Helping students to 'study happy'

Earlier this year, CILIP Update ran a news story about a series of Carnegie UK Trust databases outlining how libraries support their local communities as a social hub, learning hub, economic enabler and cultural centre.1 The databases and their attendant publications highlight how ‘public libraries are safe spaces at the heart of our communities, providing completely free access to huge resources of information, knowledge and technology. They have dedicated staff and are well linked with other local services’.2. They detail how libraries tackle isolation and foster inclusion, provide an arena for creativity and cultural events, and can support both traditional and digital skills development. All of this is dynamic, and as the trust points out ‘to respond to the changing needs of the 21st century, libraries are changing and must continue to change. Libraries must be brave, innovative and show how they are doing things which really make a difference to their community’

Using personal response systems for induction

In the autumn term of 2006 the business and economics subject team at Warwick University decided to try a slightly different approach to library induction for undergraduates. We wanted to keep our sessions brief, fi rmly believing that not much is retained by students from induction sessions, and we wanted a session that would not just be a brief introduction to services. Drawing on a colleague’s experience we decided to focus on one specifi c problem we know students face early on in their course, namely understanding what they are looking for when they see references on a reading list. This had worked in a presentation format with quite large groups and included an element of interactivity. Having seen the Personal Response System (PRS) technology showcased on Warwick’s e-learning website, we felt this might enhance the interactive element so arranged for a demonstration of the system in the library. PRS is used extensively by the medical school within lectures and is used to great success in revision sessions, especially when used in a competitive team environment

A network analysis to identify pathophysiological pathways distinguishing ischaemic from non-ischaemic heart failure

Aims Heart failure (HF) is frequently caused by an ischaemic event (e.g. myocardial infarction) but might also be caused by a primary disease of the myocardium (cardiomyopathy). In order to identify targeted therapies specific for either ischaemic or non‐ischaemic HF, it is important to better understand differences in underlying molecular mechanisms. Methods and results We performed a biological physical protein–protein interaction network analysis to identify pathophysiological pathways distinguishing ischaemic from non‐ischaemic HF. First, differentially expressed plasma protein biomarkers were identified in 1160 patients enrolled in the BIOSTAT‐CHF study, 715 of whom had ischaemic HF and 445 had non‐ischaemic HF. Second, we constructed an enriched physical protein–protein interaction network, followed by a pathway over‐representation analysis. Finally, we identified key network proteins. Data were validated in an independent HF cohort comprised of 765 ischaemic and 100 non‐ischaemic HF patients. We found 21/92 proteins to be up‐regulated and 2/92 down‐regulated in ischaemic relative to non‐ischaemic HF patients. An enriched network of 18 proteins that were specific for ischaemic heart disease yielded six pathways, which are related to inflammation, endothelial dysfunction superoxide production, coagulation, and atherosclerosis. We identified five key network proteins: acid phosphatase 5, epidermal growth factor receptor, insulin‐like growth factor binding protein‐1, plasminogen activator urokinase receptor, and secreted phosphoprotein 1. Similar results were observed in the independent validation cohort. Conclusions Pathophysiological pathways distinguishing patients with ischaemic HF from those with non‐ischaemic HF were related to inflammation, endothelial dysfunction superoxide production, coagulation, and atherosclerosis. The five key pathway proteins identified are potential treatment targets specifically for patients with ischaemic HF

Women choosing silence: transformational practices and relational perspectives

This thesis explores chosen practices of silence in contemporary Christian women’s lives, insubstantially addressed within the literature of feminist and practical theologians. A survey of their discourse, which predominantly addresses the imposed silencing of women and the attendant quest for authentic voice to name their experiences, is supplemented by interdisciplinary exploration of silence within wider theologies, Quaker Studies, linguistics, and the talking and arts therapies. Employing feminist research methodologies, this qualitative study utilises descriptively rich material from semi-structured interviews to consider the function of silence within research interviews, to identify and map women’s engagement within a spectrum of practices of silence, to explore their role in the women’s spiritual journeys, and to highlight difficulties reported in sustaining this discipline. Data analysis shows that although frequently associated with solitude, practices of silence are valued as transformational in the women’s relationships with God, self, and others. A metaphor of a web is proposed to represent the process of relational change, and silence’s potential in developing relationally responsible communities is advocated. Explanations for feminist theologians’ neglect of chosen silence are derived from the analysis, and this discipline is invited to re-engage with silence as a resource for discovering authentic identity beyond egoic selfhood

