The Implementation, Application and Effects of the EU Directive on Copyright in the Information Society. CEPS Special Report No. 120, 19 November 2015

This study provides an ex-post evaluation of the EU copyright framework as provided by EU Directive 29/2001 on Copyright in the Information Society (InfoSoc Directive) and related legislation, focusing on four key criteria: effectiveness, efficiency, coherence and relevance. The evaluation finds that the EU copyright framework scores poorly on all four accounts. Of the four main goals pursued by the InfoSoc, only the alignment with international legislation can be said to have been fully achieved. The wider framework on copyright still generates costs by inhibiting content production, distribution and creation and generating productive, allocative and dynamic inefficiencies. Several problems also remain in terms of both internal and external coherence. Finally, espite its overall importance and relevance as a domain of legislation in the fields of content and media, the EU copyright framework is outdated in light of technological developments. Policy options to reform the current framework are provided in the CEPS companion study on the functioning and efficiency of the Digital Single Market in the field of copyright (CEPS Special Report No. 121/November 2015).

Bariatric surgery in women of child-bearing age, timing between an operation and birth, and associated perinatal complications

Thesis (Master's)--University of Washington, 2016-06

The importance of the relevance of the issue to the group in voting intentions: The case of the Australian republic referendum

A questionnaire was distributed on the Australian republic issue to examine the interplay between norms and relevance of the issue to the group on voting intentions. Supporters of an Australian republic (N = 188) indicated the level of support for a republic within their peer Group, the relevance of the republic issue to the group, and measures designed to assess voting intentions and other attitude outcomes. Analysis revealed an interaction between normative support and relevance of the issue to the group. On the measure of intention, increasing normative support was associated with increased intention to vote in an attitude-consistent way at both relevance levels, but the effect was heightened when the issue was highly relevant to the group. On the outcomes of willingness to express opinion and perceived personal importance of the republic issue, normative support had a positive effect only when the issue was highly relevant to the group. Mediation analyses revealed that the impact of normative support and group relevance on intention were mediated through perceived personal importance of the republic issue.

Bridging technical and HCI research: Creating usable ubiquitous computing

This paper describes methods used to support collaboration and communication between practitioners, designers and engineers when designing ubiquitous computing systems. We tested methods such as “Wizard of Oz” and design games in a real domain, the dental surgery, in an attempt to create a system that is: affordable; minimally disruptive of the natural flow of work; and improves human-computer interaction. In doing so we found that such activities allowed the practitioners to be on a ‘level playing ground’ with designers and engineers. The findings we present suggest that dentists are willing to engage in detailed exploration and constructive critique of technical design possibilities if the design ideas and prototypes are presented in the context of their work practice and are of a resolution and relevance that allow them to jointly explore and question with the design time. This paper is an extension of a short paper submitted to the Participatory Design Conference, 2004.

Managing the quality, value and impact of academic libraries: the role of external standards

Purpose – The purpose of this paper is to explore the role and relevance of external standards in demonstrating the value and impact of academic library services to their stakeholders. Design/methodology/approach – Two UK standards, Charter Mark and Customer Service Excellence, are evaluated via an exploratory case study, employing multiple data collection techniques. Methods and results of phases 1-2 of a three phase research project are outlined. Findings – Despite some limitations, standards may assist the manager in demonstrating the value, impact and quality of academic libraries in a recessional environment. Active engagement and partnership with customers is imperative if academic libraries are to be viewed as vital to their parent organisations and thus survive. Originality/value – This paper provides a systematic evaluation of the role of external accreditation standards in measuring academic library service value and impact.

Insights into factors affecting production and operations management (POM) journal evaluation

The paper extends the current literature on peer review journal evaluations by providing a number of insights based on the diversity of Production and Operations Management (POM) research. We provide peer review evaluations for POM research outlets, based on a sampling frame that includes a large number of POM researchers worldwide. More specifically, the paper develops and tests various hypotheses as to whether the perceived quality and relevance of a journal is affected by such factors as: (i) nature of research work (empiricists versus modelers), (ii) society membership, (iii) research productivity, (iv) geographical location, and (v) seniority. Our findings suggest that caution must be exercised when utilizing existing POM journal rankings, as some factors, particularly the difference between empiricists and modelers, may influence journal evaluation. These must be considered when addressing issues such as faculty promotions, tenure, and salary. © 2006 Elsevier B.V. All rights reserved.

