RIO Country Report 2015: Denmark

The 2015 series of RIO Country Reports analyse and assess the policy and the national research and innovation system developments in relation to national policy priorities and the EU policy agenda with special focus on ERA and Innovation Union. The executive summaries of these reports put forward the main challenges of the research and innovation systems.JRC.J.6-Innovation Systems Analysi

RIO Country Report 2015: United Kingdom

The 2015 series of RIO Country Reports analyse and assess the policy and the national research and innovation system developments in relation to national policy priorities and the EU policy agenda with special focus on ERA and Innovation Union. The executive summaries of these reports put forward the main challenges of the research and innovation systems.JRC.B.7-Knowledge for Finance, Innovation and Growt

RIO Country Report 2017: Finland

The R&I Observatory country report 2017 provides a brief analysis of the R&I system covering the economic context, main actors, funding trends & human resources, policies to address R&I challenges, and R&I in national and regional smart specialisation strategies. Data is from Eurostat, unless otherwise referenced and is correct as at January 2018. Data used from other international sources is also correct to that date. The report provides a state-of-play and analysis of the national level R&I system and its challenges, to support the European Semester.JRC.B.7-Knowledge for Finance, Innovation and Growt

Management of early pregnancy loss with mifepristone and misoprostol: clinical predictors of treatment success from a randomized trial.

BackgroundEarly pregnancy loss is a common event in the first trimester, occurring in 15%-20% of confirmed pregnancies. A common evidence-based medical regimen for early pregnancy loss uses misoprostol, a prostaglandin E1 analog, with a dosage of 800 μg, self-administered vaginally. The clinical utility of this regimen is limited by suboptimal effectiveness in patients with a closed cervical os, with 29% of patients experiencing early pregnancy loss requiring a second dose after 3 days and 16% of patients eventually requiring a uterine aspiration procedure.ObjectiveThis study aimed to evaluate clinical predictors associated with treatment success in patients receiving medical management with mifepristone-misoprostol or misoprostol alone for early pregnancy loss.Study designWe performed a planned secondary analysis of a randomized trial comparing mifepristone-misoprostol with misoprostol alone for management of early pregnancy loss. The published prediction model for treatment success of single-dose misoprostol administered vaginally included the following variables: active bleeding, type of early pregnancy loss (anembryonic pregnancy or embryonic and/or fetal demise), parity, gestational age, and treatment site; previous significant predictors were vaginal bleeding within the past 24 hours and parity of 0 or 1 vs >1. To determine if these characteristics predicted differential proportions of patients with treatment success or failure, we performed bivariate analyses; given the small proportion of treatment failures in the combined treatment arm, both arms were combined for analysis. Thereafter, we performed a logistic regression analysis to assess the effect of these predictors collectively in each of the 2 treatment groups separately as well as in the full cohort as a proxy for the combined treatment arm. Finally, by using receiver operating characteristic curves, we tested the ability of these predictors in association with misoprostol treatment success to discriminate between treatment success and treatment failure. To quantify the ability of the score to discriminate between treatment success and treatment failure in each treatment arm as well as in the entire cohort, we calculated the area under the curve. Using multivariable logistic regression, we then assessed our study population for other predictors of treatment success in both treatment groups, with and without mifepristone pretreatment.ResultsOverall, 297 evaluable participants were included in the primary study, with 148 in the mifepristone-misoprostol combined treatment group and 149 in the misoprostol-alone treatment group. Among patients who had vaginal bleeding at the time of treatment, 15 of 17 (88%) in the mifepristone-misoprostol combined treatment group and 12 of 17 (71%) in the misoprostol-alone treatment group experienced expulsion of pregnancy tissue. Among patients with a parity of 0 or 1, 94 of 108 (87%) in the mifepristone-misoprostol treatment group and 66 of 95 (69%) in the misoprostol-alone treatment group experienced expulsion of pregnancy tissue. These clinical characteristics did not predict treatment success in the combined cohort alone (area under the curve=0.56; 95% confidence interval, 0.48-0.64). No other baseline clinical factors predicted treatment success in the misoprostol-alone treatment arm or mifepristone pretreatment arm. In the full cohort, the significant predictors of treatment success were pretreatment with mifepristone (adjusted odds ratio=2.51; 95% confidence interval, 1.43-4.43) and smoking (adjusted odds ratio=2.15; 95% confidence interval, 1.03-4.49).ConclusionNo baseline clinical factors predicted treatment success in women receiving medical management with misoprostol for early pregnancy loss. Adding mifepristone to the medical management regimen of early pregnancy loss improved treatment success; thus, mifepristone treatment should be considered for management of early pregnancy loss regardless of baseline clinical factors

