Showing papers by "Northumbria University published in 2007"

Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial

Abstract: Objectives: Gait and mobility problems are difficult to treat in people with Parkinson's disease. The Rehabilitation in Parkinson's Disease: Strategies for Cueing (RESCUE) trial investigated the effects of a home physiotherapy programme based on rhythmical cueing on gait and gait-related activity. Methods: A single-blind randomised crossover trial was set up, including 153 patients with Parkinson's disease aged between 41 and 80 years and in Hoehn and Yahr stage II-IV. Subjects allocated to early intervention (n = 76) received a 3-week home cueing programme using a prototype cueing device, followed by 3 weeks without training. Patients allocated to late intervention (n = 77) underwent the same intervention and control period in reverse order. After the initial 6 weeks, both groups had a 6-week follow-up without training. Posture and gait scores (PG scores) measured at 3, 6 and 12 weeks by blinded testers were the primary outcome measure. Secondary outcomes included specific measures on gait, freezing and balance, functional activities, quality of life and carer strain. Results: Small but significant improvements were found after intervention of 4.2% on the PG scores (p = 0.005). Severity of freezing was reduced by 5.5% in freezers only (p = 0.007). Gait speed (p = 0.005), step length (p,0.001) and timed balance tests (p = 0.003) improved in the full cohort. Other than a greater confidence to carry out functional activities (Falls Efficacy Scale, p = 0.04), no carry-over effects were observed in functional and quality of life domains. Effects of intervention had reduced considerably at 6-week follow-up. Conclusions: Cueing training in the home has specific effects on gait, freezing and balance. The decline in effectiveness of intervention effects underscores the need for permanent cueing devices and follow-up treatment. Cueing training may be a useful therapeutic adjunct to the overall management of gait disturbance in Parkinson's disease.

Fieldwork is Good: the Student Perception and the Affective Domain

Abstract: This paper reports on research that investigates the effectiveness of residential field courses in geography, earth science and environmental science courses at UK institutions of higher education. The research focuses on the effects of fieldwork in the affective domain, which is thought to be linked to the adoption of effective approaches to learning. Approximately 300 students were surveyed immediately before and after a field class, enabling analysis of changes in responses brought about as a result of the field experience. Potential differences were looked for between groups of students determined by gender, age, previous experience of fieldwork and place of residence. The research finds that fieldwork leads to significant effects in the affective domain. In general, student responses were very positive prior to fieldwork and became more positive as a result of the field experience. Some groups exhibited higher levels of anxiety about this learning method prior to the field class; however, such differ...

Male facial appearance signals physical strength to women.

Abstract: Previous studies showed that male faces with extreme features that are likely to be associated with testosterone (T) are perceived as dominant and masculine. Women were reported to prefer masculinized male faces, as they may consider T markers to be an "honest" indication of good health. However, it is also likely that female preferences for certain male faces arise from the fact that dominant- and masculine-looking males are signaling characteristics which may be beneficial in intrasexual conflict, and thereby also indicate potential achievers of high status, an important factor in female mate selection. Although numerous studies were built on this assumption, nothing is known about the relationship between perceived facial dominance and physical strength in men. We measured hand-grip strength, as a measure of overall physical strength, in a sample of 32 male students, and recorded age, body weight, and height. Seventy-nine women rated facial images of these men for dominance, masculinity, and attractiveness. After controlling for age and body weight, hand-grip strength was found to correlate significantly positively with all three measures. The present data thus support the supposition that a male's physical strength is also signaled via facial characteristics of dominance and masculinity, which are considered attractive by women.

