279 research outputs found

    The Dynamics of School Attainment of Englands Ethnic Minorities

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    We exploit a universe dataset of state school students in England with linked test score records to document the evolution of attainment through school for different ethnic groups. The analysis yields a number of striking findings. First, we show that, controlling for personal characteristics, all minority groups make greater progress than white students over secondary schooling. Second, much of this improvement occurs in the high-stakes exams at the end of compulsory schooling. Third, we show that for most ethnic groups, this gain is pervasive, happening in almost all schools in which these students are found. We address some of the usual factors invoked to explain attainment gaps: poverty, language, school quality, and teacher influence. We conclude that our findings are more consistent with the importance of factors like aspirations and attitudes.Ethnic test score gap, school attainment, education

    Segregation and the Attainment of Minority Ethnic Pupils in England

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    In this paper we ask whether ethnic segregation in schools and in neighbourhoods has a causal effect on differential school attainment. We ask two related but different questions. First, we look at the test score gap between White and minority ethnic students, separately for Black Caribbean, Indian and Pakistani ethnic groups. Second, we consider the absolute performance of students in each of these minority ethnic groups across cities with varying levels of segregation. We show that, in strong contrast to similar studies in the US, the test score gap is largely unaffected by segregation for any of the three groups we study, and we find no evidence of a negative impact of ethnic segregation on absolute attainment levels.ethnic segregation, schools

    M-health review: joining up healthcare in a wireless world

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    In recent years, there has been a huge increase in the use of information and communication technologies (ICT) to deliver health and social care. This trend is bound to continue as providers (whether public or private) strive to deliver better care to more people under conditions of severe budgetary constraint

    Hearing new voices: re-viewing youth justice policy through practitioners’ relationships with young people

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    The relationship between young people and practitioners is the centrepiece of youth justice provision, yet little research-based knowledge has accumulated on its minutiae. After reviewing reforms affecting professional discretion, the article draws on the concepts of dyadic relationships and praxis to reinvigorate a research agenda aimed at delineating a more nuanced understanding of practice relationships. Drawing on practice wisdom from across related social work fields, we argue that centralizing the practitioner-young person relationship remains the key to successful practice and thus needs greater, more detailed research attention. These claims are supported with a number of pilot interviews with youth justice workers about successful interventions that complement and extend related studies. The article concludes with suggestions for research to enable joint activity between young people and practitioners to ‘rethink’ youth justice

    Disruption of the Unique ABCG-Family NBD:NBD Interface Impacts Both Drug Transport and ATP Hydrolysis

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    ABCG2 is one of a triumvirate of human multidrug ATP binding cassette (ABC) transporters that are implicated in defense of cells and tissues against cytotoxic chemicals, but which can confer chemotherapy resistance states in oncology. Understanding the mechanism of ABCG2 is thus imperative if we are to be able to counter its deleterious activity. The structure of ABCG2 and related family members (ABCG5/G8) demonstrated that there were two interfaces between the nucleotide binding domains. In addition to the canonical ATP “sandwich-dimer” interface, there was a second contact region between residues at the C-terminus of the NBD. We mutated this second interface by making mutations to a series of residues which are in close interaction with the opposite NBD. Mutated ABCG2 isoforms were expressed in HEK293T cells and analyzed for targeting to the membrane, drug transport and ATPase activity. Mutations to this second interface had a number of effects on ABCG2 including altered drug specificity, altered drug transport and, in two mutants, a loss of ATPase activity. The results demonstrate that this region is particularly sensitive to mutation and can impact upon both direct, local NBD events (i.e. ATP hydrolysis) but also on the allosteric communication to the transmembrane domains and drug transport

    Osteosarcoma Associated With Diamond-Blackfan Anaemia: A Case of a Child Receiving Growth Hormone Therapy

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    Purpose: Diamond–Blackfan anaemia (DBA) is a rare pure congenital red cell aplasia, usually presenting in infancy or early childhood. The literature suggests a predisposition to haemopoietic malignancy but in addition solid tumours have been reported, with five cases of osteosarcoma described

