5 research outputs found
Sex and communication effects in a mixed-motive game
No full textThis study investigates the effects of restricted communication opportunity and the sex of the subject on co-operative responses made by British dyads in a 180-trial matrix version of Prisoner's Dilemma. The first experiment employed 20 male, 20 female and 20 mixed-sex dyads who were assigned to one of four verbal communication conditions: none allowed; allowed before trial l; allowed after trial 31; allowed throughout. No differences due to the sex of the dyad were demonstrated but communication allowed throughout elicited significantly higher levels of co-operation. A financial incentive was introduced into the second experiment. Two communication conditions were retained: none allowed; allowed after trial 31. 10 male and 10 female dyads took part. Communication opportunity elicited higher levels of co-operation, especially for male pairs. Subjects were more than twice as co-operative when offered a financial incentive. Both of these experiments were conducted by a female E, the author. When experiment 2 was replicated by a male E communicaction effects, but no sex effects, were observed. However, there were no effects due to the sex of the subject but there was a main communication effect when Expts. 2 and 3 were replicated in a 8aianced sex of E.design. However, the female experimenter elicited higher levels of cooperation from all subjects regardless of their sex. The data from Expts. 2-4 were analysed in a multiple E design. Communication opportunity elicited significantly higher levels of cooperation and female Ss were less co-operative in the presence of male experimenters, but only as the duration of the inter-action increased. The experimenters themselves were found to elicit different levels of co-operation from subjects regardless of the sex of the player or of the sex of E. Experiment 2 was replicated by the author using 32 American students. American males were more co-operative than British men and both American and British women. No communication effects were observed. Experiment 2 was then repeated with E absent from the room. No significant main or inter-action effects were observed. It seems that the presence of the experimenter, whatever their sex, helps to define the psychological environment in which the subjects' strategic inter-action occurs
Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study
No full textBackground Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restrictions. Methods This international, prospective, cohort study enrolled 20 006 adult (>= 18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index <20), moderate lockdowns (20-60), and full lockdowns (>60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10middot0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0middot6% non-operation rate (26 of 4521), moderate lockdowns with a 5middot5% rate (201 of 3646; adjusted hazard ratio [HR] 0middot81, 95% CI 0middot77-0middot84; p<0middot0001), and full lockdowns with a 15middot0% rate (1775 of 11 827; HR 0middot51, 0middot50-0middot53; p<0middot0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0middot84, 95% CI 0middot80-0middot88; p<0middot001), and full lockdowns (0middot57, 0middot54-0middot60; p<0middot001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9middot1%] of 4521 in light restrictions, 317 [10middot4%] of 3646 in moderate lockdowns, 2001 [23middot8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and longterm investment in surge capacity for acute care during public health emergencies to protect elective staff and services.Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license
Landscape and Crisis in Northern England: The Representation of Communal Trauma in Film and Photography
No full textCommunal trauma is a culturally constructed ascription. Social agents propose that disastrous events have had traumatic effects upon the communities affected. If this proposition is convincing, then these events become acknowledged as communal traumas, and those affected as traumatised. This thesis examines how two crises in northern England: the Foot and Mouth Disease (F.M.D.) epidemic in Cumbria in 2001, and the demise of the mining industry in County Durham from the late 1970s onwards, have been constructed as communal traumas. While the F.M.D. epidemic in Cumbria has been explicitly studied, and therefore constructed as traumatic in sociological studies, the crisis was also broadcast through landscape imagery in press and documentary photography. This thesis examines such imagery in the work of photographers Nick May, John Darwell and Ian Geering, and in the printed and television media, and assesses how it has also contributed to the idea of F.M.D. as a communal trauma. This is one of the original contributions of this thesis. Another is the examination of the disappearance of the mining industry in County Durham since the rationalisation of the late 1970s, as communal trauma. This demise also had devastating economic, social and cultural effects for the communities involved, but has seldom been construed as communally traumatic. However, the film and photography of Newcastle’s Amber art collective creates a narrative that suggests precisely this, and fundamental to that narrative is landscape imagery. Their collaboration with the communities experiencing the effects of this demise, and the exhibition of their films and photography back to that community has created a vision of traumatic social change that is both corroborated and constructed by those most affected. With a detailed examination of the imagery of these two specific crises
in Northern England, this thesis examines how landscape has contributed to the cultural construction of trauma
Validation of the OAKS prognostic model for acute kidney injury after gastrointestinal surgery
No full textBackground Postoperative acute kidney injury (AKI) is a common complication of major gastrointestinal surgery with an impact on short- and long-term survival. No validated system for risk stratification exists for this patient group. This study aimed to validate externally a prognostic model for AKI after major gastrointestinal surgery in two multicentre cohort studies.Methods The Outcomes After Kidney injury in Surgery (OAKS) prognostic model was developed to predict risk of AKI in the 7 days after surgery using six routine datapoints (age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker). Validation was performed within two independent cohorts: a prospective multicentre, international study ('IMAGINE') of patients undergoing elective colorectal surgery (2018); and a retrospective regional cohort study ('Tayside') in major abdominal surgery (2011-2015). Multivariable logistic regression was used to predict risk of AKI, with multiple imputation used to account for data missing at random. Prognostic accuracy was assessed for patients at high risk (greater than 20 per cent) of postoperative AKI.Results In the validation cohorts, 12.9 per cent of patients (661 of 5106) in IMAGINE and 14.7 per cent (106 of 719 patients) in Tayside developed 7-day postoperative AKI. Using the OAKS model, 558 patients (9.6 per cent) were classified as high risk. Less than 10 per cent of patients classified as low-risk developed AKI in either cohort (negative predictive value greater than 0.9). Upon external validation, the OAKS model retained an area under the receiver operating characteristic (AUC) curve of range 0.655-0.681 (Tayside 95 per cent c.i. 0.596 to 0.714; IMAGINE 95 per cent c.i. 0.659 to 0.703), sensitivity values range 0.323-0.352 (IMAGINE 95 per cent c.i. 0.281 to 0.368; Tayside 95 per cent c.i. 0.253 to 0.461), and specificity range 0.881-0.890 (Tayside 95 per cent c.i. 0.853 to 0.905; IMAGINE 95 per cent c.i. 0.881 to 0.899).Conclusion The OAKS prognostic model can identify patients who are not at high risk of postoperative AKI after gastrointestinal surgery with high specificity.Presented to Association of Surgeons in Training (ASiT) International Conference 2018 (Edinburgh, UK), European Society of Coloproctology (ESCP) International Conference 2018 (Nice, France), SARS (Society of Academic and Research Surgery) 2020 (Virtual, UK)
