364 research outputs found
Securing effective work from labor
There is probably no more pressing and important managerial problem today, than the securing of effective work from labor. This article presents a review of a seasoned incentive wage system which has produced satisfactory results. The system is being operated by a concern employing at times over five thousand workers in three plants. The beneficial results obtained from its use have been increased production, decreased costs and higher wages
Lessons Learned from the British: The Liverpool Project
Universities around the country are beginning to feel the need to add a global dimension to their programs. One way to prepare teachers to address the challenges associated with teaching children in a global age is through carefully structured, international study abroad where the candidates are immersed in another culture and school system. This article seeks to demonstrate how a successful Teacher Education study abroad program can develop and transform pre-service candidates’ global perspective. This qualitative study was informed by the use of journal writing to prompts by ninety-six teacher education students over three different summers to learn about the Literacy Hour used in British schools during a study abroad conducted during an 8-week immersive learning experience in a setting in a northern British city. Readers will learn from participants themselves through carefully reported vignettes that focus on four themes that emerged in data analysis: Global Awareness, Retrospective Appreciation of U.S. schools based on British Literacy Practices, Teaching Self-Efficacy, and Travel Maturity
Adjustment with aphasia after stroke: study protocol for a pilot feasibility randomised controlled trial for SUpporting wellbeing through PEeR Befriending (SUPERB)
Background: Despite the high prevalence of mood problems after stroke, evidence on effective interventions particularly for those with aphasia is limited. There is a pressing need to systematically evaluate interventions aiming to improve wellbeing for people with stroke and aphasia. This study aims to evaluate the feasibility of a peer-befriending intervention.
Methods/design: SUPERB is a single blind, parallel group feasibility trial of peer befriending for people with aphasia post-stroke and low levels of psychological distress. The trial includes a nested qualitative study and pilot economic evaluation and it compares usual care (n = 30) with usual care + peer befriending (n = 30). Feasibility outcomes include proportion screened who meet criteria, proportion who consent, rate of consent, number of missing/incomplete data on outcome measures, attrition rate at follow-up, potential value of conducting main trial using value of information analysis (economic evaluation), description of usual care, and treatment fidelity of peer befriending. Assessments and outcome measures (mood, wellbeing, communication, and social participation) for participants and significant others will be administered at baseline, with outcome measures re-administered at 4 and 10 months post-randomisation. Peer befrienders will complete outcome measures before training and after they have completed two cycles of befriending. The qualitative study will use semi-structured interviews of purposively sampled participants (n = 20) and significant others (n = 10) from both arms of the trial, and all peer befrienders to explore the acceptability of procedures and experiences of care. The pilot economic evaluation will utilise the European Quality of life measure (EQ-5D-5 L) and a stroke-adapted version of the Client Service Receipt Inventory (CSRI).
Discussion: This study will provide information on feasibility outcomes and an initial indication of whether peer befriending is a suitable intervention to explore further in a definitive phase III randomised controlled trial.
Trial registration: ClinicalTrials.gov identifier NCT02947776, registered 28th October 2016
A privileged intraphagocyte niche is responsible for disseminated infection ofStaphylococcus aureusin a zebrafish model
The innate immune system is the primary defence against the versatile pathogen, Staphylococcus aureus. How this organism is able to avoid immune killing and cause infections is poorly understood. Using an established larval zebrafish infection model, we have shown that overwhelming infection is due to subversion of phagocytes by staphylococci, allowing bacteria to evade killing and found foci of disease. Larval zebrafish coinfected with two S. aureus strains carrying different fluorescent reporter gene fusions (but otherwise isogenic) had bacterial lesions, at the time of host death, containing predominantly one strain. Quantitative data using two marked strains revealed that the strain ratios, during overwhelming infection, were often skewed towards the extremes, with one strain predominating. Infection with passaged bacterial clones revealed the phenomenon not to be due to adventitious mutations acquired by the pathogen. After infection of the host, all bacteria are internalized by phagocytes and the skewing of population ratios is absolutely dependent on the presence of phagocytes. Mathematical modelling of pathogen population dynamics revealed the data patterns are consistent with the hypothesis that a small number of infected phagocytes serve as an intracellular reservoir for S. aureus, which upon release leads to disseminated infection. Strategies to specifically alter neutrophil/macrophage numbers were used to map the potential subpopulation of phagocytes acting as a pathogen reservoir, revealing neutrophils as the likely ‘niche’. Subsequently in a murine sepsis model, S. aureus abscesses in kidneys were also found to be predominantly clonal, therefore likely founded by an individual cell, suggesting a potential mechanism analogous to the zebrafish model with few protected niches. These findings add credence to the argument that S. aureus control regimes should recognize both the intracellular as well as extracellular facets of the S. aureus life cycle
A concise patient reported outcome measure for people with aphasia: the aphasia impact questionnaire 21
Background: There are many validated and widely used assessments within aphasiology. Few, however, describe language and life with aphasia from the perspective of the person with aphasia. Across healthcare, patient experience and user involvement are increasingly acknowledged as fundamental to person-centred care. As part of this movement, Patient Reported Outcome Measures (PROMs) are being used in service evaluation and planning.
Aims: This paper reports the quantitative aspects of a mixed methods study that developed and validated a concise PROM, the Aphasia Impact Questionnaire (AIQ), co-produced with People with Aphasia (PWA).
