Free to publish - free to read

Full Text: August 2001 saw the birth of the British Journal of Diabetes & Vascular Disease (Figure 1): an open-access peer review journal.1 Free to publish and free to read. The founding editorial board and publisher (MediNews Diabetes) aimed to deliver a free journal to the diabetes team and vascular professionals with a special interest in diabetes. Despite the shifting sands of time and a change of publisher (SAGE) the journal has remained true to its founding philosophy - publication is on merit, not on ability to pay and free online access remains available worldwide (www.bjdvd.com) plus an extensive – mainly UK - print circulation. Evolution- The journal attracted much attention and was soon receiving good quality experimental and clinical science manuscripts. However it was felt that these articles, especially experimental and pre-clinical studies, were not within the focus of the British Journal of Diabetes & Vascular Disease, thus Diabetes & Vascular Disease Research was conceived –and is now also a SAGE journal and has an impact factor of 2.59. Over the years the organisation of topics has changed, for example the Healthcare management, The diabetes care team and Trans-cultural medicine sections have been absorbed into the Achieving Best Practice and Current Topics sections which better reflect the broader-based content of submitted material. Landmark Studies was a regular highly popular section – but how many truly Landmark Studies are undertaken? Not enough to warrant special attention 6 times a year for 12 years. Interestingly one of the studies reviewed is consistently amongst the top ten of our most read online articles.2 The British Journal of Diabetes & Vascular Disease has also challenged convention with the production of two Jubilee issues.3,4 The celebrations for the golden and diamond jubilees of Her Majesty Queen Elizabeth II afforded opportunities to reflect on changes in the understanding and treatment of diabetes during her reign. Most of the articles in these issues were written by authors who had first hand experience of the changing face of diabetes and vascular disease care. The increased costs of print and post – both financially and environmentally mean that digital communications are likely to become more popular (assuming that these approaches have a smaller ecological footprint). The British Journal of Diabetes & Vascular Disease is pleased to be able to celebrate its 12th birthday as an original open-access journal, with an ongoing commitment to support authors to publish free of charge whilst providing free reader access. As for what the future holds: tomorrow is another day. References 1.British Journal of Diabetes & Vascular Disease 2001; 1: 1-92. 2.Levy J. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. Br J Diabetes Vasc Dis 2002; 2: 278-80. 3.British Journal of Diabetes & Vascular Disease. (Golden Jubilee Issue) 2002; 2: 415-480. 4.British Journal of Diabetes & Vascular Disease. (Diamond Jubilee Issue) 2012; 12: 266-380.

Making mole-hills out of mountains:Peer Mentoring in Engineering education - A case-study

Based on the emergent findings of a pilot study which examined the issues around introducing Peer Mentoring into an Engineering School, this paper, which is very much a 'work in progress', describes and discusses results from the first year of what will be a three year exploratory study. Focusing on three distinctive concepts integral to the student experience, Relationships, Variety and Synergy, the study follows an Action Research Design in that it aims to find a realistic and workable solution to issues of attrition within the Engineering School in which the Project and Study are set. Starting with the research question "Does Peer Mentoring improve engineering students' transition into university?"', the Pilot Project and Study will run for three years, each year building on the lessons of the previous year.

The effects of cultural distance on student socialization and departure decisions

Organizational socialization theory and university student retention literature support the concept that social integration influences new recruits' level of satisfaction with the organization and their decision to remain. This three-phase study proposes and tests a Cultural Distance Model of student retention based on Tinto's (1975) Student Integration Model, Louis' (1980) Model of Newcomer Experience, and Kuh and Love's (2000) theory relating cultural distance to departure from the organization. ^ The main proposition tested in this study was that the greater the cultural distance, the greater the likelihood of early departure from the organization. Accordingly, it was inferred that new recruits entering the university culture experience some degree of social and psychological distance. The extent of the distance correspondingly influences satisfaction with the institution and intent to remain for subsequent years. ^ The model was tested through two freshman student surveys designed to examine the effects of cultural distance on non-Hispanics at a predominantly Hispanic, urban, public university. The first survey was administered eight weeks into their first Fall semester and the second at the end of their first year. Student retention was determined through their re-enrollment for the second Fall semester. Path analysis tested the viability of the hypothesis relating cultural distance to satisfaction and retention as suggested in the model. Logistic regression tested the model's predictive power. ^ Correlations among variables were significant, accounting for 54% of variance in students' decisions to return for the second year with 96% prediction accuracy. Initial feelings of high cultural distance were related to increased dissatisfaction with social interactions and institutional choice at the end of the first year and students' intention not to re-enroll. Path analysis results supported the view that the construct of culture distance incorporates both social and psychological distance, and is composed of beliefs of institutional fit with one's cultural expectations, individual comfort with the fit, and the consequent sense of “belonging” or identifying with the institution. ^

