London School Research Articles

Increasing Access to Eye Health Services in Kenya Using an mHealth System: A Cluster Randomised Controlled Trial

Background: A combination of limited access to eye services and low numbers of eye care providers in low- and middle-income (LMIC) populations results in high prevalence of avoidable vision impairment. Poverty, lack of awareness and greater distance are key barriers to accessing services. We investigated the effectiveness of the Peek Community Eye Health system (Peek CEH), a smartphone-based referral system comprising decision support algorithms (Peek Community Screening app), Short Message Service (SMS) reminders and real-time system level reporting. Methods: We conducted a single masked, cluster randomised controlled trial. All participants in a ‘community unit’ defined as a dispensary or health centre with its catchment population were eligible. Community units were randomly allocated (1:1) to receive either the Peek CEH and referral (intervention group) or the current standard with periodic health centre-based outreach clinics and onward referral (control group). Participants in the intervention group were assessed in their houses by screeners and those referred were asked to present for triage assessment in a central location. They also received regular SMS reminders. In both groups, community sensitisation was done followed by a triage clinic at the link health facility four weeks from sensitisation. During triage, participants in both groups were assessed and treated and, if necessary, were given a referral to Kitale Eye Unit, participants in the intervention arm received further SMS reminders. The primary outcome was the number of people per 10,000 population (rate) with eye conditions attending triage at four weeks of sensitization. Primary analysis was by intention to treat, with the intervention effect estimated using a t-test performed on cluster-level rates. Findings: Trial recruitment occurred between November 26, 2018, and June 7, 2019. We randomly selected 36 out of the 66 eligible Community Units; these were then randomised to either the intervention group (68,348 participants) or the control group (60,243 participants). 9,387 (13·7%) participants from the intervention group and 3,070 (5·1%) from the control group attended triage assessment. The mean attendance rate by participants with eye problems was 1,429 per 10,000 in the intervention arm and 522 per 10,000 in the control group, giving an estimated rate difference of 906 per 10,000 (95%CI: 689-1,124; p <0·0001). The mean hospital attendance was 82 per 10,000 in the intervention group and 33 per 10,000 in the control group, estimated rate difference of 49 per 10,000 (95%CI:25-73; p=0·0002). Hospital utilization (secondary care) by the catchment population remained consistent with normal annual levels (80 per 10,000), however a major improvement in the proportion of appropriate utilization was seen, with 13% (baseline 61%) having primary eye care conditions (most managed at triage) and 56% (baseline 8%) having priority vision impairing eye conditions. Interpretation: The Peek Community Eye Health system increased primary care and hospital attendance by people with eye problems compared with the standard approach in communities. This indicates the potential of this mHealth package to improve uptake of eye services and guide appropriate task sharing, through better matching of need to services. Trial Registration: This trial is registered with Pan African Clinical Trial Registry, number PACTR 201807329096632. Funding Statement: This study was funded through the Commonwealth Eye Health Consortium (CEHC), with funding from the Queen Elizabeth Diamond Jubilee Trust’s “Avoidable Blindness” programme. The CEHC is administered through the International Centre for Eye Health (ICEH) based at the London School of Hygiene & Tropical Medicine. MJB is supported by the Wellcome Trust 207472/Z/17/Z. Declaration of Interests: The Peek Vision Foundation (09919543) is a registered charity in England and Wales (1165960) with a wholly owned trading subsidiary, Peek Vision Ltd (09937174). Professor Matthew Burton is a Trustee of The Peek Vision Foundation and Dr Andrew Bastawrous is CEO of The Peek Vision Foundation and Peek Vision Ltd. HR is an advisor to Peek Vision Ltd. CB works at Peek Vision Ltd. All other authors declare no conflict of interest. This submission has not been published anywhere previously and is not simultaneously being considered for any other publication. Ethics Approval Statement: The study was approved by the Moi University Institutional Research and Ethics Committee, Kenya and the London School of Hygiene & Tropical Medicine Ethics Committee, UK. Permission was also granted by department of Health, Trans Nzoia County, Kenya. The study adhered to the principles of the Declaration of Helsinki on Ethics. Written informed consent from all participants was obtained by a trained field research team before enrolment; parents or guardians consented for children.

