Measuring and reporting quality of life outcomes in clinical trials in cystic fibrosis: a critical review

Good quality clinical trials are essential to inform the best cystic fibrosis (CF) management and care, by determining and comparing the effectiveness of new and existing therapies and drug delivery systems. The formal inclusion of quality of life (QoL) as an outcome measure in CF clinical trials is becoming more common. Both an appropriate QoL measure and sound methodology are required in order to draw valid inferences about treatments and QoL. A review was undertaken of randomised controlled trials in cystic fibrosis where QoL was measured. EMBASE, MEDLINE and ISI Web of Science were searched to locate all full papers in the English language reporting randomised controlled trials in cystic fibrosis, published between January 1991 and December 2004. All Cochrane reviews published before December 2004 were hand searched. Papers were included if the authors had reported that they had measured QoL or well being in the trial. 16 trials were identified. The interventions investigated were: antibiotics (4); home versus hospital administration of antibiotics (1); steroids (1); mucolytic therapies (6); exercise (3) and pancreatic enzymes (1). Not one trial evaluated in this review provided conclusive results concerning QoL. This review highlights many of the pitfalls of QoL measurement in CF clinical trials and provides constructive information concerning the design and reporting of trials measuring QoL

Everything Must Go

Thomas Brothers' generous advice and manifold goods helped build, fix and maintain countless artworks and houses in and beyond Archway for ninety-seven years (1917-2014). 'Everything Must Go' was an exhibition of artworks organised by AIR and made by their customers, past and present, to mark the closure of Thomas Brothers, and to say thank you to the brothers and their esteemed Archway institution. The art works were bequeathed to the Thomas family. The works were placed by the artists within a certain moment of the emptying shelves. Over the next three weeks the brothers chose to continue the exhibition. It took various forms as they moved the works around their dwindling stock, eventually placing them all together in the central window

ALight

Between 2007-2012 AIR worked with Islington Council Arts Team and the Archway Town Centre Management Group to commission new works that explored a perceived darkness in Archway. Anna Hart produced the four commissions: Hillary Powell 'Light Years Away', Jane Watt 'Trip the Light Fantastic', David Batchelor 'Big Rock Candy Fountain', Ruth Ewan 'How to Make Archway Tower Disappear'

Are medical educators following General Medical Council guidelines on obesity education: if not why not?

BackgroundAlthough the United Kingdom's (UK's) General Medical Council (GMC) recommends that graduating medical students are competent to discuss obesity and behaviour change with patients, it is difficult to integrate this education into existing curricula, and clinicians report being unprepared to support patients needing obesity management in practice. We therefore aimed to identify factors influencing the integration of obesity management education within medical schools.MethodsTwenty-seven UK and Irish medical school educators participated in semi-structured interviews. Grounded theory principles informed data collection and analysis. Themes emerging directly from the dataset illustrated key challenges for educators and informed several suggested solutions.ResultsFactors influencing obesity management education included: 1) Diverse and opportunistic learning and teaching, 2) Variable support for including obesity education within undergraduate medical programmes, and 3) Student engagement in obesity management education. Findings suggest several practical solutions to identified challenges including clarifying recommended educational agendas; improving access to content-specific guidelines; and implementing student engagement strategies.ConclusionsStudents' educational experiences differ due to diverse interpretations of GMC guidelines, educators' perceptions of available support for, and student interest in obesity management education. Findings inform the development of potential solutions to these challenges which may be tested further empirically

Rebuilding knowledge: Opportunities and risks for higher education in post-conflict regions

The transition from violence and instability to peace and prosperity is rarely linear, but rather defined more by its complexity and the alignment of often-surprising conditions. The rebuilding and reorganization of the higher education sector, in particular, is increasingly being recognized as both a driver and a consequence of this complex transition, which is marked by a sustained process of negotiation between various local factions and with external actors. In so-called 'intervention societies' where humanitarian relief and long-term development intersect, re-envisioning what types of 'knowledge' to promote through higher education is very much at the heart of re-writing the social contract and investing in peace and productivity. Indeed, in development circles, the reform or reconstruction of systems of higher education is now viewed as an opportunity to achieve the longterm goals of integration, intercultural communication, and tolerance building. As an outlet for young people (many of which are demobilized soldiers) and a space for breaking down knowledge monopolies in society, universities are emblematic of the aspirations for training a post-conflict generation of civil servants, politicians and thinkers, as well as for interfacing with the outside world. Keeping the unique characteristics and timeline of each conflict in mind, this paper investigates, on the one hand, comparable trends in macro-level discourse and programming around post-conflict higher education in different countries and, on the other hand, evaluates on the very routine and practical level, the challenges faced by students, teachers, and administrators to conceive of, regulate and re-build systems of higher education and the corresponding academic social life on campuses. In this, we look at how the passive byproducts of knowledge creation in a university atmosphere, such as gaining academic reflexivity, socializing with former enemies, and reproducing societal hierarchies is intertwined with content and learning

