Patient-reported outcome measures for acne: a mixed-methods validation study (acne PROMs).

OBJECTIVES: To examine the acceptability and validity of two patient-reported outcome measures (PROMs) for adult acne, comparing them to the validated Acne-specific Quality of Life (Acne-QoL) measure. DESIGN: Mixed-methods validation study. SETTING: Participants were recruited by (1) mail-out through primary care if they had ever consulted for acne and received a prescription for acne treatment within the last 6 months, (2) opportunistically in secondary care and (3) poster advertisement in community venues. PARTICIPANTS: 221 (204 quantitative and 17 qualitative) participants with acne, aged 18-50 years. OUTCOME MEASURES: Quantitative sub-study participants completed Acne-QoL, Skindex-16 and Comprehensive Acne Quality of Life Scale (CompAQ) at baseline, 24 hours and 6 weeks. Qualitative sub-study participants took part in cognitive think-aloud interviews, while completing the same measures. Transcribed audio recordings were analysed using inductive thematic analysis. RESULTS: Quantitative analyses suggested high internal consistency (Cronbach's alpha 0.74-0.96) and reliability (intraclass correlation coefficient values 0.88-0.97) for both questionnaires. Both scales showed floor effects on some subdomains. Skindex-16 and CompAQ showed good evidence of construct validity when compared with Acne-QoL with Spearman's correlation coefficients 0.54-0.81, and good repeatability over 24 hours.Qualitative data uncovered wide-ranging views regarding usability and acceptability. Interviewees held strong but differing views about layout, question/response wording, redundant/similar questions and guidance notes. Similarly, interviewees differed in perceptions of acceptability of the different scales, particularly on relatability of questions and emotive reactions to scales. CONCLUSIONS: All PROMs performed well in statistical analyses. No PROM showed superior usability and acceptability in the qualitative study. Any PROM should be acceptable for further research in adult acne but researchers should consider the different domains and whether they will measure only facial or facial and trunk acne before making a selection. A new PROM or further evaluation of novel PROMs may be beneficial

When group members admit to being conformist: the role of relative intragroup status in conformity self-reports

Authors' draft; final version published in Personality and Social Psychology BulletinFive studies examined the hypothesis that people will strategically portray the self as being more group influenced the more junior they feel within the group. Among social psychologists (Study 1), ratings of self-conformity by group members were greater when the status of the participant was low than when it was high. These effects were replicated in Studies 2, 3, and 4 in which relative intragroup status was manipulated. In Study 3, the authors found junior group members described themselves as more conformist than senior members when they were addressing an ingroup audience, but when they were addressing an outgroup audience the effect disappeared. Furthermore, junior members (but not senior members) rated themselves as more conformist when they were led to believe their responses were public than when responses were private (Study 5). The discussion focuses on the strategic processes underlying low-status group members’ self-reports of group influence and the functional role of conformity in groups

Relative distancing: a grounded theory of how learners negotiate the interprofessional.

A number of extant educational, psychological and sociological theories have been suggested as possessing utility for interprofessional education (IPE). However, there is limited theory proposed that has been derived directly from data. This article adds to the theoretical toolkit by theorizing from data using constructionist grounded theorizing. This article discusses the grounded theorizing of participants' approaches to IPE and describes the social process of relative distancing, a collection of strategies employed by participants to construct their own professional identities and negotiate their way through interprofessional interactions. The categories of relative distancing are conceptualized as (1) integrating the professional and the interprofessional; (2) constellating and maintaining distance; (3) tensioning and manipulating distance and (4) the dimensions of distance. The first, and most theoretically integrative, category will be discussed in detail here. It was found that participants valued certain learning outcomes over others. They favored learning opportunities that were perceived to be of direct relevance to their own professional development and contributed finite personal resources to these. Resources were committed to those interprofessional learning opportunities where relevance was perceived and the conditions of co-presence (with other professions) and a context for interaction were achieved. The discussion draws links between the data and contemporary discourses of economics and identity

Applying social influence insights to encourage climate resilient domestic water behaviour: Bridging the theory-practice gap

