1,812 research outputs found
Reconstructing the deficit discourse in a multi-remote school in Far North Queensland
This chapter looks to explore the effect of being both physically and culturally remote in broadly social but more specifically educational terms, and to describe aspects of a more critical approach to the formal schooling of Indigenous Australian students. Illuminating ways in which Indigenous Australian people have essentially been discursively positioned as uneducable through the operation of a discourse of deficit with its current reliance on the use of standardized testing results, a (neo-)colonial strategy common to Indigenous peoples worldwide, the chapter then moves on to feature an example of alternative practices in the education of culturally remote students in a far North Queensland State [public] school. The physical remoteness of this particular school brings with it a number of advantages and opportunities for affecting a critical indigenous education, one that seeks to secure understanding, respect, and acceptance of the ways of the Other
Should patients set the agenda for informed consent? A prospective survey of desire for information and discussion prior to routine cataract surgery
Lee Teak Tan1,2, Huw Jenkins1,2, John Roberts-Harry2, Michael Austin11Singleton Hospital, Swansea, UK; 2West Wales General Hospital, Carmarthen, UKPurpose: To ascertain the level of information relating to specific risks desired by patients prior to cataract surgery.Setting: Dedicated cataract surgery pre-assessment clinics of 2 hospitals in South West Wales, UK.Methods: Consecutive patients (106) were recruited prospectively. Of these, 6 were formally excluded due to deafness or disorientation. Eligible patients (100) were asked a set of preliminary questions to determine their understanding of the nature of cataract, risk perception, and level of information felt necessary prior to giving consent. Those who desired further information were guided through a standardized questionnaire, which included an audio-visual presentation giving information relating to each potential surgical complication, allowing patients to rate them for relevance to their giving of informed consent.Results: Of the entire group of 100, 32 did not wish to know “anything at all” about risks and would prefer to leave decision making to their ophthalmologist; 22 were interested only in knowing their overall chance of visual improvement; and 46 welcomed a general discussion of possible complications, of whom 25 went on to enquire about specific complications. Of these 25, 18 wished to be informed of posterior capsular (PC) tearing, 17 of endophthalmitis, 16 each of dropped lens, retinal detachment and corneal clouding, and 15 of bleeding, sympathetic ophthalmia, and PC opacification.Conclusion: Patients differ in their desire for information prior to cataract surgery, with one significant minority favoring little or no discussion of risk and another wishing detailed consideration of specific risks. A system of consent where patients have a choice as to the level of discussion undertaken may better suit patients’ wishes than a doctor-specified agenda.Keywords: cataract extraction, informed consent, patient-centered car
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Content Analysis of Expressive Writing Narratives About Stressful Relational Events Using Interpersonal Decentering
Article from a study completed using secondary analysis of data from two studies of expressive writing about stressful relational events to first describe the relations of word use to social-cognitive maturity of role-taking using Feffer’s Interpersonal Decentering scoring system and then to test hypotheses about active processing of relational information versus event closure. This is the Accepted Manuscript version of a published article
Experimental Investigation of Rotorcraft Outwash in Ground Effect
The wake characteristics of a rotorcraft are affected by the proximity of a rotor to the ground surface, especially during hover. Ground effect is encountered when the rotor disk is within a distance of a few rotor radii above the ground surface and results in an increase in thrust for a given power relative to that same power condition with the rotor out of ground effect. Although this phenomenon has been highly documented and observed since the beginning of the helicopter age, there is still a relatively little amount of flow-field data existing to help understand its features. Joint Army and NASA testing was conducted at NASA Langley Research Center using a powered rotorcraft model in hover at various rotor heights and thrust conditions in order to contribute to the complete outwash data set. The measured data included outwash velocities and directions, rotor loads, fuselage loads, and ground pressures. The researchers observed a linear relationship between rotor height and percent download on the fuselage, peak mean outwash velocities occurring at radial stations between 1.7 and 1.8 r/R regardless of rotor height, and the measurement azimuthal dependence of the outwash profile for a model incorporating a fuselage. Comparisons to phase-locked PIV data showed similar contours but a more contracted wake boundary for the PIV data. This paper describes the test setup and presents some of the averaged results
Down syndrome and postoperative complications after paediatric cardiac surgery: a propensity-matched analysis