The Urban Wage Premium in Imperfect Labor Markets

Boris Hirsch, Elke J. Jahn, Alan Manning and Michael Oberfichtner Boris Hirsch is Professor of Economics at Leuphana University of Lüneburg and an affiliate of the IWH and IZA. Elke J. Jahn is Professor of Economics at Bayreuth University, Distinguished Researcher at the Institute for Employment Research (IAB), and an affiliate of the IZA. Alan Manning is Professor of Economics at the London School of Economics and Director of the Community Programme at the Centre for Economic Performance at the LSE. Michael Oberfichtner is Researcher at the Institute for Employment Research (IAB).

Methotrexate and prednisolone study in erythema nodosum leprosum (MaPs in ENL) protocol: a double-blind randomised clinical trial

IntroductionErythema nodosum leprosum (ENL) is an immunological complication of leprosy. ENL results in morbidity and disability and if it is not treated can lead to death. The current treatment consists...

Co-production of an educational package for the universal human papillomavirus (HPV) vaccination programme tailored for schools with low uptake: a participatory study protocol

AimTo co-produce with young people an educational package about the human papillomavirus (HPV) vaccine that is tailored to increase vaccine uptake in schools and populations with lower uptake.IntroductionPersistent infection with...

Risk assessment for rationalizing the use of personal protective equipment for SARS-CoV2 in healthcare settings with special focus on low- and middle-income settings

Risk assessment for rationalizing the use of personal protective equipment for SARS-CoV2 in healthcare settings with special focus on low- and middle-income settings

Val Curtis: public health researcher and activist

Credit: Aunger, 2020 Val Curtis served as the director of the Environmental Health Group at the London School of Hygiene and Tropical Medicine where she built a reputation as a...

Harold Laski and his Chinese Disciples

On 2 July 2020, a virtual workshop entitled ‘Harold Laski and His Chinese Disciples: A Workshop on the Legacy of Laski’s Legal Philosophy’ was organised by Dr Ting Xu (School of Law, University of Sheffield; now Professor of Law, University of Essex). This workshop was supported and funded by Professor Xu’s British Academy Mid-Career Fellowship (2019-2020) on ‘Harold Laski and His Chinese Disciples: Using Biographical Methods to Study the Evolution of Rights’. This workshop provided the first opportunity for UK and Chinese studies scholars to discuss Laski’s long-neglected impact on China, contributing to reviving an interest in the significance and legacy of Laski’s legal philosophy. Speakers included eminent scholars who have conducted research in related areas, including Professor Roger Cotterrell (Queen Mary University of London), Professor Ross Cranston (London School of Economics and Political Science (LSE)), Dr Peter Lamb (Staffordshire University), Professor Martin Loughlin (LSE), Professor Michael Palmer (SOAS University of London) and Professor Francis Snyder (Peking University School of Transnational Law). Twenty-five people participated in the workshop, including academics, students and several members of the public.

The temporal association of introducing and lifting non-pharmaceutical interventions with the time-varying reproduction number (R) of SARS-CoV-2: a modelling study across 131 countries

