25 research outputs found

    Softening Corners: How a Carefully Considered Hospitality Operation Impacted an Educational Institution

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    Enter quickly, as I am afraid of my happiness! (Derrida, 2000, p.131) This research project is an attempt to bridge the gap between the philosophical ideals of hospitality and the hospitality industry, by examining how a carefully considered hospitality operation impacted an educational institution over the course of eight years. The aim of this study is to demonstrate that the application of the philosophical ideals to a commercial hospitality setting yielded profoundly positive results. The primary research was compiled by the author conducting a case study of her own food business, Luncheonette which was located in the National College of Art and Design in Dublin. A strong motivation behind this thesis is to present an alternative model for hospitality in an institutional setting which could be useful to others. The term Softening Corners, used in the title refers to the additional yielding layer of humanity which thoughtful hospitality can bring to harsh space. This research has been informed by the literature surrounding the philosophy, sociology, etymology and historic origins of hospitality. A qualitative approach was adopted to collect primary research. Nine semi-structured interviews were conducted with students, staff and visitors to the college. The interviews were juxtaposed with a collection of autoethnographic research compiled by the author, outlining the experience, knowledge and skills gained by operating a college canteen which had an unforeseen impact on the institution it served. These two sources of data are treated to a thematic analysis and arranged into seven themes, each one acting as a response to the directive: How to Soften Corners. The findings of this research study reveal that the influence and legacy that this active hospitality practice had on this educational institution was profoundly positive and far beyond any expectations of what an institutional catering operation could achieve

    Dreams and the Dreamers Who Dream Them

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    Structured psychological support for people with personality disorder: feasibility randomised controlled trial of a low-intensity intervention

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    National guidance cautions against low-intensity interventions for people with personality disorder, but evidence from trials is lacking. To test the feasibility of conducting a randomised trial of a low-intensity intervention for people with personality disorder. Single-blind, feasibility trial (trial registration: ISRCTN14994755). We recruited people aged 18 or over with a clinical diagnosis of personality disorder from mental health services, excluding those with a coexisting organic or psychotic mental disorder. We randomly allocated participants via a remote system on a 1:1 ratio to six to ten sessions of Structured Psychological Support (SPS) or to treatment as usual. We assessed social functioning, mental health, health-related quality of life, satisfaction with care and resource use and costs at baseline and 24 weeks after randomisation. A total of 63 participants were randomly assigned to either SPS (n = 33) or treatment as usual (n = 30). Twenty-nine (88%) of those in the active arm of the trial received one or more session (median 7). Among 46 (73%) who were followed up at 24 weeks, social dysfunction was lower (-6.3, 95% CI -12.0 to -0.6, P = 0.03) and satisfaction with care was higher (6.5, 95% CI 2.5 to 10.4; P = 0.002) in those allocated to SPS. Statistically significant differences were not found in other outcomes. The cost of the intervention was low and total costs over 24 weeks were similar in both groups. SPS may provide an effective low-intensity intervention for people with personality disorder and should be tested in fully powered clinical trials

    Effect of the Glycemic Index of Carbohydrates on Acne vulgaris

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    Acne vulgaris may be improved by dietary factors that increase insulin sensitivity. We hypothesized that a low-glycemic index diet would improve facial acne severity and insulin sensitivity. Fifty-eight adolescent males (mean age ± standard deviation 16.5 ± 1.0 y and body mass index 23.1 ± 3.5 kg/m2) were alternately allocated to high or low glycemic index diets. Severity of inflammatory lesions on the face, insulin sensitivity (homeostasis modeling assessment of insulin resistance), androgens and insulin-like growth factor-1 and its binding proteins were assessed at baseline and at eight weeks, a period corresponding to the school term. Forty-three subjects (n = 23 low glycemic index and n = 20 high glycemic index) completed the study. Diets differed significantly in glycemic index (mean ± standard error of the mean, low glycemic index 51 ± 1 vs. high glycemic index 61 ± 2, p = 0.0002), but not in macronutrient distribution or fiber content. Facial acne improved on both diets (low glycemic index −26 ± 6%, p = 0.0004 and high glycemic index −16 ± 7%, p = 0.01), but differences between diets did not reach significance. Change in insulin sensitivity was not different between diets (low glycemic index 0.2 ± 0.1 and high glycemic index 0.1 ± 0.1, p = 0.60) and did not correlate with change in acne severity (Pearson correlation r = −0.196, p = 0.244). Longer time frames, greater reductions in glycemic load or/and weight loss may be necessary to detect improvements in acne among adolescent boys

    Targeting Mre11 overcomes platinum resistance and induces synthetic lethality in XRCC1 deficient epithelial ovarian cancers

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    Platinum resistance is a clinical challenge in ovarian cancer. Platinating agents induce DNA damage which activate Mre11 nuclease directed DNA damage signalling and response (DDR). Upregulation of DDR may promote chemotherapy resistance. Here we have comprehensively evaluated Mre11 in epithelial ovarian cancers. In clinical cohort that received platinum- based chemotherapy (n = 331), Mre11 protein overexpression was associated with aggressive phenotype and poor progression free survival (PFS) (p = 0.002). In the ovarian cancer genome atlas (TCGA) cohort (n = 498), Mre11 gene amplification was observed in a subset of serous tumours (5%) which correlated highly with Mre11 mRNA levels (p < 0.0001). Altered Mre11 levels was linked with genome wide alterations that can influence platinum sensitivity. At the transcriptomic level (n = 1259), Mre11 overexpression was associated with poor PFS (p = 0.003). ROC analysis showed an area under the curve (AUC) of 0.642 for response to platinum-based chemotherapy. Pre-clinically, Mre11 depletion by gene knock down or blockade by small molecule inhibitor (Mirin) reversed platinum resistance in ovarian cancer cells and in 3D spheroid models. Importantly, Mre11 inhibition was synthetically lethal in platinum sensitive XRCC1 deficient ovarian cancer cells and 3D-spheroids. Selective cytotoxicity was associated with DNA double strand break (DSB) accumulation, S-phase cell cycle arrest and increased apoptosis. We conclude that pharmaceutical development of Mre11 inhibitors is a viable clinical strategy for platinum sensitization and synthetic lethality in ovarian cancer

