Now showing items 41-60 of 1382

    • We Belong: differential sense of belonging and its meaning for different ethnicity groups in higher education

      Cureton, Debra; Gravestock, Phil (University of Greenwich, Educational Development Unit, 2019-06-30)
      This paper covers two studies that explore student belonging in higher education and how a sense of belonging differs between ethnicity groups. The research took a mixed methodology approach, collecting both quantitative data via a survey and qualitative data via focus groups. Study One explored the differential experiences of belonging via the Belongingness Survey (Yorke, 2016), with a group of 941 students. This was followed by Study Two, which used focus groups to generate a greater understanding of what belonging meant to the students, how belonging developed and to identify barriers to developing a sense of belonging. This work concluded that ethnicity-based differences in students sense of belonging are apparent, which mirror the differences that are witnessed at a sector level in degree outcomes. Additionally, belongingness is found to have an unstable nature in that it waxes and wanes, and can be lost or developed at any part of the student lifecycle. Some student-identified initiatives to support the development of belonging are presented. The findings are discussed in the light of the current literature on differential outcomes.
    • From local to institutional attainment change: scaling-up local initiatives

      Gravestock, Phil; Cureton, Debra (Educational Development Unit, University of Greenwich, 2019-06-30)
      Ethnicity-based gaps in degree outcomes are a pervasive sector issue. At the University of Wolverhampton, substantial investments have been made a) to fund research into why the outcomes gap occurs, the better to understand it, and then b) to implement and evaluate initiatives to reduce it. However, upscaling smaller initiatives to university-wide actions can be fraught with issues. This case study will provide a synthesis of the research carried out at Wolverhampton and the ways this was used as an evidence-base to inform institutional change. The study will also consider some of the lessons learnt from our attempts to embed the outcomes into institutional business as usual.
    • The effects of physical exercise on cardiometabolic outcomes in women with polycystic ovary syndrome not taking the oral contraceptive pill: a systematic review and meta-analysis

      Woodward, A; Broom, D; Harrop, D; Lahart, I; Carter, A; Dalton, C; Metwally, M; Klonizakis, M (Springer Science and Business Media LLC, 2019-07-29)
      © 2019, The Author(s). Purpose: Women with polycystic ovary syndrome (PCOS) exhibit many metabolic abnormalities that are associated with an increased cardiovascular disease risk. Exercise may promote improvements in lipid profile and insulin sensitivity in women with PCOS. There is however, a knowledge gap on the optimal dose of exercise, regarding duration, intensity, type, and frequency of exercise. The aim of this systematic review and meta-analysis was to define effective types of exercise to improve cardiometabolic profile in PCOS. Methods: We included randomised controlled trials (RCT), quasi-RCT, and controlled clinical trials focusing on reproductive-aged women diagnosed with PCOS. Eligible interventions included those with at least two weeks of supervised exercise sessions. Primary outcomes were blood lipids, blood glucose, blood pressure, measures of abdominal adiposity, and inflammation markers. Secondary outcomes were total and free testosterone, sex hormone binding globulin, and measures of insulin resistance. Nine electronic databases were searched from inception to present for English language publications. The Cochrane Risk Assessment tool was used to assess bias in the included studies. Outcomes were quantitatively synthesised and a meta- analysis was performed. Pooled effect estimates and 95% confidence intervals were presented. Results: This systematic review identified three trials, including 231 participants with PCOS, that examined the effect of structured, supervised exercise on cardiometabolic outcomes. Analysis of pooled data indicated statistical favourable effects of exercise on total cholesterol, fasting glucose, waist circumference and waist-to-hip ratio, systolic blood pressure, C-reactive protein, total testosterone, and sex hormone binding globulin using post-intervention scores. Conclusions: Moderate aerobic exercise interventions ≥3 months in duration, with a frequency of 3/week for at least 30-min, may have favourable effects on various cardiometabolic risk factors in women with PCOS. However, results should be interpreted with caution. Many of the outcomes were based on studies with serious methodological limitations, and only one “gold-standard” RCT was identified. PROSPERO ID: CRD42018086117.
    • The effects of exercise on cardiometabolic outcomes in women with polycystic ovary syndrome not taking the oral contraceptive pill: Protocol for a systematic review and meta-analysis

