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Much of the research in higher education has treated student bodies as homogeneous groups with a consequent neglect of any consideration of gender differences. To test the validity of such research a questionnaire was administered to 255 psychology students. The results showed some important differences in responses between the genders. In particular, the female students reported attaching more importance than males to pre-course aims, rated various learning activities as more valuable and interesting than males and reported more improvement in nine of the 12 skills surveyed than the males. The males rated experiencing less difficulty for various aspects of the course than anticipated than did the females for 11 of 12 potential difficulties listed. As a consequence, it is suggested that researchers ought to be wary of conducting research into various aspects of higher education without considering potential gender differences. (Contains 9 tables.)

The traditional notion of the curriculum as a fixed list of topics to be studied sequentially is under strain as the pressure for flexibility in education increases. However, curriculum flexibility can lead to curriculum complexity, so that guidance systems are needed to assist learners in their study choices. This article proposes the use of the open, technical specification IMS Learning Design as a formal model for the description of curricula used by guidance support systems for learners. The article compares the approach to other work in the area, and illustrates its application with a number of case studies. The article concludes by describing the type of advanced guidance services which are enabled through a standardized approach and examining the e-learning infrastructure required when implementing the approach.

In an e-learning environment there is a need to integrate various e-learning services like assessment services, collaboration services, learning design services and communication services. In this article we present the design and implementation of a generic integrative service framework, called CopperCore Service Integration (CCSI). We will concentrate on the integration of two services: CopperCore, an IMS Learning Design service and an IMS Question and Test Interoperability service called Assessment Provision through Interoperable Segments (APIS). One of the design goals of the architecture was to minimize the intrusion for both the services as well as any legacy client that already uses these services. The result of this work is that the flow of learning activities can be made dependent on test results. (Contains 3 figures.)

Local and national media have always played an instrumental role in the communication of academic research to the public. In recent years, this has proved even more important due to the extensive online national and international coverage of topics such as climate change and the Covid-19 pandemic. Given that the media represent the public's first point of contact with, and key source of information about, science and research, then, as academics, we need to know, firstly, whether the media make this research easily identifiable for the public and, secondly, whether the research itself is accessible. Our study examined coverage of University of Sheffield published research in UK local and national media to explore how far it is identifiable and accessible; using data from Altmetric.com we investigated what proportion of research covered provided sufficient details to identify research, including links to the published articles and explored how much of the research was accessible via open access. A large proportion of research that featured in local media cited the journal, academic institution and author, but did not link to the article. By contrast, national media cited the author, institution or funder much less than local news websites, but often linked to the actual research article. Most articles featured were open access. The implications of this and potential reasons for the national and local differences are discussed. [ABSTRACT FROM AUTHOR]

The School of Health and Related Research (Sc HARR) at The University of Sheffield run an innovative series of informal 20-minute Bite Size sessions to help staff and students teach, research, collaborate and communicate more effectively. The sessions have two clear strands: one focused on teaching and the other on research. The remit is not to teach people how to use something in their work or study, but to let them know why they should use it and how they can employ it. By introducing participants to the possibilities and how they can apply ideas and technologies in their work and study in an enthusiastic manner, it is possible to send them away with at least the intention to explore and experiment. The evidence shows that this organic approach is working - staff and students are starting to use many of the tools that Bite Size has covered. Any kind of widespread change within organisations can be hard to deliver, but by bringing champions on your side and delivering sessions in a convenient, informal and timely manner; good practice and ideas can spread naturally. H.S. [ABSTRACT FROM AUTHOR]

The Information Resources team within the School of Health and Related Research (ScHARR) at the University of Sheffield has a long-standing interest in the application of new and emerging Web 2.0 technologies for research, learning, and teaching. In early 2008, members of the group began to discuss the development of customized web portals, also referred to as personal start pages, to aggregate various streams of specialist information relevant to researchers within the School and in the wider National Health Service (NHS) research community. This paper documents the background to the portals, their development, and reflects on the challenges and issues the team encountered. [ABSTRACT FROM AUTHOR]

The article offers insights on the potential of union-community coalitions in Great Britain. It argues that such coalitions are just an alignment of organisational leaders, and do not enhance the campaigning skills of union or community organisation members. Also discussed are the principles that help coalitions to meet the challenge of achieving social change goals as they attempt to strengthen the organisations that participate in them, according to the book "Power in Coalition."

