Comorbidity in severe asthma requiring systemic corticosteroid therapy: cross-sectional data from the Optimum Patient Care Research Database and the British Thoracic Difficult Asthma Registry

Objective: To determine the prevalence of systemic corticosteroid-induced morbidity in severe asthma.
Design: Cross-sectional observational study.Setting The primary care Optimum Patient Care Research Database and the British Thoracic Society Difficult Asthma Registry.
Participants: Optimum Patient Care Research Database (7195 subjects in three age- and gender-matched groups)—severe asthma (Global Initiative for Asthma (GINA) treatment step 5 with four or more prescriptions/year of oral corticosteroids, n=808), mild/moderate asthma (GINA treatment step 2/3, n=3975) and non-asthma controls (n=2412). 770 subjects with severe asthma from the British Thoracic Society Difficult Asthma Registry (442 receiving daily oral corticosteroids to maintain disease control).
Main outcome measures: Prevalence rates of morbidities associated with systemic steroid exposure were evaluated and reported separately for each group.
Results: 748/808 (93%) subjects with severe asthma had one or more condition linked to systemic corticosteroid exposure (mild/moderate asthma 3109/3975 (78%), non-asthma controls 1548/2412 (64%); p<0.001 for severe asthma versus non-asthma controls). Compared with mild/moderate asthma, morbidity rates for severe asthma were significantly higher for conditions associated with systemic steroid exposure (type II diabetes 10% vs 7%, OR=1.46 (95% CI 1.11 to 1.91), p<0.01; osteoporosis 16% vs 4%, OR=5.23, (95% CI 3.97 to 6.89), p<0.001; dyspeptic disorders (including gastric/duodenal ulceration) 65% vs 34%, OR=3.99, (95% CI 3.37 to 4.72), p<0.001; cataracts 9% vs 5%, OR=1.89, (95% CI 1.39 to 2.56), p<0.001). In the British Thoracic Society Difficult Asthma Registry similar prevalence rates were found, although, additionally, high rates of osteopenia (35%) and obstructive sleep apnoea (11%) were identified.

Conclusions: Oral corticosteroid-related adverse events are common in severe asthma. New treatments which reduce exposure to oral corticosteroids may reduce the prevalence of these conditions and this should be considered in cost-effectiveness analyses of these new treatments.

Exploiting local controversy: regional British censorship of Last Tango in Paris (1972)

This article explores local authority responses to the cinematic release of Last Tango in Paris in Britain. Using a range of archival material from the BBFC, the National Archives and the Public Records Office of Northern Ireland, it offers a detailed, comparative case study of three different locations; Belfast, Newport and Oxford. It argues that comparing local censorship decisions with the national decisions of the BBFC offer little in the way of regional nuance. In order to effectively understand the workings of local censorship, a deeper understanding of local discourses is needed as well as acknowledgement of broader pressure group activity and its impact on the local picture, such as that of the National Festival of Light.

The reception of British literature under dictatorships in Hungary and Portugal

Esta tese tem como objectivo comparar aspectos da recepção da literatura britânica durante o Estado Novo em Portugal, e na Hungria durante a era comunista. Na primeira parte da dissertação fica contextualizada e analisada a alteração da posição da literatura britânica nos dois países, enquanto na segunda parte se comparam facetas da recepção da mesma, contrastando as traduções literárias publicadas em Portugal e na Hungria entre 1949 e 1974, altura em que ambos os países foram dirigidos simultaneamente por regimes autocratas. Este estudo faz-se, em parte, através da comparação de manuais escolares e seletas, a fim de examinar os diferentes métodos usados pelos dois regimes ditatoriais politicamente opostos na tentativa de moldarem os seus leitores. É dada especial atenção à literatura proibida e aos motivos para as atitudes restritivas diferenciadas em relação a certos escritores na era de Salazar e na Hungria durante o período de Bloco de Leste. A tese conclui que a abordagem divergente em relação às obras literárias britânicas, bem como à literatura em geral, é principalmente enraizada na ideologia de governação diametralmente oposta dos dois regimes ditatoriais. A crença idealista no poder educativo da literatura em estabelecer o socialismo na Hungria está em nítido contraste com a política de cultura obscurantista do Estado Novo. Mesmo quando o apoio à literatura britânica não era uma das principais prioridades da esfera cultural húngara, parece evidente que a literatura canónica britânica teve uma recepção mais favorável na Hungria comunista do que no Estado Novo.

