The impact of study support : a report of a longitudinal study into the impact of participation in out-of-school-hours learning on the academic attainment, attitudes and school attendance of secondary school students

Study support makes a difference. It has an impact on three key aspects of students’ school careers: • attainment at GCSE and KS3 SATs; • attitudes to school; • attendance at school. These findings were consistent for all groups of students in all schools in the study. - Study support can help to improve schools and can influence the attitudes to learning of teachers and parents as well as students

Clinical Judgment Analysis

SUMMARY Judgment is central to the practice of medicine and occurs between making clinical observations and taking clinical decisions. Clinical judgment analysis has developed as a method of making statistically firm models of doctors' judgments. Computed models reveal the differential importance attached to items of clinical, social, or other data which are determinants of clinical decisions. These models can both reveal the causes of conflicts of judgment and may help resolve them in a way that unaided discussion cannot. Revealing experts' models to students speeds learning of diagnostic skills. Clinical judgment analysis offers a method of probing the judgments not just of students and doctors but also of patients who have shown systematic differences in their perceptions of risk and benefit. The power and relevance of clinical trials can be improved by the consistent application of judgment policies generated from both the trialists and those who will use their result

The agrodiversity experiment

Intensively managed grasslands are globally prominent ecosystems. We investigated whether experimental increases in plant diversity in intensively managed grassland communities can increase their resource use efficiency. This work consisted of a coordinated, continental-scale 33-site experiment. The core design was 30 plots, representing 15 grassland communities at two seeding densities. The 15 communities comprised four monocultures (two grasses and two legumes) and 11 four-species mixtures that varied in the relative abundance of the four species at sowing. There were 1028 plots in the core experiment, with another 572 plots sown for additional treatments. Sites followed a protocol and employed the same experimental methods with certain plot management factors, such as seeding rates and number of cuts, determined by local practice. The four species used at a site depended on geographical location, but the species were chosen according to four functional traits: a fast-establishing grass, a slow-establishing persistent grass, a fast-establishing legume, and a slow-establishing persistent legume. As the objective was to maximize yield for intensive grassland production, the species chosen were all highyielding agronomic species. The data set contains species-specific biomass measurements (yield per species and of weeds) for all harvests for up to four years at 33 sites. Samples of harvested vegetation were also analyzed for forage quality at 26 sites. These data should be of interest to ecologists studying relationships between diversity and ecosystem function and to agronomists interested in sustainable intensification. The large spatial scale of the sites provides opportunity for analyses across spatial (and temporal) scales. The database can also complement existing databases and meta-analyses on biodiversity– ecosystem function relationships in natural communities by focusing on those same relationships within intensively managed agricultural grasslands

Evidence of mononuclear cell preactivation in the fasting state in polycystic ovary syndrome

OBJECTIVE: We evaluated mononuclear cell (MNC) preactivation in women with polycystic ovary syndrome (PCOS) by examining the effect of in vitro lipopolysaccharide (LPS) exposure on cytokine release in the fasting state. STUDY DESIGN: Twenty women with PCOS (10 lean, 10 obese) and 20 weight-matched controls (10 lean, 10 obese) volunteered for study participation. Tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) release was measured from mononuclear cells isolated from fasting blood samples and cultured in the presence and absence of LPS. Plasma IL-6 was measured from the same fasting blood samples. Insulin sensitivity was derived from an oral glucose tolerance test using the Matsuda index, and truncal fat was measured by dual-energy x-ray absorptiometry. RESULTS: The percent change from baseline in TNF-α and IL-6 release from MNC following LPS exposure was increased (P < .04) in lean and obese women with PCOS and obese controls compared with lean controls. Plasma IL-6 was increased (P < .02) in obese women with PCOS compared with lean women with PCOS, which in turn was increased (P < .02) compared with lean controls. The MNC-derived TNF-α and IL-6 responses from MNCs were negatively correlated with insulin sensitivity (P < .03) and positively correlated with testosterone (P < .03) and androstenedione (P < .006) for the combined groups. Plasma IL-6 was positively correlated with percentage truncal fat (P < .008). CONCLUSION: In PCOS, increased cytokine release from MNCs following LPS exposure in the fasting state reveals the presence of MNC preactivation. Importantly, this phenomenon is independent of obesity and may contribute to the development of insulin resistance and hyperandrogenism in PCOS. In contrast, the source of plasma IL-6 elevations in PCOS may be excess adiposity