A bridge too far? Breaching the research/learning and teaching nexus in a previously research-led university

The relationship between research and learning and teaching represents what has been described as ‘amongst the most intellectually tangled, managerially complex and politically contentious issues in mass higher education’ (Scott, 2005, p 53). Despite this, arguments that in order to achieve high quality scholarly outcomes, university teachers need to adopt an approach to teaching similar to that of research (i.e. founded upon academic rigour and evidence), has long been discussed in the literature (see for example, Elton, 2005 & Healey, 2000). However, the practicalities of promoting an empirical and evidence-based approach to teaching within a research-led institution makes dealing with the research/learning and teaching nexus a somewhat challenging proposition. Drawing upon the findings of a mixed methodological study, this paper critically analyses the pedagogical, organisational and practical issues encountered by academics and support staff working within a newly established Centre for Learning Innovation and Professional Practice. Comprising an eclectic group of staff drawn from across the five Schools in the University, the Centre is dedicated to enhancing student learning through the development of evidence based teaching practice. Based upon the premise that the promotion of research-led teaching will act to bring teaching and research together, and in doing so enhance students learning experiences (Simmons & Elen 2007), the paper critically analyses the challenges encountered by staff responsible for developing and introducing a new learning & teaching focused organisational strategy (by reflecting on the previous 12 months work). In doing so it makes a significant contribution to current academic theory and debate in the areas of pedagogic practice and organisational management. Focusing specifically on the impact of the new policy on various aspects of university life including, pedagogic practice, student support, staff training, and organisational management, the paper critically addresses the cultural and attitudinal challenges of change management (Kotter, 1996) within a ‘grey-brick’ university. It concludes by arguing that the move towards becoming a more learning-focused university has started to develop an awareness of the positive impact the change initiative is having on the student experience and wider institution; whilst also drawing attention to the organisational challenges ahead.

Independent modulation of engagement and connectivity of the facial network during affect processing by CACNA1C and ANK3 risk genes for bipolar disorder

IMPORTANCE Genome-wide association studies (GWASs) indicate that single-nucleotide polymorphisms in the CACNA1C and ANK3 genes increase the risk for bipolar disorder (BD). The genes influence neuronal firing by modulating calcium and sodium channel functions, respectively. Both genes modulate ?-aminobutyric acid-transmitting interneuron function and can thus affect brain regional activation and interregional connectivity. OBJECTIVE To determine whether the genetic risk for BD associated with 2 GWAS-supported risk single-nucleotide polymorphisms at CACNA1C rs1006737 and ANK3 rs10994336 is mediated through changes in regional activation and interregional connectivity of the facial affect-processing network. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional functional magnetic resonance imaging study at a research institute of 41 euthymic patients with BD and 46 healthy participants, all of British white descent. MAIN OUTCOMES AND MEASURES Blood oxygen level-dependent signal and effective connectivity measures during the facial affect-processing task. RESULTS In healthy carriers, both genetic risk variants were independently associated with increased regional engagement throughout the facial affect-processing network and increased effective connectivity between the visual and ventral prefrontal cortical regions. In contrast, BD carriers of either genetic risk variant exhibited pronounced reduction in ventral prefrontal cortical activation and visual-prefrontal effective connectivity. CONCLUSIONS AND RELEVANCE Our data demonstrate that the effect of CACNA1C rs1006737 and ANK3 rs10994336 (or genetic variants in linkage disequilibrium) on the brain converges on the neural circuitry involved in affect processing and provides a mechanism linking BD to genome-wide genetic risk variants.

