861 research outputs found
The specification and design of an interactive virtual environment for use in teacher training
In this paper, we examine the rationale behind the specification and design of an interactive, virtual environment, optimized for particular task-based learning activities and the dissemination of information. The software we describe represents a typical British primary school, for use in training Information and Communications Technology (ICT)co-ordinators at primary level. By documenting our ongoing evaluation of both this resource and the technologies used in its implementation, we provide a detailed description of the production process of a prototype piece of software. This highlights the importance of pedagogy, new technologies and project management, and should be of particular interest to multimedia designers and academics preparing to develop innovative learning applications
Effectiveness of fatigue management interventions in reducing severity and impact of fatigue in people with progressive multiple sclerosis: a systematic review
Evaluating detection limits of next-generation sequencing for the surveillance and monitoring of international marine pests
Most surveillance programmes for marine invasive species (MIS) require considerable taxonomic expertise, are laborious, and are unable to identify species at larval or juvenile stages. Therefore, marine pests may go undetected at the initial stages of incursions when population densities are low. In this study, we evaluated the ability of the benchtop GS Junior™ 454 pyrosequencing system to detect the presence of MIS in complex sample matrices. An initial in-silico evaluation of the mitochondrial cytochrome c oxidase subunit I (COI) and the nuclear small subunit ribosomal DNA (SSU) genes, found that multiple primer sets (targeting a ca. 400 base pair region) would be required to obtain species level identification within the COI gene. In contrast a single universal primer set was designed to target the V1–V3 region of SSU, allowing simultaneous PCR amplification of a wide taxonomic range of MIS. To evaluate the limits of detection of this method, artificial contrived communities (10 species from 5 taxonomic groups) were created using varying concentrations of known DNA samples and PCR products. Environmental samples (water and sediment) spiked with one or five 160 hr old Asterias amurensis larvae were also examined. Pyrosequencing was able to recover DNA/PCR products of individual species present at greater than 0.64% abundance from all tested contrived communities. Additionally, single A. amurensis larvae were detected from both water and sediment samples despite the co-occurrence of a large array of environmental eukaryotes, indicating an equivalent sensitivity to quantitative PCR. NGS technology has tremendous potential for the early detection of marine invasive species worldwide
Ethiopia’s vulnerable tropical forests are key to securing future of wild coffee
Coffee is the drink of choice for millions of us. But the world’s second-most traded commodity originates in Ethiopia – and its home is under threat.
Ethiopia isn’t all dusty deserts – far from it. The country also contains rugged highlands and lush, tropical forests. Coffea arabica grows here in its original, wild form. The forests of south-west Ethiopia are considered to be the birthplace of coffee and the centre of its genetic diversity
Establishing a set of research priorities in care homes for older people in the UK: a modified Delphi consensus study with care home staff
Background: currently, there is little evidence base for much of the care provided for older people in care homes. Given
the wide range of topics that require further investigation, and limited resources, one solution is to identify the priorities for
future research.
Methods: a modified Delphi technique was used to identify research topics and develop consensus among care home staff
participants. The survey was conducted across three rounds. Firstly to elicit topics that were considered by participants to
require further research, secondly to prioritise the long list of research questions, followed by a third round to reach a consensus
on the highest ranked 15 questions.
Results: eighty-three participants responded to the initial survey, providing 144 questions. Following analysis and review
against existing evidence, 76 research questions remained. Of note, 40/83 participants responded to the interim prioritisation
round and 43/83 participants responded to the final round, which ranked the top 15 research questions by importance.
Two other groups of health and social care professionals also participated in the final ranking. The results from these groups
had a similar ordering to those of the original cohort of participants.
