The Essence of Christian Paideia for Career Classical Christian Educators: A Hermeneutic Phenomenology

The purpose of this hermeneutic phenomenology was to discover the essence of Christian paideia for career classical Christian educators who make daily curricular decisions at a classical Christian online academy that serves a 2nd-12th grade international student body. A qualitative research design was used to gather data on the experiences of classical Christian educational practitioners when making curricular decisions. The theory that guided this study was Mezirow’s transformational learning theory (TLT), as all manner of teaching and learning attempts transformation to a higher ideal. A hermeneutic phenomenology was employed through the interpretive framework of critical realism to discover the essence of Christian paideia. The participants included thirteen current career CC educators with a minimum of three years teaching in an online global CC academy in the 6th through 12th grades known as the logic and rhetoric/dialectic stages of CCE. The semi-structured interview, archive observation, and focus group were the data collection methods chosen to answer the central research question: What is the essence of Christian paideia for career CC educators within their lived experiences of online global curricular decisions? Data collection, analysis, and synthesis followed van Manen’s (2016) hermeneutic phenomenological reflection and Saldaña’s (2021) analytic memoing, in vivo, process, and value coding, and theming the data. Results included the following themes: understanding the nature and character of God, building holistic connections, forming Christian character, and leading Christian culture. A point of structure (van Manen, 2016) was also revealed: everything God intended anchored in history

'Sexercise': Working out heterosexuality in Jane Fonda’s fitness books

This is an Author's Accepted Manuscript of an article published in Leisure Studies, 30(2), 237 - 255, 2011, copyright Taylor & Francis, available online at: http://www.tandfonline.com/10.1080/02614367.2010.523837.This paper explores the connection between the promotion of heterosexual norms in women’s fitness books written by or in the name of Jane Fonda during the 1980s and the commodification of women’s fitness space in both the public and private spheres. The paper is set in the absence of overt discussions of normative heterosexuality in leisure studies and draws on critical heterosexual scholarship as well as the growing body of work theorising geographies of corporeality and heterosexuality. Using the principles of media discourse analysis, the paper identifies three overlapping characteristics of heterosexuality represented in Jane Fonda’s fitness books, and embodied through the exercise regimes: respectable heterosexual desire, monogamous procreation and domesticity. The paper concludes that the promotion and prescription of exercise for women in the Jane Fonda workout books centred on the reproduction and embodiment of heterosexual corporeality. Set within an emerging commercial landscape of women’s fitness in the 1980s, such exercise practices were significant in the legitimation and institutionalisation of heteronormativity

International Influences and Drag: Just a Case of Tucking or Binding?

Recently there has been an  internationalisation in the training of UK drag performers. Whilst papers exist focused on drag kings and queens related to their community, few explore how kings/queens train – and fewer still explore international aspects. There are formal courses for drag, but historically this training was informal, present within specific performance communities built around LGBTQ cultures. Tracing dominant figures in such training – the drag mother/father – in order to historicise and contextualise the current explosion in drag performance,the paper argues that the potential globalisation of drag is largely down to the diversification of sources of knowledge available via the internet. Traditionally, performers trained with an established practitioner, where regional variances of drag were passed on. However, current new performers often learn ‘tricks of the trade’ through internet videos posted by people on other continents. In these videos, practitioners pass on their knowledge from the perspective of their locality, as if universal. New kings/queens are not passive in this training and locally infuse their acts, yet historical and local erasures persist. The paper argues that to engage with drag as performance one must be aware of locality and the deep connects drag has with its communities

The relationships between regional Quaternary uplift, deformation across active normal faults and historical seismicity in the upper plate of subduction zones: The Capo D’Orlando Fault, NE Sicily