BackgroundNon-pharmaceutical interventions (NPIs) were implemented by many countries to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causal agent of COVID-19. A resurgence in COVID-19 cases has been reported in some countries that lifted some of these NPIs. We aimed to understand the association of introducing and lifting NPIs with the level of transmission of SARS-CoV-2, as measured by the time-varying reproduction number (R), from a broad perspective across 131 countries.MethodsIn this modelling study, we linked data on daily country-level estimates of R from the London School of Hygiene & Tropical Medicine (London, UK) with data on country-specific policies on NPIs from the Oxford COVID-19 Government Response Tracker, available between Jan 1 and July 20, 2020. We defined a phase as a time period when all NPIs remained the same, and we divided the timeline of each country into individual phases based on the status of NPIs. We calculated the R ratio as the ratio between the daily R of each phase and the R from the last day of the previous phase (ie, before the NPI status changed) as a measure of the association between NPI status and transmission of SARS-CoV-2. We then modelled the R ratio using a log-linear regression with introduction and relaxation of each NPI as independent variables for each day of the first 28 days after the change in the corresponding NPI. In an ad-hoc analysis, we estimated the effect of reintroducing multiple NPIs with the greatest effects, and in the observed sequence, to tackle the possible resurgence of SARS-CoV-2.Findings790 phases from 131 countries were included in the analysis. A decreasing trend over time in the R ratio was found following the introduction of school closure, workplace closure, public events ban, requirements to stay at home, and internal movement limits; the reduction in R ranged from 3% to 24% on day 28 following the introduction compared with the last day before introduction, although the reduction was significant only for public events ban (R ratio 0·76, 95% CI 0·58–1·00); for all other NPIs, the upper bound of the 95% CI was above 1. An increasing trend over time in the R ratio was found following the relaxation of school closure, bans on public events, bans on public gatherings of more than ten people, requirements to stay at home, and internal movement limits; the increase in R ranged from 11% to 25% on day 28 following the relaxation compared with the last day before relaxation, although the increase was significant only for school reopening (R ratio 1·24, 95% CI 1·00–1·52) and lifting bans on public gatherings of more than ten people (1·25, 1·03–1·51); for all other NPIs, the lower bound of the 95% CI was below 1. It took a median of 8 days (IQR 6–9) following the introduction of an NPI to observe 60% of the maximum reduction in R and even longer (17 days [14–20]) following relaxation to observe 60% of the maximum increase in R. In response to a possible resurgence of COVID-19, a control strategy of banning public events and public gatherings of more than ten people was estimated to reduce R, with an R ratio of 0·71 (95% CI 0·55–0·93) on day 28, decreasing to 0·62 (0·47–0·82) on day 28 if measures to close workplaces were added, 0·58 (0·41–0·81) if measures to close workplaces and internal movement restrictions were added, and 0·48 (0·32–0·71) if measures to close workplaces, internal movement restrictions, and requirements to stay at home were added.InterpretationIndividual NPIs, including school closure, workplace closure, public events ban, ban on gatherings of more than ten people, requirements to stay at home, and internal movement limits, are associated with reduced transmission of SARS-CoV-2, but the effect of introducing and lifting these NPIs is delayed by 1–3 weeks, with this delay being longer when lifting NPIs. These findings provide additional evidence that can inform policy-maker decisions on the timing of introducing and lifting different NPIs, although R should be interpreted in the context of its known limitations.FundingWellcome Trust Institutional Strategic Support Fund and Data-Driven Innovation initiative.

Implementation of accelerated research: strategies for implementation as applied in a phase 1 Ad26.ZEBOV, MVA-BN-Filo two-dose Ebola vaccine clinical trial in Uganda

ABSTRACT Background The 2013–2016 Ebola epidemic in West Africa is the worst ever caused by Ebolaviruses with over 28,000 human cases and 11,325 deaths. The World Health Organisation (WHO) declared the epidemic a public health crisis that required accelerated development of novel interventions including vaccines. The Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit (MRC/UVRI & LSHTM Uganda Research Unit) was among the African research sites that implemented the VAC52150EBL1004 Ebola vaccine trial. Objective We report on the strategies utilised by the Unit and sponsor in ensuring expedited clinical trial approval and accelerated conduct. Methods Janssen Vaccines and Prevention B.V. conducted a phase 1 trial to evaluate the safety, tolerability, and immunogenicity of heterologous two-dose vaccination regimens using Ad26.ZEBOV and MVA-BN-Filo, in healthy adults in Africa. Accelerated implementation strategies are hereby presented. Results Strategies included: holding the African Vaccine Regulatory Forum (AVAREF) joint review meeting; expedited review by institutional ethics and country-specific regulatory bodies; competitive recruitment between sites; electronic data capture (EDC); frequent study monitoring schedule; involvement of a community advisory board (CAB); and utilization of a ‘phased’ study information-sharing approach in community engagement and participant recruitment. These strategies enabled the site to acquire approvals within 2 months and enrol 47 participants within a spurn of five. The same milestone is usually acquired in at least 1 year without accelerated implementation. Conclusion The use of well-thought strategies by sponsors and research sites can enable the implementation of accelerated research. We recommend the use of similar strategies in other settings.