      Woodward, A; Klonizakis, M; Lahart, I; Carter, A; Dalton, C; Metwally, M; Broom, D; Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Crescent, Sheffield, S10 2BP, UK. (Springer Science and Business Media LLC, 2019-05-16)
      © 2019 The Author(s). Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy, affecting 4-12% of reproductive-aged women. Women with PCOS often exhibit many metabolic abnormalities that are associated with an increased cardiovascular disease (CVD) risk, independent of obesity. Exercise interventions from 12 to 24 weeks have been shown to have positive effects on blood lipid profile, ovulation and insulin resistance in women with PCOS. However, no consensus on which exercise interventions are effective (i.e. duration, type of exercise, frequency), including for different phenotypes, currently exists. The aim of this systematic review and meta-analysis is to define effective types of exercise interventions to improve cardiometabolic profile, across the range of phenotypes of PCOS. Methods: We will conduct electronic database searches, including randomised-controlled trials (RCT), quasi-RCT and clinical trials. Primary outcomes sought will be lipid profile, carotid-intima media thickness, fasting blood glucose, %HbA1c, blood pressure, waist circumference, waist-to-hip ratio, abdominal adiposity and inflammation markers. Secondary outcomes sought will be free and total testosterone, sex hormone binding globulin and insulin resistance. The Cochrane Risk Assessment Tool will be used to assess study quality. Data will be analysed in RevMan. Analysis of heterogeneity will be undertaken using the I 2 statistic. Significant heterogeneity will be explored, and sensitivity analyses carried out as appropriate. A subgroup analysis based on androgen profile will be undertaken if data are sufficient. Discussion: A large proportion of women are affected by PCOS. It is prudent to examine how CVD risk can be mitigated in this high-risk population, and this review aims to provide evidence-driven recommendations on the types of exercise interventions that are effective for this. The review will seek to provide recommendations regarding type, frequency and duration of exercise interventions to improve cardiometabolic profile in PCOS. The subgroup analysis may be able to highlight difference in intervention effects between normo-androgenic and hyper-androgenic profile. Limitations include heterogeneity across studies and a scarcity of clinical trials involving a PCOS control group not undertaking any intervention.
    • The effects of continuous compared to accumulated exercise on health: A meta-analytic review

      Murphy, MH; Lahart, I; Carlin, A; Murtagh, E; Centre for Exercise, Physical Activity, Medicine and Health, Ulster University, Jordanstown, Northern Ireland, UK. (Springer Science and Business Media LLC, 2019-07-02)
      © 2019, The Author(s). Background: Public health guidelines suggest that physical activity can be accumulated in multiple short bouts dispersed through the day. A synthesis of the evidence for this approach is lacking. Objective: Our objective was to undertake a systematic review and meta-analysis to examine if exercise interventions consisting of a single bout of exercise compared with interventions comprising the same total duration, mode, and intensity of exercise accumulated over the course of the day have different effects on health outcomes in adults. Methods: Six electronic databases were searched (Jan 1970–29 August 2018). Two authors identified studies that evaluated the effects of a single bout of exercise compared with the same intensity, total duration, and mode of exercise accumulated in multiple bouts over the course of a day, in community-dwelling adults. Risk of bias was assessed using the Cochrane Collaboration tool. Pooled effects were reported as standardised mean differences (MDs) and 95% confidence intervals (CIs) using a random effects model. Results: A total of 19 studies involving 1080 participants met the inclusion criteria. There were no differences between accumulated and continuous groups for any cardiorespiratory fitness or blood pressure outcomes. A difference was found in body mass changes from baseline to post-intervention in favour of accumulated exercise compared with continuous (MD − 0.92 kg, 95% CI − 1.59 to − 0.25, I2 = 0%; five studies, 211 participants). In subgroup analyses, accumulating > 150 min of weekly exercise in multiple bouts per day resulted in small effects on body fat percentage (combined post-intervention and change from baseline values: MD − 0.87%, 95% CI − 1.71 to − 0.04, I2 = 0%; three studies, 166 participants) compared with 150 min of exercise amassed via single continuous bouts per day. There was a decrease in low-density lipoprotein (LDL) cholesterol with accumulated versus continuous exercise (MD − 0.39 mmol/l, 95% CI − 0.73 to − 0.06, I2 = 23%; two studies, 41 participants). No differences were observed for any other blood biomarker (total cholesterol, high-density lipoprotein cholesterol, triglycerides, fasting blood glucose, and fasting insulin). Conclusions: There is no difference between continuous and accumulated patterns of exercise in terms of effects on fitness, blood pressure, lipids, insulin and glucose. There is some evidence from a small number of studies that changes in body mass and LDL cholesterol are more favourable following the accumulated condition. Collectively our findings suggest that adults are likely to accrue similar health benefits from exercising in a single bout or accumulating activity from shorter bouts throughout the day. This review will inform public health guidelines for physical activity at the global and national levels (PROSPERO 2016 CRD42016044122).
    • HeadStart local evaluation: qualitative perspectives from schools: Second Report

