67 research outputs found
"Ordinary, the same as anywhere else": notes on the management of spoiled identity in 'marginal' middle class neighbourhoods
Urban sociologists are becoming increasingly interested in neighbourhood as a source of middle-class identity. Particular emphasis is currently being given to two types of middle-class neighbourhood; gentrified urban neighbourhoods of ‘distinction’ and inconspicuous ‘suburban landscapes of privilege’. However, there has been a dearth of work on ‘marginal’ middle-class neighbourhoods that are similarly ‘inconspicuous’ rather than distinctive, but less exclusive, thus containing sources of ‘spoiled identity’. This article draws on data gathered from two ‘marginal’ middleclass neighbourhoods that contained a particular source of ‘spoiled identity’: social renters. Urban sociological analyses of neighbour responses to these situations highlight a process of dis-identification with the maligned object, which exacerbates neighbour differences. Our analysis of data from the ‘marginal’ middle-class neighbourhoods suggests something entirely different and Goffmanesque. This entailed the management of spoiled identity, which emphasized similarities rather than differences between neighbours.</p
Overall survival in patients with endometrial cancer treated with dostarlimab plus carboplatin–paclitaxel in the randomized ENGOT-EN6/GOG-3031/RUBY trial
Background: Part 1 of the RUBY trial (NCT03981796) evaluated dostarlimab plus carboplatin–paclitaxel compared with placebo plus carboplatin–paclitaxel in patients with primary advanced or recurrent endometrial cancer (EC). At the first interim analysis, the trial met one of its dual primary endpoints with statistically significant progression-free survival benefits in the mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) and overall populations. Overall survival (OS) results are reported from the second interim analysis. Patients and methods: RUBY is a phase III, global, double-blind, randomized, placebo-controlled trial. Part 1 of RUBY enrolled eligible patients with primary advanced stage III or IV or first recurrent EC who were randomly assigned (1: 1) to receive either dostarlimab (500 mg) or placebo, plus carboplatin–paclitaxel every 3 weeks for 6 cycles followed by dostarlimab (1000 mg) or placebo every 6 weeks for up to 3 years. OS was a dual primary endpoint. Results: A total of 494 patients were randomized (245 in the dostarlimab arm; 249 in the placebo arm). In the overall population, with 51% maturity, RUBY met the dual primary endpoint for OS at this second interim analysis, with a statistically significant reduction in the risk of death [hazard ratio (HR) = 0.69, 95% confidence interval (CI) 0.54-0.89, P = 0.0020] in patients treated with dostarlimab plus carboplatin–paclitaxel versus carboplatin–paclitaxel alone. The risk of death was lower in the dMMR/MSI-H population (HR = 0.32, 95% CI 0.17-0.63, nominal P = 0.0002) and a trend in favor of dostarlimab was seen in the mismatch repair-proficient/microsatellite stable population (HR = 0.79, 95% CI 0.60-1.04, nominal P = 0.0493). The safety profile for dostarlimab plus carboplatin–paclitaxel was consistent with the first interim analysis. Conclusions: Dostarlimab in combination with carboplatin–paclitaxel demonstrated a statistically significant and clinically meaningful OS benefit in the overall population of patients with primary advanced or recurrent EC while demonstrating an acceptable safety profile.</p
Computerised interpretation of fetal heart rate during labour (INFANT): a randomised controlled trial
Background. Continuous electronic fetal heart-rate monitoring is widely used during labour, and computerised interpretation could increase its usefulness. We aimed to establish whether the addition of decision-support software to assist in the interpretation of cardiotocographs affected the number of poor neonatal outcomes.
Methods. In this unmasked randomised controlled trial, we recruited women in labour aged 16 years or older having continuous electronic fetal monitoring, with a singleton or twin pregnancy, and at 35 weeks’ gestation or more at 24 maternity units in the UK and Ireland. They were randomly assigned (1:1) to decision support with the INFANT system or no decision support via a computer-generated stratified block randomisation schedule. The primary outcomes were poor neonatal outcome (intrapartum stillbirth or early neonatal death excluding lethal congenital anomalies, or neonatal encephalopathy, admission to the neonatal unit within 24 h for ≥48 h with evidence of feeding difficulties, respiratory illness, or encephalopathy with evidence of compromise at birth), and developmental assessment at age 2 years in a subset of surviving children. Analyses were done by intention to treat. This trial is completed and is registered with the ISRCTN Registry, number 98680152.
