'I felt that I do live in the UK now':international students' self-reports of their English language speaking experiences on a pre-sessional programme

This article focuses on the English language experiences of a group of pre-sessional students, an under-represented group in the literature on language and education. In particular, it investigates the opportunities that such students have to use English outside the classroom, shown to be a key factor in student satisfaction with their study abroad experience. Drawing on data from questionnaires, interviews and on-line diaries, we show that students have a variety of opportunities to use English; however, these opportunities may require students to engage in complex negotiations right from the beginning of their sojourn in the UK. Micro-analysis of the data shows that agency is a key construct in understanding students' representations of their English encounters as they begin their lives in the UK. The article concludes with some suggestions as to how pre-sessional courses may develop students' linguistic and socio-cultural skills in order that they may interact successfully in English outside the classroom

EQRbot: A chatbot delivering EQR argument-based explanations

Data availability statement: The provided link: https://github.com/FCast07/EQRbot refers to the GitHub repository that stores the chatbot programming code.Recent years have witnessed the rise of several new argumentation-based support systems, especially in the healthcare industry. In the medical sector, it is imperative that the exchange of information occurs in a clear and accurate way, and this has to be reflected in any employed virtual systems. Argument Schemes and their critical questions represent well-suited formal tools for modeling such information and exchanges since they provide detailed templates for explanations to be delivered. This paper details the EQR argument scheme and deploys it to generate explanations for patients' treatment advice using a chatbot (EQRbot). The EQR scheme (devised as a pattern of Explanation-Question-Response interactions between agents) comprises multiple premises that can be interrogated to disclose additional data. The resulting explanations, obtained as instances of the employed argumentation reasoning engine and the EQR template, will then feed the conversational agent that will exhaustively convey the requested information and answers to follow-on users' queries as personalized Telegram messages. Comparisons with a previous baseline and existing argumentation-based chatbots illustrate the improvements yielded by EQRbot against similar conversational agents.This research was partially funded by the UK Engineering & Physical Sciences Research Council (EPSRC) under Grant #EP/P010105/1

Activation of epiplexus macrophages in hydrocephalus caused by subarachnoid hemorrhage and thrombin

AimsWe have found that hydrocephalus development in spontaneously hypertensive rats was associated with activation of epiplexus cells. The current study examined whether epiplexus cell activation occurs in a rat subarachnoid hemorrhage (SAH), whether activation would be greater in a subset of rats that developed hydrocephalus and the potential role of thrombin in epiplexus cell activation.MethodsThere were two parts in this study. First, an endovascular perforation was performed in rats to induce SAH. Second, rats received an intraventricular infusion of either thrombin or saline. Magnetic resonance imaging was used to measure the ventricular volumes. Immunofluorescence and immunohistochemistry were used to study epiplexus cell activation.ResultsIba‐1, OX‐6, and CD68 were expressed in the epiplexus cells of the choroid plexus in sham‐operated rats. SAH increased Iba‐1 and CD68 immunoreactivity in epiplexus cells in addition to an increase in Iba‐1‐positive cell soma size. Those effects were greater in rats that developed hydrocephalus. Intraventricular thrombin mimicked the effects of SAH on epiplexus cell activation and hydrocephalus.ConclusionThis study supports the concept that epiplexus cell activation is associated with hydrocephalus development. Epiplexus cell activation may be in response to thrombin production after hemorrhage, and it may be a therapeutic target.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151813/1/cns13203_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151813/2/cns13203.pd

Familial hypercholesterolaemia: challenges in primary care

Familial hypercholesterolaemia remains largely unrecognised and undertreated in Australian primary care. A new approach involving increased awareness, early detection, lifelong treatment and cascade testing of relatives is essential to improve outcomes of patients with this disorder. Key Points Familial hypercholesterolaemia (FH) is a relatively common inherited disorder of high cholesterol levels. FH can lead to atherosclerosis, premature coronary artery disease and early death if left untreated. Cascade testing of relatives of patients with FH is cost- effective and necessary as one in two will have the condition. Innovations in primary care can improve FH detection in the community. An integrated approach to FH detection involving GPs, specialists and pathology laboratories is recommended. Primary care teams are well positioned to provide a sustainable approach to FH diagnosis and management but greater awareness of this condition is needed

Challenges in the care of familial hypercholesterolemia: a community care perspective

Familial hyperchoelsterolaemia (FH) remains under-diagnosed and under-treated in the community setting. Earlier evidence suggested prevalence of 1:500 worldwide but newer evidence suggests it is more common. Less than 15% of FH patients are ever diagnosed with children and young adults rarely tested despite having most to gain given their lifetime exposure. Increasing awareness among primary care teams is critical to improve detection profile for FH. Cascade testing in the community setting needs a sustainable approach to be developed to facilitate family tracing of index cases. The use of the Dutch Lipid Clinic Network Criteria score to facilitate a phenotypic diagnosis is the preferred approach adopted in Australia and eliminates the need to undertake genetic testing for all suspected FH cases

