Next steps – Building on and using research in training and practice

The final chapter provides a summary as well as space for reflection on the research journey; readers are encouraged to revisit their assumptions about research and why it is important for counsellors and psychotherapists to be engaged with research (Chapter 1). Readers are also be encouraged to reflect on their commitment to staying informed about research findings and to think pragmatically about how to ensure that they do. In doing so, the chapter addresses the issue of how research awareness and activity can contribute to both career development and the development of practitioner competencies. The chapter ends with a challenge to readers to continue to engage in their own research (as creators as well as consumers) and provides some practical guidance and recommendations on how to integrate research into training and professional life

Delay in diabetic retinopathy screening increases the rate of detection of referable diabetic retinopathy

Aims - To assess whether there is a relationship between delay in retinopathy screening after diagnosis of Type 2 diabetes and level of retinopathy detected. Methods - Patients were referred from 88 primary care practices to an English National Health Service diabetic eye screening programme. Data for screened patients were extracted from the primary care databases using semi-automated data collection algorithms supplemented by validation processes. The programme uses two-field mydriatic digital photographs graded by a quality assured team. Results - Data were available for 8183 screened patients with diabetes newly diagnosed in 2005, 2006 or 2007. Only 163 with Type 1 diabetes were identified and were insufficient for analysis. Data were available for 8020 with newly diagnosed Type 2 diabetes. Of these, 3569 were screened within 6 months, 2361 between 6 and 11 months, 1058 between 12 and 17 months, 366 between 18 and 23 months, 428 between 24 and 35 months, and 238 at 3 years or more after diagnosis. There were 5416 (67.5%) graded with no retinopathy, 1629 (20.3%) with background retinopathy in one eye, 753 (9.4%) with background retinopathy in both eyes and 222 (2.8%) had referable diabetic retinopathy. There was a significant trend (P = 0.0004) relating time from diagnosis to screening detecting worsening retinopathy. Of those screened within 6 months of diagnosis, 2.3% had referable retinopathy and, 3 years or more after diagnosis, 4.2% had referable retinopathy. Conclusions - The rate of detection of referable diabetic retinopathy is elevated in those who were not screened promptly after diagnosis of Type 2 diabetes

Evolving Design Pedagogies: Broadening Universal Design for Social Justice

Universal Design came into prominence as a successor to the Americans with Disabilities Act (ADA), contributing to broader notions of accessibility beyond baseline codes and standards. Rooted in human factors research, Universal Design primarily centers on supporting human performance through the development of accessible and usable environments (Steinfeld and Maisel 2012, 95-96). As such, Universal Design pedagogies predominantly focus on enhancing environments for people with disabilities and aging populations (O Shea 2018, 721; Steinfeld and Maisel 2012, 49). However, some believe Universal Design is on the cusp of a paradigm shift to address broader aspects of social justice (Salmen 2012; Steinfeld and Maisel 2012, 159-160). This paper synthesizes existing literature to explore how current academic and practice-facing Universal Design pedagogies support the movement’s expansion to address social justice across demographic groups. Critical audiences for this work include architectural educators, students, researchers, policymakers, and building professionals interested in advancing the theory and practice of Universal Design. Recommendations from this work reposition Universal Design pedagogies as a pathway for creating more equitable and inclusive buildings, spaces, and communities that are truly designed for all.&nbsp

Action Potential Waveform Variability Limits Multi-Unit Separation in Freely Behaving Rats

Extracellular multi-unit recording is a widely used technique to study spontaneous and evoked neuronal activity in awake behaving animals. These recordings are done using either single-wire or mulitwire electrodes such as tetrodes. In this study we have tested the ability of single-wire electrodes to discriminate activity from multiple neurons under conditions of varying noise and neuronal cell density. Using extracellular single-unit recording, coupled with iontophoresis to drive cell activity across a wide dynamic range, we studied spike waveform variability, and explored systematic differences in single-unit spike waveform within and between brain regions as well as the influence of signal-to-noise ratio (SNR) on the similarity of spike waveforms. We also modelled spike misclassification for a range of cell densities based on neuronal recordings obtained at different SNRs. Modelling predictions were confirmed by classifying spike waveforms from multiple cells with various SNRs using a leading commercial spike-sorting system. Our results show that for single-wire recordings, multiple units can only be reliably distinguished under conditions of high recording SNR (≥4) and low neuronal density (≈20,000/ mm3). Physiological and behavioural changes, as well as technical limitations typical of awake animal preparations, reduce the accuracy of single-channel spike classification, resulting in serious classification errors. For SNR <4, the probability of misclassifying spikes approaches 100% in many cases. Our results suggest that in studies where the SNR is low or neuronal density is high, separation of distinct units needs to be evaluated with great caution

Deciphering signatures of mutational processes operative in human cancer.

