The nature of practitioner research: critical distance, power and ethics

Researching within one’s place of practice allows the researcher to have the unique position of knowing the participants and the research context. The relationship the participants have with the researcher will impact upon the disclosure of information differently than research conducted by someone outside the area of practice. This can be a benefit and a drawback for the participants, the area of practice and the researcher. However, as is demonstrated within this paper, the role the researcher adopts throughout the process of gathering information is not always clear. As a student on the Doctorate of Education programme myself, the nature of practitioner research and the complexities of this type of research is of great interest to me. Beginning to develop my own research project through this taught programme has allowed an opportunity to think through these challenges and wrestle with the complexity and contradiction, dilemma and incongruity which emerges from being a researching practitioner. Within this piece it is suggested that these quandaries can be considered from the perspective of critical distance, relationships and power and ethical considerations. The idea of considering these conflicts reflexively will be explored here. Although this discussion was not based on empirical research findings as such, it is anticipated that this piece will further the understanding of practitioner research in higher education from the position of being a student and through scholastic analysis of the Ed D programme providing a particular perspective on the nature of research

The Nature of Practitioner Research: Critical distance, power and ethics

Researching within one’s place of practice allows the researcher to have the unique position of knowing the participants and the research context. The relationship the participants have with the researcher will impact upon the disclosure of information differently than research conducted by someone outside the area of practice. This can be a benefit and a drawback for the participants, the area of practice and the researcher. However, as is demonstrated within this paper, the role the researcher adopts throughout the process of gathering information is not always clear. As a student on the Doctorate of Education programme myself, the nature of practitioner research and the complexities of this type of research is of great interest to me. Beginning to develop my own research project through this taught programme has allowed an opportunity to think through these challenges and wrestle with the complexity and contradiction, dilemma and incongruity which emerges from being a researching practitioner. Within this piece it is suggested that these quandaries can be considered from the perspective of critical distance, relationships and power and ethical considerations. The idea of considering these conflicts reflexively will be explored here. Although this discussion was not based on empirical research findings as such, it is anticipated that this piece will further the understanding of practitioner research in higher education from the position of being a student and through scholastic analysis of the Ed D programme providing a particular perspective on the nature of research

Consultancy project for NACRO Osmaston Family Project: Final report

National Association for the Care and Rehabilitation of Offenders (NACRO

'Pre-endoscopy point of care test (Simtomax- IgA/IgG-Deamidated Gliadin Peptide) for coeliac disease in iron deficiency anaemia: diagnostic accuracy and a cost saving economic model'.

BACKGROUND: International guidelines recommend coeliac serology in iron deficiency anaemia, and duodenal biopsy for those tested positive to detect coeliac disease. However, pre-endoscopy serology is often unavailable, thus committing endoscopists to take routine duodenal biopsies. Some endoscopists consider duodenal biopsy mandatory in anaemia to exclude other pathologies. We hypothesise that using a point of care test at endoscopy could fill this gap, by providing rapid results to target anaemic patients who require biopsies, and save costs by biopsy avoidance. We therefore assessed three key aspects to this hypothesis: 1) the availability of pre-endoscopy serology in anaemia; 2) the sensitivities and cost effectiveness of pre-endoscopy coeliac screening with Simtomax in anaemia; 3) whether other anaemia-related pathologies could be missed by this targeted-biopsy approach. METHODS: Group 1: pre-endoscopy serology availability was retrospectively analysed in a multicentre cohort of 934 anaemic patients at 4 UK hospitals. Group 2: the sensitivities of Simtomax, endomysial and tissue-transglutaminase antibodies were compared in 133 prospectively recruited patients with iron deficiency anaemia attending for a gastroscopy. The sensitivities were measured against duodenal histology as the reference standard in all patients. The cost effectiveness of Simtomax was calculated based on the number of biopsies that could have been avoided compared to an all-biopsy approach. Group 3: the duodenal histology of 153 patients presenting to a separate iron deficiency anaemia clinic were retrospectively reviewed. RESULTS: In group 1, serology was available in 361 (33.8 %) patients. In group 2, the sensitivity and negative predictive value (NPV) were 100 % and 100 % for Simtomax, 96.2 % and 98.9 % for IgA-TTG, and 84.6 % and 96.4 % for EMA respectively. In group 3, the duodenal histology found no causes for anaemia other than coeliac disease. CONCLUSION: Simtomax had excellent diagnostic accuracy in iron deficiency anaemia and was comparable to conventional serology. Duodenal biopsy did not identify any causes other than coeliac disease for iron deficiency anaemia, suggesting that biopsy avoidance in Simtomax negative anaemic patients is unlikely to miss other anaemia-related pathologies. Due to its 100 % NPV, Simtomax could reduce unnecessary biopsies by 66 % if only those with a positive Simtomax were biopsied, potentially saving £3690/100 gastroscopies. TRIAL REGISTRATION: The group 2 study was retrospectively registered with clinicaltrials.gov. Trial registration date: 13(th) July 2016; TRIAL REGISTRATION NUMBER: NCT02834429