Communities of practice and virtual learning communities : benefits, barriers and success factors

Abstract: Summary A virtual Community of Practice (CoP) is a network of individuals who share a domain of interest about which they communicate online. The practitioners share resources (for example experiences, problems and solutions, tools, methodologies). Such communication results in the improvement of the knowledge of each participant in the community and contributes to the development of the knowledge within the domain. A virtual learning community may involve the conduct of original research but it is more likely that its main purpose is to increase the knowledge of participants, via formal education or professional development. Virtual learning communities could have learning as their main goal or the elearning could be generated as a side effect. Virtual communities of practice (CoPs) and virtual learning communities are becoming widespread within higher education institutions (HEIs) thanks to technological developments which enable increased communication, interactivity among participants and incorporation of collaborative pedagogical models, specifically through information communications technologies (ICTs) They afford the potential for the combination of synchronous and asynchronous communication, access to -and from- geographically isolated communities and international information sharing. Clearly there are benefits to be derived from sharing and learning within and outwith HEIs. There is a sense of connectedness, of shared passion and a deepening of knowledge to be derived from ongoing interaction. Knowledge development can be continuous, cyclical and fluid. However, barriers exist in virtual CoPs and these are defined by the authors and illustrated with quotes from academic staff who have been involved in CoPs. Critical success factors (CSFs) for a virtual CoP are discussed. These include usability of technology; trust in, and acceptance of, ICTs in communication; a sense of belonging among members; paying attention to cross-national and cross-cultural dimensions of the CoP; shared understandings; a common sense of purpose; use of netiquette and user-friendly language and longevity. The authors recognise the enormous potential for the development of CoPs through e-mail discussion lists and discussion boards but have themselves experienced the difficulties inherent in initiating such a community. These are corroborated and illustrated with text from interviews with academic staff. Much of the literature on CoPs emanates from outside Europe, despite the fact that e-learning articles have a large diffusion around Europe. The authors suggest further exploration of this topic by identifying and studying CoPs and virtual learning communities across EU countries.

Competitive Advantage Revisited: Michael Porter on Strategy and Competitiveness:

Abstract: Strategic management is constantly evolving as both an academic discipline and as a reflection of management practice. This article, based on a recent interview with Michael Porter, assesses his contribution to the development of the discipline in the context of the advances that have taken place since the publication of his seminal work Competitive Strategy in 1980. The authors conclude that Porter has made major lasting contributions to strategy, increasing both its academic rigor and its accessibility to managers. The article and interview place Porter's work at the center of the development of strategic management in terms of the provision of practical analytical frameworks, transforming it into a recognized and recognizable field of academic study and management practice. This feat of transformation has not been equaled before or since, so that 25 years after his first seminal contribution, Porter's work continues to provide remarkable insights into the nature of competition and strategy.

The attentional cost of external rhythmical cues and their impact on gait in Parkinson's disease: effect of cue modality and task complexity

Abstract: Changes in gait performance in 153 subjects with PD using three rhythmical cues (auditory, visual and somatosensory) were measured during a simple walking task and a dual walking task in the home. Subjects were ‘on’ medication and were cued at preferred step frequency. Accelerometers recorded gait and walking speed, step amplitude and step frequency were determined from raw data. Data were analysed with SAS using linear regression models. Gait performance during a single task reduced with cues in contrast to a dual task where PD subjects appeared to benefit from rhythmical cues (increased speed and step length). Effects were dependent on cue modality with significant improvements for auditory cues compared to others. A significant short-term carry-over effect of cues reduced 3 weeks later. Cues may reduce attentional demands by facilitating attentional allocation, accounting for differences of cue seen during single and dual task. Furthermore cue modality may influence attentional demand which is an important consideration for rehabilitation.

Earplugs and eye masks: do they improve critical care patients’ sleep?

