Work-family characteristics as determinants of sickness absence: A large-scale cohort study of three occupational grades

This study examined the previously unexplored occupational grade-specific relationships of domestic responsibilities, the age of children, and work-family spillover, with registered sickness absence (>3 days' sick leave episodes, a mean follow-up of 17 months; n = 18,366 municipal employees; 76% women). The results showed that negative spillover from work into family life predicted a heightened rate of sickness absence spells among both women and men in all occupational categories (except upper white-collar men), but especially among blue-collar and lower white-collar employees. Furthermore, among all white-collar employees (except upper white-collar men), having young children (

Awarding global grades in OSCEs: Evaluation of a novel eLearning resource for OSCE examiners

BACKGROUND:
A novel online resource has been developed to aid OSCE examiner training comprising a series of videos of OSCE performances that allow inter-examiner comparison of global grade decisions.

AIMS:
To evaluate this training resource in terms of usefulness and ability to improve examiner confidence in awarding global grades in OSCEs.

METHOD:
Data collected from the first 200 users included global grades awarded, willingness to change grades following peer comparison and confidence in awarding grades before and after training.

RESULTS:
Most (86.5%) agreed that the resource was useful in developing global grade scoring ability in OSCEs, with a significant improvement in confidence in awarding grades after using the training package (p<0.001).

CONCLUSIONS:
This is a useful and effective online training package. As an adjunct to traditional training it offers a practical solution to the problem of availability of examiners.

Interpreting A-level Mathematics grades – as easy as A, B, C?

Many concerns have been expressed that students’ basic mathematical skills have deteriorated during the 1990s and there has been disquiet that current A-level grading does not distinguish adequately between the more able students. This study reports the author’s experiences of teaching maths to large classes of first-year engineering students and aims to enhance understanding of levels of mathematical competence in more recent years. Over the last four years, the classes have consisted of a very large proportion of highly qualified students – about 91% of them had at least grade B in A-level Mathematics. With a small group of students having followed a non-traditional route to university (no A-level maths) and another group having benefitted through taking A-level Further Mathematics at school, the classes have contained a very wide range of mathematical backgrounds. Despite the introductory maths course at university involving mainly repetition of A-level material, students’ marks were spread over a very wide range – for example, A-level Mathematics grade B students have scored across the range 16 – 97%. Analytical integration is the topic which produced the largest variation in performance across the class but, in contrast, the A-level students generally performed well in differentiation. Initial analysis suggests some stability in recent years in the mathematical proficiency of students with a particular A-level Mathematics grade. Allowing choice of applied maths modules as part of the A-level maths qualification increases the variety of students’ mathematical backgrounds and their selection from mechanics, statistics or decision maths is not clear from the final qualification.

Fast and frugal models of clinical judgement in novice and expert physicians

Our objective was to study whether “compensatory” models provide better descriptions of clinical judgment than fast and frugal models, according to expertise and experience. Fifty practitioners appraised 60 vignettes describing a child with an exacerbation of asthma and rated their propensities to admit the child. Linear logistic (LL) models of their judgments were compared with a matching heuristic (MH) model that searched available cues in order of importance for a critical value indicating an admission decision. There was a small difference between the 2 models in the proportion of patients allocated correctly (admit or not-admit decisions), 91.2% and 87.8%, respectively. The proportion allocated correctly by the LL model was lower for consultants than juniors, whereas the MH model performed equally well for both. In this vignette study, neither model provided any better description of judgments made by consultants or by pediatricians compared to other grades and specialties.

Cost Estimation of Machined Parts within an Aerospace Supply Chain

A generic, hierarchical, and multifidelity unit cost of acquisition estimating methodology for outside production machined parts is presented. The originality of the work lies with the method’s inherent capability of being able to generate multilevel and multifidelity cost relations for large volumes of parts utilizing process, supply chain costing data, and varying degrees of part design definition information. Estimates can be generated throughout the life cycle of a part using different grades of the combined information available. Considering design development for a given part, additional design definition may be used as it becomes available within the developed method to improve the quality of the resulting estimate. Via a process of analogous classification, parts are classified into groups of increasing similarity using design-based descriptors. A parametric estimating method is then applied to each subgroup of the machined part commodity in the direction of improved classification and using which, a relationship which links design variables to manufacturing cycle time may be generated. A rate cost reflective of the supply chain is then applied to the cycle time estimate for a given part to arrive at an estimate of make cost which is then totalled with the material and treatments cost components respectively to give an overall estimate of unit acquisition cost. Both the rate charge applied and the treatments cost calculated for a given procured part is derived via the use of ratio analysis.