Persistent Malaria Transmission from Asymptomatic Children Despite Highly Effective Malaria Control in Eastern Uganda

Background: Persistent asymptomatic Plasmodium falciparum infections are common in malaria- endemic settings, but their contribution to transmission is poorly understood. Methods: A cohort of children and adults from Tororo, Uganda was closely followed for 24 months by continuous passive surveillance and routine assessments. P. falciparum parasite density, gametocyte density and genetic composition were determined molecularly; mosquito membrane feeding assays were performed on samples from participants with symptomatic and asymptomatic infections. Findings: From October 2017 to October 2019, we followed all 531 residents from 80 households. Parasite prevalence was 5·8% by microscopy and 17·3% by PCR at enrolment and declined thereafter. We conducted 538 mosquito feeding experiments on samples from 107 individuals. Mosquito infection rates were strongly associated with gametocyte densities of participants. Considering both transmissibility of infections and their relative frequency, the estimated human infectious reservoir was primarily asymptomatic microscopy-detected infections (83·8%), followed by asymptomatic submicroscopic (15·6%) and symptomatic (0·6%) infections. Over half of the infectious reservoir was children aged 5-15 years (56·8%); individuals 16 years (15·7%) contributed less. Four children were responsible for 62·6% (279/446) of infected mosquitos and were infectious at multiple timepoints. Interpretation: Individuals with asymptomatic infections were important drivers of malaria transmission. School-aged children were responsible for over half of all mosquito infections, with a small minority of asymptomatic children highly infectious. Demographically targeted interventions, aimed at school-aged children, could further reduce transmission in areas under effective vector control. Funding Statement: National institute of Health, Bill & Melinda Gates Foundation, European Research Council. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Ethical approval for the study was received from the Uganda National Council of Science and Technology (HS119ES), Makerere University School of Medicine, the University of California, San Francisco and the London School of Hygiene & Tropical Medicine.

The Effect of BCG on Mortality Beyond Infancy: 30-Year Follow-Up of a Double-Blind Randomised Placebo-Controlled Trial of BCG Re-Vaccination in Malawi

Background: Trials of BCG to prevent COVID-19 are taking place in adults, some of whom have been previously vaccinated, but evidence of BCG’s beneficial non-specific effects come largely from data on mortality in infants, and from in vitro and animal studies. We assess all-cause mortality following a large BCG re-vaccination trial in Malawi. Methods: A population-based double-blind randomised trial comparing BCG re-vaccination vs placebo to prevent tuberculosis and leprosy was initiated in Karonga District, Malawi, in 1986-9, in individuals aged 3 months to 75 years. Active follow-up was carried out in northern areas of the district in 1991-94 and in a southern area in 2002-2018 covering 15.8% (7389 individuals) and 12.0% (5616 individuals) of the trial population respectively. Year of death or leaving the area were recorded for those not found. We used survival analysis to estimate all-cause mortality rates. Findings: There was no difference in mortality rate between the BCG and placebo group in either follow-up, overall or by age group. Mortality rates in the northern areas were 6.6/1000 person years at risk (pyar), 95% confidence interval 5.5-7.8, and 7.0/1000pyar (5.9-8.2) for those who received BCG and placebo, respectively. In the southern area they were 6.3/1000 pyar, (5.5-7.1), and 5.9/1000 pyar, (5.2-6.8), respectively. Interpretation: We found no evidence of any beneficial effect of BCG re-vaccination on all-cause mortality. The high proportion of deaths attributable to non-infectious causes beyond infancy, and the long time interval since BCG for most deaths, may obscure any benefits. Funding Statement: The original trial was funded by primarily by the British Leprosy Relief Association (LEPRA), with assistance from the International Federation of Anti-Leprosy Organizations (ILEP), and the Immunology of Leprosy component of the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (IMMLEP/TDR), with support of the Malawian Ministry of Health. The later follow-up was funded by The Wellcome Trust There was no specific funding for this analysis.Declaration of Interests: We declare no competing interests.Ethics Approval Statement: The trial protocol was approved in 1985 by the Health Sciences Research Committee of the Malawi Ministry of Health, the Standing Committee on Research in Human Subjects of WHO, and the Ethics Committee of the London School of Hygiene & Tropical Medicine. Follow-up of the population has been approved in the context of other studies by the Health Sciences Research Committee of the Malawi Ministry of Health and the Ethics Committee of the London School of Hygiene & Tropical Medicine.

