Eliciting patient preferences, priorities and trade-offs for outcomes following kidney transplantation: A pilot best-worst scaling survey

Objectives: Eliciting preferences and trade-offs that patients may make to achieve important outcomes, can assist in developing patient-centred research and care. The pilot study aimed to test the feasibility of a case 2 best-worst scaling survey (BWS) to elicit recipient with kidney transplantation preferences after transplantation. Design: Preferences for graft survival and dying, cancer, cardiovascular disease, diabetes, infection and side effects (gastrointestinal, weight-gain and appearance) were assessed in recipients with transplantation using a BWS (20 scenarios of nine outcomes). Participants chose 'best' and 'worst' outcomes. Responses were analysed using a multinomial logit model. Selected participants were interviewed. Outcomes: Attribute coefficients and survey completion error rates. Results: 81 recipients with transplantation were approached, and 39 (48%), mean age 50.5 years, completed the BWS. 4 (10%) surveys were invalid with major errors and of 35 remaining, 7 of 1400 (0.5%) choices were missing. -23 (59%) took >20 min to complete the survey. 1 was unable to finish, and 1 did not understand the survey. 2 (5%) found it very hard and 14 (35%) moderately hard. Most attribute coefficients were significant (p<0.05) and showed face validity. Graft survival was most important with normalised coefficients from 1 (95% CI 0.89 to 1.11) to 0.06 (95% CI -0.03 to 0.16) for 30 and 1 year duration, respectively. Attribute level coefficients decreased with increasing risk of adverse outcomes. Error rates of 20% and 2% were estimated for dominant attributes '100% risk of dying' and '30 years graft survival', respectively. 7 participants were interviewed regarding counterintuitive selection of '100% risk of dying' as a 'best' outcome. Misunderstanding, not linking dying to graft survival and aversion to dialysis were reasons given. Conclusions: Recipients with transplant recipients successfully completed a complex case 2 BWS with attribute coefficients having face validity with respect to duration of graft survival and risk of adverse outcomes. Areas for refinement to reduce complexity in design have been identified

The mid-UV population of the nucleus and the bulk of the post-merger NGC 3610

The very center of NGC~3610, a clearly disturbed giant elliptical generally assumed to be a post-merger remnant, appears dominated in the mid-UV (2500-3200 A spectral region) by a stellar population markedly different from that dominating the bulk of its stellar body. I want here to make use of the mid-UV spectra of NGC~3610 as seen through tiny ($\sim$1") and large (10"$\times$20") apertures as a diagnostic population tool. I compare archive IUE/LWP large aperture and HST/FOS UV data of NGC 3610. The strength of mid-UV triplet (dominated by the turnoff population) shows a remarkable drop when switching from the galaxy central arcsec (FOS aperture) to an aperture size comparable to $\sim$0.5 r$_e$ (IUE). The sub-arsec (mid)-UV properties of this galaxy involved in a past merger reveal a central metal enrichment which left intact the bulk of its pre-existing population.Comment: 6 pages, 2 figures, accepted for publication in astronomy and Astrophysic

But is it innovation?: the development of novel methodological methods in qualitative research

Focusing on three case studies of novel approaches about which claims of innovation have been made, this paper explores the process of methodological innovation and the response of the social science community to innovations. The study focuses on three specific innovations: ‘netnography’, ‘child-led research’ and ‘creative methods’ and draws on interview data with researchers who have developed these approaches and those who have engaged with them. Data are explored through the lens of the social context of contemporary qualitative research methods and specifically what has been referred to in the UK as the ‘impact’ agenda. We argue that while methodological innovation may be viewed by researchers as important for the continued success of social science disciplines, the processes whereby new methods are developed and marketed, within the context of contemporary social research and the impact culture, may limit their acknowledgement and acceptance within the broader social science community. This culture increases the speed at which innovations are developed and marketed, encourages the dissemination of codified or procedural approaches to innovations which limit the craft of qualitative research and encourages early career researchers to adopt approaches without being reflexive about the affordances these methods might provide

