The wicked and complex in education: developing a transdisciplinary perspective for policy formulation, implementation and professional practice

The concept of 'wicked issues', originally developed in the field of urban planning, has been taken up by design educators, architects and public health academics where the means for handling 'wicked issues' has been developed through 'reflective practice'. In the education of teachers, whilst reflective practice has been a significant feature of professional education, the problems to which this has been applied are principally 'tame' ones. In this paper, the authors argue that there has been a lack of crossover between two parallel literatures. The literature on 'wicked issues' does not fully recognise the difficulties with reflective practice and that in education which extols reflective practice, is not aware of the 'wicked' nature of the problems which confront teachers and schools. The paper argues for a fresh understanding of the underlying nature of problems in education so that more appropriate approaches can be devised for their resolution. This is particularly important at a time when the government in England is planning to make teaching a masters level profession, briefly defined by the Quality Assurance Agency for Higher Education (QAA) benchmark statement as 'Decision-making in complex and unpredictable situations'. The paper begins by locating the argument and analysis of 'wicked problems' within the nature of social complexity and chaos. The second part of the paper explores implications for those involved in policy formation, implementation and service provision. Given the range of stakeholders in education, the paper argues for a trans-disciplinary approach recognising the multiple perspectives and methodologies leading to the acquisition of reticulist skills and knowledge necessary to boundary cross. © 2009 Taylor & Francis

110: Non-invasive coronary flow reserve predicts response to exercise in asymptomatic severe aortic stenosis

In patients (pts) with asymptomatic aortic stenosis (AS), exercise stress echocardiography (ESE) provides additional prognostic information beyond baseline. The coronary flow reserve (CFR) is impaired in AS but its link with exertion is missing in this setting. We hypothesize that CFR could predict exercise capacity and an abnormal exercise test in AS.Methodsnon-invasive CFR and symptom limited semi-supine exercise stress echocardiography (ESE) were performed the same morning in 20 consecutive pts with asymptomatic isolated severe AS (mean age 69±12 years, 30% women, mean aortic valve area 0.8±0.1cm2;, mean LVEF 70±6%). CFR was performed in the distal part of the left anterior descending artery using intravenous adenosine infusion (140μg/kg/min over 2min). An abnormal ESE was defined as onset of symptoms at less than 80% of maximum predicted workload, ECG ST-segment depression ≥2mm during exercise, rise of systolic blood pressure < 20mmHg or fall in blood pressure, complex ventricular arrhythmia.Resultswhen compared to pts with normal ESE, pts with an abnormal ESE (n=9) were older, had higher left atrial volume index (all, ≤0.05), and lower CFR (2.1±0.3 vs. 2.9±0.7, ≤0.01), whereas resting hemodynamic variables assessing AS severity were not significantly different between subgroups. Furthermore, CFR was significantly correlated to age, the change of transvalvular pressure gradient and LVEF with exercise, workload (in watts), and exercise duration (all, p<0.05). After adjusting for age, and sex, CFR remained significantly correlated to exercise duration and workload (all, p<0.05). Using a ROC curve analysis, a CFR < 2.17 was the best cut-off to predict an abnormal ESE with a sensitivity of 67%, a specificity of 90% (AUC=0.8, p<0.01).ConclusionIn pts with asymptomatic severe AS, non-invasive CFR is correlated to exercise duration and workload, and a low CFR predicts an abnormal ESE with a good accuracy

Temporal and spatial analysis of the 2014-2015 Ebola virus outbreak in West Africa

West Africa is currently witnessing the most extensive Ebola virus (EBOV) outbreak so far recorded. Until now, there have been 27,013 reported cases and 11,134 deaths. The origin of the virus is thought to have been a zoonotic transmission from a bat to a two-year-old boy in December 2013 (ref. 2). From this index case the virus was spread by human-to-human contact throughout Guinea, Sierra Leone and Liberia. However, the origin of the particular virus in each country and time of transmission is not known and currently relies on epidemiological analysis, which may be unreliable owing to the difficulties of obtaining patient information. Here we trace the genetic evolution of EBOV in the current outbreak that has resulted in multiple lineages. Deep sequencing of 179 patient samples processed by the European Mobile Laboratory, the first diagnostics unit to be deployed to the epicentre of the outbreak in Guinea, reveals an epidemiological and evolutionary history of the epidemic from March 2014 to January 2015. Analysis of EBOV genome evolution has also benefited from a similar sequencing effort of patient samples from Sierra Leone. Our results confirm that the EBOV from Guinea moved into Sierra Leone, most likely in April or early May. The viruses of the Guinea/Sierra Leone lineage mixed around June/July 2014. Viral sequences covering August, September and October 2014 indicate that this lineage evolved independently within Guinea. These data can be used in conjunction with epidemiological information to test retrospectively the effectiveness of control measures, and provides an unprecedented window into the evolution of an ongoing viral haemorrhagic fever outbreak.status: publishe