Metformin in patients with type 2 diabetes and kidney disease:a systematic review

IMPORTANCE: Metformin is widely viewed as the best initial pharmacological option to lower glucose concentrations in patients with type 2 diabetes mellitus. However, the drug is contraindicated in many individuals with impaired kidney function because of concerns of lactic acidosis. OBJECTIVE: To assess the risk of lactic acidosis associated with metformin use in individuals with impaired kidney function. EVIDENCE ACQUISITION: In July 2014, we searched the MEDLINE and Cochrane databases for English-language articles pertaining tometformin, kidney disease, and lactic acidosis in humans between 1950 and June 2014.We excluded reviews, letters, editorials, case reports, small case series, and manuscripts that did not directly pertain to the topic area or that met other exclusion criteria. Of an original 818 articles, 65 were included in this review, including pharmacokinetic/metabolic studies, large case series, retrospective studies, meta-analyses, and a clinical trial. RESULTS: Although metformin is renally cleared, drug levels generally remain within the therapeutic range and lactate concentrations are not substantially increased when used in patients with mild to moderate chronic kidney disease (estimated glomerular filtration rates, 30-60 mL/min per 1.73m2). The overall incidence of lactic acidosis in metformin users varies across studies from approximately 3 per 100 000 person-years to 10 per 100 000 person-years and is generally indistinguishable from the background rate in the overall population with diabetes. Data suggesting an increased risk of lactic acidosis in metformin-treated patients with chronic kidney disease are limited, and no randomized controlled trials have been conducted to test the safety ofmetformin in patients with significantly impaired kidney function. Population-based studies demonstrate that metformin may be prescribed counter to prevailing guidelines suggesting a renal risk in up to 1 in 4 patients with type 2 diabetes mellitus-use which, in most reports, has not been associated with increased rates of lactic acidosis. Observational studies suggest a potential benefit from metformin on macrovascular outcomes, even in patients with prevalent renal contraindications for its use. CONCLUSIONS AND RELEVANCE: Available evidence supports cautious expansion of metformin use in patients with mild to moderate chronic kidney disease, as defined by estimated glomerular filtration rate, with appropriate dosage reductions and careful follow-up of kidney function.

The examination of the relationships among secondary principals' leadership behaviors, school climate, and student achievement in an urban context

School principals' leadership is key to successful school reform, as is increased student achievement. This nonexperimental ex post facto study tested relationships among secondary school principals' leadership behaviors, school climate, and student achievement. Of 165 secondary school principals from the three largest school districts in South Florida, 58 completed three online survey instruments: the Leadership Practices Inventory, School Climate Inventory-Revised, and researcher-designed Demographic Questionnaire. Student achievement was measured by students' scores on the reading and mathematics Florida Comprehensive Assessment Tests. Three null hypotheses tested relationships among (a) five principals' leadership behaviors and seven domains of school climate; (b) principals' leadership behaviors and student achievement; and (c) principals' leadership behaviors, school climate, and student achievement. Multiple linear regressions were used to determine the degree to which the independent variables predicted the dependent variables for the first two hypotheses. ANOVAs tested possible group differences between the demographic and research variables as controls for the third hypothesis. Partial correlational analyses tested the strength and direction of relationships among leadership behaviors, climate, and achievement. Results revealed partial support of the hypotheses. None of the leadership variables significantly predicted school climate. No significant relationships were found among the five leadership behaviors and student achievement. Demographic group differences in school climate and student achievement were marginally significant. The leadership behaviors of Inspiring a Shared Vision and Enabling Others to Act were positively linked to reading achievement. Partial correlations were found (r .27 to −.35) among school climate variables of Order, Involvement, and Expectation and achievement variables. The Modeling the Way leadership variable was negatively associated with reading achievement. After controlling for gender, years at current school, and years in the district, partial positive correlations were found among leadership, school climate, and student achievement. Inspiring a Shared Vision, Enabling Others to Act, Encouraging the Heart, and Challenging the Process leadership variables were partially correlated to Order, Leadership (Instructional), and Expectation climate variables. Study results should provide policymakers and educators with a leadership profile for school leaders challenging the status quo who can create schools for enhanced student learning and relevance to the needs of students, families, and society.

