Homework through a network: designing technologies to support learning activities within the home and between home and school

Government policy and academic research both talk about transforming learning through networked technologies – sharing newly available information about the learning context with new partners to support lifelong learning activities, and giving learners increased power and autonomy. This thesis examines how such learning opportunities might be supported. In order to ground these learning opportunities in current educational activity it studies homework, which is an example of a learning activity that spans multiple contexts and the current roll-out point of networked technologies in UK schools. This thesis uses an ecological approach to studying homework practices and activities, and the views, needs and roles of stakeholders, working with ICT coordinators, children, and families. Its core findings are twofold, and centre on the opening up and closing down of homework to involvement within the homework community. The first core finding is that children benefit from actively structuring their homework activities to involve or exclude other family members, and that the networked technologies which teachers plan to use in homework fail to mediate these processes successfully, unlike traditional homework technologies. The second core finding is that details of homework activities transmitted across a network can include too much information about a child or a family’s wider activities, violating privacy and leading families to reject technologies. This thesis identifies design tactics which can help children and their families negotiate how and when information is shared, and provides evidence that these design solutions can be implemented successfully within homework, if designed to fit within the ecology of the home. It discusses the circumstances in which these tactics could be useful in supporting lifelong learning, and establishes the importance of considering how families will integrate any educational activity or technology within their everyday activities

The Effects of Various Periodontal Procedures on the Detection of Bacteria in the Bloodstream

Background : Transient bacteraemias have been detected following dental manipulation for many years. Infective endocarditis can arise in susceptible individuals and antibiotic prophylaxis is required for certain procedures considered to be 'at risk'. Evidence is emerging that periodontal disease may contribute a significant risk factor for the development of certain diseases and CVD could be detrimentally influenced by the repeated entry of bacteria into the bloodstream. It is possible that antimicrobial mouthwashes such as chlorhexidine, could influence the subgingival microflora, reducing the levels of bacteraemia induced by instrumentation. Method: A single blind parallel study lasting two weeks. A baseline blood sample was obtained from 38 volunteers with untreated periodontal disease following which a periodontal probing depth chart was collected. A blood sample was taken following this procedure. Patients were assigned to a mouthwash by a random block assignment chart by the order in which they attended. Following 2 weeks of either chlorhexidine or fluoride mouthwash use twice daily a blood sample was taken. Each subject rinsed with their mouthwash for 1 minute and performed toothbrushing for 2 minutes. A blood sample was taken following this procedure. A full mouth cavitron scaling was performed and a final blood sample was taken. Blood samples were analysed by conventional microbiology. Polymerase Chain Reaction and the LAL assay. Results : Incidence of bacteraemias detected by conventional culture were : cavitron scaling (13.33%), periodontal probing (13.16%), toothbrushing (3.33%). By PCR : cavitron scaling (20%), toothbrushing (13.3%), probing (10.8%). The LAL assay was not considered to be a robust technique for LPS detection. Sample numbers were too small to determine any mouthwash effects. Conclusions : These findings would suggest that dental bacteraemias induced by periodontal procedures are of a low level and pose further questions on the clinical significance of bacteraemia induced by dental manipulation

The Iconography of the library

The University of Northampton and De Montfort University are working together to analyse the use of social learning spaces within a Higher Education setting using qualitative and quantitative research methods. The group is intending to reproduce earlier work that mapped the university campuses to provide a comparative understanding of where students work and then interview students in situ to gather a rationale for their choice of space. These findings will then be developed to understand how narratives of learning spaces are constructed, the concept of identity in the selection of space and the notion of spaces such as the library holding an iconic status within centres of learnin

Homework through a network: designing technologies to support learning activities within the home and between home and school

