Researching educational disadvantage : using participatory research to engage marginalised students with education

Educational disadvantage, long recognised as a factor in determining post-school options, manifests in forms of marginalisation from and resistance to education, and in under-representation in tertiary education. Moreover, while student voice is becoming a more normalised aspect of decision making in schools, marginalised students have limited opportunities to participate in education reform processes. The practice of &quotstudents as researchers" (SaR) extends student voice through engaging students in researching the educational issues that directly affect them and inviting participation in pedagogical and school reform issues. In this research, I examine the application of an SaR model with marginalised secondary school students, and the outcomes for the participants and their schools. The Student Action Research for University Access (SARUA) project provides the site of my empirical investigation. The research is informed by two complementary lines of theory: Habermasian critical theory, which provides the framework for participatory research, and Bourdieuian social reproduction theory, which scaffolds the aims of empowerment underlying SaR. These theories are extended by a theory of imagination to take account of difference and to establish a link to post-modern considerations. I employed a participatory action research methodology to investigate changes in the students' awareness of post-school options, their aspirations regarding tertiary study, and the development of related educational skills as a result of their participation in the project. The principal findings from the research are that the SARUA model provides an effective medium for the empowerment of marginalised students through engagement in meaningful, real-life research; that participant schools are positioned to benefit from the students' research and interventions when school and student habitus are in accord; and that the SARUA model complements current pedagogical reforms aimed at increasing student engagement, retention, and progression to higher education

Joining the dots between teacher education and widening participation in higher education

In England and Australia, higher education institutions are required to widen participation in higher education by including students from under-represented and non-traditional groups. Widening participation is most effective when it starts early – during compulsory education and other forms of pre-tertiary education. Higher education institutions are providers of pre-service and in-service teacher education, and therefore have the potential to ‘join the dots’ between teacher education and widening participation. Two approaches are identified: recruiting more diverse cohorts of students to teacher education through targeted, relevant and engaging pre-entry experiences in schools and communities with low rates of progression to higher education, and preparing all teachers to better support the tenets of widening participation through their professional roles in schools, colleges and communities. This paper focuses on the former, using a structural theoretical lens to understand low participation by particular groups of students. This framework is used to analyse two empirical examples, one from Australia and one from England. The paper concludes by recommending a more systemic approach to widening participation through teacher education, and makes practical suggestions informed by theory, practice and research

Financial Analysis of Dalbavancin for Acute Bacterial Skin and Skin Structure Infections for Self-Pay Patients

© 2020, The Author(s). Introduction: Acute bacterial skin and skin structure infections (ABSSSI) are an increasing cause of admission in the self-pay population. We previously reported that patients with ABSSSI discharged to receive dalbavancin showed a decreased length of stay (LOS) and total direct costs without increasing 30-day readmission rate. For patients who are financially eligible, a dalbavancin vial replacement program can offset costs. The objective of this study was to determine cost differences in treating ABSSSI in self-pay inpatients discharged to receive dalbavancin compared to standard of care (SOC). Methods: This retrospective cohort within a community health system compared self-pay adult inpatients with ABSSSI from February 3, 2016 to August 5, 2019 discharged to receive dalbavancin at an outpatient infusion center with SOC intravenous antibiotics. Patients were included with cellulitis, abscess, or postoperative wound infections diagnoses on the basis of International Classification of Disease, Tenth Revision (ICD-10) codes. Excluded populations were patients without dalbavancin vial replacement performed, pregnant, infections caused exclusively by gram-negative bacteria or fungi, or ICD-10 codes not consistent with ABSSSI. The primary outcome was direct cost of hospital stay. Secondary outcomes included length of stay (LOS), 30-day readmission rates, adverse events (AE), and indirect hospital costs. On the basis of previous studies, a one-sided Student’s t test was performed on financial data. Results: Twelve dalbavancin and 263 SOC patients met inclusion criteria. Direct cost ($2758 vs$4010, p = 0.105) and indirect hospital cost ($2913 vs$3646 , p = 0.162) per patient were less in the dalbavancin group. There was no significant difference between median LOS (4 vs 4, p = 0.888), AE (0% vs 14.8%), and 30-day readmission rates for dalbavancin vs SOC group (8.3% vs 7.2%, p = 0.604). Conclusion: Self-pay patients with ABSSSI discharged to receive dalbavancin with vial replacement resulted in decreased direct and indirect costs per patient with similar 30-day readmission rates, AE, and LOS. More studies targeted toward this population are warranted to determine ultimate benefit

