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Ultra-radical (UR) procedures, including splenectomy, are utilized to increase complete cytoreduction rates during Cytoreductive Surgery (CRS) performed with the aim of complete macroscopic clearance of disease. The purpose of this study was to investigate if splenectomy negatively impacts survival when undertaken during CRS for advanced ovarian cancer (AOC) and compare published splenectomy and cytoreduction rates.A retrospective review of all consecutive patients who underwent cytoreductive surgery for AOC between 16/05/2013-28/01/2019. Survival, baseline patient characteristics, complications and surgical parameters were recorded. Propensity scored matching (PSM) was performed to reduce bias.154 patients identified over 71 months. 97 underwent standard, 57 underwent UR surgery, 27 patients received splenectomy (17.5%) No difference was seen in overall survival (OS) between all patients (median OS 34 months (95%CI 25.9-41.1) and patients who underwent splenectomy (median OS not yet reached) (p =0.05). After PSM for various baseline covariates, no significant difference in splenectomy versus non-splenectomy patients (3-year survival 54% compared to 56%) (P 0.05). Three splenectomy specific complications occurred; one each of pancreatic tail injury, left pleural effusion and streptococcal pharyngitis during chemotherapy. We found wide variation in utilization of splenectomy in published case series; from 9% to 35%.Splenectomy performed as part of CRS is not detrimental to survival in AOC. There is a wide variation in utilization of splenectomy in published case series with little correlation with cytoreduction rates.

The majority of studies into recruitment to the headship role have focused on supply-side dynamics and teachers’ own accounts of the factors that (dis)incentivize them from aspiring or progressing to headship. Significantly less work has been done in analyzing demand-side factors. This paper addresses the gap by presenting findings from a mixed-methods analysis of headteacher job descriptions (n = 67) published in a complete school year within Wales – one of the UK’s devolved education systems. A discourse analysis was conducted, based on organizational and occupational conceptions of professional work, which informed a subsequent content analysis of the job descriptions. Our findings identified a dominance of articulations that privileged organizationally-orientated understandings of headship and evidence of a lack of contextualization and agency by stakeholders responsible for recruitment. Such ‘demand-side’ analysis offers scope for examining and understanding the way in which headship is framed and aligns with policy within a variety of international educational contexts and jurisdictions.

Based on data from the Welsh adaptation of the Langdon Induction and Mentoring Survey, this article presents the perceptions of induction and mentoring held by school leaders, mentors, classroom teachers and Newly Qualified Teachers in Welsh schools. Differences according to professional role were found, suggesting that school leaders have more positive perceptions of induction and mentoring in their schools than all other staff but particularly more than general teaching staff. Possible reasons for this variation in perspective are explored. The research conceptualises schools as complex, relational sites for the professional formation of new teachers. Within this context, induction and mentoring are multifaceted and comprised of multiple interactions between stakeholders and their respective engagements with the policy environment at all levels. Results suggest that, in this environment, induction and mentoring involve largely ‘privatised’ practices that and are not viewed as the concern of those not occupying a designated mentoring role. This presents a problem for the realisation of schools as professional learning organisations which can harness the professional capital of all staff – including leaders - in order to help new teachers, and all others, to thrive.

It has been argued that qualitative research can be valuable in providing a forum for the voices of those who may usually be excluded from academic discourse and that it is therefore well suited to...

This paper examines how Task Force votes were central to the development of Diagnostic and Statistical Manual of Mental Disorders (DSM-III and DSM-III-R). Data were obtained through a literature review, investigation of DSM archival material housed at the American Psychiatric Association (APA), and interviews with key Task Force members of DSM-III and DSM-III-R. Such data indicate that Task Force votes played a central role in the making of DSM-III, from establishing diagnostic criteria and diagnostic definitions to settling questions about the inclusion or removal of diagnostic categories. The paper concludes that while the APA represented DSM-III, and the return to descriptive psychiatry it inaugurated, as a triumph of empirically based decision-making, the evidence presented here fails to support that view. Since the DSM is a cumulative project, and as DSM-III lives on through subsequent editions, this paper calls for a more socio-historically informed understanding of DSM's construction to be deployed in how the DSM is taught and implemented in training and clinical settings.

This paper seeks to evaluate the factors influencing students’ choice of Higher Education provision with specific reference to language of study. Placing the recent development of the Coleg Cymraeg Cenedlaethol (the National Welsh-Medium College) in an appropriate historical and theoretical perspective, this paper evaluates a major qualitative study relating to student choice in Wales. It argues that while location, reputation, finance and employability are the primary drivers for student choice, there is considerable evidence to demonstrate a latent demand for Welsh-medium provision in specific subjects and locations. Furthermore there is a clear link to future job prospects in patterns of linguistic choice amongst prospective Higher Education students.

The expert, not the cultivated man, is the educated ideal of the bureaucratic age. (Max Weber, 1947) I write this response to balance the papers set down in this current edition. For although these...

One aim of writing a ‘response’ is to tease from the event reviewed its less explicit aspects, to render implied themes overtly declared and thus, in short, with the benefit of hindsight, to uncove...

Dear Editors,As a parent of two children under the age of 4, I read Sue Gerhardt’s article with both fear and admiration. Fear because, no matter how hard we try as parents to resist neoliberalism’...

Small-scale excavations in 1976 demonstrated that the hillfort of Liddington Castle was first defended in the Late Bronze Age/Earliest Iron Age, though there had been earlier use of the hilltop. The initial defences were of timber and turf, later enlarged to a more massive dump rampart; there was evidence of at least two or three phases in these works. In the interior of the fort, a shaft of uncertain date was located, and a small pit or emplacement of the Early or Middle Iron Age. Test pits in the entrance area suggested a possible refurbishment. Finds include a useful group of pottery of the seventh—fifth centuries B.C., a group of probably associated flints, iron and copper alloy objects, human and animal bone, and mollusca. There were also a few Roman and later sherds; the discovery of the former was germane to the principal aim of the excavation, to test the hypothesis that the site might be identified as that of the Battle of Mount Badon. In pursuance of this aim, the report includes an extensive di...