      Smith, Matthew; Bramwell, Lisa; Littley, Deborah (University of Wolverhampton, 2019-08-13)
      HEADLINES  There is some discontent within schools as to the levels of support from HeadStart, and a clear confusion about responsibility for the programme/s offered. Some school staff seem to want or expect HeadStart staff to run the programme/s, and there has been little take-up of staff responsibility for these. This lack of consistency from, and communication with, the HeadStart team has affected schools’ involvement and satisfaction.  Where HeadStart initiatives and programmes have had time and resources allocated to them by the schools they are reported as being effective for raising the resilience, self-esteem and selfconfidence of children, but schools are clear on the need for high quality training for all members of staff, which needs to be maintained as staff move key stages or new staff join the school.  There is a clear perception that schools have been hampered by the turnover of HeadStart staff and what they see as a lack of consistency in the support offered. The intermittent participation of schools and discontinuous support from HeadStart has resulted in limited impacts on children.  Although the profile of MHWB has been raised for staff and children, the Standards still dominate the school outlook and the input from HeadStart has not by itself been enough to meet the growing need identified by our research participants.  The development of a shared language through the use of the SUMO highlighted as a clear positive in round 1 of the research was much less obvious in this focus group exercise, with respondents stating that this was not being used by staff or students in schools.
    • Moving at scale: Promising practice and practical guidance on evaluation of physical activity programmes in the UK

      Varney, Justin; Lawson, Rachel; Williams, Tim; Copeland, Robert; Brannan, Mike; Lane, Andy; Kennedy, Lynne; Beedie, Chris; Whyte, Greg; Jimenez, Alfonso; et al. (Human Kinetics, 2018-10-30)
      Purpose: To develop effective physical activity (PA) frameworks policy makers require an understanding of which interventions increase PA at population level. This investigation identified PA interventions in the UK; considered key challenges in evaluating interventions; and provided guidance to inform and support effective evaluation. It followed from a 2014 investigation that identified and benchmarked PA interventions in England. Methods: An open call for examples of good and promising practice was made to organisations, groups, and individuals delivering PA interventions in the UK. Participants completed a questionnaire based upon elements of the Standard Evaluation Framework for Physical Activity Programmes. Nesta Standards of Evidence were interpreted and used to score projects and programmes based on an assessment of the evaluation method used. Results: A total of 302 completed submissions were assessed; 17 interventions used a control or comparison group; 12 were evaluated by an external evaluator; 55% of interventions collected pre/post measures; 22% engaged between 1,000 and 5,000 participants with 8% including >25,000 participants; 27% had been on-going for 2-5 years; 55% were delivered in a local authority leisure facility; 40% received funding from local authorities and 32% from private funders. Conclusions: The quality of monitoring, data collection, and evaluation processes embedded into programme delivery has improved since the 2014 review, which is encouraging. Non-inclusion of control or comparison groups (although not always appropriate) remains a barrier in demonstrating the causal impact of programmes. Few studies reported independent evaluation. Inadequate or incomplete submissions also impacted assessment.
    • Do I focus on the process of cycling or try to put my mind elsewhere? A comparison of concentration strategies for use in pacing by novice riders

