1,294 research outputs found

    Getting diverse students and staff to talk about integration on campus, and what they say when they do: A UK-India collaborative case study.

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    This paper reports the early stages of a UKIERI-funded project, ‘Widening Participation: Diversity, isolation or integration in Higher Education?’.The project is concerned with greater equity, social justice, community and social cohesion within the current globalised, market oriented context of higher education (HE), and with enabling students to be better prepared for, and thrive in social networks and work-related arenas which are increasingly diverse, multicultural, interdependent and global. The main aim of this 3 year project is to explore the nature of social cohesion, integration and separation, diversity, equality and discrimination experienced by diverse, minority, disadvantaged and under-represented students attending HE in UK and India. Group stereotypes are often subconsciously held, emerging into consciousness only when they appear confirmed or confounded by personal experience or public events. Where there is little knowledge or personal experience then reliance upon group stereotypes is more likely (Kunda & Thagard, 1996). This can impact upon student and staff expectations of, responses to, and interactions with each other. Individual students’ experiences and perceptions lie at the core of this project, but the ultimate purpose is to illuminate our understanding as to how these are mediated, shaped and formed, in relation to and in interaction with the structures and contextual features of the educational environments in which they, as students, are located. It is thus framed by socio-cultural rather than psychological or therapeutic theories and is located within a social-constructivist perspective (Moore, 2000). Social constructivism facilitates the development of improved understandings of educational and social environments that shape rather than determine individual dispositions towards social diversity encountered on campus. It is highly suited to the understanding of perceptions, and exploring resonances with actions, reactions and interactions. The initial stage of this project involved inviting students and staff (academic and support staff) from five HE colleges and universities in England and India to keep a record (written and photographic) of what for them seemed to be important and relevant events relating to what they saw, heard, did and experienced on campus for a period of 1 month, in teaching, learning and social situations; namely interactions in classes and social settings; what seem to be good experiences and what seem to be negative ones; how and if their particular knowledge and experiences were used, valued and incorporated into their HE experience and learning or how they were negated. A sample size of 90 record keepers was sought across the participating institutions. Getting that sample presented significant difficulties to all but one of the participating institutions, and raised questions about • the methods initially adopted, • the general willingness of students and staff to address and share issues relating to diversity, equality, social cohesion and integration on HE campuses with researchers • cultural differences in accessing respondents to take part in the research Additional data collection methods were adopted and by January 2009 the intended sample size almost met. This paper will address the problems encountered in undertaking the first stage of this research and present initial findings from the data that were eventually obtained

    A qualitative study of the contribution of pharmacists to heart failure management in Scotland

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    Study objectives: (1) To identify the medication management needs of chronic heart failure (CHF) patients and their caregivers; (2) To examine the perceived support for medication management available to these people from health professionals; (3) To identify the actual and potential perceived contribution of pharmacists to medication management. Setting: A mixed urban/ rural region in the west of Scotland. Design: Semi-structured qualitative research interviews. Participants: A total of 50 people with CHF (NYHA Class II and III) due to left ventricular systolic dysfunction (33 males; mean age 67 years, 17 females; mean age 68 years) and 30 nominated caregivers recruited from the outpatient departments of two hospitals in the West of Scotland. Sampling was purposive to include patients from a range of CHF severity, ages and sexes. Main results: Managing medications was a responsibility shared by both the patients with CHF and caregivers. Treatment regimens were reported to be difficult to comply with. Health professionals were seen to provide little support for medication management. Pharmacists were viewed as being a good and accessible source of practical assistance who were also knowledgeable about the individual’s heart health history. Participants reported valuing advice from pharmacists about the side effects of medications and for their assistance in reducing the complex logistics of medication management and in having medications delivered. Conclusions: Patients with CHF and caregivers voiced a willingness to try to manage their medication regimen accurately but had a limited capacity to do so. Pharmacists were viewed as providing valuable support to patients with CHF and their caregivers, in terms of medication management. The extended role of pharmacists in medication management of CHF should be encouraged

    Environment-induced dynamical chaos

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    We examine the interplay of nonlinearity of a dynamical system and thermal fluctuation of its environment in the ``physical limit'' of small damping and slow diffusion in a semiclassical context and show that the trajectories of c-number variables exhibit dynamical chaos due to the thermal fluctuations of the bath.Comment: Revtex, 4 pages and 4 figure