The aim of this audit cycle is to measure the extent to which unregistered or wrongly classified studies (research, clinical audit, satisfaction surveys/service evaluations) are conducted within a National Health Service (NHS) Trust, and to ascertain whether promotion of the correct processes can improve the results. An anonymous questionnaire was sent to staff in a single NHS Trust via internal post and email concerning unregistered or wrongly classified studies being conducted. An information sheet was attached to the questionnaire, which gave a brief description and information relating to conducting different types of study. The audit was conducted before and after the introduction of a variety of promotional activities within the Research and Development (R&D) department. The percentage of unregistered research was shown to be 45.8% in audit 1, with audit 2 showing a reduction in unregistered studies to 5.2% (P = 0.005). For clinical audits the results were similar between audits (with no additional promotion) (2.3-2.4%). Satisfaction surveys which were included in the promotion of the research department reduced its level of unregistered studies from 46% to 5% (P = 0.0084). With the targeted and persistent promotion of the relevant departments a dramatic reduction in unregistered studies can be achieved (P = 0.01). [ABSTRACT FROM AUTHOR]

Summary: This article explores working conditions and quality of life in social services. The article focuses on the qualitative findings generated throughout a phased study comprising: in-depth interviews (n = 8) used to develop an original questionnaire; a large survey (n = 1237) of staff in two social service departments in the UK; and focus groups (n = 4) used in Children and Families Division to develop a better understanding of the difficulties experienced and develop context-specific interventions aimed at reducing or eliminating these stressors. It also reports quantitative findings in respect stress (measured using the General Health Questionnaire - GHQ-12). #x2022;Findings: The survey findings indicated that 36 percent (n = 392) of the respondents were considered to be suffering from mental distress. Children and Families Division was worst affected, reporting the highest levels of absenteeism and poorest well-being. The qualitative findings were summarized into five broad themes: organizational culture and function; control; lack of resources; responsibility for people; and the rate and pace of change, which were incorporated into a model. #x2022;Application: The article suggests that during times of change a thorough understanding of working conditions in the public sector are a fundamental prerequisite to developing interventions aimed at improving them. Additionally, the model clearly identifies a number of factors that are 'organizational', rather than being intrinsic to working in social services. [ABSTRACT FROM AUTHOR]

IntroductionBeta-blockers have, for 25 years, been a commonly used agent in the treatment of raised intraocular pressure (IOP). Beta-blockers can also reduce the pulse rate. With no available literature examining a cohort of patients, this study aims to investigate the resting pulse rates in patients attending a specialist glaucoma clinic in order to identify if routine review of ophthalmic medication use is indicated.MethodThe resting pulse rates of patients attending a glaucoma clinic were measured using pulseoximetry, with a medical and drug history established for each patient.ResultsIn all, 205 patients were included in the study. A total of 101 (49%) of patients were using beta-blockers in some form. The mean pulse rate for patients not using beta-blockers (104 patients) was 76 beats per minute (bpm), for topical use only (68 patients) it was 70.3 bpm, for oral use (18 patients) it was 64.7 bpm, and 58 bpm for patients using both topical and oral beta-blockers (15 patients). Groups using beta-blockers (oral, topical, oral and topical) were considered in relation to patients not using beta-blockers. All groups using beta-blockers showed a significant association with causing a bradycardia of less than 60 bpm. Patients with a pulse rate of less than 50 bpm were significantly more likely to be using topical and oral beta-blockers than oral beta-blockers alone (P=0.01).ConclusionTopical beta-blockers should be used with caution, even in the presence of established systemic beta-blocker use. Routine pulse rate monitoring and review of ophthalmic medication are indicated in patients using beta-blocker therapy.Eye (2006) 20, 221–225. doi:10.1038/sj.eye.6701859; published online 1 April 2005 [ABSTRACT FROM AUTHOR]