Cathepsin S expression: An independent prognostic factor in glioblastoma tumours - A pilot Study

Cysteine proteinases have been implicated in astrocytoma invasion. We recently demonstrated that cathepsin S (CatS) expression is up-regulated in astrocytomas and provided evidence for a potential role in astrocytoma invasion (Flannery et al., Am J Path 2003;163(1):175–82). We aimed to evaluate the significance of CatS in human astrocytoma progression and as a prognostic marker. Frozen tissue homogenates from 71 patients with astrocytomas and 3 normal brain specimens were subjected to ELISA analyses. Immunohistochemical analysis of CatS expression was performed on 126 paraffin-embedded tumour samples. Fifty-one astrocytoma cases were suitable for both frozen tissue and paraffin tissue analysis. ELISA revealed minimal expression of CatS in normal brain homogenates. CatS expression was increased in grade IV tumours whereas astrocytoma grades I–III exhibited lower values. Immunohistochemical analysis revealed a similar pattern of expression. Moreover, high-CatS immunohistochemical scores in glioblastomas were associated with significantly shorter survival (10 vs. 5 months, p = 0.014). With forced inclusion of patient age, radiation dose and Karnofsky score in the Cox multivariate model, CatS score was found to be an independent predictor of survival. CatS expression in astrocytomas is associated with tumour progression and poor outcome in glioblastomas. CatS may serve as a useful prognostic indicator and potential target for anti-invasive therapy.

Decision making in childhood asthma exacerbation – a clinical judgement analysis

Background: Clinical decisions which impact directly on patient safety and quality of care are made during acute asthma attacks by individual doctors on the basis of their knowledge and experience. These include administration of systemic corticosteroids (CS), oral antibiotics, and admission to hospital. Clinical judgement analysis provides a methodology for comparing decisions between practitioners with different training and experience, and improving decision making. Methods: Stepwise linear regression was used to select clinical cues based on visual analogue scale assessments of the propensity of 62 clinicians to prescribe a short course of oral CS (decision 1), a course of antibiotics (decision 2), and/or admit to hospital (decision 3) for 60 â??paperâ?? patients. Results:When compared by specialty, paediatriciansâ?? models for decision 1 were more likely to include as a cue level of alertness (54% v. 16%); for decision 2 presence of crepitations (49% v. 16%), and less likely to include inhaled CS (8% v. 40%), respiratory rate (0% v. 24%), and air entry (70% v. 100%). When compared to other grades, the models derived for decision 3 by consultants/general practitioners were more likely to include wheeze severity as a cue (39% v. 6%). Conclusions: Clinicians differed in their use of individual cues and the number included in their models. Patient safety and quality of care will benefit from clarification of decision making strategies as general learning points during medical training, in the development of guidelines and care pathways, and by clinicians developing self-awareness of their own preferences.

Where there is smoke, there is (the potential for) fire: soft indicators of research and policy impact

There is a growing literature examining the impact of research on informing policy, and of research and policy on practice. Research and policy do not have the same types of impact on practice but can be evaluated using similar approaches. Sometimes the literature provides a platform for methodological debate but mostly it is concerned with how research can link to improvements in the process and outcomes of education, how it can promote innovative policies and practice, and how it may be successfully disseminated. Whether research-informed or research-based, policy and its implementation is often assessed on such 'hard' indicators of impact as changes in the number of students gaining five or more A to C grades in national examinations or a percentage fall in the number of exclusions in inner city schools. Such measures are necessarily crude, with large samples smoothing out errors and disguising instances of significant success or failure. Even when 'measurable' in such a fashion, however, the impact of any educational change or intervention may require a period of years to become observable. This paper considers circumstances in which short-term change may be implausible or difficult to observe. It explores how impact is currently theorized and researched and promotes the concept of 'soft' indicators of impact in circumstances in which the pursuit of conventional quantitative and qualitative evidence is rendered impractical within a reasonable cost and timeframe. Such indicators are characterized by their avowedly subjective, anecdotal and impressionistic provenance and have particular importance in the context of complex community education issues where the assessment of any impact often faces considerable problems of access. These indicators include the testimonies of those on whom the research intervention or policy focuses (for example, students, adult learners), the formative effects that are often reported (for example, by head teachers, community leaders) and media coverage. The collation and convergence of a wide variety of soft indicators (Where there is smoke …) is argued to offer a credible means of identifying subtle processes that are often neglected as evidence of potential and actual impact (… there is fire).