Methods & Procedures: The AIQ was developed within the social model of disability and all stages of the development of the AIQ were performed in partnership with PWA. It was adapted from a pre-existing and lengthier PROM for PWA, the Communication Disability Profile. The first iterations of the AIQ focused on domains of communication, participation and well-being/emotional state. Subsequently the AIQ was extended to include additional items relating to reading and writing (AIQ-21). The research design was iterative. Initially, concurrent validity, internal consistency, and sensitivity of the AIQ-prototype were obtained. The AIQ-prototype was modified to become the AIQ-21. Statistical testing with a new group of PWA was performed, investigating internal consistency and concurrent validity of the AIQ-21.
Outcomes & Results: Results for both the AIQ-prototype and AIQ-21 showed statistically significant concurrent validity and good internal consistency. Repeated measurement using the AIQ-prototype demonstrated statistically significant change after PWA accessed a community intervention.
Conclusions: The AIQ-21 is a PROM that has great potential to be one of the core set of aphasia tests for clinical and research use. Results can be used alongside language assessment to enable person-centred goal setting and partnership working for people with aphasia
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Blinding participants and assessors in a feasibility randomised controlled trial of peer-befriending for people with aphasia post-stroke
Background and aims: In behavioural interventions, blinding participants to intervention versus control conditions is problematic, as is blinding assessors to participants’ group allocation. When participants are provided with information about the intervention to be tested, they will know whether they are in the intervention or the control arm of the study. This is particularly problematic in psychological interventions where people who may already be distressed or anxious are likely to become even more distressed when they realise they are in the control arm of a study. To minimise potential threats to validity and maintain lack of bias, we took a number of steps in the SUpporting well-being through PEeR-Befriending (SUPERB) feasibility trial for people with aphasia to ensure blinding. This presentation will report on these steps and evaluate their effectiveness. Methods: SUPERB is a single blind, mixed methods, parallel group phase II randomised controlled trial (RCT) comparing usual care+peer-befriending (n = 30) versus usual care (n = 30), starting at discharge from hospital. Little is known about what usual care for psychological support after stroke-aphasia constitutes, and this study will document the services the participants receive in their area for both groups. A modified two-stage consent design has been adopted (Campbell, Peters, Grant, Quilty, & Dieppe, 2005; Torgerson & Roland, 1998), as highlighted in the Medical Research Council framework for complex interventions (Craig et al., 2008). In the first stage, all participants consent to take part in a study on adjustment post-stroke and have their data collected at three time points (i.e., baseline, 4 months, and 10 months). They know they may be compared to other people in the study receiving different packages of care, but are blind to the fact that the study tests a specific intervention (peer-befriending). Following baseline assessments, participants are randomised to either usual care+peer-befriending or usual care. At this point, a second stage consent to take part in the intervention is completed with those participants allocated to the peer-befriending arm. Rate of consent at both stages is monitored. Blinded researchers (assessors) complete assessments for both groups at 4 months and 10 months. Strategies to maintain blinding of assessors include the following: the use of scripts during assessments and asking the participants not to reveal what care they have received; unblinded researcher organising post-randomisation appointments, so that assessors cannot become unblinded by partners/carers of people with aphasia revealing information; and management of the work environment (separate office space, different telephones, and no physical or electronic access to sensitive data). Instances of unblinding are recorded. Results: The trial is currently underway. Thirty-eight of 60 participants have been recruited and 27 have been randomised. The two-stage consent process has been largely successful. No instances of unblinding by participants or researchers have been recorded. Near misses (n = 4) have been recorded for the blinded researchers. These are unrelated to the assessments with participants but rather workplace factors (e.g., use of email, shared calendars, and overhearing telephone conversations). Conclusions: Blinding of participants and researchers is critical to the success of a RCT. This paper raises and discusses a range of processes including a modified two-stage consent process and careful preparation and monitoring of participants, researchers, and workplace factors – which are all important steps to reducing the possibility of unblinding
A Comparison of Nucleosome Organization in \u3cem\u3eDrosophila\u3c/em\u3e Cell Lines
Changes in the distribution of nucleosomes along the genome influence chromatin structure and impact gene expression by modulating the accessibility of DNA to transcriptional machinery. However, the role of genome-wide nucleosome positioning in gene expression and in maintaining differentiated cell states remains poorly understood. Drosophila melanogastercell lines represent distinct tissue types and exhibit cell-type specific gene expression profiles. They thus could provide a useful tool for investigating cell-type specific nucleosome organization of an organism’s genome. To evaluate this possibility, we compared genome-wide nucleosome positioning and occupancy in five different Drosophila tissue-specific cell lines, and in reconstituted chromatin, and then tested for correlations between nucleosome positioning, transcription factor binding motifs, and gene expression. Nucleosomes in all cell lines were positioned in accordance with previously known DNA-nucleosome interactions, with helically repeating A/T di-nucleotide pairs arranged within nucleosomal DNAs and AT-rich pentamers generally excluded from nucleosomal DNA. Nucleosome organization in all cell lines differed markedly from in vitro reconstituted chromatin, with highly expressed genes showing strong nucleosome organization around transcriptional start sites. Importantly, comparative analysis identified genomic regions that exhibited cell line-specific nucleosome enrichment or depletion. Further analysis of these regions identified 91 out of 16,384 possible heptamer sequences that showed differential nucleosomal occupation between cell lines, and 49 of the heptamers matched one or more known transcription factor binding sites. These results demonstrate that there is differential nucleosome positioning between these Drosophila cell lines and therefore identify a system that could be used to investigate the functional significance of differential nucleosomal positioning in cell type specification
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