Abstract: Disturbed sleep and sleep deprivation is common in patients in critical care settings. Noise and inappropriate use of light/dark cycles are two of the causes of sleep interruptions. The purpose of the study was to evaluate eye masks and earplugs to help control patients' exposure to noise and light within the critical care environment. An intervention study using a two group post-test quasi-experimental design of high dependency patients within a cardiothoracic critical care unit was undertaken by a group of critical care nurses. Sleep assessment rating scales and open-ended questions were used to obtain patients' reported experiences of their sleep. Patients self-selected into either an intervention or non-intervention group. Sixty-four patients consented to take part in the study, 34 patients tried the interventions earplugs and eye masks and many found they improved sleep. However, noise was still a factor preventing sleep for both groups of patients. Mixed reports were found with the interventions from very comfortable to very uncomfortable. At a cost of 2.50 pounds sterling/patient, earplugs and eye masks were a relatively cheap intervention with notable improvements for some critically ill patients. Further research is required with a larger sample size, plus an examination of both earplugs and eye masks separately. Offering patient's earplugs and eye masks to improve sleep should be considered as a matter of routine nursing practice, this should include time to show patients how to use and try them out for comfort.

Understanding distress in people with severe communication difficulties: developing and assessing the Disability Distress Assessment Tool (DisDAT).

Abstract: Background Meaningful communication with people with profound communication difficulties depends on the ability of carers to recognize and translate many different verbal cues. Carers appear to be intuitively skilled at identifying distress cues, but have little confidence in their observations. To help in this process, a number of pain tools have been developed, but this sits uncomfortably with the lack of evidence that pain has any specific signs or behaviours. A palliative care team working with people with intellectual disabilities developed the Disability Distress Assessment Tool (DisDAT) to document a wide range of signs and behaviours of distress and when an individual is content. Method The tool was piloted with 16 carers and 8 patients. It was then assessed using quantitative and qualitative methods, employing 56 carers in routine clinical situations with 25 patients, most with severe communication difficulties. Carers of 10 patients participated in semi-structured interviews exploring the signs and behaviours demonstrated by patients when distressed and when content. These same 10 patients were observed for distress cues during different activities. Results It became clear that distress did not have a common meaning among carers, but there was a clear understanding that distress did not just cover physical pain. The range of distress cues was wide, with no evidence that any cues were specific to particular causes. Although some distress cues were common between patients, each patient had a distinct pattern of distress cues. In addition, different carers identified a different range of distress cues, while the length of the relationship did not influence the number of cues identified. Most distress cues were a change from the norm, but some patients demonstrated distress as an absence of content cues. Carers found the DisDAT simple to use and useful, and several felt that DisDAT would have helped advocate for the patients in previous conflicts with clinical teams. Conclusions There was no evidence that pain has any specific signs or behaviours. The preliminary and assessment phases showed that distress was a useful clinical construct in providing care. The DisDAT reflected patients’ distress communication identified by a range of carers, and provided carers with evidence for their intuitive observations of distress.

International practice development in nursing and healthcare

Abstract: Chapter 1: Introduction. Kim Manley, Brendan McCormack, Val Wilson . Chapter 2: Person-centred Systems and Processes. Brendan McCormack, Kim Manley and Ken Walsh . Chapter 3: The ever-changing discourse of practice development: Can we all keep afloat?. Lucienne. Hoogwerf, Donna. Frost and Tanya McCance . Chapter 4: A methodological walk in the forest: critical creativity and human flourishing. Angie Titchen & Brendan McCormack . Chapter 5: Evidence use and evidence generation in practice development. Tracey Bucknall, Bridie Kent, Kim Manley . Chapter 6: Learning - the Heart of Practice Development. Charlotte Clarke & Val Wilson . Chapter 7: An Exploration Of Practice Development Evaluation: Unearthing Praxis. Val Wilson, Sally Hardy, Bob Brown . Chapter 8: Enabling Practice development: delving into the concept of facilitation from a practitioner perspective. Theresa Shaw, Jan Dewing, Ros Young, Margaret Devlin, Christine Boomer and Marja Legius . Chapter 9: Being Culturally Sensitive in Development Work. Cheryle Moss & Jane Chittenden . Chapter 10: Person-centred outcomes and cultural change. Brendan McCormack, Tanya McCance, Paul Slater, Joanna McCormick, Charlotte McArdle and Jan Dewing . Chapter 11: Changing the culture and context of practice: Evaluating the Journey Towards Family-Centred Care. Val Wilson, Raelene Walsh . Chapter 12: Becoming a Facilitator - the journey. Shirley Burke, Helen O'Neal and Jacqueline Clarke . Chapter 13: Leadership Support. Annette Solman & Mary FitzGerald . Chapter 14: Becoming and Being Active Learners and Creating Active Learning Workplaces: The Value of Active Learning in Practice Development. Jan Dewing . Chapter 15: Evidence use in practice development. Rob McSherry and Karen Cox . Chapter 16: Using Practice Development approaches in the development of a. Managed Clinical Network. Liz Henderson and Sandra McKillop . Chapter 17: Accrediting Practice Development Activity: an approach for achieving person-centred and evidence-based care. Kim Manley, Jane Canny, Jill Down ,Jane-Marie Hamill, Elaine Manderson, Natalie Moroney, Jenny Newton, Alyce Schultz, Helen Young . Chapter 18: The Future Contribution of Practice Development in a Changing Healthcare Context. Kim Manley, Brendan McCormack, Val Wilson and Debra Thoms

