Beyond prospective accountancy : reassessing the case for British membership of the single European currency comparatively

The fact that Britain will, at most, be a late signatory to the single European currency means that the strategic deliberations it faces in deciding whether to enter EMU are rather different to those of earlier entrants. However, this crucial point is lost in almost all discussion of the subject. To date, the academic debate has been dominated by what we term 'prospective accountancy', in which a series of abstract counterfactuals ostensibly inform a stylised cost–benefit analysis. This article moves beyond such an approach by combining conjectures about the specificities of the British case with a concrete analysis of the experiences of the Eurozone member whose economy appears most closely to resemble Britain's: namely, Ireland. The comparative dimension of our work facilitates more empirically-based analysis of the merits and demerits of British entry into EMU. Yet, it is important not to lose sight of the limits of an exclusively comparative approach, for the British growth model is qualitatively different to that of other European Union economies. British growth since the early 1990s has been consumption led, and this in turn has been fuelled to a considerable degree by the release of equity from the housing market. The likely impact of EMU on the British economy will be determined to a significant extent, then, by its effect upon this key catalyst of British growth. Sadly, no retrospective comparison can inform such an assessment

Digital Literary Mapping: I. Visualizing and Reading Graph Topologies as Maps for Literature

This paper is the first of two linked pieces that emerge out of the AHRC-funded Chronotopic Cartographies project for the mapping of place and space in literature. The paper aims to establish the value of a topological approach for the mapping of literary texts. It is centred on Bakhtin’s concept of the “chronotope” or “time-space” as the basis for digitally mapping spatial meaning in literary works. It begins by contextualizing our work in relation to the field of literary geography and cartography. It then makes a clear distinction between mapping to the real world using GIS (as is common in fields such as history or geography) and mapping relatively, using topologies, which we argue is essential for the mapping of fictional place and space. The current digital models that are closest to this project concern social network analysis and its adaptation to the mapping of character networks in literary texts. After contextualizing our work in relation to this research, we aim to provide a rationale for the use of topological models in literary mapping. A range of topological forms and their meaning for literature is examined with reference to particular examples from the Chronotopic Cartographies project

Digital Literary Mapping: II. Towards an Integrated Visual–Verbal Method for the Humanities

This is the second of two linked articles that aim to present new ways of mapping literature by means of digital tools for the twenty-first century. The preceding article articulated the need to move beyond the mapping of literary texts onto geographic sites in the world and into the mapping of space relationally in nonreferential ways by means of literary topology. This second article seeks to make a larger case for new ways of working in the digital humanities and suggests that new methods of analysis and new tools are needed. It articulates an integrated visual–verbal method of interpretation that combines the close reading of spatial meanings and structures within a text with analysis of the map series generated out of that same text in an iterative structure. It also argues for the value of layers of mapping and of comparative mapping of the same place both referentially and nonreferentially. The literary texts chosen to exemplify the method are Mary Shelley’s Frankenstein and Lewis Carroll’s Through the Looking-Glass and What Alice Found There. These allow us to explore the validity of the claims made

Artificial Intelligence and Authorship Editor Policy: ChatGPT, Bard Bing AI, and beyond

Artificial intelligence and large-language model chatbots have generated significant attention in higher education, and in research practice. Whether ChatGPT, Bard, Jasper Chat, Socratic, Bing AI, DialoGPT, or something else, these are all shaping how education and research occur. In this Editorial, we offer five editorial principles to guide decision-making for editors, which will also become policy for the Journal of University Teaching and Learning Practice. First, we articulate that non-human authorship does not constitute authorship. Second, artificial intelligence should be leveraged to support authors. Third, artificial intelligence can offer useful feedback and pre-review. Fourth, transparency of artificial intelligence usage is an expectation. And fifth, the use of AI in research design, conduct, and dissemination must comply with established ethical principles. In these five principles, we articulate a position of optimism for the new forms of knowledge and research we might garner. We see AI as a mechanism that may augment our current practices but will not likely replace all of them. However, we do issue caution to the limitations of large language models including possible proliferation of poor-quality research, Stochastic Parroting, and data hallucinations. As with all research, authors should be comfortably familiar with the underlying methods being used to generate data and should ensure a clear understanding of the AI tools being used prior to deployment for research