      Robinson, DT; Cloak, R; Lahart, IM; Lane, AM; University of Wolverhampton, Wolverhampton, United Kingdom. (Elsevier, 2018-10-13)
      © 2018 Elsevier B.V. The ability to hold a pace is a key skill for endurance athletes. The present study compared the influence of different strategies on how athletes learn to pace at 80% of their maximum performance for a 3-min cycle time trial. Participants first completed three maximal 3-min tests to establish maximal performance. During subsequent visits we asked participants to ride at 80% of their average maximal 3-min power output for four 3-min efforts under different conditions. Participants were blinded to feedback for three of the four conditions with participants (a) riding on feel (all feedback blinded), (b) associating on the task by focusing attention on the skills needed for efficient cycling, and (c) dissociating from the task by intentionally focusing concentration elsewhere (d) and finally, participants rode with full feedback where pace could be regulated via observation. All participants completed the blind condition first, the full feedback condition last, with association focus and dissociation focus rides being alternated. As expected, results showed participants rode close to the 80% goal when observing full feedback. Participants rode at 82% of maximum in the blind “ride on feel” condition, 79% in the associative condition, and 70% in the dissociative condition. We suggest results show that simple strategies related to concentration can influence the accuracy of pacing efforts. The difference in the ability to pace while using an associative or dissociative attentional focus was consistent with theory. The differences we observed occurred with minimal input from participants in terms of actively learning psychological skills. Future research is needed to investigate how athletes learn to use pacing strategies to help performance.
    • Pedagogically mediated listening practices; the development of pedagogy through the development of trust

      Lyndon, H; Bertram, T; Brown, Z; Pascal, C (Informa UK Limited, 2019-04-18)
      © 2019 EECERA. This paper reports on a segment of Ph.D. research which was undertaken to develop participatory pedagogy working specifically within a praxeological paradigm [Oliveira-Formosinho, J., and J. Formosinho. 2012a. “Praxeological Research in Early Childhood: a Contribution to a Social Science of the Social.” European Early Childhood Education Research Journal 20 (4): 471–476; Pascal, C., and T. Bertram. 2012. “Praxis, Ethics and Power: Developing Praxeology as a Participatory Paradigm for Early Childhood Research.” European Early Childhood Education Research Journal 20 (4): 477–492]. It focuses on the development of listening practices through a process of pedagogic mediation [Oliveira-Formosinho, J., and J. Formosinho. 2012b. Pedagogy-in Participation: Childhood Association Educational Perspective. Porto: Childhood association and Porto Editoria]. The research was carried over two academic years in a private day care setting in England and aimed to enhance pedagogic practice with three and four-year olds. This qualitative methodology encompassed ethnographic techniques to develop a case study [Stake, R. 1995. The Art of Case Study Research. London: Sage]. It researched the development of participatory practice through pedagogic mediation, as developed by the Childhood Association, Portugal (Oliveira-Formosinho and Formosinho 2012b). This paper reports on two listening methods which were developed between researcher, practitioner and the children in the setting. These methods demonstrate the co-constructed participatory pedagogy and the isomorphic nature of learning [Formosinho, J., and J. Formosinho. 2016. “The Search for a Holistic Approach.” In Assessment and Evaluation for Transformation in Early Childhood, edited by J. Formosinho, and C. Pascal, 93–106. London: Routledge].
    • HeadStart schools qualitative research

      Smith, Matthew (BESA, 2019-06-27)
      In order to understand the perspectives of schools participating in the HeadStart programme better, the Education Observatory undertook qualitative research with the member of senior management with overall responsibility for PSHE, SUMO and/or the integration of HeadStart in a focused sample group of four primary schools. Using a common semi-structured interview schedule based on our created theoretical framework, four researchers each went in to one primary school to interview the lead teacher. Their responses were then analysed by the research team and collated to identify key themes. Schools stated programmes which were embedded in school practice had greater impact. In these cases HeadStart activities are seen as complementary rather than an add-on; that children were involved in learning essential skills for life, coupled with developing greater self-esteem and resilience; and that teachers have also become more conscious of their own mental health and wellbeing as a result of their engagement with HeadStart. The development of a shared language through SUMO was highlighted as positive, but schools were clear about the need for high quality training for all members of staff, which needs to be maintained as staff move key stages or new staff join the school.
    • Where bias begins: a snapshot of police officers’ beliefs about factors that influence the investigative interview with suspects

      Adams-Quackenbush, Nicole M; Horselenberg, Robert; van Koppen, Peter J (Springer Nature, 2018-11-10)
      The aim of the current study was to obtain a snapshot of police officer’s beliefs about factors that may influence the outcome of the investigative interview with suspects. We created a 26-item survey that contained statements around three specific themes: best interview practices, confessions and interviewee vulnerabilities. Police officers (N = 101) reported their beliefs on each topic by indicating the level of agreement or disagreement with each statement. The findings indicated that this sample of officers held beliefs that were mostly consistent with the literature. However, many officers also responded in the mid-range (neither agree nor disagree) which may indicate they are open to developing literature-consistent beliefs of the topics. Understanding what officers believe about factors within the investigative interview may have implications for future training. It may also help explain why some officers do not consistently apply best practices (i.e. strong counterfactual beliefs) versus officers who reliably apply literature-consistent practices to their interviews (i.e. knowledge-consistent beliefs).
    • Death by effectiveness: Exercise as medicine caught in the efficacy trap!

