Effectiveness and tolerability of pegylated interferon alfa2b in combination with ribavirin for treatment of chronic hepatitis C: the PegIntrust study

Background and study aims : Large international clinical trials conducted in the past 5 years rapidly improved the treatment of chronic hepatitis C; however, it is unclear whether the advances seen in clinical trials are being paralleled by similar improvements in routine clinical practice. PegIntrust is a Belgian community based trial evaluating the sustained virological response. Patients and Methods : Observational study of 219 patients receiving pegylated interferon alfa-2b (1.5 μg/kg/wk) and weight-based ribavirin (800-1200 mg/day) for 48 weeks. Primary study end point was sustained virological response (SVR), defined as undetectable HCV RNA 6 months after the completion of treatment. Results : In total, 108 patients (49.3 %) had undetectable HCV RNA at the end of therapy, 91 (41.6%) attaining SVR. Of the 111 patients without an end-of-treatment response, 28 were non-responders, and 21 had virological breakthrough. In total, 134 patients attained early virological response (EVR); 88 (65.7%) of those patients attained SVR. In contrast, 82 (96.5 %) of the 85 patients who did not attain EVR also did not attain SVR. Age, fibrosis score and baseline viral load were identified as important predictors of treatment outcome. The most frequently reported serious adverse events resulting in treatment discontinuation were anemia (n = 10), fatigue/asthenia/malaise (n = 6) and fever (n = 3). Conclusion : Our data indicate that treatment of chronic hepatitis C with PEG-IFN alfa-2b plus weight-based ribavirin results in favourable treatment outcomes in a Belgian cohort of patients treated in community- based clinical practice

Recognising Desire: A psychosocial approach to understanding education policy implementation and effect

It is argued that in order to understand the ways in which teachers experience their work - including the idiosyncratic ways in which they respond to and implement mandated education policy - it is necessary to take account both of sociological and of psychological issues. The paper draws on original research with practising and beginning teachers, and on theories of social and psychic induction, to illustrate the potential benefits of this bipartisan approach for both teachers and researchers. Recognising the significance of (but somewhat arbitrary distinction between) structure and agency in teachers’ practical and ideological positionings, it is suggested that teachers’ responses to local and central policy changes are governed by a mix of pragmatism, social determinism and often hidden desires. It is the often underacknowledged strength of desire that may tip teachers into accepting and implementing policies with which they are not ideologically comfortable

Dominion cartoon satire as trench culture narratives: complaints, endurance and stoicism

Although Dominion soldiers’ Great War field publications are relatively well known, the way troops created cartoon multi-panel formats in some of them has been neglected as a record of satirical social observation. Visual narrative humour provides a ‘bottom-up’ perspective for journalistic observations that in many cases capture the spirit of the army in terms of stoicism, buoyed by a culture of internal complaints. Troop concerns expressed in the early comic strips of Australians, Canadians, New Zealanders and British were similar. They shared a collective editorial purpose of morale boosting among the ranks through the use of everyday narratives that elevated the anti-heroism of the citizen soldier, portrayed as a transnational everyman in the service of empire. The regenerative value of disparagement humour provided a redefinition of courage as the very act of endurance on the Western Front

Theoretical studies of the historical development of the accounting discipline: a review and evidence

Many existing studies of the development of accounting thought have either been atheoretical or have adopted Kuhn's model of scientific growth. The limitations of this 35-year-old model are discussed. Four different general neo-Kuhnian models of scholarly knowledge development are reviewed and compared with reference to an analytical matrix. The models are found to be mutually consistent, with each focusing on a different aspect of development. A composite model is proposed. Based on a hand-crafted database, author co-citation analysis is used to map empirically the entire literature structure of the accounting discipline during two consecutive time periods, 1972–81 and 1982–90. The changing structure of the accounting literature is interpreted using the proposed composite model of scholarly knowledge development

Reflectivity, Reflexivity, Reflexivism: IR's 'Reflexive Turn' - and Beyond

The notion of ‘reflexivity’ has been so intimately tied to the critique of positivism and empiricism in International Relations (IR) that the emergence of post-positivism has naturally produced the anticipation of a ‘reflexive turn’ in IR theory. Three decades after the launch of the post-positivist critique, however, reflexive IR has failed to impose itself as either a clear or serious contender to mainstream scholarship. Reasons for this failure include: the proliferation of different understandings of ‘reflexivity’ in IR theory that entail significantly different projects and concerns for IR scholarship; the equation of ‘reflexive theory’ with ‘critical’ and ‘emancipatory theory’ and the consequent confusion of ethical/normative issues with strictly epistemic/theoretical ones; and the refusal to consider reflexive IR as a ‘research programme’ concerned with empirical knowledge, not just meta-explanation. The development of reflexivity in IR theory as a sustainable cognitive and praxeological effort is nonetheless possible — and still needed. This article suggests what taking the ‘reflexive turn’ would really entail for IR.</jats:p