Presents an interview with Dame Mary L. Cartwright, Dame of the British Empire and Fellow of the Royal Society in Oxford, England. Educational attainment of Cartwright; Research and seminars attended by Cartwright; Experiences with other women in mathematics; Philosophy of Cartwright in mathematics.

Discusses the role and functions of public examinations in Great Britain. General Certificate of Education (GCE) and General Certificate of Secondary Education (GCSE) examinations; Significance of the Education Reform Act; Change in the nature of Standard Assessment Tasks (SATs); Decisions to preserve the GCSE's limited target group; Introduction of new assessment systems.

Presents several comments related to medicine published in the 'British Medical Journal' in Great Britain as of May 1989. Significance of the oral cholecystogram in assessing secretory functions of the gall bladder; Suggestion for systematizing multiple authorship of research; Pathophysiology of shock.

Comments on issues related to health services in Great Britain. Number of important issues concerning the accuracy and use of hospital activity analysis data; Measurement of the inhaled smoke markers carboxyhemoglobin and plasma thiocyanate; Prevalence of insulin-treated diabetes mellitus.

Comments on several medical issues in Great Britain. Complaints on articles in the press on medical matters; Arguments on the limitation of professional participation; Uncertainties in prenatal screening for neural tube defect.

Focuses on medical-related issues in Great Britain. Comparison of procedures for obtaining consent in clinical trials; Effects of breast conservation on psychological morbidity; Symptoms of hyperresponsiveness.

Comments on various topics related to medicine in Great Britain. Details on the antidepressant effects of electroconvulsive therapy; Aspects of modern diuretic treatment; Use of beta blockers and sympathomimetics for treatment.

Presents comments on research works related to medicine in Great Britain. Care of dying patients in hospital; Detection of bilateral isodense subdural hematomas; Link between moderate drinking and loss of brain cells.

Background Juvenile osteochondritis dissecans (JOCD) is a condition of bone and cartilage lesions. Contributory factors may include ischaemia, trauma, genetic or biomechanical factors such as abnormal joint loading. Children and young people (CYP) with juvenile idiopathic arthritis (JIA) have low physical activity levels, present with joint abnormalities and are exposed to immunosuppression including steroids which may cause reduced bone density. Here we describe JOCD in CYP with JIA in our service. Methods Retrospective reviews of case notes were conducted for current CYP with JIA in our service with known JOCD, detailing: JIA diagnosis Age & BMI at diagnosis Symptom duration pre-diagnosis Management (including steroids) JOCD diagnosis Age & BMI at diagnosis Imaging Management Results Table 1 summarises the results. Twelve (n = 10 female) CYP in our cohort of 270 had JOCD with 20 lesions diagnosed on magnetic resonance imaging (MRI). Polyarticular (n = 4) and extended oligoarticular (n = 5) were the commonest JIA sub-types with all CYP receiving systemic therapy and 75% (n = 9) requiring more than one biologic. Mean symptom duration before JIA diagnosis was 6 months (range: 1-24 months) with a mean age of 6.5 years (range: 1.5-13 years). Mean time to JOCD diagnosis was 5.5 years (range: 1.5-10.25 years) with a mean age of 12 years (range: 8-17 years) and 7 CYP having a high BMI (>85th percentile for age). The mean number of previous steroid injections per JOCD joint was 4 (range: 0-17) compared with 3 (range: 0-8) in the non-JOCD joint. Talar dome lesions (n = 9) were commonest, followed by femoral condyle (n = 4 medial, n = 3 lateral). Initial management was conservative, with half (n = 10) requiring surgery. P09 Table 1     P09 Table 1     Conclusion This review identifies that 4% (n = 12/270) of our CYP with JIA have known JOCD, compared with 0.03% (n = 29/100,000) of the general population. Risk factors appear to be polyarticular disease, exposure to ≥ 4 steroid injections per joint, biologic-resistant disease and high BMI with low physical activity. Where CYP with JIA report symptoms which do not fit an inflammatory pattern there should be a low threshold to consider JOCD, with prospective research needed to better understand the relationship between JOCD and JIA. Conflicts of Interest The authors declare no conflicts of interest. [ABSTRACT FROM AUTHOR]

