Open Access and the REF: Issues and Potential Solutions Workshop

This report provides a summary of the discussion and findings of the Open Access and the REF: Issues and Potential Solutions workshop held as part of the End-to-End Project. The workshop was highly interactive and feedback received indicated it was considered an excellent event, and that it was vital and useful to bring together various key stakeholders to discuss problems and procedures and develop ideas

Open Access and the REF: Issues and Potential Solutions Workshop: Executive Summary

This report provides a summary of the discussion and findings of the Open Access and the REF: Issues and Potential Solutions workshop held as part of the End-to-End Project. The workshop was highly interactive and feedback received indicated it was considered an excellent event, and that it was vital and useful to bring together various key stakeholders to discuss problems and procedures and develop ideas

Analyzing Claims of Sovereignty in International Economic Disputes

The extraterritorial application of national laws has become a battle ground over the last forty years for both private parties and states, who are either seeking to enforce their laws or to protect their nationals and their own interests. The conflicts have been most intense over the application of economic regulation to international business conduct where the situs and the effects of the conduct may be quite difficult to locate within the borders of any single state. Often, the United States has sought to enforce its laws when conduct abroad by foreign nationals adversely affected its interests. The intention of this paper is to develop an objective framework within which to analyze the opposing claims of states embroiled in international economic disputes, wherever they arise. This paper presents a framework which departs from the traditional analysis of extraterritorial jurisdiction. Instead, it focuses on the assertion of sovereignty claims as the more fruitful avenue of inquiry. The paper proposes a set of criteria to assess: 1) the validity of claims that the extraterritorial application of national law constitutes an infringement of sovereignty; and 2) the propriety of states using such claims as a basis of intervention to protect their nationals

Ovarian and cervical cancer awareness: development of two validated measurement tools.

The aim of the study was to develop and validate measures of awareness of symptoms and risk factors for ovarian and cervical cancer (Ovarian and Cervical Cancer Awareness Measures)

Spatio-temporal differences in the history of health and noise complaints about Australian wind farms: evidence for the psychogenic, “communicated disease” hypothesis.

Background and objectives With often florid allegations about health problems arising from wind turbine exposure now widespread in parts of rural Australia and on the internet, nocebo effects potentially confound any future investigation of turbine health impact. Historical audits of health complaints across periods when such claims were rare are therefore important. We test 4 hypotheses relevant to psychogenic explanations of the variable timing and distribution of health and noise complaints about wind farms in Australia. Setting All (n=51) Australian wind farms (with 1634 turbines) operating from 1993–2012 . Methods Records of complaints about noise or health obtained from wind farm companies regarding residents living near 51 Australian wind farms, expressed as proportions of estimated populations residing within 5km of wind farms, and corroborated with complaints in submissions to 3 government public enquiries and news media records and court affidavits . Results There are large spatio-temporal variations in wind farm noise and health complaints.33/51(64.7%) of Australian wind farms including 17/34(50%) with turbine size >1MW have never been subject to noise or health complaints. These 33 farms have some 21,592 residents within 5km of their turbines and have operated complaint-free for a cumulative total of 267 years. Western Australia and Tasmania Have seen no complaints. Only 131 individuals across Australia representing approximately 1 in 250 residents living within 5km of wind farms appear to have ever complained, with 94(72%) of these being residents near 6 wind farms which have been targeted by anti wind farm groups . About 1 in 87 (126/10901) of those living near turbines >1MW have ever complained. The large majority 104/131(79%) of health and noise complaints commenced after 2009 when anti wind farm groups began to add health concerns to their wider opposition. In the preceding years, health or noise complaints were rare despite large and small turbined wind farms having operated for many years. Conclusions In view of scientific consensus that the evidence for wind turbine noise and infrasound causing health problems is poor, the reported spatio-temporal variations in complaints are consistent with psychogenic hypotheses that health problems arising are “communicated diseases” with nocebo effects likely to play an important role in the aetiology of complaints

PinR mediates the generation of reversible population diversity in Streptococcus zooepidemicus