Community indicators: a framework for observing and supporting community activity on Cloudworks

Cloudworks (Cloudworks.ac.uk) is a social networking site designed for sharing, finding and discussing learning and teaching ideas and experiences. Design and development of the site has been based on an iterative analysis, development and implementation approach, underpinned by ongoing research and evaluation. To this end, we have been seeking to establish strategies to enable us to systematically position transactions and emerging patterns of activity on the site so that we can more reliably use the empirical evidence we have gathered (Galley, 2009a, Galley 2009b, Alevizou et al., 2010a, Conole et al, 2010). In this paper we will introduce a framework we have developed for observing and supporting community development on the site. In building our framework we have used empirical evidence gathered from the site, then related it to the literature from a range of disciplines concerned with professional and learning communities. We link research relating to distance learning communities with studies into Computer Mediated Communication (CMC), self-organising communities on the web, and wider research about the nature of learning organisations and continuous professional development. We argue that this framework can be used to capture the development of productive communities in the space (i.e. how far cohesive, productive groups can be said to be emerging or not) and also help focus futur

I’m not joking! The strategic use of humour in stories of racism

This study examines the use of humour by Black football coaches in England as a rhetorical device against racism. The paper draws on humour studies and critical race theory to illustrate signs of humour as defence. Research on humour has popularly explored the ambiguities and qualities of humour and, in particular, joke telling through its use as a foil to stem racial ills is less well understood. Where previous work has focused on explicit joke telling/banter in sport, this paper examines how techniques of humour are used in everyday racialised experiences. The use of techniques of humour enables feelings of subordination, and humiliation to be transposed into forms of resistance, while its physiological and psychological benefits can lead to inter-racial relief and catharsis. The paper concludes that techniques of humour remain underexplored as important tools of resistance to everyday racism

Legal, medical and lay understanding of embryos in Portugal: alignment with biology?

Pretende-se contribuir para o debate em torno dos processos de circulação de conhecimentos e sentidos entre especialistas e “leigos” no que concerne ao estatuto dos embriões humanos em Portugal. Reflete-se sobre as expectativas e preocupações manifestadas quanto à confiança, qualidade, segurança e eficácia das tecnologias médicas de reprodução assistida. O estudo assenta na realização de entrevistas individuais, com vistas a explorar as complexidades, similitudes e diferenças entre as visões e os valores de juristas, médicos e casais envolvidos em tratamentos de fertilização in vitro. Trata-se de uma análise qualitativa em um estudo de caso. Se os juristas e os médicos enquadram o estatuto dos embriões em categorias de índole biológica, técnica e/ou jurídico-legal, já os casais estabelecem com os mesmos diversas relações ontológicas de índole moral, afetiva e social, pelo que estes podem ser representados como seres éticos face à biologização médico-legal dos embriões.Our aim is to contribute towards the debate about the processes through which knowledge and meanings regarding the status of human embryos circulate among experts and laymen in Portugal. Expectations and concerns expressed regarding the reliability, quality, safety and efficacy of medical technologies for assisted reproduction were assessed. This study is based on data from individual interviews that sought to explore the complexities, similarities and differences among the views and values of jurists, doctors and couples involved in in vitro fertilization treatments. It consists of a qualitative analysis on a case study. If jurists and doctors frame the status of embryos as categories of a biological, technical and/or legal nature, couples establish between themselves a variety of ontological relationships of a moral, affective and social nature. Through these, they can be represented as ethical beings, thus contrasting with the medical-legal biologization of the embryos.To the jurists, doctors and women and men who we interviewed and who shared with us their views and experiences, our sincere thanks. We also thank Helena Lima and Filomena Louro (Scientific Editing Programme, University of Minho) for the translation of the Portuguese text into English; and the revision of David George Elliff. The authors thank the Foundation for Science and Technology (Portuguese Ministry of Science, Technology and Higher Education) for the financial support for this research, through a PhD fellowship (SFRH/BD/10396/2002) and a post-doctoral fellowship (SFRH/BPD/47020/2008).info:eu-repo/semantics/publishedVersio