Poster presentation Tuesday 8 October Background Haemophagocytic lymphohistiocytosis (HLH)/macrophage activation syndrome (MAS) is a hyperinflammatory syndrome which can complicate sepsis, malignancy or autoimmune/autoinflammatory disease, potentially leading to critical illness and death at all ages. A previous service evaluation of children with ferritin > 10,000 μg/L, which is highly specific for HLH/MAS, reported mortality of 33% and in 44% there was no documented evidence that HLH had been considered by clinicians. The condition may present to generalists, specialists and intensivists and prompt recognition and treatment can be life-saving. A consensus for the management of HLH in older children and adults has not been defined. The aim of this ongoing project is to identify current practice and improve the evidence-base for diagnosis and treatment of HLH. Methods A national cross-specialty group was established in June 2018 including paediatric and adult specialists in rheumatology, haematology, oncology, immunology, infectious diseases, virology, nephrology and intensive care. Clinicians, scientists, pharmacists and data management experts have been incorporated. The group, which numbers over 50 professionals, has met on three occasions to set clinical and research priorities and is supported by Histiocytosis UK, a charity representing patients with HLH. Results The group agreed these priorities: To complete a retrospective service evaluation of adult patients with ferritin > 10,000 μg/L identified over a 3-year period using a standardised proforma established in the previous paediatric cohort [provisionally, this has identified over 200 adults with a mortality rate of 39%] To provide education to clinicians across the UK to improve recognition of HLH [in progress] To develop guidance for investigation of suspected HLH [in progress] To link local multi-specialty teams experienced in managing HLH to create a national network [in progress] To conduct a retrospective, observational study of the use and outcomes of anakinra treatment in HLH To establish a national registry for HLH as part of the UK Histiocytosis Registry (UKHR) using the REDCap online portal for data collection. Patients with definite and probable HLH, including those with MAS secondary to rheumatological conditions, will be eligible for recruitment. Baseline demographic and clinical data, investigations which contribute to the HLH 2004 criteria and H score, and underlying diagnoses will constitute a minimal dataset. Treatments, and responses, and long-term follow-up data will be recorded. In addition to data collection, with the appropriate consents, biological samples will be available for genetic and histopathological analysis and cellular samples for in vitro studies. Conclusion HLH/MAS is an under-recognised condition with high mortality. A national cross-specialty, all-age collaboration has established priorities to improve clinical care and advance research. Development of a registry, with collection of biological samples, will facilitate investigation of disease pathogenesis and help to stratify patients with a view to future clinical trials. Conflicts of Interest The authors declare no conflicts of interest. [ABSTRACT FROM AUTHOR]

