46 research outputs found
A view from elsewhere :the spatiality of children's fantasy fiction
PhD ThesisFantasy other worlds are often seen as alternatives with which to critique
the ârealâ world, or as offering spaces where child protagonists can take
advantage of the otherness they encounter in their own process of maturation.
However, such readings of fantasy other worlds, rather than celebrating
heterogeneity, implicitly see âotherâ spaces as âunrealâ and there either to support
the real in some way, as being in some way inferior to the real, or in need of
salvation by protagonists from the real world. This thesis proposes a reading of
such texts that draws on social theories of constructed spatiality in order to
examine first how, to varying degrees, and depending upon the attitude of
authors towards the figure of the child, such âfantasyâ places can be seen as
potentially real âthirdspacesâ of performance and agency for protagonists, and
thus as neutral spaces of activity rather than confrontation or growth and, second,
how such presentations may be seen as reflecting back into the potential for the
spatial activity of readers
A view from elsewhere : the spatiality of children's fantasy fiction
Fantasy other worlds are often seen as alternatives with which to critique the ârealâ world, or as offering spaces where child protagonists can take advantage of the otherness they encounter in their own process of maturation. However, such readings of fantasy other worlds, rather than celebrating heterogeneity, implicitly see âotherâ spaces as âunrealâ and there either to support the real in some way, as being in some way inferior to the real, or in need of salvation by protagonists from the real world. This thesis proposes a reading of such texts that draws on social theories of constructed spatiality in order to examine first how, to varying degrees, and depending upon the attitude of authors towards the figure of the child, such âfantasyâ places can be seen as potentially real âthirdspacesâ of performance and agency for protagonists, and thus as neutral spaces of activity rather than confrontation or growth and, second, how such presentations may be seen as reflecting back into the potential for the spatial activity of readers.EThOS - Electronic Theses Online ServiceGBUnited Kingdo
Significance of Pelvic Fluid Observed during Ovarian Cancer Screening with Transvaginal Sonogram
The primary objective was to examine the role of pelvic fluid observed during transvaginal ultrasonography (TVS) in identifying ovarian malignancy. A single-institution, observational study was conducted within the University of Kentucky Ovarian Cancer Screening trial from January 1987 to September 2019. We analyzed true-positive (TP), false-positive (FP), true-negative (TN), and false-negative (FN) groups for the presence of pelvic fluid during screening encounters. Measured outcomes were the presence and duration of fluid over successive screening encounters. Of the 48,925 women surveyed, 2001 (4.1%) had pelvic fluid present during a TVS exam. The odds ratio (OR) of detecting fluid in the comparison group (TN screen; OR = 1) significantly differed from that of the FP cases (benign pathology; OR: 13.4; 95% confidence interval (CI): 9.1â19.8), the TP cases with a low malignant potential (LMP; OR: 28; 95% CI: 26.5â29.5), TP ovarian cancer cases (OR: 50.4; 95% CI: 27.2â93.2), and FN ovarian cancer cases (OR: 59.3; 95% CI: 19.7â178.1). The mean duration that pelvic fluid was present for women with TN screens was 2.2 ± 0.05 encounters, lasting 38.7 ± 1.3 months. In an asymptomatic screening population, free fluid identified in TVS exams was more associated with ovarian malignancy than in the control group or benign ovarian tumors. While pelvic free fluid may not solely discriminate malignancy from non-malignancy, it appears to be clinically relevant and warrants thoughtful consideration
Using the 4 pillarsâą practice transformation program to increase adult influenza vaccination and reduce missed opportunities in a randomized cluster trial
Europe-wide expansion and eradication of multidrug-resistant Neisseria gonorrhoeae lineages: a genomic surveillance study