Effectiveness and cost-effectiveness of basic versus biofeedback-mediated intensive pelvic floor muscle training for female stress or mixed urinary incontinence: protocol for the OPAL randomised trial

This is the final version. Available on open access from BMJ Publishing Group via the DOI in this recordIntroduction Accidental urine leakage is a distressing problem that affects around one in three women. The main types of urinary incontinence (UI) are stress, urgency and mixed, with stress being most common. Current UK guidelines recommend that women with UI are offered at least 3 months of pelvic floor muscle training (PFMT). There is evidence that PFMT is effective in treating UI, however it is not clear how intensively women have to exercise to give the maximum sustained improvement in symptoms, and how we enable women to achieve this. Biofeedback is an adjunct to PFMT that may help women exercise more intensively for longer, and thus may improve continence outcomes when compared with PFMT alone. A Cochrane review was inconclusive about the benefit of biofeedback, indicating the need for further evidence. Methods and analysis This multicentre randomised controlled trial will compare the effectiveness and cost-effectiveness of PFMT versus biofeedback-mediated PFMT for women with stress UI or mixed UI. The primary outcome is UI severity at 24 months after randomisation. The primary economic outcome measure is incremental cost per quality-adjusted life-year at 24 months. Six hundred women from UK community, outpatient and primary care settings will be randomised and followed up via questionnaires, diaries and pelvic floor assessment. All participants are offered six PFMT appointments over 16 weeks. The use of clinic and home biofeedback is added to PFMT for participants in the biofeedback group. Group allocation could not be masked from participants and healthcare staff. An intention-to-treat analysis of the primary outcome will estimate the mean difference between the trial groups at 24 months using a general linear mixed model adjusting for minimisation covariates and other important prognostic covariates, including the baseline score. Ethics and dissemination Approval granted by the West of Scotland Research Ethics Committee 4 (16/LO/0990). Written informed consent will be obtained from participants by the local research team. Serious adverse events will be reported to the data monitoring and ethics committee, the ethics committee and trial centres as required. A Standard Protocol Items: Recommendations for Interventional Trials checklist and figure are available for this protocol. The results will be published in international journals and included in the relevant Cochrane review. Trial registration number ISRCTN57746448; Pre-results.National Institute for Health Research (NIHR

The community paediatric respiratory infection surveillance study protocol:a feasibility, prospective inception cohort study

INTRODUCTION: Paediatric respiratory tract infections (RTIs) are common reasons for primary care consultations and antibiotic prescribing. Locally relevant syndromic and microbiological surveillance information has the potential to improve the care of children with RTIs by normalising illness (parents) and reducing uncertainty (clinicians). Currently, most RTI studies are conducted at the point of healthcare service consultation, leaving the community burden, microbiology, symptom duration and proportion consulting largely unknown. This study seeks to establish the feasibility of (mainly online) participant recruitment and retention, and the acceptability/comparability of parent versus nurse-collected microbiological sampling, to inform the design of a future surveillance intervention study. Evidence regarding consultation rates and symptom duration is also sought. METHODS AND ANALYSIS: A community-based, feasibility prospective inception cohort study, recruiting children aged ≥3 months and <16 years and their parents via general practitioner surgery invitation letter, aiming to collect data on 300 incident RTIs by July 2016. Following informed consent, parents provide baseline (demographic) data online, and respond to weekly emails to confirm the absence/presence of new RTI symptoms. Once symptomatic, parents provide daily data online (RTI symptoms, school/day-care attendance, time off work, health service use, medication), and a research nurse visits to collect clinical examination data and microbiological (nasal and saliva) swabs. Parents are invited to provide symptomatic (at nurse visit, but without nurse assistance) and asymptomatic (alone) swabs on recovery. A review of primary care medical notes will gather medical history, health service utilisation, referral and antibiotic prescribing rates. Feasibility will be assessed using recruitment and retention rates, data completeness; and acceptability by quantitative survey and qualitative interviews. Symptomatic parent and nurse swab pairs will be compared for microbe isolation

