Content without context is noise : Looking for curriculum harmony in primary arts education in Western Australia

Arts education in Western Australian primary schools consist of learning opportunities outlined by mandated curriculum. However, assumptions underlying this curriculum involving access, resources and support impact schools’ capacity to implement the curriculum without them being adequately addressed by the written curriculum. Drawing on the policy enactment theory of Ball, Maguire, and Braun (2012), four contextual variables (situated contexts, professional cultures, material contexts and external factors) are used to highlight the differences between the written published curriculum and the implemented, practised curriculum. Drawing on interviews with 24 participants across four schools issues of geographic location, use of arts specialists, appropriate learning spaces and the stresses associated with mandated literacy and numeracy testing are reported as contextual pressures by this study. This paper details the disruptive interference of these contextual pressures that we describe as ‘noise’. The provision of a better understanding of this contextual landscape brings schools and teachers away from the ‘noise’ of disruption and closer to curriculum harmony

Workplace-based interventions to promote healthy lifestyles in the NHS workforce : a rapid scoping and evidence map

Background:The health and well-being of staff working in the NHS is a significant issue for UK health care. We sought to identify research relevant to the promotion of healthy lifestyles among NHS staff on behalf of NHS England. Objectives:To map existing reviews on workplace-based interventions to promote health and well-being, and to assess the scope for further evidence synthesis work. Design:Rapid and responsive scoping search and evidence map. Participants:Adult employees in any occupational setting and in any role. Interventions:Any intervention aimed at promoting or maintaining physical or mental health and well-being. Early intervention initiatives and those addressing violence against staff, workplace bullying or harassment were also included. Main outcome measures:Any outcome related to the effectiveness, cost-effectiveness or implementation of interventions.Data sources:A scoping search of nine databases was conducted to identify systematic reviews on health and well-being at work. Searches were limited by publication date (2000 to January/February 2019). Review methods:The titles and abstracts of over 8241 records were screened and a total of 408 potentially relevant publications were identified. Information on key characteristics were extracted from the titles and abstracts of all potentially relevant publications. Descriptive statistics (counts and percentages) for key characteristics were generated and data from reviews and ‘reviews of reviews’ were used to produce the evidence map. Results:Evidence related to a broad range of physical and mental health issues was identified across 12 ‘reviews of reviews’ and 312 other reviews, including 16 Cochrane reviews. There also exists National Institute for Health and Care Excellence guidance addressing multiple issues of potential relevance. A large number of reviews focused on mental health, changing lifestyle behaviour, such as physical activity, or on general workplace health/health promotion. Most of the reviews that focused only on health-care staff addressed mental health issues, and stress/burnout in particular. Limitations:The scoping search process was extensive and clearly effective at identifying relevant publications, but the strategy used may not have identified every potentially relevant review. Owing to the large number of potentially relevant reviews identified from the scoping search, it was necessary to produce the evidence map using information from the titles and abstracts of reviews only. Conclusions: It is doubtful that further evidence synthesis work at this stage would generate substantial new knowledge, particularly within the context of the NHS Health and Wellbeing Framework published in 2018. Additional synthesis work may be useful if it addressed an identifiable need and it was possible to identify one of the following: (1) a specific and focused research question arising from the current evidence map; it may then be appropriate to focus on a smaller number of reviews only, and provide a more thorough and critical assessment of the available evidence; and (2) a specific gap in the literature (i.e. an issue not already addressed by existing reviews or guidance); it may then be possible to undertake further literature searching and conduct a new evidence review

Union equality structures and the challenge of democratic legitimacy: the case of the Fire Brigades Union

This article examines two commonly adopted trade union strategies to increase the representation of under-represented groups – first, reserved seats on union decision-making bodies and second, self-organisation, involving separate structures. It does so through the case of the Fire Brigades Union (FBU), whose equality reforms were considered remarkable within the union movement and fire service due to the union’s small size and highly male-dominated, white membership. However, reserved seats at senior levels were later removed following objection on the grounds of democratic legitimacy. The article examines this decision using original data comparing UK union rules for additional representation. It exposes the tensions for small, male-dominated unions of reconciling Young’s theoretical principles of ‘group-differentiated democracy’ with the realities of perceived democratic legitimacy, and argues that progress on union equality is contingent on both the particular forms of democratic representation and the political and industrial context

Using Deep Dive Methodology to Investigate an Increased Incidence of Hospital-Acquired Avoidable Category 2 and 3 Pressure Ulcers

