A longitudinal, observational study examining the relationships of patient satisfaction with services and mental well-being to their clinical course in young people with Type 1 diabetes mellitus during transition from child to adult health services

AIM: We hypothesized that participant well-being and satisfaction with services would be positively associated with a satisfactory clinical course during transition from child to adult health care. METHODS: Some 150 young people with Type 1 diabetes mellitus from five diabetes units in England were recruited to a longitudinal study of transition. Each young person was visited at home four times by a research assistant; each visit was 1 year apart. Satisfaction with services (Mind the Gap; MTG) and mental well-being (Warwick-Edinburgh Mental Well-being Scale; WEMWBS) were captured. Change in HbA1c , episodes of ketoacidosis, clinic and retinal screening attendance were used to assess clinical course. In total, 108 of 150 (72%) young people had sufficient data for analysis at visit 4. RESULTS: Mean age at entry was 16 years. By visit 4, 81.5% had left paediatric healthcare services. Median HbA1c increased significantly (P = 0.01) from 69 mmol/mol (8.5%) at baseline to 75 mmol/mol (9.0%) at visit 4. WEMWBS scores were comparable with those in the general population at baseline and were stable over the study period. MTG scores were also stable. By visit 4, some 32 individuals had a 'satisfactory' and 76 a 'suboptimal' clinical course. There were no significant differences in average WEMWBS and MTG scores between the clinical course groups (P = 0.96, 0.52 respectively); nor was there a significant difference in transfer status between the clinical course groups. CONCLUSIONS: The well-being of young people with diabetes and their satisfaction with transition services are not closely related to their clinical course. Investigating whether innovative psycho-educational interventions can improve the clinical course is a research priority

Effects of Heat Stress and Plane of Nutrition on Production and Metabolism in Growing Pigs

We heat-stressed growing pigs and evaluated the differential effects of environmental hyperthermia and reduced feed intake. Our results indicate that hyperthermia directly effects production and metabolism and many of these are independent of reduced nutrient intake. Identifying how and why heat stress alters metabolism and physiology are prerequisites in developing ameliorating strategies to prevent the reduction in performance and lost income typically observed during the warm summer months

Using legume-based mixtures to enhance the nitrogen use efficiency and economic viability of cropping systems - Final report (LK09106/HGCA3447)

As costs for mineral fertilisers rise, legume-based leys are recognised as a potential alternative nitrogen source for crops. Here we demonstrate that including species-rich legume-based leys in rotations helps to maximise synergies between agricultural productivity and other ecosystem services. By using functionally diverse plant species mixtures, these services can be optimised and fine-tuned to regional and farm-specific needs. Replicated field experiments were conducted over three years at multiple locations, testing the performance of 12 legume species and 4 grass species sown in monocultures, as well as in a mixture of 10 of the legumes and all 4 grasses (called the All Species Mix, ASM). In addition, we compared this complex mixture to farmer-chosen ley mixtures on 34 sites across the UK. The trials showed that there is a large degree of functional complementarity among the legume species. No single species scored high on all evaluation criteria. In particular, the currently most frequently used species, white clover, is outscored by other legume species on a number of parameters such as early development and resistance to decomposition. Further complementarity emerged from the different responses of legume species to environmental variables, with soil pH and grazing or cutting regime being among the more important factors. For example, while large birdsfoot trefoil showed better performance on more acidic soils, the opposite was true for sainfoin, lucerne and black medic. In comparison with the monocultures, the ASM showed increased ground cover, increased above-ground biomass and reduced weed biomass. Benefits of mixing species with regard to productivity increased over time. In addition, the stability of biomass production across sites was greater in the ASM than in the legume monocultures. Within the on-farm trials, we further found that on soils low in organic matter the biomass advantage of the ASM over the Control ley was more marked than on the soils with higher organic matter content. Ecological modelling revealed that the three best multifunctional mixtures all contained black medic, lucerne and red clover. Within the long term New Farming Systems (NFS) rotational study, the use of a clover bi-crop showed improvement to soil characteristics compared to current practice (e.g. bulk density and water infiltration rate). Improvements in wheat yield were also noted with respect to the inclusion of a clover bi-crop in 2010, but there was evidence of a decline in response as the N dose was increased. Cumulatively, over both the wheat crop and the spring oilseed rape crop, the clover bi-crop improved margin over N. The highest average yield response (~9%) was associated with the ASM legume species mix cover cropping approach

The limits of process: On (re)reading Henri Bergson

This article offers a reading of the work of Henri Bergson as it pertains to organizations through the lens of ideas drawn from critical realism. It suggests an alternative to interpretations based on a stark division between process and realist perspectives. Much of the existing literature presents a rather partial view of Bergson’s work. A review suggests some interesting parallels with themes in critical realism, notably the emergence of mind. Critical realism has a focus on process at its heart, but is also concerned with how the products of such processes become stabilized and form the conditions for action. This suggests that attention might usefully be paid to the relationship between organizational action and the sedimented practices grouped under the heading of ‘routines’. More attention to Bergson’s account of the relationship between instinct, intuition and intelligence provides a link to the social character of thought, something which can be mapped on to Archer’s work on reflexivity and the ‘internal conversation’. This suggests that our analyses need to pay attention to both memory and history, to building and dwelling, rather than the one-sided focus found in some process theory accounts

What Makes Theatrical Performances Successful in China's Tourism Industry?