The effect of antecedent fatiguing activity on the relationship between perceived exertion and physiological activity during a constant load exercise task.

Abstract: This study assessed the relationship between the rate of change of the rating of perceived exertion (RPE), physiological activity, and time to volitional exhaustion. After completing a graded exercise test, 10 participants cycled at a constant load equating to 75% of peak oxygen uptake (V O(2)peak) to exhaustion. Participants performed two further constant load exercise tests at 75%V O(2)peak in a fresh state condition within the next 7 days. The RPE was regressed against time and percentage of the time (%time) to volitional exhaustion in both conditions. Despite a lower respiratory exchange ratio (RER) and higher heart rate at the start of the exercise bout in the fatigued condition, there were no differences in RPE at the onset or completion of exercise. As expected, the rate of increase in RPE was greater in the fatigued condition, but there were no differences when expressed against %time. Results suggest that RPE is set at the start of exercise using a scalar internal timing mechanism, which regulates RPE by altering the gain of the relationship with physiological parameters such as heart rate and RER when these are altered by previous fatiguing exercise.

Thiacetazone, an antitubercular drug that inhibits cyclopropanation of cell wall mycolic acids in mycobacteria

Abstract: Background. Mycolic acids are a complex mixture of branched, long-chain fatty acids, representing key components of the highly hydrophobic mycobacterial cell wall. Pathogenic mycobacteria carry mycolic acid sub-types that contain cyclopropane rings. Double bonds at specific sites on mycolic acid precursors are modified by the action of cyclopropane mycolic acid synthases (CMASs). The latter belong to a family of S-adenosyl-methionine-dependent methyl transferases, of which several have been well studied in Mycobacterium tuberculosis, namely, MmaA1 through A4, PcaA and CmaA2. Cyclopropanated mycolic acids are key factors participating in cell envelope permeability, host immunomodulation and persistence of M. tuberculosis. While several antitubercular agents inhibit mycolic acid synthesis, to date, the CMASs have not been shown to be drug targets. Methodology/Principle Findings. We have employed various complementary approaches to show that the antitubercular drug, thiacetazone (TAC), and its chemical analogues, inhibit mycolic acid cyclopropanation. Dramatic changes in the content and ratio of mycolic acids in the vaccine strainMycobacterium bovis BCG, as well as in the related pathogenic speciesMycobacterium marinum were observed after treatment with the drugs. Combination of thin layer chromatography, mass spectrometry and Nuclear Magnetic Resonance (NMR) analyses of mycolic acids purified fromdrug-treated mycobacteria showed a significant loss of cyclopropanation in both the a- and oxygenated mycolate sub-types. Additionally, High-Resolution Magic Angle Spinning (HR-MAS) NMR analyses on whole cells was used to detect cell wall-associated mycolates and to quantify the cyclopropanation status of the cell envelope. Further, overexpression of cmaA2, mmaA2 or pcaA in mycobacteria partially reversed the effects of TAC and its analogue on mycolic acid cyclopropanation, suggesting that the drugs act directly on CMASs. Conclusions/Significance. This is a first report on them echanism of action of TAC, demonstrating the CMASs as its cellular targets in mycobacteria. The implications of this study may be important for the design of alternative strategies for tuberculosis treatment.