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).Background: Between October 2017 and March 2018, the Trust experienced significant winter pressures and an increase in category 2 and 3 hospital-acquired avoidable pressure ulcers. This review aimed to investigate the causal factors of this increase. Methods: A ‘Deep Dive’ review of 37 cases was undertaken in three stages: (i) assurance; ensure the increase was not due to insufficient equipment; (ii) collation of relevant data, including age, length of time in A&E, bed surface, number of internal moves; (iii) analysis identifying factors that might account for the observed increase. Findings: Age combined with prolonged length of time in A&E, being nursed on a trolley followed by three or four internal moves were observed in patients who developed pressure ulcers. Patient age was observed as a key factor, with those over 80 years experiencing pressure ulcers more frequently. Conclusion: The small size of this data suggests a need for the greater awareness of frailty issues in older people, timely assessment and intervention to prevent a chain of detrimental factors might be key to reduce and prevent hospital-acquired avoidable pressure ulcers. Recommendations for immediate action, education and future research have been made to the Trust Quality and Safety Committee.publishedVersio

Ethnic differences in dietary intake at age 12 and 18 months: the Born in Bradford 1000 Study.

OBJECTIVE: To compare the intake of key indicator foods at age 12 months and 18 months between infants of Pakistani and White British origin. DESIGN: Logistic regression was used to model associations between ethnicity and consumption of key indicator foods defined by high or low energy density using an FFQ at age 12 and 18 months. SETTING: Born in Bradford 1000 study, Bradford, UK. SUBJECTS: Infants (n 1259; 38 % White British, 49 % Pakistani), mean age 12·7 (sd 1·0) months and toddlers (n 1257; 37 % White British, 49 % Pakistani), mean age 18·7 (sd1·0) months. RESULTS: At 12 months, Pakistani infants consumed more commercial sweet baby meals than White British infants, with greater odds for being above average consumers (adjusted OR (AOR)=1·90; 95 % CI 1·40, 2·56), more chips/roast potatoes (AOR=2·75; 95 % CI 2·09, 3·62), less processed meat products (AOR=0·11; 95 % CI 0·08, 0·15), more fruit (AOR=2·20; 95 % CI 1·70, 2·85) and more sugar-sweetened drinks (AOR=1·68; 95 % CI 1·29, 2·18). At 18 months these differences persisted, with Pakistani infants consuming more commercial sweet baby meals (AOR=4·57; 95 % CI 2·49, 8·39), more chips/roast potato shapes (AOR=2·26; 95 % CI 1·50, 3·43), more fruit (AOR=1·40; 95 % CI 1·08, 1·81), more sugar-sweetened drinks (AOR=2·03; 95 % CI 1·53, 2·70), more pure fruit juice (AOR=1·82; 95 % CI 1·40, 2·35), more water (AOR=3·24; 95 % CI 2·46, 4·25) and less processed meat (AOR=0·10; 95 % CI 0·06, 0·15) than White British infants. CONCLUSIONS: Dietary intake during infancy and the early toddlerhood period is associated with ethnicity, suggesting the importance of early and culturally adapted interventions aimed at establishing healthy eating behaviours

Genomic variant sharing: a position statement.

Sharing de-identified genetic variant data is essential for the practice of genomic medicine and is demonstrably beneficial to patients. Robust genetic diagnoses that inform medical management cannot be made accurately without reference to genetic test results from other patients, as well as population controls. Errors in this process can result in delayed, missed or erroneous diagnoses, leading to inappropriate or missed medical interventions for the patient and their family. The benefits of sharing individual genetic variants, and the harms of not sharing them, are numerous and well-established. Databases and mechanisms already exist to facilitate deposition and sharing of pseudonomised genetic variants, but clarity and transparency around best practice is needed to encourage widespread use, prevent inconsistencies between different communities, maximise individual privacy and ensure public trust. We therefore recommend that widespread sharing of a small number of individual genetic variants associated with limited clinical information should become standard practice in genomic medicine. Information robustly linking genetic variants with specific conditions is fundamental biological knowledge, not personal information, and therefore should not require consent to share. For additional case-level detail about individual patients or more extensive genomic information, which is often essential for clinical interpretation, it may be more appropriate to use a controlled-access model for data sharing, with the ultimate aim of making as much information as open and de-identified as possible with appropriate consent