Transport Properties of Self-Consolidating Concrete

The permeability of concrete is influenced by the porosity and the interconnectivity of the pores in the cement paste and the microcracks in concrete, especially in the interface of paste-aggregate. The movements of gases, liquids, and ions through concrete is important because of their interactions with concrete constituents, including pore water, which can alter the integrity of concrete directly and indirectly, leading to the deterioration of structures. This study reports the findings from an investigation carried out to study the effect of the mixture variations on the durability of medium- and high-strength self-consolidating concrete (SCC). The mixture variations studied include the type of mineral admixtures, such as limestone powder (LSP) and pulverized fuel ash (PFA), and viscositymodifying admixtures (VMA) for both medium- and high-strength SCC. Air permeability, water permeability, capillary absorption, and chloride diffusivity were used to assess the durability of SCC mixtures in comparison with normal, vibrated concretes. The results showed that SCC mixtures, for medium- and high-strength grades using PFA followed by LSP, have lower permeability properties compared with normal concretes. SCC made with VMA had a higher sorptivity, air permeability, and water permeability compared with other SCC mixtures, which can be attributed to higher watercement ratio (w/c) and lack of pore filling effect. An in-place migration coefficient was obtained using the in-place ion migration test. This was used to compare the potential diffusivity of different concretes. The results indicated that SCC, for both grades of strength, made with PFA showed much lower diffusivity values in comparison with other mixtures, whereas the SCC mixtures with VMA showed higher diffusivity.

Bond and Interfacial Properties of Reinforcement in Self-Compacting Concrete

This paper reports a study carried out to assess the impact of the use of self-compacting concrete (SCC) on bond and interfacial properties around steel reinforcement in practical concrete element. The pull-out tests were carried out to determine bond strength between reinforcing steel bar and concrete, and the depth-sensing nano-indentation technique was used to evaluate the elastic modulus and micro-strength of the interracial transition zone (ITZ) around steel reinforcement. The bond and interracial properties around deformed steel bars in different SCC mixes with strength grades of 35 MPa and 60 MPa (C35, C60) were examined together with those in conventional vibrated reference concrete with the same strength grades. The results showed that the maximum bond strength decreased when the diameter of the steel bar increased from 12 to 20 mm. The normalised bond strengths of the SCC mixes were found to be about 10-40% higher than those of the reference mixes for both bar diameters (12 and 20 mm). The study of the interfacial properties revealed that the elastic modulus and the micro-strength of the ITZ were lower on the bottom side of a horizontal steel bar than on the top side, particularly for the vibrated reference concrete. The difference of ITZ properties between top and bottom side of the horizontal steel bar appeared to be less pronounced for the SCC mixes than for the corresponding reference mixes.

A systematic review protocol on the use of teaching portfolios for educators in further and higher education.

portfolio and undergraduate students have suggested that a teachingportfolio may have a benefit for educators in higher education as a means to providerelevancy and focus to their teaching.Design. The objectives of the review are to evaluate how a teaching portfolio assistseducators in teaching and learning; to evaluate the effects of maintaining a teachingportfolio for educators in relation to personal development; to explore the type ofportfolio used; to determine whether a teaching portfolio is perceived more beneficialfor various grades and professional types; and to determine any motivatingfactors or workplace incentives behind its implementation and completion. A searchof the following databases will be made MEDLINE, CINAHL, BREI, ERIC andAUEI. The review will follow the Joanna Briggs Institute guidance for systematicreviews of quantitative and qualitative research.Conclusion. The review will offer clarity and direction on the use of teachingportfolios, for educators, policymakers, supervisory managers and researchers involvedin further and higher education.

