Using narrative as a tool to locate and challenge pre service teacher bodies in health and physical education

This paper reports on research that has explored the use of narrative as a pedagogical tool in pre service teacher education. Specifically, we pursue the use of narrative to engage with pre service teachers’ embodied experiences [their lived body] and the ways in which these experiences are in turn currently influencing their ‘living bodies’ in regard to what Health and Physical Education (HPE) is and how it should be taught. Data in the form of an assemblage of pre service teachers’ narratives are presented to show how both the lived and living body contributes to thoughts and ideas about HPE. Discussion also reflects on the pedagogical merits of using narrative in pre service teacher education. We contend that narrative has a potentially important role to play in pre service teachers coming to better understand their bodies and can assist in moving them beyond what they experienced as HPE as school students

Numbers are Not Enough: Women in Higher Education in the 21st Century

Women are now the majority of students in institutions of higher education in the United States, and in many ways women as students and faculty have seen significant progress. But numbers do not tell the whole story. Subtle forms of discrimination continue to exist, and the higher up the pyramid you go, the fewer women are to be found, whether among tenured faculty, as presidents and provosts or as board members and board chairs. Many steps can be taken to improve the situation. Some institutions are recognizing that. We note some positive changes and discuss areas where improvement is needed. True gender equality would benefit not only higher education, but society as a whole

Embarrassment as a Key Emotion in Young People Talking About Sexual Health

This paper highlights embarrassment as one of the often-ignored emotions of young people when it comes to discussing issues around sexual health. There have been many sexual health studies on knowledge, attitudes and behaviour of young people over the past two decades, but emotional aspects have been largely ignored, despite a growing literature in the sociology of emotion. A qualitative approach was adopted in the form of focus group discussions, which included questions on sex education, sexual health campaigns and formal and informal sources of sexual health information and advice. Focus groups were conducted in secondary schools in and around Edinburgh and Aberdeen as part of a four-year evaluation study of a Scottish Demonstration Project on young people's sexual health: 'Healthy Respect'. We conclude that is it important for policy makers and sexual health promoters to understand young people's notions of embarrassment. Not only are there elements of sex education that (some) young people perceive as embarrassing, they also sense embarrassment in those people providing them with sex education. Young people reported that both professionals (e.g. teachers and doctors) and their parents could be embarrassed about raising the topic of sexual health. Moreover, as one of the goals of sex education is to ensure an open and non-embarrassing attitude towards sex and sexuality, there is still a major gap between the aspirations of health educators and policy makers and the ways that young people experience such education.Sexual Health Services, Adolescence, School, Scotland, Emotion, Qualitative Research, Sex Education, Parents, Focus Groups, Relationships

The Heritability of Prostate Cancer in the Nordic Twin Study of Cancer

BACKGROUND: Prostate cancer is thought to be the most heritable cancer, although little is known about how this genetic contribution varies across age. METHODS: To address this question, we undertook the world's largest prospective study in the Nordic Twin Study of Cancer cohort, including 18,680 monozygotic and 30,054 dizygotic same sex male twin pairs. We incorporated time-to-event analyses to estimate the risk concordance and heritability while accounting for censoring and competing risks of death, essential sources of biases that have not been accounted for in previous twin studies modeling cancer risk and liability. RESULTS: The cumulative risk of prostate cancer was similar to that of the background population. The cumulative risk for twins whose co-twin was diagnosed with prostate cancer was greater for MZ than for DZ twins across all ages. Among concordantly affected pairs, the time between diagnoses was significantly shorter for MZ than DZ pairs (median 3.8 versus 6.5 years, respectively). Genetic differences contributed substantially to variation in both the risk and the liability (heritability=58% (95% CI 52%–63%) of developing prostate cancer. The relative contribution of genetic factors was constant across age through late life with substantial genetic heterogeneity even when diagnosis and screening procedures vary. CONCLUSIONS: Results from the population based twin cohort, indicate a greater genetic contribution to the risk of developing prostate cancer when addressing sources of bias. The role of genetic factors is consistently high across age IMPACT: Findings impact the search for genetic and epigenetic markers and frame prevention efforts

Correction to: The “State of Implementation” Progress Report (SIPREP): a pilot demonstration of a navigation system for implementation

Following publication of the original article [1], it was reported that the incorrect version of a reviewer’s comments were published. The correct version has now been uploaded and the original article has been corrected

The "State of Implementation" Progress Report (SIPREP): a pilot demonstration of a navigation system for implementation

BACKGROUND: Implementation of new clinical programs across diverse facilities in national healthcare systems like the Veterans Health Administration (VHA) can be extraordinarily complex. Implementation is a dynamic process, influenced heavily by local organizational context and the individual staff at each medical center. It is not always clear in the midst of implementation what issues are most important to whom or how to address them. In recognition of these challenges, implementation researchers within VHA developed a new systemic approach to map the implementation work required at different stages and provide ongoing, detailed, and nuanced feedback about implementation progress. METHODS: This observational pilot demonstration project details how a novel approach to monitoring implementation progress was applied across two different national VHA initiatives. Stage-specific grids organized the implementation work into columns, rows, and cells, identifying specific implementation activities at the site level to be completed along with who was responsible for completing each implementation activity. As implementation advanced, item-level checkboxes were crossed off and cells changed colors, offering a visual representation of implementation progress within and across sites across the various stages of implementation. RESULTS: Applied across two different national initiatives, the SIPREP provided a novel navigation system to guide and inform ongoing implementation within and across facilities. The SIPREP addressed different needs of different audiences, both described and explained how to implement the program, made ample use of visualizations, and revealed both what was happening and not happening within and across sites. The final SIPREP product spanned distinct stages of implementation. CONCLUSIONS: The SIPREP made the work of implementation explicit at the facility level (i.e., who does what, and when) and provided a new common way for all stakeholders to monitor implementation progress and to help keep implementation moving forward. This approach could be adapted to a wide range of settings and interventions and is planned to be integrated into the national deployment of two additional VHA initiatives within the next 12 months

