ICT, cultural knowledge, and teacher education in\ud Africa

In this paper, we make a case for the need to carry out more culturally\ud appropriate research on ICT and teacher education in Africa generally and in\ud Uganda more specifically. We begin by examining the promise of ICTs and digital\ud literacies, and highlight the importance ascribed to ICTs for national development\ud and educational change. While agreeing that ICTs may have transformative\ud potential in developing countries, we argue that the much-hyped potential may not\ud be realized if the major focus of promoting ICTs in a developing country like\ud Uganda is merely to provide greater access to global information, rather than\ud encouraging local knowledge production for wealth creation. We frame our\ud argument with reference to the New Literacy Studies perspective of viewing\ud literacy as a social practice situated in a specific sociocultural context

A Confirmatory Factor Analysis of Facets of Psychological Flexibility in a Sample of People Seeking Treatment for Chronic Pain

Background: Evidence supports the validity of individual components of the psychological flexibility model in the context of chronic pain. However, there is a need to test the inter-relationships amongst measures of individual components of psychological flexibility in a more integrative manner. In particular, research is needed to examine whether a model with discrete facets as proposed is indeed reflected in data from currently used assessment measures in people with chronic pain. Purpose: This cross-sectional study investigated the underlying structure of measures of processes of psychological flexibility amongst individuals with chronic pain and the associations between this measurement model and patient functioning. Methods: Five-hundred and seventy-three adults with chronic pain completed measures of pain, physical and social functioning, mental health, depression and processes of psychological flexibility, including acceptance, cognitive defusion, decentering and committed action. Confirmatory factor analyses tested lower-order, higher-order and bifactor models to examine the structure of psychological flexibility process measures. Results: A single general factor reflecting openness explained variability in items across all of the psychological flexibility process measures. In addition to this general factor, distinct decentering and committed action group factors emerged in the data. As expected, the general factor was strongly correlated with measures of social functioning, mental health and depression. Conclusions: Future research is needed to determine the most useful means by which the presence of the general factor can be reflected in the measurement and theory of psychological flexibility.</p

Data quality predicts care quality: findings from a national clinical audit

Background: Missing clinical outcome data are a common occurrence in longitudinal studies. Data quality in clinical audit is a particular cause for concern. The relationship between departmental levels of missing clinical outcome data and care quality is not known. We hypothesise that completeness of key outcome data in a national audit predicts departmental performance. Methods: The National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis (NCAREIA) collected data on care of patients with suspected rheumatoid arthritis (RA) from early 2014 to late 2015. This observational cohort study collected data on patient demographics, departmental variables, service quality measures including time to treatment, and the key RA clinical outcome measure, disease activity at baseline, and 3 months follow-up. A mixed effects model was conducted to identify departments with high/low proportions of missing baseline disease activity data with the results plotted on a caterpillar graph. A mixed effects model was conducted to assess if missing baseline disease activity predicted prompt treatment. Results: Six thousand two hundred five patients with complete treatment time data and a diagnosis of RA were recruited from 136 departments. 34.3% had missing disease activity at baseline. Mixed effects modelling identified 13 departments with high levels of missing disease activity, with a cluster observed in the Northwest of England. Missing baseline disease activity was associated with not commencing treatment promptly in an adjusted mix effects model, odds ratio 0.50 (95% CI 0.41 to 0.61, p < 0.0001). Conclusions: We have shown that poor engagement in a national audit program correlates with the quality of care provided. Our findings support the use of data completeness as an additional service quality indicator

Physiotherapy informed by Acceptance and Commitment Therapy (PACT):Protocol for a randomised controlled trial of PACT versus usual physiotherapy care for adults with chronic low back pain

