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  • Open Access
    Authors: 
    Ishak Berrebbah;
    Publisher: New Bulgarian University

    This paper discusses the politics and multi-functionality of storytelling in Diana Abu-Jaber’s novel Crescent (2003). I argue that the strategic use of storytelling places Crescent as a complex hybrid text that projects the nature, and development, of Arab American literature in the contemporary era. In addition to having the practice of storytelling as an apparatus to project identity in Crescent, Abu-Jaber re-appropriates its empowered status in Arab culture as well as politicizes its image in the mind of her readers. Besides employing critical and analytical approaches to the novel, this paper relies on arguments and perspectives of prominent postcolonial and literary critics and theorists such as Edward Said, Suzanne Keen, Walter Benjamin, and Samaya Sami Sabry, to name a few.

  • Open Access English
    Authors: 
    Sammons, P.; Sylva, K.; Melhuish, Edward C.; Siraj-Blatchford, I.; Taggart, B.;
    Publisher: DCSF Publications
    Country: United Kingdom

    These reports forms part of a set of two reports that examine key influences on children’s Maths, English and social behavioural outcomes (self-regulation, pro-social behaviour, hyperactivity and anti-social behaviour) in Year 6 and on their progress across Key Stage 2. The sister report describes the results of analyses on children’s social/behavioural outcomes (ref: DCSF-RR049).\ud \ud The report is from the effective pre-school and primary education 3 to 11 project (EPPE 3 to 11) which is longitudinal study using multi-level modelling investigating the effects of home background, pre-school and primary education on pupils’ attainment and social / behavioural development.\ud \ud Around 3,000 children were recruited from 141 pre-school settings in 6 English LEAs at the age of 3+ between 1996 and 1999. The study followed these children through pre-school and into more than 900 primary schools in 100 local authorities.

  • Open Access English
    Authors: 
    Sammons, P.; Sylva, K.; Melhuish, Edward C.; Siraj-Blatchford, I.; Taggart, B.; Hunt, S.;
    Publisher: DCSF Publications
    Country: United Kingdom

    These reports forms part of a set of two reports that examine key influences on children’s Maths, English and social behavioural outcomes (self-regulation, pro-social behaviour, hyperactivity and anti-social behaviour) in Year 6 and on their progress across Key Stage 2. The sister report describes the results of analyses on children’s social/behavioural outcomes (ref: DCSF-RR049).\ud \ud The report is from the effective pre-school and primary education 3 to 11 project (EPPE 3 to 11) which is longitudinal study using multi-level modelling investigating the effects of home background, pre-school and primary education on pupils’ attainment and social / behavioural development.\ud \ud Around 3,000 children were recruited from 141 pre-school settings in 6 English LEAs at the age of 3+ between 1996 and 1999. The study followed these children through pre-school and into more than 900 primary schools in 100 local authorities.

  • Open Access English
    Authors: 
    Shrestha, Prithvi;

    In the context of higher education, many higher order skills and knowledge are expected to be transferable by lecturers. Sustaining these skills and knowledge is therefore central to learning and disciplinary writing development. English for Specific Purposes (ESP) courses can contribute to this purpose as they aim to enable Higher Education students to participate in their chosen academic communities as fully as possible. Despite learning transfer being a key purpose in ESP, research in this area is still limited (Cheng, 2007). \ud In this context, this paper reports on a small-scale study investigating the transfer of academic writing skills and conceptual knowledge among undergraduate business studies students. The data are derived from a larger study (Shrestha, 2011) conducted at a British university. One assignment text each was collected from four students who studied an ESP course for business studies. While three students had received interactive feedback on their previous two assignments, following a Vygotsky-inspired dynamic assessment (DA) approach, one student was provided with traditional tutor feedback. DA blends instruction with assessment by targeting and further developing students’ potential abilities (Poehner, 2011) whereas traditional tutor feedback is less interactive and hence, may not sufficiently target learners’ potential abilities. The student texts were analysed by drawing on Vygotskian sociocultural theory of learning (Vygotsky, 1978), and genre theory (Martin & Rose, 2007) based on Halliday’s Systemic Functional Linguistics (Halliday & Matthiessen, 2004). The findings suggest that the transfer of academic writing skills and conceptual knowledge occurred more in the texts of the students that underwent dynamic assessment than that of the student who followed a traditional assessment approach for their first two assignments. Implications of this for ESP instruction and assessment design will be presented.

