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This chapter takes the form of two Case Studies. In the course of these you will be asked to establish facts, work out explanations and interpretations, and draw conclusions. The purpose of these activities is threefold: firstly, to encourage critical thinking, so that, by asking questions and looking for answers you can form your own opinions; secondly, by presenting information in a variety of forms, to give you experience in looking for information in charts, diagrams, graphs and tables as well as from text; and thirdly, to offer a practical introduction to a method of inquiry from source material increasingly required on a number of courses.

This chapter is about the practical business of translating an essay plan into an essay. Chapter 6 gives advice on how to write paragraphs and arrange the points within them and chapter 7 discusses how to analyse essay titles. This chapter picks up from here and considers how to structure essays and make the paragraphs in them work for you in answering the question set.

What are the main difficulties you have found with studying so far? Jot down two or three points, then read on.

It is often the prospect of writing that causes the greatest dread in students — particularly when the only writing they have done in the past few years is the weekly shopping list and such like. As with any neglected skill, with practice you will regain confidence in your ability to write. But before you can write, you need to be able to organise your ideas. The aim of this chapter is to approach this process by drawing on those skills of organisation you use successfully every day.

The Artificial Intelligence research field sits at the intersection of several overlapping spheres (academia, industry, media), each with their own logics and commitments. The influence of research within these worlds is studied through a number of bibliometric methods, including citation metrics for measuring influence within academia, and counts of patents and news-media mentions for influence in industry and the media. Using a large-scale, publicly-available dataset of research outputs, we compare the topical content of outputs that are highly influential in each of these worlds. We identify significant differences between the content of influential research in these worlds, indicating that the academic, industry and media worlds value different aspects of the Artificial Intelligence field. These differences provide new insights on the evaluation of research produced within the Artificial Intelligence field.

A key goal of public policy and public administration research is to inform policy decisions. It is not clear, however, to what extent this is the case. In this study, therefore, citations from policy documents to public policy and administration research were analyzed to identify which research contributed most to policy reports and decisions. Additionally, we identified which policy institutions used research literature more than others to justify their policy decisions. Our findings show that think tanks use public policy and administration research literature more often than governmental organizations when justifying policy reports and decisions.

Urinary symptoms are fairly common among the adult population yet only a small percentage report them as bothersome. There are many reasons why people do not seek help for urinary symptoms, e.g. the embarrassment felt by those experiencing them. Little research, however, has looked at the reasons why some people seek healthcare professional help for urinary symptoms. This article describes a study aimed to identify the triggers that prompt a person with urinary symptoms to seek help. The findings suggest that health promotion campaigns play an important role in both raising awareness and demand for services. Furthermore, this study highlights the personal and social reasons why people seek help for urinary symptoms. It is important, therefore, that healthcare professionals take these personal and social circumstances into account when carrying out any assessment to ensure that a successful management of symptoms is achieved.