INTRODUCTION: Chronic low back pain (CLBP) is a common condition and source of significant suffering, disability and healthcare costs. Current physiotherapy treatment is moderately effective. Combining theory-based psychological methods with physiotherapy could improve outcomes for people with CLBP. The primary aim of this randomised controlled trial (RCT) is to evaluate the efficacy of Physiotherapy informed by Acceptance and Commitment Therapy (PACT) on functioning in patients with CLBP. METHODS AND ANALYSIS: The PACT trial is a two-armed, parallel-group, multicentre RCT to assess the efficacy of PACT in comparison with usual physiotherapy care (UC). 240 patients referred to physiotherapy with CLBP will be recruited from three National Health Service (NHS) hospitals trusts. Inclusion criteria are: age ≥18 years, CLBP ≥12-week duration, scoring ≥3 points on the Roland-Morris Disability Questionnaire (RMDQ) and adequate understanding of spoken and written English to participate. Patients will be randomised to PACT or UC (120 per arm stratified by centre) by an independent randomisation service and followed up at 3 and 12 months post randomisation. The sample size of 240 will provide adequate power to detect a standardised mean difference of 0.40 in the primary outcome (RMDQ; 5% significance, 80% power) assuming attrition of 20%. Analysis will be by intention to treat conducted by the trial statistician, blind to treatment group, following a prespecified analysis plan. Estimates of treatment effect at the follow-up assessments will use an intention-to-treat framework, implemented using a linear mixed-effects model. ETHICS AND DISSEMINATION: This trial has full ethical approval (14/SC/0277). It will be disseminated via peer-reviewed publications and conference presentations. The results will enable clinicians, patients and health service managers to make informed decisions regarding the efficacy of PACT for patients with CLBP. TRIAL REGISTRATION: number ISRCTN95392287; Pre-results

Comorbidity and dementia: a scoping review of the literature

BackgroundEvidence suggests that amongst people with dementia there is a high prevalence of comorbid medical conditions and related complaints. The presence of dementia may complicate clinical care for other conditions and undermine a patient¿s ability to manage a chronic condition. The aim of this study was to scope the extent, range and nature of research activity around dementia and comorbidity.MethodsWe undertook a scoping review including all types of research relating to the prevalence of comorbidities in people with dementia; current systems, structures and other issues relating to service organisation and delivery; patient and carer experiences; and the experiences and attitudes of service providers. We searched AMED, Cochrane Library, CINAHL, PubMed, NHS Evidence, Scopus, Google Scholar (searched 2012, Pubmed updated 2013), checked reference lists and performed citation searches on PubMed and Google Scholar (ongoing to February 2014).ResultsWe included 54 primary studies, eight reviews and three guidelines. Much of the available literature relates to the prevalence of comorbidities in people with dementia or issues around quality of care. Less is known about service organisation and delivery or the views and experiences of people with dementia and their family carers. There is some evidence that people with dementia did not have the same access to treatment and monitoring for conditions such as visual impairment and diabetes as those with similar comorbidities but without dementia.ConclusionsThe prevalence of comorbid conditions in people with dementia is high. Whilst current evidence suggests that people with dementia may have poorer access to services the reasons for this are not clear. There is a need for more research looking at the ways in which having dementia impacts on clinical care for other conditions and how the process of care and different services are adapting to the needs of people with dementia and comorbidity. People with dementia should be included in the debate about the management of comorbidities in older populations and there needs to be greater consideration given to including them in studies that focus on age-related healthcare issues.</p

HB 1134: Amendments to the Georgia Street Gang Terrorism and Prevention Act

The Act amends the Georgia Street Gang Terrorism and Prevention Act to provide the attorney general with concurrent authority to prosecute criminal gang activity alongside local prosecuting attorneys in Georgia. Modeled after a similar act that created concurrent authority for the attorney general to prosecute human trafficking crimes, the Act seeks to enhance the government’s investigation and prosecution of gang crimes in the state by making the effort more corroborative, coordinated, and multi-jurisdictional

Aerobic exercise, cognitive behavioural therapy and energy conservation management for Multiple Sclerosis (MS) fatigue: Are three trials better than one?

