Cohort profile: The Scottish Research Register SHARE. A register of people interested in research participation linked to NHS datasets

SHARE is a NHS Scotland Research (NRS) infrastructure initiative and is funded by the Chief Scientists Office of the Scottish Government. Additional funding and initiation of the spare blood retention in Tayside was supported by The Wellcome Trust Biomedical Resource Award Number 099177/Z/12/Z.Purpose: Recruitment to trials is often difficult. Many trials fail to meet recruitment targets resulting in underpowered studies which waste resources and the time of those who participated. While there is evidence that many people are willing to take part in research, particularly if it involves a condition from which they suffer, researchers are unable to easily contact such people often relying on busy clinicians to identify them. Many clinicians perceive themselves as too busy to take part in research activities. The Scottish Health Research Register SHARE adopts an approach which asks the public to consent to their data held in National Health Service databases to be used to determine their suitability for research projects. Additionally, participants can consent for spare blood, left after routine venepuncture to be automatically identified in the laboratory and stored for future research studies. Participants: Anyone over the age of 16 years in Scotland can participate. Participants are approached through a range of methods including directly at outpatient clinics and general practitioners practices, leaflets with hospital letters and personal email from employers. Findings to date: SHARE has recruited around 130 000 people. SHARE has demonstrated that it can quickly and efficiently recruit to studies, over 20 until now. In addition, it can be used to administer questionnaire studies by email and recruit to patient and public involvement groups. Future plans: SHARE continues to steadily recruit with the ambition of eventually achieving 1 000 000 people in Scotland. We are steadily increasing the number of data sets we use for identifying participants. We are adding a mobile app which will facilitate dissemination about research and allow the collection of physiological and activity data if desired. We anticipate that SHARE will soon become the main source of health research recruitment in Scotland.Publisher PDFPeer reviewe

Leniency and halo effects in marking undergraduate short research projects

BACKGROUND: Supervisors are often involved in the assessment of projects they have supervised themselves. Previous research suggests that detailed marking sheets may alleviate leniency and halo effects. We set out to determine if, despite using such a marking schedule, leniency and halo effects were evident in the supervisors' marking of undergraduate short research projects (special study modules (SSM)). METHODS: Review of grades awarded by supervisors, second markers and control markers to the written reports of 4(th )year medical students who had participated in an SSM during two full academic years (n = 399). Paired t-tests were used to compare mean marks, Pearson correlation to look at agreement between marks and multiple linear regression to test the prediction of one mark from several others adjusted for one another. RESULTS: There was a highly significant difference of approximately half a grade between supervisors and second markers with supervisors marking higher. (t = 3.12, p < 0.01, difference in grade score = 0.42, 95% CI for mean difference 0.18–0.80). There was a high correlation between the two marks awarded for performance of the project and the written report by the supervisor (r = 0.75), but a low-modest correlation between supervisor and second marker (r = 0.28). Linear regression analysis of the influence of the supervisors' mark for performance on their mark for the report gave a non-significant result. This suggests a leniency effect but no halo effect. CONCLUSIONS: This study shows that with the use of structured marking sheet for assessment of undergraduate medical students, supervisors marks are not associated with a halo effect, but leniency does occur. As supervisor assessment is becoming more common in both under graduate and postgraduate teaching new ways to improve objectivity in marking and to address the leniency of supervisors should be sought

Development Status of Adjustable Grazing Incidence Optics for 0.5 Arcsecond X-Ray Imaging

We describe progress in the development of adjustable grazing incidence X-ray optics for 0.5 arcsec resolution cosmic X-ray imaging. To date, no optics technology is available to blend high resolution imaging like the Chandra X-ray Observatory, with square meter collecting area. Our approach to achieve these goals simultaneously is to directly deposit thin film piezoelectric actuators on the back surface of thin, lightweight Wolter-I or Wolter- Schwarschild mirror segments. The actuators are used to correct mirror figure errors due to fabrication, mounting and alignment, using calibration and a one-time figure adjustment on the ground. If necessary, it will also be possible to correct for residual gravity release and thermal effects on-orbit. In this paper we discuss our most recent results measuring influence functions of the piezoelectric actuators using a Shack-Hartmann wavefront sensor. We describe accelerated and real-time lifetime testing of the piezoelectric material, and we also discuss changes to, and recent results of, our simulations of mirror correction

Recent Progress in Adjustable X-ray Optics for Astronomy

Two adjustable X-ray optics approaches are being developed for thin grazing incidence optics for astronomy. The first approach employs thin film piezoelectric material sputter deposited as a continuous layer on the back of thin, lightweight Wolter-I mirror segments. The piezoelectric material is used to correct mirror figure errors from fabrication, mounting/alignment, and any ground to orbit changes. The goal of this technology is to produce Wolter mirror segment pairs corrected to 0.5 arc sec image resolution. With the combination of high angular resolution and lightweight, this mirror technology is suitable for the Square Meter Arc Second Resolution Telescope for X-rays (SMART-X) mission concept.. The second approach makes use of electrostrictive adjusters and full shell nickel/cobalt electroplated replication mirrors. An array of radial adjusters is used to deform the full shells to correct the lowest order axial and azimuthal errors, improving imaging performance from the 10 - 15 arc sec level to ~ 5 arc sec. We report on recent developments in both technologies. In particular, we discuss the use of insitu strain gauges on the thin piezo film mirrors for use as feedback on piezoelectric adjuster functionality, including their use for on-orbit figure correction. We also report on the first tests of full shell nickel/cobalt mirror correction with radial adjusters

