Using the technology of the confessional as an analytical resource: four analytical stances towards research interviews in discourse analysis

Among the various approaches that have developed from FOUCAULT's work is an Anglophone discourse analysis that has attempted to combine Foucaultian insights with the techniques of Conversation Analysis. An important current methodological issue in this discourse analytical approach is its theoretical preference for "naturally occurring" rather than research interview data. A Foucaultian perspective on the interview as a research instrument, questions the idea of "naturally-occurring discourse". The "technology of the confessional" operates, not only within research interviews, but permeates other interactions as well. Drawing on FOUCAULT does not dismiss the problems of the interview as research instrument rather it shows they cannot be escaped by simply switching to more "natural" interactions. Combining these insights with recent developments within discourse analysis can provide analytical resources for, rather than barriers to, the discourse analysis of research interviews. To aid such an approach, we develop a four-way categorisation of analytical stances towards the research interview in discourse analysis. A demonstration of how a research interview might be subjected to a discourse analysis using elements of this approach is then provided

Impact of Hyperkalemia and Worsening Renal Function on the Use of Renin Angiotensin Aldosterone System Inhibitors in Chronic Heart Failure With Reduced Ejection Fraction

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138255/1/cpt746.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138255/2/cpt746_am.pd

OER Evidence Report 2013-2014

The Open Educational Resources Research Hub (OER Research Hub) provides a focus for research, designed to give answers to the overall question ‘What is the impact of OER on learning and teaching practices?’ and identify the particular influence of openness. We do this by working in collaboration with projects across four education sectors (K12, college, higher education and informal) extending a network of research with shared methods and shared results. The project combines: – Targeted research collaboration with high profile OER projects – A programme of international fellowship – Global networking and expertise in OER implementation and evaluation – A hub for research data and excellence in practice This report is an interim review of evidence recorded against the key hypotheses that focus the research of the OER Research Hub project

Evidence for a Single-Spin Azimuthal Asymmetry in Semi-inclusive Pion Electroproduction

Single-spin asymmetries for semi-inclusive pion production in deep-inelastic scattering have been measured for the first time. A significant target-spin asymmetry of the distribution in the azimuthal angle φ of the pion relative to the lepton scattering plane was formed for π^+ electroproduction on a longitudinally polarized hydrogen target. The corresponding analyzing power in the sinφ moment of the cross section is 0.022±0.005±0.003. This result can be interpreted as the effect of terms in the cross section involving chiral-odd spin distribution functions in combination with a chiral-odd fragmentation function that is sensitive to the transverse polarization of the fragmenting quark

Games Without Frontiers: Trends in the International Response to Insider Trading

A study examines, from the perspective of two practitioners, current trends in the global regulation of insider trading

Limitation of the excessive extracellular matrix turnover is a major determinant of the beneficial effect of spironolactone on survival in patients with CHF: Insights from the RALES trial

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106131/1/ejhf80350-5.pd

Aldosterone status associates with insulin resistance in patients with heart failure-data from the ALOFT study

<b>Background</b>: Aldosterone plays a key role in the pathophysiology of heart failure. In around 50% of such patients, aldosterone 'escapes' from inhibition by drugs that interrupt the renin-angiotensin axis; such patients have a worse clinical outcome. Insulin resistance is a risk factor in heart failure and cardiovascular disease. The relationship between aldosterone status and insulin sensitivity was investigated in a cohort of heart failure patients. <b>Methods</b>: 302 patients with New York Heart Association (NYHA) class II-IV heart failure on conventional therapy were randomized in ALiskiren Observation of heart Failure Treatment study (ALOFT), designed to test the safety of a directly acting renin inhibitor. Plasma aldosterone and 24-hour urinary aldosterone excretion as well as fasting insulin and Homeostasis model assessment of insulin resistance (HOMA-IR) were measured. Subjects with aldosterone escape and high urinary aldosterone were identified according to previously accepted definitions. <b>Results</b>: Twenty per-cent of subjects demonstrated aldosterone escape and 34% had high urinary aldosterone levels. At baseline, there was a positive correlation between fasting insulin and plasma(r=0.22 p<0.01) and urinary aldosterone(r=0.19 p<0.03). Aldosterone escape and high urinary aldosterone subjects both demonstrated higher levels of fasting insulin (p<0.008, p<0.03), HOMA-IR (p<0.06, p<0.03) and insulin-glucose ratios (p<0.006, p<0.06) when compared to low aldosterone counterparts. All associations remained significant when adjusted for potential confounders. <b>Conclusions</b>: This study demonstrates a novel direct relationship between aldosterone status and insulin resistance in heart failure. This observation merits further study and may identify an additional mechanism that contributes to the adverse clinical outcome associated with aldosterone escape