  • Closed Access
    Authors: 
    Yu-Tzu Wu; Hsin Yi Lee; Sam Norton; Chuanfeng Chen; Hongxia Chen; Chenglin He; Jane Fleming; Fiona E. Matthews; Carol Brayne;
    Publisher: Wiley

    Background Many studies have considered the prevalence of dementia in mainland China, Hong Kong and Taiwan. However, area level estimates have not been produced. This study examines area differences across mainland China, Hong Kong and Taiwan adjusting for the effect of methodological factors with the aim of producing estimates of the numbers of people with dementia in these areas. Method and Findings A search of Chinese and English databases identified 76 dementia prevalence studies based on samples drawn from mainland China, Hong Kong and Taiwan between 1980 and 2012. A pattern of significantly decreasing prevalence was observed from northern, central, southern areas of mainland China, Hong Kong and Taiwan. Area variations in dementia prevalence were not explained by differences in methodological factors (diagnostic criteria, age range, study sample size and sampling method), socioeconomic level or life expectancy between areas. The results of meta-analysis were applied to current population data to provide best estimate. Based on the DSM-IV diagnostic criteria, the total number of people aged 60 and over with dementia in mainland China, Hong Kong and Taiwan is 8.4 million (4.6%, 95% CI: 3.4, 5.8) and in northern, central and southern areas are 3.8 (5.1%, 95% CI: 4.1, 6.1), 3.2 (4.4%, 95% CI: 3.2, 5.6) and 1.2 (3.9%, 95% CI: 2.3, 5.4) million respectively. These estimates were mainly based on the studies existing in highly developed areas and potentially affected by incomplete and insufficient data. Conclusions The findings of this review provide a robust estimate of area differences in dementia prevalence. Application of the estimated prevalence to population data reveals the number of people with dementia is expected to double every 20 years, areas in mainland China will be facing the greatest dementia challenge.

  • Open Access English
    Authors: 
    Cooke, D.; O'Hara, M. C.; Beinart, N.; Heller, S.; La Marca, R.; Byrne, M.; Mansell, P.; Dinneen, S. F.; Clark, M.; Bond, R.; +2 more
    Publisher: American Diabetes Association
    Countries: United Kingdom, Ireland

    OBJECTIVE To develop a linguistically and psychometrically validated U.K. English (U.K./Ireland) version of the Diabetes-Specific Quality-of-Life Scale (DSQOLS) for adults with type 1 diabetes. RESEARCH DESIGN AND METHODS We conducted independent forward and backward translation of the validated German DSQOLS. An iterative interview study with health professionals (n = 3) and adults with type 1 diabetes (n = 8) established linguistic validity. The DSQOLS was included in three Dose Adjustment for Normal Eating (DAFNE) studies (total N = 1,071). Exploratory factor analysis (EFA) was undertaken to examine questionnaire structure. Concurrent and discriminant validity, internal consistency, and reliability were assessed. RESULTS EFA indicated a six-factor structure for the DSQOLS (social aspects, fear of hypoglycemia, dietary restrictions, physical complaints, anxiety about the future, and daily hassles). High internal consistency reliability was found for these factors and the weighted treatment satisfaction scale (α = 0.85–0.94). All subscales were moderately, positively correlated with the Audit of Diabetes-Dependent Quality-of-Life (ADDQoL) measure, demonstrating evidence of concurrent validity. Lower DSQOLS subscale scores [indicating impaired quality of life (QoL)] were associated with the presence of diabetes-related complications. CONCLUSIONS The DSQOLS captures the impact of detailed aspects of modern type 1 diabetes management (e.g., carbohydrate counting and flexible insulin dose adjustment) that are now routine in many parts of the U.K. and Ireland. The U.K. English version of the DSQOLS offers a valuable tool for assessing the impact of treatment approaches on QoL in adults with type 1 diabetes.

