Audit of walk-in access for members of the public to online resources at higher education and further education libraries in the South West of England

This SWRLS-funded project aims to analyse and evaluate the extent to which Higher Education (HE) and Further Education (FE) libraries across the South West region of the United Kingdom provide walk-in access to electronic resources.The information presented within this report is derived from the findings of a survey questionnaire of librarians from across the South West region. Findings of the survey reveal that in the majority of the six institutions that provide walk-in access, the service is not actively promoted. Potential audiences are not actively identified. Information about walk-in services and which resources are available to use within HE or FE in the region is currently hard to discover. There does appear to be some desire to provide walk-in access but the report identifies IT difficulties and legal issues over licences as particular barriers to implementation

Trait-Level Resilience in Pet Dogs—Development of the Lincoln Canine Adaptability Resilience Scale (L-CARS)

The concept of psychological resilience is well-explored in the human literature and is often described as the ability to ‘bounce back’ following adversity. However, it remains a neglected research area in dogs despite observations that like humans, dogs vary in their ability to cope with stress. This study aimed to develop the first canine ‘resilience’ scale. An on-line survey was developed for owners. This covered demographics, medical/behavioural history of the dog, and 19 potential resilience items assessed using a 5-point Likert scale; 1084 complete responses were received during the survey period, with 329 respondents subsequently completing the questionnaire a second time, 6–8 weeks later. Intra-rater reliability was assessed, and only reliable items retained. A principal component analysis (PCA) with varimax rotation was then performed with components extracted on the basis of the inspection of scree plots and the Kaiser criterion. Items were retained if they loaded >0.4 onto one of the components but removed if they cross-loaded onto more than one component. This resulted in a 14-item, 2-component solution. One component appeared to describe “Adaptability/behavioural flexibility” and the other “Perseverance”, which are described in the human literature on resilience. Predictive validity was established for expected correlates, such as problem behaviour. The resulting instrument was called the Lincoln Canine Adaptability and Resilience Scale (L-CARS) and is the first to be developed for the assessment of resilience in dogs

The Future of Cancer and Collective Intelligence in the Post-Covid World

The Future of Cancer and Collective Intelligence in the Post-Covid World project was jointly conceived by the Innovation School at Glasgow School of Art and the Institute of Cancer Sciences at the University of Glasgow. Graduating year Product Design students from the Innovation School were presented with a challenge-based project to produce a vision of the future based on current trends that relate to the Future of Cancer and Collective Intelligence in the Post-Covid World. Currently, cancer research and development occur in isolated pockets within stages across the cancer care continuum, which often negatively impacts on the potential for cancer professionals to exchange, integrate and share data, insights and knowledge across the framework. One of the most significant societal shifts currently taking place within Cancer and Collective Intelligence is the transformation from the siloed clinic point of care model to a seamless continuum of care with greater focus on prevention and early intervention, changing what it means to be someone living with cancer and a professional working within this context. From this new dynamic, emerges the concept of living-labs; transdisciplinary communities of practice involving people working within and living with cancer, capable, through collective intelligence-enabled systems and services, of generating knowledge which can be used locally, and shared globally, to deliver focused innovations across the whole cancer ecosystem. If collective intelligence holds the potential to truly connect people to people, and people to data, across diverse communities, linking peoples’ lived experiences locally and globally, what kinds of new health and care services might emerge to improve cancer control across the continuum from prevention, detection, treatment and survivorship, and what types of new roles might emerge for citizens, patients and community groups to collaboratively drive these forward with health professionals? In order to address this challenge, the GSA Innovation School’s final year Product Design students and faculty formed a dynamic community of practice with cancer practitioners and researchers from the Institute of Cancer Sciences at The University of Glasgow and beyond to envisage a 2030 cancer blueprint as a series of future world exhibits, and create the designed products, services and experiences for the people who might live and work within this ecosystem. This project involved the students working in partnership with an Expert Faculty composed of Cancer Physicians, Cancer Researchers, Social Scientists, Biomedical Engineers, Health Research Specialists, Past Patients, Digital Health Specialists, Design Experts and Government Agencies. The Expert Faculty was assembled from a range of local to global organisations including the University of Glasgow, the Beatson West of Scotland Cancer Centre, the Malawi Ministry of Health and the International Agency for Research on Cancer (IARC is part of the World Health Organization). This project asked the students to embark on a speculative design exploration into future experiences of working and living with cancer ten years from now, where advances in collective intelligence have evolved to the extent that new forms and ecosystems of medical practice, cancer care and experiences of living with, through and beyond cancer transform how we interact with each other, with health professionals and the communities around us. This project was conceived and carried out during the global COVID-19 pandemic. Throughout the project the students positively used this situation to creatively embrace a digital studio practice and innovate around digital and remote access platforms and forums for collaboration, development and engagement. Thus, the designed products, services and experiences for the people who might live and work within the cancer ecosystem are presented as innovative, highly creative, fully immersive, experiential exhibits. The project was divided into two sections: The first was a collaborative stage based on Future Worlds. The worlds are groups of students working together on specific topics, to establish the context for their project and collaborate on research and development. These were clustered together around ‘Future Working’ and ‘Future Living’ but also joined up across these groups to create pairs of worlds, and in the process generate collective intelligence between the groups. The worlds clustered around ‘Future Working’ are Education, Care and Treatment, Prevention and Detection. Future Worlds clustered around ‘Future Living’ are Personal Wellbeing, Communicating Cancer, Beyond Cancer. The second stage saw students explore their individual response to their assigned Future World that had been created in the first stage. Each student developed their own research by iteratively creating a design outcome that was appropriate to the Future cancer World. This culminated in each student producing designed products, services or systems and a communication of the future experiences created. Throughout the project, the results were presented as a series live interactive digitally curated, virtual work-in-progress exhibitions for specific audiences including a special global event to participate in World Cancer Day on the 4th February 2021. An event which allowed the students to actively interact and discuss the project with a global audience of cancer community leaders. The deposited materials are arranged as follows: 1. Readme files - two readme files relate to tage one and stage two of the project as outlined above. 2. Project overview document - gives a visual overview of the structure and timeline of the project. 3. Stage one data folders - the data folders for stage one of the project are named by the six Future Worlds through which each group explored possible futures. 4. Stage two data folders - the data folders for stage two of the project are named for the individual students who conducted the work and organised by the Future World cluster they worked within

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research