Understanding the Impact of Technology: Learner and School Level Factors

The first part of this report focuses on the factors impacting on learner performance in national tests at primary and secondary level. This was the central research question of this research. The second section focuses on teacher and learner perceptions of their own responses to learning and the learning environment. This was centred on, but not confined to, their school. The institutional structures record the level of development of the schools sampled here and investigate the use of two key technologies – interactive whiteboards and learning platform

The impact of broadband in schools: Summary report

Summary of the report, which reviews evidence for the impact of broadband in English schools, exploring; variations in provision in level of broadband connectivity. Links between the level of broadband activity and nationally accessible performance data; aspects of broadband connectivity and the school environment that contribute to better outcomes for pupils and teachers; academic and motivational benefits associated with educational uses of this technology

Personalising Learning

This report presents the findings of the Personalising Learning project, which was commissioned by Becta. The core aim of the project is to develop a robust model of the effective use of digital technologies for the personalising of learning. Personalising learning in this context involves the tailoring of pedagogy, curriculum and learning support to meet the needs and aspirations of individual learners irrespective of ability, culture or social status in order to nurture the unique talents of every pupil. Section 2 of this report outlines the background and aims of this research project. Section 3 traces the development of the model and the accompanying learning equation. The key concept encapsulated in this model is that of overlapping action spaces, school, teaching, personal and living spaces, in which learning occurs. These spaces are populated by the key educational stakeholders: learners, their teachers, their family and peers. In each of these spaces a range of digital technologies is available to support the learner. Section 4 is a validation of the model using evidence from field research

An explanatory randomised controlled trial of a nurse-led, consultation-based intervention to support patients with adherence to taking glucose lowering medication for type 2 diabetes.

BACKGROUND: Failure to take medication reduces the effectiveness of treatment leading to increased morbidity and mortality. We evaluated the efficacy of a consultation-based intervention to support objectively-assessed adherence to oral glucose lowering medication (OGLM) compared to usual care among people with type 2 diabetes. METHODS: This was a parallel group randomised trial in adult patients with type 2 diabetes and HbA1c ≥ 7.5% (58 mmol/mol), prescribed at least one OGLM. Participants were allocated to a clinic nurse delivered, innovative consultation-based intervention to strengthen patient motivation to take OGLM regularly and support medicine taking through action-plans, or to usual care. The primary outcome was the percentage of days on which the prescribed dose of medication was taken, measured objectively over 12 weeks with an electronic medication-monitoring device (TrackCap, Aardex, Switzerland). The primary analysis was intention-to-treat. RESULTS: 211 patients were randomised between July 1, 2006 and November 30, 2008 in 13 British general practices (primary care clinics). Primary outcome data were available for 194 participants (91.9%). Mean (sd) percentage of adherent days was 77.4% (26.3) in the intervention group and 69.0% (30.8) in standard care (mean difference between groups 8.4%, 95% confidence interval 0.2% to 16.7%, p = 0.044). There was no significant adverse impact on functional status or treatment satisfaction. CONCLUSIONS: This well-specified, theory based intervention delivered in a single session of 30 min in primary care increased objectively measured medication adherence, with no adverse effect on treatment satisfaction. These findings justify a definitive trial of this approach to improving medication adherence over a longer period of time, with clinical and cost-effectiveness outcomes to inform clinical practice.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Blood pressure self-monitoring in pregnancy (BuMP) feasibility study; a qualitative analysis of women's experiences of self-monitoring

Background Hypertensive disorders in pregnancy are a leading cause of maternal and fetal morbidity worldwide. Raised blood pressure (BP) affects 10% of pregnancies worldwide, of which almost half develop pre-eclampsia. The proportion of pregnant women who have risk factors for pre-eclampsia (such as pre-existing hypertension, obesity and advanced maternal age) is increasing. Pre-eclampsia can manifest itself before women experience symptoms and can develop between antenatal visits. Incentives to improve early detection of gestational hypertensive disorders are therefore strong and self-monitoring of blood pressure (SMBP) in pregnancy might be one means to achieve this, whilst improving women’s involvement in antenatal care. The Blood Pressure Self-Monitoring in Pregnancy (BuMP) study aimed to evaluate the feasibility and acceptability of SMBP in pregnancy. Methods To understand women’s experiences of SMBP during pregnancy, we undertook a qualitative study embedded within the BuMP observational feasibility study. Women who were at higher risk of developing hypertension and/or pre-eclampsia were invited to take part in a study using SMBP and also invited to take part in an interview. Semi-structured interviews were conducted at the women’s homes in Oxfordshire and Birmingham with women who were self-monitoring their BP as part of the BuMP feasibility study in 2014. Interviews were conducted by a qualitative researcher and transcribed verbatim. A framework approach was used for analysis. Results Fifteen women agreed to be interviewed. Respondents reported general willingness to engage with monitoring their own BP, feeling that it could reduce anxiety around their health during pregnancy, particularly if they had previous experience of raised BP or pre-eclampsia. They felt able to incorporate self-monitoring into their weekly routines, although this was harder post-partum. Self-monitoring of BP made them more aware of the risks of hypertension and pre-eclampsia in pregnancy. Feelings of reassurance and empowerment were commonly reported by the women in our sample