  • Open Access English
    Authors: 
    Pinfield, S.; Salter, J.; Bath, P.A.; Hubbard, B.; Millington, P.; Anders, J.H.S.; Hussain, A.;
    Publisher: American Society for Information Sciences and Technology
    Country: United Kingdom
    Project: WT

    This paper reviews the worldwide growth of open-access (OA) repositories, December 2005 to December 2012, using data collected by the OpenDOAR project. It shows that initial repository development was focused on North America, Western Europe and Australasia, particularly the USA, UK, Germany and Australia. Soon after, Japan increased its repository numbers. Since 2010, other geographical areas and countries have seen repository growth, including East Asia (especially Taiwan), South America (especially Brazil) and Eastern Europe (especially Poland). During the whole period, countries such as France, Italy and Spain have maintained steady growth, whereas countries such as China and Russia have experienced relatively low levels of growth. Globally, repositories are predominantly institutional, multidisciplinary and English-language-based. They typically use open-source OAI-compliant repository software but remain immature in terms of explicit licensing arrangements. Whilst the size of repositories is difficult to assess accurately, the available data indicate that a small number of large repositories and a large number of small repositories make up the repository landscape. These trends and characteristics are analyzed using Innovation Diffusion Theory (IDT) building on previous studies. IDT is shown to provide a useful explanatory framework for understanding repository adoption at various levels: global, national, organizational and individual. Major factors affecting both the initial development of repositories and their take up by users are identified, including IT infrastructure, language, cultural factors, policy initiatives, awareness-raising activity and usage mandates. It is argued that mandates in particular are likely to play a crucial role in determining future repository development.

  • Open Access English
    Authors: 
    Yu-Tzu Wu; Hsin Yi Lee; Sam Norton; Chuanfeng Chen; Hongxia Chen; Chenglin He; Jane Fleming; Fiona E. Matthews; Carol Brayne;
    Publisher: Public Library of Science (PLoS)
    Country: United Kingdom

    BACKGROUND: Many studies have considered the prevalence of dementia in mainland China, Hong Kong and Taiwan. However, area level estimates have not been produced. This study examines area differences across mainland China, Hong Kong and Taiwan adjusting for the effect of methodological factors with the aim of producing estimates of the numbers of people with dementia in these areas. METHOD AND FINDINGS: A search of Chinese and English databases identified 76 dementia prevalence studies based on samples drawn from mainland China, Hong Kong and Taiwan between 1980 and 2012. A pattern of significantly decreasing prevalence was observed from northern, central, southern areas of mainland China, Hong Kong and Taiwan. Area variations in dementia prevalence were not explained by differences in methodological factors (diagnostic criteria, age range, study sample size and sampling method), socioeconomic level or life expectancy between areas. The results of meta-analysis were applied to current population data to provide best estimate. Based on the DSM-IV diagnostic criteria, the total number of people aged 60 and over with dementia in mainland China, Hong Kong and Taiwan is 8.4 million (4.6%, 95% CI: 3.4, 5.8) and in northern, central and southern areas are 3.8 (5.1%, 95% CI: 4.1, 6.1), 3.2 (4.4%, 95% CI: 3.2, 5.6) and 1.2 (3.9%, 95% CI: 2.3, 5.4) million respectively. These estimates were mainly based on the studies existing in highly developed areas and potentially affected by incomplete and insufficient data. CONCLUSIONS: The findings of this review provide a robust estimate of area differences in dementia prevalence. Application of the estimated prevalence to population data reveals the number of people with dementia is expected to double every 20 years, areas in mainland China will be facing the greatest dementia challenge. This is the final version of the article. It first appeared from the Public Library of Science via http://dx.doi.org/10.1371/journal.pone.0066252