Social Mpower: An Educational Game for Energy Efficiency

A number of serious games have been developed for energy systems that act as an educational tool and help energy consumers to better understand concepts such as resource allocation, electricity prices and grid sustainability. In such gamified environments, players use technology to solve environmental problems including greener environment, optimised energy and water infrastructure, sustainable resources and reduced energy use. Social Mpower game is a representation of an autonomous energy community for local power generation and distribution in which the participants have to avoid a collective blackout by individually reducing their energy consumption by synchronising and coordinating their actions. Our experimental hypothesis is that collective awareness can be enhanced by appropriate features of the game interface, and therefore to increase the opportunities and prospects for successful collective action (e.g to avoid a blackout)

Cost-effectiveness of eplerenone in patients with systolic heart failure and mild symptoms

Aim In the Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF), aldosterone blockade with eplerenone decreased mortality and hospitalisation in patients with mild symptoms (New York Heart Association class II) and chronic systolic heart failure (HF). The present study evaluated the cost-effectiveness of eplerenone in the treatment of these patients in the UK and Spain.<p></p> Methods and results Results from the EMPHASIS-HF trial were used to develop a discrete-event simulation model estimating lifetime direct costs and effects (life years and quality-adjusted life years (QALYs) gained) of the addition of eplerenone to standard care among patients with chronic systolic HF and mild symptoms. Eplerenone plus standard care compared with standard care alone increased lifetime direct costs per patient by £4284 for the UK and €7358 for Spain, with additional quality-adjusted life expectancy of 1.22 QALYs for the UK and 1.33 QALYs for Spain. Mean lifetime costs were £3520 per QALY in the UK and €5532 per QALY in Spain. Probabilistic sensitivity analysis suggested a 100% likelihood of eplerenone being regarded as cost-effective at a willingness-to-pay threshold of £20 000 per QALY (UK) or €30 000 per QALY (Spain).<p></p> Conclusions By currently accepted standards of value for money, the addition of eplerenone to optimal medical therapy for patients with chronic systolic HF and mild symptoms is likely to be cost-effective.<p></p&gt

Can the retinal screening interval be safely increased to 2 years for type 2 diabetic patients without retinopathy?

This is the final version. Available from American Diabetes Association via the DOI in this recordOBJECTIVE: In the U.K., people with diabetes are typically screened for retinopathy annually. However, diabetic retinopathy sometimes has a slow progression rate. We developed a simulation model to predict the likely impact of screening patients with type 2 diabetes, who have not been diagnosed with diabetic retinopathy, every 2 years rather than annually. We aimed to assess whether or not such a policy would increase the proportion of patients who developed retinopathy-mediated vision loss compared with the current policy, along with the potential cost savings that could be achieved. RESEARCH DESIGN AND METHODS: We developed a model that simulates the progression of retinopathy in type 2 diabetic patients, and the screening of these patients, to predict rates of retinopathy-mediated vision loss. We populated the model with data obtained from a National Health Service Foundation Trust. We generated comparative 15-year forecasts to assess the differences between the current and proposed screening policies. RESULTS The simulation model predicts that implementing a 2-year screening interval for type 2 diabetic patients without evidence of diabetic retinopathy does not increase their risk of vision loss. Furthermore, we predict that this policy could reduce screening costs by ~25%. CONCLUSIONS: Screening people with type 2 diabetes, who have not yet developed retinopathy, every 2 years, rather than annually, is a safe and cost-effective strategy. Our findings support those of other studies, and we therefore recommend a review of the current National Institute for Health and Clinical Excellence (NICE) guidelines for diabetic retinopathy screening implemented in the U.K.National Institute for Health Research (NIHR