Flu viruses a lucky community and cosine graphs: the possibilities opened up by the use of a socio-political perspective to study learning in an undergraduate access course in mathematics

This is an Accepted Manuscript of an article published by Taylor & Francis in African Journal of Research in Mathematics, Science and Technology Education on 20 August 2013 available online: http://www.tandfonline.com/10.1080/10288457.2009.10740656.In this paper I present a perspective of mathematics education and learning, termed a 'sociopolitical perspective'. Classroom mathematical activity, in which certain ways of acting, behaving and knowing are given value, is located in a wider network of socio-political practices. Learning in mathematics is regarded as coming to participate in the discourse of the community that practises the mathematics. I argue that the use of a socio-political perspective allows the researcher and teacher to view classroom mathematical activity as a product of the network of socio-political practices in which it is located, rather than as a product of individual cognitive ability. I illustrate the use of this perspective by drawing on a study of learning in a first-year university access course in Mathematics at a South African university. Fairclough's method for critical discourse analysis, supplemented with work by Sfard and Morgan in mathematics education, was used to analyse both the text of a 'real world' problem in mathematics and a transcript representing the activity as a group of five students solved the problem. This analysis suggests that, despite containing traces of discourses from outside of mathematics, the problem text constructs the activity as solving a mathematical problem with features of a school mathematical word problem. When solving the problem the students draw on practices associated with school mathematics and their university mathematics course, some of which enable and others constrain their participation. For example, they refer to named functions learned at school, they have difficulty making productive links between the mathematical functions and the 'real world' context, and they have varied opportunities for mathematical talk in the group. The study identifies as key to the students' progress the presence of an authority (in this case a tutor) who can make explicit the ways of thinking, acting, and talking that are valued in the discourse of undergraduate mathematics, and who provides opportunities for mathematical talk

Screening and diagnosing depression in women visiting GPs' drop in clinic in Primary Health Care

<p>Abstract</p> <p>Background</p> <p>Only half of all depressions are diagnosed in Primary Health Care (PHC). Depression can remain undetected for a long time and entail high costs for care and low quality of life for the individuals. Drop in clinic is a common form of organizing health care; however the visits are short and focus on solving the most urgent problems. The aim of this study was to investigate the prevalence and severity of depression among women visiting the GPs' drop in clinic and to identify possible clues for depression among women.</p> <p>Methods</p> <p>The two-stage screening method with "high risk feedback" was used. Beck's Depression Inventory (BDI) was used to screen 155 women visiting two GPs' drop in clinic. Women who screened positive (BDI score ≥10) were invited by the GP to a repeat visit. Major depression (MDD) was diagnosed according to DSM-IV criteria and the severity was assessed with Montgomery-Asberg Depression Rating Scale (MADRS). Women with BDI score <10 constituted a control group. Demographic characteristics were obtained by questionnaire. Chart notations were examined with regard to symptoms mentioned at the index visit and were categorized as somatic or mental.</p> <p>Results</p> <p>The two-stage method worked well with a low rate of withdrawals in the second step, when the GP invited the women to a repeat visit. The prevalence of depression was 22.4% (95% CI 15.6–29.2). The severity was mild in 43%, moderate in 53% and severe in 3%. The depressed women mentioned mental symptoms significantly more often (69%) than the controls (15%) and were to a higher extent sick-listed for a longer period than 14 days. Nearly one third of the depressed women did not mention mental symptoms. The majority of the women who screened as false positive for depression had crisis reactions and needed further care from health professionals in PHC. Referrals to a psychiatrist were few and revealed often psychiatric co-morbidity.</p> <p>Conclusion</p> <p>The prevalence of previously undiagnosed depression among women visiting GPs' drop in clinic was high. Clues for depression were identified in the depressed women's symptom presentation; they often mention mental symptoms when they visit the GP for somatic reasons e.g. respiratory infections. We suggest that GPs do selective screening for depression when women mention mental symptoms and offer to schedule a repeat visit for follow-up rather than just recommending that the patient return if the mental symptoms do not disappear.</p

Functional Dissection of Streptococcus pyogenes M5 Protein: the Hypervariable Region is Essential for Virulence

