Using personal response systems for induction

In the autumn term of 2006 the business and economics subject team at Warwick University decided to try a slightly different approach to library induction for undergraduates. We wanted to keep our sessions brief, fi rmly believing that not much is retained by students from induction sessions, and we wanted a session that would not just be a brief introduction to services. Drawing on a colleague’s experience we decided to focus on one specifi c problem we know students face early on in their course, namely understanding what they are looking for when they see references on a reading list. This had worked in a presentation format with quite large groups and included an element of interactivity. Having seen the Personal Response System (PRS) technology showcased on Warwick’s e-learning website, we felt this might enhance the interactive element so arranged for a demonstration of the system in the library. PRS is used extensively by the medical school within lectures and is used to great success in revision sessions, especially when used in a competitive team environment

Helping students to 'study happy'

Earlier this year, CILIP Update ran a news story about a series of Carnegie UK Trust databases outlining how libraries support their local communities as a social hub, learning hub, economic enabler and cultural centre.1 The databases and their attendant publications highlight how ‘public libraries are safe spaces at the heart of our communities, providing completely free access to huge resources of information, knowledge and technology. They have dedicated staff and are well linked with other local services’.2. They detail how libraries tackle isolation and foster inclusion, provide an arena for creativity and cultural events, and can support both traditional and digital skills development. All of this is dynamic, and as the trust points out ‘to respond to the changing needs of the 21st century, libraries are changing and must continue to change. Libraries must be brave, innovative and show how they are doing things which really make a difference to their community’

Women choosing silence: transformational practices and relational perspectives

This thesis explores chosen practices of silence in contemporary Christian women’s lives, insubstantially addressed within the literature of feminist and practical theologians. A survey of their discourse, which predominantly addresses the imposed silencing of women and the attendant quest for authentic voice to name their experiences, is supplemented by interdisciplinary exploration of silence within wider theologies, Quaker Studies, linguistics, and the talking and arts therapies. Employing feminist research methodologies, this qualitative study utilises descriptively rich material from semi-structured interviews to consider the function of silence within research interviews, to identify and map women’s engagement within a spectrum of practices of silence, to explore their role in the women’s spiritual journeys, and to highlight difficulties reported in sustaining this discipline. Data analysis shows that although frequently associated with solitude, practices of silence are valued as transformational in the women’s relationships with God, self, and others. A metaphor of a web is proposed to represent the process of relational change, and silence’s potential in developing relationally responsible communities is advocated. Explanations for feminist theologians’ neglect of chosen silence are derived from the analysis, and this discipline is invited to re-engage with silence as a resource for discovering authentic identity beyond egoic selfhood

School quality ratings are weak predictors of students’ achievement and well‐being

Background: In England, all state-funded schools are inspected by an independent government agency, the Office for Standards in Education (Ofsted). Inspections aim to hold schools accountable and to promote the improvement of education, with the results made available to the public. Ofsted reports intend to index school quality but their influence on students’ individual outcomes has not been previously studied. The aim of the current study was to explore the extent to which school quality, as indexed by Ofsted ratings, is associated with students’ educational achievement, wellbeing, and school engagement. Methods: We use an England population-based sample of 4,391 individuals, for whom school performance at age 11 and GCSE grades at age 16 were accessed from the National Pupil Database, and who completed measures of wellbeing and school engagement at age 16. Results: We found that Ofsted ratings of secondary school quality accounted for 4% of the variance in students' educational achievement at age 16, which was further reduced to 1% of the variance after we accounted for prior school performance at age 11 and family socioeconomic status. Furthermore, Ofsted ratings were poor predictors of school engagement and student wellbeing, with an average correlation of .03. Conclusion: Our findings suggest that differences in school quality, as indexed by Ofsted ratings, have little relation with students’ individual outcomes. Accordingly, our results challenge the usefulness of Ofsted ratings as guides for parents and students when choosing secondary schools

The Growth Hormone Deficiency (GHD) Reversal Trial: effect on final height of discontinuation versus continuation of growth hormone treatment in pubertal children with isolated GHD—a non-inferiority Randomised Controlled Trial (RCT)