Are Ethnic and Gender Specific Equations Needed to Derive Fat Free Mass from Bioelectrical Impedance in Children of South Asian, Black African-Caribbean and White European Origin? Results of the Assessment of Body Composition in Children Study

Background Bioelectrical impedance analysis (BIA) is a potentially valuable method for assessing lean mass and body fat levels in children from different ethnic groups. We examined the need for ethnic- and gender-specific equations for estimating fat free mass (FFM) from BIA in children from different ethnic groups and examined their effects on the assessment of ethnic differences in body fat. Methods Cross-sectional study of children aged 8–10 years in London Primary schools including 325 South Asians, 250 black African-Caribbeans and 289 white Europeans with measurements of height, weight and arm-leg impedance (Z; Bodystat 1500). Total body water was estimated from deuterium dilution and converted to FFM. Multilevel models were used to derive three types of equation {A: FFM = linear combination(height+weight+Z); B: FFM = linear combination(height2/Z); C: FFM = linear combination(height2/Z+weight)}. Results Ethnicity and gender were important predictors of FFM and improved model fit in all equations. The models of best fit were ethnicity and gender specific versions of equation A, followed by equation C; these provided accurate assessments of ethnic differences in FFM and FM. In contrast, the use of generic equations led to underestimation of both the negative South Asian-white European FFM difference and the positive black African-Caribbean-white European FFM difference (by 0.53 kg and by 0.73 kg respectively for equation A). The use of generic equations underestimated the positive South Asian-white European difference in fat mass (FM) and overestimated the positive black African-Caribbean-white European difference in FM (by 4.7% and 10.1% respectively for equation A). Consistent results were observed when the equations were applied to a large external data set. Conclusions Ethnic- and gender-specific equations for predicting FFM from BIA provide better estimates of ethnic differences in FFM and FM in children, while generic equations can misrepresent these ethnic differences

Position-specific Performance Indicators that Discriminate between Successful and Unsuccessful Teams in Elite Women’s Indoor Field Hockey: Implications for Coaching

The aim of this investigation was to establish median performance profiles for the six playing positions in elite women’s indoor hockey and then identify whether these position-specific profiles could discriminate between qualifying (top four), mid-table and relegated teams in the 2011-12 England Hockey premier league. Successful passing in relegated teams was significantly lower (p<0.008) than in mid-table and qualifying teams in four of the five outfield positions. Furthermore, the right backs of qualifying teams demonstrated significantly fewer (p<0.008) unsuccessful passes (x̃=15.5 ±CLs 15.0 and 10.0 respectively) and interceptions (x̃=4.0 ±CLs 4.0 and 3.0 respectively) than relegated teams (x̃=19.5 ±CLs 21.0 and 17.0; x̃=7.5 ±CLs 8.0 and 6.0 respectively). Finally, the right forwards of relegated teams demonstrated significantly fewer (p<0.008) successful interceptions (x̃=4.0 ±CLs 5.0 and 4.0 respectively) than qualifying teams (x̃=5.0 ±CLs 6.0 and 3.0 respectively) and significantly more (p<0.008) unsuccessful interceptions (x̃=5.5 ±CLs 6.0 and 4.0 respectively) than mid-table teams (x̃=3.0 ±CLs 3.0 and 2.0 respectively). Based on these findings, coaches should adapt tactical strategies and personnel deployment accordingly to enhance the likelihood of preparing a qualifying team. Research should build from these data to examine dribbling, pressing and patterns of play when outletting

