491 research outputs found
Musicians’ work : creativity, community and insecurity
This chapter examines the evolving nature of work patterns and income streams for contemporary Musicians in the UK. It explores the experiences of independent, portfolio career Musicians working in the Rock/Pop/Indie/Jazz Live Music scene. The Music industry is reported to contribute £5.2bn in GVA to the economy, of which according to UK Music (2019) £2.5bn is generated by ‘Creative Sector’ workers, which includes performing Musicians. Despite these high revenues, UK Music (2019) consistently reports that many Musicians earn below the average working wage of other professions. Challenges to Musicians’ work and income streams have been compounded by changes in consumption of Music due to digitisation, a lack of systematic support from Government for Grass Roots venues, and unequal revenue distribution. In this context, we reveal findings from research interviews with Musicians, which were conducted just before and during the peak of the Covid-19 pandemic (mainly in the North of England and Wales). Our research discovers how these Musicians utilise informal community mechanisms to navigate poor working conditions, value ‘dignity’ and ‘meaningfulness’ above remuneration, and often default to individualist assumptions regarding career success
Do Viruses Require the Cytoskeleton?
Background: It is generally thought that viruses require the cytoskeleton during their replication cycle. However, recent experiments in our laboratory with rubella virus, a member of the family Togaviridae (genus rubivirus), revealed that replication proceeded in the presence of drugs that inhibit microtubules. This study was done to expand on this observation. Findings: The replication of three diverse viruses, Sindbis virus (SINV; family Togaviridae family), vesicular stomatitis virus (VSV; family Rhabdoviridae), and Herpes simplex virus (family Herpesviridae), was quantified by the titer (plaque forming units/ml; pfu/ml) produced in cells treated with one of three anti-microtubule drugs (colchicine, noscapine, or paclitaxel) or the anti-actin filament drug, cytochalasin D. None of these drugs affected the replication these viruses. Specific steps in the SINV infection cycle were examined during drug treatment to determine if alterations in specific steps in the virus replication cycle in the absence of a functional cytoskeletal system could be detected, i.e. redistribution of viral proteins and replication complexes or increases/decreases in their abundance. These investigations revealed that the observable impacts were a colchicine-mediated fragmentation of the Golgi apparatus and concomitant intracellular redistribution of the virion structural proteins, along with a reduction in viral genome and sub-genome RNA levels, but not double-stranded RNA or protein levels. Conclusions: The failure of poisons affecting the cytoskeleton to inhibit the replication of a diverse set of viruses strongly suggests that viruses do not require a functional cytoskeletal system for replication, either because they do not utilize it or are able to utilize alternate pathways when it is not available
The outcome of extubation failure in a community hospital intensive care unit: a cohort study
INTRODUCTION: Extubation failure has been associated with poor intensive care unit (ICU) and hospital outcomes in tertiary care medical centers. Given the large proportion of critical care delivered in the community setting, our purpose was to determine the impact of extubation failure on patient outcomes in a community hospital ICU. METHODS: A retrospective cohort study was performed using data gathered in a 16-bed medical/surgical ICU in a community hospital. During 30 months, all patients with acute respiratory failure admitted to the ICU were included in the source population if they were mechanically ventilated by endotracheal tube for more than 12 hours. Extubation failure was defined as reinstitution of mechanical ventilation within 72 hours (n = 60), and the control cohort included patients who were successfully extubated at 72 hours (n = 93). RESULTS: The primary outcome was total ICU length of stay after the initial extubation. Secondary outcomes were total hospital length of stay after the initial extubation, ICU mortality, hospital mortality, and total hospital cost. Patient groups were similar in terms of age, sex, and severity of illness, as assessed using admission Acute Physiology and Chronic Health Evaluation II score (P > 0.05). Both ICU (1.0 versus 10 days; P < 0.01) and hospital length of stay (6.0 versus 17 days; P < 0.01) after initial extubation were significantly longer in reintubated patients. ICU mortality was significantly higher in patients who failed extubation (odds ratio = 12.2, 95% confidence interval [CI] = 1.5–101; P < 0.05), but there was no significant difference in hospital mortality (odds ratio = 2.1, 95% CI = 0.8–5.4; P < 0.15). Total hospital costs (estimated from direct and indirect charges) were significantly increased by a mean of US22,573–45,280; P < 0.01). CONCLUSION: Extubation failure in a community hospital is univariately associated with prolonged inpatient care and significantly increased cost. Corroborating data from tertiary care centers, these adverse outcomes highlight the importance of accurate predictors of extubation outcome
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Evaluation Of Sludge Heel Dissolution Efficiency With Oxalic Acid Cleaning At Savannah River Site
The chemical cleaning process baseline strategy at the Savannah River Site was revised to improve efficiency during future execution of the process based on lessons learned during previous bulk oxalic acid cleaning activities and to account for operational constraints imposed by safety basis requirements. These improvements were also intended to transcend the difficulties that arise from waste removal in higher rheological yield stress sludge tanks. Tank 12 implemented this improved strategy and the bulk oxalic acid cleaning efforts concluded in July 2013. The Tank 12 radiological removal results were similar to previous bulk oxalic acid cleaning campaigns despite the fact that Tank 12 contained higher rheological yield stress sludge that would make removal more difficult than the sludge treated in previous cleaning campaigns. No appreciable oxalate precipitation occurred during the cleaning process in Tank 12 compared to previous campaigns, which aided in the net volume reduction of 75-80%. Overall, the controls established for Tank 12 provide a template for an improved cleaning process
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Plasma sTNFR1 and IL8 for prognostic enrichment in sepsis trials: a prospective cohort study.