This Pussy Grabs back: Humour, Digital Affects and Women’s Protest

The “affective” turn has enabled many scholars to theorise media representations not only as texts that can be distantly decoded but also as a matter of emotional attachments, intensities of feelings, synesthetic sensations, and embodied experiences. Yet, what has been less often theorized is how this affective meaningmaking is (re)shaped by the dynamic and interactive nature of social networking systems such as Facebook or Twitter. How do images and the affective qualities that “stick” to them, travel and transform through user engagement where “users grab images and technologies by which they are grabbed in return” (Paasonen, Carnal Resonance 178; Senft 2008). We aim to explore this question further through examples of humorous images from the January 2017 Women’s March, considered within the digital contexts of Facebook and Twitter. Social movement scholars argue that emotional engagement can be a powerful and positive motivating factor in getting people involved in political life, and we here suggest that these humorous images can move the reader in new critical directions, encouraging them to challenge systems of inequality and oppression in contemporary society

When lung cancer was rare: An historical study of prevalence from 1760.

International audienc

Non-Targeted Dried Blood Spot-Based Metabolomics Analysis Showed Rice Bran Supplementation Effects Multiple Metabolic Pathways during Infant Weaning and Growth in Mali

Rice bran contains essential nutrients, antioxidants, and bioactives with anti-inflammatory and diarrheal protective properties important for infants. This 6-month randomized controlled trial investigated the effects of heat-stabilized rice bran supplementation during Malian infant weaning. Fifty healthy 6-month-old infants were randomized to a rice bran intervention (N = 25) or non-intervention control group (N = 25). Intervention infants received dose-escalating rice bran supplementation for 6 months (1–5 g/day). Monthly infant dried blood spot and anthropometric measurements were collected. Dried blood spot metabolite abundances were compared monthly according to diet for six months. Supplementation resulted in favorable weight-for-age and weight-for-length z-score changes. Non-targeted dried blood spot-based metabolomics identified 796 metabolites, of which 33% had significant fold differences between groups (7–12 months). Lipids and amino acids represented 70.6% of the metabolites identified. Rice bran supplementation during infant weaning significantly modulated the metabolites involved in antioxidant defenses and with neuroactive properties including reduced glutathione, glycine, glutamate, cysteinylglycine, tryptophan betaine, and choline. These findings support rice bran as a weaning ingredient to meet infant nutritional requirements and with the potential to reduce oxidative stress and improve cognitive outcomes. This study provides evidence for dried blood spots as a cost-effective tool to detect infant biomarkers of nutritional and metabolic status

Favipiravir pharmacokinetics in Ebola-Infected patients of the JIKI trial reveals concentrations lower than targeted.

BACKGROUND: In 2014-2015, we assessed favipiravir tolerance and efficacy in patients with Ebola virus (EBOV) disease (EVD) in Guinea (JIKI trial). Because the drug had never been used before for this indication and that high concentrations of the drugs were needed to achieve antiviral efficacy against EBOV, a pharmacokinetic model had been used to propose relevant dosing regimen. Here we report the favipiravir plasma concentrations that were achieved in participants in the JIKI trial and put them in perspective with the model-based targeted concentrations. METHODS AND FINDINGS: Pre-dose drug concentrations were collected at Day-2 and Day-4 of treatment in 66 patients of the JIKI trial and compared to those predicted by the model taking into account patient's individual characteristics. At Day-2, the observed concentrations were slightly lower than the model predictions adjusted for patient's characteristics (median value of 46.1 versus 54.3 μg/mL for observed and predicted concentrations, respectively, p = 0.012). However, the concentrations dropped at Day-4, which was not anticipated by the model (median values of 25.9 and 64.4 μg/mL for observed and predicted concentrations, respectively, p<10-6). There was no significant relationship between favipiravir concentrations and EBOV viral kinetics or mortality. CONCLUSIONS: Favipiravir plasma concentrations in the JIKI trial failed to achieve the target exposure defined before the trial. Furthermore, the drug concentration experienced an unanticipated drop between Day-2 and Day-4. The origin of this drop could be due to severe sepsis conditions and/or to intrinsic properties of favipiravir metabolism. Dose-ranging studies should be performed in healthy volunteers to assess the concentrations and the tolerance that could be achieved with high doses. TRIAL REGISTRATION: ClinicalTrials.gov NCT02329054

Observed and adjusted predicted (from the pharmacokinetic model provided by the manufacturer) trough concentrations of favipiravir at Day-2 and Day-4 in the 66 patients included in the PK analysis of the JIKI trial.

<p>Observed and adjusted predicted (from the pharmacokinetic model provided by the manufacturer) trough concentrations of favipiravir at Day-2 and Day-4 in the 66 patients included in the PK analysis of the JIKI trial.</p