  • Open Access
    Authors: 
    Linda Sharp; C. E. D. Chilvers; K.K. Cheng; Patricia McKinney; R. F. A. Logan; Paula Cook-Mozaffari; Ahmed Ashour Ahmed; Nicholas E. Day;
    Publisher: Springer Science and Business Media LLC

    Oesophageal cancer rates in women in the UK are more than 3 times higher than in most other European populations. A population-based matched case–control study of histologically confirmed squamous cell carcinoma of the oesophagus in women was carried out in 4 regions in England and Scotland. Interviews were carried out in hospital or at home and topics included: smoking; alcohol; tea and coffee consumption; medical and obstetric history; and diet. Response rates were 62% for cases and 65% for first-chosen controls. There were 159 case–control pairs. Significant results were found for: eating salads (odds ratio (OR) 0.42, 95% CI 0.20–0.92 in the highest quartile of consumption) and a light (as distinct from no) breakfast (OR 0.18, 95% CI 0.07 – 0.48) were protective; quantity of tea was a risk factor and there was a significant positive trend with temperature at which hot drinks were consumed (P = 0.03). Alcohol consumption was unrelated to risk, but there was a significant trend with years of smoking (P = 0.015). A protective effect of aspirin consumption was confined to the English centres (OR 0.08, 95% CI 0.01–0.56). Comparison with a parallel study of adenocarcinoma indicated a common protective effect of a healthy diet but otherwise distinct risk factors. © 2001 Cancer Research Campaign http://www.bjcancer.com

  • Open Access English
    Authors: 
    Aziz Sheikh; Tony Cornford; Nick Barber; Anthony J Avery; Amirhossein Takian; Valentina Lichtner; Dimitra Petrakaki; Sarah Crowe; Kate Marsden; Ann Robertson; +11 more
    Countries: Netherlands, United Kingdom, United Kingdom, United Kingdom, United Kingdom
    Project: EC | ICREL (201002)

    This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode. Objectives: To evaluate the implementation and adoption of the NHS detailed care records service in “early adopter” hospitals in England. Design: Theoretically informed, longitudinal qualitative evaluation based on case studies. Setting: 12 “early adopter” NHS acute hospitals and specialist caresettings studied over two and a half years. Data sources: Data were collected through in depth interviews, observations, and relevant documents relating directly to case study sites and to wider national developments that were perceived to impact on the implementation strategy. Data were thematically analysed, initially within and then across cases. The dataset consisted of 431 semistructured interviews with key stakeholders, including hospital staff, developers, and governmental stakeholders; 590 hours of observations of strategic meetings and use of the software in context; 334 sets of notes from observations, researcher’ field notes, and notes from national conferences; 809 NHS documents; and 58 regional and national documents. Results: Implementation has proceeded more slowly, with a narrower scope and substantially less clinical functionality than was originally planned. The national strategy had considerable local consequences (summarised under five key themes), and wider national developments impacted heavily on implementation and adoption. More specifically, delays related to unrealistic expectations about the capabilities of systems; the time needed to build, configure, and customise the software; the work needed to ensure that systems were supporting provision of care; and the needs of end users for training and support. Other factors hampering progress included the changing milieu of NHS policy and priorities; repeatedly renegotiated national contracts; different stages of development of diverse NHS care records service systems; and a complex communication process between different stakeholders, along with contractual arrangements that largely excluded NHS providers. There was early evidence that deploying systems resulted in important learning within and between organisations and the development of relevant competencies within NHS hospitals. Conclusions: Implementation of the NHS Care Records Service in “early adopter” sites proved time consuming and challenging, with as yet limited discernible benefits for clinicians and no clear advantages for patients. Although our results might not be directly transferable to later adopting sites because the functionalities we evaluated were new and untried in the English context, they shed light on the processes involved in implementing major new systems. The move to increased local decision making that we advocated based on our interim analysis has been pursued and welcomed by the NHS, but it is important that policymakers do not lose sight of the overall goal of an integrated interoperable solution.