Tree Islands in Everglades Landscapes: Current Status, Historical Changes, and Hydrologic Impacts on Population Dynamics and Moisture Relations, First Annual Report

In 2005 we initiated a project designed to better understand tree island structure and function in the Everglades and the wetlands bordering it. Focus was on the raised portions at the upstream end of the islands, where tropical hardwood species adapted to well-drained conditions usually are the most prominent component of the vegetation. The study design is hierarchical, with four levels; in general, a large number of sites is to be surveyed once for a limited set of parameters, and increasingly small sets of islands are to be sampled more intensively, more frequently, and for more aspects of ecosystem function. During the first year of the 3-year study, we completed surveys of 41 Level 1 (i.e., the least intensive level) islands, and established permanent plots in two and three islands of Levels 2 and 4 intensity, respectively. Tree species richness and structural complexity was highest in Shark Slough “hammocks”, while islands in Northeast Shark Slough and Water Conservation Area 3B, which receive heavy human use, were simpler, more park-like communities. Initial monitoring of soil moisture in Level 4 hammocks indicated considerable local variation, presumably associated with antecedent rainfall and current water levels in the adjacent marsh. Tree islands throughout the study area were impacted significantly by Hurricanes Katrina and Wilma in 2005, but appear to be recovering rapidly. As the project continues to include more islands and repeated measurements, we expect to develop a better grasp of tree island dynamics across the Everglades ecosystem, especially with respect to moisture relations and water levels in the adjacent marsh. The detailed progress report which follows is also available online at http://www.fiu.edu/~serp1/projects/treeislands/tree_islands_2005_annual_report.pd

Da educação infantil ao ensino fundamental: o que contam as crianças sobre essa travessia na cultura de escola

From inquiries concerning the child as an individual with rights, this work takes as its object of study the perception of 5-7 years old children on their journey from kindergarten to elementary school, in a school culture. The objective of the research is, therefore, to investigate what the children tell in narratives drawn into a conversation circle about their experiences of school life in kindergarten and the first grade of elementary school. The participants were 18 children from a public school in the city of Natal (RN). Five rounds of conversation were held in which the children told a little alien, who was unaware of the school culture, what they knew about school and what they did at it. The research is linked to the project "Children's Narratives. What the children tell about childhood schools?"(Passeggi et all, 2011) and adopts epistemological principles and research methods of (auto)biographical education, taking as a working hypothesis the child's ability to reflect on their experiences and understand from their point of view, what happens to them. Analyses were organized based on the concept of school culture (Barroso, 2012). In the narratives of children, the three dimensions of school culture: the functionalist (purpose and rules), structural (structure and pedagogical organization) and the interactional (relations with others, with the spaces and with knowledge) are considered intertwined in their school perceptions and signal experienced tensions in a process of "conversion" from child to student. Children seem to realize the uniqueness of each level of education. They recognize as a characteristic of early childhood education the recreational activities, and as injunctions of the first year of elementary school the "study", "learning to read and write" to "be smart" to "change." The schooling will thus, constitute, in their eyes, as a time and a place where the children's culture gives way to school culture, and in this journey they experience that the desire to play and the duty/want to study cross the three dimensions of school. At the end of the journey, the status of children as cultural beings with rights is confirmed, whose narratives about school and about their experiences of "conversion" in a student, reveal much about the power of reflection on themselves, the school and the society in which they live, legitimizing their place in educational research and in child care policies.