    Overcoming challenges to data quality in the ASPREE clinical trial

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    © 2019 The Author(s). Background: Large-scale studies risk generating inaccurate and missing data due to the complexity of data collection. Technology has the potential to improve data quality by providing operational support to data collectors. However, this potential is under-explored in community-based trials. The Aspirin in reducing events in the elderly (ASPREE) trial developed a data suite that was specifically designed to support data collectors: the ASPREE Web Accessible Relational Database (AWARD). This paper describes AWARD and the impact of system design on data quality. Methods: AWARD's operational requirements, conceptual design, key challenges and design solutions for data quality are presented. Impact of design features is assessed through comparison of baseline data collected prior to implementation of key functionality (n = 1000) with data collected post implementation (n = 18,114). Overall data quality is assessed according to data category. Results: At baseline, implementation of user-driven functionality reduced staff error (from 0.3% to 0.01%), out-of-range data entry (from 0.14% to 0.04%) and protocol deviations (from 0.4% to 0.08%). In the longitudinal data set, which contained more than 39 million data values collected within AWARD, 96.6% of data values were entered within specified query range or found to be accurate upon querying. The remaining data were missing (3.4%). Participant non-attendance at scheduled study activity was the most common cause of missing data. Costs associated with cleaning data in ASPREE were lower than expected compared with reports from other trials. Conclusions: Clinical trials undertake complex operational activity in order to collect data, but technology rarely provides sufficient support. We find the AWARD suite provides proof of principle that designing technology to support data collectors can mitigate known causes of poor data quality and produce higher-quality data. Health information technology (IT) products that support the conduct of scheduled activity in addition to traditional data entry will enhance community-based clinical trials. A standardised framework for reporting data quality would aid comparisons across clinical trials

    A multistate model of health transitions in older people: a secondary analysis of ASPREE clinical trial data

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    Background: Understanding the nature of transitions from a healthy state to chronic diseases and death is important for planning health-care system requirements and interventions. We aimed to quantify the trajectories of disease and disability in a population of healthy older people. Methods: We conducted a secondary analysis of data from the ASPREE trial, which was done in 50 sites in Australia and the USA and recruited community-dwelling, healthy individuals who were aged 70 years or older (≥65 years for Black and Hispanic people in the USA) between March 10, 2010, and Dec 24, 2014. Participants were followed up with annual face-to-face visits, biennial assessments of cognitive function, and biannual visits for physical function until death or June 12, 2017, whichever occurred first. We used multistate models to examine transitions from a healthy state to first intermediate disease events (ie, cancer events, stroke events, cardiac events, and physical disability or dementia) and, ultimately, to death. We also examined the effects of age and sex on transition rates using Cox proportional hazards regression models. Findings: 19 114 participants with a median age of 74·0 years (IQR 71·6–77·7) were included in our analyses. During a median follow-up of 4·7 years (IQR 3·6–5·7), 1933 (10·1%) of 19 114 participants had an incident cancer event, 487 (2·5%) had an incident cardiac event, 398 (2·1%) had an incident stroke event, 924 (4·8%) developed persistent physical disability or dementia, and 1052 (5·5%) died. 15 398 (80·6%) individuals did not have any of these events during follow-up. The highest proportion of deaths followed incident cancer (501 [47·6%] of 1052) and 129 (12·3%) participants transitioned from disability or dementia to death. Among 12 postulated transitions, transitions from the intermediate states to death had much higher rates than transitions from a healthy state to death. The progression rates to death were 158 events per 1000 person-years (95% CI 144–172) from cancer, 112 events per 1000 person-years (86–145) from stroke, 88 events per 1000 person-years (68–111) from cardiac disease, 69 events per 1000 person-years (58–82) from disability or dementia, and four events per 1000 person-years (4–5) from a healthy state. Age was significantly associated with an accelerated rate for most transitions. Male sex (vs female sex) was significantly associated with an accelerate rate for five of 12 transitions. Interpretation: We describe a multistate model in a healthy older population in whom the most common transition was from a healthy state to cancer. Our findings provide unique insights into the frequency of events, their transition rates, and the impact of age and sex. These results have implications for preventive health interventions and planning for appropriate levels of residential care in healthy ageing populations. Funding: The National Institutes of Health

