Improving retention for all students, studying mathematics as part of their chosen qualification, by using a voluntary diagnostic quiz

This case study demonstrates the issues and advantages in encouraging students to take responsibility for their learning and to be better prepared both in terms of knowledge and expectations for their study. The study outlines the improvement in retention achieved when students were encouraged to use a voluntary diagnostic quiz on a first year university mathematics module. Initially the power of the diagnostic quiz, in predicting future success on the module, was identified using predictive analytics. Students were contacted by experienced Education Guidance staff who encouraged them to take the quiz prior to course start with the aim of using their results to steer them to start on the “right” course. The diagnostic quiz total score was made available to the student’s course tutor prior to course start to enable further tailoring of support to individual students. Early indications show an improvement in early module retention. The module in this case study was for distance learning students on an open access mathematics course

Paediatric extracranial germ-cell tumours.

Management of paediatric extracranial germ-cell tumours carries a unique set of challenges. Germ-cell tumours are a heterogeneous group of neoplasms that present across a wide age range and vary in site, histology, and clinical behaviour. Patients with germ-cell tumours are managed by a diverse array of specialists. Thus, staging, risk stratification, and treatment approaches for germ-cell tumours have evolved disparately along several trajectories. Paediatric germ-cell tumours differ from the adolescent and adult disease in many ways, leading to complexities in applying age-appropriate, evidence-based care. Suboptimal outcomes remain for several groups of patients, including adolescents, and patients with extragonadal tumours, high tumour markers at diagnosis, or platinum-resistant disease. Survivors have significant long-term toxicities. The challenge moving forward will be to translate new insights from molecular studies and collaborative clinical data into improved patient outcomes. Future trials will be characterised by improved risk-stratification systems, biomarkers for response and toxic effects, rational reduction of therapy for low-risk patients and novel approaches for poor-risk patients, and improved international collaboration across paediatric and adult cooperative research groups.This is the author accepted manuscript. The final version is available from Elsevier via http://dx.doi.org/10.1016/S1470-2045(15)00545-

Family composition and age at menarche: findings from the international Health Behaviour in School-Aged Children Study

This research was funded by The University of St Andrews and NHS Health Scotland.Background Early menarche has been associated with father absence, stepfather presence and adverse health consequences in later life. This article assesses the association of different family compositions with the age at menarche. Pathways are explored which may explain any association between family characteristics and pubertal timing. Methods Cross-sectional, international data on the age at menarche, family structure and covariates (age, psychosomatic complaints, media consumption, physical activity) were collected from the 2009–2010 Health Behaviour in School-aged Children (HBSC) survey. The sample focuses on 15-year old girls comprising 36,175 individuals across 40 countries in Europe and North America (N = 21,075 for age at menarche). The study examined the association of different family characteristics with age at menarche. Regression and path analyses were applied incorporating multilevel techniques to adjust for the nested nature of data within countries. Results Living with mother (Cohen’s d = .12), father (d = .08), brothers (d = .04) and sisters (d = .06) are independently associated with later age at menarche. Living in a foster home (d = −.16), with ‘someone else’ (d = −.11), stepmother (d = −.10) or stepfather (d = −.06) was associated with earlier menarche. Path models show that up to 89% of these effects can be explained through lifestyle and psychological variables. Conclusions Earlier menarche is reported amongst those with living conditions other than a family consisting of two biological parents. This can partly be explained by girls’ higher Body Mass Index in these families which is a biological determinant of early menarche. Lower physical activity and elevated psychosomatic complaints were also more often found in girls in these family environments.Publisher PDFPeer reviewe

An automated, online feasibility randomized controlled trial of a just-in-time adaptive intervention for smoking cessation (Quit Sense)

Introduction: Learned smoking cues from a smoker’s environment are a major cause of lapse and relapse. Quit Sense, a theory-guided Just-In-Time Adaptive Intervention smartphone app, aims to help smokers learn about their situational smoking cues and provide in-the-moment support to help manage these when quitting. Methods: A two-arm feasibility randomized controlled trial (N = 209) to estimate parameters to inform a definitive evaluation. Smoker’s willing to make a quit attempt were recruited using online paid-for adverts and randomized to “usual care” (text message referral to NHS SmokeFree website) or “usual care” plus a text message invitation to install Quit Sense. Procedures, excluding manual follow-up for nonresponders, were automated. Follow-up at 6 weeks and 6 months included feasibility, intervention engagement, smoking-related, and economic outcomes. Abstinence was verified using cotinine assessment from posted saliva samples. Results: Self-reported smoking outcome completion rates at 6 months were 77% (95% CI 71%, 82%), viable saliva sample return rate was 39% (95% CI 24%, 54%), and health economic data 70% (95% CI 64%, 77%). Among Quit Sense participants, 75% (95% CI 67%, 83%) installed the app and set a quit date and, of those, 51% engaged for more than one week. The 6-month biochemically verified sustained abstinence rate (anticipated primary outcome for definitive trial), was 11.5% (12/104) among Quit Sense participants and 2.9% (3/105) for usual care (adjusted odds ratio = 4.57, 95% CIs 1.23, 16.94). No evidence of between-group differences in hypothesized mechanisms of action was found. Conclusions: Evaluation feasibility was demonstrated alongside evidence supporting the effectiveness potential of Quit Sense. Implications: Running a primarily automated trial to initially evaluate Quit Sense was feasible, resulting in modest recruitment costs and researcher time, and high trial engagement. When invited, as part of trial participation, to install a smoking cessation app, most participants are likely to do so, and, for those using Quit Sense, an estimated one-half will engage with it for more than 1 week. Evidence that Quit Sense may increase verified abstinence at 6-month follow-up, relative to usual care, was generated, although low saliva return rates to verify smoking status contributed to considerable imprecision in the effect size estimate