Background: Young people (YP; 12–24 years old) with rheumatic diseases face many challenges associated with chronic illness in addition to the physiological and psychosocial changes of adolescence. Timely access to developmentally appropriate multidisciplinary care is key to successfully managing rheumatic diseases, but gaps in the care of this vulnerable age group still exist. This study aimed to develop a benchmarking toolkit to enable comparative evaluation of YP rheumatology services in order to promote best practice and reduce variations in service delivery. Methods: A staged and consultative method was used across a broad group of stakeholders in the UK (YP, parents/other carers, and healthcare professionals, HCPs) to develop this toolkit, with reference to pre-existing standards of YP-friendly healthcare. Eighty-seven YP (median age 19 years, range 12–24 years) and 26 rheumatology HCPs with 1–34 years of experience caring for YP have participated. Results: Thirty quality criteria were identified, which were grouped into four main domains: assessment and treatment, information and involvement, accessibility and environment, and continuity of care. Two toolkit versions, one to be completed by HCPs and one to be completed by patients, were developed. These were further refined by relevant groups and face validity was confirmed. Conclusions: A toolkit has been developed to systematically evaluate and benchmark YP rheumatology services, which is key in setting standards of care, identifying targets for improvement and facilitating research. Engagement from YP, clinical teams, and commissioners with this tool should facilitate investigation of variability in levels of care and drive quality improvement. [ABSTRACT FROM AUTHOR]

Focuses on the controversies about the government policy on the use of insulin syringes among the diabetics in Great Britain. Recommendation of the Department of Health and Security; Inclination of patients to reuse syringes; Anomalies about syringe use.

Explores the significance of blood glucose self monitoring in patients with non-insulin dependent diabetes in Great Britain. Advantage of the scheme in terms of weight loss or glycemic control; Drawbacks encountered in the strategy.

Focuses on various topics related to medicine in Great Britain. Impact of the BBC television program 'Think Child' on road safety; Reactions to the program on first aid; Details on books available for the insulin dependent diabetic.

Infection with SARS-CoV-2 may trigger a delayed hyperinflammatory illness in children called paediatric multisystem inflammatory syndrome temporally associated with COVID-19 (PIMS-TS). A similar syndrome is increasingly recognised in adults termed multisystem inflammatory syndrome in adults (MIS-A) and may present acutely to medical or surgical specialties with severe symptoms, such as acute abdominal pain or cardiogenic shock. No national guidelines exist in the UK for the management of MIS-A and there is limited evidence to guide treatment plans. We undertook a national Delphi process to elicit opinions from experts in hyperinflammation about the diagnosis and management of MIS-A with the dual aim of improving recognition and producing a management guideline. Colleagues in paediatrics successfully initiated a national consensus management document that facilitated regional multidisciplinary referral and follow-up pathways for children with PIMS-TS, and we propose a similar system be developed for adult patients across the UK. This would facilitate better recognition and treatment of MIS-A across the multiple specialties to which it may present as well as enable follow-up with specialty services post-discharge. [ABSTRACT FROM AUTHOR]