Adiposity measures, lean body mass, physical activity and mortality: NHANES 1999–2004

BACKGROUND: Obesity and physical inactivity are major public health problems. We studied the associations between measures of adiposity, lean body mass, leisure time physical activity (LTPA), and death in those with and without chronic kidney disease (CKD). METHODS: Associations between body mass index (BMI), waist circumference (WC), percent body fat, lean body mass (assessed with Dual-Energy X-ray Absorptiometry[DEXA]), leisure time physical activity (LTPA) and death were examined using the National Health and Nutrition Examination Surveys (NHANES 1999–2004). All-cause mortality was ascertained by linkage of NHANES files with the National Death Index. RESULTS: 9,433 non-CKD participants and 2,153 CKD participants who had fat mass measured using DEXA, BMI, WC, LTPA and mortality data were included. After adjusting for demographics, comorbid conditions, kidney function measures, C-Reactive Protein (CRP), and sodium intake there was no significant risk for death noted with higher WC, fat mass and BMI in those with and without CKD. When examining normal, overweight, and obese groups based on BMI criteria, being overweight (BMI 25–29.9 kg/m(2)) was associated with lower risk of death in those without CKD (Hazard ratio 0.62, 95% CI 0.40, 0.95). Higher lean body mass was associated with lower risk for death in those without kidney disease but not in the CKD population. There was a significantly higher risk for death among those who did not meet the minimum LTPA goals compared to those who met or exceeded the recommended activity levels (>450 MET/min/week) in those with and without CKD (CKD Hazard ratio: 1.36, 95% CI 1.003, 1.85; non-CKD HR 1.65, 95% CI 1.21, 2.26). CONCLUSIONS: In a representative sample of the US population, higher LTPA levels and lean body mass were associated with lower mortality in those without kidney disease. In CKD, higher LTPA was associated with lower risk of death. There was no association between adiposity measures and death in those with and without CKD except for lower mortality associated with overweight among those without CKD. The data suggests the need to develop programs to facilitate an increase in physical activity in people with and without kidney disease

Glucose and lipopolysaccharide regulate proatherogenic cytokine release from mononuclear cells in polycystic ovary syndrome

Women with polycystic ovary syndrome (PCOS) have chronic low-grade inflammation, which can increase the risk of atherogenesis. We examined the effect of glucose ingestion and lipopolysaccharide (LPS) on markers of proatherogenic inflammation in the mononuclear cells (MNC) and plasma of women with PCOS. Sixteen women with PCOS (8 lean, 8 obese) and 15 weight-matched controls (8 lean, 7 obese) underwent a 3-h oral glucose tolerance test (OGTT). Interleukin-6 (IL-6) and interleukin-1β (IL-1β) release from MNC cultured in the presence of LPS and plasma IL-6, C-reactive protein (CRP), and soluble vascular adhesion molecule-1 (sVCAM-1) were measured from blood samples drawn while fasting and 2 h after glucose ingestion. Truncal fat was measured by dual-energy absorptiometry (DEXA). Lean women with PCOS and obese controls failed to suppress LPS-stimulated IL-6 and IL-1β release from MNC after glucose ingestion. In contrast, obese women with PCOS suppressed these MNC-derived cytokines under the same conditions. In response to glucose ingestion, plasma IL-6 and sVCAM-1 increased and CRP suppression was attenuated in both PCOS groups and obese controls compared with lean controls. Fasting plasma IL-6 and CRP correlated positively with percentage of truncal fat. The absolute change in plasma IL-6 correlated positively with testosterone. We conclude that glucose ingestion promotes proatherogenic inflammation in PCOS with a systemic response that is independent of obesity. Based on the suppressed MNC-derived cytokine responses suggestive of LPS tolerance, chronic low-grade inflammation may be more profound in obese women with PCOS. Excess abdominal adiposity and hyperandrogenism may contribute to atherogenesis in PCOS

