A Novel Way to Develop Policy and Practice

In this paper I explore the relevance to Q methodology of the work of Mikhail Bakhtin (1895–1975), the Russian philosopher and literary theorist whose concept of human language emphasised the interrelationship of all utterances, and a value-governed experiencing of the world from a multiplicity of unique perspectives. Bakhtin theorised novelistic discourse as a polyphony of contesting voices, with an interacting diversity of characters’ voices valued over a monologic authorial voice. This preference for heteroglossia over monoglossia has not only an aesthetic but also an ethical dimension, with wider implications beyond literature for our individual lives and public society. Bakhtin emphasised the plural nature of subjectivity and the development of meaning and understanding through the interplay of multiple voices. This developmental process requires respect for the voice and values of, and an answerable attitude toward, the other. I consider the theoretical underpinnings of Bahktin’s work in relation to that of William Stephenson and describe how Bakhtin’s concepts and related sociocultural theory might be combined with Q methodology to develop more ethical, democratic and efficacious policy and practice in a range of contexts. I explore and illustrate these developmental possibilities at a range of levels with reference to a Q study on policy and practice (Deignan, 2012) that I carried out in the UK higher education sector

An Exploratory Study into the Traumatic Impact of Advanced Cancer among Patients and Partners

People living with cancer may experience both psychological distress and a sense of personal development. These two responses can be conceptualised using theories of post-traumatic stress (PTS) and post-traumatic growth (PTG), respectively. This hospice-based study investigated the range of experiences of people living with advanced cancer and of their partners, with consideration of how theories of PTS and PTG resonated with their accounts. Strategic sampling (n=11) was used to gather data from eight individuals living with advanced cancer and from three individuals caring for someone with the diagnosis. Q methodology was used to investigate the participants’ subjective experiences. A set of 62 statements, informed by theories of trauma, were sorted by the participants according to the extent to which the individual statements were consistent with their personal experiences of living with cancer. The participants were then interviewed about their Q sorts, to consider the personal meanings that had informed their statement rankings. The Q sort data were factor analysed, and theories of PTS and PTG were used to aid the interpretation of four differing viewpoints: “Accepting and Growing,†“Fearful yet Adapting,†“Resigned and Grieving†and “Traumatised.†These different expressions of the positive and negative feelings associated with living with advanced cancer are considered in relation to professional healthcare provision. The study recommends that future research involve a broader sample of individuals, including patients not accessing hospice care, the partners of this population and cancer healthcare professionals

Variation in pre-PCR processing of FFPE samples leads to discrepancies in BRAF and EGFR mutation detection: a diagnostic RING trial.

Aims Mutation detection accuracy has been described extensively; however, it is surprising that pre-PCR processing of formalin-fixed paraffin-embedded (FFPE) samples has not been systematically assessed in clinical context. We designed a RING trial to (i) investigate pre-PCR variability, (ii) correlate pre-PCR variation with EGFR/BRAF mutation testing accuracy and (iii) investigate causes for observed variation. Methods 13 molecular pathology laboratories were recruited. 104 blinded FFPE curls including engineered FFPE curls, cell-negative FFPE curls and control FFPE tissue samples were distributed to participants for pre-PCR processing and mutation detection. Follow-up analysis was performed to assess sample purity, DNA integrity and DNA quantitation. Results Rate of mutation detection failure was 11.9%. Of these failures, 80% were attributed to pre-PCR error. Significant differences in DNA yields across all samples were seen using analysis of variance (p<0.0001), and yield variation from engineered samples was not significant (p=0.3782). Two laboratories failed DNA extraction from samples that may be attributed to operator error. DNA extraction protocols themselves were not found to contribute significant variation. 10/13 labs reported yields averaging 235.8ng (95% CI 90.7 to 380.9) from cell-negative samples, which was attributed to issues with spectrophotometry. DNA measurements using Qubit Fluorometry demonstrated a median fivefold overestimation of DNA quantity by Nanodrop Spectrophotometry. DNA integrity and PCR inhibition were factors not found to contribute significant variation. Conclusions In this study, we provide evidence demonstrating that variation in pre-PCR steps is prevalent and may detrimentally affect the patient's ability to receive critical therapy. We provide recommendations for preanalytical workflow optimisation that may reduce errors in down-stream sequencing and for next-generation sequencing library generation

Modeling and Developing a Dyslexia Support System

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The challenges of English medium instruction for subject lecturers: a shared viewpoint

Abstract English medium instruction (EMI) is seen as a site for improving students’ English language, yet the role of the EMI lecturer in achieving this is contested. Views on what constitutes appropriate training and professional development for EMI lecturers also differ regarding English language skills and EMI-specific methodology. Using Q methodology, this paper explores these issues from a particular perspective, a synthetic viewpoint based on six EMI lecturers with very similar views. Its voice is pro-EMI yet has significant concerns regarding the workload involved, is insecure about its own linguistic performance, fears a loss of subject content depth, and questions the effectiveness of EMI for students learning a subject. The paper highlights the importance of such feelings in relation to perceived language and pedagogy challenges and considers the broader implications for EMI teacher training interventions regarding the practices of disciplinary knowledge-building and the linguistic and communicative resources used to enact them.</jats:p