both eyes operated on. The cost of cataract surgery per QALY gained was higher than previously reported and was associated with considerable degree of uncertainty. Hip and knee replacement both improve HRQoL. The cost per QALY gained from knee replacement is two-fold compared to hip replacement. Cost-utility results from the three studied specialties showed that there is great variation in the cost-utility of surgical interventions performed in a real-world setting even when only common, widely accepted interventions are considered. However, the cost per QALY of all the studied interventions, except for revision hip arthroplasty, was well below 50 000, this figure being sometimes cited in the literature as a threshold level for the cost-effectiveness of an intervention. Based on the present study it may be concluded that routine evaluation of the cost-utility of secondary health care is feasible and produces information essential for a rational and balanced allocation of scarce health care resources.

High yielding irrigated grains in cotton cropping systems

Design, build and install twelve lysimeters at Kingsthorpe. Undertake deficit irrigation study using lysimeters at Kingsthorpe to determine the response of a wheat crop to deficit irrigation and full irrigation regimes. Prepare and present publications based on the field trials.