1,378 research outputs found
The complexity of learning : relations all the way down
University of Technology, Sydney. Faculty of Arts and Social Sciences.This is a conceptual thesis about how both learning in relation to professional practice,
particularly learning from practice, and the production and use of professional
knowledge, can be understood. The work of the thesis is an attempt to address the issue
of how to conceptualise an onto-epistemological framework for inquiry in the field of
social sciences that consists of learning, practice, learning from practice and producing
and using knowledge; a framework that fits more productively with practitioners’
experience in these areas than the one we currently use.
The traditional ontological perspective, that frames the way in which concepts such as
practice and learning are conceptualised, imposes significant limitations on their
understanding and use. This traditional framework is substantialist in form. That is, it
reflects a model of the world in which substances or entities have prime ontological
significance. Because of this, the relations between entities are commonly either treated
themselves reductively as additional entities, or are ignored. I argue that it is this
relational reductionism of the traditional substantialist ontology that is problematic
when considering human processes such as practice and learning.
The thesis has its experiential origins in the lack of fit between espoused theories of
learning and theories-in-use as related to professional practice. To illustrate this I use
the claims of Evidence-based Medicine to function as a theory of medical practice and
as a medical epistemology. I argue that its limitations in both areas follow from its
development within the traditional substantialist, or entity-based, framework which
shapes these claims. The limitations of Evidence-based Medicine serve as an example
of the way in which applying relationally reductive manoeuvres to the complex relations
of lived experience, while to some degree a necessary aspect of all human social
functioning, is problematic if not done in a critical or reflective manner.
The body of constructs and theories known as ‘complexity’ offers a more encompassing
onto-epistemological framework for considering human processes. It does so because it
is relation-based. In such a framework, systems and processes are conceptualised as
being constituted by their relations, rather than built up of their composite entities. In
this thesis I draw on several already current theories and bodies of concepts which are
consistent with a complexity perspective, to support the use of complexity as a
framework in re-formulating learning and its relation to practice.
The first of these is the pragmatist philosopher John Dewey’s formulation of living
functionality which has ‘trans-actional’ relations as a central feature. I argue that if these
relations are understood as an exemplar of complex living relations, then complexity
has a capacity to account for the generativity (the emergence of the radically new) and
the indeterminacy (the unknown unknowns) of human functioning, neither of which can
be done within the traditional substantialist framework.
The second is a body of concepts derived from psychoanalytic thinking and other
theories of psycho-biological functioning which relate to human affective functioning.
Human affective needs act as a driver of social processes and activities and human
experience that is affectively shared between individuals and socially processed.
produces meaning. What these concepts have in common is an understanding of human
psycho-social function as having a relational basis at multiple levels, for which transactional
relating can function as a model. These psycho-biological concepts, with
sociologist Niklas Luhmann’s theories of social functioning as emerging from interpersonal
communication, allow for distinctions to be made between aspects of human
functioning at biological, psychological and social ‘levels’, levels that are both
differentiated and mutually dependent, allowing a re-formulation of learning, its relation
to practice and the production of knowledge.
With these theories in mind, I take the ‘co-present group’ as central to an exploration of
how practice and learning might look from a complexity perspective. The human copresent
group is a group, such as a work group, where individuals are each known to the
others as specific individuals. It functions as a complex system (the group) of complex
systems (the participating individuals). I argue that the co-present group functions as the
site of both human learning and of the origin, development and modification of all
social and cultural phenomena, both of which depend on the group processing of human
affective states.
Because humans have the capacity to ‘share’ the processing of affective states with
other specific individuals, this processing function is not co-terminous with the
biological human individual but can be considered as an aspect of co-present group’s
functionality. Learning, for the individual, emerges from co-present group processes
through the bio-psychological individual. In contrast, and following the work of
sociologist Niklas Luhmann, ‘communications’ emerge from complexity-reducing
interactions between individuals, thus having a social origin, and are available for
elaboration into social and cultural phenomena through repeated use and re-use in
multiple contexts.