    Pre-hospital pain management by ambulance staff

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    BACKGROUND In the 2004 Healthcare Commission report the majority of patients (4 out of 5) said they had suffered pain from their presenting conditions while in the ambulance. Although 81% felt that the ambulance crew did everything they could to control pain, 1 in 5 wanted more pain relief: 14% said the crew did this to some extent and 5% that the crew did not do everything they could to control the pain. The management of pain in the pre-hospital environment has been shown to be an important determinant of subsequent pain in the emergency department. How ambulance services manage pain is therefore clinically important and a key indicator of quality of service. Management of pain can be differentiated into a number of essential components. Recording of pain both at the scene (either the patient's home or the scene of an emergency) and on arrival at hospital has been shown to be feasible using numerical, verbal 1 and visual analogue scales 2 . Recording pain scores is valuable, not only because it is a simple method of assessing pain, but because it has been shown to increase the likelihood of administration of analgesia and facilitates an estimation of the effectiveness of treatment. 3 In one study, a reduction in pain score of at least 20mm out of 100mm on a visual analogue scale corresponded to a clinically meaningful reduction in the level of pain reported by patients experiencing acute pain 4 . The type, dose, route 5;6 and timeliness 7 of analgesia are important determinants of the effectiveness of pain relief. Strong analgesics including opiates have been available for use by paramedics for the management of pain since the early 1990s.. The feasibility of pain assessment in the prehospital setting. Prehosp.Emerg.Care 2004;8:155-61. 2 Lord BA,.Parsell B. Measurement of pain in the prehospital setting using a visual analogue scale. Prehospital.Disaster.Med. 2003;18:353-8. 3 Silka PA, Roth MM, Moreno G, Merrill L, Geiderman JM, Pain scores improve analgesic administration patterns for trauma patients in the emergency department. Acad.Emerg.Med. 2004;11:264-70. 4 Kelly AM. Setting the benchmark for research in the management of acute pain in emergency departments. Emerg.Med.(Fremantle.) 2001;13:57-60. 5 Woollard M, Jones T, Pitt K, Vetter N. Hitting them where it hurts? Low dose nalbuphine therapy. Emerg.Med.J. et al. Less IS less: a randomised controlled trial comparing cautious and rapid nalbuphine dosing regimens. Emerg.Med.J. 2004;21:362-4. 7 Karlson BW, Sjolin M, Herlitz J. Clinical factors associated with pain in acute myocardial infarction. Cardiology 1993;83:107-17. RESEARCH AIMS The aim of the study is to examine whether factors such age, sex, condition of the patient, and distance from hospital etc affect decisions to assess pain and/or administer analgesia

    Direct health costs of inflammatory polyarthritis 10 years after disease onset:Results from the Norfolk Arthritis Register

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    Objectives: To explore the change in direct medical costs associated with inflammatory polyarthritis (IP) 10 to 15 years after its onset. Methods: Patients from the Norfolk Arthritis Register who had previously participated in a health economic study in 1999 were traced 10 years later and invited to participate in a further prospective questionnaire-based study. The study was designed to identify direct medical costs and changes in health status over a 6-month period using previously validated questionnaires as the primary source of data. Results: A representative sample of 101 patients with IP from the 1999 cohort provided complete data over the 6-month period. The mean disease duration was 14 years (SD 2.1, median 13.6, interquartile range 12.6–15.4). The mean direct medical cost per patient over the 6-month period was £1496 for IP (inflated for 2013 prices). This compared with £582 (95% CI £355–£964) inflated to 2013 prices per patient with IP 10 years earlier in their disease. The increased cost was largely associated with the use of biologics in the rheumatoid arthritis subgroup of patients (51% of total costs incurred). Other direct cost components included primary care costs (11%), hospital outpatient (19%), day care (12%), and inpatient stay (4%). Conclusion: The direct healthcare costs associated with IP have more than doubled with increasing disease duration, largely as a result of the use of biologics. The results showed a shift in the direct health costs from inpatient to outpatient service use

    Application of fluorescence correlation spectroscopy to study substrate binding in styrene maleic acid lipid copolymer encapsulated ABCG2

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    © 2020 The Authors ABCG2 is one of a trio of human ATP binding cassette transporters that have the ability to bind and transport a diverse array of chemical substrates out of cells. This so-called “multidrug” transport has numerous physiological consequences including effects on how drugs are absorbed into and eliminated from the body. Understanding how ABCG2 is able to interact with multiple drug substrates remains an important goal in transporter biology. Most drugs are believed to interact with ABCG2 through the hydrophobic lipid bilayer and experimental systems for ABCG2 study need to incorporate this. We have exploited styrene maleic acid to solubilise ABCG2 from HEK293T cells overexpressing the transporter, and confirmed by dynamic light scattering and fluorescence correlation spectroscopy (FCS) that this results in the extraction of SMA lipid copolymer (SMALP) particles that are uniform in size and contain a dimer of ABCG2, which is the predominant physiological state. FCS was further employed to measure the diffusion of a fluorescent ABCG2 substrate (BODIPY-prazosin) in the presence and absence of SMALP particles of purified ABCG2. Autocorrelation analysis of FCS traces enabled the mathematical separation of free BODIPY-prazosin from drug bound to ABCG2 and allowed us to show that combining SMALP extraction with FCS can be used to study specific drug: transporter interactions
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