Yes / Introduction As a consequence of the low cost and perceived safety, proton pump inhibitors (PPIs) are widely prescribed but they can cause longterm adverse effects and are often overprescribed. For most patients PPIs should not be continued long-term as patients can become dependent on PPIs and they are rarely stepped down/off treatment. We aimed to measure whether a dyspepsia review service could help patients on PPIs to step down/off treatment whilst still keeping them symptom free. Methods Pharmacists were provided with training on dyspepsia management. Four general practices were selected. Patients taking a PPI for more than two months were included. A list of exclusion criteria (e.g. active ulcers, newly initiated) was applied. Between six and eight dyspepsia review clinics were run at each site. Patients were booked into a 15-minute consultation. A concordance style consultation was held with clinicians providing information on dyspepsia management and exploring the patients’ ideas, concerns and expectations about stepping down or stepping off treatment. A follow-up audit was performed at four months to determine if patients had remained stepped down/off. An economic evaluation of clinic costs and drugs savings was performed. Results A total of 508 patients were invited to a review; 136 did not attend and 58 were excluded due to not meeting the inclusion criteria, leaving 314 patients reviewed for step-down/step-off. Successful step down/step off was achieved in 257 people (82% of those reviewed). The total cost savings of PPIs was £7,100. The additional cost of alginates was £1,207 giving a net saving on medicines of £5,893 per annum. Set-up costs were £1,194 and staff costs £3,524 to £5,156 giving total running costs, which vary dependent on the Agenda for Change (AfC) grade of pharmacist involved, of £4,720 - £6,351. Conclusion A dyspepsia review clinic is cost-neutral to run but, given that many patients are on polypharmacy, PPI step down might best be considered as part of a holistic medication review clinic. / Reckitt Benckiser, National Institute for Health Research, Health Education England

Yes / Objective: Past research has suggested that social influences on drinking can be manipulated with subsequent reductions in alcohol intake. However, the experimental evidence for this and the best strategies to positively change these social influences have not been meta-analyzed. This research addressed these gaps. Method: Randomized controlled trials testing social influence-based interventions on adults’ drinking were systematically reviewed and meta-analyzed. The behavior change techniques used in each study were coded and the effect sizes showing the impact of each intervention on (a) social influence and (b) alcohol intake were calculated. Meta-regressions identified the association between these effect sizes, as well as the effect of specific behavior change techniques on social influences. Results: Forty-one studies comprising 17445 participants were included. Changes in social influences were significantly associated with changes in alcohol intake. However, even moderate-to-large changes in social influences corresponded with only a small change in drinking behavior and changing social influences did not reduce alcohol-related problems. Providing normative information about others’ behavior and experiences was the most effective technique to change social influences. Conclusions: Social influences and normative beliefs can be changed in drinkers, particularly by providing normative information about how much others’ drink. However, even generating large changes in these constructs are likely to engender only small changes in alcohol intake. / NHS Leeds, UK.

Yes / Purpose: The aim of this study was to systematically review the literature to investigate the link (if any) between vision and dizziness. Methods: Medline, CINAHL, AMED, Web of Science and The Cochrane Library were searched with keywords chosen to find articles which investigated the causes of dizziness and considered vision as a possible trigger. Citation chaining of all included papers was performed in addition to the hand searching of all reference lists. Unpublished literature was identified using www.opengrey.eu. The review considered studies involving adults which link, measure or attempt to improve any aspect of vision in relation to dizziness. Results: Nine thousand six hundred and eighty one possible references were found, and the abstracts were screened independently by two reviewers to determine if they should be included in the study. Thirteen papers were found which investigated whether dizziness was linked to an assessment of vision. Visual impairment measures were crude and typically self-report, or Snellen visual acuity with little or no measurement details. Five studies found an independent link between dizziness and vision, five found a weak association (typically finding a link when univariate analyses were used, but not when multivariate analyses were used), and three found no association. Studies finding a strong link were usually cross-sectional with a large study population whereas those finding a weak association had relatively small numbers of participants. Studies which did not find an association used a broad definition of dizziness that included the term light-headedness, an unreliable Rosenbaum near visual acuity chart or an unusual categorisation of visual acuity. Conclusions: This review suggests that dizziness (although likely not ‘light-headedness’) is linked with poor vision although further studies using more appropriate measures of vision are recommended. / Deborah Armstrong was funded by a College of Optometrists Research Scholarship and Emily Charlesworth by a College of Optometrists summer studentship.

