'Fitting it in' : a study exploring ICT use in a UK primary school

This paper presents a case study of a primary school which was seen as using ICT effectively to support teaching and learning. Research was carried out over two years (2003-2005) and included observation of lessons, document analysis, interviews, and questionnaires with staff at the school. It was found that 'fitting ICT in', rather than 'effective use of ICT', provided a more accurate description of the complex decisions and actions that were made regarding ICT use in the school. Using a grounded theory framework the paper describes the causal conditions; the contextual conditions; the intervening conditions and the consequences for staff and pupils associated with 'fitting ICT in'. The study argues for an approach to research which seeks to develop collaboration and understanding between researchers and practitioners

Integrating sanitation and environment assessments for use in emergencies

Emergency response is characterised by the need for rapid and effective assessment of the existing situation to allow for informed decision making. It is within these constraints of limited time and resources that personnel are expected to implement life sustaining interventions. During this time the consideration of cross-cutting issues such as the environment are limited as they are not seen as an integral part of immediate emergency response. Environmental awareness needs to be improved during emergency response to avoid future implications for the population and the environment upon which they depend. This study therefore focused on determining the likelihood of successful integration of environmental considerations within an existing emergency sanitation assessment. It tested two assessment methods, one for environmental sanitation and one for environmental impacts in a refugee camp in Zambia and makes recommendations on the practical application of these frameworks

Cytokine regulation of monocytic cell subsets in the peritoneal cavity

It is well known that Interleukin (IL)-6 is important in the regulation of both the chemokine directed recruitment and apoptotic removal of neutrophils and lymphocytes (Hurst et al. 2001, McLoughlin et al. 2003, 2005). However little is currently known about the role of IL-6 in governing the phenotype, activation and inflammatory trafficking of monocytic cells. In this thesis, an in vivo model of peritoneal inflammation was utilised in combination with in vitro studies using murine resident peritoneal leukocytes, to determine a role for IL-6 in the regulation of monocytic cell activity and trafficking during inflammation. In this respect, it was shown that resident peritoneal macrophages and dendritic cells (DC) were non-responsive to IL-6 signalling, which in DC was associated with an activation-induced loss of IL-6 receptor. This provides a potential mechanism by which DC are able to remove themselves from the immunosuppressive constraint imposed by IL-6, which is known to maintain immature DC (Park et al. 2004), allowing them to mature into activated DC. Upon activation, resident DC did not display a change in chemokine receptor expression, suggesting that they may remain within the peritoneal cavity and undergo antigen presentation and lymphocyte activation locally. In vivo studies revealed that IL-6 did not regulate the inflammatory trafficking of resident macrophages, DC or recruited circulatory monocytes during acute peritonitis. However upon repeated inflammatory activation, IL-6 directed the increased recruitment of infiltrating monocytes to the peritoneal cavity, implicating them as a contributing factor to the peritoneal tissue damage and fibrosis associated with chronic disease progression. Later studies focused on IL-10, since there is a known interplay that exists between IL-6 and IL-10 (Niemand et al. 2003, Fiorentino et al. 1991, Chernoff et al. 1995). In vivo studies defined an anti-inflammatory role for IL-10, whereby it was responsible for limiting inflammatory leukocyte recruitment via its control of chemokine expression, and the suppression of IL-17A secreting T cell development and recruitment. Therefore the pro-inflammatory and anti-inflammatory roles of IL-6 and IL-10 respectively must be finely balanced to allow competent cell mediated immunity against infection whilst preventing excessive tissue damage associated with disease progression.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Cytokine regulation of monocytic cell subsets in the peritoneal cavity

It is well known that Interleukin (IL)-6 is important in the regulation of both the chemokine directed recruitment and apoptotic removal of neutrophils and lymphocytes (Hurst et al. 2001, McLoughlin et al. 2003, 2005). However little is currently known about the role of IL-6 in governing the phenotype, activation and inflammatory trafficking of monocytic cells. In this thesis, an in vivo model of peritoneal inflammation was utilised in combination with in vitro studies using murine resident peritoneal leukocytes, to determine a role for IL-6 in the regulation of monocytic cell activity and trafficking during inflammation. In this respect, it was shown that resident peritoneal macrophages and dendritic cells (DC) were non-responsive to IL-6 signalling, which in DC was associated with an activation-induced loss of IL-6 receptor. This provides a potential mechanism by which DC are able to remove themselves from the immunosuppressive constraint imposed by IL-6, which is known to maintain immature DC (Park et al. 2004), allowing them to mature into activated DC. Upon activation, resident DC did not display a change in chemokine receptor expression, suggesting that they may remain within the peritoneal cavity and undergo antigen presentation and lymphocyte activation locally. In vivo studies revealed that IL-6 did not regulate the inflammatory trafficking of resident macrophages, DC or recruited circulatory monocytes during acute peritonitis. However upon repeated inflammatory activation, IL-6 directed the increased recruitment of infiltrating monocytes to the peritoneal cavity, implicating them as a contributing factor to the peritoneal tissue damage and fibrosis associated with chronic disease progression. Later studies focused on IL-10, since there is a known interplay that exists between IL-6 and IL-10 (Niemand et al. 2003, Fiorentino et al. 1991, Chernoff et al. 1995). In vivo studies defined an anti-inflammatory role for IL-10, whereby it was responsible for limiting inflammatory leukocyte recruitment via its control of chemokine expression, and the suppression of IL-17A secreting T cell development and recruitment. Therefore the pro-inflammatory and anti-inflammatory roles of IL-6 and IL-10 respectively must be finely balanced to allow competent cell mediated immunity against infection whilst preventing excessive tissue damage associated with disease progression