    Psychological Support for Personality (PSP) versus treatment as usual: study protocol for a feasibility randomized controlled trial of a low intensity intervention for people with personality disorder

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    Background: Previous research has demonstrated the clinical effectiveness of long-term psychological treatment for people with some types of personality disorder. However, the high intensity and cost of these interventions limit their availability. Lower-intensity interventions are increasingly being offered to people with personality disorder, but their clinical and cost effectiveness have not been properly tested in experimental studies. We therefore set out to develop a low intensity intervention for people with personality disorder and to test the feasibility of conducting a randomized controlled trial to compare the clinical effectiveness of this intervention with that of treatment as usual (TAU). Methods: A two-arm, parallel-group, single-blind, randomized controlled trial of Psychological Support for Personality (PSP) versus TAU for people aged over 18 years, who are using secondary care mental health services and have personality disorder. We will exclude people with co-existing organic or psychotic mental disorders (dementia, bipolar affective disorder, delusional disorder, schizophrenia, schizoaffective disorder, or schizotypal disorder), those with cognitive or language difficulties that would preclude them from providing informed consent or compromise participation in study procedures, and those who are already receiving psychological treatment for personality disorder. Participants will be randomized via a remote system in a ratio of PSP to TAU of 1:1. Randomization will be stratified according to the referring team and gender of the participant. A single follow-up assessment will be conducted by masked researchers 24 weeks after randomization to assess mental health (using the Warwick and Edinburgh Well-Being Schedule), social functioning (using the Work and Social Adjustment Scale), health-related quality of life (EQ-5D-5 L), incidence of suicidal behavior, satisfaction with care (Client Satisfaction Questionnaire), and resource use and costs using a modified version of the Adult Service Use Schedule. In addition to this, each participant will be asked to complete the patient version of the Clinical Global Impression Scale. Feasibility and acceptability will primarily be judged by study recruitment rate and engagement and retention in treatment. The analysis will focus principally on descriptive data on the rate of recruitment, characteristics of participants, attrition, adherence to therapy, and follow-up. We will explore the distribution of study outcomes to investigate assumptions of normality in order to plan the analysis and sample size of a future definitive trial. Discussion: Most people with personality disorder do not currently receive evidence-based interventions. While a number of high intensity psychological treatments have been shown to be effective, there is an urgent need to develop effective low intensity approaches to help people unable to use existing treatments. PSP is a low intensity intervention for individuals, which was developed following extensive consultation with users and providers of services for people with personality disorder. This study aims to examine the feasibility of a randomized trial of PSP compared to TAU for people with personality disorder

    Housing Trust Funds and Wisconsin: Funding for Lead Hazard Control

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    For PA 869: Public Affairs Workshop, Domestic IssuesThe Wisconsin Department of Health and Family Services seeks funding for the rehabilitation of pre-1950 housing as a way to eliminate childhood lead poisoning in this state. The state constitution prohibits using Wisconsin funds for private building improvements. The authors? analysis examines one option to finance lead hazard control: housing trust funds. The report compares administering a statewide housing trust fund, enabling regional governments to develop their own funds, and working within the confines of the status quo

    Effect of non-invasive positive pressure ventilation (NIPPV) on mortality in patients with acute cardiogenic pulmonary oedema : a meta-analysis

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    Summary Background Non-invasive positive pressure ventilation (NIPPV), using continuous positive airway pressure (CPAP) or bilevel ventilation, has been shown to reduce the need for invasive mechanical ventilation in patients with acute cardiogenic pulmonary oedema. We assessed additional benefits of NIPPV in a meta-analysis. Methods Meta-analysis comparison in acute cardiogenic pulmonary oedema was undertaken to compare (1) CPAP with standard therapy (oxygen by face-mask, diuretics, nitrates, and other supportive care), (2) bilevel ventilation with standard therapy, and (3) bilevel ventilation with CPAP, incorporating randomised controlled trials identified by electronic and hand search (1966–May, 2005). In 23 trials that fulfilled inclusion criteria, we assessed the effect of NIPPV on hospital mortality and mechanical ventilation, estimated as relative risks. Findings CPAP was associated with a significantly lower mortality rate than standard therapy (relative risk 0·59, 95% CI 0·38–0·90, p=0·015). A non-significant trend towards reduced mortality was seen in the comparison between bilevel ventilation and standard therapy (0·63, 0·37–1·10, p=0·11). We recorded no substantial difference in mortality risk between bilevel ventilation and CPAP (p=0·38). The need for mechanical ventilation was reduced with CPAP (0·44, 0·29–0·66, p=0·0003) and with bilevel ventilation (0·50, 0·27–0·90, p=0·02), compared with standard therapy; but no significant difference was seen between CPAP and bilevel ventilation (p=0·86). Weak evidence of an increase in the incidence of new myocardial infarction with bilevel ventilation versus CPAP was recorded (1·49, 0·92–2·42, p=0·11). Heterogeneity of treatment effects was not evident for mortality or mechanical ventilation across patients' groups. Interpretation In patients with acute cardiogenic pulmonary oedema, CPAP and bilevel ventilation reduces the need for subsequent mechanical ventilation. Compared with standard therapy, CPAP reduces mortality; our results also suggest a trend towards reduced mortality after bilevel NIPPV.9 page(s
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