    Positive pion absorption on 3He using modern trinucleon wave functions

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    We study pion absorption on 3He employing trinucleon wave functions calculated from modern realistic NN interactions (Paris, CD Bonn). Even though the use of the new wave functions leads to a significant improvement over older calculations with regard to both cross section and polarization data, there are hints that polarization data with quasifree kinematics cannot be described by just two-nucleon absorption mechanisms.Comment: 14 pages, 6 figure

    Continuous variable entanglement and quantum state teleportation between optical and macroscopic vibrational modes through radiation pressure

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    We study an isolated, perfectly reflecting, mirror illuminated by an intense laser pulse. We show that the resulting radiation pressure efficiently entangles a mirror vibrational mode with the two reflected optical sideband modes of the incident carrier beam. The entanglement of the resulting three-mode state is studied in detail and it is shown to be robust against the mirror mode temperature. We then show how this continuous variable entanglement can be profitably used to teleport an unknown quantum state of an optical mode onto the vibrational mode of the mirror.Comment: 18 pages, 10 figure

    Engaging stakeholders across a socio-environmentally diverse network of water research sites in North and South America

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    Maintaining and restoring freshwater ecosystem services in the face of local and global change requires adaptive research that effectively engages stakeholders. However, there is a lack of understanding and consensus in the research community regarding where, when, and which stakeholders should be engaged and what kind of researcher should do the engaging (e.g., physical, ecological, or social scientists). This paper explores stakeholder engagement across a developing network of aquatic research sites in North and South America with wide ranging cultural norms, social values, resource management paradigms, and eco-physical conditions. With seven sites in six countries, we found different degrees of engagement were explained by differences in the interests of the stakeholders given the history and perceived urgency of water resource problems as well as differences in the capacities of the site teams to effectively engage given their expertise and resources. We categorized engagement activities and applied Hurlbert and Gupta's split ladder of participation to better understand site differences and distill lessons learned for planning comparative socio-hydrological research and systematic evaluations of the effectiveness of stakeholder engagement approaches. We recommend research networks practice deliberate engagement of stakeholders that adaptively accounts for variations and changes in local socio-hydrologic conditions. This, in turn, requires further efforts to foster the development of well-integrated research teams that attract and retain researchers from multiple social science disciplines and enable training on effective engagement strategies for diverse conditions

    Characterization of ERG, AR and PTEN gene status in circulating tumor cells from patients with castration-resistant prostate cancer

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    Hormone-driven expression of the ERG oncogene after fusion with TMPRSS2 occurs in 30% to 70% of therapy-naive prostate cancers. Its relevance in castration-resistant prostate cancer (CRPC) remains controversial as ERG is not expressed in some TMPRSS2-ERG androgen-independent xenograft models. However, unlike these models, CRPC patients have an increasing prostate-specific antigen, indicating active androgen receptor signaling. Here, we collected blood every month from 89 patients (54 chemotherapy-naive patients and 35 docetaxel-treated patients) treated in phase I/phase II clinical trials of an orally available, highly specific CYP17 inhibitor, abiraterone acetate, that ablates the synthesis of androgens and estrogens that drive TMPRSS2-ERG fusions. We isolated circulating tumor cells (CTC) by anti-epithelial cell adhesion molecule immunomagnetic selection followed by cytokeratin and CD45 immunofluorescence and 4',6diamidino-2-phenylindole staining. We used multicolor fluorescence in situ hybridization to show that CRPC CTCs, metastases, and prostate tissue invariably had the same ERG gene status as therapy-naive tumors (n = 31). We then used quantitative reverse transcription-PCR to show that ERG expression was maintained in CRPC. We also observed homogeneity in ERG gene rearrangement status in CTCs (n = 48) in contrast to significant heterogeneity of AR copy number gain and PTEN loss, suggesting that rearrangement of ERG may be an earlier event in prostate carcinogenesis. We finally report a significant association between ERG rearrangements in therapy-naive tumors, CRPCs, and CTCs and magnitude of prostate-specific antigen decline (P = 0.007) in CRPC patients treated with abiraterone acetate. These data confirm that CTCs are malignant in origin and indicate that hormone-regulated expressio
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