Categorisation of built environment characteristics: the trouble with tertiles

BACKGROUND: In the analysis of the effect of built environment features on health, it is common for researchers to categorise built environment exposure variables based on arbitrary percentile cut-points, such as median or tertile splits. This arbitrary categorisation leads to a loss of information and a lack of comparability between studies since the choice of cut-point is based on the sample distribution. DISCUSSION: In this paper, we highlight the various drawbacks of adopting percentile categorisation of exposure variables. Using data from the SocioEconomic Status and Activity in Women (SESAW) study from Melbourne, Australia, we highlight alternative approaches which may be used instead of percentile categorisation in order to assess built environment effects on health. We discuss these approaches using an example which examines the association between the number of accessible supermarkets and body mass index. We show that alternative approaches to percentile categorisation, such as transformations of the exposure variable or factorial polynomials, can be implemented easily using standard statistical software packages. These procedures utilise all of the available information available in the data, avoiding a loss of power as experienced when categorisation is adopted.We argue that researchers should retain all available information by using the continuous exposure, adopting transformations where necessary

James Spratt White, Sr. Papers - Accession 547

This collection consists of the papers of Reverend James Spratt White, Sr. (1841-1891) who was a Presbyterian minister who served in Americus, Georgia, and Chester County, South Carolina. The collection consists of White’s Civil War amnesty oath, sermons, newspaper clippings, view books, and photographs from Le Bosphore (Bosporus), France, Greece, Jerusalem, London, Venice, Washington (D.C.), Constantinople, Damascus, the Holy Land, Paris, and North Carolina.https://digitalcommons.winthrop.edu/manuscriptcollection_findingaids/2642/thumbnail.jp

Virtual patient educational programme to teach counselling to clinical pharmacists: development and proof of concept

Pharmacist–patient counselling can benefit patients and optimise care, but appropriate training is required. A virtual patient (VP) tool to teach pharmacists non-vitamin K oral anticoagulant counselling was developed; the VP may be used for continuing professional development. The objective was to develop and show proof of concept of the VP. A cyclic development approach was adopted whereby the client, developers and a steering group informed VP design, content and aesthetic. This included formal and informal evaluation; ethical approval was not required. The VP received varied feedback. Positive feedback concerned the technology and the high-standard of animations. Negative elements concerned international VP use and differences in practice, also technological comments, regarding VP delivery and usability on various electronic devices. The VP was reported to be ‘valuable’ and realistic with high-quality animations. The steering group commented on VP’s clinical appropriateness, cultural relevance and usability. Areas highlighted for improvement were rectified during development, including the incorporation of printable feedback. European considerations concerned differences in culture and practice. The development process successfully developed the VP and the proof of the concept was demonstrated. This will inform future VP development; a large-scale VP evaluation is underway

Endophytes and heat tolerance in lambs grazing perennial ryegrass

Paper presented at the 56th New Zealand Grassland Association Conference, 17-20 October 1994, Hanmer Springs.Endophytes in perennial ryegrass protect their hosts against attack by Argentine stem weevil but cause adverse affects, including heat stress, in grazing animals. Ten lambs were grazed on Grasslands Nui ryegrass without endophyte or with its wildtype or a high ergovaline-producing endophyte (196). Five lambs from the 196 treatment were swapped for 5 on the endophyte-free treatment after 20 days. Rectal temperatures and respiration rates were measured daily; on one day they were measured every 2-4 hours. There was a significant difference in respiration rate and body temperature between lambs grazing endophyte and endophyte free treatments but not between the two endophyte treatments. There was no interaction with ambient temperature within the range 12-30°C. When lambs where transferred from toxic to non-toxic treatments there was no significant decrease in body temperature or respiration rate witbin 14 days. Ergovaline, even at low concentrations, affects thermo-regulation in lambs and is undesirable in perennial ryegrass endophyte associations.Meat Research and Development Council

Virtual patients as a tool for training pre-registration pharmacists and increasing their preparedness to practice: A qualitative study

Virtual patients are an active learning pedagogical tool which simulate clinical scenarios in a three-dimensional environment. Their use in pharmacy education is under-researched in comparison to other healthcare professions. In the United Kingdom, pre-registration training refers to a year of workplace based training which pharmacy graduates must complete prior to professional registration as pharmacists. This study aimed to evaluate pre-registration pharmacists’ perceptions on the integration, usefulness and enjoyment of completing virtual patient simulations or non-interactive case studies as part of their training. Pre-registration trainees completed three virtual patient simulations or three non-interactive case studies on the topics of: emergency hormonal contraception, renal function and childhood illnesses. Telephone interviews were conducted with twenty pre-registration pharmacists, exploring their perspectives on the use of the virtual patient or non-interactive case studies. Data was analysed using the five-stage framework approach. Four main themes emerged from the data: case study design; usefulness of the case studies as a training tool; support in pre-registration training; utility of the learning tools. Trainees also identified technical issues they had experienced while completing the virtual patient simulations, specifically with keyword recognition. Pre-registration trainees who used the virtual patients provided comments relating to the novelty, realism and enjoyment in completing them. Trainees in both groups reported developing knowledge and skills from completing the case studies; those who used the virtual patient commented on the development of communication skills and an increase in confidence for practice and those who used the non-interactive cases focused on knowledge acquisition and numeracy. Participants were enthusiastic about virtual patients as a novel training tool which provided an opportunity for learners to practice realistic scenarios in a safe environment. Virtual patients offer the potential to ‘bridge the gap’ in pharmacist pre-registration sector-related training variation, promote learning through reflection on doing and increase overall preparedness for practice

Actual vs. Perceived Competency Development-How Can Virtual Patients Impact Pharmacist Pre-Registration Training?