A Century of Cardiomythology: Exercise and the Heart c.1880–1980

The relationship between health and exercise involves risks as well as rewards. This article focuses on heart disease and the marathon to show how doctors have negotiated that relationship over a century. Three distinct changes in biomedical attitudes towards vigorous exercise are outlined. First, the mid-Victorian interpretation of pathological hypertrophy of the heart was overturned at the end of the nineteenth century. Secondly, hypertrophy was reinvented as a beneficial physiological adaptation in the 1940s and 1950s. Thirdly, these claims of distinctiveness were challenged by the leisure revolution. Sports doctors and cardiologists reinvented exercise as a drug that could only be safely used with the guidance of a medical professional. Medicalising sport reduced its risk and maximised its reward, both to the individual and the state

Action, arousal and subjective time

Saccadic chronostasis refers to the subjective temporal lengthening of the first visual stimulus perceived after an eye movement. It has been quantified using a duration discrimination task. Most models of human duration discrimination hypothesise an internal clock. These models could explain chronostasis as a transient increase in internal clock speed due to arousal following a saccade, leading to temporal overestimation. Two experiments are described which addressed this hypothesis by parametrically varying the duration of the stimuli that are being judged. Changes in internal clock speed predict chronostasis effects proportional to stimulus duration. No evidence for proportionality was found. Two further experiments assessed the appropriateness of the control conditions employed. Results indicated that the chronostasis effect is constant across a wide range of stimulus durations and does not reflect the pattern of visual stimulation experienced during a saccade, suggesting that arousal is not critical. Instead, alternative processes, such as one affecting the onset of timing (i.e., the time of internal clock switch closure) are implicated. Further research is required to select between these alternatives

Modular Evolution and the Origins of Symmetry: Reconstruction of a Three-Fold Symmetric Globular Protein

SummaryThe high frequency of internal structural symmetry in common protein folds is presumed to reflect their evolutionary origins from the repetition and fusion of ancient peptide modules, but little is known about the primary sequence and physical determinants of this process. Unexpectedly, a sequence and structural analysis of symmetric subdomain modules within an abundant and ancient globular fold, the β-trefoil, reveals that modular evolution is not simply a relic of the ancient past, but is an ongoing and recurring mechanism for regenerating symmetry, having occurred independently in numerous existing β-trefoil proteins. We performed a computational reconstruction of a β-trefoil subdomain module and repeated it to form a newly three-fold symmetric globular protein, ThreeFoil. In addition to its near perfect structural identity between symmetric modules, ThreeFoil is highly soluble, performs multivalent carbohydrate binding, and has remarkably high thermal stability. These findings have far-reaching implications for understanding the evolution and design of proteins via subdomain modules

Professional discourses on single parenthood in international adoptions in Spain

This is the pre-peer reviewed version of the following article: Poveda, David, Jociles, María Isabel, Rivas, Ana María. Professional discourses on single parenthood in international adoptions in Spain. PoLAR: Political and Legal Anthropology Review 36.1 (2013): 35–55, which has been published in final form at http://dx.doi.org/10.1111/plar.12002. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-ArchivingThis article examines psychologists’ and social workers’ discourses in relation to international adoptions by single parents in Spain. The analysis suggests that these professionals, who play a key role in moving forward (or not) the adoption process,work with a distinctive notion of “the best interest of the child” in which a hetero-sexual couple is taken as the normative referent of parental and family relations. Theprinciple of the child’s best interest is explicitly defined at the legislative level andis incorporated as part of child protection policies, though in interview discourses itintertwines with many other themes. Our analysis uncovered some diversity in psy-chologists’ and social workers’ discourses, which seem to be tied to their professionaland experiential background, though an argument that portrays single parenthoodin negative terms dominates their views. These representations are developed eventhough the available evidence from post-adoption assessments does not support such biasThe findings presented in this article are part of the research project funded by the Spanish Ministry of Science and Innovation Monoparentalidad por Eleccion: ´Estrategias de Autodefinicion, Distinción y Legitimación de Nuevos Modelos Familiares [Single Parenthood by Chioce: Self-definition, Distinction and Legitimation Strategies of New Family Models] (Plan Nacional I+D+I 2008–2011, Reference: FEM2009–07717FEME