This study aims to explore the factors affecting the success of a popular tourist product, namely, theatrical performance, within the context of China's tourism industry and develop a model based on previously successful productions. Using qualitative software, 22 Chinese-language articles on theatrical performances are analyzed to generate a list of success factors, classified as internal and external. The internal factors are storyline and performing, market positioning and marketing strategy, investment and financial support, operation and management, performing team, outdoor venue, indoor/outdoor stage supporting facilities, continuous improvement, and production team. The external factors are collaboration between cultural industries and local tourism, government support, privatization, and social and cultural effect. This study also provides suggestions for the future development of theatrical performances in China

A participatory methodology for large scale field trials in the UK

Farmer participation was essential in developing a uniquely useful set of wheat variety trials data on a wide range of organic farms over two years. Although the trials were successful, it became clear that some of the participating farmers felt there were some limitations in the process. These included a lack of ownership in the project and a concern for more researcher help. It was clear that a greater time in-vestment was needed at the start of the project to help with farmer understanding and ownership. De-spite the negative comments, farmers appreciated their involvement, particularly in contrasting their own views and information with that from the wider scene. Farmer participation is essential for systems-level research and this project helped to develop a small core of trained farmers and researchers

Sex and the Cinema: What American Pie Teaches the Young

This paper focuses upon the wildly successful blockbuster American Pie teenpics, especially American Pie 3 – the Wedding. I argue that these films, which are sited so securely within the visual and pedagogical machinery of Hollywood culture, are specifically designed to appeal to teenage male audiences, and to provide lessons in sex and romance. Movies like this are especially important as they are experienced by far more teenagers than, for example, instructional films or other classroom materials; indeed, as Henry Giroux has observed, "teens and youth learn how to define themselves outside of the traditional sites of instruction, such as the home and the school… Learning in the postmodern age is located elsewhere – in popular spheres that shape their identities, through forms of knowledge and desires that appear absent from what is taught in schools" (Giroux, 1997, p.49). In this paper I discuss whether the American Pie series is actually a "new age" effort which, via insubordinate performances of gender, contests the hegemonic field of signification which regulates the production of sex, gender and desire, or whether it is more accurately described as a retrogressive hetero-conservative opus with a veneer of sexual radicalism. In short, I intend to probe whether this filmic vector for sex education is all about the shaping of responsible, caring, vulnerable men, or is it guiding them to become just like their heterosexual, middle-class fathers? And whether, despite its riotous and raunchy advertising, American Pie really dishes up something spicy or something terribly wholesome instead

Mitigating Gender Bias in Machine Learning Data Sets

Artificial Intelligence has the capacity to amplify and perpetuate societal biases and presents profound ethical implications for society. Gender bias has been identified in the context of employment advertising and recruitment tools, due to their reliance on underlying language processing and recommendation algorithms. Attempts to address such issues have involved testing learned associations, integrating concepts of fairness to machine learning and performing more rigorous analysis of training data. Mitigating bias when algorithms are trained on textual data is particularly challenging given the complex way gender ideology is embedded in language. This paper proposes a framework for the identification of gender bias in training data for machine learning.The work draws upon gender theory and sociolinguistics to systematically indicate levels of bias in textual training data and associated neural word embedding models, thus highlighting pathways for both removing bias from training data and critically assessing its impact.Comment: 10 pages, 5 figures, 5 Tables, Presented as Bias2020 workshop (as part of the ECIR Conference) - http://bias.disim.univaq.i

Case-control study of multiple myeloma and farming.

A previous case-control study which utilised the occupational information available on the New Zealand Cancer Registry found an increased risk of multiple myeloma in agricultural workers consistent with previous findings in the United States. The findings are now presented for the second phase of the study which involved interviewing 76 cases of multiple myeloma (who had been included in the previous study) together with 315 controls with other types of cancer. The previous finding on an excess of farmers in the case group was confirmed by the interview data (odds ratio = 1.7, 95% confidence limits 1.0-2.9, P = 0.04). There were no significant differences between cases and controls regarding potential exposure to phenoxy herbicides or chlorophenols. There were also no significant differences regarding activities involving potential exposure to other agricultural chemicals, although the odds ratio for fencing work, which may involve exposure to arsenic and sodium pentachlorophenate, was 1.6 (95% confidence limits 0.9-2.7, P = 0.11). The odds ratios were significantly elevated for sheep farming (odds ratio = 1.9, 95% confidence limits 1.0-3.6, P = 0.04) and exposure to beef cattle (odds ratio = 1.7, 95% confidence limits 1.0-2.9, P = 0.05). The odds ratio was also elevated for persons reporting a history of hay fever (odds ratio = 1.9, 95% confidence limits 1.0-3.5, P = 0.05). Overall, these findings suggest that the search for the causes of elevated mortality in farmers from multiple myeloma should be directed to potential causes other than pesticide exposure