Recurrent De Novo NAHR Reciprocal Duplications in the ATAD3 Gene Cluster Cause a Neurogenetic Trait with Perturbed Cholesterol and Mitochondrial Metabolism

Recent studies have identified both recessive and dominant forms of mitochondrial disease that result from ATAD3A variants. The recessive form includes subjects with biallelic deletions mediated by non-allelic homologous recombination. We report five unrelated neonates with a lethal metabolic disorder characterized by cardiomyopathy, corneal opacities, encephalopathy, hypotonia, and seizures in whom a monoallelic reciprocal duplication at the ATAD3 locus was identified. Analysis of the breakpoint junction fragment indicated that these 67 kb heterozygous duplications were likely mediated by non-allelic homologous recombination at regions of high sequence identity in ATAD3A exon 11 and ATAD3C exon 7. At the recombinant junction, the duplication allele produces a fusion gene derived from ATAD3A and ATAD3C, the protein product of which lacks key functional residues. Analysis of fibroblasts derived from two affected individuals shows that the fusion gene product is expressed and stable. These cells display perturbed cholesterol and mitochondrial DNA organization similar to that observed for individuals with severe ATAD3A deficiency. We hypothesize that the fusion protein acts through a dominant-negative mechanism to cause this fatal mitochondrial disorder. Our data delineate a molecular diagnosis for this disorder, extend the clinical spectrum associated with structural variation at the ATAD3 locus, and identify a third mutational mechanism for ATAD3 gene cluster variants. These results further affirm structural variant mutagenesis mechanisms in sporadic disease traits, emphasize the importance of copy number analysis in molecular genomic diagnosis, and highlight some of the challenges of detecting and interpreting clinically relevant rare gene rearrangements from next-generation sequencing data.This article is freely available via Open Access. Click on the publisher URL to access it via the publisher's site.We acknowledge funding from Wellcome ( 200990 ). S.E. is a Wellcome Senior Investigator. U.F.P. is supported by a predoctoral fellowship from the Basque Government ( PRE_2018_1_0253 ). M.M.O. is supported by a predoctoral fellowship from the University of the Basque Country ( UPV/EHU, PIF 2018 ). I.J.H. is supported by the Carlos III Health Program ( PI17/00380 ), and País Vasco Department of Health ( 2018111043 ; 2018222031 ). A.S. is supported by the UK Medical Research Council with a Senior Non-Clinical Fellowship ( MC_PC_13029 ). T. Harel is supported by the Israel Science Foundation grant 1663/17 . W.H.Y. is supported by the National Institute of General Medical Sciences of the National Institutes of Health through grant 5 P20 GM103636-07 . J.R.L. is supported by the US National Institute of Neurological Disorders and Stroke ( R35NS105078 ), the National Institute of General Medical Sciences ( R01GM106373 ), and the National Human Genome Research Institute and National Heart Lung and Blood Institute (NHGRI/NHBLI) to the Baylor-Hopkins Center for Mendelian Genomics (BHCMG, UM1 HG006542 ). R.W.T. is supported by the Wellcome Centre for Mitochondrial Research ( 203105/Z/16/Z ), the Medical Research Council (MRC) International Centre for Genomic Medicine in Neuromuscular Disease , Mitochondrial Disease Patient Cohort (UK) ( G0800674 ), the UK NIHR Biomedical Research Centre for Aging and Age-related disease award to the Newcastle upon Tyne Foundation Hospitals NHS Trust, the MRC/EPSRC Molecular Pathology Node , The Lily Foundation , and the UK NHS Highly Specialised Service for Rare Mitochondrial Disorders of Adults and Children . The DDD study presents independent research commissioned by the Health Innovation Challenge Fund (grant number HICF-1009-003). This study makes use of DECIPHER, which is funded by Wellcome. See Nature PMID: 25533962 or https://www.ddduk.org/access.html for full acknowledgment.pre-print, post-print (6 month embargo

