Does aspirin detract from the benefits of mineralocorticoid receptor antagonists in patients with heart failure and a reduced left ventricular ejection fraction? Probably!

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Teaching Chang-rae Lee’s _Aloft_: Exploring the Limits of Race and Ethnicity

Chang-rae Lees 2004 novel Aloft may not be his most famous work, but it is a highly effective classroom text. In its contemporary, multicultural, suburban setting, it portrays a world that students recognize; simultaneously, however, it can effectively challenge their assumptions about ethnic American literature. The novel centers on Jerry Battle, an amateur pilot who distances himself from his problems in his private jet, and explores the problems of four generations of his multi-ethnic family. The Battles, with both Italian and Korean heritage, are representative of the current landscape of race and ethnicity in America; mixed-race identities have become accepted and popularized through the election of Barack Obama, the visibility of celebrities such as Tiger Woods, Salma Hayek, and Shakira (to name just a few), and the changes to the U.S. Census in 2000 that allowed respondents to select more than one race when describing themselves. In its portrayal of contemporary demographics, Aloft contrasts with earlier classics of ethnic American literature. Commonly autobiographical or based closely on the authors life, such works have typically relied on factuality and personal identity to combat racism, educate outsiders, articulate the challenges of belonging to a minority group in the United States, and express pride in personal heritage and community. Aloft, however, is narrated by an Italian American character, rather than a Korean American like the author, causing students to question their expectations of ethnic writing. Furthermore, Jerrys identity provides a framework for discussing whiteness, so often an invisible category. As Jerry recounts his familys history, from impoverished immigrants to business owners, it is apparent that this upward mobility is bound up in the eventual acceptance of Italians as white rather than racially other (although the novel also helps to clarify continuing stereotypical attitudes toward Italian Americans). The Battle familys transition into whiteness also raises issues of class. Aloft highlights the ways that race and class are linked, and questions whether the American Dream is really achievable or sustainable. Finally, the novel features characters and situations that students are interested in; they enjoy discussing the characters decisions and exploring the books themes and symbolism. The appeal of the story itself helps the class to rethink their expectations about race, class, and ethnicity

Simulation-based education : what's it all about?

Funding information: Funder : Clinical Skills Managed Educational Network (CSMEN)Peer reviewedPublisher PD

The qualitative orientation in medical education research

Peer reviewedPublisher PD

Reinforcement Learning for Racecar Control

This thesis investigates the use of reinforcement learning to learn to drive a racecar in the simulated environment of the Robot Automobile Racing Simulator. Real-life race driving is known to be difficult for humans, and expert human drivers use complex sequences of actions. There are a large number of variables, some of which change stochastically and all of which may affect the outcome. This makes driving a promising domain for testing and developing Machine Learning techniques that have the potential to be robust enough to work in the real world. Therefore the principles of the algorithms from this work may be applicable to a range of problems. The investigation starts by finding a suitable data structure to represent the information learnt. This is tested using supervised learning. Reinforcement learning is added and roughly tuned, and the supervised learning is then removed. A simple tabular representation is found satisfactory, and this avoids difficulties with more complex methods and allows the investigation to concentrate on the essentials of learning. Various reward sources are tested and a combination of three are found to produce the best performance. Exploration of the problem space is investigated. Results show exploration is essential but controlling how much is done is also important. It turns out the learning episodes need to be very long and because of this the task needs to be treated as continuous by using discounting to limit the size of the variables stored. Eligibility traces are used with success to make the learning more efficient. The tabular representation is made more compact by hashing and more accurate by using smaller buckets. This slows the learning but produces better driving. The improvement given by a rough form of generalisation indicates the replacement of the tabular method by a function approximator is warranted. These results show reinforcement learning can work within the Robot Automobile Racing Simulator, and lay the foundations for building a more efficient and competitive agent

What factors are critical to attracting NHS foundation doctors into specialty or core training?:A discrete choice experiment

Our thanks to all those who participated in developing and piloting the DCE and completing the survey. With thanks to NHS Education for Scotland for merging the DCE onto the destination survey. Funding: NHS Education for Scotland funded this programme of work.Peer reviewedPublisher PD

