Investigating the prevalence and causes of prescribing errors in general practice: the PRACtICe Study

Aim: To determine the prevalence and nature of prescribing errors in general practice; to explore the causes, and to identify defences against error. Methods: 1) Systematic reviews; 2) Retrospective review of unique medication items prescribed over a 12 month period to a 2% sample of patients from 15 general practices in England; 3) Interviews with 34 prescribers regarding 70 potential errors; 15 root cause analyses, and six focus groups involving 46 primary health care team members Results: The study involved examination of 6,048 unique prescription items for 1,777 patients. Prescribing or monitoring errors were detected for one in eight patients, involving around one in 20 of all prescription items. The vast majority of the errors were of mild to moderate severity, with one in 550 items being associated with a severe error. The following factors were associated with increased risk of prescribing or monitoring errors: male gender, age less than 15 years or greater than 64 years, number of unique medication items prescribed, and being prescribed preparations in the following therapeutic areas: cardiovascular, infections, malignant disease and immunosuppression, musculoskeletal, eye, ENT and skin. Prescribing or monitoring errors were not associated with the grade of GP or whether prescriptions were issued as acute or repeat items. A wide range of underlying causes of error were identified relating to the prescriber, patient, the team, the working environment, the task, the computer system and the primary/secondary care interface. Many defences against error were also identified, including strategies employed by individual prescribers and primary care teams, and making best use of health information technology. Conclusion: Prescribing errors in general practices are common, although severe errors are unusual. Many factors increase the risk of error. Strategies for reducing the prevalence of error should focus on GP training, continuing professional development for GPs, clinical governance, effective use of clinical computer systems, and improving safety systems within general practices and at the interface with secondary care.

Data Mining in Clinical Practice for the Quantification of Motor Impairment in Parkinson's Disease

Advances in biomedical signal acquisition systems for motion analysis have led to lowcost and ubiquitous wearable sensors which can be used to record movement data in different settings. This implies the potential availability of large amounts of quantitative data. It is then crucial to identify and to extract the information of clinical relevance from the large amount of available data. This quantitative and objective information can be an important aid for clinical decision making. Data mining is the process of discovering such information in databases through data processing, selection of informative data, and identification of relevant patterns. The databases considered in this thesis store motion data from wearable sensors (specifically accelerometers) and clinical information (clinical data, scores, tests). The main goal of this thesis is to develop data mining tools which can provide quantitative information to the clinician in the field of movement disorders. This thesis will focus on motor impairment in Parkinson's disease (PD). Different databases related to Parkinson subjects in different stages of the disease were considered for this thesis. Each database is characterized by the data recorded during a specific motor task performed by different groups of subjects. The data mining techniques that were used in this thesis are feature selection (a technique which was used to find relevant information and to discard useless or redundant data), classification, clustering, and regression. The aims were to identify high risk subjects for PD, characterize the differences between early PD subjects and healthy ones, characterize PD subtypes and automatically assess the severity of symptoms in the home setting.

Exploring a model of skillful engagement in nursing practice

Prominent challenges facing nurse leaders are the growing shortage of nurses and the increasingly complex care required by acutely ill patients. In organizations that shortage is exacerbated by turnover and intent to leave. Unsatisfactory working conditions are cited by nurses when they leave their current jobs. Disengagement from the job leads to plateaued performance, decreased organizational commitment, and increased turnover. Solutions to these challenges include methods both to retain and to increase the effectiveness of each nurse. ^ The specific aim of this study was to examine the relationships among organizational structures thought to foster the clinical development of the nurse, with indicators of the development of clinical expertise, resulting in outcomes of positive job attitudes and effectiveness. Causal loop modeling is incorporated as a systems tool to examine developmental cycles both for an organization and for an individual nurse to look beyond singular events and investigate deeper patterns that emerge over time. ^ The setting is an academic specialty-care institution, and the sample in this cross-sectional study consists of paired data from 225 RNs and their nurse managers. Two panels of survey instruments were created based on the model's theoretical variables, one completed by RNs and the other by their Nurse Managers. The RN survey panel examined the variables of structural empowerment, magnet essentials, knowledge as identified by the Benner developmental stage, psychological empowerment, job stage, engagement, intent to leave, job satisfaction and the early recognition of patient complications. The nurse manager survey panel examined the Benner developmental stage, job stage, and overall level of nursing performance. ^ Four regression models were created based on the outcome variables. Each model identified significant organizational and individual characteristics that predicted higher job satisfaction, decreased intent to leave, more effectiveness as measured by early recognition and acting upon subtle patient complications, and better job performance. ^ Implications for improving job attitudes and effectiveness focus on ways that nursing leaders can foster a more empowering and healthy work environment. ^

