Perceptions of learner identity amongst students progressing from a Foundation degree to Honours top-up

This study examines perceptions of learner identity and the factors that influence and shape this amongst direct entrants (‘top-up’ students) from Foundation Degree (FD) study in Further Education Colleges (FECs) into year three of an undergraduate Education degree in a large post-1992 Higher Education Institution (HEI). Since the origination of Foundation Degrees (FDs) in 2000-2001, enrolment numbers have borne witness to rapid peaks, a trend that has declined significantly in recent years. Despite the unique temporal nature of this brisk emergence and growth within the UK Higher Education (HE) sector, there is an absence of studies that scrutinise the significance and impact of dual HE experiences for these learners. This creates an opportunity to examine the nature of the capital these students bring with them and the extent to which this is valued, as studies in this area tend to identify these learners as deficient in the skills, knowledge and experience required to flourish in an HEI. Through employing Interpretative Phenomenological Analysis (IPA), this thesis presents the findings of interviews with eight top-up learners progressing from five different FECs at the end of their Honours level year. The study uses the concepts of institutional habitus and capital (identity, social and cultural) to understand their experiences, and illustrates the complexity of the dual institutional habitus these students are required to navigate, and the impact of this upon perceptions of the self as a learner. Findings show that exposure to contrasting institutional habitus and the peripheral nature of participation these learners experience has significant consequences for their inclusion in HE, yet this can be mediated to some degree through the social capital top-up students bring to their learning at an HEI, which can serve as an important contributor to validate their sense of self as authentic learners. This study therefore presents an analysis of a distinctly changeable period of HE provision that is now subject to contraction within a broader climate of farreaching HE proposals and scrutiny, and so makes a timely contribution to debates around diversity and the nature of transformation possible as a result of HE participation

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Burden of mental disorders and unmet needs among street homeless people in Addis Ababa, Ethiopia

BACKGROUND: The impact of mental disorders among homeless people is likely to be substantial in low income countries because of underdeveloped social welfare and health systems. As a first step towards advocacy and provision of care, we conducted a study to determine the burden of psychotic disorders and associated unmet needs, as well as the prevalence of mental distress, suicidality, and alcohol use disorder among homeless people in Addis Ababa, the capital of Ethiopia. METHODS: A cross-sectional survey was conducted among street homeless adults. Trained community nurses screened for potential psychosis and administered standardized measures of mental distress, alcohol use disorder and suicidality. Psychiatric nurses then carried out confirmatory diagnostic interviews of psychosis and administered a locally adapted version of the Camberwell Assessment of Needs Short Appraisal Schedule. RESULTS: We assessed 217 street homeless adults, about 90% of whom had experienced some form of mental or alcohol use disorder: 41.0% had psychosis, 60.0% had hazardous or dependent alcohol use, and 14.8% reported attempting suicide in the previous month. Homeless people with psychosis had extensive unmet needs with 80% to 100% reporting unmet needs across 26 domains. Nearly 30% had physical disability (visual and sensory impairment and impaired mobility). Only 10.0% of those with psychosis had ever received treatment for their illness. Most had lived on the streets for over 2 years, and alcohol use disorder was positively associated with chronicity of homelessness. CONCLUSION: Psychoses and other mental and behavioural disorders affect most people who are street homeless in Addis Ababa. Any programme to improve the condition of homeless people should include treatment for mental and alcohol use disorders. The findings have significant implications for advocacy and intervention programmes, particularly in similar low income settings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12916-014-0138-x) contains supplementary material, which is available to authorized users

Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant

Open Source as Leverage towards Sustainable Housing

Shelter poses global sustainability challenges, as the population increase accelerates and resources dwindle. It is crucial for initiatives addressing the growing housing demand to incorporate a sustainability perspective. Open source, a form of Internet information-sharing, is being utilised by various housing initiatives worldwide. However, a sustainability perspective is not always included in a robust and holistic way, despite the negative impacts for human needs and ecosystems resulting from many aspects of current housing practices. The Framework for Strategic Sustainable Development includes basic conditions for a sustainable society and a planning and decision-making methodology to move systematically towards sustainability. It provides a robust method for organizing, evaluating and using tools to aid in handling sustainability challenges effectively. This thesis aims to contribute to the development of affordable, sustainable design solutions, by modelling the incorporation of the FSSD into open source housing initiatives. A case study of a housing project under development in Ghana is used. Despite the complexity of the system under study, the research concludes that bringing a strategic sustainable development perspective to open source approaches can act as leverage for housing to move towards sustainability. Within this context, guidance is provided for approaching open source housing to contribute to [email protected]</p

More than your degree title: transferable skills, employability and diverse opportunities for education students.

This chapter is salient for current or potential students undertaking a degree in education, looking forward to their own employability after university. Education falls within the social sciences, which is a multi-discipline area and offers graduates diverse careers. There are many paths to take in potential employment, with teaching only one element. By broadening learners’ awareness of workforce shifts, graduate mind-sets and individual qualities, the chapter explores and emphasises creative approaches to career-building in the social sciences. It invites education students to see their holistic value, in terms of their transferable skills, assets and experiences which make them highly employable. It covers attributes that undergraduates may not know employers ask for, in every work setting, such as flexibility, creativity and complex problem solving. The authors support learners to understand their own unique worth and to be confident in identifying their individual assets and experiences to present assertively and positively to employers. This approach aims to help students flourish and find their own fulfilling career