Actions Above Words: A Biography of Vice Admiral Clifton “Ziggy” Sprague

Among the many larger than life and fascinating figures of the Second World War, one who is seldom spoken of is the late Vice Admiral Clifton A.F. Ziggy Sprague. A quiet man from New England, Admiral Sprague was an accomplished pilot, administrator, and commander. From service during the First World War to assisting in the testing of nuclear devices following the end of the Second World War, Sprague was a force behind the scenes. He was devoted to his profession and refused to play the political game those above him did, preferring that his actions speak greater volumes than any impassioned speech could. From his time as a student before he entered the United States Naval Academy through the famous Battle Off Samar in which he won a strategic victory against overwhelming odds and to his retirement, this thesis explores not only the heroics of quiet man that was Admiral Sprague, but also the kind of man he was

Xenobiotic metabolism: the effect of acute kidney injury on non-renal drug clearance and hepatic drug metabolism.

Acute kidney injury (AKI) is a common complication of critical illness, and evidence is emerging that suggests AKI disrupts the function of other organs. It is a recognized phenomenon that patients with chronic kidney disease (CKD) have reduced hepatic metabolism of drugs, via the cytochrome P450 (CYP) enzyme group, and drug dosing guidelines in AKI are often extrapolated from data obtained from patients with CKD. This approach, however, is flawed because several confounding factors exist in AKI. The data from animal studies investigating the effects of AKI on CYP activity are conflicting, although the results of the majority do suggest that AKI impairs hepatic CYP activity. More recently, human study data have also demonstrated decreased CYP activity associated with AKI, in particular the CYP3A subtypes. Furthermore, preliminary data suggest that patients expressing the functional allele variant CYP3A5*1 may be protected from the deleterious effects of AKI when compared with patients homozygous for the variant CYP3A5*3, which codes for a non-functional protein. In conclusion, there is a need to individualize drug prescribing, particularly for the more sick and vulnerable patients, but this needs to be explored in greater depth

Electron spin resonance studies of radicals derived from primary amine-boranes in solution

The reactions of photochemically generated t-butoxyl radicals with primary amine-boranes (RNH2→BH3) were studied by electron spin resonance (e.s.r.) spectroscopy. Primary amine-boranes are isoelectronic analogues of the alkanes (RCH2CH3). Much research has been carried out with carbon-centred radicals, the present work set out to investigate the similarities and differences in structures and chemical reactions between these species and the radicals derived from primary amine-boranes. t-Butoxyl radicals abstract hydrogen atoms from RNH2?BH2 to form, initially, the nucleophilic amine-boryl radical which subsequently abstracts hydrogen from the parent to give the more stable isomeric aminyl-borane radical RNH?BH3. The amine-boryl radicals can be intercepted by alkyl bromides or chlorides or by nitriles, with which they react by halogen atom abstraction or by addition to the CN group to give iminyl radicals, respectively. The e.s.r. spectra of RNH→BH3 show the presence of extensive hyperconjugative delocalization of the unpaired electron onto the BH3 group [α(3BH) 64-66 G]. Monoalkylaminyl-borane radicals react rapidly with alkenes with arenes and with conjugated or cumulated dienes to transfer a β-hydrogen atom from boron to give alkyl, cyclohexadienyl, or allyl radicals, respectively. Hydrogen-atom transfer to alkenes from the electrophilic MeNH→BH3 takes place with high regioselectivity to give the more stable alkyl radical when two adducts are possible; the rate of transfer increases as the ionization potential of the alkene decreases along the series CH2=CH2 < MeCH=CH2 < Me2C=CH2 ≈ Me2=CHMe < Me2C=CMe2. The absolute rate for reduction of propene by MeNH→BH3 was determined to be ca. 2.0 x 103 1 mol-1 s-1 at 282 K. Competition experiments have been carried out to determine the relative rates of various reactions undergone by RNH2→BH2 and RNH→BH3. The results are interpreted with the aid of ah initio molecular orbital calculations at the 6-31** level for RNH2→BH2, RNH→BH3, RNH2→BH3, and RNH=BH2 (R = H or Me), together with similar calculations for the isoelectronic counterparts. It was found that the Si-Si bond was cleaved by the same type of reagents that cleave the C—C π-bond and that aminyl-borane radicals transfered a hydrogen atom to hexamethyldisilane (HMDS) by displacement of Me3Si