Second Chance Stories: Children and Families' Journey from School Exclusion to Therapeutic Alternative Provision

A child is a ‘relational’ being, formed through their relationships with significant others: parents, siblings, teachers and peers. A child’s behaviour in school is correspondingly influenced by multiple factors, some of which are external to the school environment. This is illustrated in the demographics of children and young people (CYP) most likely to be excluded from school, who often have multiple vulnerability factors in their home life (Gill, 2017). Despite the acknowledgment of systemic factors within numerous government policies, much of the research on therapeutic interventions for excluded children in Alternative Provision (AP) focuses on behavioural and psychodynamic interventions. Alternatively, this qualitative study is based on a systemic multi-family therapeutic Alternative Provision (AP) exploring children and families’ perspectives of school exclusion and integration into this AP. A process relational ontological approach (Brown & Stenner, 2009) and critical realist epistemology underpin this study. CYP and families undertook semi-structured interviews and CYP also completed a drawing exercise. A thematic analysis of the data identified four themes characterising the journey from school exclusion to AP: ‘System Breakdown’, ‘System Integration’, ‘System Transformation’ and ‘Cracks in the System’. It is argued that school exclusion affects the whole of the child’s world, leading also to the exclusion of other family members from many different systems. Furthermore, this study argues that the model of the school, which seeks to include and work with all excluded parts of the child’s system, is positively transformative. The findings of this study suggest that systemic approaches for CYP excluded from school provide an important and valuable contribution to clinical practice, highlighting the need for clinical psychologists to develop clinical and theoretical frameworks that engage more fully with school exclusion as a systemic issue. It is further argued that future research should explore how interventions can attend to broader macro systemic factors at play in school exclusion for example, the family’s economic and employment circumstances

Transmission of multidrug-resistant tuberculosis in the UK: a cross-sectional molecular and epidemiological study of clustering and contact tracing

BACKGROUND: Between 2000 and 2012 the number of multidrug-resistant (MDR) tuberculosis cases in the UK increased from 28 per year to 81 per year. We investigated the proportion of MDR tuberculosis cases arising from transmission in the UK and associated risk factors. METHOD: We identified patients with MDR tuberculosis notified in England, Wales, and Northern Ireland between Jan 1, 2004, and Dec 31, 2007, by linking national laboratory and surveillance data. Data for laboratory isolates, including drug sensitivities and 24-mycobacterial interspersed repetitive-unit-variable-number tandem repeat (MIRU-VNTR) typing were obtained routinely from the National Tuberculosis Reference laboratories as part of national tuberculosis surveillance. We investigated clusters of cases with indistinguishable MIRU-VNTR profiles to identify epidemiological links. We calculated transmission using the n-1 method and established associated risk factors by logistic regression. We also assessed the likelihood of transmission to additional secondary active tuberculosis cases, identified through conventional contact tracing. FINDINGS: 204 patients were diagnosed with MDR tuberculosis in the study period; 189 (92·6%) had an MIRU-VNTR profile. We identified 12 clusters containing 40 individuals and 149 unique strains. The proportion of cases attributable to recent transmission, on the basis of molecular data, was 15% (40 cases clustered-12 clusters/189 with a strain type). The proportion of cases attributable to recent transmission (ie, transmission within the UK) after adjustment for epidemiological links was 8·5% (22 cases with epidemiological links-six clusters/189 cases with a strain type). Being UK born (odds ratio 4·81; 95% CI 2·03-11·36, p=0·0005) and illicit drug use (4·75; 1·19-18·96, p=0·026) were significantly associated with clustering. The most common transmission setting was the household but 21 of 22 of epidemiological links were missed by conventional contact tracing. 13 secondary active tuberculosis cases identified by conventional contact tracing were mostly contacts of patients with MDR tuberculosis from countries of high tuberculosis burden. 11 (85%) of 13 shared the same country of birth as the index case, of whom ten did not share a strain type or drug resistance pattern. INTERPRETATION: Transmission of MDR tuberculosis in the UK is low and associated with being UK born or illicit drug use. MIRU-VNTR typing with cluster investigation was more successful at identifying transmission events than conventional contact tracing. Individuals with tuberculosis who have had contact with a known MDR tuberculosis source case from a country of high tuberculosis burden should have drug-sensitivity testing on isolates to ensure appropriate treatment is given. FUNDING: Public Health England

Growth of 1T ' MoTe2 by thermally assisted conversion of electrodeposited tellurium films