Social Philosophy and the Early Development of Winnipeg's Public Parks

Les premiers parcs de Winnipeg firent leur apparition vers la fin du XIXe siècle. Pour comprendre leur origine, il faut se situer dans le contexte plus large des philosophies sociales qui avaient cours alors en Amérique du Nord. Bien que leur conception et leur fonction aient évolué, les parcs furent établis pour servir les intérêts des promoteurs immobiliers et pour satisfaire aux exigences des réformateurs sociaux. Ils furent donc conçus pour accroître la valeur des terrains et améliorer la qualité de la vie à Winnipeg. Vers le milieu des années vingt, les efforts combinés des entrepreneurs privés et des pouvoirs publics avaient créé un réseau de parcs et d’espaces verts qui répondaient aux besoins et intérêts d’une grande partie de la population de la ville.Winnipeg's earliest parks were developed towards the end of the nineteenth century. Their origins are explained in the wider context of social philosophies prevalent in North America at the time. Although there was a shift in emphasis and an evolutionary trend in their functions, parks were established to serve the interests of real estate promoters and to satisfy the demands of social reformers. They were thus designed both to enhance land values and to improve the quality of life in Winnipeg. By the mid-twenties, the joint efforts of private entrepreneurs and public authorities had created a system of parks and green spaces that catered to the diverse needs and interests of a large proportion of Winnipeg society

Are there enough GPs in England to detect hypertension and maintain access?

We read with interest the paper by Baker et al exploring the interrelationship between size of hypertension register, GP provision, and access (defined as the ability to get an appointment within 48 hours), assessed in 8052 practices. It suggests a conundrum in primary care: the ‘better’ a practice’s recognition and presumably management of hypertension, the worse the access, given finite staffing resources. The same inverse relationship may apply in other chronic diseases such as diabetes mellitus, where the recognition of risk factors or disease in often asymptomatic individuals also leads to additional workload. As acknowledged by the authors, no information was available on how different members of the primary healthcare team are used, but it appears that, ‘an extra GP per 1000 patients would be associated with a 6% increase in detected hypertension’

Triage tests for identifying atrial fibrillation in primary care : a diagnostic accuracy study comparing single-lead ECG and modified BP monitors

Objective New electronic devices offer an opportunity within routine primary care settings for improving the detection of atrial fibrillation (AF), which is a common cardiac arrhythmia and a modifiable risk factor for stroke. We aimed to assess the performance of a modified blood pressure (BP) monitor and two single-lead ECG devices, as diagnostic triage tests for the detection of AF. Setting 6 General Practices in the UK. Participants 1000 ambulatory patients aged 75 years and over. Primary and secondary outcome measures Comparative diagnostic accuracy of modified BP monitor and single-lead ECG devices, compared to reference standard of 12-lead ECG, independently interpreted by cardiologists. Results A total of 79 participants (7.9%) had AF diagnosed by 12-lead ECG. All three devices had a high sensitivity (93.9–98.7%) and are useful for ruling out AF. WatchBP is a better triage test than Omron autoanalysis because it is more specific—89.7% (95% CI 87.5% to 91.6%) compared to 78.3% (95% CI 73.0% to 82.9%), respectively. This would translate into a lower follow-on ECG rate of 17% to rule in/rule out AF compared to 29.7% with the Omron text message in the study population. The overall specificity of single-lead ECGs analysed by a cardiologist was 94.6% for Omron and 90.1% for Merlin. Conclusions WatchBP performs better as a triage test for identifying AF in primary care than the single-lead ECG monitors as it does not require expertise for interpretation and its diagnostic performance is comparable to single-lead ECG analysis by cardiologists. It could be used opportunistically to screen elderly patients for undiagnosed AF at regular intervals and/or during BP measurement