Sarah Lewis

`Make me normal' The views and experiences of pupils on the autistic spectrum in mainstream secondary schools

Facilitating the learning and participation of pupils with Asperger syndrome and high-functioning autism (herein referred to as AS) in mainstream schools is complex and poorly understood. We report on a small-scale qualitative study of the views and experiences of 20 such pupils drawn from four secondary schools in north-west England. Data were collected through semi-structured interviews and pupil diaries. Interpretive phenomenological analysis was used to explore how pupils with AS make sense of their educational experiences. The central theme was how participants constructed their understanding of what their AS meant to them. This was often characterized by negative perceptions of their differences, such as being `retarded or having a `bad brain. The links between this understanding and reported difficulties with peers and teachers, the desire to `fit in, and other themes are discussed. The implications of these findings for policy and practice in this area are also presented.

GSTM1, GSTT1 and GSTP1 polymorphisms and lung cancer risk.

Previous studies have suggested that GST genotypes may play a role in determining susceptibility to lung cancer, though the data are often conflicting. In this study we investigated GSTM1, GSTT1 and GSTP1 status in relation to lung cancer risk in patients attending a Manchester bronchoscopy clinic. Cases were all patients (n=94) currently with, or with a history of, tumours of the lung, trachea or bronchus. The control group were all other patients (n=165) who were free of benign and malignant tumours both at the time of, or prior to, diagnosis. All patients were interviewed for information on lifestyle risk factors, and DNA extracted from bronchial lavage and blood samples was used for genotyping. GSTM1 null genotype was associated with decreased lung cancer risk (odds ratio (OR) 0.50, 95% confidence interval (CI) 0.29-0.87), particularly among men (OR 0.43, 95% CI 0.21-0.87) and those above the median age (OR 0.33, 95% CI 0.15-0.70). No difference in GSTT1 and GSTP1 genotype distribution was seen between cases and controls. The GSTM1 null genotype was associated with a decreased risk of squamous cell carcinoma: the OR, adjusted for age, sex and pack years was 0.32 (95% CI 0.12-0.82). As previous studies have reported that the GSTM1 null genotype is associated with an increased lung cancer risk, further work is required to determine whether the observed association is true, or whether it arises from bias or confounding factors.

Cotinine levels and self-reported smoking status in patients attending a bronchoscopy clinic

The reliability of self-reported smoking behaviour can vary and may result in bias if errors in misclassification vary with outcome. We examined whether self-report was an accurate measure of current smoking status in patients with malignant or non-malignant respiratory disease. Smoking behaviour was assessed by self-report and by analysis of whole blood for cotinine, a biomarker of exposure to cigarette smoke, in 166 patients attending a bronchoscopy clinic. Cotinine levels ranged from 2.5 to >400 ng ml−1 blood and were higher in self-reported current smokers (173±123 ng ml−1) than in never smokers (3.7±8.7 ng ml−1) or ex-smokers (20.5±49.0 ng ml−1). Cotinine levels in self-reported current smokers increased with the numbers of cigarettes smoked (p=0.06), and levels in smokers and ex-smokers decreased with the reported length of time since the last cigarette (p=0.001). Using a cotinine level of 20 ng ml−1 and self-report as the gold standard, the sensitivity and specificity for defining current smoking status were 90.2% and 82.4%, respectively. Out of a total of 125 self-reported current non-smokers, 23 (18.4%) had cotinine levels greater than 20 ng ml−1. Smoking prevalence was significantly underestimated by self-report (24.7%) when compared with that defined using blood cotinine levels (36.1%: p<0.001). Misclassification of current smoking status was particularly high in ex-smokers, in patients without malignant respiratory disease, in men, and in those below the median age. Such differential misclassification may result in bias in studies examining associations between current smoking habits and disease risk.

Polymorphisms in the NAD(P)H: quinone oxidoreductase gene and small cell lung cancer risk in a UK population.

NAD(P)H: quinone oxidoreductase (NQO1) protects the cell against cytotoxicity by reducing the concentration of free quinone available for single electron reduction. The NQO1 gene is polymorphic and the variant protein exhibits just 2% of the enzymatic activity of the wildtype protein. In this study, we investigated NQO1 genotype in relation to lung cancer risk in patients attending a Manchester bronchoscopy clinic. The cases were patients with a current, or history of, malignant tumour of the lung, trachea or bronchus. The control group were all other patients attending the clinic who had never been diagnosed with a tumour. DNA extraction from bronchial lavage or blood samples and genotyping was successfully carried out for 82 of the cases and 145 controls. Patients carrying at least one variant allele were found to have almost a 4-fold increased risk of developing small cell lung cancer (adjusted OR=3.80, 95% C.I. 1.19-12.1). No association between NQO1 genotypes and non-small cell lung cancer risk was found. Furthermore, the excess small cell lung cancer risk associated with non-wildtype NQO1 genotypes was only apparent in heavy smokers where there was a >10-fold increased risk (adjusted OR=12.5, 95% C.I. 2.1-75.5). These results suggest that the NQO1 protein may be involved in the detoxification of those carcinogens associated with the development of small cell lung cancer. Individuals with reduced enzyme activity, due to a polymorphism in this gene, may therefore have an increased risk of developing this disease.

Partnership, policy and politics: Initial teacher education in England under New Labour

Over the last 15 years, initial teacher education in England has been established as a national system, closely controlled by the government. One of the consequences of this move is that teacher education is now intimately bound up with changing national politics and policy priorities which reach down into the finest of detail of provision. In this paper, we focus on the way in which politics and policy have impacted on one of the defining features of teacher education provision in England – that of ‘partnership’. In particular we examine the way in which the concept and practice of partnership has been transformed in line with New Labour’s ‘Third Way’ politics. In order to do this, we reflect on our recent evaluation of the National Partnership Project, an initiative established by the Training and Development Agency for Schools to increase the quality and quantity of schools’ involvement in initial teacher education.