Molybdenum ditelluride (MoTe2) is a transition metal dichalcogenide (TMD) which has two phases stable under ambient conditions, a semiconducting (2H) and semimetallic (1T') phase. Despite a host of interesting properties and potential applications, MoTe2 is one of the less-studied TMDs, perhaps due its relatively low abundance in nature or challenges associated with its synthesis, such as the toxicity of most precursors. In this report, we describe the fabrication of thin films of phase-pure IT' MoTe2 using predeposited molybdenum and electrodeposited tellurium layers, at the relatively low temperature of 450 C. This method allows control over film geometry and over the tellurium concentration during the conversion. The MoTe2 films are characterized by Raman spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction, atomic force microscopy, and electron microscopies. When applied as a catalyst for the hydrogen evolution reaction, the films display promising initial results. The MoTe2 films have a Tafel slope of below 70 mV dec(-1) and compare favorably with other MoTe2 catalysts reported in the literature, especially considering the inherently scalable fabrication method. The variation in electrocatalytic behavior with thickness and morphology of the films is also investigated

Attitudes towards trusting artificial intelligence insights and factors to prevent the passive adherence of GPs: a pilot study

Artificial Intelligence (AI) systems could improve system efficiency by supporting clinicians in making appropriate referrals. However, they are imperfect by nature and misdiagnoses, if not correctly identified, can have consequences for patient care. In this paper, findings from an online survey are presented to understand the aptitude of GPs (n = 50) in appropriately trusting or not trusting the output of a fictitious AI-based decision support tool when assessing skin lesions, and to identify which individual characteristics could make GPs less prone to adhere to erroneous diagnostics results. The findings suggest that, when the AI was correct, the GPs’ ability to correctly diagnose a skin lesion significantly improved after receiving correct AI information, from 73.6% to 86.8% (X2 (1, N = 50) = 21.787, p < 0.001), with significant effects for both the benign (X2 (1, N = 50) = 21, p < 0.001) and malignant cases (X2 (1, N = 50) = 4.654, p = 0.031). However, when the AI provided erroneous information, only 10% of the GPs were able to correctly disagree with the indication of the AI in terms of diagnosis (d-AIW M: 0.12, SD: 0.37), and only 14% of participants were able to correctly decide the management plan despite the AI insights (d-AIW M:0.12, SD: 0.32). The analysis of the difference between groups in terms of individual characteristics suggested that GPs with domain knowledge in dermatology were better at rejecting the wrong insights from AI. View Full-Tex

Lifeworld Inc. : and what to do about it

Can we detect changes in the way that the world turns up as they turn up? This paper makes such an attempt. The first part of the paper argues that a wide-ranging change is occurring in the ontological preconditions of Euro-American cultures, based in reworking what and how an event is produced. Driven by the security – entertainment complex, the aim is to mass produce phenomenological encounter: Lifeworld Inc as I call it. Swimming in a sea of data, such an aim requires the construction of just enough authenticity over and over again. In the second part of the paper, I go on to argue that this new world requires a different kind of social science, one that is experimental in its orientation—just as Lifeworld Inc is—but with a mission to provoke awareness in untoward ways in order to produce new means of association. Only thus, or so I argue, can social science add to the world we are now beginning to live in

Preliminary Assessment of the Efficacy of a T-Cell–Based Influenza Vaccine, MVA-NP+M1, in Humans

A single vaccination with MVA-NP+M1 boosts T-cell responses to conserved influenza antigens in humans. Protection against influenza disease and virus shedding was demonstrated in an influenza virus challenge study

Mediation and digital intensities: Topology, psychology and social media

Social media are said to offer seemingly endless ways of connecting with people in a variety of online spaces. The mediated form that such communication takes has re-opened many theoretical debates regarding the status of relationships that are organized and managed online. In this article we seek to explore these issues through the lens of topological thinking, and particularly through the work of Kurt Lewin (1890–1947). Lewin’s topological psychology has recently featured in the social sciences as a way of overcoming some of the, frankly unhelpful, dualistic thinking that features commonly in psychology (e.g. subject–object, mind–body, individual–social). Topological thought focuses on the spatial distribution of psychological experience, and therefore offers a social perspective not reliant on traditional notions of internalized psychological states and traits. The kind of spatiality at work though is not one that relies on Euclidean fixity, but one that draws out notions of stretching, moulding, bending and flexing. Space is seen not as a fixed property, but rather the form that psychological activity takes through connections and relations with others. In this article we seek to explore the potential value in characterizing social media activity topologically. This involves analysing people’s experiences with social media, and how topological concerns of boundaries, connections and thresholds work (or not) in and through social media. Furthermore, the focus is not only on extensive properties of social media, but rather on how intensive processes are actualized and distributed in and through mediation