Detraining and tapering effects on hormonal responses and strength performance.

Abstract: This study examined the impact of 4 weeks of either complete cessation of training (DTR) or a tapering period (TAP; short-term reduction of the strength training volume, while the intensity is kept high), subsequent to 16 weeks of periodized heavy resistance training (PRT) on strength/power gains and the underlying physiologic changes in basal circulating anabolic/catabolic hormones in strength-trained athletes. Forty-six physically active men were matched and randomly assigned to a TAP (n = 11), DTR (n = 14), or control group (C; n = 21), subsequent to a 16-week PRT program. Muscular and power testing and blood draws to determine basal hormonal concentrations were conducted before the initiation of training (T0), after 16 weeks of training (T1), and after 4 weeks of either DTR or TAP (T2). Short-term DTR (4 weeks) results in significant decreases in maximal strength (-6 to -9%) and muscle power output (-17 and -14%) of the arm and leg extensor muscles. However, DTR had a significant (p < 0.01) larger effect on muscle power output more than on strength measurements of both upper and lower extremity muscles. Short-term (4 weeks) TAP reached further increases for leg (2%) and arm (2%) maximal strength, whereas no further changes were observed in both upper and lower muscle power output. Short-term DTR resulted in a tendency for elevation resting serum insulin-like growth factor (IGF)-1 concentrations, whereas the corresponding TAP experienced elevation in resting serum insulin-like binding protein-3 (IGFBP-3). These data indicated that DTR may induce larger declines in muscle power output than in maximal strength, whereas TAP may result in further strength enhancement (but not muscle power), mediated, in part, by training-related differences in IGF-1 and IGFBP-3 concentrations.

Lean Construction: Prospects for the German construction industry

Abstract: There is little, if any, information available about the range and dissemination of lean concepts among construction companies in Germany. Building on the methodologies and conceptual frameworks used in earlier work in the UK (Common et al., 2000) and the Netherlands (Johansen et al., 2002) this study carried out a similar survey among German construction companies to discover the current understanding of lean principles, perceptions of lean and trends in lean development. Qualitative and quantitative analysis of an email questionnaire sent to large German construction companies indicates that there is little awareness of lean in the German construction industry and that hardly any company uses lean concepts on a company wide basis despite evidence that procedures and techniques that are used on German construction sites are generally consistent with lean construction practice. There appears to be cultural resistance to a manufacturing derived, production-system-view of construction.

A double-blind, placebo-controlled, multi-dose evaluation of the acute behavioural effects of guaraná in humans:

Abstract: The present study aimed to systematically assess acute, dose-related behavioural effects of an extract of guarana plant for the first time in humans. This double-blind, counterbalanced, placebo-controlled study (n=26) assessed the acute mood and cognitive effects throughout the day of four different doses (37.5 mg, 75 mg, 150 mg and 300 mg) of a standardised guarana extract (PC-102). Assessment included the Cognitive Drug Research computerized test battery and Bond-Lader mood scales. Guarana improved secondary memory performance and increased alert and content mood ratings. The two lower doses produced more positive cognitive effects than the higher doses. This research supports previous findings of cognitive improvements following 75 mg guarana and provides the first exploration of different dose effects of guarana in humans. The findings suggest that the effects cannot be attributed to caffeine alone.