I draw conclusions to this thesis in two areas. The first is that if complexity is
understood broadly as being based on complex living relations as exemplified by John
Dewey’s trans-actions, it can function as an onto-epistemological framework for inquiry
into living human processes. The second area, which follows as a consequence of using
such a framework, is that human processes are re-conceptualised in functional terms and
can be seen as being based in, and emergent from, co-present group function. This, in
turn, has consequences for how we understand learning, its relation to practice and the
production and use of knowledge
Bridging Time Scales in Cellular Decision Making with a Stochastic Bistable Switch
Cellular transformations which involve a significant phenotypical change of
the cell's state use bistable biochemical switches as underlying decision
systems. In this work, we aim at linking cellular decisions taking place on a
time scale of years to decades with the biochemical dynamics in signal
transduction and gene regulation, occuring on a time scale of minutes to hours.
We show that a stochastic bistable switch forms a viable biochemical mechanism
to implement decision processes on long time scales. As a case study, the
mechanism is applied to model the initiation of follicle growth in mammalian
ovaries, where the physiological time scale of follicle pool depletion is on
the order of the organism's lifespan. We construct a simple mathematical model
for this process based on experimental evidence for the involved genetic
mechanisms. Despite the underlying stochasticity, the proposed mechanism turns
out to yield reliable behavior in large populations of cells subject to the
considered decision process. Our model explains how the physiological time
constant may emerge from the intrinsic stochasticity of the underlying gene
regulatory network. Apart from ovarian follicles, the proposed mechanism may
also be of relevance for other physiological systems where cells take binary
decisions over a long time scale.Comment: 14 pages, 4 figure
Design and feasibility testing of a novel group intervention for young women who binge drink in groups
BackgroundYoung women frequently drink alcohol in groups and binge drinking within these natural drinking groups is common. This study describes the design of a theoretically and empirically based group intervention to reduce binge drinking among young women. It also evaluates their engagement with the intervention and the acceptability of the study methods.MethodsFriendship groups of women aged 18–35 years, who had two or more episodes of binge drinking (>6 UK units on one occasion; 48g of alcohol) in the previous 30 days, were recruited from the community. A face-to-face group intervention, based on the Health Action Process Approach, was delivered over three sessions. Components of the intervention were woven around fun activities, such as making alcohol free cocktails. Women were followed up four months after the intervention was delivered. Results The target of 24 groups (comprising 97 women) was recruited. The common pattern of drinking was infrequent, heavy drinking (mean consumption on the heaviest drinking day was UK 18.1 units). Process evaluation revealed that the intervention was delivered with high fidelity and acceptability of the study methods was high. The women engaged positively with intervention components and made group decisions about cutting down. Twenty two groups set goals to reduce their drinking, and these were translated into action plans. Retention of individuals at follow up was 87%.ConclusionsThis study successfully recruited groups of young women whose patterns of drinking place them at high risk of acute harm. This novel approach to delivering an alcohol intervention has potential to reduce binge drinking among young women. The high levels of engagement with key steps in the behavior change process suggests that the group intervention should be tested in a full randomised controlled trial
Repetitive arm functional tasks after stroke (RAFTAS): a pilot randomised controlled trial
Background
Repetitive functional task practise (RFTP) is a promising treatment to improve upper limb recovery following stroke. We report the findings of a study to determine the feasibility of a multi-centre randomised controlled trial to evaluate this intervention.
Methods
A pilot randomised controlled trial was conducted. Patients with new reduced upper limb function were recruited within 14 days of acute stroke from three stroke units in North East England. Participants were randomised to receive a four week upper limb RFTP therapy programme consisting of goal setting, independent activity practise, and twice weekly therapy reviews in addition to usual post stroke rehabilitation, or usual post stroke rehabilitation. The recruitment rate; adherence to the RFTP therapy programme; usual post stroke rehabilitation received; attrition rate; data quality; success of outcome assessor blinding; adverse events; and the views of study participants and therapists about the intervention were recorded.