Effectiveness of transanal irrigation in low anterior resection syndrome

Background: Low anterior resection syndrome (LARS) is a frequent issue leading to bowel dysfunction after anterior resection surgery. NICE guidelines state that there is limited research around the management of LARS. Transanal irrigation (TAI) is a suggested treatment by guidelines; however, there is limited research surrounding the effectiveness of this treatment. Aim: The aim of this prospective study was to evaluate the effectiveness of TAI in reducing LARS score post anterior resection surgery. Methods: Patients who were referred to the pelvic floor nurse specialist team between 2019 and 2023 with bowel dysfunction post anterior resection surgery were evaluated. Bowel dysfunction was assessed using the LARS scoring system during the first assessment and on discharge. These patients were offered TAI and trained to perform TAI. Patients with missing LARS scores and those who were not using TAI were excluded from the study. Results: Of the total 37 patients who were referred and using TAI, 16 were excluded. In total, 21 patients were included (12 male, 9 female). At baseline, 33% of patients were recorded to have minor LARS, and 66% with major LARS. At discharge, there was a significant improvement in LARS score (80% of patients reported no LARS, 10% minor LARS and 10% major LARS). Overall, the LARS score at discharge was significantly lower among patients who underwent irrigation (mean 34.57 vs. 12.48, p = 0.0000000038). Conclusion: Our study shows the importance of TAI in the management of bowel dysfunction post anterior resection for rectal cancer, with more than two‐third of patients' symptom improvement

School quality ratings are weak predictors of students’ achievement and well‐being

Background: In England, all state-funded schools are inspected by an independent government agency, the Office for Standards in Education (Ofsted). Inspections aim to hold schools accountable and to promote the improvement of education, with the results made available to the public. Ofsted reports intend to index school quality but their influence on students’ individual outcomes has not been previously studied. The aim of the current study was to explore the extent to which school quality, as indexed by Ofsted ratings, is associated with students’ educational achievement, wellbeing, and school engagement. Methods: We use an England population-based sample of 4,391 individuals, for whom school performance at age 11 and GCSE grades at age 16 were accessed from the National Pupil Database, and who completed measures of wellbeing and school engagement at age 16. Results: We found that Ofsted ratings of secondary school quality accounted for 4% of the variance in students' educational achievement at age 16, which was further reduced to 1% of the variance after we accounted for prior school performance at age 11 and family socioeconomic status. Furthermore, Ofsted ratings were poor predictors of school engagement and student wellbeing, with an average correlation of .03. Conclusion: Our findings suggest that differences in school quality, as indexed by Ofsted ratings, have little relation with students’ individual outcomes. Accordingly, our results challenge the usefulness of Ofsted ratings as guides for parents and students when choosing secondary schools

Feasibility, acceptability and appropriateness of laparoscopic versus abdominal hysterectomy for women and healthcare professionals:the LAVA trial qualitative process evaluation

