A corpus-based approach to mind style

Fowler's (Linguistics and the novel, Methuen, 1977) original definition of mind style emphasised consistency as a defining feature of the phenomenon, something that is (i) difficult to measure, and (ii) often missed in qualitative analyses. In this paper we investigate how a computational semantic analysis might be used to address this difficulty, with particular reference to McIntyre's (Journal of Literary Semantics 34: 21–40, 2005) analysis of the deviant mind style of the character of Miss Shepherd in Alan Bennett's play The Lady in the Van. To do this we analyse the speech of all the characters in The Lady in the Van using Wmatrix (Rayson, Matrix: A statistical method and software tool for linguistic analysis through corpus comparison, Lancaster University PhD thesis, 2003, Wmatrix: A web-based corpus processing environment, Lancaster University, 2008), to see whether it provides quantitative support for the interpretative conclusions reached by McIntyre. Wmatrix utilises the UCREL Semantic Annotation System (USAS) which has been designed to undertake the automatic semantic analysis of English. The initial tag-set of the USAS system was loosely based on McArthur's Longman Lexicon of Contemporary English (McArthur, Longman, 1981), but has since been considerably revised in the light of practical tagging problems met in the course of previous research, and now contains 232 category labels (such as medicine and medical treatment, movement, obligation and necessity, etc.). We use Wmatrix's facility for identifying key semantic domains in pursuit of our two main aims: (i) to determine whether Miss Shepherd's odd mind style is consistent, as Fowler's definition suggests it should be; and (ii) to determine the usefulness of computational semantic analysis for investigating mind style

Practicing what we preach: Assessing communication center client and staff perspectives of positive communication conferencing practices

Using Mirivel's (2014) Positive Communication Model as a communication center conferencing training framework, both clients and staff were surveyed to determine  to what extent positive communication behaviors were present in communication center client/staff interactions as well as to what extent center staff self-perceptions of positive communication conferencing behaviors align with client perceptions of staff behaviors. Overall, all positive communication behaviors were present in interactions and client and staff perceptions closely aligned. The findings support the use of the Positive Communication Model as a useful framework for training communication center staff on effective conferencing behaviors

Antiphospholipid autoantibodies as blood biomarkers for detection of early stage Alzheimer's disease

A robust blood biomarker is urgently needed to facilitate early prognosis for those at risk for Alzheimer's disease (AD). Redox reactive autoantibodies (R-RAAs) represent a novel family of antibodies detectable only after exposure of cerebrospinal fluid (CSF), serum, plasma or immunoglobulin fractions to oxidizing agents. We have previously reported that R-RAA antiphospholipid antibodies (aPLs) are significantly decreased in the CSF and serum of AD patients compared to healthy controls (HCs). These studies were extended to measure R-RAA aPL in serum samples obtained from Alzheimer's Disease Neuroimaging Initiative (ADNI). Serum samples from the ADNI-1 diagnostic groups from participants with mild cognitive impairment (MCI), AD and HCs were blinded for diagnosis and analyzed for R-RAA aPL by ELISA. Demographics, cognitive data at baseline and yearly follow-up were subsequently provided by ADNI after posting assay data. As observed in CSF, R-RAA aPL in sera from the AD diagnostic group were significantly reduced compared to HC. However, the sera from the MCI population contained significantly elevated R-RAA aPL activity relative to AD patient and/or HC sera. The data presented in this study indicate that R-RAA aPL show promise as a blood biomarker for detection of early AD, and warrant replication in a larger sample. Longitudinal testing of an individual for increases in R-RAA aPL over a previously established baseline may serve as a useful early sero-epidemiologic blood biomarker for individuals at risk for developing dementia of the Alzheimer's type