Psychometric properties of the Tinnitus Functional Index (TFI): assessment in a UK research volunteer population

Objectives Questionnaires are essential for measuring tinnitus severity and intervention-related change but there is no standard instrument used routinely in research settings. Most tinnitus questionnaires are optimised for measuring severity but not change. However, the Tinnitus Functional Index (TFI) claims to be optimised for both. It has not however been fully validated for research purposes. Here we evaluate the relevant psychometric properties of the TFI, specifically the questionnaire factor structure, reproducibility, validity and responsiveness guided by quality criteria for the measurement properties of health-related questionnaires. Methods The study involved a retrospective analysis of data collected for 294 members of the general public who participated in a randomised controlled trial of a novel tinnitus device (ClinicalTrials.gov Identifier: NCT01541969). Participants completed up to eight commonly used assessment questionnaires including the TFI, Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), a Visual Analogue Scale of loudness (VAS-Loudness), Percentage Annoyance question, the Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), and the World Health Organisation Quality of Life-Bref (WHOQOL-BREF). A series of analyses assessed the study objectives. Forty four participants completed the TFI at a second visit (within 7–21 days and before receiving any intervention) providing data for reproducibility assessments. Results The 8-factor structure was not fully confirmed for this general (non-clinical) population. Whilst it was acceptable standalone subscale, the ‘auditory’ factor showed poor loading with the higher order factor ‘functional impact of tinnitus’. Reproducibility assessments for the overall TFI indicate high internal consistency (α = 0.80) and extremely high reliability (ICC: 0.91), whilst agreement was borderline acceptable (93%). Construct validity was demonstrated by high correlations between scores on the TFI and THI (r = 0.82) and THQ (r = 0.82), moderate correlations with VAS-L (r = 0.46), PR-A (r = 0.58), BDI (r = 0.57), BAI (r = 0.39) and WHOQOL (r = −0.48). Floor effects were observed for more than 50% of the items. A smallest detectable change score of 22.4 is proposed for the TFI global score. Conclusion Even though the proposed 8-factor structure was not fully confirmed for this population, the TFI appears to cover multiple symptom domains, and to measure the construct of tinnitus with an excellent reliability in distinguishing between patients. While the TFI may discriminate those whose tinnitus is not a problem, floor effects in many items means it is less appropriate as a measure of change in this subgroup. Further investigation is needed to determine whether these effects are relevant in other populations

Interleukin-6 Is a Potential Biomarker for Severe Pandemic H1N1 Influenza A Infection

Pandemic H1N1 influenza A (H1N1pdm) is currently a dominant circulating influenza strain worldwide. Severe cases of H1N1pdm infection are characterized by prolonged activation of the immune response, yet the specific role of inflammatory mediators in disease is poorly understood. The inflammatory cytokine IL-6 has been implicated in both seasonal and severe pandemic H1N1 influenza A (H1N1pdm) infection. Here, we investigated the role of IL-6 in severe H1N1pdm infection. We found IL-6 to be an important feature of the host response in both humans and mice infected with H1N1pdm. Elevated levels of IL-6 were associated with severe disease in patients hospitalized with H1N1pdm infection. Notably, serum IL-6 levels associated strongly with the requirement of critical care admission and were predictive of fatal outcome. In C57BL/6J, BALB/cJ, and B6129SF2/J mice, infection with A/Mexico/4108/2009 (H1N1pdm) consistently triggered severe disease and increased IL-6 levels in both lung and serum. Furthermore, in our lethal C57BL/6J mouse model of H1N1pdm infection, global gene expression analysis indicated a pronounced IL-6 associated inflammatory response. Subsequently, we examined disease and outcome in IL-6 deficient mice infected with H1N1pdm. No significant differences in survival, weight loss, viral load, or pathology were observed between IL-6 deficient and wild-type mice following infection. Taken together, our findings suggest IL-6 may be a potential disease severity biomarker, but may not be a suitable therapeutic target in cases of severe H1N1pdm infection due to our mouse data