TST positivity in household contacts of tuberculosis patients : a case-contact study in Malawi

This work was supported by a Wellcome Trust Fellowship awarded to DJ Sloan (086757/Z/08/A) a Malawi Liverpool Wellcome Trust (MLW) Core grant awarded by the Wellcome Trust and by a grant from the European Union Action for Diseases of Poverty Program (Sante–2006–105-061).Background:  Screening household contacts of active tuberculosis (TB) patients is recommended for TB control. Due to resource constraints this rarely occurs in lower income countries. Demographic and clinical features of index cases may influence the likelihood of onwards TB transmission. It has also been proposed that accumulation of intracellular lipid bodies within M. tuberculosis cells may also enhance bacterial transmissibility. This study explored whether clinical and bacteriological observations recorded at baseline in TB cases in Malawi could help identify those with the highest risk of onwards transmission, to prioritise contact tracing. Methods:  In this case-contact study, data on clinical presentation, sputum bacterial load and the percentage of lipid body positive acid-fast bacilli (%LB + AFB) on sputum smears were recorded in adults with sputum smear and culture positive pulmonary TB before initiation of therapy. The Tuberculin Skin Test (TST) was used to detect infection with M. tuberculosis amongst household contacts under the age of 15 years. TST positivity of the child contacts was related to characteristics of the index case. Results:  Thirty four index cases brought 56 contacts (median: 1, range: 1–4 contacts each). 37 (66%) of contacts had a positive TST. Cavities or a high percentage of lung affected on index patient CXRs were associated with TST positivity. Multivariate analysis of non-radiological factors showed that male sex, HIV-negative status and raised peripheral blood white blood count (WBC) in index patients were also independent risk factors of TST positivity. Lower %LB + AFB counts were associated with TST positivity on univariate analysis only. Conclusion:  TST positivity is common amongst household contacts of sputum smear positive adult TB patients in Malawi. Contact tracing in this high risk population could be guided by prioritising index cases with CXR cavities and extensive radiological disease or, in the absence of CXRs, those who are HIV-negative with a raised WBC.Publisher PDFPeer reviewe

The structure of Organizational Virtual Social Networks

Organizational virtual social networks (OVSN) reshape social structures due to their ability to strengthen social ties, to change power relations and to enable new forms of cooperation. Research in Information and Communication Technologies (ICT) has led to various approaches that analyze the impact of OVSN on organizations in terms of structure and behavior. Our study aims to analyze important features related to the structure of OVSN. It also aims to strengthen a network approach to analyze organizational phenomena such as working groups and connected individuals, as well as the impact of online networks in organizations. This study was based on the lines of approach described by Oinas-Kukkonen et al. (2010) and on the research carried out by Bobsin & Hoppen (2012) to understand the process of structuring OVSN. Our main results are an OVSN structure consisting of actors and roles, interactions, operating elements and articulating goals. We also analyzed some structural elements of networks which may contribute to the development of a network based approach to study organizational phenomena

Detection and management of familial hypercholesterolaemia in primary care in Australia: protocol for a pragmatic cluster intervention study with pre-post intervention comparisons

Introduction: Familial hypercholesterolaemia (FH), an autosomal dominant disorder of lipid metabolism, results in accelerated onset of atherosclerosis if left untreated. Lifelong treatment with diet, lifestyle modifications and statins enable a normal lifespan for most patients. Early diagnosis is critical. This protocol trials a primary care-based model of care (MoC) to improve detection and management of FH. Methods and analysis: Pragmatic cluster intervention study with pre-post intervention comparisons in Australian general practices. At study baseline, current FH detection practice is assessed. Medical records over 2 years are electronically scanned using a data extraction tool (TARB-Ex) to identify patients at increased risk. High-risk patients are clinically reviewed to provide definitive, phenotypic diagnosis using Dutch Lipid Clinic Network Criteria. Once an index family member with FH is identified, the primary care team undertake cascade testing of first-degree relatives to identify other patients with FH. Management guidance based on disease complexity is provided to the primary care team. Study follow-up to 12 months with TARB-Ex rerun to identify total number of new FH cases diagnosed over study period (via TARB-Ex, cascade testing and new cases presenting). At study conclusion, patient and clinical staff perceptions of enablers/barriers and suggested improvements to the approach will be examined. Resources at each stage will be traced to determine the economic implications of implementing the MoC and costed from health system perspective. Primary outcomes: increase in number of index cases clinically identified; reduction in low-density lipoprotein cholesterol of treated cases. Secondary outcomes: increase in the number of family cases detected/contacted; cost implications of the MoC. Ethics and dissemination: Study approval by The University of Notre Dame Australia Human Research Ethics Committee Protocol ID: 0 16 067F. Registration: Australian New Zealand Clinical Trials Registry ID: 12616000630415. Information will be disseminated via research seminars, conference presentations, journal articles, media releases and community forums