In order to investigate deformation within the upper plate of the Calabrian subduction zone we have mapped and modelled a sequence of Late Quaternary palaeoshorelines tectonically-deformed by the Capo D’Orlando normal fault, NE Sicily, which forms part of the actively deforming Calabrian Arc. In addition to the 1908 Messina Strait earthquake (Mw 7.1), this region has experienced damaging earthquakes, possibly on the Capo D’Orlando Fault, however, it is not considered by some to be a potential seismogenic source. Uplifted Quaternary palaeoshorelines are preserved on the hangingwall of the Capo D’Orlando Fault, indicating that hangingwall subsidence is counteracted by regional uplift, likely because of deformation associated with subduction/collision. We attempt to constrain the relationship between regional uplift, crustal extensional processes and historical seismicity, and we quantify both the normal and regional deformation signals. We report uplift variations along the strike of the fault and use a synchronous correlation technique to assign ages to palaeoshorelines, facilitating calculation of uplift rates and the fault throw-rate. Uplift rates in the hangingwall increase from 0.4 mm/yr in the centre of the fault to 0.89 mm/yr beyond its SW fault tip, suggesting 0.5 mm/yr of fault related subsidence, which implies a throw-rate of 0.63 ± 0.02 mm/yr, and significant seismic hazard. Overall, we emphasise that upper plate extension and related vertical motions complicate the process of deriving information on the subduction/collision process, such as coupling and slip distribution on the subduction interface, parameters that are commonly inferred for other subduction zones without considering upper plate deformation

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Lateralizing and Localizing Values of Ictal Onset Recorded on the Scalp: Evidence from Simultaneous Recordings with Intracranial Foramen Ovale Electrodes

Purpose: The value of scalp recordings to localize and lateralize seizure onset in temporal lobe epilepsy has been assessed by comparing simultaneous scalp and intracranial foramen ovale (FO) recordings during presurgical assessment. The sensitivity, of scalp recordings for detecting mesial temporal ictal onset has been compared with a "gold standard" provided by simultaneous deep intracranial FO recordings from the mesial aspect of the temporal lobe. As FO electrodes are introduced via anatomic holes they provide a unique opportunity to record simultaneously from scalp and mesial temporal structures without disrupting the conducting properties of the brain coverings by burr holes and wounds. which can otherwise make simultaneous scalp and intracranial recordings unrepresentative of the habitual EEG.Methods: Simultaneous FO and scalp recordings from 314 seizures have been studied in 110 patients under telemetric presurgical assessment for temporal lobe epilepsy, Seizure on,set was identified on scalp records while blind to recordings from FO electrodes and vice versa.Results: Bilateral onset (symmetric or asymmetric) was more commonly found in scalp than in FO recordings. The contrary was true for unilateral seizure onset. In seizures with bilateral asymmetric onset on the scalp, the topography of largest-amplitude scalp changes at onset does not have localizing or lateralizing value. However. 75-76% of seizures showing unilateral scalp onset with largest amplitude at T1/T2 or T3/T4 had mesial temporal onset. This proportion dropped to 42% among all seizures with a unilateral scalp onset at other locations. Of those seizures with unilateral onset on the scalp at T1/T2, 65.2% showed an ipsilateral mesial temporal onset, and 10.9% had scalp onset incorrectly lateralized with respect to the mesial temporal onset seen on FO recordings. In seizures with a unilateral onset on the scalp at electrodes other than T1/T2, the proportions of seizures With correctly and incorrectly lateralized mesial temporal onset were 37.5 and 4.2%, respectively. Thus the ratio between incorrectly and correctly lateralized mesial temporal onse is largely similar for seizures with unilateral scalp onset at T1/T2 (16.7%)and for seizures with unilateral scalp onset at electrodes other than T1/T2 (11.2%). The onset of scalp changes before the onset of clinical manifestations is not associated with a lower proportion of seizures with bilateral onset on the scalp, or with a higher percentage of mesial temporal seizures or of mesial temporal seizures starting ipsilateral to the side of scalp onset. In contrast, the majority (78.4%) of mesial temporal seizures showed clinical manifestations starting after ictal onset on FO recordings.Conclusions: A bilateral scalp onset (symmetric or asymmetric) is compatible with a mesial temporal onset, and should not deter further surgical assessment. Although a unilateral scalp onset at T1/T2 jr T3/T4 is associated with a higher probability of mesial temporal onset, a unilateral onset at other scalp electrodes does not exclude mesial temporal onset. A unilateral scalp onset at electrodes other than T1/T2 is less likely to be associated with mesial temporal onset, but its lateralizing value is similar to that of unilateral scalp onset at T1/T2. The presence of clinical manifestations preceding scalp onset does not reduce the localizing or lateralizing values of scalp recordings