Water scarcity is one of the most pressing issues of our time and it is projected to increase as global demand surges and climate change limits fresh water availability. If we are to reduce water demand, it is essential that we draw on every tool in the box, including one that is underestimated and underutilised: social influence. Research from the psychological sciences demonstrates that behaviour is strongly influenced by the behaviour of others, and that social influence can be harnessed to develop cost-effective strategies to encourage climate resilient behaviour. Far less attention has been paid to investigating water-related interventions in comparison to interventions surrounding energy. In this paper we consider the application of three social influence strategies to encourage water conservation: social norms; social identity; and socially-comparative feedback. We not only review their empirical evidence base, but also offer an example of their application in the residential sector with the aim of highlighting how theoretical insights can be translated into practice. We argue that collaborations between researchers and industry are essential if we are to maximise the potential of behaviour change interventions to encourage climate resilient water behaviour

Identification of a General O-linked Protein Glycosylation System in Acinetobacter baumannii and Its Role in Virulence and Biofilm Formation

Acinetobacter baumannii is an emerging cause of nosocomial infections. The isolation of strains resistant to multiple antibiotics is increasing at alarming rates. Although A. baumannii is considered as one of the more threatening “superbugs” for our healthcare system, little is known about the factors contributing to its pathogenesis. In this work we show that A. baumannii ATCC 17978 possesses an O-glycosylation system responsible for the glycosylation of multiple proteins. 2D-DIGE and mass spectrometry methods identified seven A. baumannii glycoproteins, of yet unknown function. The glycan structure was determined using a combination of MS and NMR techniques and consists of a branched pentasaccharide containing N-acetylgalactosamine, glucose, galactose, N-acetylglucosamine, and a derivative of glucuronic acid. A glycosylation deficient strain was generated by homologous recombination. This strain did not show any growth defects, but exhibited a severely diminished capacity to generate biofilms. Disruption of the glycosylation machinery also resulted in reduced virulence in two infection models, the amoebae Dictyostelium discoideum and the larvae of the insect Galleria mellonella, and reduced in vivo fitness in a mouse model of peritoneal sepsis. Despite A. baumannii genome plasticity, the O-glycosylation machinery appears to be present in all clinical isolates tested as well as in all of the genomes sequenced. This suggests the existence of a strong evolutionary pressure to retain this system. These results together indicate that O-glycosylation in A. baumannii is required for full virulence and therefore represents a novel target for the development of new antibiotics

Experimental concepts for toxicity prevention and tissue restoration after central nervous system irradiation

Several experimental strategies of radiation-induced central nervous system toxicity prevention have recently resulted in encouraging data. The present review summarizes the background for this research and the treatment results. It extends to the perspectives of tissue regeneration strategies, based for example on stem and progenitor cells. Preliminary data suggest a scenario with individually tailored strategies where patients with certain types of comorbidity, resulting in impaired regeneration reserve capacity, might be considered for toxicity prevention, while others might be "salvaged" by delayed interventions that circumvent the problem of normal tissue specificity. Given the complexity of radiation-induced changes, single target interventions might not suffice. Future interventions might vary with patient age, elapsed time from radiotherapy and toxicity type. Potential components include several drugs that interact with neurodegeneration, cell transplantation (into the CNS itself, the blood stream, or both) and creation of reparative signals and a permissive microenvironment, e.g., for cell homing. Without manipulation of the stem cell niche either by cell transfection or addition of appropriate chemokines and growth factors and by providing normal perfusion of the affected region, durable success of such cell-based approaches is hard to imagine

‘Messy Democracy’: Democratic pedagogy and its discontents

This paper reflects on a recent participatory installation by the artists’ collective @.ac, entitled Messy Democracy, as a case study to raise questions concerning the ‘distribution of the sensible’ within the neoliberal art school. The project set up a quasi-autonomous artists’ space within Hanover Project gallery 9 April–3 May, 2018 at University of Central Lancashire, Preston. This exhibition functioned as a space of collective pedagogy, co-labour and ‘dissensus’ situated in relation to the wider operation of the department of Fine Art. It also sought to operate as a critical alternative to contemporary models of the art school, rooted in notions of usefulness and romantic self-realisation, but re-structured in the service of ‘commodification’ and ‘financialisation’ in wake of the Browne Report (2010). Most importantly, Messy Democracy represented a ‘theatocractic’ ‘undercommons’ for alternate and counter-hegemonic subjectivities to emerge. However, hierarchical logics, resulting from the hegemonic ‘distribution of the sensible’ stubbornly persisted even within this nascent pedagogic democracy

Geschlechterstereotype und Geschlechterrollen

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