Motivating Persons with Schizophrenia to Exercise: Rationale and Design

Persons with schizophrenia spectrum disorders (SSDs) are not only at risk because of disabling disease symptoms but because necessary medications create health risks associated with high rates of obesity. Despite the well-known benefits of exercise, persons with SSDs rarely adhere to such regimens; few interventions to motivate exercise behavior have been tested in this group. The purpose of this study is to examine effects of the Walk, Address sensations, Learn about exercise, Cue exercise behavior for persons with SSDs (WALC-S) motivational intervention upon exercise behavior. We will recruit a total of eighty outpatients 18–68 years, meeting these criteria: 1) chart diagnosis of schizophrenia, any subtype, schizoaffective disorder or schizophreniform disorder, according to the criteria described in the Diagnostic and Statistical Manual for Mental Disorders, 2) English speaking, 3) Stable medication regimen (defined as no medication changes within the last month), and 4) medical clearance for moderate exercise in writing from primary care provider. Participants will be randomly assigned to the experimental (4-week WALC-S motivational intervention), or the control group (4-week time and attention control). After the first 4 weeks, all participants will attend a 16-week walking group. The primary measures of the effectiveness of the WALC-S are attendance, persistence and compliance to the 16-week walking group. The study will be completed in approximately January 2010. In addition to hypothesis testing, this study will provide information to estimate effect sizes to calculate power and determine appropriate sample sizes for future inquiries. This paper describes the rationale and design of the study

Mapping the links between gender, status and genre in Shakespeare’s plays

The AHRC-funded Encyclopedia of Shakespeare’s Language (ESL) project has produced a resource allowing users to explore Shakespeare’s plays in a variety of (semi-automatic) ways, via a web-based corpus query processor interface (CQPweb) hosted by Lancaster University. It enables users, for example, to interrogate a corpus of Shakespeare’s plays using queries restricted by dramatic genre, gender and/or social status of characters, and to target and explore the language of the plays not only at the word level, but also at the grammatical and semantic levels (by querying part-of-speech or semantic categories). Using keyword techniques, we examine how female and male language varies in general, by social status (high or low), and by genre (comedy, history and tragedy). Among our findings, we note differences in the use of pronouns and references to male authority (female overuse of ‘I’ and ‘husband’; male overuse of ‘we’ and ‘king’). We also observe that high-status males in comedies (as opposed to histories and tragedies) are characterised by polite requests (‘please you’) and sharp-minded ‘wit’. Despite many similarities between female and male usage of gendered forms of language (‘woman’), male characters alone use terms such as ‘womanish’ in a disparaging way

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Tensions, issues and challenges in special education in Aotearoa New Zealand : stories of mismatch between the policies and the practice : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Education, Massey University, Palmerston North, New Zealand

This study identifies issues, tensions and challenges within education in Aotearoa New Zealand through the responses of nine families who talked about their experiences when supporting their children with special learning needs in regular schools. The policies and practices of the Education Act 1989 and Special Education 2000 underpin a vision of inclusive education that gives all children access to high quality learning programmes enabling them to participate and achieve at school. My interpretations of the experiences of these nine families and their children suggests that these tensions arise from mismatches between the families’ expectations and the philosophies, policies and practices of health, government and educational professionals which created barriers leading to the exclusion of their children from regular school placements. This thesis argues that these tensions and issues have an adverse impact on the children and their families. The study revealed perceptions by families that some schools practised a culture of exclusion by being unable or unwilling to meet the learning or personal care needs of their children. Barriers identified by the families included some schools being unwilling to accept their children’s enrolments; the inability of some teachers to provide appropriate programmes of learning; incidents of bullying of their children by students and staff; and issues involving access to therapist support. Barriers were also identified to positive communication between families and health professionals. Issues involving the Special Education case managers were also identified by the families as contributing to the families’ decisions to remove their children from their regular schools or to seek alternative education providers at times of transition to secondary school. This study concludes with recommendations for key stakeholders outlining ways that may enhance the experiences of families and their children with special needs within inclusive education. Children with special needs and their families do have a right to the experience of inclusive education. It is the role of the key stakeholders to ensure this becomes reality for all children and their families