Background: Growth hormone deficiency (GHD) is the commonest endocrine cause of short stature and may occur in isolation (I-GHD) or combined with other pituitary hormone deficiencies. Around 500 children are diagnosed with GHD every year in the UK, of whom 75% have I-GHD. Growth hormone (GH) therapy improves growth in children with GHD, with the goal of achieving a normal final height (FH). GH therapy is given as daily injections until adult FH is reached. However, in many children with I-GHD their condition reverses, with a normal peak GH detected in 64–82% when re-tested at FH. Therefore, at some point between diagnosis and FH, I-GHD must have reversed, possibly due to increase in sex hormones during puberty. Despite increasing evidence for frequent I-GHD reversal, daily GH injections are traditionally continued until FH is achieved. // Methods/design: Evidence suggests that I-GHD children who re-test normal in early puberty reach a FH comparable to that of children without GHD. The GHD Reversal study will include 138 children from routine endocrine clinics in twelve UK and five Austrian centres with I-GHD (original peak GH < 6.7 mcg/L) whose deficiency has reversed on early re-testing. Children will be randomised to either continue or discontinue GH therapy. This phase III, international, multicentre, open-label, randomised controlled, non-inferiority trial (including an internal pilot study) will assess whether children with early I-GHD reversal who stop GH therapy achieve non-inferior near FH SDS (primary outcome; inferiority margin 0.55 SD), target height (TH) minus near FH, HRQoL, bone health index and lipid profiles (secondary outcomes) than those continuing GH. In addition, the study will assess cost-effectiveness of GH discontinuation in the early retesting scenario. // Discussion: If this study shows that a significant proportion of children with presumed I-GHD reversal generate enough GH naturally in puberty to achieve a near FH within the target range, then this new care pathway would rapidly improve national/international practice. An assumed 50% reversal rate would provide potential UK health service cost savings of £1.8–4.6 million (€2.05–5.24 million)/year in drug costs alone. This new care pathway would also prevent children from having unnecessary daily GH injections and consequent exposure to potential adverse effects. // Trial registration: EudraCT number: 2020-001006-3

Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson’s disease: preliminary cost-consequence analysis of the PD COMM pilot randomised controlled trial

Additional file 1: Table S1. Speech and language therapy (SLT) set-up costs. Table S2. Derivation of unit costs: sources and assumptions. Table S3. Resource use per patient over 12 months (NHS and social care funded). Table S4. Mean medication costs by drug type over 12 months, per patient (2014/15 costs). Table S5. Resource use per patient over 12 months (privately funded). Table S6. Patient funded care costs and out of pocket expenses over 12 months, per patient. Table S7. Convergence between index scores of EQ-5D-3L and ICECAP-O dimensions (Spearman’s rank correlation). Table S8. Convergence between index scores of PDQ39 dimensions and ICECAP-O responses (Spearman’s rank correlation). Table S9. Convergence between index scores of PDQ39 dimensions and EQ-5D-3L responses (Spearman’s rank correlation

Bilateral Remote Ischaemic Conditioning in Children (BRICC) trial:protocol for a two-centre, double-blind, randomised controlled trial in young children undergoing cardiac surgery

IntroductionMyocardial protection against ischaemic-reperfusion injury is a key determinant of heart function and outcome following cardiac surgery in children. However, with current strategies, myocardial injury occurs routinely following aortic cross-clamping, as demonstrated by the ubiquitous rise in circulating troponin. Remote ischaemic preconditioning, the application of brief, non-lethal cycles of ischaemia and reperfusion to a distant organ or tissue, is a simple, low-risk and readily available technique which may improve myocardial protection. The Bilateral Remote Ischaemic Conditioning in Children (BRICC) trial will assess whether remote ischaemic preconditioning, applied to both lower limbs immediately prior to surgery, reduces myocardial injury in cyanotic and acyanotic young children.Methods and analysisThe BRICC trial is a two-centre, double-blind, randomised controlled trial recruiting up to 120 young children (age 3 months to 3 years) undergoing primary repair of tetralogy of Fallot or surgical closure of an isolated ventricular septal defect. Participants will be randomised in a 1:1 ratio to either bilateral remote ischaemic preconditioning (3×5 min cycles) or sham immediately prior to surgery, with follow-up until discharge from hospital or 30 days, whichever is sooner. The primary outcome is reduction in area under the time-concentration curve for high-sensitivity (hs) troponin-T release in the first 24 hours after aortic cross-clamp release. Secondary outcome measures include peak hs-troponin-T, vasoactive inotrope score, arterial lactate and central venous oxygen saturations in the first 12 hours, and lengths of stay in the paediatric intensive care unit and the hospital.Ethics and disseminationThe trial was approved by the West Midlands-Solihull National Health Service Research Ethics Committee (16/WM/0309) on 5 August 2016. Findings will be disseminated to the academic community through peer-reviewed publications and presentation at national and international meetings. Parents will be informed of the results through a newsletter in conjunction with a local charity.Trial registration numberISRCTN12923441