Include:
11 Research products, page 1 of 2
  • Open Access
    Authors: 
    Ishak Berrebbah;
    Publisher: New Bulgarian University

    This paper discusses the politics and multi-functionality of storytelling in Diana Abu-Jaber’s novel Crescent (2003). I argue that the strategic use of storytelling places Crescent as a complex hybrid text that projects the nature, and development, of Arab American literature in the contemporary era. In addition to having the practice of storytelling as an apparatus to project identity in Crescent, Abu-Jaber re-appropriates its empowered status in Arab culture as well as politicizes its image in the mind of her readers. Besides employing critical and analytical approaches to the novel, this paper relies on arguments and perspectives of prominent postcolonial and literary critics and theorists such as Edward Said, Suzanne Keen, Walter Benjamin, and Samaya Sami Sabry, to name a few.

  • Open Access English
    Authors: 
    Sammons, P.; Sylva, K.; Melhuish, Edward C.; Siraj-Blatchford, I.; Taggart, B.;
    Publisher: DCSF Publications
    Country: United Kingdom

    These reports forms part of a set of two reports that examine key influences on children’s Maths, English and social behavioural outcomes (self-regulation, pro-social behaviour, hyperactivity and anti-social behaviour) in Year 6 and on their progress across Key Stage 2. The sister report describes the results of analyses on children’s social/behavioural outcomes (ref: DCSF-RR049).\ud \ud The report is from the effective pre-school and primary education 3 to 11 project (EPPE 3 to 11) which is longitudinal study using multi-level modelling investigating the effects of home background, pre-school and primary education on pupils’ attainment and social / behavioural development.\ud \ud Around 3,000 children were recruited from 141 pre-school settings in 6 English LEAs at the age of 3+ between 1996 and 1999. The study followed these children through pre-school and into more than 900 primary schools in 100 local authorities.

  • Open Access English
    Authors: 
    Sammons, P.; Sylva, K.; Melhuish, Edward C.; Siraj-Blatchford, I.; Taggart, B.; Hunt, S.;
    Publisher: DCSF Publications
    Country: United Kingdom

    These reports forms part of a set of two reports that examine key influences on children’s Maths, English and social behavioural outcomes (self-regulation, pro-social behaviour, hyperactivity and anti-social behaviour) in Year 6 and on their progress across Key Stage 2. The sister report describes the results of analyses on children’s social/behavioural outcomes (ref: DCSF-RR049).\ud \ud The report is from the effective pre-school and primary education 3 to 11 project (EPPE 3 to 11) which is longitudinal study using multi-level modelling investigating the effects of home background, pre-school and primary education on pupils’ attainment and social / behavioural development.\ud \ud Around 3,000 children were recruited from 141 pre-school settings in 6 English LEAs at the age of 3+ between 1996 and 1999. The study followed these children through pre-school and into more than 900 primary schools in 100 local authorities.

  • Open Access English
    Authors: 
    Shrestha, Prithvi;

    In the context of higher education, many higher order skills and knowledge are expected to be transferable by lecturers. Sustaining these skills and knowledge is therefore central to learning and disciplinary writing development. English for Specific Purposes (ESP) courses can contribute to this purpose as they aim to enable Higher Education students to participate in their chosen academic communities as fully as possible. Despite learning transfer being a key purpose in ESP, research in this area is still limited (Cheng, 2007). \ud In this context, this paper reports on a small-scale study investigating the transfer of academic writing skills and conceptual knowledge among undergraduate business studies students. The data are derived from a larger study (Shrestha, 2011) conducted at a British university. One assignment text each was collected from four students who studied an ESP course for business studies. While three students had received interactive feedback on their previous two assignments, following a Vygotsky-inspired dynamic assessment (DA) approach, one student was provided with traditional tutor feedback. DA blends instruction with assessment by targeting and further developing students’ potential abilities (Poehner, 2011) whereas traditional tutor feedback is less interactive and hence, may not sufficiently target learners’ potential abilities. The student texts were analysed by drawing on Vygotskian sociocultural theory of learning (Vygotsky, 1978), and genre theory (Martin & Rose, 2007) based on Halliday’s Systemic Functional Linguistics (Halliday & Matthiessen, 2004). The findings suggest that the transfer of academic writing skills and conceptual knowledge occurred more in the texts of the students that underwent dynamic assessment than that of the student who followed a traditional assessment approach for their first two assignments. Implications of this for ESP instruction and assessment design will be presented.