The genome of a cancer cell carries somatic mutations that are the cumulative consequences of the DNA damage and repair processes operative during the cellular lineage between the fertilized egg and the cancer cell. Remarkably, these mutational processes are poorly characterized. Global sequencing initiatives are yielding catalogs of somatic mutations from thousands of cancers, thus providing the unique opportunity to decipher the signatures of mutational processes operative in human cancer. However, until now there have been no theoretical models describing the signatures of mutational processes operative in cancer genomes and no systematic computational approaches are available to decipher these mutational signatures. Here, by modeling mutational processes as a blind source separation problem, we introduce a computational framework that effectively addresses these questions. Our approach provides a basis for characterizing mutational signatures from cancer-derived somatic mutational catalogs, paving the way to insights into the pathogenetic mechanism underlying all cancers

Impact of Professional Student Mentored Research Fellowship on Medical Education and Academic Medicine Career Path

CONTEXT: This study explores the long-term impact of the Professional Student Mentored Research Fellowship (PSMRF) program at the University of Kentucky College of Medicine (UKCOM) on medical students\u27 research productivity and career paths. METHODS: Demographic characteristics, academic profiles, number of publications and residency placements from 2007 to 2012 were used to assess 119 PSMRF graduates against a comparison cohort of 898 UKCOM (non-PSMRF) students. RESULTS: PSMRF students had higher MCAT scores at admission (31.5 ± 0.6 vs. 30.6 ± 0.2, p = 0.007) and achieved higher USMLE Step 1 scores (228 ± 4.2 vs. 223 ± 1.5, p = 0.03) than comparison group. PSMRF students were more likely to publish PubMed-indexed papers (36.7% vs. 17.9%, p \u3c 0.0001), achieve AOA status (19.3% vs. 8.5%, p = 0.0002) and match to top 25 US News and World Report residency programs (23.4% vs. 12.1%, p = 0.008). A greater proportion of PSMRF fellows matched to top tier competitive specialties (23% vs. 14.2%, p = 0.07), however this difference was not statistically significant. CONCLUSIONS: The PSMRF program shows a significant increase in enrollment, as well as positive associations with indicators of success in medical school and subsequent quality of residency program

Review of family, couples and systemic therapy outcome research 2000-2009

These tables present the result of a systematic collation of empirical studies of outcomes over 10 years of English language publication in refereed journals. The Review is intended to be a resource for practitioners and researchers, as a readily available source of recent research publications on specific conditions. For this purpose a description of the main aspects of each study has been provided in a standard form. A full alphabetical listing of references is provided from page 98. A substantial further study, primarily by Emma Silver and Natasha Nascimento, involves a detailed coding of each article so that we can report trends and patterns in the research. This project is currently being written up for journal submission. An account of the methodology will be provided in that publication. In summary: The listing does not include review articles that did not report original data. We have taken a broad definition of family, couple and systemic therapy, and most of the articles were identified by searching electronic data-bases with a variety of keywords, then reviewing every publication to select those that fitted our criteria

Fitting the man to the machine: The ADAPT project

The size and shape of humans have been changing dramatically over the last 100 years. People have grown taller and fatter, with relatively longer legs and higher waist–hip ratios. Aircraft, on the other hand, are often designed to last for several decades. Consequently, there is an increasing mismatch between the size and shape of crewstations and the size and shape of aircrew. This mismatch has been exacerbated by the introduction of female aircrew. This is particularly true in Australia, where the most recent anthropometric survey dates from the 1970s, and crewstations are designed based on overseas specifications. In the past, anthropometric surveys have been conducted with the traditional instruments of tape measures and calipers. The Australian Defence Anthropometric Personnel Testing (ADAPT) project is taking a different approach, using a combination of 3D whole-body scanners, laser scans of crewstations, human modelling and animation software, and mathematical optimisation, to refine anthropometric recruitment standards for the RAAF. The project will additionally improve clothing and equipment fit, human functionality in aircraft, reduce the risk of injury and provide the opportunity to open recruitment to a wider selection of applicants. The work done in the ADAPT project has applications across the ADF, and will spill over into many civilian fields.C

On the exact electric and magnetic fields of an electric dipole

We derive from Jefimenko's equations a multipole expansion in order to obtain the exact expressions for the electric and magnetic fields of an electric dipole with an arbitrary time dependence. A few comments are also made about the usual expositions found in most common undergraduate and graduate textbooks as well as in the literature on this topic