      Beedie, C; Mann, S; Jimenez, A; Kennedy, L; Lane, AM; Domone, S; Wilson, S; Whyte, G; Department of Psychology, Aberystwyth University, Ceredigion, Wales, UK ukactive Research Institute, London, UK. (BMJ, 2016-03-02)
      Sport and Exercise Medicine (SEM) has had a good run. For a while it was the low-cost magic bullet. With efficacy demonstrated in study after study, the conclusion was clear: ‘Exercise is Medicine’, a potential public health panacea. Sadly, the early promise waned. While we continue to be bombarded by original research and reviews extoling the efficacy of exercise, there is an apparent dearth of evidence of its effectiveness. This fact is highlighted in 2014 reports from the UK Government and Public Health England.
    • The experiences of orthopaedic and trauma hospital care from the perspectives of adults with an intellectual/learning disability in England, UK: An interpretative phenomenological analytical study

      Drozd, Mary; Chadwick, Darren; Jester, Rebecca (RCN, 2019-09-03)
      Introduction: Musculoskeletal conditions and injuries are prevalent in people with intellectual disabilities and have significant impacts on wellbeing. This study was important as this group seldom have their voices heard and their experiences valued and interpreted. Aim: To better understand the orthopaedic and trauma hospital experiences from the perspective of people with an intellectual disability. Methods: A qualitative perspective focusing on peoples’ lived experiences was utilized. A purposive sample of five participants was recruited and one-to-one, semi-structured interviews were undertaken. Analysis of the interviews employed an interpretative phenomenological analytical framework. Results: A cross-case comparison was undertaken and the themes below represent common experiences across participants: • Communication problems. • Lack of person-centred care. • Issues related to pain. • Lack of confidence in hospital care. • The support of carers. • Incompetence of hospital staff. • Loneliness. Implication for practice: Specific and on-going education and training of health care staff is required to improve orthopaedic and trauma care for people with an intellectual disability around: • Effective communication • Regular and competent pain assessment and management • Including and valuing carers of adults with an intellectual disability • Person-centred care for all
    • Should patients be denied access to total joint replacement surgery because they are obese?

      Jester, Rebecca (Elsevier, 2019-12-31)
      Since 1990 The World Health Organisation (WHO) has raised concerns about increasing rates of obesity in both children and adults. Once considered a problem only in high income countries, overweight and obesity are now dramatically on the rise in low- and middle-income countries, particularly in urban settings. WHO defines individuals who have a BMI between 25-29.9 as overweight and a BMI of 30 or over as obese. Obesity is subdivided into 3 classes: class 1 BMI 30-34.9, class 2 BMI 35-39.9 and class 3 BMI of 40 or over. Overweight and obesity are major risk factors for a number of chronic diseases including diabetes, cardiovascular and cancer. In our speciality the impact of overweight and obesity on development of osteoarthritis in load bearing joints is well documented. Increasing numbers of people with severe OA of the knee joint requiring TKR is a global challenge in the developed world with TKR in-patient costs exceeding $9 billion in 2008 in the USA alone- the highest aggregate cost among the ten procedures for which demand is growing fastest. Between, 2005-2030 the demand for primary TKR in the US is projected to grow by 673% or 3.48 million procedures annually (Tomek et al, 2012).
    • Agile digital age pedagogy for teachers: ADAPT

