Exploring the relationship between baseline physical activity levels and mortality reduction associated with increases in physical activity : a modelling study

Background Increasing physical activity (PA) levels among the general adult population of developed nations is important for reducing premature mortality and the burdens of preventable illness. Assessing how effective PA interventions are as health interventions often involves categorising participants as either ‘active’ or ‘sedentary’ after the interventions. A model was developed showing that doing this could significantly misestimate the health effect of PA interventions. Methods A life table model was constructed combining evidence on baseline PA levels with evidence indicating the non-linear relationship between PA levels and all-cause mortality risks. PA intervention scenarios were modelled which had the same mean increase in PA but different levels of take-up by people who were more active or more sedentary to begin with. Results The model simulations indicated that, compared with a scenario where already-active people did most of the additional PA, a scenario where the least active did the most additional PA was around a third more effective in preventing deaths between the ages of 50 and 60 years. The relationship between distribution of PA take-up and health effect was explored systematically and appeared non-linear. Conclusions As the health gains of a given PA increase are greatest among people who are most sedentary, smaller increases in PA in the least active may have the same health benefits as much larger PA increases in the most active. To help such health effects to be assessed, PA studies should report changes in the distribution of PA level between the start and end of the study

Test-Optional Admission: Why and How?

Scott, E. (2021). Test-Optional Admission: Why and How Throughout my time as an admission counselor, I have come to the conclusion that there are many students who are not served by including a standardized test as a part of their admission application This has lead to the research question addressed in this project Why might test-optional admission be beneficial and what does that mean for a student’s application? Among colleges and universities, there has been a growing trend of adopting test-optional admission policies. Schools have made this decision in large part due to the dubious history of standardized testing (Lemann, 2000), the disparate modern testing outcomes (Bowen et. al, 2009; Mattern et al, 2011; Sanchez & Mattern, 2018), and as a way to live up to their ideals and support their mission (Shanley, 2007). In an already complicated college admission landscape, the COVID-19 pandemic has forced many schools to adopt test-optional policies very quickly and with little standardization, creating confusion for applicants (Stegmeir, 2020) that I see every day in my work as an admission counselor. This device-neutral resource guide project aims to fill the current knowledge gap by providing students with the information and resources they need like explanations of test-optional policies, how applying test-optional may impact their application, and questions to ask of admission professionals. Understanding this information allows students to be more active participants in the college application and decision process and better understand the nuances of test-optional admission

The Artivism Intervention: Can art be used to conscientise artists (Mental Health Service Users) and audience (the general public)?

Social attitudes can be problematic for mental health service user’s (MHSU’s) in everyday settings, medical encounters, at work, and within social networks. The present research ‘The Artivism Intervention’ aimed to generate a proactive intervention to raise awareness of mental illness by producing artwork of MHSU’s experiences to exhibit to the general public. This thesis aims to understand two questions (1) can art be used to conscientise (raise consciousness) amongst artists (MHSUs) and audience (the general public), and (2) are discussions about artwork an effective intervention to raise awareness of mental health stigma and suggest possible solutions? Artivism is a proaction strategy using art as a tool to raise public awareness of Disability and Mental Health Service Users experiences. A mixed methodological approach using a qualitative Thematic Analysis was utilised to examine MHSU’s experiences in studies one (chapter four). The Workshops (study one) were undertaken at Reachout: With Arts in Mind a mental health and arts charity. An exhibition (study two) exhibited MHSU’s artwork (produced by study one), at The University of Stirling Central Library. Questionnaires (study 2A) and group interviews (study 2B) were employed to gauge public views after viewing the exhibition. A quantitative analysis provided numerical findings in study 2A (the questionnaires) and a Thematic Analysis was employed in study 2B (the group interviews). The findings show that new knowledge and conscientisation was produced. However, there was limited evidence of conscientisation in practice, during the art workshop process. Overall, the present research found that ‘The Artivism Intervention’ has the potential to generate positive change and raise awareness of mental illness and disability. The intervention could be incorporated into integrated care pathways providing a supportive role to aid patient recovery in their local communities after hospital discharge

GP perspectives on hospital discharge letters : an interview and focus group study