Higher Education and Globalization in the Context of the COVID-19 Crisis

The competition of civilizations forced the European universities to adapt to the competition with the Chinese and American universities. European integration cannot advance without the collaboration between European universities. An answer to these challenges is the CIVICA project, the European University of Social Sciences, a consortium of the following universities: Bocconi University (Italy), Central European University (Hungary), European University Institute (European Intergovernmental Organization), Hertie School of Governance (Germany), The National University of Political Studies and Public Administration (Romania), Sciences Po (France) and the School of Economics in Stockholm (Sweden). This experiment aims to become one of the European pilot universities, in the first round of applications for Erasmus+ in February 2019. The experiment takes into consideration the most important resource of a country: the human resource. The network of universities that are part of the CIVICA consortium will group approximately 38,000 students, 7,000 teachers and 3,000 people from the administrative apparatus. The London School of Economics is part of the CIVICA consortium, as an associate partner. At the Bucharest conference, the public presentation of the consortium and its objectives, the rectors of the seven universities set out to educate the future generations of professionals in social sciences, in order to solve the most pressing problems of the world. Creating a European identity is essentially the long-term, fundamental objective of the CIVICA consortium. In the context of this conference, we interviewed a few representatives of CIVICA, and their answers will be analyzed in this paper’s section dedicated to the results of the research.

Impact of population density on Covid-19 infected and mortality rate in India.

The Covid-19 is a highly contagious disease which becomes a serious global health concern. The residents living in areas with high population density, such as big or metropolitan cities, have a higher probability to come into close contact with others and consequently any contagious disease is expected to spread rapidly in dense areas. However, recently, after analyzing Covid-19 cases in the USA researchers at the Johns Hopkins Bloomberg School of Public Health, London school of economics, and IZA—Institute of Labour Economics conclude that the spread of Covid-19 is not linked with population density. Here, we investigate the influence of population density on Covid-19 spread and related mortality in the context of India. After a detailed correlation and regression analysis of infection and mortality rates due to Covid-19 at the district level, we find moderate association between Covid-19 spread and population density.

In Memoriam: Constance M. Fulmer (21 November 1938–17 March 2020)

