The provision of distance education within the HE sector - some areas for concern

This paper presents a summary of the findings of a recent survey of the way in which UK higher education institutions (HEIs) are offering distance education (DE) courses, the types of courses being offered, and their modes of delivery. From analysis of the findings of this survey, it is apparent that the emphasis of HEIs is very much on the exploitation of available teaching technology in the delivery of DE courses. However, teaching at a distance is quite different from face-toface teaching, and the evidence suggests that many HEIs fail to implement any meaningful academic staff training for the new role of DE tutor. The authors consider the difficulties this presents to academic staff who are required to move from face-to-face teaching to online facilitating. The paper concludes with an examination of the current provision of staff development and training within UK HEIs and suggests the type of academic staff training required if DE courses are to become truly core activities

Dabbing the Skin Surface Dry during Ice Massage Augments Rate of Temperature Drop

While ice massage (IM) is a rapid cooling technique used to facilitate therapeutic movements in the rehabilitation process, evidence of its efficacy over alternative therapeutic protocols is scarce. We determined whether dabbing the skin surface dry during a standard IM treatment would lead to greater rate of skin temperature reduction in comparison to without dabbing; and whether dabbing the skin would lead to an acute change in flexibility. Sixteen healthy volunteers received a “dabbing” and “non-dabbing” 7-minute IM treatment over the surface of each triceps surae muscle. Minute-by-minute temperature change in skin surface was evaluated using an infrared thermometer. Active (AROM) and passive (PROM) range of motion were evaluated via hand-held goniometer and passive stretch force was evaluated with an algometer. Dependent variables (reported as Mean ± SD) were tested with two-way analysis of variance with repeated measures. Skin temperature (&#;C) was reduced to with dabbing (5.8 ± 1.1) in comparison to without dabbing (6.8 ± 1.4), evoking significantly greater cooling at 1-min of ice massage (group X time interaction, p\u3c0.01). However, after two minutes of IM, each method of application evoked similar surface temperatures. There was no significant difference in AROM, with dabbing (-0.63 ± 2.55&#;) in comparison to without dabbing (1.18 ± 2.90&#;), and no significant difference in passive-length tension relations (p\u3e0.05) for either IM group. The dabbing protocol resulted in more rapid rate of temperature drop at 1-minute, however, both IM techniques are sufficient in cooling surface temperature after 2-minutes of IM. Further study is warranted to determine the clinical significance of the dabbing procedure

Service quality management in local authority sport and recreation services : a study of quality management methods in use and an evaluation of the efficacy of the ISO 9002 and Investors in People standards.

Two key research questions are addressed in this thesis. First, to ascertain what quality management methods are in use in local authority sport and recreation services. Second, to evaluate the effectiveness in these services of two management standards, namely the international quality assurance standard ISO 9002 and the UK Investors in People (liP) standard. A review of the literature indicated that little was known about how managers of sport and recreation services attempted to secure quality of service. The first stage of primary research therefore provided this knowledge through a postal survey of managers of sports and recreation facilities. The survey was mailed to 1700 sports and recreation facility managers in the UK and 388 fully usable responses were received, a response rate of 23%. The results indicated that two standards, ISO 9002 and liP, were in frequent use. The second stage of primary research assessed the effectiveness of the two standards in local authority sports and recreation services. The literature review showed a considerable volume of work on the subjects of quality management, service quality and the quality of public sector services. However, little had been done to develop a method for evaluating quality management practice in services generally or in public sector services in particular. The method developed by the researcher for the second stage of primary research was case study investigation of eight local authority sport and recreation facilities which were managing to one of the above standards or to no quality management standard. Each case was investigated in two ways. The perceptions of members of the management team were explored through structured interviews, a total of 24 interviews being conducted. The perceptions of service users were studied through administration of a multivanate customer questionnaire, which received 820 fully usable responses. The management interviews showed support for ISO 9002 from those cases using it, and responses indicated that management of organisational processes was stronger than in the other cases. In those cases managing to the liP standard, the interviews showed that people management was more robust than in the other cases; however there was a more varied view of the utility of the liP standard. The customer survey showed that users of the liP registered facilities evaluated service quality more highly than did customers of the ISO 9002 registered ones. This was true of questions about staff quality and of those about processes and tangible assets. It was concluded that whilst ISO 9002 helped managers to deliver a more consistent and less wasteful service, these results were not visible to customers. liP had a beneficial effect on management of staff and this impacted on other service attribute

