Examining the Overlooked Complexities of School Lunch: An Investigation into the Juncture of Food, Schooling, and the Developing Adolescent

School lunch is a universal experience for students everywhere and yet remains largely understudied by educational researchers. This dissertation explores school lunch through the lens of adolescent identity theory, with the purpose of investigating the unarticulated and overlooked complexities inherent in the lunch block, from issues of the developing sense of self, to social and cultural meanings surrounding food, and consequences for social reproduction. I used a combination of ethnographic observations and narrative interviews at a rural New England high school, focusing on participants’ daily habits, food practices, and choices during the lunch block. Through this, I established the normative routines of the cafeteria and examined the ways in which participants deviated from these norms. I also investigated the complex intersection of adolescent development with matters of food, social class, peer relations, and individuals’ increasing maturation and autonomy. Through this study and review of the current literature, I argue that school lunch plays a multifaced role in students’ lives. Not only does school lunch provide daily nutrition and a break from the classroom, but moreover serves as a site where adolescents navigate their social world in ways that inform and prepare them for their adult lives. For the field of educational research, understanding the role the lunchroom plays in this forming social and self-awareness is consequential to grasping the complexity of the period of adolescence

Students\u27 perspectives on required English courses taught via a communicative approach and a CLIL approach

This paper looks at two required English courses at the University of Shimane: Freshman English Communication and Sophomore English Communication. It compares students\u27 perceptions of two courses, the first taught in 2015 and designed according to a Communicative Approach, and the second, taught in 2016, designed according to a Content and Language Integrated Learning (CLIL) approach. The paper begins by comparing the two approaches, then describes the differences between the two courses, and analyzes students\u27 responses to the courses. It was found that students on the CLIL course learned content in addition to English communication skills; emphasized more higher order thinking skills(HOTS): used various methods of communication to connect with classmates; and many students gained confidence in speaking English. Finally, implications for language courses at the tertiary level are discussed, with the recommendation that more content be included in required courses for higher proficiency students. In conclusion, this study shows that a CLIL approach at the University of Shimane can combine skill-getting with knowledge-getting, allowing students to enjoy learning appropriate new content while still developing their language skills

Palliative care among heart failure patients in primary care: A comparison to cancer patients using english family practice data

© 2014 Gadoud et al. Introduction: Patients with heart failure have a significant symptom burden and other palliative care needs often over a longer period than patients with cancer. It is acknowledged that this need may be unmet but by how much has not been quantified in primary care data at the population level. Methods: This was the first use of Clinical Practice Research Datalink, the world's largest primary care database to explore recognition of the need for palliative care. Heart failure and cancer patients who had died in 2009 aged 18 or over and had at least one year of primary care records were identified. A palliative approach to care among patients with heart failure was compared to that among patients with cancer using entry onto a palliative care register as a marker for a palliative approach to care. Results: Among patients with heart failure, 7% (234/3 122) were entered on the palliative care register compared to 48% (3 669/7 608) of cancer patients. Of heart failure patients on the palliative care register, 29% (69/234) were entered onto the register within a week of their death. Conclusions: This confirms that the stark inequity in recognition of palliative care needs for people with heart failure in a large primary care dataset. We recommend a move away from prognosis based criteria for palliative care towards a patient centred approach, with assessment of and attention to palliative needs including advance care planning throughout the disease trajectory

Risk of mature B-cell neoplasms and precursor conditions after joint replacement : a report from the Haematological Malignancy Research Network