Topological susceptibility with the improved Asqtad action

As a test of the chiral properties of the improved Asqtad (staggered fermion) action, we have been measuring the topological susceptibility as a function of quark masses for 2 + 1 dynamical flavors. We report preliminary results, which show reasonable agreement with leading order chiral perturbation theory for lattice spacing less than 0.1 fm. The total topological charge, however, shows strong persistence over Monte Carlo time.Comment: Lattice2002(algor

Principals’ Perceptions and Understandings of Teacher Leadership

No singular definition of teacher leadership (TL) exists in empirical literature or practice in the field. This lack of clarity has greatly impacted the implementation of TL in American schools. The purpose of this study qualitative case study was to investigate public school principals’ perceptions and understandings of TL in an effort to better inform continued efforts toward its ubiquitous application in American schools. Principals’ definitions of TL fell into three categories: action-based, quality-based, and role-based definitions. Principals’ recognition of the work of teacher leaders in schools fell into two parallel categories: action-based and role-based leadership. Findings reveal that many principals appear to have not yet “caught” any waves of TL beyond the second. More in-depth research is required to determine the accuracy of this evaluation and how to best encourage principals to extend their understanding of and openness to TL

Metabolomic Analysis of Urine From a Rat Model Relevant to Diabetes Using NMR

https://louis.uah.edu/rceu-hcr/1119/thumbnail.jp

Interpersonal Dynamics of the Supervisory Triad of Pre-Service Teacher Education: Lessons Learned from 15 Years of Research

Clinical field experience is recognized by many as the most influential and beneficial component of pre-service teacher education. The present article represents part of a larger qualitative meta-synthesis, the purpose of which was to explore the influence of the interpersonal dynamics of the supervisory triad—comprised of the pre-service teacher candidate, the mentor teacher, and the university supervisor—on pre-service candidates’ clinical experiences. Positioning theory was chosen to frame this investigation, as it employs distinct definitions for role and position, the delineation of which is of critical importance in the context of pre-service clinical relationships. Findings of the larger study reveal three primary factors of influence, four primary patterns of communication, and many modes of positioning of self and others as influential to pre-service teachers’ clinical experiences. This article addresses those findings regarding factors of influence and modes of positioning, the implications of which are discussed through the lens of positioning theory and in connection to practice in the field

The effect of locomotion on early visual contrast processing in humans

Most of our knowledge about vision comes from experiments in which stimuli are presented to immobile human subjects or animals. In the case of human subjects, movement during psychophysical, electrophysiological or neuroimaging experiments is considered to be a source of noise to be eliminated. Animals used in visual neuroscience experiments are typically restrained and, in many cases, anaesthetized. In reality however, vision is often used to guide the motion of awake, ambulating organisms. Recent work in mice has shown that locomotion elevates visual neuronal response amplitudes (Erisken et al., 2014; Fu et al., 2014; Lee et al., 2014; Mineault et al., 2016; Niell and Stryker, 2010) and reduces long-range gain control (Ayaz et al., 2013). Here we use both psychophysics and steady-state electrophysiology to ask whether similar effects of locomotion on early visual processing can be measured in humans. Our psychophysical results show that brisk walking has little effect on subjects’ ability to detect briefly-presented contrast changes and that co-oriented flankers are, if anything, more effective masks when subjects are walking. Our electrophysiological data were consistent with the psychophysics, indicating no increase in stimulus-driven neuronal responses whilst walking and no reduction in surround suppression. In summary we find evidence that early contrast processing is altered by locomotion in humans but in a manner that differs from that reported in mice. The effects of locomotion on very low-level visual processing may differ on a species-by-species basis and may reflect important differences in the levels of arousal associated with locomotion