The surface-localized M protein of Streptococcus pyogenes is a major virulence factor that inhibits phagocytosis, as determined ex vivo. Because little is known about the role of M protein in vivo we analyzed the contribution of different M protein regions to virulence, using the fibrinogen (Fg)-binding M5 protein and a mouse model of acute invasive infection. This model was suitable, because M5 is required for mouse virulence and binds mouse and human Fg equally well, as shown here. Mixed infection experiments with wild type bacteria demonstrated that mutants lacking the N-terminal hypervariable region (HVR) or the Fg-binding B-repeat region were strongly attenuated, while a mutant lacking the conserved C-repeats was only slightly attenuated. Because the HVR of M5 is not required for phagocytosis resistance, our data imply that this HVR plays a major but unknown role during acute infection. The B-repeat region is required for phagocytosis resistance and specifically binds Fg, suggesting that it promotes virulence by binding Fg. However, B-repeat mutants were attenuated even in Fg-deficient mice, implying that the B-repeats may have a second function, in addition to Fg-binding. These data demonstrate that two distinct M5 regions, including the HVR, are essential to virulence during the early stages of an infection. In particular, our data provide the first in vivo evidence that the HVR of an M protein plays a major role in virulence, focusing interest on the molecular role of this region

Changes in Body Weight and Psychotropic Drugs: A Systematic Synthesis of the Literature

<div><h3>Introduction</h3><p>Psychotropic medication use is associated with weight gain. While there are studies and reviews comparing weight gain for psychotropics within some classes, clinicians frequently use drugs from different classes to treat psychiatric disorders.</p> <h3>Objective</h3><p>To undertake a systematic review of all classes of psychotropics to provide an all encompassing evidence-based tool that would allow clinicians to determine the risks of weight gain in making both intra-class and interclass choices of psychotropics.</p> <h3>Methodology and Results</h3><p>We developed a novel hierarchical search strategy that made use of systematic reviews that were already available. When such evidence was not available we went on to evaluate randomly controlled trials, followed by cohort and other clinical trials, narrative reviews, and, where necessary, clinical opinion and anecdotal evidence. The data from the publication with the highest level of evidence based on our hierarchical classification was presented. Recommendations from an expert panel supplemented the evidence used to rank these drugs within their respective classes. Approximately 9500 articles were identified in our literature search of which 666 citations were retrieved. We were able to rank most of the psychotropics based on the available evidence and recommendations from subject matter experts. There were few discrepancies between published evidence and the expert panel in ranking these drugs.</p> <h3>Conclusion</h3><p>Potential for weight gain is an important consideration in choice of any psychotropic. This tool will help clinicians select psychotropics on a case-by-case basis in order to minimize the impact of weight gain when making both intra-class and interclass choices.</p> </div

Violence and threats of violence within psychiatric care--a comparison of staff and patient experience of the same incident

This study compared staff members' and psychotic patients' experiences of one and the same violent incident. The staff exposed to the violence completed the Staff Observation Aggression Scale (SOAS). The patients who had exhibited the violent behaviour were interviewed prior to discharge from the ward. When comparing the SOAS data with the patient interviews, it was found that the staff members were able to identify less than 50% of the provocations that the patient experienced. According to the patient interviews, giving the patient medication was far more often experienced as a provocation, resulting in violence, than the staff perceived. Knowledge about how to interpret the patients' body language and other signals, and how patients perceive the staff's behaviour, must be understood for an efficient prevention of violence in psychiatric care

Incidents of violence in psychiatric inpatient care

During a period of 18 months a systematic inventory of aggressive incidents was made on two psychosis wards at the psychiatric department of Danderyd Hospital, Stockholm, Sweden. The Staff Observation Aggression Scale (SOAS) for recording and assessing aggressive incidents was used. Staff subjected to violence or threat of violence was interviewed using a semi-structured questionnaire. In one part of the study, a somewhat reduced variant of the same questionnaire was used but this time staff answered anonymously. Aggressive incidents were distributed over the 24 h, but had two distinct peaks - morning and evening. Aggressive incidents most often occur with patients with some kind of a psychotic diagnosis, most often schizophrenic psychoses. The female staff was more exposed to violence than male. Female patients are also more violent to female staff than to male staff. There is a significant difference in the emotional reactions of female and male staff after aggressions. In the staff, men are more often frightened while women tend to get surprised. Still, staff members of both genders feel insulted and angry. The "research" interviews were experienced as therapeutic discussions by the staff

Mangageable violence in a new ward for acutely admitted patients

SummaryBoth clinical experience and earlier research have indicated that an increased number of violent incidents in a psychiatric ward may be strongly associated with the use of new staff. In 1991 a substantial number of staff was recriuted to a ward for commited patients. Incidents of violence were registered over the following 12-month period. The results of this study were compared with early registered violent incidents in a previous setting. It was found that the frequency of violent incidents could be kept at a low and stable level despite the new situation. In conclusion, a certain number of factors may be expected to affect the results: the specific pharmacotherapy in the treatment of acute psychosis, the physical environment of the ward, and, in particular, staff training.</jats:p