A systematic review examining reducing unplanned hospital admissions in adults with cancer

Review question:1.What interventions have been tested and have successfully reduced unplanned hospital admissions in adults with cancer?2.What are the factors associated with unplanned hospital admissions in adults with cancer

Exploring the Impact of Efficacy Messages on Cessation-Related Outcomes Using Ecological Momentary Assessment

Introduction:Observational studies indicate that cigarette package inserts with efficacy messages about the benefits of quitting (i.e. response efficacy) and recommendations for successful cessation increase smokers’ self-efficacy to quit and promote sustained cessation. However, the effects of inserts with such efficacy messages have not been studied using experimental designs. This study used ecological momentary assessment (EMA) to assess smokers’ responses to efficacy inserts.Material and Methods:In a randomized case-crossover study among smokers from the United States (n=23), participants received a one-week supply of cigarettes with efficacy inserts and a one-week supply without any inserts, and were randomized to use the packs with inserts on either the first or second week of the study. For 14 consecutive days, participants used a smartphone to answer brief surveys on cessation-related variables during smoking sessions and at the beginning of each day. Multilevel mixed-effects linear and logistic regression models compared responses during the insert period to those of the non-insert period.Results:The insert period was associated with greater desire to quit (b=0.21, p=0.012), motivation to quit (b=0.18, p=0.001), self-efficacy to cut down (b=0.26, p\u3c0.001) and to quit (b=0.28, p\u3c0.000), and response efficacy/ perceived benefits of quitting (b=0.13, p=0.012). Insert exposure was not significantly associated with forgoing cigarettes (OR=1.9, p=0.2).Conclusions:Results from this EMA study suggest that inserts with efficacy messages may promote determinants of smoking cessation. This is consistent with observational research in Canada, which is the only country to use inserts with efficacy messages as well as pictorial warnings about smoking risks on the outside of packs. Future studies should assess the extent to which efficacy inserts can not only be used to communicate health information to smokers but also work in synergy with pictorial warnings

Using Social Judgment Theory method to examine how experienced occupational therapy driver assessors use information to make fitness-to-drive recommendations

Introduction - As people with a range of disabilities strive to increase their community mobility, occupational therapy driver assessors are increasingly required to make complex recommendations regarding fitness-to-drive. However, very little is known about how therapists use information to make decisions. The aim of this study was to model how experienced occupational therapy driver assessors weight and combine information when making fitness-to-drive recommendations and establish their level of decision agreement. Method - Using Social Judgment Theory method, this study examined how 45 experienced occupational therapy driver assessors from the UK, Australia and New Zealand made fitness-to-drive recommendations for a series of 64 case scenarios. Participants completed the task on a dedicated website, and data were analysed using discriminant function analysis and an intraclass correlation coefficient. Results - Accounting for 87% of the variance, the cues central to the fitness-to-drive recommendations made by assessors are the client’s physical skills, cognitive and perceptual skills, road law craft skills, vehicle handling skills and the number of driving instructor interventions. Agreement (consensus) between fitness-to-drive recommendations was very high: intraclass correlation coefficient = .97, 95% confidence interval .96–.98). Conclusion - Findings can be used by both experienced and novice driver assessors to reflect on and strengthen the fitness-to-drive recommendations made to clients.This work was supported by the UK Occupational Therapy Research Foundation, Research Priority Grant scheme, 2012

Testing Cessation Messages for Cigarette Package Inserts: Findings from a Best/Worst Discrete Choice Experiment

This study assessed smokers’ responses to different smoking cessation topics and imagery for cigarette package inserts. Adult smokers from Canada (n = 1000) participated in three discrete choice experiments (DCEs): DCE 1 assessed five cessation benefit topics and five imagery types; DCE 2 assessed five messages with tips to improve cessation success and five imagery types; DCE 3 assessed four reproductive health benefits of cessation topics and four imagery types. In each DCE, participants evaluated four or five sets of four inserts, selecting the most and least motivating (DCEs 1 & 3) or helpful (DCE 2) for quitting. Linear mixed models regressed choices on insert and smoker characteristics. For DCE 1, the most motivating messages involved novel disease topics and imagery of younger women. For DCE 2, topics of social support, stress reduction and nicotine replacement therapy were selected as most helpful, with no differences by imagery type. For DCE 3, imagery influenced choices more than topic, with imagery of a family or a mom and baby selected as most motivating. Statistically significant interactions for all three experiments indicated that the influence of imagery type on choices depended on the message topic. Messages to promote smoking cessation through cigarette pack inserts should consider specific combinations of message topic and imagery