Beyond the Death of Linear Response: 1/f optimal information transport

Non-ergodic renewal processes have recently been shown by several authors to be insensitive to periodic perturbations, thereby apparently sanctioning the death of linear response, a building block of nonequilibrium statistical physics. We show that it is possible to go beyond the ``death of linear response" and establish a permanent correlation between an external stimulus and the response of a complex network generating non-ergodic renewal processes, by taking as stimulus a similar non-ergodic process. The ideal condition of 1/f-noise corresponds to a singularity that is expected to be relevant in several experimental conditions.Comment: 4 pages, 2 figures, 1 table, in press on Phys. Rev. Let

Psychological distress among primary school teachers: a comparison with clinical and population samples

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.Objectives: This analysis explored the level of psychological distress among primary school teachers in the South West of England as compared to clinical and general population samples. Study design: Secondary analysis of data from the Supporting Teachers And childRen in Schools (STARS) trial completed by up to 90 teachers at baseline, 9, 18 and 30 months of follow up. Methods: We used the Everyday Feelings Questionnaire (EFQ) as a measure of psychological distress. Baseline data on teachers were compared with a population sample of professionals and a clinical sample of patients attending a depression clinic. Results: Our teacher cohort experienced higher levels of psychological distress than comparable professionals from the general population, which were sustained over 30 months follow-up. Levels of psychological distress were lower than those found in the clinical sample. Using a cut-point indicative of moderate depression, our data suggest between 19% and 29% of teachers experienced clinically significant distress at each time-point. Conclusions: We detected high and sustained levels of psychological distress among primary school teachers, which suggests an urgent need for intervention. Effective support for teachers’ mental health is particularly important given the potential impact of poor teacher mental health on pupil wellbeing, pupil attainment and teacher-pupil relationships.The STARS trial was funded by the National Institute for Health Research Public Health Research Programme (project number 10/3006/07) and the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula

The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial

This is the final version of the article. Available from Cambridge University Press via the DOI in this record.Background. We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools’ important influence on child mental health. Methods. A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the outcomes. Trial registration: ISRCTN84130388. Results. Eighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (S.D.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference = −1.0; 95% CI−1.9 to −0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori subgroup analyses suggested TCM is more effective for children with poor mental health. Conclusions. TCM provided a small, short-term improvement to children’s mental health particularly for children who are already struggling.This project was funded by the National Institute for Health Research Public Health Research Programme (project number 10/ 3006/07) and the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula

Myocardial infarction after acute ischaemic stroke: incidence, mortality, and risk factors

Objectives: To determine the risk factor profiles associated with post-acute ischaemic stroke (AIS) myocardial infarction (MI) over long-term follow-up. Methods: This observational study includes prospectively identified AIS patients (n=9840) admitted to a UK regional centre between January 2003-December 2016 (median follow-up: 4.72 years). Predictors of post-stroke MI during follow up were examined using logistic and Cox regression models for in-hospital and post-discharge events, respectively. MI incidence was determined using a competing risk non-parametric estimator. The influence of post-stroke MI on mortality was examined using Cox regressions. Results: Mean age (SD) of study participants was 77.3(12.2) years (48% males). Factors associated with in-hospital MI (OR(95%CI)) were increasing blood glucose (1.80(1.17-2.77) per 10mmol/L), total leukocyte count (1.25(1.01-1.54) per 10x109/L), and CRP (1.05(1.02-1.08) per 10mg/L increase). Age (HR(95%CI) =1.03(1.01-1.06)), coronary heart disease (1.59(1.01-2.50)), chronic kidney disease (2.58(1.44-4.63)), and cancers (1.76(1.08-2.89)) were associated with incident MI between discharge and one year follow-up. Age ((1.02(1.00-1.03)), diabetes (1.96(1.38-2.65)), congestive heart failure (2.07(1.44-2.99), coronary heart disease (1.81(1.31-2.50)), hypertension (1.86(1.24-2.79)), and peripheral vascular disease (2.25(1.40-3.63)) were associated with incident MI between 1-5 years after discharge. Diabetes (2.01(1.09-3.72)), hypertension (3.69(1.44-9.45)), and peripheral vascular disease (2.46(1.02-5.98)) were associated with incident MI between 5-10 years after discharge. Cumulative MI incidence over 10 years was 5.4%. MI during all follow-up periods (discharge-1 year, 1-5 years, 5-10 years) was associated with increased risk of death (respective HR(95%CI)=3.26(2.51-4.15), 1.96(1.58-2.42) and 1.92(1.26-2.93)). Conclusions: In conclusion, prognosis is poor in post-stroke MI. We highlight a range of potential areas to focus preventative efforts

Training teachers in classroom management to improve mental health in primary school children: the STARS cluster RCT