Treatment compliance and effectiveness of a cognitive behavioural intervention for low back pain : a complier average causal effect approach to the BeST data set

Background: Group cognitive behavioural intervention (CBI) is effective in reducing low-back pain and disability in comparison to advice in primary care. The aim of this analysis was to investigate the impact of compliance on estimates of treatment effect and to identify factors associated with compliance. Methods: In this multicentre trial, 701 adults with troublesome sub-acute or chronic low-back pain were recruited from 56 general practices. Participants were randomised to advice (control n = 233) or advice plus CBI (n = 468). Compliance was specified a priori as attending a minimum of three group sessions and the individual assessment. We estimated the complier average causal effect (CACE) of treatment. Results: Comparison of the CACE estimate of the mean treatment difference to the intention-to-treat (ITT) estimate at 12 months showed a greater benefit of CBI amongst participants compliant with treatment on the Roland Morris Questionnaire (CACE: 1.6 points, 95% CI 0.51 to 2.74; ITT: 1.3 points, 95% CI 0.55 to 2.07), the Modified Von Korff disability score (CACE: 12.1 points, 95% CI 6.07 to 18.17; ITT: 8.6 points, 95% CI 4.58 to 12.64) and the Modified von Korff pain score (CACE: 10.4 points, 95% CI 4.64 to 16.10; ITT: 7.0 points, 95% CI 3.26 to 10.74). People who were non-compliant were younger and had higher pain scores at randomisation. Conclusions: Treatment compliance is important in the effectiveness of group CBI. Younger people and those with more pain are at greater risk of non-compliance

'PhysioDirect' telephone assessment and advice services for physiotherapy: protocol for a pragmatic randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Providing timely access to physiotherapy has long been a problem for the National Health Service in the United Kingdom. In an attempt to improve access some physiotherapy services have introduced a new treatment pathway known as PhysioDirect. Physiotherapists offer initial assessment and advice by telephone, supported by computerised algorithms, and patients are sent written self-management and exercise advice by post. They are invited for face-to-face treatment only when necessary. Although several such services have been developed, there is no robust evidence regarding clinical and cost-effectiveness, nor the acceptability of PhysioDirect.</p> <p>Methods/Design</p> <p>This protocol describes a multi-centre pragmatic individually randomised trial, with nested qualitative research. The aim is to determine the effectiveness, cost-effectiveness, and acceptability of PhysioDirect compared with usual models of physiotherapy based on patients going onto a waiting list and receiving face-to-face care. PhysioDirect services will be established in four areas in England. Adult patients in these areas with musculoskeletal problems who refer themselves or are referred by a primary care practitioner for physiotherapy will be invited to participate in the trial. About 1875 consenting patients will be randomised in a 2:1 ratio to PhysioDirect or usual care. Data about outcome measures will be collected at baseline and 6 weeks and 6 months after randomisation. The primary outcome is clinical improvement at 6 months; secondary outcomes include cost, waiting times, time lost from work and usual activities, patient satisfaction and preference. The impact of PhysioDirect on patients in different age-groups and with different conditions will also be examined.</p> <p>Incremental cost-effectiveness will be assessed in terms of quality adjusted life years in relation to cost.</p> <p>Qualitative methods will be used to explore factors associated with the success or failure of the service, the acceptability of PhysioDirect to patients and staff, and ways in which the service could be improved.</p> <p>Discussion</p> <p>It is still relatively unusual to evaluate new forms of service delivery using randomised controlled trials. By combining rigorous trial methods with economic analysis of cost-effectiveness and qualitative research this study will provide robust evidence to inform decisions about the widespread introduction of PhysioDirect services.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN55666618</p