This edition of Multiple Sclerosis Journal includes reports from three randomised controlled trials (RCTs) of cognitive behaviour therapy1, aerobic training2 and energy conservation3 management for the treatment of MS fatigue. The three trials were led by separate research teams as part of the Dutch TREFAMS-ACE consortium4. Each trial compared one of the active treatments against a standardised control condition of three 45-minute individual face-to-face consultations with experienced and trained MS-nurses over a 4-month period. The MS nurses gave patients a standardised brochure about fatigue. Patients had the opportunity to discuss their fatigue and set goals for managing fatigue. In contrast, the three active treatments (summarised in the Table) included 12 45 minute individual face-to face treatment sessions with a health professional over the same time period. Participants in all three trials were followed up over 12-months. The primary outcomes, Checklist Individual Strengths (CIS20r)5 domain fatigue and Impact on Participation and Autonomy Questionnaire (IPA) 6 were identical in all studies. Secondary outcomes included the Modified Fatigue Impact Scale7 and the Fatigue Severity Scale8. ECM showed no significant improvements over the control condition on any outcomes. The CBT and aerobic training RCTS reported positive effects on the primary and secondary fatigue measures at the end of treatment, but effects were lost at 52-weeks follow-up. None of the trials found a positive effect for the active interventions on IPA at any follow-up point

Early Life Conditions and Adolescent Sexual Orientation:A Prospective Birth Cohort Study

This study tested the association between multiple prenatal and postnatal early life factors and adolescent sexual orientation in a longitudinal birth cohort. Factors included birthweight, gestational age, parental ages at birth, number of older brothers and sisters, breastfeeding, maternal anxiety/depression, family socioeconomic position, parent-child relationships, parental absences, pubertal body mass index, and housing issues. We used data on 5007 youth from the Avon Longitudinal Study of Parents and Children (ALSPAC). Sexual orientation was assessed using a 5-point scale of sexual attraction at 15.5 years. Early life factors were separated into three developmental periods: prenatal (n = 9), before 7 years (n = 5), and after 7 years (n = 5). We controlled for childhood gender nonconformity (GNCB), handedness, and digit ratio as markers of prenatal androgen exposure. GNCB was strongly associated with later male and female nonheterosexuality, and higher right-hand digit ratio was associated with later male nonheterosexuality. Boys with low birthweight and shorter breastfeeding duration were more likely to have a later nonheterosexual orientation. Boys with parental absence before 7 years of age were more likely to be nonheterosexual, but this effect disappeared after entering all early life history factors. Parental absence since birth, low prenatal family socioeconomic position, and poorer parent-child relationship were associated with later nonheterosexuality among girls. The results are discussed in the context of a life history framework for understanding human sexual orientation development in male

Adolescent Sexual Behavior Patterns in a British Birth Cohort: A Latent Class Analysis

This study examined adolescent sexual behaviors patterns, and the consistency between sexual behavior and sexual orientation, in a prospective birth cohort. We used data on 5150 young people from the Avon Longitudinal Study of Parents and Children. Sexual orientation was assessed using a 5-point scale of sexual attraction at 15.5 years. Fourteen sexual activities were assessed using the Adolescent Sexual Activities Index at 13.5 and 15.5 years. Latent class analysis suggested four subgroups of adolescent sexual behaviors at 13.5: a “high-intensity sexual behaviors exclusively with other-sex, no same-sex intimacy” group (3.87%); a “moderate-intensity sexual behaviors exclusively with other-sex, no same-sex intimacy” group (16.57%); a “low-intensity sexual behaviors exclusively with other-sex, no same-sex intimacy” group (34.21%); and a “no sexual behavior” group (45.35%). There were five subgroups at 15.5 where four of them (23.42%, 18.37%, 28.12%, and 24.52%, respectively) were interpreted the same as at 13.5 years and a new “high-intensity sexual behaviors, some same-sex intimacy” subgroup (5.57%). Latent transition analysis showed approximately half the adolescents moved toward greater engagement in higher intensity sexual activities with other-sex at 15.5. Boys and girls who were in groups without same-sex intimacy were predominantly attracted to the other-sex, whereas there were moderate consistencies between same-sex intimacy and same-sex attraction for boys and low consistency for girls. Findings suggest that it may be important to include low-intensity sexual behaviors when assigning adolescents to sexual orientation groupings (via sexual behaviors) in order to reduce selection biases and increase statistical power via the increase in sample size.</p