Government policy and academic research both talk about transforming learning through networked technologies – sharing newly available information about the learning context with new partners to support lifelong learning activities, and giving learners increased power and autonomy. This thesis examines how such learning opportunities might be supported. In order to ground these learning opportunities in current educational activity it studies homework, which is an example of a learning activity that spans multiple contexts and the current roll-out point of networked technologies in UK schools. This thesis uses an ecological approach to studying homework practices and activities, and the views, needs and roles of stakeholders, working with ICT coordinators, children, and families. Its core findings are twofold, and centre on the opening up and closing down of homework to involvement within the homework community. The first core finding is that children benefit from actively structuring their homework activities to involve or exclude other family members, and that the networked technologies which teachers plan to use in homework fail to mediate these processes successfully, unlike traditional homework technologies. The second core finding is that details of homework activities transmitted across a network can include too much information about a child or a family’s wider activities, violating privacy and leading families to reject technologies. This thesis identifies design tactics which can help children and their families negotiate how and when information is shared, and provides evidence that these design solutions can be implemented successfully within homework, if designed to fit within the ecology of the home. It discusses the circumstances in which these tactics could be useful in supporting lifelong learning, and establishes the importance of considering how families will integrate any educational activity or technology within their everyday activities

Non-randomised evaluations of strategies to increase participant retention in randomised controlled trials:a systematic review

Peer reviewedPublisher PD

Identifying the emergence of the superficial peroneal nerve through deep fascia on ultrasound and by dissection:Implications for regional anesthesia in foot and ankle surgery

Regional anesthesia relies on a sound understanding of anatomy and the utility of ultrasound in identifying relevant structures. We assessed the ability to identify the point at which the superficial peroneal nerve (SPN) emerges through the deep fascia by ultrasound on 26 volunteers (mean age 27.85 years ± 13.186; equal male: female). This point was identified, characterized in relation to surrounding bony landmarks (lateral malleolus and head of the fibula), and compared to data from 16 formalin‐fixed human cadavers (mean age 82.88 years ± 6.964; equal male: female). The SPN was identified bilaterally in all subjects. On ultrasound it was found to pierce the deep fascia of the leg at a point 0.31 (±0.066) of the way along a straight line from the lateral malleolus to the head of the fibula (LM‐HF line). This occurred on or anterior to the line in all cases. Dissection of cadavers found this point to be 0.30 (±0.062) along the LM‐HF line, with no statistically significant difference between the two groups (U = 764.000; exact two‐tailed P = 0.534). It was always on or anterior to the LM‐HF line, anterior by 0.74 cm (±0.624) on ultrasound and by 1.51 cm (±0.509) during dissection. This point was significantly further anterior to the LM‐HF line in cadavers (U = 257.700, exact two‐tailed P < 0.001). Dissection revealed the nerve to divide prior to emergence in 46.88% (n = 15) limbs, which was not identified on ultrasound (although not specifically assessed). Such information can guide clinicians when patient factors (e.g., obesity and peripheral edema) make ultrasound‐guided nerve localization more technically challenging.PostprintPeer reviewe

Developing a Methodology Protocol for Identifying the Superficial Peroneal Nerve in Living Models Sonographically and Formalin-Fixed Cadavers Morphologically: a Proof of Concept Study

The superficial peroneal nerve (SPN) provides cutaneous innervation to the distal anterolateral leg and dorsum of foot.1 Knowing the position where the SPN penetrates the deep fascia, to become superficial, is useful in clinical practice (e.g. ankle blocks and internal fixation of distal fibular fractures). However, there is variability in the literature as to where the SPN penetrates the deep fascia as well as the methodology to identify it with no standardised guidelines. Our primary aim was to identify this point and create a methodology protocol that could be implemented in clinical practice. The study involved sonography of living healthy adult volunteers and dissection of formalin-fixed cadavers with no past history of pathology or surgery affecting the SPN. During sonography, the bony prominences of the fibular head and lateral malleolus were identified and marked with a straight line. A 6-12 MHz linear array ultrasound probe was positioned anterior to the lateral malleolus and moved proximally to identify the location where the SPN penetrates the deep fascia to lie in a superficial plane. The lateral malleolus-fibular head (length of fibula) and lateral malleolus-SPN distances were measured. The distance of emergence from the deep fascia of the SPN anterior or posterior to the length of fibula was measured (fig 1). In the cadavers, a skin incision was made from the tibial tuberosity to the anterior intermalleolar line and the skin reflected laterally to a line posterior to fibula. The superficial fascia was explored to identify the SPN and branches (fig 2). The same bony landmarks/measurements as in the sonography were marked and measured to allow for comparison with the sonographic methodology. We successfully developed a protocol that can provide standardisation for identifying the SPN. This can reduce incorrect identification and improve success rates of clinical procedures, though individual variation must be considered. Reference: 1. STANDRING, S (Editor) 2008. Gray’s Anatomy The Anatomical Basis of Clinical Practice (Fortieth Edition). London: Churchill Livingstone ELSEVIER, page 1427. Acknowledgements: For their help and support in this study, we would to thank the volunteers, the anatomy technical staff, and the clinical skills suite manager from the University of St Andrews Medical School