Background Laparoscopic hysterectomies performed for benign gynaecological conditions are increasing. However, there is a lack of up-to-date evidence on their surgical outcomes when compared with abdominal hysterectomy. The LAparoscopic Versus Abdominal hysterectomy trial aimed to address this gap. A qualitative process evaluation was embedded within the pilot phase of the LAparoscopic Versus Abdominal hysterectomy trial.Objective To explore the feasibility, acceptability and appropriateness of LAparoscopic Versus Abdominal hysterectomy for women and healthcare professionals.Design and methods A qualitative process evaluation using semistructured interviews informed by the Medical Research Council/National Institute for Health and Care Research updated Framework for Developing and Evaluating Complex Interventions. Interviews were thematically analysed to inform the development of a LAparoscopic Versus Abdominal hysterectomy trial programme theory (used to demonstrate how an intervention is expected to lead to its effects, under what conditions and for which stakeholders).Setting and participants Eligible women and healthcare professionals (gynaecologists, research nurses and research midwives) from participating clinical sites in National Health Service England.Main outcome measures Insight on the feasibility,acceptability and appropriateness of LAparoscopic Versus Abdominal hysterectomy related to the: (1) environment, (2) patient and (3) the healthcare professionals.Results Eleven women and 7 healthcare professionals (6 research nurses and 1 consultant gynaecologist) were interviewed. Four themes were interpreted. Theme 1 identified decision-making processes for LAparoscopic Versus Abdominal hysterectomy participation. Conditional altruism motivated women to participate, alongside the ‘relief’ of being offered a hysterectomy. The decision to decline participation was influenced by surgical preference and beliefs of laparoscopy having a faster recovery rate. Theme 2 highlighted surgical preferences, with women’s preferences being influenced by their previous experiences of surgery or perceived recovery times and family/friends. All healthcare professionals demonstrated community equipoise but did observe that ‘younger surgeons’ may prefer laparoscopic surgery based on their contemporary training. Theme 3 identified attitudes towards the LAparoscopic Versus Abdominal hysterectomy trial, with women and healthcare professionals reporting positively about LAparoscopic Versus Abdominal hysterectomy’s feasibility, acceptability and appropriateness in terms of burden, information and understanding of the study. Theme 4 identified the facilitators and barriers for LAparoscopic Versus Abdominal hysterectomy participation. Facilitators included the key role of the research nurses and women having personal social support during their recovery. Telephone consultations may be a barrier, with face-to-face discussion being preferred by both women and healthcare professionals. These findings informed the refinement of the LAparoscopic Versus Abdominal hysterectomy programme theory, identifying the interplay of factors related to the environment, patient and healthcare professionals.Limitations The majority of insight from women was gathered from one site (72.7%), and the majority of healthcare professionals’ insight was obtained from research nurses (85.7%). Only English-speaking participants were recruited into LAparoscopic Versus Abdominal hysterectomy.Conclusions Overall, LAparoscopic Versus Abdominal hysterectomy was acceptable for women and healthcare professionals. The trial, however, closed early due to the negative impact of the COVID-19 pandemic and lack of healthcare professional equipoise (these findings were published previously). The qualitative process evaluation highlighted additional factors to consider for future trials, including influences on women’s decision-making and the challenges of addressing patient and healthcare professional equipoise.Future work Comparison of laparoscopic and abdominal hysterectomy outcomes still need to be explored in a large-scale randomised controlled trial. Further qualitative insight is needed from women who decline participation and from healthcare professionals who lack equipoise

Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson’s disease: preliminary cost-consequence analysis of the PD COMM pilot randomised controlled trial

Additional file 1: Table S1. Speech and language therapy (SLT) set-up costs. Table S2. Derivation of unit costs: sources and assumptions. Table S3. Resource use per patient over 12 months (NHS and social care funded). Table S4. Mean medication costs by drug type over 12 months, per patient (2014/15 costs). Table S5. Resource use per patient over 12 months (privately funded). Table S6. Patient funded care costs and out of pocket expenses over 12 months, per patient. Table S7. Convergence between index scores of EQ-5D-3L and ICECAP-O dimensions (Spearman’s rank correlation). Table S8. Convergence between index scores of PDQ39 dimensions and ICECAP-O responses (Spearman’s rank correlation). Table S9. Convergence between index scores of PDQ39 dimensions and EQ-5D-3L responses (Spearman’s rank correlation