Virtual learning environments – help or hindrance for the ‘disengaged’ student?

The introduction of virtual learning environments (VLEs) has been regarded by some as a panacea for many of the problems in today’s mass numbers modular higher education system. This paper demonstrates that VLEs can help or hinder student engagement and performance, and that they should be adapted to the different types of learner. A project is described that aimed to investigate whether the introduction of a VLE can assist ‘disengaged’ students, drawing on click count tracking data and student performance. The project took place in the context of two very large undergraduate modules (850 and 567 students) in a Business School of a new university in the UK. In an adaptation of a model of learner engagement in Web-enhanced environments, four distinct learner types have emerged: model, traditionalist, geek and disengaged. There was evidence that use of the VLE exacerbated, rather than moderated, the differences between these learner types

The prediction and monitoring of toxicity associated with long-term systemic glucocorticoid therapy

Glucocorticoids are often required for adequate control of inflammation in many serious inflammatory diseases; common indications for long-term treatment include polymyalgia rheumatica, giant cell arteritis, asthma and chronic obstructive pulmonary disease. Long-term glucocorticoid therapy is, however, associated with many adverse effects involving skin, gastro-intestinal, eye, skeletal muscle, bone, adrenal, cardio-metabolic and neuropsychiatric systems. This balance between benefits and risks of glucocorticoids is important for clinical practice and glucocorticoid-related adverse effects can significantly impair health-related quality of life. Understanding the nature and mechanisms of glucocorticoid-related adverse effects may inform how patients are monitored for toxicity and identify those groups, such as older people, that may need closer monitoring. For clinical trials in diseases commonly treated with glucocorticoids, standardised measurement of glucocorticoid-related adverse effects would facilitate future evidence synthesis and meta-analysis

Endangered Species Protection in the Arctic: A Comparative Legal Study of the Polar Regions of Europe and North America

Ph. D. ThesisThe Arctic is changing faster than any other region on earth. Climate change is leading to warming within the Arctic at least twice the rate of the rest of the planet. Climate change, combined with the impact of pollution, plastics in the ocean, natural resource extraction, and many other harmful anthropogenic activities, is threatening the survival of many Arctic species. Reliant on sea ice habitats or adapted to bitterly cold conditions, animals and plants in the Arctic are facing extinction if they cannot be protected. Endangered species protection in the Arctic is primarily the responsibility of the nation states with territory north of the Arctic Circle. Each country has their own laws and regulations aimed at protecting species. This project uses a comparative legal method to assess the effectiveness of the endangered species protection systems within the domestic legal systems of the Arctic nations of Europe and North America. The study considers the legislation, regulations and other written laws of each country as well as using a number of case studies to demonstrate how the law is used in practice. Selection of the case studies is made possible through the collation of reported endangered species court cases from north of the Arctic Circle over the past two decades. By conducting a comparison of domestic endangered species protection laws within the Arctic, this project identifies strengths and weaknesses in the systems of the various jurisdictions, draws on examples of good practice which could be used to influence changes in the approach of other Arctic countries and makes recommendations of improvements which need to be made to help Arctic species to survive the threats which they will face in the coming years

What is the absolute risk of developing diabetes mellitus in patients with glucocorticoid-treated polymyalgia rheumatica and giant cell arteritis? a systematic review and meta-analysis

Background: Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are treated with glucocorticoids (GCs) but long-term GC use is associated with diabetes mellitus (DM). The absolute incidence of this serious complication in this patient group remains unclear. Objectives: To quantify the absolute risk of GC-induced DM in PMR and GCA in published literature. Methods: We identified literature from inception to February 2016 reporting diabetes following exposure to oral GC in patients with PMR and/or GCA without preexisting diabetes. A random-effects meta-analysis was performed to summarise the literature. Risk of bias was assessed using the Cochrane Collaboration tool. Results: 21 eligible publications were identified. In studies of patients with GCA, mean cumulative GC dose was almost two times higher than in studies of PMR (8.9g vs 5.0g), with slightly longer treatment duration but much longer duration of follow-up (8.8years vs 4.4years). The incidence proportion (cumulative incidence) of patients who developed new-onset DM was 6% (95% CI: 3–9%) for PMR and 12% (95% CI: 8–17%) for GCA. Heterogeneity between studies was high (I2=78.2%), as there were differences in study designs, patient population, geographical locations and treatment strategies. Based on UK data on incidence rate of DM in the general population1, the expected background incidence rate of DM over 4.4 years in PMR patients and 8.8 years in GCA patients (the duration of follow-up) would be 4.8% and 9.7%, respectively. Very little information on predictors of DM in PMR or GCA patients was found. The overall risk of bias was high for many of the observational studies, especially relating to definition and recording of outcome and prognostic variables. Conclusions: Physicians should screen patients treated for PMR/GCA for DM but it remains unclear what is the time-period of greatest risk and the influence of risk factors. Our meta-analysis produced plausible estimates of DM incidence in patients with PMR and GCA but there is insufficient published data to allow precise quantification of the DM risk or, crucially, which patients are at greatest ris

Aphasia United - A Unified Voice for Aphasia

Aphasia United is a new peak international organization that aims to bring together the global aphasia community and represent its voice to the World Stroke Organization. The aim of this paper is to describe the processes of development and the strategic direction of Aphasia United, and its proposed process for developing an international research agenda. Initial discussions and a summit have prioritized capacity building of consumer organization, building consensus around best practice, raising awareness and creating a governance structure as well as developing an international research agenda for aphasia. Opportunities for involvement are outlined