Background: Alveolar soft-part sarcoma (ASPS) is a rare soft-tissue sarcoma that is unresponsive to chemotherapy. Cediranib, a tyrosine-kinase inhibitor, has shown substantial activity in ASPS in non-randomised studies. The Cediranib in Alveolar Soft Part Sarcoma (CASPS) study was designed to discriminate the effect of cediranib from the intrinsically indolent nature of ASPS.Methods: In this double-blind, placebo-controlled, randomised, phase 2 trial, we recruited participants from 12 hospitals in the UK (n=7), Spain (n=3), and Australia (n=2). Patients were eligible if they were aged 16 years or older; metastatic ASPS that had progressed in the previous 6 months; had an ECOG performance status of 0-1; life expectancy of more than 12 weeks; and adequate bone marrow, hepatic, and renal function. Participants had to have no anti-cancer treatment within 4 weeks before trial entry, with exception of palliative radiotherapy. Participants were randomly assigned (2:1), with allocation by use of computer-generated random permuted blocks of six, to either cediranib (30 mg orally, once daily) or matching placebo tablets for 24 weeks. Treatment was supplied in number-coded bottles, masking participants and clinicians to assignment. Participants were unblinded at week 24 or sooner if they had progression defined by Response Evaluation Criteria in Solid Tumors (version 1.1); those on placebo crossed over to cediranib and all participants continued on treatment until progression or death. The primary endpoint was percentage change in sum of target marker lesion diameters between baseline and week 24 or progression if sooner, assessed in the evaluable population (all randomly assigned participants who had a scan at week 24 [or sooner if they progressed] with target marker lesions measured). Safety was assessed in all participants who received at least one dose of study drug. This study is registered with ClinicalTrials.gov, number NCT01337401; the European Clinical Trials database, number EudraCT2010-021163-33; and the ISRCTN registry, number ISRCTN63733470 recruitment is complete and follow-up is ongoing.Findings: Between July 15, 2011, and July 29, 2016, of 48 participants recruited, all were randomly assigned to cediranib (n=32) or placebo (n=16). 23 (48%) were female and the median age was 31 years (IQR 27-45). Median follow-up was 34·3 months (IQR 23·7-55·6) at the time of data cutoff for these analyses (April 11, 2018). Four participants in the cediranib group were not evaluable for the primary endpoint (one did not start treatment, and three did not have their scan at 24 weeks). Median percentage change in sum of target marker lesion diameters for the evaluable population was -8·3% (IQR -26·5 to 5·9) with cediranib versus 13·4% (IQR 1·1 to 21·3) with placebo (one-sided p=0·0010). The most common grade 3 adverse events on (blinded) cediranib were hypertension (six [19%] of 31) and diarrhoea (two [6%]). 15 serious adverse reactions in 12 patients were reported; 12 of these reactions occurred on open-label cediranib, and the most common symptoms were dehydration (n=2), vomiting (n=2), and proteinuria (n=2). One probable treatment-related death (intracranial haemorrhage) occurred 41 days after starting open-label cediranib in a patient who was assigned to placebo in the masked phase.Interpretation: Given the high incidence of metastatic disease and poor long-term prognosis of ASPS, together with the lack of efficacy of conventional chemotherapy, our finding of significant clinical activity with cediranib in this disease is an important step towards the goal of long-term disease control for these young patients. Future clinical trials in ASPS are also likely to involve immune checkpoint inhibitors.Funding: Cancer Research UK and AstraZeneca. [ABSTRACT FROM AUTHOR]

The article presents an overview of one day in the life of four clinical equipment nurse specialists in Great Britain. Ruth Hodgkinson visits loan stores where she checks through referrals. She identifies and deals with clinical issues such as inappropriate prescription of equipment. Caroline Marshall ensures equity and standardization in the supply of high specification equipment. Joe Nightingale looks into referrals for pressure care equipment that need reviewing and deals with administrative staff. Sarah Tattersall's role is divided between equipment and infection control. The nurse specialists face everyday challenges in dealing with inappropriate use of equipment.

Objectives: Health technology assessment aims to inform and support healthcare decision making, and trials are part of that process. The purpose of this study was to measure the impact of a sample of trials in a meaningful but robust fashion., Methods: All randomized controlled trials funded and published by the UK National Institute of Health Research in the Health Technology Assessment journal series and other peer-reviewed journals were identified for 2006 to 2015. Citation analysis was performed for all trials, and quantitative content analysis was undertaken on a purposive sample to determine whether impact could be categorized as "instrumental" (ie, having a clear influence on key research and policy publications)., Results: The search identified 133 relevant trials. The citation rate per trial was 102.97. Of the 133 trials, 129 (98%) were cited in 1 or more systematic reviews or meta-analyses (mean per trial = 7.18, range = 0-44). Where they were cited, the trials were used in some form of synthesis 63% of the time. Ninety-one of the 133 (68%) trials were found to be cited in 1 or more guidance or policy document (mean per trial = 2.75, range = 0-26) and had an instrumental influence 41% of the time. The publication of these trials' results in journals other than the Health Technology Assessment journal appears to enhance the discoverability of the trial data. Altmetric.com proved to be very useful in identifying unique policy and guidance documents., Conclusion: These trials have impressive citation rates, and a sizeable proportion are certainly being used in key publications in a genuinely instrumental manner., (Copyright © 2020 ISPOR–The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)