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"Children are more than just a statistic. Education is more than government outlines": Primary teachers' perspectives on the standards agenda in EnglandThis paper focuses on qualitative findings from a study that investigated primary teachers’ perspectives on the standards agenda in England. Q-methodology was used to investigate the complexity of their perspectives. The study’s Q-methodology findings are published in Education 3-13 (Williams-Brown and Jopling, 2021). This paper focuses on qualitative responses from this study that were completed after the Q-methodology card sort. It focuses on teachers’ overall perspectives on the standards agenda and statements from the card sort that were placed by five participants or more in the extreme columns of the distribution grid. Findings from the study evidence that teachers were not opposed to standards and accountability, but they voiced a variety of concerns that did not focus solely on SATs. These include concerns about perceptions of achievement, experiences of assessment and measures taken to hold teachers and schools accountable for their actions. Teachers did also emphasise concerns with SATs and discussed the need for objectives to be inclusive and consider the needs of children with SEND. The paper concludes by questioning whether this is the time to reconsider standards agenda objectives.
Abiraterone acetate and prednisolone with or without enzalutamide for high-risk non-metastatic prostate cancer: a meta-analysis of primary results from two randomised controlled phase 3 trials of the STAMPEDE platform protocolBackground Men with high-risk non-metastatic prostate cancer are treated with androgen-deprivation therapy (ADT) for 3 years, often combined with radiotherapy. We analysed new data from two randomised controlled phase 3 trials done in a multiarm, multistage platform protocol to assess the efficacy of adding abiraterone and prednisolone alone or with enzalutamide to ADT in this patient population. Methods These open-label, phase 3 trials were done at 113 sites in the UK and Switzerland. Eligible patients (no age restrictions) had high-risk (defined as node positive or, if node negative, having at least two of the following: tumour stage T3 or T4, Gleason sum score of 8–10, and prostate-specific antigen [PSA] concentration ≥40 ng/mL) or relapsing with high-risk features (≤12 months of total ADT with an interval of ≥12 months without treatment and PSA concentration ≥4 ng/mL with a doubling time of <6 months, or a PSA concentration ≥20 ng/mL, or nodal relapse) non-metastatic prostate cancer, and a WHO performance status of 0–2. Local radiotherapy (as per local guidelines, 74 Gy in 37 fractions to the prostate and seminal vesicles or the equivalent using hypofractionated schedules) was mandated for node negative and encouraged for node positive disease. In both trials, patients were randomly assigned (1:1), by use of a computerised algorithm, to ADT alone (control group), which could include surgery and luteinising-hormone-releasing hormone agonists and antagonists, or with oral abiraterone acetate (1000 mg daily) and oral prednisolone (5 mg daily; combination-therapy group). In the second trial with no overlapping controls, the combination-therapy group also received enzalutamide (160 mg daily orally). ADT was given for 3 years and combination therapy for 2 years, except if local radiotherapy was omitted when treatment could be delivered until progression. In this primary analysis, we used meta-analysis methods to pool events from both trials. The primary endpoint of this meta-analysis was metastasis-free survival. Secondary endpoints were overall survival, prostate cancer-specific survival, biochemical failure-free survival, progression-free survival, and toxicity and adverse events. For 90% power and a one-sided type 1 error rate set to 1·25% to detect a target hazard ratio for improvement in metastasis-free survival of 0·75, approximately 315 metastasis-free survival events in the control groups was required. Efficacy was assessed in the intention-to-treat population and safety according to the treatment started within randomised allocation. STAMPEDE is registered with ClinicalTrials.gov, NCT00268476, and with the ISRCTN registry, ISRCTN78818544. Findings Between Nov 15, 2011, and March 31, 2016, 1974 patients were randomly assigned to treatment. The first trial allocated 455 to the control group and 459 to combination therapy, and the second trial, which included enzalutamide, allocated 533 to the control group and 527 to combination therapy. Median age across all groups was 68 years (IQR 63–73) and median PSA 34 ng/ml (14·7–47); 774 (39%) of 1974 patients were node positive, and 1684 (85%) were planned to receive radiotherapy. With median follow-up of 72 months (60–84), there were 180 metastasis-free survival events in the combination-therapy groups and 306 in the control groups. Metastasis-free survival was significantly longer in the combination-therapy groups (median not reached, IQR not evaluable [NE]–NE) than in the control groups (not reached, 97–NE; hazard ratio [HR] 0·53, 95% CI 0·44–0·64, p<0·0001). 6-year metastasis-free survival was 82% (95% CI 79–85) in the combination-therapy group and 69% (66–72) in the control group. There was no evidence of a difference in metatasis-free survival when enzalutamide and abiraterone acetate were administered concurrently compared with abiraterone acetate alone (interaction HR 1·02, 0·70–1·50, p=0·91) and no evidence of between-trial heterogeneity (I2 p=0·90). Overall survival (median not reached [IQR NE–NE] in the combination-therapy groups vs not reached [103–NE] in the control groups; HR 0·60, 95% CI 0·48–0·73, p<0·0001), prostate cancer-specific survival (not reached [NE–NE] vs not reached [NE–NE]; 0·49, 0·37–0·65, p<0·0001), biochemical failure-free-survival (not reached [NE–NE] vs 86 months [83–NE]; 0·39, 0·33–0·47, p<0·0001), and progression-free-survival (not reached [NE–NE] vs not reached [103–NE]; 0·44, 0·36–0·54, p<0·0001) were also significantly longer in the combination-therapy groups than in the control groups. Adverse events grade 3 or higher during the first 24 months were, respectively, reported in 169 (37%) of 451 patients and 130 (29%) of 455 patients in the combination-therapy and