The Comparative Effectiveness of Sub-Acromial Corticosteroid Injection and Physiotherapy for Musculoskeletal Shoulder Pain: A Systematic Review

Background Shoulder pain is a common presentation in primary care with an estimated UK prevalence of anywhere between 6.9% and 20%. There is currently a lack of evidence about the efficacy of the most commonly used interventions in treating shoulder pain such as Corticosteroid injection and Physiotherapy. It has also been seen that the tests used to diagnose shoulder pain is a failed paradigm and that patients should be sub-grouped based on a pragmatic design and by easily identifiable symptoms rather than given specific labels which does not aid in the treatment process. Objective To compare the efficacy of Sub-Acromial Corticosteroid injections and Physiotherapy modalities as treatments for musculoskeletal shoulder pain in the short, medium, and long term. Outcome measures The primary outcome measure was shoulder functional disability as measured by a patient reported outcome tool. The secondary outcome measure was pain intensity as measured by a visual analogue scale. Results Both interventions produced significant improvements over baseline at all time points for both outcome measures. There was some evidence that there was a trend towards exercise based Physiotherapy interventions for the primary outcome measure in the short and medium term. However, this trend seemed to disappear at long term follow-up. There was also some low quality evidence to support the use of Corticosteroid injection in the early phases of treatment for the secondary outcome measure and Physiotherapy for the medium to long term follow-up. Conclusion Both Sub-Acromial Corticosteroid injection and Physiotherapy significantly improves function and decreases pain in subjects with shoulder pain, but methodological shortcomings meant no firm conclusions could be made to establish if one treatment was significantly superior to the other. The effectiveness of Sub-Acromial Corticosteroid injection was similar to that of Physiotherapy interventions in subjects with shoulder pain

Improved Cauchy radius for scalar and matrix polynomials

We improve the Cauchy radius of both scalar and matrix polynomials, which is an upper bound on the moduli of the zeros and eigenvalues, respectively, by using appropriate polynomial multipliers.Comment: 12 page

Impact of primary health care providers’ initial role security and therapeutic commitment on implementing brief interventions in managing risky alcohol consumption: a cluster randomised factorial trial

Background: Brief interventions in primary healthcare to detect and intervene in risky alcohol consumption are cost-effective in reducing drinking problems, but poorly implemented in routine care. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation.Methods: In a cluster randomised factorial trial 120 Primary Healthcare Units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design. Results: Data from 746 providers of 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore there were no significant interactions between these characteristics and allocated groups. Conclusions: The extent to which providers’ managed to change their brief intervention proportions when submitted to different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research more attention is needed for the causal relation between these parameters, as it can inform us whether to focus on these or not in implementation trajectories

The Higher Skills Agenda

We investigate some of the ways in which higher education institutions can, and do, provide effective research and skills development for postgraduate and other novice researchers, students and staff, and also new supervisors. This workshop offers an overview of the skills and competencies that are recognised, in the context of challenges to the skills agenda in higher education. It discusses the notion for an appropriate balance between formal and informal means of developing transferable skills and the need to embed skills development into developmental programmes of all sorts. Participants will consider the relevance of learning needs analysis and personal development profiling for researchers and the place of assessment in development provision, informed by a CETL funded project investigating this theme. Participants should be happy to contribute in such a way which, after anonymisation, informs the ongoing project

Supplementary material from "Modelling pyruvate dehydrogenase under hypoxia and its role in cancer metabolism"

Metabolism is the only biological system that can be fully modelled at genome scale. As a result, metabolic models have been increasingly used to study the molecular mechanisms of various diseases. Hypoxia, a low-oxygen tension, is a well-known characteristic of many cancer cells. Pyruvate dehydrogenase controls the flux of metabolites between glycolysis and the tricarboxylic acid cycle and is a key enzyme in metabolic reprogramming in cancer metabolism. Here, we develop and manually curate a constraint-based metabolic model to investigate the mechanism of pyruvate dehydrogenase under hypoxia. Our results characterize the activity of pyruvate dehydrogenase and its decline during hypoxia. This results in lactate accumulation, consistent with recent hypoxia studies and a well-known feature in cancer metabolism. We apply machine-learning techniques on the flux datasets to identify reactions that drive variations. We also identify distinct features on the structure of the variable and individual components. Our results provide a framework for future studies by integrating multi-omics data to predict condition-specific metabolic phenotypes under hypoxia

Quick Guides to Learning and Teaching: Assessing Groupwork

A staff guide exploring key principles and practical issues concerning the 'what?', 'Why?' and 'How?' of summatively assessing group work. Working and being assessed as part of a team is a reality in the world of work and therefore a key graduate skill that arguably should be embedded in the learning experience. However, whilst very appropriate, assessing group work can also pose significant challenges. This guide offers a range of ideas and additional resources of particular relevance to staff new to this aspect of summative assessment.

Introduction to Designing Distance Learning

This resource is in 2 parts: a workbook and a draft module (10credits at M level)specification document (workbook Appendix A). It has been designed to enable HE staff to develop critical understanding of, and some practical skills in, planning and designing programmes that support learning at a distance.The workbook can be used by individuals or groups and successful completion should result in a draft distance learning module that may be put forward locally for formal validation.The workbook has been designed to enable the widest possible range of people to discover and engage with principles of effective design of distance programmes of learning, and also to reflect on, plan and start designing such learning opportunities. Appendix A may be used to form part of a professional development framework. Learning from engagement with this resource could support demonstration of UKPSF (2011)A1,4,5;CK1-4,6; PV:1-3. It can also be used in conjunction with the Staff Guide to Distance Learning found at: http://dspace.jorum.ac.uk/xmlui/handle/123456789/17504

Model

Metabolic model in SBML forma

Source code from Modelling pyruvate dehydrogenase under hypoxia and its role in cancer metabolism

Matlab script to generate the metabolic prediction

Quick Guides to Learning and Teaching: Programme Leadership

Practical guidance for staff new to the role of Programme Leader (includes Course, Pathway and Route Leader). Tips are included on initial priorities when taking up this role, as well as on how to lead and inspire others by working most effectively in partnership with your programme team and students. The guide also includes information on key contacts and additional resources.