A comparative analysis of marine mammal tracheas

Author Posting. © The Author(s), 2013. This is the author's version of the work. It is posted here by permission of Company of Biologists for personal use, not for redistribution. The definitive version was published in Journal of Experimental Biology 217 (2014): 1154-1166, doi:10.1242/​jeb.093146.In 1940, Scholander suggested that stiffened upper airways remained open and received air from highly compressible alveoli during marine mammal diving. There are little data available on the structural and functional adaptations of the marine mammal respiratory system. The aim of this research was to investigate the anatomical (gross) and structural (compliance) characteristics of excised marine mammal tracheas. Here we defined different types of tracheal structures, categorizing pinniped tracheas by varying degrees of continuity of cartilage (categories 1-4) and cetacean tracheas by varying compliance values (categories 5A and 5B). Some tracheas fell into more than one category, along their length, for example, the harbor seal (Phoca vitulina) demonstrated complete rings cranially, and as the trachea progressed caudally tracheal rings changed morphology. Dolphins and porpoises had less stiff, more compliant spiraling rings while beaked whales had very stiff, less compliant spiraling rings. The pressure-volume (P-V) relationships of isolated tracheas from different species were measured to assess structural differences between species. These findings lend evidence for pressure-induced collapse and re-inflation of lungs, perhaps influencing variability in dive depth or ventilation rates of the species investigated.This project was supported by a grant from the Office of Naval Research (award number N00014-10-1-0059).2014-12-0

Bubbles in live-stranded dolphins

© The Author(s), 2011. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Proceedings of the Royal Society B : Biological Sciences 279 (2012): 1396-1404, doi:10.1098/rspb.2011.1754.Bubbles in supersaturated tissues and blood occur in beaked whales stranded near sonar exercises, and post-mortem in dolphins bycaught at depth and then hauled to the surface. To evaluate live dolphins for bubbles, liver, kidneys, eyes and blubber–muscle interface of live-stranded and capture-release dolphins were scanned with B-mode ultrasound. Gas was identified in kidneys of 21 of 22 live-stranded dolphins and in the hepatic portal vasculature of 2 of 22. Nine then died or were euthanized and bubble presence corroborated by computer tomography and necropsy, 13 were released of which all but two did not re-strand. Bubbles were not detected in 20 live wild dolphins examined during health assessments in shallow water. Off-gassing of supersaturated blood and tissues was the most probable origin for the gas bubbles. In contrast to marine mammals repeatedly diving in the wild, stranded animals are unable to recompress by diving, and thus may retain bubbles. Since the majority of beached dolphins released did not re-strand it also suggests that minor bubble formation is tolerated and will not lead to clinically significant decompression sickness.Funding for this work was provided by the US Office of Naval Research Award no. N000140811220 and the International Fund for Animal Welfare

Advanced Hodgkin lymphoma in the East of England: a 10-year comparative analysis of outcomes for real-world patients treated with ABVD or escalated-BEACOPP, aged less than 60 years, compared with 5-year extended follow-up from the RATHL trial

Treatment with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) or escalated(e)-BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone) remains the international standard of care for advanced-stage classical Hodgkin lymphoma (HL). We performed a retrospective, multicentre analysis of 221 non-trial (“real-world”) patients, aged 16–59 years, diagnosed with advanced-stage HL in the Anglia Cancer Network between 2004 and 2014, treated with ABVD or eBEACOPP, and compared outcomes with 1088 patients in the Response-Adjusted Therapy for Advanced Hodgkin Lymphoma (RATHL) trial, aged 18–59 years, with median follow-up of 87.0 and 69.5 months, respectively. Real-world ABVD patients (n=177) had highly similar 5-year progression-free survival (PFS) and overall survival (OS) compared with RATHL (PFS 79.2% vs 81.4%; OS 92.9% vs 95.2%), despite interim positron-emission tomography-computed tomography (PET/CT)-guided dose-escalation being predominantly restricted to trial patients. Real-world eBEACOPP patients (n=44) had superior PFS (95.5%) compared with real-world ABVD (HR 0.20, p=0.027) and RATHL (HR 0.21, p=0.015), and superior OS for higher-risk (international prognostic score ≥3 [IPS 3+]) patients compared with real-world IPS 3+ ABVD (100% vs 84.5%, p=0.045), but not IPS 3+ RATHL patients. Our data support a PFS, but not OS, advantage for patients with advanced-stage HL treated with eBEACOPP compared with ABVD and suggest higher-risk patients may benefit disproportionately from more intensive therapy. However, increased access to effective salvage therapies might minimise any OS benefit from reduced relapse rates after frontline therapy

Epilepsia partialis continua complicated by disseminated tuberculosis and hemophagocytic lymphohistiocytosis: a case report.