(Table 1) Description of structures in cores at DSDP Holes 59-451, 59-448A and 59-447A

Fifteen lengths of Leg 59 cores (primarily from Hole 451 as well as from Holes 447A and 448A) exhibiting macroscopic faults were selected by Dr. R. B. Scott (Co-Chief Scientist, Leg 59) to help us initiate this petrofabric analysis. We proposed to (1) determine what dynamically useful deformation features might be associated with the faults, and (2) infer from these features as much as possible about the physical environment of the deformation (effective pressure, differential stress, temperature, and strain rate), the orientation and relatively magnitudes of the principal stresses at the time of deformation, and the degree of induration of the rocks at the time of deformation. The cores, mainly from Hole 451, had been slabbed on board ship with respect to the trace of bedding so that each cut surface contains the true bedding dip-direction. In general, the cores from Hole 451 are largely calcareous, lithic and vitric, brecciated tuffs, whereas those from Holes 447A and 448A are basalts or basalt breccias.

Coherent structures in statistically-stationary homogeneous shear turbulence

La región cerca de la pared de flujos turbulentos de pared ya está bien conocido debido a su bajo número de Reynolds local y la separación escala estrecha. La región lejos de la pared (capa externa) no es tan interesante tampoco, ya que las estadísticas allí se escalan bien por las unidades exteriores. La región intermedia (capa logarítmica), sin embargo, ha estado recibiendo cada vez más atención debido a su propiedad auto-similares. Además, de acuerdo a Flores et al. (2007) y Flores & Jiménez (2010), la capa logarítmica es más o menos independiente de otras capas, lo que implica que podría ser inspeccionado mediante el aislamiento de otras dos capas, lo que reduciría significativamente los costes computacionales para la simulación de flujos turbulentos de pared. Algunos intentos se trataron después por Mizuno & Jiménez (2013), quien simulan la capa logarítmica sin la región cerca de la pared con estadísticas obtenidas de acuerdo razonablemente bien con los de las simulaciones completas. Lo que más, la capa logarítmica podría ser imitado por otra turbulencia sencillo de cizallamiento de motor. Por ejemplo, Pumir (1996) encontró que la turbulencia de cizallamiento homogéneo estadísticamente estacionario (SS-HST) también irrumpe, de una manera muy similar al proceso de auto-sostenible en flujos turbulentos de pared. Según los consideraciones arriba, esta tesis trata de desvelar en qué medida es la capa logarítmica de canales similares a la turbulencia de cizalla más sencillo, SS-HST, mediante la comparación de ambos cinemática y la dinámica de las estructuras coherentes en los dos flujos. Resultados sobre el canal se muestran mediante Lozano-Durán et al. (2012) y Lozano-Durán & Jiménez (2014b). La hoja de ruta de esta tarea se divide en tres etapas. En primer lugar, SS-HST es investigada por medio de un código nuevo de simulación numérica directa, espectral en las dos direcciones horizontales y compacto-diferencias finitas en la dirección de la cizalla. Sin utiliza remallado para imponer la condición de borde cortante periódica. La influencia de la geometría de la caja computacional se explora. Ya que el HST no tiene ninguna longitud característica externa y tiende a llenar el dominio computacional, las simulaciopnes a largo plazo del HST son ’mínimos’ en el sentido de que contiene sólo unas pocas estructuras media a gran escala. Se ha encontrado que el límite principal es el ancho de la caja de la envergadura, Lz, que establece las escalas de longitud y velocidad de la turbulencia, y que las otras dos dimensiones de la caja debe ser suficientemente grande (Lx > 2LZ, Ly > Lz) para evitar que otras direcciones estando limitado también. También se encontró que las cajas de gran longitud, Lx > 2Ly, par con el paso del tiempo la condición de borde cortante periódica, y desarrollar fuertes ráfagas linealizadas no físicos. Dentro de estos límites, el flujo muestra similitudes y diferencias interesantes con otros flujos de cizalla, y, en particular, con la capa logarítmica de flujos turbulentos de pared. Ellos son exploradas con cierto detalle. Incluyen un proceso autosostenido de rayas a gran escala y con una explosión cuasi-periódica. La escala de tiempo de ruptura es de aproximadamente universales, ~20S~l(S es la velocidad de cizallamiento media), y la disponibilidad de dos sistemas