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This paper examines the usage of institutional and non-institutional technologies to support learning and teaching in UK higher education. Previous work on disruptive technology and disruptive innovation has argued that users prefer simple and convenient technologies, and often repurpose technologies from designers' intentions; this paper evaluates its data in relation to this argument. The paper uses a structured observation as its research instrument; seven participants (three lecturers and four students) were given one of two tasks. Results showed the participants using a narrow range of technologies, and showed a preference for non-institutional over institutional technologies. The paper argues that there is a misalignment between the technologies provided by higher education institutions (HEIs) and the technologies used in practice by students and lecturers, and further argues that disruptive technology and disruptive innovation comprise a useful means of assessing the likely success, in terms of usage, of a technology.

Higher education institutions (HEIs) have invested significantly in digital technologies for learning and teaching. However, technologies provided by HEIs have not been universally successful in terms of adoption and usage. Meanwhile, both students and lecturers use disruptive technologies to support learning and teaching. This article examines the impact of disruptive technologies in higher education, using activity theory as a lens through which to consider their impact. Data are gathered from a questionnaire and interviews. The research suggests that participants provide explanation for disruptive technologies from their experience in handling them, rather than in keeping with a designer's intentions, and therefore, the participants/users prefer convenient and easy-to-use technologies. The application of disruptive technologies has implications for how knowledge is accessed, for the division of labour in higher education and for the role of the HEI as gatekeeper to knowledge.

The use of robotic-assisted laparoscopic techniques has transformed the face of urological surgery in the last decade, with demonstrable benefits over both unassisted laparoscopic and traditional open approaches. For example, robotic-assisted partial nephrectomy is associated with lower morbidity, improved convalescence, reduced postoperative pain, shorter length of hospital stay, and a superior cosmetic result when compared to an open procedure. This review discusses the various perioperative influences on the renal physiology of patients undergoing robotic-assisted urological procedures.

Brain biopsy in patients presenting with subacute encephalopathy is never straightforward, and only undertaken when a ‘treatable condition’ is a realistic possibility.This 63 year old right handed, immunocompetent Caucasian woman presented with an 8 month history of rapidly progressive right-sided hearing impairment, a 4 month history of intermittent headaches, tinnitus, ‘dizziness’, dysphagia, nausea and vomiting, with the subsequent evolution of progressive gait ataxia and a subacute global encephalopathy. The possibility of CJD was raised. Brain biopsy was carried out. Western blot for prion protein was negative. She died 9 days later and autopsy brain examination confirmed widespread subacute infarction due to an EBV positive atypical NK/T-cell infiltrate with positivity for CD3, CD56, granzyme B, perforin and EBER with absence of CD4, CD5 and CD8 expression. Molecular studies for T-cell clonality were attempted but failed due to insufficient DNA quality. Serology was consistent with past EBV infection (EBV VCA and EBNA IgG Positive). There was no evidence of disease outside the CNS. Primary central nervous system NK/T-cell lymphoma is extremely rare. The rare reported cases all present with a discrete intracranial mass, unlike the diffuse infiltrative pattern in this case. Whilst the diffuse interstitial pattern is reminiscent of chronic active EBV infection (CAEBV) seen in other organ systems such as the liver and bone marrow, the clinical presentation and epidemiologic profile are not typical for CAEBV.

Thrombocytopenia is one of the most common hematological abnormalities observed during pregnancy, and in rare cases, this may be the first indicator of an underlying hematological malignancy. Hairy cell leukemia (HCL) is an uncommon B-cell lymphoproliferative disorder of which thrombocytopenia is a recurrent presenting feature. A case of pancytopenia presenting in pregnancy is described in which the thrombocytopenia persisted postpartum coincidental with a vesicular, pustular rash characterised as Sweet’s syndrome. Hematological, histological, immunophenotypic, and molecular investigations confirmed the presence of HCL. The patient was treated with cladribine resulting in resolution of Sweet’s syndrome, hematological remission from HCL, and achievement of a normal platelet count. This case highlights the need to maintain a wide differential diagnosis for presentations of pancytopenia or thrombocytopenia in pregnancy and the requirement for follow-up investigation of unusual cases with a lack of response to steroids or immunoglobulin.

The paper studies the impact of the portfolio constraint imposed by the consumption demand for housing (the "housing constraint") on the household's optimal holdings of financial assets. Since the ratio of housing to net worth declines as the household accumulates wealth, the housing constraint induces a life-cycle pattern in the portfolio shares of stocks and bonds. For reasonable degrees of risk aversion, the changes in portfolio composition over the life-cycle can be dramatic. For example, for a coefficient of relative risk aversion of 3, the ratio of stocks to net worth in the optimal portfolio is .09 for the youngest households (ages 18-30) and .60 for the oldest (age 70 and over).Using data from the PSID on home values to construct household level panel data on the real after-tax return to owner-occupied housing, as well as data on the returns to financial assets, the paper estimates the vector of expected returns and the covariance matrix for the set of assets consisting of housing, mortgages, stocks, Treasury bonds, and T-bills. Numerical methods are used to calculate the mean-variance efficient frontier, conditional on different values of the housing constraint, and the optimal portfolios associated with different levels of relative risk aversion.

State preemption of local policymaking is an increasingly used political tool and source of intergovernmental conflict. While previous studies have examined the determinants and effects of preemption, to date no study has examined citizens' attitudes and opinions about the practice. Using two original public opinion surveys, we find that support for preemption does not seem to be politically driven as there are no discernable partisan differences and citizens are no more likely to support preemption when their party controls state government. Instead, support for preemption appears to be tied to more general feelings about state government such as trust and perceived responsiveness to citizens. Moreover, when using a survey experiment that primes respondents with a concrete example of preemption—forbidding cities from raising their minimum wage—support for preemption falls. These findings provide important context about citizens' attitudes toward an increasingly prominent tool of state governments. [ABSTRACT FROM AUTHOR]