BACKGROUND: We describe a patient copresenting with epilepsia partialis continua, tuberculosis, and hemophagocytic lymphohistiocytosis. To our knowledge, this is the first documented case of this triad. CASE PRESENTATION: A 54-year-old black South African woman presented to a hospital in Scotland with an acute history of right-sided facial twitching, breathlessness, and several months of episodic night sweats. Clinical examination revealed pyrexia and continuous, stereotyped, right-sided facial contractions. These worsened with speech and continued through sleep. A clinical diagnosis of epilepsia partialis continua was made, and we provide a video of her seizures. Computed tomographic imaging of the chest and serous fluid analyses were consistent with a diagnosis of disseminated Mycobacterium tuberculosis. An additional diagnosis of hemophagocytic lymphohistiocytosis was made following the identification of pancytopenia and hyperferritinemia in peripheral blood, with hemophagocytosis evident in bone marrow investigation. We provide images of her hematopathology. The patient was extremely unwell and was hospitalized for 6 months, including two admissions to the intensive care unit for ventilatory support. She was treated successfully with high doses of antiepileptic drugs (benzodiazepines, levetiracetam, and phenytoin) and 12 months of oral antituberculosis therapy, and she underwent chemotherapy with 8 weeks of etoposide and dexamethasone for hemophagocytic lymphohistiocytosis, followed by 12 months of cyclosporine and prednisolone. CONCLUSIONS: This combination of pathologies is unusual, and this case report helps educate clinicians on how such a patient may present and be managed. A lack of evidence surrounding the coexpression of this triad may represent absolute rarity, underdiagnosis, or incomplete case ascertainment due to early death caused by untreated tuberculosis or hemophagocytic lymphohistiocytosis. Further research is needed

Deficits in peroneal latency and electromechanical delay in patients with functional ankle instability

The purpose of this study was to compare alterations in peroneal latency and electromechanical delay (EMD) following an inversion perturbation during walking in patients with functional ankle instability (FAI) and with a matched control group. Peroneal latency and EMD were measured from 21 patients with unilateral FAI and 21 controls. Latencies were collected during a random inversion perturbation while walking. EMD measures were collected during stance using a percutaneous stimulus. Two-way ANOVAs were used to detect differences between leg (affected, unaffected) and group (FAI, Control). Functionally unstable ankles displayed delayed peroneus longus (PL) latencies and EMD when compared to the unaffected leg and a matched control group. Peroneal latency and EMD deficits could contribute to recurrence of ankle injury in FAI subjects. How these deficits are associated with the chronic symptoms associated with FAI remains unclear, but gamma activation and subsequent muscle spindle sensitivity likely play a role. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:1541–1546, 2009Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/64439/1/20934_ftp.pd

Static stretching does not alter pre and post-landing muscle activation

<p>Abstract</p> <p>Background</p> <p>Static stretching may result in various strength and power deficiencies. Prior research has not determined, however, if static stretching causes a change in muscle activation during a functional task requiring dynamic stability. The purpose of this study was to determine if static stretching has an effect on mean pre and postlanding muscle (vastus medialis VM, vastus lateralis VL, medial hamstring MH, and biceps femoris BF) activity.</p> <p>Methods</p> <p>26 healthy, physically active subjects were recruited, from which 13 completed a 14-day static stretching regimen for the quadriceps and hamstrings. Using the data from the force plate and EMG readings, a mean of EMG amplitude was calculated for 150 msec before and after landing. Each trial was normalized to an isometric reference position. Means were calculated for the VM, VL, MH, and BF from 5 trials in each session. Measures were collected pre, immediately following the 1^ststretching session, and following 2 weeks of stretching.</p> <p>Results</p> <p>A 14-day static stretching regimen resulted in no significant differences in pre or postlanding mean EMG amplitude during a drop landing either acutely or over a 14-day period.</p> <p>Conclusions</p> <p>Static stretching, done acutely or over a 14-day period does not result in measurable differences of mean EMG amplitude during a drop landing. Static stretching may not impede dynamic stability of joints about which stretched muscles cross.</p