      Royle, Karl; Nikolic, Jasmina (NAACE, 2013-07-01)
      Introduction Recent research Underwood et al,( 2010), Hadfield et al (2009) Royle and Hadfield (2012) has illustrated that the integration and use of ICT in education tends towards the enhancement of existing practices and this may account for a lack of transformation or innovation in approach at the pedagogic level. Potential drivers of educational transformation are the digital tools and related habits that are transforming how we work, learn in informal and formal spaces and socialise in daily life. This affords us new insights into how institutions can be organised, knowledge generated and created and leads to the potential for a greater range of capabilities. In a world where the use of technology can enable a more personalised and diverse approach perhaps a different way of looking at human development is required. The capability approach Sen (1992, 1999) is one such way of thinking about the manner in which human beings are able or otherwise (due to particular contexts or systems) to achieve the sort of life that they value. Sen, (1992:40) describes the approach as follows: The major constituents of the capability approach are functionings and capabilities. Functionings are the “beings and doings” of a person, whereas a person’s capability is “the various combinations of functionings that a person can achieve” Zheng (2010) notes, quoting Sen (1987:36) that: “A functioning is an achievement, whereas a capability is the ability to achieve.” Sen (1987) This means that capability is the range of possibilities open to individuals that can subsequently be converted into valued functionings. This range is dependent upon their context and the systems and processes, good and services etc. that may extend their capabilities or constrain them. With this in mind it is imperative that educators are knowledgeable about their learners and the digital systems that they engage in so that their skills are valued and capabilities converted into effective functioning. At the same time, the education system, its values and in particular its curricula must be examined to ensure that it does not constrain those that engage with it but rather that it opens a space for diversity in both learning and teaching.
    • Hard Times today: popular culture and the austerity myth

      Bennett, Peter; MacDougall, Julian (openDemocracy, 2016-07-21)
      “Where are the red-eyed dreamers and clenched fist fighters? Didn’t they swear when these walls fell a citadel would rise? They’ve turned to schemers, all, and underwriters Leaning on the parapets to tell the same old lies.” (Nick Burbridge, After the Deluge) In his seminal collection of cultural readings, Mythologies, Roland Barthes turned his attention to a quintessential twentieth century myth embodied in ‘The Brain of Einstein’. This appropriation of the brain of the great genius as “a mythical object” is, for Barthes, paradoxical since “the greatest intelligence of all provides an image of the most up-to-date machine, the man who is too powerful is removed from psychology, and introduced into a world of robots”. As Barthes points out, Einstein “is commonly signified by his brain, which is like an object for anthologies, a true museum exhibit”.
    • Why we must never become classroom managers

      Bennett, Peter; Robinson, Denise (Bloomsbury Publishing, 2019-07-11)
      This chapter offers a genealogical account of the issues surrounding ‘classroom management’ as manifest in schools, the Education and Training sector and in Teacher Education departments. Genealogy here is one of Foucault’s methodological ‘weapons’ for flushing out assumptions; claims about what is right and what is wrong and judgments based on second order political positions. It does not believe that history is going somewhere or indeed has come from anywhere, but it does seek to identify the contingent events which may have prompted one course of action over other possibilities (Kendall & Wickham 1999: 29-31). In 2014 Ofsted published a report, Low-level disruption in classrooms: below the radar which underlined the degree to which a neo-liberal and at the same time retrogressive agenda had gripped English education. This ‘survey report looking into the nature and extent of low-level disruptive behaviour in primary and secondary schools in England’ was widely reported with the headlines suggesting that ‘pupils are potentially losing up to an hour of learning each day in English schools because of this kind of disruption in classrooms’ (Ofsted 2014: 5).
    • Abiraterone in “high-” and “low-risk” metastatic hormone-sensitive prostate cancer