Celebrating the life of Constance Fulmer calls for celebration of her two favorite authors: George Eliot and Edith Simcox. Constance has received many tributes from grateful students and colleagues for her contributions as teacher and dean at Pepperdine University. But for those of us still working on Eliot and Simcox, two of her many, many publications will never go out of date: George Eliot: A Reference Guide (1977) and A Monument to the Memory of George Eliot: Edith J. Simcox's Autobiography of a Shirtmaker (1998).The early 1980s saw a peak in the number of George Eliot doctoral dissertations. In 1948, when F. R. Leavis installed her in his Great Tradition, he almost singlehandedly ended a fifty-year period during which her novels gained little interest. Afterward, with women's studies flourishing in the 1970s and 1980s, Eliot made an appealing subject: canonical enough to satisfy any dissertation director, yet with miles more to write no matter what literary theory came into fashion. Hence Constance's reference guide showed perfect timing. Not just a list, the guide inserts paragraphs summarizing books and articles of particular interest. By the early 1980s, she had done at least half the research chores needed no matter what approach an ABD working on Eliot was taking in a dissertation.Nor has the Guide lost its usefulness. As research on Eliot goes on, it guards against the real risk of writing things twice over. Hence it remains indispensable for younger scholars. Moreover, certain names recurring therein merit repeated reading: Barbara Hardy, U. C. Knoepflmacher, J. Hillis Miller, Reva Stump, and so many others. No teacher should overlook Jerome Beaty's Middlemarch: From Notebook to Novel (1960), which proves that even Eliot could tell a lie about her creativity—so useful in diverting students who believe in inspiration rather than revision. Beaty's study of the notes for chapter 82 in Middemarch proves that the climactic meeting between Dorothea and Rosamond came not from a fit of inspiration as Eliot claimed but through the less glamorous labor of revising.Meanwhile, Constance found the figure who probably engaged her heart as much as her mind: Edith Jemima Simcox. She and her coeditor Margaret Barfield traveled first to the Bodleian, which held the manuscript of what Simcox called The Autobiography of a Shirtmaker, not only a narrative of love for Eliot but an account of Simcox's incredibly various other interests: economics, journalism, fair labor, women's education and jobs, and, yes, manufacturing shirts. (Its misnaming as A Monument to the Memory of George Eliot, Constance confided, was down to the publisher, not herself and Barfield.) In the ninth volume of Gordon Haight's collection of letters (as supplemented by William Baker's ongoing ferreting out of still more letters), more than a hundred of the pages concerning Eliot's later life come from Simcox's Autobiography, of great value at the time (1978) but selected entirely for their references to Eliot rather than for such significant parts of Simcox's life as her service on the London School Board or her attendance as a delegate to trade unions meetings. Just as Haight's biography superseded John Cross's choice of excerpts for his Life in Letters, Fulmer and Barfield have superseded Haight's selections in the ninth volume of his Letters.Constance and Margaret well understood that online research, though wonderfully convenient, can never entirely replace on-site scholarship, including conferences. In Britain, they visited as many locations associated with Eliot and Simcox as possible and generously shared what they saw at countless meetings in photographs and paper readings. They participated enthusiastically in the George Eliot Fellowship, making friends, in particular, with Kathleen Adams. While her generosity of time and spirit reached Constance's students and colleagues at Pepperdine, for readers of this periodical I recommend the Reference Guide and the Simcox Autobiography as the greatest monuments to the scholarship of Constance Fulmer.

Daniel P. Biebuyck: 1925–2019

October 01 2020 Daniel P. Biebuyck: 1925–2019 Allen F. Roberts Allen F. Roberts Allen F. Roberts is Distinguished Professor of World Arts and Cultures at UCLA and a member of the African Arts editorial board. aroberts@arts.ucla.edu Search for other works by this author on: This Site Google Scholar Author and Article Information Allen F. Roberts Allen F. Roberts is Distinguished Professor of World Arts and Cultures at UCLA and a member of the African Arts editorial board. aroberts@arts.ucla.edu Online Issn: 1937-2108 Print Issn: 0001-9933 © 2020 by the Regents of the University of California.2020The Regents of the University of California African Arts (2020) 53 (4): 15–16. https://doi.org/10.1162/afar_a_00547 Cite Icon Cite Permissions Share Icon Share Twitter LinkedIn Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Search Site Citation Allen F. Roberts; Daniel P. Biebuyck: 1925–2019. African Arts 2020; 53 (4): 15–16. doi: https://doi.org/10.1162/afar_a_00547 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search nav search search input Search input auto suggest search filter All ContentAll JournalsAfrican Arts Search Advanced Search Daniel P. Biebuyck died on December 31, 2019, aged 94. First trained in philology and law at the University of Ghent, Dr. Biebuyck took advanced degrees in cultural anthropology at the London School of Economics. Working for the Belgian Institute for Scientific Research in Central Africa from 1949 to 1961, he undertook detailed ethnographic studies in east-central Belgian Congo among Lega, Nyanga, Bembe, and related peoples. He wrote monographs and scholarly articles from these experiences, and through shorter IRSAC projects, he visited more than fifty other Congolese ethnic groups, contributing to wide-ranging overviews such as Congo Tribes and Parties (1961) that he coauthored with Mary Douglas. Through a position at the University of Delaware in 1961, Dr. Biebuyck helped found the Department of Anthropology. After teaching anthropology at UCLA from 1964 to... © 2020 by the Regents of the University of California.2020The Regents of the University of California You do not currently have access to this content.