Relevance of the community college curriculum to the international student

The purpose of this study was to ascertain the perception of the level of satisfaction that international students have regarding the services and the relevance of the curriculum offered at Miami-Dade Community College. Trends and issues at universities and community colleges in providing services and an international curriculum for foreign students are outlined. Focus is on characteristics, personal and career needs as well as needs of national development for the students' countries. A sample of students from four developing nations was selected to qualitatively and quantitatively determine their level of satisfaction. The nations are the Bahamas, Colombia, Haiti and Pakistan. Students responses were recorded through group interviews, four personal interviews, an open ended questionnaire and a Likert scaled survey questionnaire. Matrix charts, mean calculations and one way analysis of variance were used to analyze data collected. Country of origin and major program of study were the variables used for statistical analysis. Information gathered through qualitative research presented a variety of perspectives and responses, both positive and negative. Students supplied specific examples of experiences and insights to help explain their various perceptions. Statistically, there were no significant differences between the variables of country of origin and major program of study regarding program services and relevance of the curriculum. Implications and recommendations for community college programs were outlined.

Television history: archives, excavation and the future. A discussion

This article considers possible futures for television (TV) studies, imagining how the discipline might evolve more productively over the next 10 years and what practical steps are necessary to move towards those outcomes. Conducted as a round-table discussion between leading figures in television history and archives, the debate focuses on the critical issue of archives, considering and responding to questions of access/inaccessibility, texts/contexts, commercial/symbolic value, impact and relevance. These questions reflect recurrent concerns when selecting case studies for historical TV research projects: how difficult is it to access the material (when it survives)? What obstacles might be faced (copyright, costs, etc.) when disseminating findings to a wider public? The relationship between the roles of ‘researcher’ and ‘archivist’ appears closer and more mutually supportive in TV studies than in other academic disciplines, with many people in practice straddling the traditional divide between the two roles, combining specialisms that serve to further scholarship and learning as well as the preservation of, and broad public engagements with, collections. The Research Excellence Framework’s imperative for academic researchers to achieve ‘impact’ in broader society encourages active and creative collaboration with those based in public organizations, such as the British Film Institute (BFI), who have a remit to reach a wider public. The discussion identifies various problems and successes experienced in collaboration between the academic, public and commercial sectors in the course of recent and ongoing research projects in TV studies.

Natriuretic peptide-based screening and collaborative care for heart failure:the STOP-HF randomized trial

IMPORTANCE: Prevention strategies for heart failure are needed.

OBJECTIVE: To determine the efficacy of a screening program using brain-type natriuretic peptide (BNP) and collaborative care in an at-risk population in reducing newly diagnosed heart failure and prevalence of significant left ventricular (LV) systolic and/or diastolic dysfunction.

DESIGN, SETTING, AND PARTICIPANTS: The St Vincent's Screening to Prevent Heart Failure Study, a parallel-group randomized trial involving 1374 participants with cardiovascular risk factors (mean age, 64.8 [SD, 10.2] years) recruited from 39 primary care practices in Ireland between January 2005 and December 2009 and followed up until December 2011 (mean follow-up, 4.2 [SD, 1.2] years).

INTERVENTION: Patients were randomly assigned to receive usual primary care (control condition; n=677) or screening with BNP testing (n=697). Intervention-group participants with BNP levels of 50 pg/mL or higher underwent echocardiography and collaborative care between their primary care physician and specialist cardiovascular service.

MAIN OUTCOMES AND MEASURES: The primary end point was prevalence of asymptomatic LV dysfunction with or without newly diagnosed heart failure. Secondary end points included emergency hospitalization for arrhythmia, transient ischemic attack, stroke, myocardial infarction, peripheral or pulmonary thrombosis/embolus, or heart failure.