Analysis of the 10q11 Cancer Risk Locus Implicates MSMB and NCOA4 in Human Prostate Tumorigenesis

Genome-wide association studies (GWAS) have established a variant, rs10993994, on chromosome 10q11 as being associated with prostate cancer risk. Since the variant is located outside of a protein-coding region, the target genes driving tumorigenesis are not readily apparent. Two genes nearest to this variant, MSMB and NCOA4, are strong candidates for mediating the effects of rs109939934. In a cohort of 180 individuals, we demonstrate that the rs10993994 risk allele is associated with decreased expression of two MSMB isoforms in histologically normal and malignant prostate tissue. In addition, the risk allele is associated with increased expression of five NCOA4 isoforms in histologically normal prostate tissue only. No consistent association with either gene is observed in breast or colon tissue. In conjunction with these findings, suppression of MSMB expression or NCOA4 overexpression promotes anchorage-independent growth of prostate epithelial cells, but not growth of breast epithelial cells. These data suggest that germline variation at chromosome 10q11 contributes to prostate cancer risk by influencing expression of at least two genes. More broadly, the findings demonstrate that disease risk alleles may influence multiple genes, and associations between genotype and expression may only be observed in the context of specific tissue and disease states

How PETE comes to matter in the performance of social justice education

Background: For over four decades there have been calls for physical education (PE) and physical education teacher education (PETE) to address social inequality and foster social justice. Yet, as numerous studies demonstrate, attempts to educate for social justice in PETE are infrequent and rarely comprehensive. This raises the question why it appears to be possible in some situations but not others, and for some students and not others.    Purpose: The purpose of this paper is to examine the multiple socio-political networks or assemblages in which PETE is embedded and explore how these shape the possibilities for students to engage with the concept of social justice and sociocultural issues when learning to teach PE. Two research questions guided this study: How does an orientation for social justice education within education policy affect the standards for enacting PETE programs? How is social justice education encouraged within PETE programs? Methodology: Methodology: Drawing from a broader study of over 70 key personnel in more than 40 PETE programs, we examined how faculty in PETE understand their professional world, identify their subjective meanings of their experiences, and address sociocultural issues (SCI) and social justice education (SJE) within PETE. Data sources included an initial survey, a semi-structured interview, and program artifacts. We analyze the ways that SJE/SCI was represented in three national settings (England, the United States, and New Zealand) and identified common themes. Results:  Examination of each national setting reveals ways that SJE and SCI were enabled and constrained across the national, programmatic, and individual level in each of the countries. The coherence of explicit National policy and curricula, PETE program philosophies, and the presence of multiple individual interests in social justice served to reify a sociocultural agenda. Conversely possibilities were nullified by narrow or general National Standards, programs that failed to acknowledge sociocultural interests, and the absence of a critical mass of actors with a socio-critical orientation. These differences in assemblage culminated in variations in curriculum time that served to restrict or enable the breadth, frequency, and consistency of the messages surrounding SCI in PETE Conclusion: These findings highlight the importance of acknowledging socio-political networks where PETE operates. The agency of PETEs to enact pedagogies that foreground sociocultural interests is contingent on congruity of the networks. The authors caution that although the ‘perfect storm’ of conditions have a profound influence of the possibility of transformational learning of SCI in PETE, this arrangement is always temporary, fluid, and subject to changes in any of the three network levels. Additionally, the success of PETE in enabling graduating PE teachers to recognize the inequities that may be reinforced through the ‘hidden curriculum’ and to problematize the subject area is contingent on the expectations of the schools in which they teach.   

Red-flag sepsis and SOFA identifies different patient population at risk of sepsis-related deaths on the general ward

Controversy exists regarding the best diagnostic and screening tool for sepsis outside the intensive care unit (ICU). Sequential organ failure assessment (SOFA) score has been shown to be superior to systemic inflammatory response syndrome (SIRS) criteria, however, the performance of “Red Flag sepsis criteria” has not been tested formally. The aim of the study was to investigate the ability of Red Flag sepsis criteria to identify the patients at high risk of sepsis-related death in comparison to SOFA based sepsis criteria. We also investigated the comparison of Red Flag sepsis to quick SOFA (qSOFA), SIRS, and national early warning score (NEWS) scores and factors influencing patient mortality. Patients were recruited into a 24-hour point-prevalence study on the general wards and emergency departments across all Welsh acute hospitals. Inclusion criteria were: clinical suspicion of infection and NEWS 3 or above in-line with established escalation criteria in Wales. Data on Red Flag sepsis and SOFA criteria was collected together with qSOFA and SIRS scores and 90-day mortality. 459 patients were recruited over a 24-hour period. 246 were positive for Red Flag sepsis, mortality 33.7% (83/246); 241 for SOFA based sepsis criteria, mortality 39.4% (95/241); 54 for qSOFA, mortality 57.4% (31/54), and 268 for SIRS, mortality 33.6% (90/268). 55 patients were not picked up by any criteria. We found that older age was associated with death with OR (95% CI) of 1.03 (1.02–1.04); higher frailty score 1.24 (1.11–1.40); DNA-CPR order 1.74 (1.14–2.65); ceiling of care 1.55 (1.02–2.33); and SOFA score of 2 and above 1.69 (1.16–2.47). The different clinical tools captured different subsets of the at-risk population, with similar sensitivity. SOFA score 2 or above was independently associated with increased risk of death at 90 days. The sequalae of infection-related organ dysfunction cannot be reliably captured based on routine clinical and physiological parameters alone