de ruptura diferentes permite el crecimiento de las ráfagas a estar relacionado con algo de confianza a la cizalladura de turbulencia inicialmente isotrópico. Se concluye que la SS-HST, llevado a cabo dentro de los parámetros de cílculo apropiados, es un sistema muy prometedor para estudiar la turbulencia de cizallamiento en general. En segundo lugar, las mismas estructuras coherentes como en los canales estudiados por Lozano-Durán et al. (2012), es decir, grupos de vórticidad (fuerte disipación) y Qs (fuerte tensión de Reynolds tangencial, -uv) tridimensionales, se estudia mediante simulación numérica directa de SS-HST con relaciones de aspecto de cuadro aceptables y número de Reynolds hasta Rex ~ 250 (basado en Taylor-microescala). Se discute la influencia de la intermitencia de umbral independiente del tiempo. Estas estructuras tienen alargamientos similares en la dirección sentido de la corriente a las familias separadas en los canales hasta que son de tamaño comparable a la caja. Sus dimensiones fractales, longitudes interior y exterior como una función del volumen concuerdan bien con sus homólogos de canales. El estudio sobre sus organizaciones espaciales encontró que Qs del mismo tipo están alineados aproximadamente en la dirección del vector de velocidad en el cuadrante al que pertenecen, mientras Qs de diferentes tipos están restringidos por el hecho de que no debe haber ningún choque de velocidad, lo que hace Q2s (eyecciones, u < 0,v > 0) y Q4s (sweeps, u > 0,v < 0) emparejado en la dirección de la envergadura. Esto se verifica mediante la inspección de estructuras de velocidad, otros cuadrantes como la uw y vw en SS-HST y las familias separadas en el canal. La alineación sentido de la corriente de Qs ligada a la pared con el mismo tipo en los canales se debe a la modulación de la pared. El campo de flujo medio condicionado a pares Q2-Q4 encontró que los grupos de vórticidad están en el medio de los dos, pero prefieren los dos cizalla capas alojamiento en la parte superior e inferior de Q2s y Q4s respectivamente, lo que hace que la vorticidad envergadura dentro de las grupos de vórticidad hace no cancele. La pared amplifica la diferencia entre los tamaños de baja- y alta-velocidad rayas asociados con parejas de Q2-Q4 se adjuntan como los pares alcanzan cerca de la pared, el cual es verificado por la correlación de la velocidad del sentido de la corriente condicionado a Q2s adjuntos y Q4s con diferentes alturas. Grupos de vórticidad en SS-HST asociados con Q2s o Q4s también están flanqueadas por un contador de rotación de los vórtices sentido de la corriente en la dirección de la envergadura como en el canal. La larga ’despertar’ cónica se origina a partir de los altos grupos de vórticidad ligada a la pared han encontrado los del Álamo et al. (2006) y Flores et al. (2007), que desaparece en SS-HST, sólo es cierto para altos grupos de vórticidad ligada a la pared asociados con Q2s pero no para aquellos asociados con Q4s, cuyo campo de flujo promedio es en realidad muy similar a la de SS-HST. En tercer lugar, las evoluciones temporales de Qs y grupos de vórticidad se estudian mediante el uso de la método inventado por Lozano-Durán & Jiménez (2014b). Las estructuras se clasifican en las ramas, que se organizan más en los gráficos. Ambas resoluciones espaciales y temporales se eligen para ser capaz de capturar el longitud y el tiempo de Kolmogorov puntual más probable en el momento más extrema. Debido al efecto caja mínima, sólo hay un gráfico principal consiste en casi todas las ramas, con su volumen y el número de estructuras instantáneo seguien la energía cinética y enstrofía intermitente. La vida de las ramas, lo que tiene más sentido para las ramas primarias, pierde su significado en el SS-HST debido a las aportaciones de ramas primarias al total de Reynolds estrés o enstrofía son casi insignificantes. Esto también es cierto en la capa exterior de los canales. En cambio, la vida de los gráficos en los canales se compara con el tiempo de ruptura en SS-HST. Grupos de vórticidad están asociados con casi el mismo cuadrante en términos de sus velocidades medias durante su tiempo de vida, especialmente para los relacionados con las eyecciones y sweeps. Al igual que en los canales, las eyecciones de SS-HST se mueven hacia arriba con una velocidad promedio vertical uT (velocidad de fricción) mientras que lo contrario es cierto para los barridos. Grupos de vórticidad, por otra parte, son casi inmóvil en la dirección vertical. En la