Online peer assessment: helping to facilitate learning through participation

The focus of this paper is on the combination of enquiry-based learning, information literacy and e-learning and how they are embedded in an online peer assessment exercise. What it shall present is a structure and strategy that aids student learning in the short and long-term. Ninety eight students completed a questionnaire before and after a three-week online peer assessment exercise during a first year undergraduate research and study skills module. The results demonstrate that a significant number of students valued the design of the exercise and the benefits it can have on their future learning and development. The paper concludes by suggesting that new and innovative ways of assessment are needed to keep engaging students and develop their learning in different ways

The public sector's role in infertility management in India.

This objective of this paper is to explore the public sector's role in infertility management in India. It focuses on services available in the public sector, problems faced by and critiques of public sector providers. A postal survey was conducted with a sample of 6000 gynaecologists and in-depth interviews were conducted with 39 gynaecologists in four cities. The role of the public sector in infertility management is weak as even basic investigations and services were limited or incomplete. Inadequate infrastructure, inappropriate management including time management, lack of information and training, absence of clear protocols at all levels, private practice by public health doctors, pre-occupation with other health issues and lack of regulation were the main problems mentioned by providers. Amongst key recommendations are realistic and low-cost management, streamlining and regulating services, counselling of couples, providing information and raising awareness of patients, health personnel and policy makers

Monthly economic review: May 2014

The Monthly Economic Review is an overview of the New Zealand economy. It includes the latest data on New Zealand’s economic growth, unemployment, inflation, merchandise trade and balance of payments figures, along with certain financial data (such as the Reserve Bank’s official cash rate). The unemployment rate, economic growth and central bank interest rates for several of our main OECD trading partners are also included. Each publication highlights a specific topic of interest. The Monthly Economic Review is produced eleven times per year. Recent data and events New Zealand’s unemployment rate remained at six percent in the March 2014 quarter, with a 0.9 percent rise in both employment and the labour force over the quarter. The labour force participation rate, at 69.3 percent, rose to its highest level since the survey commenced in the 1980s. There was an increase in both full-time and part-time employment, with full-time employment rising by 1.1 percent over the quarter and parttime employment rising by 0.3 percent. New Zealand’s unemployment rate was the 11th lowest in the OECD. Inflation was 0.3 percent in the March 2014 quarter, resulting in an annual inflation rate of 1.5 percent in the year to the March quarter. In the March quarter, an 11.3 percent rise in the excise duty on tobacco and tobacco products from 1 January 2014 was a significant driver to higher consumer prices. Costs associated with the purchase of newly built houses rose by 1.2 percent. Reserve Bank Governor, Graeme Wheeler, lifted the official cash rate by a further 25 basis points to three percent in April. This followed the commencement of a tightening in monetary policy in March, where the official cash rate was also lifted by 25 basis points. In the latest media release, the Governor commented that economic activity has gained considerable momentum, reducing spare capacity within the economy, and leading to inflationary pressures. This has been offset by a higher exchange rate, which has resulted in lower tradables inflation. The exchange rate on a trade weighted basis has reached a new peak since it was floated. During the month of April, the trade weighted index (TWI) averaged 80.2 index points. The Reserve Bank considers the exchange rate to be overvalued. The Governor commented that the Bank has the policy option of intervening in the currency if it thought the exchange rate was significantly out of line with economic fundamentals

Extent of sexual coercion among young female migrant carpet and garment factory workers in Nepal

This paper explores sexual coercion of young female migrant workers in the carpet and garment factories in the Kathmandu Valley. Information is drawn from 12 in-depth case histories and a sample survey of 550 respondents aged 14-19 years. The survey found that one in ten young women had ever experienced sexual harassment or coercion in their lifetime. Perpetrators included co-workers, boyfriends, employers and relatives. In-depth interviews revealed that the inability of young working women to communicate effectively with their peers and sex partners, lack of self esteem, job insecurity and other socio-economic problems made them vulnerable to these abuses. The results suggest the need for a range of factory-based interventions