Towards a conceptual framework demonstrating the effectiveness of audiovisual patient descriptions (patient video cases): a review of the current literature

Background: Technological advances have enabled the widespread use of video cases via web-streaming and online download as an educational medium. The use of real subjects to demonstrate acute pathology should aid the education of health care professionals. However, the methodology by which this effect may be tested is not clear. Methods: We undertook a literature review of major databases, found relevant articles relevant to using patient video cases as educational interventions, extracted the methodologies used and assessed these methods for internal and construct validity. Results: A review of 2532 abstracts revealed 23 studies meeting the inclusion criteria and a final review of 18 of relevance. Medical students were the most commonly studied group (10 articles) with a spread of learner satisfaction, knowledge and behaviour tested. Only two of the studies fulfilled defined criteria on achieving internal and construct validity. The heterogeneity of articles meant it was not possible to perform any meta-analysis. Conclusions: Previous studies have not well classified which facet of training or educational outcome the study is aiming to explore and had poor internal and construct validity. Future research should aim to validate a particular outcome measure, preferably by reproducing previous work rather than adopting new methods. In particular cognitive processing enhancement, demonstrated in a number of the medical student studies, should be tested at a postgraduate level

Design and construction of new central and forward muon counters for CDF II

New scintillation counters have been designed and constructed for the CDF upgrade in order to complete the muon coverage of the central CDF detector, and to extend this coverage to larger pseudorapidity. A novel light collection technique using wavelength shifting fibers, together with high quality polystyrene-based scintillator resulted in compact counters with good and stable light collection efficiency over lengths extending up to 320 cm. Their design and construction is described and results of their initial performance are reported.Comment: 20 pages, 15 figure

Cognitive representations of disability behaviours in people with mobility limitations : consistency with theoretical constructs

Disability is conceptualised as behaviour by psychological theory and as a result of bodily impairment by medical models. However, how people with disabilities conceptualise those disabilities is unclear. The purpose of this study was to examine disability representations in people with mobility disabilities. Thirteen people with mobility disabilities completed personal repertory grids (using the method of triads) applied to activities used to measure disabilities. Ten judges with expertise in health psychology then examined the correspondence between the elicited disability constructs and psychological and medical models of disability. Participants with mobility disabilities generated 73 personal constructs ofdisability. These constructs were judged consistent with the content of two psychological models, namely the theory of planned behaviour and social cognitive theory and with the main medical model of disability, the International Classification of Functioning Disability and Health.Individuals with activity limitations conceptualise activities in a manner that is compatible with both psychological and medical models. This ensures adequate communication in contexts where the medical model is relevant, e.g. clinical contexts, as well as in everyday conversation about activities and behaviours. Finally, integrated models of disability may be of value for theory driven interdisciplinary approaches to disability and rehabilitation

Domestic violence, adult social care and MARACs: implications for practice

Assesses the effectiveness of social care’s contribution to the development of MARACs and the protection of adults facing domestic violence, using the city of Manchester as a case study site. MARACs are multi-agency risk assessment conferences that share information about the top ten per cent of high risk domestic violence cases in order to produce co-ordinated actions to reduce the risk and increase victim safety. The research data collection used a multi-methods approach and included attending MARACs; interviewing agency representatives who attend MARACs (plus some who did not) and adult social workers; focus groups with survivors of domestic violence, and practitioners who specialise in domestic violence support. People whose cases had been considered at a MARAC were also interviewed. The study found that agency representatives attending MARACs showed high levels of commitment to the MARAC approach. However, most attendees felt unsupported by their employer and supervisors in this demanding work while adults at risk of domestic violence who have had their information shared at a MARAC generally did not understand the process. Participants from different agencies considered the MARAC arrangements would benefit from being made statutory, as this would enhance the profile of the work and ensure that key agencies attend

Milling plant and soil material in plastic tubes over-estimates carbon and under-estimates nitrogen concentrations

Peer reviewedPostprin

Digital technology and governance in transition: The case of the British Library

Comment on the organizational consequences of the new information and communications technologies (ICTs) is pervaded by a powerful imagery of disaggregation and a tendency for ?virtual? forms of production to be seen as synonymous with the ?end? of bureaucracy. This paper questions the underlying assumptions of the ?virtual organization?, highlighting the historically enduring, diversified character of the bureaucratic form. The paper then presents case study findings on the web-based access to information resources now being provided by the British Library (BL). The case study evidence produces two main findings. First, radically decentralised virtual forms of service delivery are heavily dependent on new forms of capacity-building and information aggregation. Second, digital technology is embedded in an inherently contested and contradictory context of institutional change. Current developments in the management and control of digital rights are consistent with the commodification of the public sphere. However, the evidence also suggests that scholarly access to information resources is being significantly influenced by the ?information society? objectives of the BL and other institutional players within the network of UK research libraries

Influence of hyperhomocysteinemia on the cellular redox state - Impact on homocysteine-induced endothelial dysfunction

Hyperhomocysteinemia is an independent risk factor for the development of atherosclerosis. An increasing body of evidence has implicated oxidative stress as being contributory to homocysteines deleterious effects on the vasculature. Elevated levels of homocysteine may lead to increased generation of superoxide by a biochemical mechanism involving nitric oxide synthase, and, to a lesser extent, by an increase in the chemical oxidation of homocysteine and other aminothiols in the circulation. The resultant increase in superoxide levels is further amplified by homocysteinedependent alterations in the function of cellular antioxidant enzymes such as cellular glutathione peroxidase or extracellular superoxide dismutase. One direct clinical consequence of elevated vascular superoxide levels is the inactivation of the vasorelaxant messenger nitric oxide, leading to endothelial dysfunction. Scavenging of superoxide anion by either superoxide dismutase or 4,5-dihydroxybenzene 1,3-disulfonate (Tiron) reverses endothelial dysfunction in hyperhomocysteinemic animal models and in isolated aortic rings incubated with homocysteine. Similarly, homocysteineinduced endothelial dysfunction is also reversed by increasing the concentration of the endogenous antioxidant glutathione or overexpressing cellular glutathione peroxidase in animal models of mild hyperhomocysteinemia. Taken together, these findings strongly suggest that the adverse vascular effects of homocysteine are at least partly mediated by oxidative inactivation of nitric oxide