Opportunistic pathogens must adapt to and survive in a wide range of complex ecosystems. Streptococcus zooepidemicus is an opportunistic pathogen of horses and many other animals, including humans. The assembly of different surface architecture phenotypes from one genotype is likely to be crucial to the successful exploitation of such an opportunistic lifestyle. Construction of a series of mutants revealed that a serine recombinase, PinR, inverts 114 bp of the promoter of SZO_08560, which is bordered by GTAGACTTTA and TAAAGTCTAC inverted repeats. Inversion acts as a switch, controlling the transcription of this sortase-processed protein, which may enhance the attachment of S. zooepidemicus to equine trachea. The genome of a recently sequenced strain of S. zooepidemicus, 2329 (Sz2329), was found to contain a disruptive internal inversion of 7 kb of the FimIV pilus locus, which is bordered by TAGAAA and TTTCTA inverted repeats. This strain lacks pinR and this inversion may have become irreversible following the loss of this recombinase. Active inversion of FimIV was detected in three strains of S. zooepidemicus, 1770 (Sz1770), B260863 (SzB260863) and H050840501 (SzH050840501), all of which encoded pinR. A deletion mutant of Sz1770 that lacked pinR was no longer capable of inverting its internal region of FimIV. The data highlight redundancy in the PinR sequence recognition motif around a short TAGA consensus and suggest that PinR can reversibly influence the wider surface architecture of S. zooepidemicus, providing this organism with a bet-hedging solution to survival in fluctuating environments

Developing a Methodology for Designing Routine Information Systems Based on the Situational Theory of Action

Information systems are part of purposeful socio-technical systems and consequently theories of action may help in understanding them. Current systems analysis and design methodologies seem to have been influenced only by one particular theory of action, which asserts that action results from deliberation upon an abstract representation of the world. Many disciplines have discussed an alternative ‘situational’ theory of action. There is no design methodology that fully supports designing systems reflecting the situational theory of action. The aim of this paper is to describe the motivation for, and progress to date of research-in-progress developing a design methodology based on concepts from the situational theory of action. This methodology for designing situational information systems is being iteratively refined using a combination of case studies and action research. This project is significant because many information systems fail in pressured routine environments where we would argue that the situational theory of action provides a better description of purposeful activity

Promoting prompt help-seeking for symptoms – assessing the impact of a gynaecological cancer leaflet on presentations to primary care: a record-based randomised control trial

BACKGROUND: Information leaflets have been shown to significantly improve awareness of the symptoms of gynaecological cancers and to reduce perceived barriers to seeking medical help. This record-based, parallel, randomised control trial study aimed to assess whether receipt of a leaflet would change the behaviour of women experiencing symptoms indicative of gynaecological cancers by prompting them to visit their general practitioner (GP). METHODS: 15,538 women aged 40 years or over registered with five general practices in Northamptonshire, UK were randomised to two groups using the SystmOne randomise facility. Those in the intervention group received an educational leaflet from their general practice explaining the symptoms of gynaecological cancers and advising symptomatic women to visit their GP. The control group were not contacted. Electronic records were interrogated to extract sociodemographic data and details of GP consultations for symptoms, tests, referrals and diagnoses relating to gynaecological cancers in the 4-month period following the mail-out of the leaflets. RESULTS: 7739 records were extracted from the intervention group and 7799 from the control group. 231 (3.0%) of the women in the intervention group, and 207 (2.7%) of the controls, presented to their GP with a relevant symptom during the 4-month period following leaflet distribution. The slightly higher rate in the intervention group did not reach statistical significance at the 5% level (RR = 1.11; 95% CI 0.92-1.33; z = 1.08; p = 0.28). There was a significantly lower mean time to first presentation in the symptomatic intervention group (57.2 days, sd = 36.5) compared to the control group (65.2 days, sd = 35.0) (t = - 2.415; p = 0.016). Survival analysis did not reveal a difference between the patterns of presentation in the two cohorts (Log Rank (Mantel-Cox) χ 2 = 1.42; p = 0.23). CONCLUSION: There was no difference between intervention and control groups in the proportion of women presenting with symptoms identified in the leaflet in the four months following leaflet distribution, although the women who had been sent a leaflet presented earlier than those in the control group. A larger study is needed to test for a modest effect of leaflet distribution. TRIAL REGISTRATION: Listed on the ISRCTN registry with study ID ISRCTN61738692 on 23-8-2017 (retrospectively registered)