RESULTS: A total of 263 patients (41.6%) in the intervention group had at least 1 BNP reading of 50 pg/mL or higher. The intervention group underwent more cardiovascular investigations (control, 496 per 1000 patient-years vs intervention, 850 per 1000 patient-years; incidence rate ratio, 1.71; 95% CI, 1.61-1.83; P<.001) and received more renin-angiotensin-aldosterone system-based therapy at follow-up (control, 49.6%; intervention, 56.5%; P=.01). The primary end point of LV dysfunction with or without heart failure was met in 59 (8.7%) of 677 in the control group and 37 (5.3%) of 697 in the intervention group (odds ratio [OR], 0.55; 95% CI, 0.37-0.82; P = .003). Asymptomatic LV dysfunction was found in 45 (6.6%) of 677 control-group patients and 30 (4.3%) of 697 intervention-group patients (OR, 0.57; 95% CI, 0.37-0.88; P = .01). Heart failure occurred in 14 (2.1%) of 677 control-group patients and 7 (1.0%) of 697 intervention-group patients (OR, 0.48; 95% CI, 0.20-1.20; P = .12). The incidence rates of emergency hospitalization for major cardiovascular events were 40.4 per 1000 patient-years in the control group vs 22.3 per 1000 patient-years in the intervention group (incidence rate ratio, 0.60; 95% CI, 0.45-0.81; P = .002).

CONCLUSION AND RELEVANCE: Among patients at risk of heart failure, BNP-based screening and collaborative care reduced the combined rates of LV systolic dysfunction, diastolic dysfunction, and heart failure.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00921960.

‘Potentially inappropriate or specifically appropriate?’ Qualitative evaluation of general practitioners views on prescribing, polypharmacy and potentially inappropriate prescribing in older people

Background: Potentially inappropriate prescribing (PIP) is common in older people in primary care, as evidenced by a significant body of quantitative research. However, relatively few qualitative studies have investigated the phenomenon of PIP and its underlying processes from the perspective of general practitioners (GPs). The aim of this paper is to explore qualitatively, GP perspectives regarding prescribing and PIP in older primary care patients.

Method: Semi-structured qualitative interviews were conducted with GPs participating in a randomised controlled trial (RCT) of an intervention to decrease PIP in older patients (≥70 years) in Ireland. Interviews were conducted with GP participants (both intervention and control) from the OPTI-SCRIPT cluster RCT as part of the trial process evaluation between January and July 2013. Interviews were conducted by one interviewer and audio recorded. Interviews were transcribed verbatim and a thematic analysis was conducted.

Results: Seventeen semi-structured interviews were conducted (13 male; 4 female). Three main, inter-related themes emerged (complex prescribing environment, paternalistic doctor-patient relationship, and relevance of PIP concept). Patient complexity (e.g. polypharmacy, multimorbidity), as well as prescriber complexity (e.g. multiple prescribers, poor communication, restricted autonomy) were all identified as factors contributing to a complex prescribing environment where PIP could occur, as was a paternalistic-doctor patient relationship. The concept of PIP was perceived to be of variable usefulness to GPs and the criteria to measure it may be at odds with the complex processes of prescribing for this patient population.

Conclusions: Several inter-related factors contributing to the occurrence of PIP were identified, some of which may be amenable to intervention. Improvement strategies focused on improved management of polypharmacy and multimorbidity, and communication across primary and secondary care could result in substantial improvements in PIP.

Proprioception in ankle sprain from exercises and bandages

Ankle sprains are the most common injuries in sports, usually causing damage to the lateral ligaments. Recurrence has as usual result permanent instability, and thus loss of proprioception. This fact, together with residual symptoms, is what is known as chronic ankle instability, CAI, or FAI, if it is functional. This problem tries to be solved by improving musculoskeletal stability and proprioception by the application of bandages and performing exercises. The aim of this study has been to review articles (meta-analisis, systematic reviews and revisions) published in 2009-2015 in PubMed, Medline, ENFISPO and BUCea, using keywords such as “sprain instability”, “sprain proprioception”, “chronic ankle instability”. Evidence affirms that there does exist decreased proprioception in patients who suffer from CAI. Rehabilitation exercise regimen is indicated as a treatment because it generates a subjective improvement reported by the patient, and the application of bandages works like a sprain prevention method limiting the range of motion, reducing joint instability and increasing confidence during exercise. As podiatrists we should recommend proprioception exercises to all athletes in a preventive way, and those with CAI or FAI, as a rehabilitation programme, together with the application of bandages. However, further studies should be generated focusing on ways of improving proprioception, and on the exercise patterns that provide the maximum benefit.