Developing a Methodology Protocol for Identifying the Superficial Peroneal Nerve in Living Models Sonographically and Formalin-Fixed Cadavers Morphologically: a Proof of Concept Study

The superficial peroneal nerve (SPN) provides cutaneous innervation to the distal anterolateral leg and dorsum of foot.1 Knowing the position where the SPN penetrates the deep fascia, to become superficial, is useful in clinical practice (e.g. ankle blocks and internal fixation of distal fibular fractures). However, there is variability in the literature as to where the SPN penetrates the deep fascia as well as the methodology to identify it with no standardised guidelines. Our primary aim was to identify this point and create a methodology protocol that could be implemented in clinical practice. The study involved sonography of living healthy adult volunteers and dissection of formalin-fixed cadavers with no past history of pathology or surgery affecting the SPN. During sonography, the bony prominences of the fibular head and lateral malleolus were identified and marked with a straight line. A 6-12 MHz linear array ultrasound probe was positioned anterior to the lateral malleolus and moved proximally to identify the location where the SPN penetrates the deep fascia to lie in a superficial plane. The lateral malleolus-fibular head (length of fibula) and lateral malleolus-SPN distances were measured. The distance of emergence from the deep fascia of the SPN anterior or posterior to the length of fibula was measured (fig 1). In the cadavers, a skin incision was made from the tibial tuberosity to the anterior intermalleolar line and the skin reflected laterally to a line posterior to fibula. The superficial fascia was explored to identify the SPN and branches (fig 2). The same bony landmarks/measurements as in the sonography were marked and measured to allow for comparison with the sonographic methodology. We successfully developed a protocol that can provide standardisation for identifying the SPN. This can reduce incorrect identification and improve success rates of clinical procedures, though individual variation must be considered. Reference: 1. STANDRING, S (Editor) 2008. Gray’s Anatomy The Anatomical Basis of Clinical Practice (Fortieth Edition). London: Churchill Livingstone ELSEVIER, page 1427. Acknowledgements: For their help and support in this study, we would to thank the volunteers, the anatomy technical staff, and the clinical skills suite manager from the University of St Andrews Medical School

The cost-effectiveness of strategies preventing late-onset infection in preterm infants

Objective: Developing a model to analyse the cost-effectiveness of interventions preventing late-onset infection (LOI) in preterm infants and applying it to the evaluation of Anti-Microbial Impregnated Peripherally Inserted Central Catheters (AM-PICCs) compared with standard PICCs (S-PICCs). Design: Model-based cost-effectiveness analysis, using data from the PREVAIL randomised controlled trial linked to routine healthcare data, supplemented with published literature. The model assumes that LOI increases the risk of neurodevelopmental impairment (NDI). Setting: Neonatal Intensive Care Units in the UK National Health Service (NHS). Patients: Infants born ≤32 weeks gestational age, requiring a 1 French gauge PICC. Interventions: AM-PICC and S-PICC. Main outcome measures: Life expectancy, quality-adjusted life years and healthcare costs over the infants’ expected lifetime. Results: Severe NDI reduces life expectancy by 14.79 (95% confidence interval (CI) 4.43; 26.68; undiscounted) years, 10.63 (95%CI 7.74; 14.02; discounted) QALYs, and costs £19,060 (95%CI £14,197; £24,70; discounted) to the NHS. If LOI causes NDI, the maximum acquisition price of an intervention reducing LOI risk by 5% is £120. AM-PICCs increase costs (£54.85 (95%CI £25.95; £89.12)) but have negligible impact on health outcomes (-0.01 (95%CI -0.09; 0.04) QALYs), compared with S-PICCs. The NHS can invest up to £2.4 million in research to confirm that AM-PICCs are not cost-effective. Conclusions: The model quantifies health losses and additional healthcare costs caused by NDI and LOI during neonatal care. Given these consequences, interventions preventing LOI, even by a small extent, can be cost-effective. AM-PICCs, being less effective and more costly than S-PICC, are not likely to be cost-effective