Safety and efficacy of vismodegib in patients aged ≥65 years with advanced basal cell carcinoma.

Because many patients with unresectable basal cell carcinoma (BCC) are aged ≥65 years, this study explores the efficacy and safety of vismodegib in these patients with locally advanced (la) or metastatic (m) basal cell carcinoma (BCC) in the ERIVANCE BCC trial and the expanded access study (EAS).We compared patients aged ≥65 years to patients aged <65 years taking vismodegib 150 mg/day, using descriptive statistics for response and safety. Patients aged ≥65 years (laBCC/mBCC) were enrolled in ERIVANCE BCC (33/14) and EAS (27/26). Investigator-assessed best overall response rate in patients ≥65 and <65 years was 46.7%/35.7% and 72.7%/52.6% (laBCC/mBCC), respectively, in ERIVANCE BCC and 45.8%/33.3% and 46.9%/28.6%, respectively, in EAS. These differences were not clinically meaningful. Safety was similar in both groups, although those aged ≥65 years had a higher percentage of grade 3-5 adverse events than those aged <65 years. Vismodegib demonstrated similar clinical activity and adverse events regardless of age

Can practice make perfect (models)? Incorporating social practice theory into quantitative energy demand models

Demand response could be increasingly valuable in coping with the intermittency of a future renewables-dominated electricity grid. There is a growing body of work being done specifically on understanding demand response from a people and practices point of view. This paper will start by introducing some of the recent research in this area and will present social practice theory (SPT) as a useful way of looking at the flexibility and timing of energy-use practices. However, for the insights gained from SPT to have value for the electricity supply industry it is important to be able to represent this flexibility in quantitative energy demand models. This requires an interdisciplinary conversation that allows SPT and modelling concepts to be mapped together. This paper presents an initial step in trying to achieve this. Drawing on empirical data from a recent SPT study into flexible energy-use practices, it will experiment with modelling flexible demand in such a way as to take account of the complexity of practices; not just their ‘stuff’ but also some of the images and skills involved in their competent performance. There are several reasons this is a useful enterprise. It encourages interdisciplinary insights which are valuable both to social practice theory and to energy demand modelling, it highlights new ways of intervening in flexible demand and it establishes a research agenda for social practice theorists and modellers which will eventually result in a set of requirements that can be used to build an energy demand model based on practice theory. This area of research is in its early stages and so the conceptual mapping is necessarily speculative but, hopefully, also stimulating

Convergence of Indigenous Science and Western Science Impacts Student\u27s Interest in STEM and Identity as a Scientist

Within the context of North American Indigenous culture, certain Elders are respected gatekeepers to Indigenous science, also known as traditional knowledge. Yet, while North American born minorities such as Black Americans, Amerindians, and Latin Americans may hail from cultures with a similar appreciation of their own Indigenous science Elders, these minority groups are especially underrepresented in Western science, technology, engineering, and math (STEM)—both in academia and in the workforce. North American underrepresented minorities experience high attrition rates in academia generally, and in STEM specifically. Canada’s Truth and Reconciliation Commission makes a call to action to Indigenize education to benefit all students. Herein lies an opportunity to investigate the impact of Indigenization of a Western science biochemistry course to assess the impact upon university students, both minority (non-White) and non-minority (White) in Anglophone North America (Canada and USA). The aim of the study is to investigate the impact of an Indigenized Western science online course upon student interest in STEM, student perception of the relevance of Elder co-instructors, and student identity as a scientist. A pedagogical quasiexperiment was conducted at North American tribal colleges and mainstream research-intensive universities, regarding an online science course taught either with or without Elder co-educators alongside PhD STEM-trained instructors. Student perceptions of the value of Elder co-educators did not differ across groups and remained unchanged after course delivery. Findings also show that after taking the course co-taught by Indigenous science Elder co-educators, students have significantly greater interest in STEM than those students not exposed to Elders’ teachings. Non-White students reported significantly less self-identification as a scientist than did White students at pre-course, but reported similar identity as a scientist to White students post-course. We attribute these findings to the impact of culturally competent course content to minority students especially. This work establishes the relevance of using online technology to Indigenize a Western science course taught internationally, and suggests the need for more investigative work toward the convergence of Indigenous science and Western science in academia

Promoting co-production in the generation and use of research evidence to improve service provision in special care dentistry

Special care dentistry (SCD) provides holistic oral service provision for people with complex health and care needs. These can include physical, sensory, intellectual, mental, medical, emotional or social impairment or disability or, more often, a combination of these factors. The level of disability within these population groups can vary, and a proportion of people will have multiple and overlapping impairments and/or medical conditions. This paper explores a number of possible research methods that may better reflect the diversity and challenges of this population group, where the emphasis is placed on co-production and co-design

Childhood contact with social services and self-harm and suicidal ideation in young adulthood: A population-wide cohort study in Northern Ireland

Objectives Childhood contact with social services is associated with adult suicide risk, but little is known about self-harm and suicidal ideation, which are recognised predictors of suicide. This study compares self-harm (SH) and suicidal ideation (SI) in young adults with childhood history of social services contact to unexposed peers. Method A longitudinal, population-wide study of all children born 1985-1993 in Northern Ireland (NI) linking primary care registrations to social services data (1985-2015) and a national registry capturing all SH and SI presentations to the 12 Emergency Departments in NI (2012-2015). Multilevel logistic regression models estimated the association between level of contact with social services in childhood (no contact; referred but assessed as not in need (NIN); child in need (CIN); and child in care (CIC)) and SH, SI and any SH/SI, accounting for confounders and the amount of variation attributable to clustering by Health and Social Care Trust. Results The cohort comprised 253,495 individuals (ages 18-30 years) alive and registered with a general practitioner during follow-up. Of the cohort, 4,026 presented with SH and 1,669 with SI. Individuals with a childhood history of social services contact comprised 10.8% of the cohort (2.9% NIN; 6.5% CIN; and 1.4% CIC) yet accounted for 40.9% of SH/SI cases. Likelihood of SH, SI, and any SH/SI increased stepwise with level of contact with social services. After full adjustment, young adults deemed NIN in childhood were three times more likely to present with SH/SI (OR 3.45 [95% CI 3.07-3.88]), former CIN five times more likely (OR 5.33 [95% CI 4.97-5.74]), and former CIC ten times more likely (OR 10.49 [95% CI 9.45-11.66]), relative to those with no contact. Conclusion Adults with a childhood history of social services contact, including those assessed as not in need, account for a disproportionate number of self-harm and suicidal ideation cases. Timely and targeted interventions aimed at this population have the potential to reduce the burden of self-harm and suicid