control groups of the abiraterone trial, respectively, and 298 (58%) of 513 patients and 172 (32%) of 533 patients of the combination-therapy and control groups of the abiraterone and enzalutamide trial, respectively. The two most common events more frequent in the combination-therapy groups were hypertension (abiraterone trial: 23 (5%) in the combination-therapy group and six (1%) in control group; abiraterone and enzalutamide trial: 73 (14%) and eight (2%), respectively) and alanine transaminitis (abiraterone trial: 25 (6%) in the combination-therapy group and one (<1%) in control group; abiraterone and enzalutamide trial: 69 (13%) and four (1%), respectively). Seven grade 5 adverse events were reported: none in the control groups, three in the abiraterone acetate and prednisolone group (one event each of rectal adenocarcinoma, pulmonary haemorrhage, and a respiratory disorder), and four in the abiraterone acetate and prednisolone with enzalutamide group (two events each of septic shock and sudden death). Interpretation Among men with high-risk non-metastatic prostate cancer, combination therapy is associated with significantly higher rates of metastasis-free survival compared with ADT alone. Abiraterone acetate with prednisolone should be considered a new standard treatment for this population.
Challenges negating virtual construction project team performance in the Middle EastPurpose Over the last couple of decades, many organisations are increasingly adopting virtual team concepts, and construction companies in the Middle East are no exception. Members of a virtual team are geographically scattered and represent diverse cultures. Thus, challenging issues emerge more frequently than in a traditional team. There are challenges associated with space and time as well as high client’s demand. Therefore, this study aims to identify and probe the causes of the challenges in virtual project teams in the construction industry of the Middle East. Design/methodology/approach A list of challenges was derived through a comprehensive review of relevant literature. Questionnaire survey was conducted with professionals who are involved in construction virtual project teams. Further, the factor analysis technique was used to analyse the survey responses. Findings Results show that the challenges in virtual team arrangement in the Middle East construction industry can be grouped into seven categories, namely: organisational culture, conflict within the team, characteristics of the team members, trust within the team members diversity of the team, communication and training, and cohesion in the team. Understanding of these factors will drive the needed platform to support effective virtual project teams in the Middle East. Originality/value This study raises the prospect that organisations may establish an environment for team members to achieve higher levels of virtual cooperation by concentrating on these potentially crucial factors. This, in turn, will encourage further innovation and performance within construction organisations.
Experimental and simulation study of the effect of cut-out defect in carbon fibres twill weave compositeThe automated fibre placement (AFP) is an effective manufacturing process that produces a large complex structure with high quality at low secondary waste. Although, the AFP is highly accurate and reproducible and very common in the aerospace application, break and cut-out defect in the plies are inevitable. In this study, we have investigated 4 different types of geometrical cut-out defect that have an equal area (38.4 mm2) that cut from identical locations in the specimen plies. The effect of triangular, rectangular, square and circular cut-out defect has been investigated and compared to a virgin material that has no flaw or cut-out defect in the plies. It has been observed and hence reported that the circle induced flaw has caused 73% reduction in the impact strength due its 360° distortion of carrying stress. The failure mode of the circular cut-out defect specimens was proven to be matrix crack due to miscarriage of the stresses in the fibre, while a pull-out fibres failure mode has been observed in the virgin specimen. The experimental work has been validated using FEA analysis that identically simulate the boundary condition of both bending and impact test.
Stressful life events and deliberate self-harm: Exploring the specificity of stressful life events and emotion regulation facetsObjective: The current study aimed to examine if specific emotion regulation facets mediated the relationship between different stressful life events and deliberate self-harm. It examined both the cumulative and specific effects of stressful life events. Methods: A quantitative correlational survey method was adopted using several questionnaires to explore the relationship between stressful life events, emotion dysregulation and self-harm engagement. The sample included 164 individuals who were seeking support from a secondary care NHS service. Analysis was conducted using Mplus 6 and involved two mediation models. Results: The results demonstrated that different types of stressful life events were significantly associated with engagement in deliberate self-harm. This varied depending on the stressful life event, in which some stressful life events decreased self-harm engagement. In isolation the number of stressful life events was not significantly associated with self-harm, indicating that there was no cumulative effect of stressful life events on engagement in deliberate self-harm. However, experiencing more stressful life events was significantly associated with deliberate self-harm through specific emotion regulation facets. Conclusions: Results indicated that stressful life events are more likely to contribute to the engagement in deliberate self-harm when they coexist. The current findings contribute to a deeper understanding of the mediating processes between stressful life events and deliberate self-harm. They specifically demonstrate that particular pathways to deliberate self-harm are not determined by the presence of stressful life events, but the ways in which emotion regulation ability is refined and developed during their presence, which subsequently effects the individuals need to use deliberate self-harm as a means of managing their distress.