A network analysis to identify pathophysiological pathways distinguishing ischaemic from non-ischaemic heart failure

Aims Heart failure (HF) is frequently caused by an ischaemic event (e.g. myocardial infarction) but might also be caused by a primary disease of the myocardium (cardiomyopathy). In order to identify targeted therapies specific for either ischaemic or non‐ischaemic HF, it is important to better understand differences in underlying molecular mechanisms. Methods and results We performed a biological physical protein–protein interaction network analysis to identify pathophysiological pathways distinguishing ischaemic from non‐ischaemic HF. First, differentially expressed plasma protein biomarkers were identified in 1160 patients enrolled in the BIOSTAT‐CHF study, 715 of whom had ischaemic HF and 445 had non‐ischaemic HF. Second, we constructed an enriched physical protein–protein interaction network, followed by a pathway over‐representation analysis. Finally, we identified key network proteins. Data were validated in an independent HF cohort comprised of 765 ischaemic and 100 non‐ischaemic HF patients. We found 21/92 proteins to be up‐regulated and 2/92 down‐regulated in ischaemic relative to non‐ischaemic HF patients. An enriched network of 18 proteins that were specific for ischaemic heart disease yielded six pathways, which are related to inflammation, endothelial dysfunction superoxide production, coagulation, and atherosclerosis. We identified five key network proteins: acid phosphatase 5, epidermal growth factor receptor, insulin‐like growth factor binding protein‐1, plasminogen activator urokinase receptor, and secreted phosphoprotein 1. Similar results were observed in the independent validation cohort. Conclusions Pathophysiological pathways distinguishing patients with ischaemic HF from those with non‐ischaemic HF were related to inflammation, endothelial dysfunction superoxide production, coagulation, and atherosclerosis. The five key pathway proteins identified are potential treatment targets specifically for patients with ischaemic HF

Headache determines quality of life in idiopathic intracranial hypertension

BACKGROUND: The effect of idiopathic intracranial hypertension (IIH) on quality of life (QOL) is poorly understood. Our objectives were to compare QOL in IIH to the normal UK population; to investigate QOL changes with treatment of IIH, using a weight loss intervention, and to determine which clinical factors influence QOL. METHODS: This was a prospective cohort evaluation of QOL, using the 36-Item Short Form (SF-36) Health Survey questionnaire, before and after a therapeutic dietary intervention which resulted in significant reduction in body mass index (BMI), intracranial pressure (ICP), papilloedema, visual acuity, perimetric mean deviation (Humphrey 24–2) and headache (six-item headache impact test (HIT-6) and headache diary). Baseline QOL was compared to an age and gender matched population. The relationship between each clinical outcome and change in QOL was evaluated. RESULTS: At baseline, QOL was significantly lower in IIH compared to an age and gender matched population in most domains, p < 0.001. Therapeutic weight loss led to a significant improvement in 10 out of 11 QOL domains in conjunction with the previously published data demonstrating significant improvement in papilloedema, visual acuity, perimetry and headache (p < 0.001) and large effect size. Despite significant improvement in clinical measures only headache correlated significantly (p < 0.001) with improving QOL domains. CONCLUSIONS: QOL in IIH patients is significantly reduced. It improved with weight loss alongside significant improvement in clinical measures and headache. However, headache was the only clinical outcome that correlated with enhanced QOL. Effective headache management is required to improve QOL in IIH. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s10194-015-0521-9) contains supplementary material, which is available to authorized users