Freedom and need: The evolution of public strategy for biomedical and health research in England

The optimal support of health-related research and development with public money is a complex challenge. Over the last century, policy makers in England have conceived and implemented a variety of models, ranging from independent, curiosity driven research to needs-based state commissions, and promoting different bodies to oversee scientific work. This paper traces these approaches, identifies the principles that drove them, and discusses their role in shaping policy for publicly funded health research, up to the recent launch of a new research strategy by the Department of Health

Teacher induction: personal intelligence and the mentoring relationship

This article is aimed at probationer teachers in Scotland, their induction supporters, and all those with a responsibility for their support and professional development. It argues that the induction process is not merely a mechanistic one, supported only by systems in schools, local authorities and the General Teaching Council for Scotland (GTCS), but a more complex process where the relationship between the new teacher and the supporter is central to its success. In particular, the characteristics and skills of the induction supporter in relation to giving feedback are influential. This applies to feedback in all its forms – formative and summative, formal and informal. The ability of the probationer to handle that feedback and to be proactive in the process is also important

Supporting both learning and research in a UK post-1992 university library: a case study

Nationally, there has been debate on the role of research within higher education and increased interest in the teaching/research nexus. A team of Academic Liaison Librarians at Anglia Polytechnic University was awarded funding to investigate the extent to which learning resources overlap with research resources, whether researcher/teachers encourage their students to use the resources they use themselves and how far electronic resources have affected the relationship between learning and research materials. Semistructured interviews were carried out with 21 academics who are both teachers and researchers. They proved to be committed to using research in their teaching. Students were encouraged to engage with research through the recommendation of resources, seminar discussion, and researchers’ own work for reading and illustrating methodologies. Respondents claimed to be making significant use of the APU library website, online databases and journals. The majority of them were also recommending the same resources to their students. Convenience, speed and variety of information sources were quoted as some of the advantages of the new e-environment. A loss of a relationship with librarians and with the physical library was cited as an example of negative effects of the electronic resource environment

Implementing the Employability Agenda: A Critical Review of Curriculum Developments in Political Science and International Relations in English Universities

This article draws on research commissioned by the Higher Education Academy (HEA) and conducted during 2013. It interrogates the ways in which the employability agenda has been fed through to the level of individual politics departments. The project was particularly concerned with establishing whether, and how, colleagues in politics and international relations (IR) had taken ownership of student employability at the level of the curriculum. In the article, the key findings of the research are summarised. There is also discussion of the (sometimes troubling) professional implications of infusing concern for graduate outcomes within a pedagogic framework that emphasises critical engagement with the underpinning political structures of the labour market

The clinical effectiveness and cost-effectiveness of STeroids Or Pentoxifylline for Alcoholic Hepatitis (STOPAH): a 2 x 2 factorial randomised controlled trial