No description available.

Despite significant gains in research and programming, domestic violence persists, with domestic homicides remaining a particular concern. Yet, very little has been written about the administrative and policy responses that exist to combat domestic homicide. In Canada, inquiries, inquests, Domestic Violence Death Review Committees, and other models are increasingly being recognized as important policy responses following an intimate partner death. To assess their potential for tertiary prevention, this thesis examines models of inquiry adopted in Ontario, Manitoba, New Brunswick, and British Columbia, using secondary data analysis of relevant literature and reports as well as qualitative interviews with 11 respondents with expertise in one or more of the models. After considering the strengths and limitations of each model of inquiry, the main conclusion drawn is that the models work in complementary fashion such that, in combination, they offer a path forward in combatting the serious problem of domestic homicide. / February 2017

M.A. (Politics) / Please refer to full text to view abstract

Abstract In New Zealand's compulsory education sector quality assurance is undertaken by the Education Review Office (ERO). When a school is found to be less effective than is acceptable through the triennial review process, ERO may return to review that school within six or twelve months. This Supplementary Review is identified to the Ministry of Education (MOE) which has several levels of intervention at its disposal which can be employed singularly or in concert to improve the school. Despite the support and interventions funded and/or managed by MOE, some schools have consecutive Supplementary Reviews and some remain under Statutory Intervention for several years. Commonalities among these schools that repeatedly or consistently present as 'at risk' may indicate a need for greater or different support or intervention. Self managing schools, while effective for many schools, may not be a workable and sustainable proposition for others. This may well be particularly true for those schools identified as 'at risk'. This paper considers ERO's process to identify schools 'at risk' and subsequent interventions employed by MOE to support the Principal and Board of Trustees in addressing improvements required within the school. Statistics and document analysis were used to extract data from documents with findings presented as a series of tables. It seeks a match between what is identified by ERO and the Statutory Intervention engaged by MOE. It explores the commonalities of schools under Statutory Intervention and on Supplementary Review. Practice in other countries is also considered in an effort to understand and contextualise the ideas and beliefs that support these approaches. While there is evidence ERO identifies teacher and Principal performance as major areas of concern, lead issues for Statutory Interventions in the same schools focus on the performance of the Board of Trustees as those with the responsibility of governing the school. The focus on governance to improve school performance is not working for some schools, more or different support may be necessary to effect positive change. The balance between capacity building, incentives and accountability for all involved in schools with Statutory Interventions, appears necessary for those with the capacity to improve.

It is heartening to note that the number of contemporary Swahili scholars whose work is receiving attention in books and university theses is steadily on the increase. This volume adds Abdilatif Abdalla to the list containing, so far as I know, the names of Muhammed Said Abdulla, Ebrahim Hussein and Euphrase Kezilahabi It is a volume on the poetry of Abdalla which Nyaigotti-Chacha writes with wrumth, understanding and a desire to place in perspective the poet`s works, in particular, Utenzi wa maisha ya Adamu na Hawaa (1971) and Sauti ya dhiki (1973) For this reason, perhaps, it tends to be less critical and more informative Nyaigotti--Chacha divides his work into four chapters. The first chapter introduces the reader to the author`s reasons for undertaking to Wiite it, originally his M A thesis at the University of Nairobi (1980) A bdefbut useful biography of Abdilatif Abdalla (ppJ-9), and a theoretical orientation to the author`s analysis of the works (pp 9--11) - socialistic in the Marxian mould - furnishes the reader with the background required fm a better understanding of what follows in the next two chapters which examine Utenzi and Sauti .. respectively The final chapter investigates the skills of Abdalla as a poet

Book Review of: Johannes Fabian (ed.), History from below. The vocabulary of Elisabethville. By Andre Yav. Text, Translations and interpretive essay (Creole Language Library, Vol.7). Edited, translated and commented by Johannes Fabian with assistance from Kalundi Mango. With linguistic notes by W. Schicho. Amsterdam- Philadelphia: John Benjamins, 1990. 236 pp. Review of Noel-Jacques Gueunier (ed.), La chroniques Swahilie du Cad/Umari de Mayotte. Edition critique. (Recherches et Documents, 2).(Madagascar\'): Etablissement d\'Enseignement Superieur des Lettres (CEDRATOM),1989.

Book Review of Ernst Dammann, Afrikanische Handschriften, Teil 1 - Handschriften in Swahili und anderen Sprachen Afrikas