This is the final version. Available from NIHR Journals Library via the DOI in this record.Background Poor mental health in childhood is common, persistent and associated with a range of adverse outcomes that include persistent psychopathology, as well as risk-taking behaviour, criminality and educational failure, all of which may also compromise health. There is a growing policy focus on children’s mental health and the role of schools in particular in addressing this. Objectives To evaluate whether or not the Incredible Years® (IY) Teacher Classroom Management (TCM) training improved children’s mental health, behaviour, educational attainment and enjoyment of school, improved teachers’ mental health and relationship with work, and was cost-effective in relation to potential improvements. Design A two-arm, pragmatic, parallel-group, superiority, cluster randomised controlled trial. Setting A total of 80 UK schools (clusters) were recruited in three distinct cohorts between 2012 and 2014 and randomised to TCM (intervention) or teaching as usual [(TAU) control] with follow-ups at 9, 18 and 30 months. Schools and teachers were not masked to allocation. Participants Eighty schools (n = 2075 children) were randomised: 40 (n = 1037 children) to TCM and 40 (n = 1038 children) to TAU. Interventions TCM was delivered to teachers in six whole-day sessions, spread over 6 months. The explicit goals of TCM are to enhance classroom management skills and improve teacher–student relationships. Main outcome measures The primary planned outcome was the teacher-reported Strengths and Difficulties Questionnaire Total Difficulties (SDQ-TD) score. Random-effects linear regression and marginal logistic regression models using generalized estimating equations were used to analyse outcomes. Results The intervention reduced the SDQ-TD score at 9 months [adjusted mean difference (AMD) –1.0, 95% confidence interval (CI) –1.9 to –0.1; p = 0.03] but there was little evidence of effects at 18 months (AMD –0.1, 95% CI –1.5 to 1.2; p = 0.85) and 30 months (AMD –0.7, 95% CI –1.9 to 0.4; p = 0.23). Planned subgroup analyses suggested that TCM is more effective than TAU for children with poor mental health. Cost-effectiveness analysis using the SDQ-TD suggested that the probability of TCM being cost-effective compared with TAU was associated with some uncertainty (range of 40% to 80% depending on the willingness to pay for a unit improvement in SDQ-TD score). In terms of quality-adjusted life-years (QALYs), there was evidence to suggest that TCM was cost-effective compared with TAU at the National Institute for Health and Care Excellence thresholds of £20,000–30,000 per QALY at 9- and 18-month follow-up, but not at 30-month follow-up. There was evidence of reduced disruptive behaviour (p = 0.04) and reductions in inattention and overactivity (p = 0.02) at the 30-month follow-up. Despite no main effect on educational attainment, subgroup analysis indicated that the intervention’s effect differed between those who did and those who did not have poor mental health for both literacy (interaction p = 0.04) and numeracy (interaction p = 0.03). Independent blind observations and qualitative feedback from teachers suggested that teachers’ behaviour in the classroom changed as a result of attending TCM training. Limitations Teachers were not masked to allocation and attrition was marked for parent-reported data. Conclusions Our findings provide tentative evidence that TCM may be an effective universal child mental health intervention in the short term, particularly for primary school children who are identified as struggling, and it may be a cost-effective intervention in the short term. Future work Further research should explore TCM as a whole-school approach by training all school staff and should evaluate the impact of TCM on academic progress in a more thorough and systematic manner.National Institute for Health Research (NIHR

Queer Touch Between Holy Women: Julian of Norwich, Margery Kempe, Birgitta of Sweden, and the Visitation

Under embargo until: 2021-12-17This essay takes a new approach to the well-known meeting between two late-medieval English visionary women, Margery Kempe and the anchoress Julian of Norwich, as described in The Book of Margery Kempe. In this analysis their conversation subtly evokes a long history of women concentrating their subversive power through intimate, spiritual exchange, a history reaching back to the Biblical Visitation scene and expressed in its medieval artistic and literary instantiations. A queer reading illuminates the way that such female same-sex relationships challenge patriarchal systems by offering a privileged access to God outside clerical supervision. By examining Margery and Julian’s encounter, Luke’s Visitation passage, its depiction in a late-medieval Book of Hours, and comparing two different Middle English translations of a Visitation vision in Birgitta of Sweden’s Revelations, the full transgressive effect of queer touch between women—or even its unspoken possibility—emerges.acceptedVersio

The impact of a special school placement on self-perceptions of confidence and competence among prospective PE teachers

School-based placements are often used as a way of preparing prospective teachers for the demands of their future role. However, little is known about the impact of such situated learning experiences on prospective PE teachers’ confidence and competence. To the best of our knowledge, this article is the first of its kind to explore prospective teachers’ views of, and experiences within, special schools in order to identify the experiential mechanisms that shape self-perceptions of competence and confidence when teaching pupils with special educational needs and disabilities in PE. Thirty-two final year undergraduate students participated in focus group interviews and were selected on the basis that they: (1) were studying a Special Educational Needs and Disability in PE undergraduate module; (2) aspired to be a PE teacher; and (3) had attended six half-days of placement in a special school. All focus group transcripts were subjected to open, axial and selective coding in order to identify themes and sub-themes. The themes that were constructed from the analysis were: impact of placement role on confidence and competence; impact of knowing pupils’ needs and capabilities; conceptualising confidence and perceptions of its development; and conceptualising competence and perceptions of its development. We use these themes to discuss the usefulness of special school-based placements for preparing aspiring teachers for their role as inclusive educators

The sociology of disability and the struggle for inclusive education

This article charts the emergence of the sociology of disability and examines the areas of contestation. These have involved a series of erasures – of the body from debates on the social model of disability, of the Other from educational policies and practices, and of academics from political discourses and action. The paper considers the contribution of the sociology of disability to inclusive education and examines some of the objections currently being voiced. It ends with some reflections on the possibilities for academics within the sociology of disability to pursue alternative forms of engagement and outlines a series of duties that they might undertake

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic