"That's the world standard": a critical ethnography of "Universal" knowledge

This paper analyzes how knowledge is reproduced as "universal" in contemporary higher education and how this production of universality influences the application of knowledge. Using a case study of clinical psychology, it describes the results of over two years of ethnographic fieldwork in a university and professional settings in Singapore with short comparative field studies in Australia and the Netherlands. The results provide critical insights into the cultural effects and knowledge contestations within transnational higher education

Tracking of structural and functional cardiac measures from infancy into school-age

Objective Cardiac structure and function are important predictors for cardiovascular disease in adults. Not much is known about tracking of cardiac measures, other than left ventricular mass, from early life onwards. We examined whether and to what extent cardiac measures track from infancy into school-age. Methods We performed a population-based prospective cohort study among 1072 children. Aortic root diameter, left atrial diameter, left ventricular mass, relative wall thickness and fractional shortening were measured repeatedly by echocardiography. We explored tracking between infancy (1.5, six and 24 months) and school-age (six and 10 years). Results Of all cardiac measures, aortic root diameter, left atrial diameter and left ventricular mass were significantly correlated between infancy and school-age (r = 0.10-0.42, all p-values < 0.01), with the strongest correlations between 24 months and 10 years. Of the different structures, aortic root diameter showed the strongest correlations. Approximately 30% of children who were in the lowest or highest quartile of a measure at the age of 1.5 months remained in that quartile at the age of 10 years. When analysing the effects of the infant cardiac measures on the same outcomes at 10 years in conditional regression models, we observed ef

SAT0583-HPR - Differences between service providers and users when defining feasible optimal NHS occupational therapy treatment for patients with thumb base OA : results from a Delphi study

Background: The OTTER (OsTeoarthritis Thumb ThERapy) trial is a two-year developmental study for a full randomised controlled trial (RCT) into the clinical and cost effectiveness of an occupational therapy and splint intervention for thumb base OA. To develop an optimal package of care for evaluation within a multi-centre RCT, the views of both clinicians and patients are crucial. Objectives: To conduct a Delphi study to obtain agreement between both patients with thumb base OA and AHPs concerning the most appropriate optimal NHS OT programme, splint and placebo splint intervention to use in the RCT. Methods: The Delphi panel consisted of 63 AHPs experienced in treating adults with thumb base OA, and 7 patients with thumb base OA. The panel were asked to rate how much they agreed or disagreed about what optimal NHS OT care for thumb base OA should include, and what method(s) of delivery (individual one-to-one, group, patient leaflets, or telephone advice) they deemed were more appropriate. The Delphi study comprised 3 rounds. A seven-point Likert-type scale was used. Pre-defined inclusion and exclusion criteria were applied in order to reach a final number of statements which, in turn, created the desired tool. Group differences were analysed using Mann-Whitney U tests. Results: Between-groups analyses showed significant differences in the ratings of overall importance of items to be included in an optimal NHS OT consultation (Table 1). Conclusions: AHPs and patients differed in their views about the importance of including ‘Education for Family/Significant Others/Carers’, ‘NHS Clinic Procedures’, ‘Prognosis Advice’, ‘Referral to other Health Care Professional’, ‘Sleep Assessment and Management’ and ‘Treatment Options’ in an optimal NHS OT consultation, and in the methods of delivery used in the consultation. AHPs placed significantly less importance than patients on ‘One-to-One Contact’, ‘Leaflets’ and ‘Telephone Advice’. These findings demonstrate the importance of consulting with patients at an early stage in developing an intervention

Categorical Dimensions of Human Odor Descriptor Space Revealed by Non-Negative Matrix Factorization

In contrast to most other sensory modalities, the basic perceptual dimensions of olfaction remain unclear. Here, we use non-negative matrix factorization (NMF) – a dimensionality reduction technique – to uncover structure in a panel of odor profiles, with each odor defined as a point in multi-dimensional descriptor space. The properties of NMF are favorable for the analysis of such lexical and perceptual data, and lead to a high-dimensional account of odor space. We further provide evidence that odor dimensions apply categorically. That is, odor space is not occupied homogenously, but rather in a discrete and intrinsically clustered manner. We discuss the potential implications of these results for the neural coding of odors, as well as for developing classifiers on larger datasets that may be useful for predicting perceptual qualities from chemical structures

Global and regional brain metabolic scaling and its functional consequences

Background: Information processing in the brain requires large amounts of metabolic energy, the spatial distribution of which is highly heterogeneous reflecting complex activity patterns in the mammalian brain. Results: Here, it is found based on empirical data that, despite this heterogeneity, the volume-specific cerebral glucose metabolic rate of many different brain structures scales with brain volume with almost the same exponent around -0.15. The exception is white matter, the metabolism of which seems to scale with a standard specific exponent -1/4. The scaling exponents for the total oxygen and glucose consumptions in the brain in relation to its volume are identical and equal to $0.86\pm 0.03$, which is significantly larger than the exponents 3/4 and 2/3 suggested for whole body basal metabolism on body mass. Conclusions: These findings show explicitly that in mammals (i) volume-specific scaling exponents of the cerebral energy expenditure in different brain parts are approximately constant (except brain stem structures), and (ii) the total cerebral metabolic exponent against brain volume is greater than the much-cited Kleiber's 3/4 exponent. The neurophysiological factors that might account for the regional uniformity of the exponents and for the excessive scaling of the total brain metabolism are discussed, along with the relationship between brain metabolic scaling and computation.Comment: Brain metabolism scales with its mass well above 3/4 exponen