Twenty-year outcomes of a longitudinal prospective evaluation of isolated endoscopic anterior cruciate ligament reconstruction with patellar tendon autografts

Background: Long term prospective follow up studies of single-incision endoscopic anterior cruciate ligament reconstruction are limited and may include confounding factors. Objectives: This longitudinal prospective study reports the outcome of isolated anterior cruciate ligament (ACL) reconstruction using middle-third patellar tendon autograft in 90 patients over 20 years. Study design: Case series; Level of evidence, 4. Methods: Between January 1993 and April 1994, 90 patients met study inclusion criteria, evaluation 1,2,3,4,5,7,10,15 and 20 years post-surgery. Exclusion criteria: associated ligamentous injury requiring surgery, previous meniscectomy; meniscal injury meniscectomy more than 1/3; chondral injury; and an abnormal contralateral knee. Results: At 20 years, 32(36%) patients had sustained another ACL injury, 8(9%) to the index limb and 27(29%) to the contralateral limb (3 injuring both knees). Mean IKDC score was 86, 50% participated in strenuous/very strenuous activities, kneeling pain was present in 63%. Radiographic degenerative change was found in 61%, 20% IKDC Grade C, 0% Grade D. IKDC clinical examination revealed 95% had a normal/nearly normal knee. Significant gender differences existed: females were less likely to re-injure the reconstructed ACL (18%v2%, p=0.01), reported poorer IKDC subjective score (90v83, p=0.03), had more activity related pain (57%v20%, p=0.02), and less likely to participate in strenuous activity (35v66, p=0.01). ACL graft survival was not related to age. Patients \u3c18years old had an increased odd ratio (3.2) for rupturing the contralateral ACL. Coronal graft angles \u3c17 degrees had increased risk of failure compared to those over 17 degrees (96% v 77%), by a factor of 8.5. Conclusion: Injury commonly occurred in the contralateral ACL than the reconstructed ACL graft, the most significant predictor of contralateral ACL injury is age under 18yrs. The most significant predictor of ACL graft rupture is a coronal graft angle of less than 17 degrees. Females had lower re- rupture rates, poorer subjective scores, decreased participation in strenuous activity, putting the graft at less risk of failure. Kneeling pain remained persistent over 20 years. Radiographic osteoarthritis was evident in 61% of subjects but symptomatic osteoarthritic symptoms were rarely reported

Ovarian cancer symptom awareness and anticipated time to help-seeking for symptoms among UK women.

OBJECTIVES: To determine levels of awareness of ovarian cancer symptoms and to identify barriers to help-seeking and predictors of a longer time to help-seeking in a UK female population-based sample. METHODS: A UK population-based sample of women [n=1000, including a subsample of women at higher risk due to their age (≥45 years, n=510)] completed the Ovarian Cancer Awareness Measure by telephone interview. Questions measured symptom awareness (using recall and recognition), barriers to medical help-seeking and anticipated time to help-seeking. Regression analyses identified predictors of a higher score on a scale of anticipated time to help-seeking. RESULTS: Most women (58% overall sample; 54% subgroup) were unable to recall any symptoms but 99% recognised at least one. Recognition was lowest for difficulty eating and persistently feeling full. In the sample overall, higher socio-economic status and higher endorsement of practical and service barriers independently predicted a longer anticipated time to help-seeking for more symptoms. White ethnicity was an additional predictor in the older subgroup. CONCLUSIONS: This study suggests awareness of ovarian cancer symptoms is low in the UK, and varies widely between symptoms. It identifies variables that may be involved in a longer time to help-seeking for possible ovarian cancer symptoms and highlights the need for more in-depth research into the factors related to time to help-seeking in real-world situations