The risk of child and adolescent overweight is related to types of food consumed

<p>Abstract</p> <p>Background/Aims</p> <p>To investigate the association between the risk of overweight and the consumption of food groups in children and adolescents.</p> <p>Methods</p> <p>We studied 1764 healthy children and adolescents (age 6-19y) attending 16 Seventh-Day Adventist schools and 13 public schools using a 106-item non-quantitative food frequency questionnaire from the late 1980 Child-Adolescent Blood Pressure Study. Logistic regression models were used to compute the risk of overweight according to consumption of grains, nuts, vegetables, fruits, meats/fish/eggs, dairy, and, low nutrient-dense foods (LNDF).</p> <p>Results</p> <p>The frequency of consumption of grains, nuts, vegetables and LNDF were inversely related to the risk of being overweight and dairy increased the risk. Specifically, the odds ratio (95% CI) for children in the highest quartile or tertile of consumption compared with the lowest quartile or tertile were as follows: grains 0.59(0.41-0.83); nuts 0.60(0.43-0.85); vegetables 0.67(0.48-0.94); LNDF 0.43(0.29-0.63); and, dairy 1.36(0.97, 1.92).</p> <p>Conclusion</p> <p>The regular intake of specific plant foods may prevent overweight among children and adolescents.</p

WISE x SuperCOSMOS photometric redshift catalog: 20 million galaxies over 3pi steradians

We cross-match the two currently largest all-sky photometric catalogs, mid-infrared WISE and SuperCOSMOS scans of UKST/POSS-II photographic plates, to obtain a new galaxy sample that covers 3pi steradians. In order to characterize and purify the extragalactic dataset, we use external GAMA and SDSS spectroscopic information to define quasar and star loci in multicolor space, aiding the removal of contamination from our extended-source catalog. After appropriate data cleaning we obtain a deep wide-angle galaxy sample that is approximately 95% pure and 90% complete at high Galactic latitudes. The catalog contains close to 20 million galaxies over almost 70% of the sky, outside the Zone of Avoidance and other confused regions, with a mean surface density of over 650 sources per square degree. Using multiwavelength information from two optical and two mid-IR photometric bands, we derive photometric redshifts for all the galaxies in the catalog, using the ANNz framework trained on the final GAMA-II spectroscopic data. Our sample has a median redshift of z_{med} = 0.2 but with a broad dN/dz reaching up to z>0.4. The photometric redshifts have a mean bias of |delta_z|~10^{-3}, normalized scatter of sigma_z = 0.033 and less than 3% outliers beyond 3sigma_z. Comparison with external datasets shows no significant variation of photo-z quality with sky position. Together with the overall statistics, we also provide a more detailed analysis of photometric redshift accuracy as a function of magnitudes and colors. The final catalog is appropriate for `all-sky' 3D cosmology to unprecedented depths, in particular through cross-correlations with other large-area surveys. It should also be useful for source pre-selection and identification in forthcoming surveys such as TAIPAN or WALLABY

Thiopurine monotherapy is effective in ulcerative colitis but significantly less so in Crohn’s disease: long-term outcomes for 11 928 patients in the UK inflammatory bowel disease bioresource

