126 research outputs found

    Transcendence over Diversity: black women in the academy

    Get PDF
    Universities, like many major public institutions have embraced the notion of ‘diversity’ virtually uncritically- it is seen as a moral ‘good in itself’. But what happens to those who come to represent ‘diversity’- the black and minority ethnic groups targeted to increase the institutions thirst for global markets and aversion to accusations of institutional racism? Drawing on existing literature which analyses the process of marginalization in higher education, this paper explores the individual costs to black and female academic staff regardless of the discourse on diversity. However despite the exclusion of staff, black and minority ethnic women are also entering higher education in relatively large numbers as students. Such ‘grassroots’ educational urgency transcends the dominant discourse on diversity and challenges presumptions inherent in top down initiatives such as ‘widening participation’. Such a collective movement from the bottom up shows the importance of understanding black female agency when unpacking the complex dynamics of gendered and racialised exclusion. Black women’s desire for education and learning makes possible a reclaiming of higher education from creeping instrumentalism and reinstates it as a radical site of resistance and refutation

    Prediction of Severe Complications and Mortality in Patients Admitted to a Coronary Care Unit

    Get PDF
    The aim of this study was to design a statistical model which will predict death or life-threatening complications in patients admitted to Coronary Care Unit using data which is available at the time of presentation. The study included 3721 consecutive admissions over a period four year period. Predictive models were developed using logistic regression analysis (with data from 1000 patients) and their performance was assessed using receiver operating characteristic (ROC) curve analysis. The most useful model included nine data items and was tested on data from 2721 patients. These could be divided into four groups according to their calculated probability of developing a serious complication. The lowest risk group had a mortality of 0.05%, compared with 3.5%, 6.4% and 18.1% respectively in the higher risk groups (p1000 U/1) in the four groups was 14.1%, 21.2%, 46.9% and 51.5% respectively (p<0.001). The overall complication rates were 16.9%, 35.4%, 75.4% and 71.8% respectively (p<0.001)

    Learners' perceptions of their successes and failures in foreign language learning

    Get PDF
    This is a postprint of an article whose final and definitive form has been published in the Language Learning Journal © 2004 Copyright Taylor & Francis; Language Learning Journal is available online at http://www.informaworld.comResearch into learners’ attributions for their successes and failures has received considerable attention. However very little has been carried out in the area of learning foreign languages. This study is timely in view of the current interest by the government in promoting foreign languages. The aims of the study were (1) to investigate secondary students’ attributions for their success and failures in learning foreign languages (2) to examine the ways in which these vary according to age, gender, perceived success and specific language studied. The sample consisted of 285 students between the ages of 11 and 16 studying French, German and Spanish in five secondary schools in the UK. A simple open questionnaire was administered by language teachers, consisting of a personal evaluation by students of their perceived level of success as learners of specific foreign languages and their attributions for success and failure in those domains. The resulting responses were analysed by means of a grounded theory approach allowing categories to emerge from the data. The resultant categories were then tabulated according to student age, gender, and language learnt, together with level of perceived success. Over one thousand attributional statements gave rise to 21 attributional categories for doing well and 16 categories for not doing well at language learning. A far wider range of attributions were identified than is generally shown in the research literature, six of which were most commonly called upon as reasons for both success and failure. Clear differences emerged between boys and girls, year groups, perceived success and language studied. These results and, in particular, the lack of clarity in the learners’ comments about strategy use and the lack of focus on metacognitive strategies, have important implications for policy makers and for teachers of foreign languages in UK schools. In addition there are important implications for future research in this area

    Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

    Get PDF
    BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, an

    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

    Get PDF
    Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

    Anomalous left coronary artery from the pulmonary artery - a therapeutic dilemma

    No full text
    An anomalous left coronary artery from the pulmonary artery was diagnosed clinically in 12 patients (and confirmed angiographically in 11 and at autopsy in 1). A classic history of 'infantile angina' was obtained in only 1 patient, while the typical electrocardiographic findings Of anterolateral ischaemia or infarction were present in 11 patients (92%). The majority had evidence of left ventricular dysfunction _and mitral regurgitation. Three patients underwent surgical reimplantation of the anomalous left coronary artery' into the ascending aorta. Two survive, but with persistent electrocardiographic changes and cardiomegaly. Nine patients, of whom 4 survive, were managed medically. Five of the 6 deaths occurred within 1 month of diagnosis. A conservative approach to surgical intervention is recommended, as surgery is unlikely to alter the ultimate prognosis

    Modeling Post-Fire Tree Mortality Using a Logistic Regression Method within a Forest Landscape Model

    Get PDF
    Fire is a multi-scale process that is an important component in determining ecosystem age structures and successional trajectories across forested landscapes. In order to address questions regarding fire effects over large spatial scales and long temporal scales researchers often employ forest landscape models which can model fire as a spatially explicit disturbance. Within forest landscape models site-level fire effects are often simplified to the species, functional type, or cohort level due to time or computational resource limitations. In this study we used a subset of publicly available U.S. Forest Service forest inventory data (FIA) to estimate short-term fire effects on tree densities across multiple stem diameter classes in two ecological sections in the central and southern United States. We found that FIA plots where low-intensity fires occurred within the preceding five years in the Ozark Highlands ecological section had significantly reduced stem densities in the two smallest diameter classes and in the Gulf Coastal Plains and Flatwoods fire reduced stem densities in the three smallest diameter classes. Using an independent subset of FIA plots we then parameterized and calibrated a forest landscape model to simulate site-level fire effects using a logistic regression based method and compare the results to previous methods of modeling fire effects. When representative landscapes from both study areas were simulated under a low-intensity fire regime using a forest landscape model the logistic regression probability method of modeling fire effects produced a similar reduction in stem densities while the previous age-cohort method overestimated density reductions across diameter classes. A more realistic representation of fire effects, particularly in low intensity fire regimes, increases the utility of forest landscape models as tools for planning and management
    corecore