Objectives To identify and synthesise studies of diagnostic processes of urinary incontinence and to construct an economic model to examine the cost-effectiveness of simple, commonly used primary care tests. Data sources The electronic databases MEDLINE (1966--2002), CINAHL (1982--2002) and EMBASE (1980--2002). Review methods Studies were selected and assessed using the Quality Assessment of Diagnostic Studies (QUADAS) tool. Studies that reported the results of applying the same diagnostic procedure using the same threshold value (cut-off) were pooled using a random effects meta-analysis model to produce pooled estimates of sensitivity, specificity and diagnostic odds ratio together with 95% confidence intervals. Results In total, 6009 papers were identified from the literature search, of which 129 were deemed relevant for inclusion in the review, and these papers compared two or more diagnostic techniques. The gold-standard diagnostic test for urinary incontinence with which each reference test was compared was multichannel urodynamics. In general, reporting in the primary studies was poor; there was a lack of literature in the key clinical areas and minimal literature dealing with diagnosis in men. Only a limited number of studies could be combined or synthesised, providing the following results when compared with multichannel urodynamics. A clinical history for diagnosing urodynamic stress incontinence (USI) in women was found to have a sensitivity of 0.92 and specificity of 0.56 and for detrusor overactivity (DO) a sensitivity of 0.61 and specificity of 0.87. For validated scales, question 3 of the Urogenital Distress Inventory was found to have a sensitivity of 0.88 and specificity of 0.60. Seven studies compared a pad test with multichannel urodynamics; however, four different pad tests were studied and therefore it was difficult to draw any conclusions about diagnostic accuracy. Of the four studies comparing urinary diary with multichannel urodynamics, only one presented data in a format that allowed sensitivity and specificity to be calculated. Their reported values of 0.88 and 0.83 suggest that a urinary diary may be effective in the diagnosis of DO in women. Examination of the incremental cost-effectiveness of three primary care tests used in addition to history found that the diary had the lowest cost-effectiveness ratio of between pound 35 and pound 77 per extra unit of effectiveness (or case diagnosed). Imaging by ultrasound to determine leakage was found to be effective in the diagnosis of USI in women, with a sensitivity of 0.94 and specificity of 0.83. Conclusions This is the first systematic review of methods for diagnosing urinary incontinence. As reporting of the primary studies was poor, clinical interpretation was often difficult because few studies could be synthesised and conclusions made. The report found that a large proportion of women with USI can be correctly diagnosed in primary care from clinical history alone. On the basis of diagnosis the diary appears to be the most cost-effective of the three primary care tests (diary, pad test and validated scales) used in addition to clinical history. Ultrasound imaging may offer a valuable alternative to urodynamic investigation. The clinical stress test is effective in the diagnosis of USI. Adaptation of such a test so that it could be performed in primary care with a naturally filled bladder may prove clinically useful. If a patient is to undergo an invasive urodynamic procedure, multichannel urodynamics is likely to give the most accurate result in a secondary care setting. There is a dearth of literature on the diagnosis of urinary incontinence in men, with no studies meeting the study criteria for data extraction in the diagnosis of bladder outlet obstruction. There is a need for large-scale, high-quality primary studies evaluating the use of a number of diagnostic methods in a primary care setting to be undertaken so that the results of this systematic review can be verified or not. Such studies should include not only an assessment of clinical effectiveness, in this case diagnostic accuracy, but also an assessment of costs and quality of life/satisfaction to inform future health policy decisions. Studies carried out should be reported to a better standard. The recommendations of the Standards for Reporting Diagnostic Accuracy (STARD) initiative should be followed to ensure the accuracy and completeness of reporting design and results.

Background Given the extent and priority of urinary symptoms there is little evidence available to inform service provision in relation to the long term effects of interventions. This study aims to determine the long term (6 year) clinical effectiveness and costs of a new continence nurse led service compared to standard care for urinary symptoms. Methods A long term follow-up study of a 2-arm, non-blinded randomised controlled trial that recruited from a community based population between 1998-2000 in Leicestershire and Rutland UK was undertaken. 3746 men and women aged 40 years and over were followed up from the original trial. The continence nurse practitioner (CNP) intervention comprised a continence service provided by specially trained nurses delivering evidence-based interventions using pre-determined care pathways. The standard care (SC) arm comprised access to existing primary care including General Practitioner and continence advisory services in the area. Primary outcome: Improvement in one or more symptom. Secondary outcomes included: a) Leicester Impact scale; b) patient perception of problem; c) number of symptoms alleviated and cost-effectiveness; all were recorded at long term follow-up (average 6 years) post-randomisation. Results Overall at long-term follow-up (average 6 years) significantly more individuals in the CNP group (72%) had improved (i.e had fewer symptoms) compared to those in the SC group (67%) (difference of 5% 95% (CI = 0.6 to 9;p = 0.02)). Conclusion The differences in outcome between the two randomised groups shown immediately post treatment had decreased by half in terms of symptom improvement at long term follow-up. Although the difference was statistically significant, the clinical significance may not be, although the direction of the difference favoured the new CNP service.