Objective: Thiopurines are widely used as maintenance therapy in inflammatory bowel disease (IBD) but the evidence base for their use is sparse and their role increasingly questioned. Using the largest series reported to date, we assessed the long-term effectiveness of thiopurines in ulcerative colitis (UC) and Crohn’s disease (CD), including their impact on need for surgery. Design: Outcomes were assessed in 11 928 patients (4968 UC, 6960 CD) in the UK IBD BioResource initiated on thiopurine monotherapy with the intention of maintaining medically induced remission. Effectiveness was assessed retrospectively using patient-level data and a definition that required avoidance of escalation to biological therapy or surgery while on thiopurines. Analyses included overall effectiveness, time-to-event analysis for treatment escalation and comparison of surgery rates in patients tolerant or intolerant of thiopurines. Results: Using 68 132 patient-years of exposure, thiopurine monotherapy appeared effective for the duration of treatment in 2617/4968 (52.7%) patients with UC compared with 2378/6960 (34.2%) patients with CD (p<0.0001). This difference was corroborated in a multivariable analysis: after adjusting for variables including treatment era, thiopurine monotherapy was less effective in CD than UC (OR 0.47, 95% CI 0.43 to 0.51, p<0.0001). Thiopurine intolerance was associated with increased risk of surgery in UC (HR 2.44, p<0.0001); with a more modest impact on need for surgery in CD (HR=1.23, p=0.0015). Conclusion: Thiopurine monotherapy is an effective long-term treatment for UC but significantly less effective in CD

Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received

Background The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective To report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, setting, and participants This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment. Outcome measurements and statistical analysis Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and limitations According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa. Conclusions Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient summary More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common

A systemic transformation of an arts and sciences curriculum to nurture inclusive excellence of all students through course-based research experiences

IntroductionWe describe herein a large-scale, multidisciplinary course-based undergraduate research experience program (CRE) developed at Lawrence Technological University (LTU). In our program, all students enrolled in CRE classes participate in authentic research experiences within the framework of the curriculum, eliminating self-selection processes and other barriers to traditional extracurricular research experiences.MethodsSince 2014, we have designed and implemented more than 40 CRE courses in our College of Arts and Sciences involving more than 30 instructors from computer science, mathematics, physics, biology, chemistry, English composition, literature, philosophy, media communication, nursing, and psychology.ResultsAssessment survey data indicates that students who participate in CRE courses have an enhanced attitude towards research and discovery, as well as increased self-efficacy. This intervention is particularly relevant for non-traditional students, such as students who commute and/or have significant work or childcare commitments, who often experience limited access to research activities.DiscussionHerein we highlight the importance of a systemic institutional change that has made this intervention sustainable and likely to outlast the external funding phase. Systemic change can emerge from a combination of conditions, including: (1) developing a critical mass of CRE courses by providing instructors with both incentives and training; (2) developing general principles on which instructors can base their CRE activities; (3) securing and maintaining institutional support to promote policy changes towards a more inclusive institution; and (4) diversifying the range of the intervention, both in terms of initiatives and disciplines involved

The association between treatment adherence to nicotine patches and smoking cessation in pregnancy: a secondary analysis of a randomised controlled trial

IntroductionIn non-pregnant ‘quitters’, adherence to nicotine replacement therapy (NRT) increases smoking cessation. We investigated relationships between adherence to placebo or NRT patches and cessation in pregnancy, including an assessment of reverse causation and whether any adherence: cessation relationship is moderated when using nicotine or placebo patches. MethodsUsing data from 1050 pregnant trial participants, regression models investigated associations between maternal characteristics, adherence and smoking cessation. ResultsAdherence during the first month was associated with lower baseline cotinine concentrations (beta -0.08, 95%CI -0.15 to -0.01) and randomisation to NRT (beta 2.59, 95%CI 1.50 to 3.68). Adherence during both treatment months was associated with being randomised to NRT (beta 0.51, 95%CI 0.29 to 0.72) and inversely associated with higher nicotine dependence. Adherence with either NRT or placebo was associated with cessation at one month (OR 1.11, 95%CI 1.08 to 1.13) and delivery (OR 1.06, 95%CI 1.03 to 1.09), but no such association was observed in the subgroup where reverse causation was not possible. Amongst all women, greater adherence to nicotine patches was associated with increased cessation (OR 2.47, 95%CI 1.32 to 4.63) but greater adherence to placebo was not (OR 0.98, 95%CI: 0.44 to 2.18). ConclusionWomen who were more adherent to NRT were more likely to achieve abstinence; more nicotine dependent women probably showed lower adherence to NRT because they relapsed to smoking more quickly. The interaction between nicotine-containing patches and adherence for cessation suggests that the association between adherence with nicotine patches and cessation may be partly causal