Findings. Between Jan 6, 2010, and Aug 31, 2013, 47062 women were randomly assigned (23515 in the decision-support group and 23547 in the no-decision-support group) and 46042 were analysed (22987 in the decision-support group and 23055 in the no-decision-support group). We noted no difference in the incidence of poor neonatal outcome between the groups—172 (0·7%) babies in the decision-support group compared with 171 (0·7%) babies in the no-decision-support group (adjusted risk ratio 1·01, 95% CI 0·82–1·25). At 2 years, no significant differences were noted in terms of developmental assessment.
Interpretation. Use of computerised interpretation of cardiotocographs in women who have continuous electronic fetal monitoring in labour does not improve clinical outcomes for mothers or babies
Swimming in a Sea of Shame: Incorporating Emotions into Explanations of Institutional Reproduction and Change
We theorize the role in institutional processes of what we call the shame nexus, a set of shame-related constructs: felt shame, systemic shame, sense of shame, and episodic shaming. As a discrete emotion, felt shame signals to a person that a social bond is at risk and catalyzes a fundamental motivation to preserve valued bonds. We conceptualize systemic shame as a form of disciplinary power, animated by persons’ sense of shame, a mechanism of ongoing intersubjective surveillance and self-regulation. We theorize how the duo of the sense of shame and systemic shame drives the self-regulation that underpins persons’ conformity to institutional prescriptions and institutional reproduction. We conceptualize episodic shaming as a form of juridical power used by institutional guardians to elicit renewed conformity and reassert institutional prescriptions. We also explain how episodic shaming may have unintended effects, including institutional disruption and recreation, when it triggers sensemaking among targets and observers that can lead to the reassessment of the appropriateness of institutional prescriptions or the value of social bonds. We link the shame nexus to three broad categories of institutional work
(Table S1) Diatom abundance according to ice cycles in ANDRILL AND1-1B drill core
The influence of Antarctica and the Southern Ocean on Late Pliocene global climate reconstructions has remained ambiguous due to a lack of well-dated Antarctic-proximal, paleoenvironmental records. Here we present ice sheet, sea-surface temperature, and sea ice reconstructions from the ANDRILL AND-1B sediment core recovered from beneath the Ross Ice Shelf. We provide evidence for a major expansion of an ice sheet in the Ross Sea that began at ~3.3 Ma, followed by a coastal sea surface temperature cooling of ~2.5°C, a stepwise expansion of sea ice, and polynya-style deep mixing in the Ross Sea between 3.3 and 2.5 Ma. The intensification of Antarctic cooling resulted in strengthened westerly winds and invigorated ocean circulation. The associated northward migration of Southern Ocean fronts has been linked with reduced Atlantic Meridional Overturning Circulation by restricting surface water connectivity between the ocean basins, with implications for heat transport to the high latitudes of the North Atlantic. While our results do not exclude low-latitude mechanisms as drivers for Pliocene cooling, they indicate an additional role played by southern high-latitude cooling during development of the bipolar world
Accounting & NPM in UK Local Government - contributions towards accountability
Despite its size and economic importance, accounting in UK local government is still relatively under-researched. Two important developments which have emerged in recent years across the whole public sector are governance and New Public Management. It is timely to study the contribution which local government accounting makes in this changing context. Governance has proved a particularly contentious concept to define. This study has attempted to understand governance from the participants’ perspective and consequently a grounded theory methodology has been used. The empirical research comprised four UK local authority case studies over a twelve month period. The grounded theory developed makes two important contributions to our knowledge of accounting and NPM in relation to governance and accountability in local government. These are the relative importance of accountability rather than governance per se to participants, and the more significant contribution to accountability made by budgeting practices rather than NPM practices such as performance indicators, contracting out of services and Best Value studies. The reasons for these findings are explored and theorised in the paper, using Bourdieu's concept of habitus
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