Association between lung cancer risk and single nucleotide polymorphisms in the first intron and codon 178 of the DNA repair gene, O6-alkylguanine–DNA alkyltransferase

The association between lung cancer risk and 2 polymorphisms, rs12268840 and rs2308327 (codon K178R), in the DNA repair protein, O6‐alkylguanine–DNA alkyltransferase, which are associated with interindividual differences in activity, have been investigated in 3 hospital‐based case–control studies. Genotyping was carried out on 617 subjects of whom 255 had lung cancer. In 2 of the 3 series, there was a significant inverse association between the 178R allele and case status (p < 0.05). In a meta‐analysis, the odds ratio (95% CI) associated with the 178R allele relative to the 178K allele was 0.64 (0.45–0.92, p = 0.01) and 0.51 (0.24–1.11, p = 0.09) in fixed effects and random effects models, respectively. In a pooled analysis, after adjustment for sex, age, pack years and series, the OR (95% CI) for a heterozygote was 0.67 (0.45–1.01) and for a 178R homozygote was 0.10 (0.01–0.94); the trend for a decreased risk with the number of R alleles was significant (p = 0.008). This trend was particularly pronounced in heavy smokers (trend test p = 0.003), but not significant in light smokers (p = 0.73). There was no evidence of an association between rs12268840 and lung cancer risk. These results suggest that the R allele may protect against lung cancer, specifically in heavy smokers, an effect that may result from this polymorphism affecting the function of the MGMT protein and/or levels in MGMT activity.

Educational Psychologists' contribution to the Every Child Matters agenda: the parents' view

In the DfES review of the role and contribution of educational psychologists (2006) the views of a range of different stakeholders were surveyed about the work that EPs do. As part of this process, questionnaires were devised and sent out to 300 parents, 30 from 10 local authorities (LA), distributed by the principal educational psychologist in each LA. Thirty per cent of parents completed the questionnaires and their responses indicated that they valued highly the contribution made by EPs to the outcomes for their child. Their responses also illustrate the broad range of work in which EPs are involved and the multiprofessional nature of support that is available. In this paper, the main findings from the survey are discussed and consideration is given to their implications for the future development of EP services.

Investigating Access to Educational Assessment for Students with Disabilities

Many countries have established systems for identifying, and providing for, the range of students with disabilities during their formal educational assessments. Most systems include the provision of variously termed ‘special access arrangements’ (SAAs), such as the provision of extra time or practical assistance with some aspect of an examination. There is, however, a paucity of outcome monitoring data relating to such systems, particularly that relating to the student and parent perspective. Using a combination of focus group, questionnaire and interview methods, the present study reports the views of 86 students with disabilities, their parents and teachers, upon the students’ educational assessment experiences. Findings indicate four specific areas for development of current practice: individualization of assessment of needs; utilization of student and parent voice; consideration of test anxiety factors; improved communication between schools, parents and students. From this, the researchers propose a revised system for needs identification and provision for students with disabilities during their formal educational assessments, highlighting a proactive role for school psychologists.

MATHEMATICS PROGRESSION 5-14: PLATEAU, CURRICULUM/AGE AND TEST YEAR EFFECTS

Mathematics performance data were collected by the MaLT project in February and March 2005 from a nationally representative sample of 12 591 pupils aged 5–14 from 111 schools in England. The tests for each year group were vertically equated using Rasch methodology and the scores were then age-standardised. Single year and three year sub-sample scores enabled comparisons to be made between maturation (within-year) and year-group (between year) effects: rates of progress appear to decline with curriculum experience, being ultimately negative, such that progress almost plateaus between age 11 to 14. Particular, notable features at years 2, 6 and 9 are discussed.

Cyclic hydrostatic pressure and cotton particles stimulate synthesis by human lung macrophages of cytokines in vitro

BackgroundInhalation of particulates is a leading cause of the development of lung diseases and current understanding of the complex relationship between lung metabolism and airborne particulates is incomplete. It is well established that mechanical load is important in the development of the lung and in lung cell differentiation. The interaction between particle exposure and physical forces on alveolar macrophages is a physiologically relevant issue, but as yet understudied. This study examines the effect of cyclic hydrostatic pressure and cotton particles on synthesis of cytokines by human alveolar macrophages.MethodsAlveolar macrophages were obtained from patients with lung disease, either from lavage samples or from lung tissue resection. The commonly used cell line THP-1 was included in the experiments. Cell cultures were exposed to cotton particles and/cyclic hydrostatic pressure (3 or 5 psi); control cultures were exposed to medium only. TNFα, IL-1β and IL-6 were assayed in the culture media using specific ELISAs. Cells were characterized using morphology and markers specific for macrophages (Jenner/Giemsa staining, CD14 and CD68).ResultsExposure to cotton particles stimulated cytokine synthesis by macrophages from all three sources; exposure to cyclic hydrostatic pressure alone did not stimulate cytokine synthesis significantly. However, the combination of both particles and cyclic hydrostatic pressure increased the simulation of cytokine synthesis still further. Cell characterization demonstrated that the large majority of cells had a macrophage morphology and were positive for CD14 and CD68.ConclusionThese data suggest an interaction between cyclic hydrostatic pressure and particulate exposure, which increases alveolar macrophage cytokine production. This interaction was only observed at the higher cyclic hydrostatic pressure. However, in patient samples, there was considerable variation in the amount by which secretion of an individual cytokine increased and there was also variation in the mechanosensitivity of cells from the three different sources. Cyclic hydrostatic pressure, therefore, may be an important modulator of the response of alveolar macrophages to cotton particles, but the source of the cells may be a confounding factor which demands further investigation.