Virtual patients are an active learning pedagogical tool that simulate clinical scenarios. There is an established disparity in pre-registration examination pass rates depending on whether individuals complete their training in a community or hospital pharmacy. This study aimed to evaluate virtual patient (VP) and non-interactive (NI) case studies, concerning knowledge, skill and confidence development of pre-registration pharmacist trainees. A quasi-experimental evaluation was conducted. Pre-registration pharmacists completed three VP or NI case studies. Each case study was associated with a pre-and post-knowledge quiz. Pre-registration trainees were invited to complete a questionnaire consisting of Likert ranking statements and open-ended questions on the case study features, usability and individual development. Both learning tools significantly improved trainees' knowledge on the topic areas (except for the NI group in case study 3). Although no significant differences in knowledge improvement were identified between the learning tools, trainees who used the VP reported the development of a wider knowledge base and skill set, an increase in confidence for practice and an opportunity to apply their learning. The sector in which pre-registration pharmacists were completing their training (community or hospital) had a significant impact on knowledge improvement in the three case studies. Future research evaluating VPs with pre-registration and qualified pharmacists should be conducted to explore their benefits and establish their effectiveness as learning tools

Gilles Deleuze and the Project of Architecture: An Expressionist Design-Research Methodology

This thesis analyses the potential of the Deleuzian philosophical concept of 'expressionism' in accounting for and driving architectural design and research. An expansive literature considering the import of Deleuze in architecture is characterised by his simultaneous use in both poles of debates concerning Critical architecture at the centre of mainstream practice and as foundational source for minoritorian approaches to both design and research. Identifying this contemporary vacillation as a reiteration of traditional reductions of design to products or processes, and seeking development of an alternative trajectory, I propose the architectural project as an 'embodied' epistemological and ontological third term of an expressionist account of architectural design‐research. A series of critical encounters between philosophy and architecture exploring the accounts and practices of Robin Evans, Rem Koolhaas, Peter Eisenman and both professional and pedagogic design‐research undertaken by the author, articulate six key principles of a non‐representational, expressionist methodology for design and research in architecture. First 'expressionism' insists on a substantive distinction between nominal and real denying any essentialist component to architectural products or production. An encounter with Evans shows how architectural bodies both produce and are constituted by 'projective relations' external to architect, drawing and discipline. Koolhaas and Eisenman's divergent positions then demonstrate how projective distinctions are always embodied in two actual forms which select content and express an exterior. Fifth, a design for a non-human 'client' makes explicit the parallel and serial nature of processes of selection and projection. Sixth, community‐engaged design‐research demonstrates that active speculation towards positive change (outside of self and social habit) is a mechanism for the serial production of simultaneously ethical and aesthetical affective relationships. Extending and sharing the production of capabilities and powers of expression beyond the architect and architecture demonstrates the overarching principle of expressionism ‐ affirmative speculation is correlative with the creation of ethical joy

Perceptions of leadership in undergraduate pharmacy students through a mixed methods study

Poster abstract from Conference; Royal Pharmaceutical Society Winter Summit 2017

Stratorotational instability in MHD Taylor-Couette flows

The stability of dissipative Taylor-Couette flows with an axial stable density stratification and a prescribed azimuthal magnetic field is considered. Global nonaxisymmetric solutions of the linearized MHD equations with toroidal magnetic field, axial density stratification and differential rotation are found for both insulating and conducting cylinder walls. Flat rotation laws such as the quasi-Kepler law are unstable against the nonaxisymmetric stratorotational instability (SRI). The influence of a current-free toroidal magnetic field depends on the magnetic Prandtl number Pm: SRI is supported by Pm > 1 and it is suppressed by Pm \lsim 1. For too flat rotation laws a smooth transition exists to the instability which the toroidal magnetic field produces in combination with the differential rotation. This nonaxisymmetric azimuthal magnetorotational instability (AMRI) has been computed under the presence of an axial density gradient. If the magnetic field between the cylinders is not current-free then also the Tayler instability occurs and the transition from the hydrodynamic SRI to the magnetic Tayler instability proves to be rather complex. Most spectacular is the `ballooning' of the stability domain by the density stratification: already a rather small rotation stabilizes magnetic fields against the Tayler instability. An azimuthal component of the resulting electromotive force only exists for density-stratified flows. The related alpha-effect for magnetic SRI of Kepler rotation appears to be positive for negative d\rho/dz <0.Comment: 10 pages, 13 figures, submitted to Astron. Astrophy