Scratching beneath the surface of communities of (mal)practice

Abstract: Purpose – This paper seeks to surface less positive aspects of communities of practice (CoPs), regardless of emergent or organisationally managed, grounded in political‐power interactions. Examples are provided from the authors' experiences of a research‐based CoP within UK higher education.Design/methodology/approach – The paper is primarily theoretical with empirical examples drawn from a descriptive CoP case study.Findings – The paper discusses the following themes: the impact of timing on CoP development; the impact of CoP leaders and managers in “managed” CoPs; the power‐political interrelationship between emergent CoPs and formal organisation; the impact of dominant actors with position power; emotional containment and emotion work within CoPs; power implications of novices and masters and the implications when CoP practices diverge from organisational practices. It finds that to ignore such issues of power within CoPs is to limit the knowledge creation process.Research limitations/implications – Fu...

Distribution of Power Output During Cycling: Impact and Mechanisms

Abstract: We aim to summarise the impact and mechanisms of work-rate pacing during individual cycling time trials (TTs). Unlike time-to-exhaustion tests, a TT provides an externally valid model for examining how an initial work rate is chosen and maintained by an athlete during self-selected exercise. The selection and distribution of work rate is one of many factors that influence cycling speed. Mathematical models are available to predict the impact of factors such as gradient and wind velocity on cycling speed, but only a few researchers have examined the inter-relationships between these factors and work-rate distribution within a TT. When environmental conditions are relatively stable (e.g. in a velodrome) and the TT is >10 minutes, then an even distribution of work rate is optimal. For a shorter TT ( 350 watts). During a TT, pacing strategy is regulated in a complex anticipatory system that monitors afferent feedback from various physiological systems, and then regulates the work rate so that potentially limiting changes do not occur before the endpoint of exercise is reached. It is critical that the endpoint of exercise is known by the cyclist so that adjustments to exercise work rate can be made within the context of an estimated finish time. Pacing strategies are thus the consequence of complex regulation and serve a dual role: they are both the result of homeostatic regulation by the brain, as well as being the means by which such regulation is achieved. The pacing strategy 'algorithm' is sited in the brain and would need afferent input from interoceptors, such as heart rate and respiratory rate, as well as exteroceptors providing information on local environmental conditions. Such inputs have been shown to induce activity in the thalamus, hypothalamus and the parietal somatosensory cortex. Knowledge of time, modulated by the cerebellum, basal ganglia and primary somatosensory cortex, would also input to the pacing algorithm as would information stored in memory about previous similar exercise bouts. How all this information is assimilated by the different regions of the brain is not known at present.

Turning in Parkinson's disease patients and controls: the effect of auditory cues.

Abstract: Turning is an impaired activity in persons with Parkinson's disease (PwPD). The current study examines the turning characteristics in PwPD (9 freezers and 10 nonfreezers) and 9 controls, and explores the effect of rhythmic auditory cues while turning. Turning parameters were collected from a 180 degrees left U-turn during a noncued and a cued condition, using a 3D measuring system. Auditory cues were supplied with a metronome at a rhythm equaling the subject's comfortable step frequency during straight line walking. Results showed that in contrast to controls, PwPD used a wider turning-arc and took smaller, narrower steps. In addition, they demonstrated a higher Coefficient of Variation (CV) of step duration (6.92%) compared to controls (4.88%, P < 0.05). The "wide-arc" turning strategy of PwPD was more prominent in freezers than in nonfreezers. Auditory cues reduced the CV of step duration in PwPD (both freezers and nonfreezers) during turning (from 6.92 to 6.00%, P < 0.05). In summary: Cueing reduced the gait-timing variability during turning, but PwPD maintained a wider arc to turn compared with controls.

Occupational therapy for patients with Parkinson's disease.