OBJECTIVESThe incidence of congenital heart disease is approximately 50%, mostly related to endocardial cushion defects. The aim of our study was to investigate the postoperative complications that occur after paediatric cardiac surgery.METHODSOur perioperative data were analysed in paediatric patients with Down syndrome undergoing cardiac surgery. We retrospectively analysed the data from 2063 consecutive paediatric patients between January 2003 and December 2008. After excluding the patients who died or had missing data, the analysed database (before propensity matching) contained 129 Down patients and 1667 non-Down patients. After propensity matching, the study population comprised 222 patients and 111 patients had Down syndrome.RESULTSBefore propensity matching, the occurrences of low output syndrome (21.2 vs 32.6%, P = 0.003), pulmonary complication (14 vs 28.7%, P < 0.001) and severe infection (11.9 vs 22.5%, P = 0.001) were higher in the Down group. Down patients were more likely to have prolonged mechanical ventilation [median (interquartile range) 22 (9-72) h vs 49 (24-117) h, P = 0.007]. The total intensive care unit length of stay [6.9 (4.2-12.4) days vs 8.3 (5.3-13.2) days, P = 0.04] and the total hospital length of stay [17.3 (13.3-23.2) days vs 18.3 (15.1-23.6) days, P = 0.05] of the Down patients were also longer. Mortality was similar in the two groups before (3.58 vs 3.88%, P = 0.86) and after (5.4 vs 4.5%, P = 1.00) propensity matching. After propensity matching, there was no difference in the occurrence of adverse events.CONCLUSIONSAfter propensity matching Down syndrome was not associated with increased mortality or complication rate following congenital cardiac surgery
Multilevel Modelling of Country Effects: A Cautionary Tale
Country effects on outcomes for individuals are often analysed using multilevel (hierarchical) models applied to harmonized multi-country data sets such as ESS, EU-SILC, EVS, ISSP, and SHARE. We point out problems with the assessment of country effects that appear not to be widely appreciated, and develop our arguments using Monte Carlo simulation analysis of multilevel linear and logit models. With large sample sizes of individuals within each country but only a small number of countries, analysts can reliably estimate individual-level effects but estimates of parameters summarizing country effects are likely to be unreliable. Multilevel modelling methods are no panacea
Genetic counselling for psychiatric disorders: accounts of psychiatric health professionals in the United Kingdom
Genetic counselling is not routinely offered for psychiatric disorders in the United Kingdom through NHS regional clinical genetics departments. However, recent genomic advances, confirming a genetic contribution to mental illness, are anticipated to increase demand for psychiatric genetic counselling. This is the first study of its kind to employ qualitative methods of research to explore accounts of psychiatric health professionals regarding the prospects for genetic counselling services within clinical psychiatry in the UK. Data were collected from 32 questionnaire participants, and 9 subsequent interviewees. Data analysis revealed that although participants had not encountered patients explicitly demanding psychiatric genetic counselling, psychiatric health professionals believe that such a service would be useful and desirable. Genomic advances may have significant implications for genetic counselling in clinical psychiatry even if these discoveries do not lead to genetic testing. Psychiatric health professionals describe clinical genetics as a skilled profession capable of combining complex risk communication with much needed psychosocial support. However, participants noted barriers to the implementation of psychiatric genetic counselling services including, but not limited to, the complexities of uncertainty in psychiatric diagnoses, patient engagement and ethical concerns regarding limited capacity
Samuel Jenkins Junior Composition Recital
https://dc.ewu.edu/music_performances/1628/thumbnail.jp
Strong negative self regulation of Prokaryotic transcription factors increases the intrinsic noise of protein expression
Background
Many prokaryotic transcription factors repress their own transcription. It is often asserted that such regulation enables a cell to homeostatically maintain protein abundance. We explore the role of negative self regulation of transcription in regulating the variability of protein abundance using a variety of stochastic modeling techniques.
Results
We undertake a novel analysis of a classic model for negative self regulation. We demonstrate that, with standard approximations, protein variance relative to its mean should be independent of repressor strength in a physiological range. Consequently, in that range, the coefficient of variation would increase with repressor strength. However, stochastic computer simulations demonstrate that there is a greater increase in noise associated with strong repressors than predicted by theory. The discrepancies between the mathematical analysis and computer simulations arise because with strong repressors the approximation that leads to Michaelis-Menten-like hyperbolic repression terms ceases to be valid. Because we observe that strong negative feedback increases variability and so is unlikely to be a mechanism for noise control, we suggest instead that negative feedback is evolutionarily favoured because it allows the cell to minimize mRNA usage. To test this, we used in silico evolution to demonstrate that while negative feedback can achieve only a modest improvement in protein noise reduction compared with the unregulated system, it can achieve good improvement in protein response times and very substantial improvement in reducing mRNA levels.
Conclusions
Strong negative self regulation of transcription may not always be a mechanism for homeostatic control of protein abundance, but instead might be evolutionarily favoured as a mechanism to limit the use of mRNA. The use of hyperbolic terms derived from quasi-steady-state approximation should also be avoided in the analysis of stochastic models with strong repressors
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