Fibrino(Geno)Lysis: The New Kid in Town for Trauma Care

Centre for Trauma Sciences, The Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London

Comments on The Middle-Income Trap 2.0: The Increasing Role of Human Capital in the Age of Automation and Implications for Developing Asia

Debin Ma, London School of Economics and Political Science: By linking the new ongoing literature on the economic impact of automation with that of the middle-income trap the paper meshes two related but distinct lines of study to come up with an insightful overview paper. This paper discusses everything at an extremely general level because it covers a vast array of countries (mostly in Asia) and draws on a wide set of relevant indicators mostly from secondary sources.There are, therefore, two major two problems with this paper. First, because of the obvious concern about the reliance on these highly aggregate indices from disparate sources, the paper should include some discussion on both the qualitative and quantitative aspect of these indicators and how comparable they might be across countries and periods.Second, because the paper also discusses everything at a highly aggregated and abstract level, it would have been desirable for the authors to present micro-level evidence to bolster the credibility of the discussion. For example, East Asian countries are characterized by widespread literacy and large-scale assembly production operations whereas South Asian countries have large class gaps in education (very literate and intellectual elites at the top, for example) and a comparative advantage in relatively small-scale high-tech and high-skill sectors. These micro-level distinctions are buried when one only looks at the aggregate statistics on years of schooling data and employment share.

Cost-effectiveness of new MDR-TB regimens: study protocol for the TB-PRACTECAL economic evaluation substudy

IntroductionCurrent treatment regimens for multidrug-resistant tuberculosis (MDR-TB) are long, poorly tolerated and have poor outcomes. Furthermore, the costs of treating MDR-TB are much greater than those for treating drug-susceptible TB,...

Partner‐bereaved individuals may face a higher risk of dying from melanoma

British Journal of DermatologyVolume 183, Issue 4 p. e132-e132 Plain Language SummaryFree Access Partner-bereaved individuals may face a higher risk of dying from melanoma First published: 04 October 2020 https://doi.org/10.1111/bjd.19443AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat Abstract Malignant melanoma is a type of skin cancer, accounting for 5% of all cancer deaths in the UK and Denmark. The first thing that people with this type of skin cancer tend to notice is a “mole” with irregular shape, size, or colour (usually darkening). People usually spot these changes themselves, but on some less accessible parts of the body such as the back, it is often a spouse or partner that sees them first. Early detection of malignant melanomas is important to improve the chance of survival. In this study, teams from the London School of Hygiene & Tropical Medicine in the UK, and Aarhus University Hospital in Denmark, investigated whether individuals whose partner had died (‘partner bereaved’) had a higher risk of being diagnosed with, or dying from, melanoma than the non-partner-bereaved. They used routinely collected health records from two large groups of people in the UK and Denmark between 1997 and 2017. The study authors found that in both countries people who had lost a partner were 12% less likely to be diagnosed with melanoma compared with people whose partner had not died. They also showed that amongst those with melanoma, people who experienced partner bereavement had a 17% higher risk of dying from their melanoma compared with those whose partner had not died. The researchers suggest that the decreased likelihood of melanoma diagnosis after losing a partner is because people no longer have a partner to help detect skin changes. This may mean that their melanoma diagnosis is delayed until a more advanced cancer stage with higher risk of death, thus also explaining the study finding of increased melanoma mortality. A link between stress and progression of melanoma may also play a role in increasing the risk of death. Overall, the study findings support a need for better awareness of the worsened outcome in bereaved individuals and a lower threshold for undertaking skin examinations. Linked Article: Langan et al. Br J Dermatol 2020; 183:673–683. Volume183, Issue4October 2020Pages e132-e132 RelatedInformation

Student Engagement in Improving Access to Taught Course Content at LSE Library: practicalities and Pitfalls

As in other academic libraries, LSE (London School of Economics and Political Science) Library does not meet student expectations for access to core readings despite increasing provision. We used user experience research to gather evidence of student experience, behaviours, and preferences for taught course content with the aim of making improvements. We found that convenience is the deciding factor for students in choosing what and how to read due the necessity of keeping up with weekly reading. They prefer PDF journal articles due to their structure and functionality and dislike e-books. This suggests that for book chapters we should offer accessible scans where possible while advocating for improved e-book functionality and licencing. Our research underlines the role of liaison librarians in encouraging appropriate use of reading lists so that they scaffold rather than spoon-feed, as students appreciate well-structured and signposted reading lists, but approach their reading instrumentally. Our next step is to engage with teaching staff.