Abstract: Background Despite drug and surgical therapies for Parkinson's disease, patients develop progressive disability. The role of the occupational therapist is to support the patient and help them maintain their usual level of self-care, work and leisure activities for as long as possible. When it is no longer possible to maintain their usual activities, occupational therapists support individuals in changing and adapting their relationship with their physical and social environment to develop new valued activities and roles. Objectives To compare the efficacy and effectiveness of occupational therapy with placebo or no interventions (control group) in patients with Parkinson's disease. Search strategy Relevant trials were identified by electronic searches of MEDLINE, EMBASE, CINAHL, ISI-SCI, AMED, MANTIS, REHABDATA, REHADAT, GEROLIT, Pascal, LILACS, MedCarib, JICST-EPlus, AIM, IMEMR, SIGLE, ISI-ISTP, DISSABS, Conference Papers Index, Aslib Index to Theses, the Cochrane Controlled Trials Register, the CentreWatch Clinical Trials listing service, the metaRegister of Controlled Trials, ClinicalTrials.gov, CRISP, PEDro, NIDRR and NRR; and the reference lists of identified studies and other reviews were examined. Selection criteria Only randomised controlled trials (RCT) were included, however those trials that allowed quasi-random methods of allocation were allowed. Data collection and analysis Data was abstracted independently by two authors and differences were settled by discussion. Main results Two trials were identified with 84 patients in total. Although both trials reported a positive effect from occupational therapy, all of the improvements were small. The trials did not have adequate placebo treatments, used small numbers of patients and the method of randomisation and concealment of allocation was not specified in one trial. These methodological problems could potentially lead to bias from a number of sources reducing the strength of the studies further. Authors' conclusions Considering the significant methodological flaws in the studies, the small number of patients examined, and the possibility of publication bias, there is insufficient evidence to support or refute the efficacy of occupational therapy in Parkinson's disease. There does not appear to be a consensus as to the best practice in occupational therapy when treating people with Parkinson's disease. A survey of therapists is needed to determine what methods of occupational therapy are currently being used by therapists to treat Parkinson's disease, and whether there is a consensus as to 'best-practice'. Large well designed placebo-controlled RCTs are needed to demonstrate occupational therapy's effectiveness in Parkinson's disease. Outcome measures with particular relevance to patients, carers, occupational therapists and physicians should be chosen and the patients monitored for at least six months to determine the duration of benefit. The trials should be reported using CONSORT guidelines.

Seismic and radar observations of subglacial bed forms beneath the onset zone of Rutford Ice Stream, Antarctica

Abstract: We present seismic and radar data from the onset region of Rutford Ice Stream, West Antarctica, which show the form and internal structure of a variety of bed forms beneath an active ice stream. The ice flow in the area of our survey accelerates from 72 to >200 m a(-1), the ice is 2200-3200 m thick, and the bed of the ice stream lies up to 2000m below present sea level. We have imaged the internal structure of the bed forms with seismic reflection techniques and also observed radar reflections from below the bed in some circumstances. We observed a transverse moraine 2 km wide and 1.5 km long beneath the slower-flowing part of the ice stream, which we interpret to be composed of unconsolidated sediment undergoing active deformation near the ice-sediment interface. We observed drumlins of classical form with elongation ratios of between 1 :1.5 and 1 : 4.0 where the surface flow speed exceeded 95 m a(-1). The conformity of the internal structure of the bed forms with the ice base suggests that the bed forms are active depositional features in congruence with the observation of a contemporary drumlin-forming episode in the distal part of the same ice stream. These observations provide the first direct evidence of the association between ice-stream flow speed and bed-form shape.

The application and adaptation of a diffusion of innovation framework for information systems research in NHS general medical practice

Abstract: This paper proposes an adapted diffusion of innovation (DOI) framework that may be considered relevant and useful to researchers undertaking studies of information systems innovations in healthcare organizations. A particular focus concerns problems and issues associated with professional cultures and powerful organizational control structures. A review of four empirical DOI studies are undertaken to identify candidate frameworks for the retrospective analysis of a pilot study conducted across General Medical Practices based within a Primary Care Trust in the north east of England. A research approach, based on phenomenology, semi-structured interviews and template analysis is adopted in order to conduct and provide a rich analysis of the data. The findings are discussed using the modified DOI framework. Discussion and conclusions relate to the extended use of the DOI framework, its further development and how it may be used to understand how ICT innovation is politically constrained, perceived and motivated within healthcare environments.