      Hoyle, Alex P; Ali, Adnan; James, Nicholas D; Cook, Adrian; Parker, Christopher C; de Bono, Johann S; Attard, Gerhardt; Chowdhury, Simon; Cross, William R; Dearnaley, David P; et al. (Elsevier BV, 2019-08-23)
      Background Abiraterone acetate received licencing for use in only “high-risk” metastatic hormone-naïve prostate cancer (mHNPC) following the LATITUDE trial findings. However, a “risk”-related effect was not seen in the STAMPEDE trial. There remains uncertainty as to whether men with LATITUDE “low-risk” M1 disease benefit from androgen deprivation therapy (ADT) combined with abiraterone acetate and prednisolone (AAP). Objective Evaluation of heterogeneity of effect between LATITUDE high- and low-risk M1 prostate cancer patients receiving ADT + AAP in the STAMPEDE trial. Design, setting, and participants A post hoc subgroup analysis of the 2017 STAMPEDE “abiraterone comparison”. Staging scans for M1 patients contemporaneously randomised to ADT or ADT + AAP within the STAMPEDE trial were evaluated centrally and blind to treatment assignment. Stratification was by risk according to the criteria set out in the LATITUDE trial. Exploratory subgroup stratification incorporated the CHAARTED criteria. Outcome measurements and statistical analysis The primary outcome measure was overall survival (OS) and the secondary outcome measure was failure-free survival (FFS). Further exploratory analysis evaluated clinical skeletal-related events, progression-free survival (PFS), and prostate cancer-specific death. Standard Cox-regression and Kaplan-Meier survival estimates were employed for analysis. Results and limitations A total of 901 M1 STAMPEDE patients were evaluated after exclusions. Of the patients, 428 (48%) were identified as having a low risk and 473 (52%) a high risk. Patients receiving ADT + AAP had significantly improved OS (low-risk hazard ratio [HR]: 0.66, 95% confidence interval or CI [0.44–0.98]) and FFS (low-risk HR: 0.24, 95% CI [0.17–0.33]) compared with ADT alone. Heterogeneity of effect was not seen between low- and high-risk groups for OS or FFS. For OS benefit in low risk, the number needed to treat was four times greater than that for high risk. However, this was not observed for the other measured endpoints. Conclusions Men with mHNPC gain treatment benefit from ADT + AAP irrespective of risk stratification for “risk” or “volume”. Patient summary Coadministration of abiraterone acetate and prednisolone with androgen deprivation therapy (ADT) is associated with prolonged overall survival and disease control, compared with ADT alone, in all men with metastatic disease starting hormone therapy for the first time.
    • Enabling Employability through inclusive placement learning

      Thompson, David (European Educational Research Association, 2019-07-18)
      The participation and experiences of disabled students in higher education has been the focus of attention in recent years (HEFCE,2018; Equality Challenge Unit and the Higher Education Academy, 2010; Brewster, 2016) in the United Kingdom. Across Europe there is a recognition that inclusive education and associated best practice is needed to facilitate the study of students with SEN/disabilities (European Agency for Special Needs and Inclusive Education, 2016). Both the EU and national governments support and acknowledge the inclusion of under-represented groups in higher education and the active engagement of disabled people in higher education, supported by the European Disability Strategy and the United Nations convention of the Rights of Persons with Disabilities (Riddell, no date).
    • Smokeless tobacco use: pattern of use, knowledge and perceptions among rural Bangladeshi adolescents

      Ullah, MZ; Lim, JNW; Ha, MA; Rahman, MM (PeerJ, 2018-08-21)
      © 2018 Ullah et al. Background. The aim of the study was to investigate the practice and pattern of smokeless tobacco (SLT) use as well as the knowledge and perception about its ill effects among rural Bangladeshi adolescents. Methods. A cross-sectional survey was conducted among students aged 13-18 years in two rural secondary schools in Bangladesh in August 2015. Data were collected through a self-administered questionnaire which consists of topics derived from the Social Cognitive Theory and Health Belief Model (personal characteristics, environmental factors, self-efficacy, outcome expectancies, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action). Data analysis was performed using SPSS version 24. A descriptive analysis was conducted to determine the current pattern of SLT use and knowledge about its ill effects. A chi-square test and Fisher exact test were conducted to explore associations between variables. Lastly, a logistic regression model was used to locate the predictors for current SLT use. Results. A total of 790 students participated in the study. Among them, 9.5% (75) had used SLT at least once and 3.7% (29) were current SLT users. Males had a higher incidence of SLT use compared with females. The majority of students (77.3%) initiated SLT use between 10-13 years of age. Zarda' was the most common type of SLT used and most of the current users (86%) were able to buy SLT without age restrictions. Most of the current users (90%) wanted to quit SLT immediately; however, professional help was not available in schools. Overall, students had a good knowledge about the harmful effects of SLT with 54.8% (428) of respondents scoring in the good knowledge category. However, the majority of never SLT users (55.4%; 396) had a good knowledge compared to ever SLT users (42.7%; 32). Significant predictors of current SLT use included being a student aged 14 years and above (OR = 6.58, 95% CI [2.23-28.31]) as well as the variables of self-efficacy (OR = 5.78, 95% CI [1.46-19.65]), perceived barriers (OR = 0.30, 95% CI [0.10-0.74]), perceived benefit (OR = 0.21, 95% CI [0.05-1.03]) and perceived severity (OR = 0.36, 95% CI [0.16-0.91]). Discussion. This study demonstrates the need for comprehensive prevention and control programme in rural schools targeting young adolescents. Effective measure should be taken to reshape the attitude of rural adolescents towards self-confidence and competence, as to prevent SLT use.