Engineering for employability:a transition into CDIO

This paper draws upon the findings of a three year study which tracks an institutions journey of CDIO. In focusing on the student perspective the findings discuss students’ prior learning experiences and their expectations of university. The study considers students’ early perceptions of CDIO; emergent findings suggest that whilst CDIO is not really what students expect when they first arrive at university, most prefer it to ‘traditional lectures’. Indeed the majority indicate that they believe the approach enhances their employability and provides a more engaging learning experience. The conclusion argues that with its focus on problem-based learning and team-working, CDIO has changed the face of the 1st year experience for mechanical engineering and designed students within the university and that in doing so it has enhanced transition and ultimately promoted student success.

Variability of marine climate on the North Icelandic Shelf in a 1357-year proxy archive based on growth increments in the bivalve Arctica islandica

A multicentennial and absolutely-dated shell-based chronology for the marine environment of the North Icelandic Shelf has been constructed using annual growth increments in the shell of the long-lived bivalve clam Arctica islandica. The region from which the shells were collected is close to the North Atlantic Polar Front and is highly sensitive to the varying influences of Atlantic and Arctic water masses. A strong common environmental signal is apparent in the increment widths, and although the correlations between the growth increment indices and regional sea surface temperatures are significant at the 95% confidence level, they are low (r ~ 0.2), indicating that a more complex combination of environmental forcings is driving growth. Remarkable longevities of individual animals are apparent in the increment-width series used in the chronology, with several animals having lifetimes in excess of 300 years and one, at 507 years, being the longest-lived non-colonial animal so far reported whose age at death can be accurately determined. The sample depth is at least three shells after AD 1175, and the time series has been extended back to AD 649 with a sample depth of one or two by the addition of two further series, thus providing a 1357-year archive of dated shell material. The statistical and spectral characteristics of the chronology are investigated by using two different methods of removing the age-related trend in shell growth. Comparison with other proxy archives from the same region reveals several similarities in variability on multidecadal timescales, particularly during the period surrounding the transition from the Medieval Climate Anomaly to the Little Ice Age.

Factors affecting transition to second year of an engineering degree

Much research has focused on students’ transition from secondary school to university. Less is known about the transition from first to second year of a university degree programme. Given the difficulties that many students face at this stage of their education, research into the relevant factors is required. Through questionnaires and focus groups, views of second- and third-year aerospace and mechanical engineering students in our university have been gathered. A large majority believed that both the volume and difficulty of work increased in second year. Many stated that first year was slightly too trivial and could have been made more challenging to prepare them better for second year. Different teaching and assessment styles in second year were considered to affect attendance and performance. The survey revealed that students were generally very well settled into university life by the end of first year and were happy with their choice of course and only 23% reported that financial responsibilities have had a negative effect on their academic performance. Differences were observed between male and female students. Male students believed that transition was helped by having regular assessments and by worked examples in lectures. Females found the teaching staff were the most helpful factor for a successful transition. The results indicate that males require more structure and guidance whereas females are more independent and settle in better.

The Hidden benefits of “poster presentation assessment”: Skill acquirement and learning; evaluated from the nursing students perspective

Introduction
This paper reports to an exercise in evaluating poster group work and poster presentation and the extra learning and skill acquisition that this can provide to nursing students, through a creative and stimulating assessment method. Much had been written about the benefits of using posters as an assessment method, yet there appears to be a lack of research that captures the student experience.
Aim
This evaluative study sought to evaluate the student experience by using a triangulation approach to evaluation:
Methodology
All students from the February 2015 nursing intake, were eligible to take part (80 students) of which 71 participated (n=71). The poster group presentations took place at the end of their first phase of year one teaching and the evaluation took place at the end of their first year as undergraduate. Evaluation involved;
1. Quantitative data by questionnaires
2. Qualitative data from focus group discussions
Results
A number of key themes emerged from analysis of the data which captured the “added value” of learning from the process of poster assessment including:
 Professionalism: developing time keeping skills, presenting skills.
 Academic skills: developing literature search, critic and reporting
 Team building and collaboration
Overall 88% agreed that the process furnished them with additional skills and benefits above the actual production of the poster, with 97% agreeing that these additional skills are important skills for a nurse.
Conclusion
These results would suggest that the process of poster development and presentation furnish student nurses with many additional skills that they may not acquire through other types of assessment and are therefore beneficial. The structure of the assessment encourages a self-directed approach so students take control of the goals and purposes of learning. The sequential organization of the assessment guides students in the transition from dependent to self-directed learners.