Background: Written discharge communication following inpatient or outpatient clinic discharge is essential for communicating information to the GP, but GPs’ opinions on discharge communication are seldom sought. Patients are sometimes copied into this communication, but the reasons for this variation, and the resultant effects, remain unclear. Aim: To explore GP perspectives on how discharge letters can be improved in order to enhance patient outcomes. Design & setting: The study used narrative interviews with 26 GPs from 13 GP practices within the West Midlands, England. Method: Interviews were transcribed and data were analysed using corpus linguistics (CL) techniques. Results Elements pivotal to a successful letter were: diagnosis, appropriate follow-up plan, medication changes and reasons, clinical summary, investigations and/or procedures and outcomes, and what information has been given to the patient. GPs supported patients receiving discharge letters and expounded a number of benefits of this practice; for example, increased patient autonomy. Nevertheless, GPs felt that if patients are to receive direct discharge letter copies, modifications such as use of lay language and avoidance of acronyms may be required to increase patient understanding. Conclusion: GPs reported that discharge letters frequently lacked content items they assessed to be important; GPs highlighted that this can have subsequent ramifications on resources and patient experiences. Templates should be devised that put discharge letter elements assessed to be important by GPs to the forefront. Future research needs to consider other perspectives on letter content, particularly those of patients

B-cell maturation antigen (BCMA) in multiple myeloma: rationale for targeting and current therapeutic approaches.

Despite considerable advances in the treatment of multiple myeloma (MM) in the last decade, a substantial proportion of patients do not respond to current therapies or have a short duration of response. Furthermore, these treatments can have notable morbidity and are not uniformly tolerated in all patients. As there is no cure for MM, patients eventually become resistant to therapies, leading to development of relapsed/refractory MM. Therefore, an unmet need exists for MM treatments with novel mechanisms of action that can provide durable responses, evade resistance to prior therapies, and/or are better tolerated. B-cell maturation antigen (BCMA) is preferentially expressed by mature B lymphocytes, and its overexpression and activation are associated with MM in preclinical models and humans, supporting its potential utility as a therapeutic target for MM. Moreover, the use of BCMA as a biomarker for MM is supported by its prognostic value, correlation with clinical status, and its ability to be used in traditionally difficult-to-monitor patient populations. Here, we review three common treatment modalities used to target BCMA in the treatment of MM: bispecific antibody constructs, antibody-drug conjugates, and chimeric antigen receptor (CAR)-modified T-cell therapy. We provide an overview of preliminary clinical data from trials using these therapies, including the BiTE® (bispecific T-cell engager) immuno-oncology therapy AMG 420, the antibody-drug conjugate GSK2857916, and several CAR T-cell therapeutic agents including bb2121, NIH CAR-BCMA, and LCAR-B38M. Notable antimyeloma activity and high minimal residual disease negativity rates have been observed with several of these treatments. These clinical data outline the potential for BCMA-targeted therapies to improve the treatment landscape for MM. Importantly, clinical results to date suggest that these therapies may hold promise for deep and durable responses and support further investigation in earlier lines of treatment, including newly diagnosed MM

Depth perception not found in human observers for static or dynamic anti-correlated random dot stereograms

One of the greatest challenges in visual neuroscience is that of linking neural activity with perceptual experience. In the case of binocular depth perception, important insights have been achieved through comparing neural responses and the perception of depth, for carefully selected stimuli. One of the most important types of stimulus that has been used here is the anti-correlated random dot stereogram (ACRDS). In these stimuli, the contrast polarity of one half of a stereoscopic image is reversed. While neurons in cortical area V1 respond reliably to the binocular disparities in ACRDS, they do not create a sensation of depth. This discrepancy has been used to argue that depth perception must rely on neural activity elsewhere in the brain. Currently, the psychophysical results on which this argument rests are not clear-cut. While it is generally assumed that ACRDS do not support the perception of depth, some studies have reported that some people, some of the time, perceive depth in some types of these stimuli. Given the importance of these results for understanding the neural correlates of stereopsis, we studied depth perception in ACRDS using a large number of observers, in order to provide an unambiguous conclusion about the extent to which these stimuli support the perception of depth. We presented observers with random dot stereograms in which correlated dots were presented in a surrounding annulus and correlated or anti-correlated dots were presented in a central circular region. While observers could reliably report the depth of the central region for correlated stimuli, we found no evidence for depth perception in static or dynamic anti-correlated stimuli. Confidence ratings for stereoscopic perception were uniformly low for anti-correlated stimuli, but showed normal variation with disparity for correlated stimuli. These results establish that the inability of observers to perceive depth in ACRDS is a robust phenomenon

Beyond letting go and moving on: New perspectives on organizational death, loss and grief

Understandings of organizational death, a term used to describe events including downsizing, site closure and business failure, are dominated by psychological stage models that promote letting go as a solution to collective loss. This approach neglects the empirical and conceptual shift which has transformed understandings of bereavement at the individual level through the theory of continuing bonds. This is the consequence of: (i) a managerialist focus on grief as a problem to be solved; (ii) a cultural orientation that constructs relationships between life and death, self and others, positive and negative emotions in dualistic terms and; (iii) an empirical emphasis on North American organizations. We conclude by suggesting how a continuing bonds perspective could enhance understandings of organizational death as a cultural phenomenon that is fundamental to the construction of meaning