  • Closed Access
    Authors: 
    Yu-Tzu Wu; Hsin Yi Lee; Sam Norton; Chuanfeng Chen; Hongxia Chen; Chenglin He; Jane Fleming; Fiona E. Matthews; Carol Brayne;
    Publisher: Wiley

    Background Many studies have considered the prevalence of dementia in mainland China, Hong Kong and Taiwan. However, area level estimates have not been produced. This study examines area differences across mainland China, Hong Kong and Taiwan adjusting for the effect of methodological factors with the aim of producing estimates of the numbers of people with dementia in these areas. Method and Findings A search of Chinese and English databases identified 76 dementia prevalence studies based on samples drawn from mainland China, Hong Kong and Taiwan between 1980 and 2012. A pattern of significantly decreasing prevalence was observed from northern, central, southern areas of mainland China, Hong Kong and Taiwan. Area variations in dementia prevalence were not explained by differences in methodological factors (diagnostic criteria, age range, study sample size and sampling method), socioeconomic level or life expectancy between areas. The results of meta-analysis were applied to current population data to provide best estimate. Based on the DSM-IV diagnostic criteria, the total number of people aged 60 and over with dementia in mainland China, Hong Kong and Taiwan is 8.4 million (4.6%, 95% CI: 3.4, 5.8) and in northern, central and southern areas are 3.8 (5.1%, 95% CI: 4.1, 6.1), 3.2 (4.4%, 95% CI: 3.2, 5.6) and 1.2 (3.9%, 95% CI: 2.3, 5.4) million respectively. These estimates were mainly based on the studies existing in highly developed areas and potentially affected by incomplete and insufficient data. Conclusions The findings of this review provide a robust estimate of area differences in dementia prevalence. Application of the estimated prevalence to population data reveals the number of people with dementia is expected to double every 20 years, areas in mainland China will be facing the greatest dementia challenge.

  • Open Access English
    Authors: 
    Cooke, D.; O'Hara, M. C.; Beinart, N.; Heller, S.; La Marca, R.; Byrne, M.; Mansell, P.; Dinneen, S. F.; Clark, M.; Bond, R.; +2 more
    Publisher: American Diabetes Association
    Countries: United Kingdom, Ireland

    OBJECTIVE To develop a linguistically and psychometrically validated U.K. English (U.K./Ireland) version of the Diabetes-Specific Quality-of-Life Scale (DSQOLS) for adults with type 1 diabetes. RESEARCH DESIGN AND METHODS We conducted independent forward and backward translation of the validated German DSQOLS. An iterative interview study with health professionals (n = 3) and adults with type 1 diabetes (n = 8) established linguistic validity. The DSQOLS was included in three Dose Adjustment for Normal Eating (DAFNE) studies (total N = 1,071). Exploratory factor analysis (EFA) was undertaken to examine questionnaire structure. Concurrent and discriminant validity, internal consistency, and reliability were assessed. RESULTS EFA indicated a six-factor structure for the DSQOLS (social aspects, fear of hypoglycemia, dietary restrictions, physical complaints, anxiety about the future, and daily hassles). High internal consistency reliability was found for these factors and the weighted treatment satisfaction scale (α = 0.85–0.94). All subscales were moderately, positively correlated with the Audit of Diabetes-Dependent Quality-of-Life (ADDQoL) measure, demonstrating evidence of concurrent validity. Lower DSQOLS subscale scores [indicating impaired quality of life (QoL)] were associated with the presence of diabetes-related complications. CONCLUSIONS The DSQOLS captures the impact of detailed aspects of modern type 1 diabetes management (e.g., carbohydrate counting and flexible insulin dose adjustment) that are now routine in many parts of the U.K. and Ireland. The U.K. English version of the DSQOLS offers a valuable tool for assessing the impact of treatment approaches on QoL in adults with type 1 diabetes.