Background: Alcoholic hepatitis (AH) is a distinct presentation of alcoholic liver disease arising in patients who have been drinking to excess for prolonged periods, which is characterised by jaundice and liver failure. Severe disease is associated with high short-term mortality. Prednisolone and pentoxifylline (PTX) are recommended in guidelines for treatment of severe AH, but trials supporting their use have given heterogeneous results and controversy persists about their benefit. Objectives: The aim of the clinical effectiveness and cost-effectiveness of STeroids Or Pentoxifylline for Alcoholic Hepatitis trial was to resolve the clinical dilemma on the use of prednisolone or PTX. Design: The trial was a randomised, double-blind, 2 × 2 factorial, multicentre design. Setting: Sixty-five gastroenterology and hepatology inpatient units across the UK. Participants: Patients with a clinical diagnosis of AH who had a Maddrey’s discriminant function value of ≥ 32 were randomised into four arms: A, placebo/placebo; B, placebo/prednisolone; C, PTX/placebo; and D, PTX/prednisolone. Of the 5234 patients screened for the trial, 1103 were randomised and after withdrawals, 1053 were available for primary end-point analysis. Interventions: Those allocated to prednisolone were given 40 mg daily for 28 days and those allocated to PTX were given 400 mg three times per day for 28 days. Outcomes: The primary outcome measure was mortality at 28 days. Secondary outcome measures included mortality or liver transplant at 90 days and at 1 year. Rates of recidivism among survivors and the impact of recidivism on mortality were assessed. Results: At 28 days, in arm A, 45 of 269 (16.7%) patients died; in arm B, 38 of 266 (14.3%) died; in arm C, 50 of 258 (19.4%) died; and in arm D, 35 of 260 (13.5%) died. For PTX, the odds ratio for 28-day mortality was 1.07 [95% confidence interval (CI) 0.77 to 1.40; p = 0.686)] and for prednisolone the odds ratio was 0.72 (95% CI 0.52 to 1.01; p = 0.056). In the logistic regression analysis, accounting for indices of disease severity and prognosis, the odds ratio for 28-day mortality in the prednisolone-treated group was 0.61 (95% CI 0.41 to 0.91; p = 0.015). At 90 days and 1 year there were no significant differences in mortality rates between the treatment groups. Serious infections occurred in 13% of patients treated with prednisolone compared with 7% of controls (p = 0.002). At the 90-day follow-up, 45% of patients reported being completely abstinent, 9% reported drinking within safety limits and 33% had an unknown level of alcohol consumption. At 1 year, 37% of patients reported being completely abstinent, 10% reported drinking within safety limits and 39% had an unknown level of alcohol consumption. Only 22% of patients had attended alcohol rehabilitation treatment at 90 days and 1 year. Conclusions: We conclude that prednisolone reduces the risk of mortality at 28 days, but this benefit is not sustained beyond 28 days. PTX had no impact on survival. Future research should focus on interventions to promote abstinence and on treatments that suppress the hepatic inflammation without increasing susceptibility to infection

From national monopoly to Multinational Corporation: how regulation shaped the road towards telecommunications internationalization

One of the consequences of major regulatory reform of the telecommunications sector from the end of the 1970s – particularly, privatization, liberalization and deregulation – was the establishment of a new business environment which permitted former national telecommunications monopolies to expand abroad. From the 1990s, a number of these firms, particularly those based in Europe, joined the rankings of the world’s leading Multinational Corporations. Their internationalization was uneven, however: while some firms internationalised strongly, others ventured abroad much slower. This article explores how the regulatory framework within which telecommunications incumbents evolved over the long-term shaped their subsequent, uneven, paths to internationalization. Two case studies representing ´maximum variation´ are selected: Telefónica, whose early and unrelenting expansion transformed it into one of the world’s most international of Multinational Corporations, and BT, whose overseas ventures failed and, with eroding domestic market share, forced the firm to partially retreat, becoming the least international of the large European incumbents. Long-term ownership, access to capital, management style and exposure to liberalization strongly influenced firms’ approaches to internationalizatio

“Without a mother”: caregivers and community members’ views about the impacts of maternal mortality on families in KwaZulu-Natal, South Africa.

BACKGROUND: Maternal mortality in South Africa is high and a cause for concern especially because the bulk of deaths from maternal causes are preventable. One of the proposed reasons for persistently high maternal mortality is HIV which causes death both indirectly and directly. While there is some evidence for the impact of maternal death on children and families in South Africa, few studies have explored the impacts of maternal mortality on the well-being of the surviving infants, older children and family. This study provides qualitative insight into the consequences of maternal mortality for child and family well-being throughout the life-course. METHODS: This qualitative study was conducted in rural and peri-urban communities in Vulindlela, KwaZulu-Natal. The sample included 22 families directly affected by maternal mortality, 15 community stakeholders and 7 community focus group discussions. These provided unique and diverse perspectives about the causes, experiences and impacts of maternal mortality. RESULTS AND DISCUSSION: Children left behind were primarily cared for by female family members, even where a father was alive and involved. The financial burden for care and children’s basic needs were largely met through government grants (direct and indirectly targeted at children) and/or through an obligation for the father or his family to assist. The repercussions of losing a mother were felt more by older children for whom it was harder for caregivers to provide educational supervision and emotional or psychological support. Respondents expressed concerns about adolescent’s educational attainment, general behaviour and particularly girl’s sexual risk. CONCLUSION: These results illuminate the high costs to surviving children and their families of failing to reduce maternal mortality in South Africa. Ensuring social protection and community support is important for remaining children and families. Additional qualitative evidence is needed to explore differential effects for children by gender and to guide future research and inform policies and programs aimed at supporting maternal orphans and other vulnerable children throughout their development.Web of Scienc