Anatomies of the subject: Spinoza and Deleuze

PhDThis thesis centres on an examination of Gilles Deleuze's non-subject centred philosophy and the influence of the earlier (seventeenth century) work of Benedict Spinoza, whom Deleuze describes as one of an "alternative" tradition of philosophers, and whom he claims as an antecedent. Historically, the subject has always appeared as a question, or as in question, as a problem around which concepts cluster. The focus here is on Deleuze's approach to the problem of subjectivity, his treatment of it and his attempt to configure an "antisubject" based on his own transformations of Spinozist concepts, which he takes up and modifies for his own purposes. The proposal is that Spinoza provides a key or a way into Deleuzean concepts, and at the same time that Deleuze's readings of Spinoza's theories reinvigorate them. What unites Spinoza and Deleuze, and is a recurring theme of this thesis, is that they both conduct their critiques and elaborate models from within a conceptual framework of a radical immanence that opposes all transcendence, and especially the' transcendent subject of consciousness. It is on the basis of Spinoza's radical immanence and his non-analogical approach to Being/beings that Deleuze constructs a theory of becoming - as "de-individualising" process - that will be his alternative to models of the subject based on identity

Vocation, caring and nurse identity

This study begins with a premise that ‘caring’ is no longer as evident in nursing practice, which in turn has repercussions for understanding nursing as a ‘vocation’. The study, therefore, sets out to problematise both ‘caring’ and ‘vocation’ and in so doing identifies that whilst both are elusive ‘caring’ is particularly difficult to ‘pin down’ - in terms of abstracting a definitive definition, and importantly, how it is articulated in practice. By situating the study within social constructionism (Berger and Luckmann, 1991) and communities of practice (Lave and Wenger, 1991) and by additionally drawing on narrative inquiry, the study pays attention to the stories of six final year student nurses. By closely reading these accounts, through a number of theoretical frames, including Sheldon Stryker (1980), it becomes possible to glimpse some of the interactions and oscillations where an individual’s nursing ideals situates them in what MacLure describes as a ‘moral universe (2003: 9). It is by disentangling this ‘universe’ that I am able to catch some of the meanings that circulate around ‘care’ and which reverberate with the notion of nursing as a ‘vocation’. Further disentanglements, especially those relating to discourses and discursive power occur when Foucault is brought into the picture. Whilst this study is unable to provide a definitive account of what it means to care or provide guidelines for nursing as a vocation it does nevertheless raise a number of pressing and critical questions; questions that highlight the political, social, emotional and ethical work that student nurses have to undertake where hopes, beliefs and ideals in relation to ‘care’ have to find ‘some sort of place’. Moreover, by working with Judith Butler’s theoretical ideas relating to ‘performance’ I am obliged to (re)turn again to the data so as to radically (re)consider the means by which the participants are con(script)ed to perform care in some ways and not others. The study also illustrates the reflexive journey that I have undertaken, where my own ideological longings in relation to ‘care’ have been sorely tampered. It is argued that such tampering is a necessary irritant and component within the context of the university classroom where it obliges both me and the students to work together so that we can, together, (re)think and (re)configure what it means to ‘care’

Clinical interventions, implementation interventions, and the potential greyness in between -a discussion paper

Background: There is increasing awareness that regardless of the proven value of clinical interventions, the use of effective strategies to implement such interventions into clinical practice is necessary to ensure that patients receive the benefits. However, there is often confusion between what is the clinical intervention and what is the implementation intervention. This may be caused by a lack of conceptual clarity between \u27intervention\u27 and \u27implementation\u27, yet at other times by ambiguity in application. We suggest that both the scientific and the clinical communities would benefit from greater clarity; therefore, in this paper, we address the concepts of intervention and implementation, primarily as in clinical interventions and implementation interventions, and explore the grey area in between. Discussion: To begin, we consider the similarities, differences and potential greyness between clinical interventions and implementation interventions through an overview of concepts. This is illustrated with reference to two examples of clinical interventions and implementation intervention studies, including the potential ambiguity in between. We then discuss strategies to explore the hybridity of clinical-implementation intervention studies, including the role of theories, frameworks, models, and reporting guidelines that can be applied to help clarify the clinical and implementation intervention, respectively. Conclusion: Semantics provide opportunities for improved precision in depicting what is \u27intervention\u27 and what is \u27implementation\u27 in health care research. Further, attention to study design, the use of theory, and adoption of reporting guidelines can assist in distinguishing between the clinical intervention and the implementation intervention. However, certain aspects may remain unclear in analyses of hybrid studies of clinical and implementation interventions. Recognizing this potential greyness can inform further discourse

REFORMS: Reporting Standards for Machine Learning Based Science

Machine learning (ML) methods are proliferating in scientific research. However, the adoption of these methods has been accompanied by failures of validity, reproducibility, and generalizability. These failures can hinder scientific progress, lead to false consensus around invalid claims, and undermine the credibility of ML-based science. ML methods are often applied and fail in similar ways across disciplines. Motivated by this observation, our goal is to provide clear reporting standards for ML-based science. Drawing from an extensive review of past literature, we present the REFORMS checklist ($\textbf{Re}$porting Standards $\textbf{For}$ $\textbf{M}$achine Learning Based $\textbf{S}$cience). It consists of 32 questions and a paired set of guidelines. REFORMS was developed based on a consensus of 19 researchers across computer science, data science, mathematics, social sciences, and biomedical sciences. REFORMS can serve as a resource for researchers when designing and implementing a study, for referees when reviewing papers, and for journals when enforcing standards for transparency and reproducibility

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Search for supersymmetry in events with b-quark jets and missing transverse energy in pp collisions at 7 TeV

Results are presented from a search for physics beyond the standard model based on events with large missing transverse energy, at least three jets, and at least one, two, or three b-quark jets. The study is performed using a sample of proton-proton collision data collected at sqrt(s) = 7 TeV with the CMS detector at the LHC in 2011. The integrated luminosity of the sample is 4.98 inverse femtobarns. The observed number of events is found to be consistent with the standard model expectation, which is evaluated using control samples in the data. The results are used to constrain cross sections for the production of supersymmetric particles decaying to b-quark-enriched final states in the context of simplified model spectra.Comment: Submitted to Physical Review

A cell atlas of human thymic development defines T cell repertoire formation.

The thymus provides a nurturing environment for the differentiation and selection of T cells, a process orchestrated by their interaction with multiple thymic cell types. We used single-cell RNA sequencing to create a cell census of the human thymus across the life span and to reconstruct T cell differentiation trajectories and T cell receptor (TCR) recombination kinetics. Using this approach, we identified and located in situ CD8αα+ T cell populations, thymic fibroblast subtypes, and activated dendritic cell states. In addition, we reveal a bias in TCR recombination and selection, which is attributed to genomic position and the kinetics of lineage commitment. Taken together, our data provide a comprehensive atlas of the human thymus across the life span with new insights into human T cell development