Viscoelastic Material Models of Polypropylene for Thermoforming Applications

Polypropylene (PP), a semi-crystalline material, is typically solid phase thermoformed at temperatures associated with crystalline melting, generally in the 150° to 160°Celsius range. In this very narrow thermoforming window the mechanical properties of the material rapidly decline with increasing temperature and these large changes in properties make Polypropylene one of the more difficult materials to process by thermoforming. Measurement of the deformation behaviour of a material under processing conditions is particularly important for accurate numerical modelling of thermoforming processes. This paper presents the findings of a study into the physical behaviour of industrial thermoforming grades of Polypropylene. Practical tests were performed using custom built materials testing machines and thermoforming equipment at Queen′s University Belfast. Numerical simulations of these processes were constructed to replicate thermoforming conditions using industry standard Finite Element Analysis software, namely ABAQUS and custom built user material model subroutines. Several variant constitutive models were used to represent the behaviour of the Polypropylene materials during processing. This included a range of phenomenological, rheological and blended constitutive models. The paper discusses approaches to modelling industrial plug-assisted thermoforming operations using Finite Element Analysis techniques and the range of material models constructed and investigated. It directly compares practical results to numerical predictions. The paper culminates discussing the learning points from using Finite Element Methods to simulate the plug-assisted thermoforming of Polypropylene, which presents complex contact, thermal, friction and material modelling challenges. The paper makes recommendations as to the relative importance of these inputs in general terms with regard to correlating to experimentally gathered data. The paper also presents recommendations as to the approaches to be taken to secure simulation predictions of improved accuracy.

Stereotactic radiosurgery for intractable cluster headache: an initial report from the North American Gamma Knife Consortium.

Abstract Object The aim of this study was to evaluate the outcomes of Gamma Knife surgery (GKS) when used for patients with intractable cluster headache (CH). Methods Four participating centers of the North American Gamma Knife Consortium identified 17 patients who underwent GKS for intractable CH between 1996 and 2008. The median patient age was 47 years (range 26-83 years). The median duration of pain before GKS was 10 years (range 1.3-40 years). Seven patients underwent unsuccessful prior surgical procedures, including microvascular decompression (2 patients), microvascular decompression with glycerol rhizotomy (2 patients), deep brain stimulation (1 patient), trigeminal ganglion stimulation (1 patient), and prior GKS (1 patient). Fourteen patients had associated autonomic symptoms. The radiosurgical target was the trigeminal nerve (TN) root and the sphenopalatine ganglion (SPG) in 8 patients, only the TN in 8 patients, and only the SPG in 1 patient. The median maximum TN and SPG dose was 80 Gy. Results Favorable pain relief (Barrow Neurological Institute Grades I-IIIb) was achieved and maintained in 10 (59%) of 17 patients at a median follow-up of 34 months. Three patients required additional procedures (repeat GKS in 2 patients, hypothalamic deep brain stimulation in 1 patient). Eight (50%) of 16 patients who had their TN irradiated developed facial sensory dysfunction after GKS. Conclusions Gamma Knife surgery for intractable, medically refractory CH provided lasting pain reduction in approximately 60% of patients, but was associated with a significantly greater chance of facial sensory disturbances than GKS used for trigeminal neuralgia.

Children making sense of science

Abstract This study explored the effects that the incorporation of nature of science (NoS) activities in the primary science classroom had on children’s perceptions and understanding of science. We compared children’s ideas in four classes by inviting them to talk, draw and write about what science meant to them: two of the classes were taught by ‘NoS’ teachers who had completed an elective nature of science (NoS) course in the final year of their Bachelor of Education (B.Ed) degree. The ‘non-NoS’ teachers who did not attend this course taught the other two classes. All four teachers had graduated from the same initial teacher education institution with similar teaching grades and all had carried out the same science methods course during their B.Ed programme. We found that children taught by the teachers who had been NoS-trained developed more elaborate notions of nature of science, as might be expected. More importantly, their reflections on science and their science lessons evidenced a more in-depth and sophisticated articulation of the scientific process in terms of scientists “trying their best” and “sometimes getting it wrong” as well as “getting different answers”. Unlike children from non-NoS classes, those who had engaged in and reflected on NoS activities talked about their own science lessons in the sense of ‘doing science’. These children also expressed more positive attitudes about their science lessons than those from non-NoS classes. We therefore suggest that there is added value in including NoS activities in the primary science curriculum in that they seem to help children make sense of science and the scientific process, which could lead to improved attitudes towards school science. We argue that as opposed to considering the relevance of school science only in terms of children’s experience, relevance should include relevance to the world of science, and NoS activities can help children to link school science to science itself.