A smoking cessation smartphone app that delivers real-time ‘context aware’ behavioural support: the Quit Sense feasibility RCT

BackgroundDuring a quit attempt, cues from a smoker’s environment are a major cause of brief smoking lapses, which increase the risk of relapse. Quit Sense is a theory-guided Just-In-Time Adaptive Intervention smartphone app, providing smokers with the means to learn about their environmental smoking cues and provides ‘in the moment’ support to help them manage these during a quit attempt.ObjectiveTo undertake a feasibility randomised controlled trial to estimate key parameters to inform a definitive randomised controlled trial of Quit Sense.DesignA parallel, two-arm randomised controlled trial with a qualitative process evaluation and a ‘Study Within A Trial’ evaluating incentives on attrition. The research team were blind to allocation except for the study statistician, database developers and lead researcher. Participants were not blind to allocation.SettingOnline with recruitment, enrolment, randomisation and data collection (excluding manual telephone follow-up) automated through the study website.ParticipantsSmokers (323 screened, 297 eligible, 209 enrolled) recruited via online adverts on Google search, Facebook and Instagram.InterventionsParticipants were allocated to ‘usual care’ arm (n = 105; text message referral to the National Health Service SmokeFree website) or ‘usual care’ plus Quit Sense (n = 104), via a text message invitation to install the Quit Sense app.Main outcome measuresFollow-up at 6 weeks and 6 months post enrolment was undertaken by automated text messages with an online questionnaire link and, for non-responders, by telephone. Definitive trial progression criteria were met if a priori thresholds were included in or lower than the 95% confidence interval of the estimate. Measures included health economic and outcome data completion rates (progression criterion #1 threshold: ≥ 70%), including biochemical validation rates (progression criterion #2 threshold: ≥ 70%), recruitment costs, app installation (progression criterion #3 threshold: ≥ 70%) and engagement rates (progression criterion #4 threshold: ≥ 60%), biochemically verified 6-month abstinence and hypothesised mechanisms of action and participant views of the app (qualitative).ResultsSelf-reported smoking outcome completion rates were 77% (95% confidence interval 71% to 82%) and health economic data (resource use and quality of life) 70% (95% CI 64% to 77%) at 6 months. Return rate of viable saliva samples for abstinence verification was 39% (95% CI 24% to 54%). The per-participant recruitment cost was £19.20, which included advert (£5.82) and running costs (£13.38). In the Quit Sense arm, 75% (95% CI 67% to 83%; 78/104) installed the app and, of these, 100% set a quit date within the app and 51% engaged with it for more than 1 week. The rate of 6-month biochemically verified sustained abstinence, which we anticipated would be used as a primary outcome in a future study, was 11.5% (12/104) in the Quit Sense arm and 2.9% (3/105) in the usual care arm (estimated effect size: adjusted odds ratio = 4.57, 95% CIs 1.23 to 16.94). There was no evidence of between-arm differences in hypothesised mechanisms of action. Three out of four progression criteria were met.The Study Within A Trial analysis found a £20 versus £10 incentive did not significantly increase follow-up rates though reduced the need for manual follow-up and increased response speed. The process evaluation identified several potential pathways to abstinence for Quit Sense, factors which led to disengagement with the app, and app improvement suggestions.LimitationsBiochemical validation rates were lower than anticipated and imbalanced between arms. COVID-19-related restrictions likely limited opportunities for Quit Sense to provide location tailored support.ConclusionsThe trial design and procedures demonstrated feasibility and evidence was generated supporting the efficacy potential of Quit Sense.Future workProgression to a definitive trial is warranted providing improved biochemical validation rates.Trial registrationThis trial is registered as ISRCTN12326962

Negotiating employability: migrant capitals and networking strategies for Zimbabwean highly skilled migrants in the UK

In this paper we focus on highly skilled migration from Zimbabwe to the UK, exploring these migrants’ social capital sources/structures and content. In doing so we pay attention to routes of migration and how they shape migrants’ networking capabilities and patterns. We further take a Bourdieusian perspective and explore the intersection between social capital and cultural capital in the process of migrants’ negotiation of employment opportunities, giving closer attention to how the distinctive habitus associated with being highly skilled migrants from Zimbabwe shape migrants’ attitudes towards work. By exploring the interplay between external processes and internalised structures, we bring to the fore the multiple positioning of our participants, who we see not as simply depending on social networks, but as complex actors whose negotiation of employability in the UK is shaped by various factors including intersecting aspects of differentiation

Letter from Juliet Bestor Coleman, Clinton, Alabama, to Dorcas B. Jones, Gainesville, Alabama, November 4, 1847

Juliet's handwriting is very legible but incredibly small; her letters to and from her mother and sisters have been transcribed

Letter from Juliet Bestor Coleman, Clinton, Alabama, to Dorcas B. Jones, Gainesville, Alabama, May 16

Juliet's handwriting is very legible but incredibly small; her letters to and from her mother and sisters have been transcribed

Booklet belonging to Juliet Bestor containing song lyrics and poetry

Booklet song lyrics or poems

Letter from Juliet Bestor Coleman, Greene County, Alabama, to Dorcas B. Jones, January 20, 1850

Juliet's handwriting is very legible but incredibly small; her letters to and from her mother and sisters have been transcribed