Clinical Outcomes in 3343 Children and Adults with Rheumatic Heart Disease from 14 Low and Middle Income Countries: 2-Year Follow-up of the Global Rheumatic Heart Disease Registry (the REMEDY study)

BACKGROUND: -There are few contemporary data on the mortality and morbidity associated with rheumatic heart disease (RHD) or information on their predictors. We report the two year follow-up of individuals with RHD from 14 low and middle income countries in Africa and Asia.

METHODS: -Between January 2010 and November 2012, we enrolled 3343 patients from 25 centers in 14 countries and followed them for two years to assess mortality, congestive heart failure (CHF), stroke or transient ischemic attack (TIA), recurrent acute rheumatic fever (ARF), and infective endocarditis (IE).

RESULTS: -Vital status at 24 months was known for 2960 (88.5%) patients. Two thirds were female. Although patients were young (median age 28 years, interquartile range 18 to 40), the two year case fatality rate was high (500 deaths, 16.9%). Mortality rate was 116.3/1000 patient-years in the first year and 65.4/1000 patient-years in the second year. Median age at death was 28.7 years. Independent predictors of death were severe valve disease (hazard ratio (HR) 2.36, 95% confidence interval (CI) 1.80-3.11), CHF (HR 2.16, 95% CI 1.70-2.72), New York Heart Association functional class III/IV (HR 1.67, 95% CI 1.32-2.10), atrial fibrillation (AF) (HR 1.40, 95% CI 1.10-1.78) and older age (HR 1.02, 95% CI 1.01-1.02 per year increase) at enrolment. Post-primary education (HR 0.67, 95% CI 0.54-0.85) and female sex (HR 0.65, 95%CI 0.52-0.80) were associated with lower risk of death. 204 (6.9%) had new CHF (incidence, 38.42/1000 patient-years), 46 (1.6%) had a stroke or TIA (8.45/1000 patient-years), 19 (0.6%) had ARF (3.49/1000 patient-years), and 20 (0.7%) had IE (3.65/1000 patient-years). Previous stroke and older age were independent predictors of stroke/TIA or systemic embolism. Patients from low and lower-middle income countries had significantly higher age- and sex-adjusted mortality compared to patients from upper-middle income countries. Valve surgery was significantly more common in upper-middle income than in lower-middle- or low-income countries.

CONCLUSIONS: -Patients with clinical RHD have high mortality and morbidity despite being young; those from low and lower-middle income countries had a poorer prognosis associated with advanced disease and low education. Programs focused on early detection and treatment of clinical RHD are required to improve outcomes.

Foundation Doctors and Dyslexia: a Qualitative Study of Their Experiences and Coping Strategies

Background Dyslexia is the most common form of specific learning difficulty affecting approximately 6% of the general UK population and believed to affect approximately 2% of UK medical students. The impact of dyslexia on early practice has not been studied. Objectives To develop an understanding of the challenges faced by doctors with dyslexia in the first year of practice and their support requirements. Methods Semistructured telephone interviews were conducted with seven foundation year 1 doctors with dyslexia from Scottish hospitals between March 2013 and August 2013. Results Foundation doctors indicated that due to their dyslexia, they experience difficulty with all forms of communication, time management and anxiety. There were concerns about disclosure of their dyslexia to colleagues and supervisors. Coping strategies used frequently were safety-netting and planning; technology solutions did offer some assistance. Conclusions Although technological interventions have the potential to offer benefits to foundation doctors with dyslexia, increased openness about a diagnosis of dyslexia with discussion between doctor and supervisors about the challenges and anxieties is likely to provide the most benefit