  • Open Access English
    Authors: 
    Pinfield, S.; Salter, J.; Bath, P.A.; Hubbard, B.; Millington, P.; Anders, J.H.S.; Hussain, A.;
    Publisher: American Society for Information Sciences and Technology
    Country: United Kingdom
    Project: WT

    This paper reviews the worldwide growth of open-access (OA) repositories, December 2005 to December 2012, using data collected by the OpenDOAR project. It shows that initial repository development was focused on North America, Western Europe and Australasia, particularly the USA, UK, Germany and Australia. Soon after, Japan increased its repository numbers. Since 2010, other geographical areas and countries have seen repository growth, including East Asia (especially Taiwan), South America (especially Brazil) and Eastern Europe (especially Poland). During the whole period, countries such as France, Italy and Spain have maintained steady growth, whereas countries such as China and Russia have experienced relatively low levels of growth. Globally, repositories are predominantly institutional, multidisciplinary and English-language-based. They typically use open-source OAI-compliant repository software but remain immature in terms of explicit licensing arrangements. Whilst the size of repositories is difficult to assess accurately, the available data indicate that a small number of large repositories and a large number of small repositories make up the repository landscape. These trends and characteristics are analyzed using Innovation Diffusion Theory (IDT) building on previous studies. IDT is shown to provide a useful explanatory framework for understanding repository adoption at various levels: global, national, organizational and individual. Major factors affecting both the initial development of repositories and their take up by users are identified, including IT infrastructure, language, cultural factors, policy initiatives, awareness-raising activity and usage mandates. It is argued that mandates in particular are likely to play a crucial role in determining future repository development.

  • Open Access English
    Authors: 
    Yu-Tzu Wu; Hsin Yi Lee; Sam Norton; Chuanfeng Chen; Hongxia Chen; Chenglin He; Jane Fleming; Fiona E. Matthews; Carol Brayne;
    Publisher: Public Library of Science (PLoS)
    Country: United Kingdom

    BACKGROUND: Many studies have considered the prevalence of dementia in mainland China, Hong Kong and Taiwan. However, area level estimates have not been produced. This study examines area differences across mainland China, Hong Kong and Taiwan adjusting for the effect of methodological factors with the aim of producing estimates of the numbers of people with dementia in these areas. METHOD AND FINDINGS: A search of Chinese and English databases identified 76 dementia prevalence studies based on samples drawn from mainland China, Hong Kong and Taiwan between 1980 and 2012. A pattern of significantly decreasing prevalence was observed from northern, central, southern areas of mainland China, Hong Kong and Taiwan. Area variations in dementia prevalence were not explained by differences in methodological factors (diagnostic criteria, age range, study sample size and sampling method), socioeconomic level or life expectancy between areas. The results of meta-analysis were applied to current population data to provide best estimate. Based on the DSM-IV diagnostic criteria, the total number of people aged 60 and over with dementia in mainland China, Hong Kong and Taiwan is 8.4 million (4.6%, 95% CI: 3.4, 5.8) and in northern, central and southern areas are 3.8 (5.1%, 95% CI: 4.1, 6.1), 3.2 (4.4%, 95% CI: 3.2, 5.6) and 1.2 (3.9%, 95% CI: 2.3, 5.4) million respectively. These estimates were mainly based on the studies existing in highly developed areas and potentially affected by incomplete and insufficient data. CONCLUSIONS: The findings of this review provide a robust estimate of area differences in dementia prevalence. Application of the estimated prevalence to population data reveals the number of people with dementia is expected to double every 20 years, areas in mainland China will be facing the greatest dementia challenge. This is the final version of the article. It first appeared from the Public Library of Science via http://dx.doi.org/10.1371/journal.pone.0066252