Results
Fifty five eligible patients were identified, 4-6% of patients screened at each site. Twenty four patients participated in the pilot study. Two of the three study sites met the recruitment target of 1-2 participants per month. The median number of face to face therapy sessions received was 6 [IQR 3-8]. The median number of daily repetitions of activities recorded was 80 [IQR 39-80]. Data about usual post stroke rehabilitation were available for 18/24 (75%). Outcome data were available for 22/24 (92%) at one month and 20/24 (83%) at three months. Outcome assessors were unblinded to participant group allocation for 11/22 (50%) at one month and 6/20 (30%) at three months. Four adverse events were considered serious as they resulted in hospitalisation. None were related to study treatment. Feedback from patients and local NHS therapists about the RFTP programme was mainly positive.
Conclusions
A multi-centre randomised controlled trial to evaluate an upper limb RFTP therapy programme provided early after stroke is feasible and acceptable to patients and therapists, but there are issues which needed to be addressed when designing a Phase III study. A Phase III study will need to monitor and report not only recruitment and attrition but also adherence to the intervention, usual post stroke rehabilitation received, and outcome assessor blinding
Interleukin-1β sequesters hypoxia inducible factor 2α to the primary cilium.
BACKGROUND: The primary cilium coordinates signalling in development, health and disease. Previously we have shown that the cilium is essential for the anabolic response to loading and the inflammatory response to interleukin-1β (IL-1β). We have also shown the primary cilium elongates in response to IL-1β exposure. Both anabolic phenotype and inflammatory pathology are proposed to be dependent on hypoxia-inducible factor 2 alpha (HIF-2α). The present study tests the hypothesis that an association exists between the primary cilium and HIFs in inflammatory signalling. RESULTS: Here we show, in articular chondrocytes, that IL-1β-induces primary cilia elongation with alterations to cilia trafficking of arl13b. This elongation is associated with a transient increase in HIF-2α expression and accumulation in the primary cilium. Prolyl hydroxylase inhibition results in primary cilia elongation also associated with accumulation of HIF-2α in the ciliary base and axoneme. This recruitment and the associated cilia elongation is not inhibited by blockade of HIFα transcription activity or rescue of basal HIF-2α expression. Hypomorphic mutation to intraflagellar transport protein IFT88 results in limited ciliogenesis. This is associated with increased HIF-2α expression and inhibited response to prolyl hydroxylase inhibition. CONCLUSIONS: These findings suggest that ciliary sequestration of HIF-2α provides negative regulation of HIF-2α expression and potentially activity. This study indicates, for the first time, that the primary cilium regulates HIF signalling during inflammation
Managing change in the nursing handover from traditional to bedside handover – a case study from Mauritius
BACKGROUND: The shift handover forms an important part of the communication process that takes place twice within the nurses' working day in the gynaecological ward. This paper addresses the topic of implementing a new system of bedside handover, which puts patients central to the whole process of managing care and also addresses some of the shortcomings of the traditional handover system. METHODS: A force field analysis in terms of the driving forces had shown that there was dissatisfaction with the traditional method of handover which had led to an increase in the number of critical incidents and complaints from patients, relatives and doctors. The restraining forces identified were a fear of accountability, lack of confidence and that this change would lead to more work. A 3 – step planned change model consisting of unfreezing, moving and refreezing was used to guide us through the change process. Resistance to change was managed by creating a climate of open communication where stakeholders were allowed to voice opinions, share concerns, insights, and ideas thereby actively participating in decision making. RESULTS: An evaluation had shown that this process was successfully implemented to the satisfaction of patients, and staff in general. CONCLUSION: This successful change should encourage other nurses to become more proactive in identifying areas for change management in order to improve our health care system
Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework
We describe a framework for defining pilot and feasibility studies focusing on studies conducted in preparation for a randomised controlled trial. To develop the framework, we undertook a Delphi survey; ran an open meeting at a trial methodology conference; conducted a review of definitions outside the health research context; consulted experts at an international consensus meeting; and reviewed 27 empirical pilot or feasibility studies. We initially adopted mutually exclusive definitions of pilot and feasibility studies. However, some Delphi survey respondents and the majority of open meeting attendees disagreed with the idea of mutually exclusive definitions. Their viewpoint was supported by definitions outside the health research context, the use of the terms ‘pilot’ and ‘feasibility’ in the literature, and participants at the international consensus meeting. In our framework, pilot studies are a subset of feasibility studies, rather than the two being mutually exclusive. A feasibility study asks whether something can be done, should we proceed with it, and if so, how. A pilot study asks the same questions but also has a specific design feature: in a pilot study a future study, or part of a future study, is conducted on a smaller scale. We suggest that to facilitate their identification, these studies should be clearly identified using the terms ‘feasibility’ or ‘pilot’ as appropriate. This should include feasibility studies that are largely qualitative; we found these difficult to identify in electronic searches because researchers rarely used the term ‘feasibility’ in the title or abstract of such studies. Investigators should also report appropriate objectives and methods related to feasibility; and give clear confirmation that their study is in preparation for a future randomised controlled trial designed to assess the effect of an intervention
Field evidence for the upwind velocity shift at the crest of low dunes
Wind topographically forced by hills and sand dunes accelerates on the upwind
(stoss) slopes and reduces on the downwind (lee) slopes. This secondary wind
regime, however, possesses a subtle effect, reported here for the first time
from field measurements of near-surface wind velocity over a low dune: the wind
velocity close to the surface reaches its maximum upwind of the crest. Our
field-measured data show that this upwind phase shift of velocity with respect
to topography is found to be in quantitative agreement with the prediction of
hydrodynamical linear analysis for turbulent flows with first order closures.
This effect, together with sand transport spatial relaxation, is at the origin
of the mechanisms of dune initiation, instability and growth.Comment: 13 pages, 6 figures. Version accepted for publication in
Boundary-Layer Meteorolog
FRA2A is a CGG repeat expansion associated with silencing of AFF3
Folate-sensitive fragile sites (FSFS) are a rare cytogenetically visible subset of dynamic mutations. Of the eight molecularly characterized FSFS, four are associated with intellectual disability (ID). Cytogenetic expression results from CGG tri-nucleotide-repeat expansion mutation associated with local CpG hypermethylation and transcriptional silencing. The best studied is the FRAXA site in the FMR1 gene, where large expansions cause fragile X syndrome, the most common inherited ID syndrome. Here we studied three families with FRA2A expression at 2q11 associated with a wide spectrum of neurodevelopmental phenotypes. We identified a polymorphic CGG repeat in a conserved, brain-active alternative promoter of the AFF3 gene, an autosomal homolog of the X-linked AFF2/FMR2 gene: Expansion of the AFF2 CGG repeat causes FRAXE ID. We found that FRA2A-expressing individuals have mosaic expansions of the AFF3 CGG repeat in the range of several hundred repeat units. Moreover, bisulfite sequencing and pyrosequencing both suggest AFF3 promoter hypermethylation. cSNP-analysis demonstrates monoallelic expression of the AFF3 gene in FRA2A carriers thus predicting that FRA2A expression results in functional haploinsufficiency for AFF3 at least in a subset of tissues. By whole-mount in situ hybridization the mouse AFF3 ortholog shows strong regional expression in the developing brain, somites and limb buds in 9.5-12.5dpc mouse embryos. Our data suggest that there may be an association between FRA2A and a delay in the acquisition of motor and language skills in the families studied here. However, additional cases are required to firmly establish a causal relationship
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