Centre for Genomic Pathogen Surveillance and the Euro-GASP study group: Sonja Pleininger, Alexander Indra, Irith De Baetselier, Wim Vanden Berghe, BlaĆŸenka Hunjak, Tatjana Nemeth BlaĆŸiÄ, Panayiota Maikanti-Charalambous, Despo Pieridou, Hana ZĂĄkouckĂĄ, Helena ĆœemliÄkovĂĄ, Steen Hoffmann, Susan Cowan, Lasse Jessen Schwartz, Rita Peetso, Jevgenia Epstein, Jelena Viktorova, Ndeindo Ndeikoundam, Beatrice Bercot, CĂ©cile BĂ©bĂ©ar, Florence Lot, Susanne Buder, Klaus Jansen, Vivi Miriagou, Georgios Rigakos, Vasilios Raftopoulos, Eszter Balla, MĂĄria DudĂĄs, Lena RĂłs ĂsmundsdĂłttir, GuĂ°rĂșn SigmundsdĂłttir, GuĂ°rĂșn Svanborg HauksdĂłttir, Thorolfur Gudnason, Aoife Colgan, Brendan Crowley, SinĂ©ad Saab, Paola Stefanelli, Anna Carannante, Patrizia Parodi, Gatis Pakarna, Raina Nikiforova, Antra Bormane, Elina Dimina, Monique Perrin, Tamir Abdelrahman, JoĂ«l Mossong, Jean-Claude Schmit, Friedrich MĂŒhlschlegel, Christopher Barbara, Francesca Mifsud, Alje Van Dam, Birgit Van Benthem, Maartje Visser, Ineke Linde, Hilde KlĂžvstad, Dominique Caugant, Beata MĆynarczyk-Bonikowska, Jacinta Azevedo, Maria-JosĂ© Borrego, Marina Lurdes Ramos Nascimento, Peter Pavlik, Irena Klavs, Andreja Murnik, Samo Jeverica, Tanja Kustec, Julio VĂĄzquez Moreno, Asuncion Diaz, Raquel Abad, Inga Velicko, Magnus Unemo, Helen Fifer, Jill Shepherd, Lynsey PattersonBackground: Genomic surveillance using quality-assured whole-genome sequencing (WGS) together with epidemiological and antimicrobial resistance (AMR) data is essential to characterise the circulating Neisseria gonorrhoeae lineages and their association to patient groups (defined by demographic and epidemiological factors). In 2013, the European gonococcal population was characterised genomically for the first time. We describe the European gonococcal population in 2018 and identify emerging or vanishing lineages associated with AMR and epidemiological characteristics of patients, to elucidate recent changes in AMR and gonorrhoea epidemiology in Europe.
Methods: We did WGS on 2375 gonococcal isolates from 2018 (mainly Sept 1-Nov 30) in 26 EU and EEA countries. Molecular typing and AMR determinants were extracted from quality-checked genomic data. Association analyses identified links between genomic lineages, AMR, and epidemiological data.
Findings: Azithromycin-resistant N gonorrhoeae (8·0% [191/2375] in 2018) is rising in Europe due to the introduction or emergence and subsequent expansion of a novel N gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroup, G12302 (132 [5·6%] of 2375; N gonorrhoeae sequence typing for antimicrobial resistance [NG-STAR] clonal complex [CC]168/63), carrying a mosaic mtrR promoter and mtrD sequence and found in 24 countries in 2018. CC63 was associated with pharyngeal infections in men who have sex with men. Susceptibility to ceftriaxone and cefixime is increasing, as the resistance-associated lineage, NG-MAST G1407 (51 [2·1%] of 2375), is progressively vanishing since 2009-10.
Interpretation: Enhanced gonococcal AMR surveillance is imperative worldwide. WGS, linked to epidemiological and AMR data, is essential to elucidate the dynamics in gonorrhoea epidemiology and gonococcal populations as well as to predict AMR. When feasible, WGS should supplement the national and international AMR surveillance programmes to elucidate AMR changes over time. In the EU and EEA, increasing low-level azithromycin resistance could threaten the recommended ceftriaxone-azithromycin dual therapy, and an evidence-based clinical azithromycin resistance breakpoint is needed. Nevertheless, increasing ceftriaxone susceptibility, declining cefixime resistance, and absence of known resistance mutations for new treatments (zoliflodacin, gepotidacin) are promising.This study was supported by the European Centre for Disease Prevention
and Control, the Centre for Genomic Pathogen Surveillance, the Li Ka
Shing Foundation (Big Data Institute, University of Oxford), the Wellcome
Genome Campus, the Foundation for Medical Research at Ărebro
University Hospital, and grants from Wellcome (098051 and 099202).
LSB was funded by Conselleria de Sanitat Universal i Salut PĂșblica,
Generalitat Valenciana (Plan GenT CDEI-06/20-B), Valencia, Spain, and
Ministry of Science, Innovation and Universities (PID2020â120113RA-I00),
Spain, at the time of analysing and writing this manuscript.info:eu-repo/semantics/publishedVersio