Conclusion: this is the first study to establish a set of research priorities for older people in the UK care homes. It is hoped that
sharing these results with clinicians, researchers and funding bodies will help to begin the process of ensuring that the future research
agenda can be focused on the areas of greatest need. Further work to identify the priorities of other key stakeholders is required
Parents' and clinicians' views of an interactive booklet about respiratory tract infections in children: a qualitative process evaluation of the EQUIP randomised controlled trial
Background:
‘When should I worry?’ is an interactive booklet for parents of children presenting with respiratory tract infections (RTIs) in primary care and associated training for clinicians. A randomised controlled trial (the EQUIP study) demonstrated that this intervention reduced antibiotic prescribing and future consulting intentions. The aims of this qualitative process evaluation were to understand how acceptable the intervention was to clinicians and parents, how it was implemented, the mechanisms for any observed effects, and contextual factors that could have influenced its effects.<p></p>
Methods:
Semi-structured interviews were conducted with 20 parents and 13 clinicians who participated in the trial. Interviews were audio-recorded and transcribed verbatim. Data were analysed using a framework approach, which involved five stages; familiarisation, development of a thematic framework, indexing, charting, and interpretation.<p></p>
Results:
Most parents and clinicians reported that the ‘When should I worry’ interactive booklet (and online training for clinicians) was easy to use and valuable. Information on recognising signs of serious illness and the usual duration of illness were most valued. The interactive use of the booklet during consultations was considered to be important, but this did not always happen. Clinicians reported lack of time, lack of familiarity with using the booklet, and difficulty in modifying their treatment plan/style of consultation as barriers to use. Increased knowledge and confidence amongst clinicians and patients were seen as key components that contributed to the reductions in antibiotic prescribing and intention to consult seen in the trial. This was particularly pertinent in a context where decisions about the safe and appropriate management of childhood RTIs were viewed as complex and parents reported frequently receiving inconsistent messages.
Conclusions:
The ‘When should I worry’ booklet, which is effective in reducing antibiotic prescribing, has high acceptability for clinicians and parents, helps address gaps in knowledge, increases confidence, and provides a consistent message. However, it is not always implemented as intended. Plans for wider implementation of the intervention in health care settings would need to address clinician-related barriers to implementation
Increased burn healing time is associated with higher Vancouver Scar Scale score
Increased burn wound healing time has been shown to influence abnormal scarring. This study hypothesized that scar severity increases commensurate to the increase in time to healing (TTH) of the wound. Wound healing and scar data from burn patients treated by the Burn Service of Western Australia at Royal Perth Hospital were examined. The relationship between TTH and scar severity, as assessed by the modified Vancouver Scar Scale (mVSS), was modelled using regression analysis. Interaction terms evaluated the effect of surgery and total body surface area – burn (TBSA) on the main relationship. Maximum likelihood estimation was used to account for potential bias from missing independent variable data. The sample had a median age of 34 years, TTH of 24 days, TBSA of 3% and length of stay of five days, 70% were men and 71% had burn surgery. For each additional day of TTH, the mVSS score increased by 0.11 points (P ⩽ 0.001) per day in the first 21 days and 0.02 points per day thereafter (P = 0.004). The relationship remained stable in spite of TBSA or surgical intervention. Investigation of the effect of missing data revealed the primary model underestimated the strength of the association. An increase in TTH within 21 days of injury is associated with an increase in mVSS or reduced scar quality. The results confirm that efforts should be directed toward healing burn wounds as early as possible
Grip and muscle strength dynamometry in acute burn injury: Evaluation of an updated assessment protocol
External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry.
Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum detectable differences were also calculated. In the same timeframe categories, construct validity was explored using regression analysis incorporating burn severity and demographic characteristics.
Thirty-eight participants with total burn surface area 5 – 40% were recruited. Reliability was determined to be clinically applicable for the assessment method (intraclass correlation coefficient \u3e0.75) at all phases after injury. Muscle strength was associated with sex and burn location during injury and wound healing. Burn size in the immediate period after surgery and age in the sub-acute phase of injury were also associated with muscle strength assessment results.
Hand held dynamometry is a reliable assessment tool for evaluating within session muscle strength in the acute and sub-acute phase of injury in burns up to 40% total burn surface area. External stabilization may assist to eliminate reliability issues related to patient and assessor strength
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