Developing a complex portrait of content teaching for multilingual learners via nonlinear theoretical understandings

Utilizing a complex theory of teacher learning and practice, this chapter analyzes ~120 empirical studies of content teacher development (both pre- and inservice) for working with multilingual learners as well as research on content teaching for multilingual students. Our analysis identified three dimensions of quality content teaching for multilingual learners that are complex and intricately connected: context, orientations and pedagogy. This chapter explores the results of our literature analysis and argues for improving content teaching for multilingual students through improved theoretically grounded research that embraces, explores and accounts for the expansive complexities inherent in teacher learning and practice

‘Smart Cities’ – Dynamic Sustainability Issues and Challenges for ‘Old World’ Economies: A Case from the United Kingdom

The rapid and dynamic rate of urbanization, particularly in emerging world economies, has resulted in a need to find sustainable ways of dealing with the excessive strains and pressures that come to bear on existing infrastructures and relationships. Increasingly during the twenty-first century policy makers have turned to technological solutions to deal with this challenge and the dynamics inherent within it. This move towards the utilization of technology to underpin infrastructure has led to the emergence of the term ‘Smart City’. Smart cities incorporate technology based solutions in their planning development and operation. This paper explores the organizational issues and challenges facing a post-industrial agglomeration in the North West of England as it attempted to become a ‘Smart City’. In particular the paper identifies and discusses the factors that posed significant challenges for the dynamic relationships residents, policymakers and public and private sector organizations and as a result aims to use these micro-level issues to inform the macro-debate and context of wider Smart City discussions. In order to achieve this, the paper develops a range of recommendations that are designed to inform Smart City design, planning and implementation strategies

Hospice Providers Awareness of the Benefits and Availability of Single-Fraction Palliative Radiotherapy

Radiotherapy effectively palliates malignant sources of pain. However, once enrolled on hospice, patients are rarely referred for this treatment. To develop educational strategies that can improve access to care, a survey of hospice providers investigated potential misconceptions about its benefits and availability. Individual surveys were distributed to administrators, nursing directors, and medical directors at 16 licensed hospices within 25 miles of a radiation oncology facility. Ninety-three percent of hospice professionals stated radiotherapy provides pain relief and is appropriate for patients with more than 1 month of life expectancy. However, less than 1% of their cancer patients had been referred to a radiation oncologist over the past year, citing concerns about cost and travel burden. Whereas most medical directors (75%) were aware it is just as effective when delivered in a single fraction, very few administrators (22%) and nursing directors (21%) had this knowledge. Meanwhile, reluctance of a radiation oncologist to offer single-fraction palliative radiotherapy was experienced by 43%. Access to palliative radiotherapy for this unique population can be increased by improving education for hospice administrators and nursing directors and reminding radiation oncologists that single-fraction palliative radiotherapy is acceptable and ideal for patients with limited financial resources at the end of life

Sexual function in 16- to 21-year-olds in Britain

Purpose: Concern about young people's sexuality is focused on the need to prevent harmful outcomes such as sexually transmitted infections and unplanned pregnancy. Although the benefit of a broader perspective is recognized, data on other aspects of sexuality, particularly sexual function, are scant. We sought to address this gap by measuring the population prevalence of sexual function problems, help seeking, and avoidance of sex in young people. Methods: A cross-sectional stratified probability sample survey (Natsal-3) of 15,162 women and men in Britain (response rate: 57.7%), using computer-assisted self-interviews. Data come from 1875 (71.9%) sexually active, and 517 sexually inactive (18.7%), participants aged 16–21 years. Measures were single items from a validated measure of sexual function (the Natsal-SF). Results: Among sexually active 16- to 21-year-old participants, 9.1% of men and 13.4% of women reported a distressing sexual problem lasting 3 months or more in the last year. Most common among men was reaching a climax too quickly (4.5%), and among women was difficulty in reaching climax (6.3%). Just over a third (35.5%) of men and 42.3% of women reporting a problem had sought help, but rarely from professional sources. Among those who had not had sex in the last year, just >10% of young men and women said they had avoided sex because of sexual difficulties. Conclusions: Distressing sexual function problems are reported by a sizeable minority of sexually active young people. Education is required, and counseling should be available, to prevent lack of knowledge, anxiety, and shame progressing into lifelong sexual difficulties