Associations between previous joint replacement and B-cell lymphoid malignancies have been reported, but despite numerous reports, associations with the disease subtypes have received little attention. Using a UK-based register of haematological malignancies and a matched general population-based cohort, joint replacements from linked hospital inpatient records were examined. Cases diagnosed 2009-2015 who were aged 50 years or more were included; 8,013 mature B-cell neoplasms comprising myeloma (n=1,763), diffuse large B-cell lymphoma (DLBCL, n=1,676), chronic lymphocytic leukaemia (CLL, n=1,594), marginal zone lymphoma (MZL, n=957), follicular lymphoma (FL, n=725), and classical Hodgkin lymphoma (CHL, n=255), together with monoclonal gammopathy of uncertain significance (MGUS, n=2,138) and monoclonal B-cell lymphocytosis (MBL, n=632). Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated relative to 10 age- and sex-matched controls using conditional logistic regression. Having had a joint replacement before diagnosis was associated with myeloma (OR=1.3, 95%CI 1.1-1.5, p=0.008) and MGUS (OR=1.3, 95%CI 1.1-1.5, p<0.001). Excluding replacements in the year before diagnosis, the MGUS risk remained, elevated where two or more joints were replaced (OR=1.5, 95%CI 1.2-2.0, p=0.001), with hip (OR=1.2, 95%CI 1.0-1.5, p=0.06) or knee replacements (OR=1.5, 95%CI 1.2-1.8, p<0.001). Associations with CHL and two or more replacements (OR=2.7, 95%CI 1.3-5.6, p=0.005) or hip replacements (OR=1.9, 95%CI 1.0-3.4, p=0.04); and between DLBCL and knee replacements (OR=1.3, 95%CI 1.0-1.6, p=0.04) were also observed. This study reports for the first time a relationship between joint replacements and MGUS; while absolute risks of disease are low and not of major public health concern, these findings warrant further investigation. This article is protected by copyright. All rights reserved

Illness patterns prior to diagnosis of lymphoma : Analysis of UK medical records

Background: Increased understanding of the relationship between lymphomas and co-morbidities is likely to provide valuable insights into the natural history of these disorders. Methods: 761 cases with lymphoma (310 diffuse large B-cell [DLBCL]; 226 follicular [FL]; and 225 Hodgkin [HL]) and 761 unaffected age and sex matched controls were recruited and their histories of infection and non-infection diagnoses in primary care records were compared using negative binomial regression. Results: No differences were observed between the infectious illness patterns of DLBCL and FL cases and their matched controls over the 15 years preceding lymphoma diagnosis. A marked excess of infectious illness episodes was recorded for HL cases compared to their controls; evident at least a decade prior to HL diagnosis. For non-infectious consultations an excess of case over control visits emerged 4-6 years before DLBCL and FL diagnosis; no specific co-morbidity associations were found. No case-control differences for non-infectious conditions were apparent for HL. Conclusion: There are substantial variations in patterns of illness prior to diagnosis of the three lymphoma subtypes examined. The excess of infectious diagnoses prior to HL may point to underlying immune abnormality, but there was no suggestion of this for DLBCL and FL where a generalized excess of non-infectious conditions was evident. (C) 2010 Elsevier Ltd. All rights reserved

Hodgkin lymphoma detection and survival : findings from the Haematological Malignancy Research Network

Background Hodgkin lymphoma is usually detected in primary care with early signs and symptoms, and is highly treatable with standardised chemotherapy. However, late presentation is associated with poorer outcomes.Aim To investigate the relationship between markers of advanced disease, emergency admission, and survival following a diagnosis of classical Hodgkin lymphoma (CHL).Design &amp; setting The study was set within a sociodemographically representative UK population-based patient cohort of ~4 million, within which all patients were tracked through their care pathways, and linked to national data obtained from Hospital Episode Statistics (HES) and deaths.Method All 971 patients with CHL newly diagnosed between 1 September 2004–31 August 2015 were followed until 18th December 2018.Results The median diagnostic age was 41.5 years (range 0–96 years), 55.2% of the patients were male, 31.2% had stage IV disease, 43.0% had a moderate–high or high risk prognostic score, and 18.7% were admitted via the emergency route prior to diagnosis. The relationship between age and emergency admission was U-shaped: more likely in patients aged &lt;25 years and ≥70 years. Compared to patients admitted via other routes, those presenting as an emergency had more advanced disease and poorer 3-year survival (relative survival 68.4% [95% confidence interval {CI} = 60.3 to 75.2] versus 89.8% [95% CI = 87.0 to 92.0], respectively [P&lt;0.01]). However, after adjusting for clinically important prognostic factors, no difference in survival remained.Conclusion These findings suggest that CHL survival as a whole could be increased by around 4% if the cancer in patients who presented as an emergency had been detected at the same point as in other patients