BackgroundEnrichment strategies improve therapeutic targeting and trial efficiency, but enrichment factors for sepsis trials are lacking. We determined whether concentrations of soluble tumor necrosis factor receptor-1 (sTNFR1), interleukin-8 (IL8), and angiopoietin-2 (Ang2) could identify sepsis patients at higher mortality risk and serve as prognostic enrichment factors.MethodsIn a multicenter prospective cohort study of 400 critically ill septic patients, we derived and validated thresholds for each marker and expressed prognostic enrichment using risk differences (RD) of 30-day mortality as predictive values. We then used decision curve analysis to simulate the prognostic enrichment of each marker and compare different prognostic enrichment strategies.Measurements and main resultsAn admission sTNFR1 concentration > 8861 pg/ml identified patients with increased mortality in both the derivation (RD 21.6%) and validation (RD 17.8%) populations. Among immunocompetent patients, an IL8 concentration > 94 pg/ml identified patients with increased mortality in both the derivation (RD 17.7%) and validation (RD 27.0%) populations. An Ang2 level > 9761 pg/ml identified patients at 21.3% and 12.3% increased risk of mortality in the derivation and validation populations, respectively. Using sTNFR1 or IL8 to select high-risk patients improved clinical trial power and efficiency compared to selecting patients with septic shock. Ang2 did not outperform septic shock as an enrichment factor.ConclusionsThresholds for sTNFR1 and IL8 consistently identified sepsis patients with higher mortality risk and may have utility for prognostic enrichment in sepsis trials
Personalized Depression Prevention: A Randomized Controlled Trial to Optimize Effects Through Risk-Informed Personalization
Objective: To evaluate whether evidence-based depression prevention programs can be optimized by matching youths to interventions that address their psychosocial vulnerabilities. Method: This randomized controlled trial included 204 adolescents (mean [SD] age ¼ 14.26 [1.65] years; 56.4% female). Youths were categorized as high or low on cognitive and interpersonal risks for depression and randomly assigned to Coping With Stress (CWS), a cognitive-behavioral program, or Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST), an interpersonal program. Some participants received a match between risk and prevention (eg, high cognitive–low interpersonal risk teen in CWS, low cognitive–high interpersonal risk teen in IPT-AST), others received a mismatch (eg, low cognitive-high interpersonal risk teen in CWS). Outcomes were depression diagnoses and symptoms through 18 months postintervention (21 months total). Results: Matched adolescents showed significantly greater decreases in depressive symptoms than mismatched adolescents from postintervention through 18-month follow-up and across the entire 21-month study period (effect size [d] ¼ 0.44, 95% CI ¼ 0.02, 0.86). There was no significant difference in rates of depressive disorders among matched adolescents compared with mismatched adolescents (12.0% versus 18.3%, t193 ¼ .78, p ¼ .44). Conclusion: This study illustrates one approach to personalizing depression prevention as a form of precision mental health. Findings suggest that risk-informed personalization may enhance effects beyond a one-size-fits-all approach. Clinical trial registration information: Bending Adolescent Depression Trajectories Through Personalized Prevention; https://www.clinicaltrials. gov/; NCT01948167
What do we know about the nexus between culture, age, gender and health literacy? Implications for improving the health and well-being of young Indigenous males
Health literacy, although diversely defined, refers to the abilities, relationships and external environments required for people to successfully promote health. Existing research suggests that health literacy is related to health inequities, including individual and community capacity to navigate health. A diverse range of factors shape health literacy abilities and environments, especially culture, gender and age. However, the nexus between these variables and their cumulative impact on health literacy development remains largely unexplored. Commentary that explores these dynamics among young Indigenous males is particularly scant. In turn, strategies to bridge health equity gaps have been obscured. This article brings together disparate research on health literacy, masculinities, youth studies and men’s health in order to address this oversight. By outlining the collective conceptual contribution of these strands of scholarship, we show that young Indigenous males navigate health literacy through a complex cultural interface that balances both Western and Indigenous understandings of health. Alternative masculine identities, which simultaneously embrace and resist components of hegemonic masculinity, also shape this health literacy lens. We explain that the development of health literacy is important for young people, particularly young Indigenous males, and that this is negotiated in tandem with external support structures, including family and friends. By describing these intersections, we explore the implications for researchers, policymakers and practitioners seeking to achieve the dual goal of improving health literacy and reducing health inequi-ties among this highly marginalised population
Facilitating Pedagogies of Possibility in Teacher Education: Experiences of Faculty Members in a Self-Study Learning Group
This collaborative self-study explores how seven members of a Faculty Self-Study Learning Group (FS-SLG) attempt to foster cultures of inquiry with teacher candidates. In so doing, we simultaneously describe a professional learning community of teacher educators engaging in reflective practice via the teaching, learning, and enacting of self-study methodology. Findings from this collaborative self-study highlight how we attempt to translate our own efforts to be more purposeful and reflective into our teacher education practice through modeling, as well as the tensions we felt in promoting a view of teaching as a process of critical inquiry. The discussion focuses on lessons learned and potential ways forward for educators who similarly desire to embrace inquiry-based pedagogies of possibility within the existing landscape of teaching and teacher preparation
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