Technology Requirements for a Square Meter, Arcsecond Resolution Telescope for X-Rays: The SMART-X Mission

Addressing the astrophysical problems of the 2020's requires sub-arcsecond x-ray imaging with square meter effective area. Such requirements can be derived, for example, by considering deep x-ray surveys to find the young black holes in the early universe (large redshifts) which will grow into the first super-massive black holes. We have envisioned a mission, the Square Meter Arcsecond Resolution Telescope for X-rays (SMART-X), based on adjustable x-ray optics technology, incorporating mirrors with the required small ratio of mass to collecting area. We are pursuing technology which achieves sub-arcsecond resolution by on-orbit adjustment via thin film piezoelectric "cells" deposited directly on the non-reflecting sides of thin, slumped glass. While SMART-X will also incorporate state-of-the-art x-ray cameras, the remaining spacecraft systems have no requirements more stringent than those which are well understood and proven on the current Chandra X-ray Observatory

The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview

Aziz Sheikh and colleagues report the findings of their systematic overview that assessed the impact of eHealth solutions on the quality and safety of health care

Toward Adaptive X-Ray Telescopes

Future x-ray observatories will require high-resolution (less than 1 inch) optics with very-large-aperture (greater than 25 square meter) areas. Even with the next generation of heavy-lift launch vehicles, launch-mass constraints and aperture-area requirements will limit the surface areal density of the grazing-incidence mirrors to about 1 kilogram per square meter or less. Achieving sub-arcsecond x-ray imaging with such lightweight mirrors will require excellent mirror surfaces, precise and stable alignment, and exceptional stiffness or deformation compensation. Attaining and maintaining alignment and figure control will likely involve adaptive (in-space adjustable) x-ray optics. In contrast with infrared and visible astronomy, adaptive optics for x-ray astronomy is in its infancy. In the middle of the past decade, two efforts began to advance technologies for adaptive x-ray telescopes: The Generation-X (Gen-X) concept studies in the United States, and the Smart X-ray Optics (SXO) Basic Technology project in the United Kingdom. This paper discusses relevant technological issues and summarizes progress toward adaptive x-ray telescopes

Risk factors for chronic ulceration in patients with varicose veins: A case control study

Background/ObjectiveIdentifying which patients with varicose veins are at risk of progressing to more severe forms of chronic venous disease could help in assigning clinical priorities and targeting appropriate treatments. The aim of this study was to determine, in subjects with varicose veins, the characteristics of venous disease and other factors associated with an increased risk of ulceration.MethodsOne hundred twenty subjects with varicose veins and an open or healed venous leg ulcer were compared with 120 controls with varicose veins and no history of venous ulcer on this case control study. Subjects were recruited from hospital settings and primary care. Each subject completed a questionnaire on lifestyle and medical history and underwent an examination comprising of clinical classification of venous disease (CEAP), duplex scanning, quantitative digital photoplethysmography, and measurement of dorsiflexion. Multiple logistic regression analyses and calculation of receiver operating characteristic (ROC) curves were performed to identify the combination of factors which most accurately predicted which patients with varicose veins will develop leg ulcers.ResultsAn increased risk of ulceration was associated with the severity of clinical venous disease, especially with the presence of skin changes (P < .0001). Other significant risk factors included history of deep vein thrombosis (DVT) (P = .001), higher body mass index (BMI) (P = .006), smoking (P = .009), and reflux in the deep veins (P = .0001). Ulceration was associated with reduced volume of blood displaced as reflected by photoplethysmography and a limited range of ankle movement (not wholly due to the effects of an active ulcer) (both P < .05). Multivariate analyses showed that skin changes including lipodermatosclerosis (odds ratio [OR] 8.90, 95% confidence interval [CI] 1.44-54.8), corona phlebectatica (OR 4.52, 95% CI 1.81-11.3) and eczema (OR 2.87, 95% CI 1.12-7.07), higher BMI (OR 1.08, 95% CI 1.01-1.15), and popliteal vein reflux (OR 2.82, 95% CI 1.03-7.75) remained independently associated with increased risk of ulceration while good dorsiflexion of the ankle (OR 0.88, 95% CI 0.81-0.97) and an effective calf muscle pump (OR 0.96, 95% CI 0.92-0.99) remained protective factors. ROC curve analyses indicated that a model based on clinical observation of skin changes, duplex scanning for popliteal reflux, and calf muscle pump tests would be the most accurate in determining which patients with varicose veins develop leg ulcers.ConclusionsThe results of this study confirm that, in patients with varicose veins, those with skin changes of chronic venous insufficiency and deep vein incompetence are at greatly increased risk of ulceration. However, the risks may also be increased in those who smoke, are obese, and have restricted ankle movement and reduced calf muscle pump power