  • Open Access
    Authors: 
    Linda Sharp; C. E. D. Chilvers; K.K. Cheng; Patricia McKinney; R. F. A. Logan; Paula Cook-Mozaffari; Ahmed Ashour Ahmed; Nicholas E. Day;
    Publisher: Springer Science and Business Media LLC

    Oesophageal cancer rates in women in the UK are more than 3 times higher than in most other European populations. A population-based matched case–control study of histologically confirmed squamous cell carcinoma of the oesophagus in women was carried out in 4 regions in England and Scotland. Interviews were carried out in hospital or at home and topics included: smoking; alcohol; tea and coffee consumption; medical and obstetric history; and diet. Response rates were 62% for cases and 65% for first-chosen controls. There were 159 case–control pairs. Significant results were found for: eating salads (odds ratio (OR) 0.42, 95% CI 0.20–0.92 in the highest quartile of consumption) and a light (as distinct from no) breakfast (OR 0.18, 95% CI 0.07 – 0.48) were protective; quantity of tea was a risk factor and there was a significant positive trend with temperature at which hot drinks were consumed (P = 0.03). Alcohol consumption was unrelated to risk, but there was a significant trend with years of smoking (P = 0.015). A protective effect of aspirin consumption was confined to the English centres (OR 0.08, 95% CI 0.01–0.56). Comparison with a parallel study of adenocarcinoma indicated a common protective effect of a healthy diet but otherwise distinct risk factors. © 2001 Cancer Research Campaign http://www.bjcancer.com

  • Open Access English
    Authors: 
    Aziz Sheikh; Tony Cornford; Nick Barber; Anthony J Avery; Amirhossein Takian; Valentina Lichtner; Dimitra Petrakaki; Sarah Crowe; Kate Marsden; Ann Robertson; +11 more
    Countries: Netherlands, United Kingdom, United Kingdom, United Kingdom, United Kingdom
    Project: EC | ICREL (201002)

    This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode. Objectives: To evaluate the implementation and adoption of the NHS detailed care records service in “early adopter” hospitals in England. Design: Theoretically informed, longitudinal qualitative evaluation based on case studies. Setting: 12 “early adopter” NHS acute hospitals and specialist caresettings studied over two and a half years. Data sources: Data were collected through in depth interviews, observations, and relevant documents relating directly to case study sites and to wider national developments that were perceived to impact on the implementation strategy. Data were thematically analysed, initially within and then across cases. The dataset consisted of 431 semistructured interviews with key stakeholders, including hospital staff, developers, and governmental stakeholders; 590 hours of observations of strategic meetings and use of the software in context; 334 sets of notes from observations, researcher’ field notes, and notes from national conferences; 809 NHS documents; and 58 regional and national documents. Results: Implementation has proceeded more slowly, with a narrower scope and substantially less clinical functionality than was originally planned. The national strategy had considerable local consequences (summarised under five key themes), and wider national developments impacted heavily on implementation and adoption. More specifically, delays related to unrealistic expectations about the capabilities of systems; the time needed to build, configure, and customise the software; the work needed to ensure that systems were supporting provision of care; and the needs of end users for training and support. Other factors hampering progress included the changing milieu of NHS policy and priorities; repeatedly renegotiated national contracts; different stages of development of diverse NHS care records service systems; and a complex communication process between different stakeholders, along with contractual arrangements that largely excluded NHS providers. There was early evidence that deploying systems resulted in important learning within and between organisations and the development of relevant competencies within NHS hospitals. Conclusions: Implementation of the NHS Care Records Service in “early adopter” sites proved time consuming and challenging, with as yet limited discernible benefits for clinicians and no clear advantages for patients. Although our results might not be directly transferable to later adopting sites because the functionalities we evaluated were new and untried in the English context, they shed light on the processes involved in implementing major new systems. The move to increased local decision making that we advocated based on our interim analysis has been pursued and welcomed by the NHS, but it is important that policymakers do not lose sight of the overall goal of an integrated interoperable solution.

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