Association between tocilizumab, sarilumab and all-cause mortality at 28 days in hospitalised patients with COVID-19:A network meta-analysis

BACKGROUND: A recent prospective meta-analysis demonstrated that interleukin-6 antagonists are associated with lower all-cause mortality in hospitalised patients with COVID-19, compared with usual care or placebo. However, emerging evidence suggests that clinicians are favouring the use of tocilizumab over sarilumab. A new randomised comparison of these agents from the REMAP-CAP trial shows similar effects on in-hospital mortality. Therefore, we initiated a network meta-analysis, to estimate pairwise associations between tocilizumab, sarilumab and usual care or placebo with 28-day mortality, in COVID-19 patients receiving concomitant corticosteroids and ventilation, based on all available direct and indirect evidence. METHODS: Eligible trials randomised hospitalised patients with COVID-19 that compared tocilizumab or sarilumab with usual care or placebo in the prospective meta-analysis or that directly compared tocilizumab with sarilumab. Data were restricted to patients receiving corticosteroids and either non-invasive or invasive ventilation at randomisation. Pairwise associations between tocilizumab, sarilumab and usual care or placebo for all-cause mortality 28 days after randomisation were estimated using a frequentist contrast-based network meta-analysis of odds ratios (ORs), implementing multivariate fixed-effects models that assume consistency between the direct and indirect evidence. FINDINGS: One trial (REMAP-CAP) was identified that directly compared tocilizumab with sarilumab and supplied results on all-cause mortality at 28-days. This network meta-analysis was based on 898 eligible patients (278 deaths) from REMAP-CAP and 3710 eligible patients from 18 trials (1278 deaths) from the prospective meta-analysis. Summary ORs were similar for tocilizumab [0·82 [0·71–0·95, p = 0·008]] and sarilumab [0·80 [0·61–1·04, p = 0·09]] compared with usual care or placebo. The summary OR for 28-day mortality comparing tocilizumab with sarilumab was 1·03 [95%CI 0·81–1·32, p = 0·80]. The p-value for the global test of inconsistency was 0·28. CONCLUSIONS: Administration of either tocilizumab or sarilumab was associated with lower 28-day all-cause mortality compared with usual care or placebo. The association is not dependent on the choice of interleukin-6 receptor antagonist

On How Network Architecture Determines the Dominant Patterns of Spontaneous Neural Activity

In the absence of sensory stimulation, neocortical circuits display complex patterns of neural activity. These patterns are thought to reflect relevant properties of the network, including anatomical features like its modularity. It is also assumed that the synaptic connections of the network constrain the repertoire of emergent, spontaneous patterns. Although the link between network architecture and network activity has been extensively investigated in the last few years from different perspectives, our understanding of the relationship between the network connectivity and the structure of its spontaneous activity is still incomplete. Using a general mathematical model of neural dynamics we have studied the link between spontaneous activity and the underlying network architecture. In particular, here we show mathematically how the synaptic connections between neurons determine the repertoire of spatial patterns displayed in the spontaneous activity. To test our theoretical result, we have also used the model to simulate spontaneous activity of a neural network, whose architecture is inspired by the patchy organization of horizontal connections between cortical columns in the neocortex of primates and other mammals. The dominant spatial patterns of the spontaneous activity, calculated as its principal components, coincide remarkably well with those patterns predicted from the network connectivity using our theory. The equivalence between the concept of dominant pattern and the concept of attractor of the network dynamics is also demonstrated. This in turn suggests new ways of investigating encoding and storage capabilities of neural networks

The use of Goal Attainment Scaling in a community health promotion initiative with seniors

<p>Abstract</p> <p>Background</p> <p>Evaluating collaborative community health promotion initiatives presents unique challenges, including engaging community members and other stakeholders in the evaluation process, and measuring the attainment of goals at the collective community level. Goal Attainment Scaling (GAS) is a versatile, under-utilized evaluation tool adaptable to a wide range of situations. GAS actively involves all partners in the evaluation process and has many benefits when used in community health settings.</p> <p>Methods</p> <p>The purpose of this paper is to describe the use of GAS as a potential means of measuring progress and outcomes in community health promotion and community development projects. GAS methodology was used in a local community of seniors (n = 2500; mean age = 76 ± 8.06 SD; 77% female, 23% male) to a) collaboratively set health promotion and community partnership goals and b) objectively measure the degree of achievement, over- or under-achievement of the established health promotion goals. Goal attainment was measured in a variety of areas including operationalizing a health promotion centre in a local mall, developing a sustainable mechanism for recruiting and training volunteers to operate the health promotion centre, and developing and implementing community health education programs. Goal attainment was evaluated at 3 monthly intervals for one year, then re-evaluated again at year 2.</p> <p>Results</p> <p>GAS was found to be a feasible and responsive method of measuring community health promotion and community development progress. All project goals were achieved at one year or sooner. The overall GAS score for the total health promotion project increased from 16.02 at baseline (sum of scale scores = -30, average scale score = -2) to 54.53 at one year (sum of scale scores = +4, average scale score = +0.27) showing project goals were achieved above the expected level. With GAS methodology an amalgamated score of 50 represents the achievement of goals at the expected level.</p> <p>Conclusion</p> <p>GAS provides a "participatory", flexible evaluation approach that involves community members, research partners and other stakeholders in the evaluation process. GAS was found to be "user-friendly" and readily understandable by seniors and other community partners not familiar with program evaluation.</p