The Psychiatrization of Poverty: Rethinking the Mental Health-Poverty Nexus

The positive association between ‘mental illness’ and poverty is one of the most well established in psychiatric epidemiology. Yet, there is little conclusive evidence about the nature of this relationship. Generally, explanations revolve around the idea of a vicious cycle, where poverty may cause mental ill health, and mental ill health may lead to poverty. Problematically, much of the literature overlooks the historical, social, political, and cultural trajectories of constructions of both poverty and ‘mental illness’. Laudable attempts to explore the social determinants of mental health sometimes take recourse to using and reifying psychiatric diagnostic categories that individualize distress and work to psychiatrically reconfigure ‘symptoms’ of oppression, poverty, and inequality as ‘symptoms’ of ‘mental illness’. This raises the paradoxical issue that the very tools that are used to research the relationship between poverty and mental health may prevent recognition of the complexity of that relationship. Looking at the mental health–poverty nexus through a lens of psychiatrization (intersecting with medicalization, pathologization, and psychologization), this paper recognizes the need for radically different tools to trace the messiness of the multiple relationships between poverty and distress. It also implies radically different interventions into mental health and poverty that recognize the landscapes in which lived realities of poverty are embedded, the political economy of psychiatric diagnostic and prescribing practices, and ultimately to address the systemic causes of poverty and inequality

An eight-parent multiparent advanced generation inter-cross population for winter-sown wheat: creation, properties, and validation

MAGIC populations represent one of a new generation of crop genetic mapping resources combining high genetic recombination and diversity. We describe the creation and validation of an eight-parent MAGIC population consisting of 1091 F7 lines of winter-sown wheat (Triticum aestivum L.). Analyses based on genotypes from a 90,000-single nucleotide polymorphism (SNP) array find the population to be well-suited as a platform for fine-mapping quantitative trait loci (QTL) and gene isolation. Patterns of linkage disequilibrium (LD) show the population to be highly recombined; genetic marker diversity among the founders was 74% of that captured in a larger set of 64 wheat varieties, and 54% of SNPs segregating among the 64 lines also segregated among the eight founder lines. In contrast, a commonly used reference bi-parental population had only 54% of the diversity of the 64 varieties with 27% of SNPs segregating. We demonstrate the potential of this MAGIC resource by identifying a highly diagnostic marker for the morphological character "awn presence/absence" and independently validate it in an association-mapping panel. These analyses show this large, diverse, and highly recombined MAGIC population to be a powerful resource for the genetic dissection of target traits in wheat, and it is well-placed to efficiently exploit ongoing advances in phenomics and genomics. Genetic marker and trait data, together with instructions for access to seed, are available at http://www.niab.com/MAGIC/

From Providers to PHOs: an institutional analysis of nonprofit primary health care governance in New Zealand

Policy reforms to primary health care delivery in New Zealand required government-funded firms overseeing care delivery to be constituted as nonprofit entities with governance shared between consumer and producers. This paper examines the consumer and producer interests in the allocation of ownership and control of New Zealand firms delivering primary health care utilising theories of competition in the markets for ownership and control of firms. Consistent with pre-reform patterns of ownership and control provider interests appear to have exerted effective control over the formation and governance of the new entities in all but a few cases where community (consumer) control was already established. Their ability to do so is implied from the absence of a defined ownership stake via which the balance of governance control could shift as a consequence of changes to incentives facing the different stakeholding groups. It appears that the pre-existing patterns will prevail and further intervention will be required if policymakers are to achieve their underlying aims