‘It's been hell.’ Italian and British practice educators’ narratives of working with struggling or failing social work students in practice learning settings

Periods of assessed learning in practice settings are common requirements for social work students world wide. The ‘practice learning opportunity’ as it is known in the UK, and ‘tirocinio di servizio sociale’ as it is referred to in Italy, are important sites of gatekeeping in preventing unsuitable people from becoming social workers. The experience of assessing failing students in practice learning settings however, has been found to be particularly stressful and challenging for practice educators. This article documents findings from two qualitative studies that explored field educators’ experiences of working with struggling or failing social work students in Italy and England. The study finds both similarities and differences in the narratives of the assessors from the two countries Similarities include, unpleasant emotional experience of working with a failing student, internalisation of the students failing as the practice educators’ own failing, perceptions that the universities may hide negative information about students and lack of acknowledgement of the gatekeeping function inherent in the practice educator role. Differences include the level of emotionality experienced by educators, the way students are spoken about and the perceived role and responses of the university. Further comparative European research which focuses on practice education is indicated.

Mid-Century Molecular: The Material Culture of X-ray Crystallographic Visualisation across Postwar British Science and Industrial Design

This thesis investigates the use and significance of X-ray crystallographic visualisations of molecular structures in postwar British material culture across scientific practice and industrial design. It is based on research into artefacts from three areas: X-ray crystallographers’ postwar practices of visualising molecular structures using models and diagrams; the Festival Pattern Group scheme for the 1951 Festival of Britain, in which crystallographic visualisations formed the aesthetic basis of patterns for domestic objects; and postwar furnishings with a ‘ball-and-rod’ form and construction reminiscent of those of molecular models. A key component of the project is methodological. The research brings together subjects, themes and questions traditionally covered separately by two disciplines, the history of design and history of science. This focus necessitated developing an interdisciplinary set of methods, which results in the reassessment of disciplinary borders and productive cross-disciplinary methodological applications. This thesis also identifies new territory for shared methods: it employs network models to examine cross-disciplinary interaction between practitioners in crystallography and design, and a biographical approach to designed objects that over time became mediators of historical narratives about science. Artefact-based, archival and oral interviewing methods illuminate the production, use and circulation of the objects examined in this research. This interdisciplinary approach underpins the generation of new historical narratives in this thesis. It revises existing histories of the cultural transmissions between X-ray crystallography and the production and reception of designed objects in postwar Britain. I argue that these transmissions were more complex than has been acknowledged by historians: they were contingent upon postwar scientific and design practices, material conditions in postwar Britain and the dynamics of historical memory, both scholarly and popular. This thesis comprises four chapters. Chapter one explores X-ray crystallographers’ visualisation practices, conceived here as a form of craft. Chapter two builds on this, demonstrating that the Festival Pattern Group witnesses the encounter between crystallographic practice, design practice and aesthetic ideologies operating within social networks associated with postwar modernisms. Chapters three and four focus on ball-and-rod furnishings in postwar and present-day Britain, respectively. I contend that strong relationships between these designed objects and crystallographic visualisations, for example the appellation ‘atomic design’, have been largely realised through historical narratives active today in the consumption of ‘retro’ and ‘mid-century modern’ artefacts. The attention to contemporary historical narratives necessitates this dual historical focus: the research is rooted in the period from the end of the Second World War until the early 1960s, but extends to the history of now. This thesis responds to the need for practical research on methods for studying cross-disciplinary interactions and their histories. It reveals the effects of submitting historical subjects that are situated on disciplinary boundaries to interdisciplinary interpretation. Old models, such as that of unidirectional ‘influence’, subside and the resulting picture is a refracted one: this study demonstrates that the material form and meaning of crystallographic visualisations, within scientific practice and across their use and echoes in designed objects, are multiple and contingent.

The discursive construction of place-identity: british lifestyle migrants in the Algarve

Tese dout., Philosophy, Lancaster University, 2011

The British Empire. Ideology, Perspectives, Perceptions

O núcleo de investigadores dedicado aos estudos de cultura do Centro de Estudos Anglísticos da Universidade de Lisboa empenhou boa parte da sua actividade, no ano de 2008-2009, na preparação de duas jornadas temáticas sobre o Império Britânico. Para a escolha deste objecto de investigação convergiram os interesses individuais dos investigadores, mobilizados para o estudo sistemático de conceitos como império e imperialismo, colónia e colonialismo, de ideologias como o liberalismo, ou para o estudo de representações de identidade. Com o intuito comum de examinar criticamente uma multiplicidade de discursos sobre o Império Britânico, as comunicações que agora são publicadas sustentam diferentes possibilidades de aproximação metodológica aos estudos de cultura e posicionam o diálogo entre elas como instrumento de desenvolvimento do conhecimento em torno de um mesmo objecto. O Império Britânico é, assim, interpelado na sua origem enquanto portador de uma “missão civilizadora” e são examinados discursos de supremacia europeia crescentemente desconstruídos pelas novas linhas de análise cultural, sensíveis estas à dissonância, à dúvida, ao silêncio e ao “não dito” das culturas em presença. O confronto e o conflito entre a cultura dominante e as culturas subordinadas, a construção de novas identidades, a instabilidade dos sujeitos foram, nestas jornadas, objecto de apresentações inovadoras em suportes visuais, como a pintura, a fotografia ou o filme.