Postoperative Bowel Function and Related Factors in Enhanced Recovery Protocol with Patients Undergoing Hepatectomy

Patients’ bowel dysfunction is a major factor that weakens the results of surgical care as it can cause pain and weaken patients’ rehabilitation. Bowel dysfunction is a common postoperative problem, yet most incidents remain undocumented. The nursing profession has a significant role in enhancing the bowel function postoperatively. However, studies of postoperative bowel function after hepatectomy are scarce and somewhat incongruous. Enhanced recovery protocols are innovative models of care aiming for better outcomes of surgical care. Enhanced recovery protocols can improve gastrointestinal function after surgery, yet patients are also known to be satisfied with their care. The aim was to investigate if postoperative bowel function day varies between patients in terms of age, gender, ASA score, type of surgery, histology, patients’ experienced pain and experienced satisfaction three days after discharge and three months after operation in patients undergoing hepatectomy. The goal was to produce information for basis of scientific research, to give nurses in clinical setting more tools to work with hepatectomy patients undergoing enhanced recovery protocol and to produce information to nurse managers to use in process management of patients undergoing enhanced recovery protocol. The design of this study is descriptive. Data was collected retrospectively from hepatectomy patients (n = 134) undergoing enhanced recovery protocol within the first year of enhanced recovery protocol implementation. The data was based on registers and analyzed statistically. Mean age of patients was 62 years and mean day of discharge was 4. Main (n = 72) histology of the patients was colorectal liver metastases. Mean bowel function day was 3. Most of the patients were very satisfied or satisfied with the care three days after discharge (99%) and three months (90%) after operation. Most of the patients (72%) experienced moderate pain three days after discharge, but three months after operation 47% of the patients did not experience pain and 48% experienced moderate pain. There were no statistically significant differences in bowel function between different age groups, genders, ASA score groups or histologies. Neither were there statistically significant differences in postoperative bowel function in terms of experienced satisfaction or pain. There were statistically significant differences in postoperative bowel function between different types of surgery (p < 0.01). Nurses should take into consideration hepatectomy patients’ type of surgery and pay special attention in supporting major open hepatectomy patients’ postoperative bowel function. Nurses should educate patients undergoing major open hepatectomy about prolonged postoperative bowel function.

Finnish Preclinical and Clinical Medical Students as Strategic L2 English Learners: Language Learning Strategies and Communicating with Patients

This thesis focused on medical students’ language learning strategies for patient encounters. The research questions concerned the types of learning strategies that medical students use and the differences between the preclinical students and the clinical students, two groups who have had varying amounts of experience with patients. Additionally, strategy use was examined through activity systems to gain information on the context of language learning strategy use in order to learn language for patient encounters. In total, 130 first-year medical students (preclinical) and 39 fifth-year medical students (clinical) participated in the study by filling in a questionnaire on language learning strategies. In addition, two students were interviewed in order to create activity systems for the medical students at different stages of their studies. The study utilised both quantitative and qualitative research methods; the analysis of the results relies on Oxford’s Strategic Self-Regulation Model in the quantitative part and on activity theory in the qualitative part. The theoretical sections of the study introduced earlier research and theories regarding English for specific purposes, language learning strategies and activity theory. The results indicated that the medical students use affective, sociocultural-interactive and metasociocultural-interactive strategies often and avoid using negative strategies, which hinder language learning or cease communication altogether. Slight differences between the preclinical and clinical students were found, as clinical students appear to use affective and metasociocultural-interactive strategies more frequently compared to the preclinical students. The activity systems of the two students interviewed were rather similar. The students were at different stages of their studies, but their opinions were very similar. Both reported the object of learning to be mutual understanding between the patient and the doctor, which in part explains the preference for strategies that support communication and interaction. The results indicate that the nature of patient encounters affects the strategy use of the medical students at least to some extent.

A indisciplina no 1.º ciclo: conceções e práticas dos professores

Relatório de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e 2.º ciclos do Ensino Básico

Laparoscopic adjustable gastric banding in adolescents: Results at two years including psychosocial aspects

International audience