Coney: Better Than Life

We are in a period of significant change. The interconnectivity that the web offers and the quick rise of pervasive media has changed how we communicate with each other, how we access information, how we experience news, stories and the world. These changes have had a deep impact on storytellers of all kinds. The tools we use to tell tales are evolving, becoming more modular and tailored, more participatory and more engaging than just the printed word or the moving image. These new forms of digitally-enabled storytelling move beyond reinterpreting a text for radio or screen. We need to find new structures, and new relationships with audiences. Better Than Life, led by Coney, an immersive theatre company that specialises in creating new forms of responsive playing theatre, brought together an extraordinary multidisciplinary team involving award-winning interactive theatre makers, digital broadcasters, developers, multi-platform creatives, academics, VR experts, a magician and many more. We wanted to create a project that focused, in particular, on how live performance fits into the landscape of this terra nova. The aim was to see how to create an event for a large online audience that combined digital connectivity and interactivity with the liveness and shared experience of theatre. In particular, we wished to understand what kinds of agency and control audiences might want and enjoy when engaging with this new form of live performance, and we set up a system that allowed both audiences - in the live space and online - to participate in and comment upon the show in several new ways. A total of eight public rehearsals and performances took places in June 2014, with over 300 people taking part either in the live space or online. At the end of the R&D process there emerged a narrative of a new medium. The material in the R&D wasn’t normal theatre and it wasn’t quite broadcast and it wasn’t a game. It was a cultural experience that built on the live-storytelling and visceral nature of theatre, but combined it with the social interaction of MMO (Massively multiplayer online role-playing games) and the delivery infrastructure of online broadcast. The show was held at a ‘secret’ location in London, with 12 people attending and entering the fictional world of the “Positive Vision Movement” (PVM). In the live space, the audience promenaded through the storyworld of the PVM, following three actors, playing, solving puzzles, chatting, debating and witnessing magic as they went. Online, people spoke and instructed characters, found commentary, spoke to each other, made choices and switched camera views at will. At points, the online audience could even take control of lighting in the space in order to create specific atmospheres, or shine light on a particular place or person. In every show the audiences were monitored carefully, questioned at various stages within the show and, in some cases, interviewed in depth about the experience. Interestingly interactivity - the ability to ‘take control’ of a situation, make a decision about plot or performance or change the mood through lighting or sound - was not rated as highly, by either audience, as the opportunities to socialise and engage with each other. Data suggests that the online audience, in particular, enjoyed the ability to form strong social bonds each other, and that they favoured elements of the show in which they were able to connect and communicate directly with performers in the show. This would suggest that this new kind of hybridised digitally-driven storytelling and play environment is seen first and foremost, as an opportunity to connect with others in a theatrical context - interacting with each other more as one might at a music festival or a house party. This is not then simply theatre with an online component bolted on. For the three R&D partners, the project was also a great ‘social’ success in terms of what we learned from each other. The project genuinely worked within the gaps of the knowledge overlaps between Coney, Goldsmiths and Showcaster, and we pushed each other to deliver a project with as many interesting new features as we could cram into one production space. Better Than Life explored what is possible - and proved that hybridised models of entertainment and performance can open up experiences to audiences that genuinely span beyond the geographic boundaries of a single location or building

Innate Immunity in Human Embryonic Stem Cells: Comparison with Adult Human Endothelial Cells

Treatment of human disease with human embryonic stem cell (hESC)-derived cells is now close to reality, but little is known of their responses to physiological and pathological insult. The ability of cells to respond via activation of Toll like receptors (TLR) is critical in innate immune sensing in most tissues, but also extends to more general danger sensing, e.g. of oxidative stress, in cardiomyocytes. We used biomarker release and gene-array analysis to compare responses in hESC before and after differentiation, and to those in primary human endothelial cells. The presence of cardiomyocytes and endothelial cells was confirmed in differentiated cultures by immunostaining, FACS-sorting and, for cardiomyocytes, beating activity. Undifferentiated hESC did not respond with CXCL8 release to Gram positive or Gram negative bacteria, or a range of PAMPs (pathogen associated molecular patterns) for TLRs 1-9 (apart from flagellin, an activator of TLR5). Surprisingly, lack of TLR-dependent responses was maintained over 4 months of differentiation of hESC, in cultures which included cardiomyocytes and endothelial cells. In contrast, primary cultures of human aortic endothelial cells (HAEC) demonstrated responses to a broad range of PAMPs. Expression of downstream TLR signalling pathways was demonstrated in hESC, and IL-1β, TNFα and INFγ, which bypass the TLRs, stimulated CXCL8 release. NFκB pathway expression was also present in hESC and NFκB was able to translocate to the nucleus. Low expression levels of TLRs were detected in hESC, especially TLRs 1 and 4, explaining the lack of response of hESC to the main TLR signals. TLR5 levels were similar between differentiated hESC and HAEC, and siRNA knockdown of TLR5 abolished the response to flagellin. These findings have potential implications for survival and function of grafted hESC-derived cells