dirección de sentido de la corriente, que están advección por la velocidad media local y por lo tanto deforman por la diferencia de velocidad media. Sweeps y eyecciones se mueven más rápido y más lento que la velocidad media, respectivamente, tanto por 1.5uT. Grupos de vórticidad se mueven con la misma velocidad que la velocidad media. Se verifica que las estructuras incoherentes cerca de la pared se debe a la pared en vez de pequeño tamaño. Los resultados sugieren fuertemente que las estructuras coherentes en canales no son especialmente asociado con la pared, o incluso con un perfil de cizalladura dado. ABSTRACT Since the wall-bounded turbulence was first recognized more than one century ago, its near wall region (buffer layer) has been studied extensively and becomes relatively well understood due to the low local Reynolds number and narrow scale separation. The region just above the buffer layer, i.e., the logarithmic layer, is receiving increasingly more attention nowadays due to its self-similar property. Flores et al. (20076) and Flores & Jim´enez (2010) show that the statistics of logarithmic layer is kind of independent of other layers, implying that it might be possible to study it separately, which would reduce significantly the computational costs for simulations of the logarithmic layer. Some attempts were tried later by Mizuno & Jimenez (2013), who simulated the logarithmic layer without the buffer layer with obtained statistics agree reasonably well with those of full simulations. Besides, the logarithmic layer might be mimicked by other simpler sheardriven turbulence. For example, Pumir (1996) found that the statistically-stationary homogeneous shear turbulence (SS-HST) also bursts, in a manner strikingly similar to the self-sustaining process in wall-bounded turbulence. Based on these considerations, this thesis tries to reveal to what extent is the logarithmic layer of channels similar to the simplest shear-driven turbulence, SS-HST, by comparing both kinematics and dynamics of coherent structures in the two flows. Results about the channel are shown by Lozano-Dur´an et al. (2012) and Lozano-Dur´an & Jim´enez (20146). The roadmap of this task is divided into three stages. First, SS-HST is investigated by means of a new direct numerical simulation code, spectral in the two horizontal directions and compact-finite-differences in the direction of the shear. No remeshing is used to impose the shear-periodic boundary condition. The influence of the geometry of the computational box is explored. Since HST has no characteristic outer length scale and tends to fill the computational domain, longterm simulations of HST are ‘minimal’ in the sense of containing on average only a few large-scale structures. It is found that the main limit is the spanwise box width, Lz, which sets the length and velocity scales of the turbulence, and that the two other box dimensions should be sufficiently large (Lx > 2LZ, Ly > Lz) to prevent other directions to be constrained as well. It is also found that very long boxes, Lx > 2Ly, couple with the passing period of the shear-periodic boundary condition, and develop strong unphysical linearized bursts. Within those limits, the flow shows interesting similarities and differences with other shear flows, and in particular with the logarithmic layer of wallbounded turbulence. They are explored in some detail. They include a self-sustaining process for large-scale streaks and quasi-periodic bursting. The bursting time scale is approximately universal, ~ 20S~l (S is the mean shear rate), and the availability of two different bursting systems allows the growth of the bursts to be related with some confidence to the shearing of initially isotropic turbulence. It is concluded that SS-HST, conducted within the proper computational parameters, is a very promising system to study shear turbulence in general. Second, the same coherent structures as in channels studied by Lozano-Dur´an et al. (2012), namely three-dimensional vortex clusters (strong dissipation) and Qs (strong tangential Reynolds stress, -uv), are studied by direct numerical simulation of SS-HST with acceptable box aspect ratios and Reynolds number up to Rex ~ 250 (based on Taylor-microscale). The influence of the intermittency to time-independent threshold is discussed. These structures have similar elongations in the streamwise direction to detached families in channels until they are of comparable size to the box. Their fractal dimensions, inner and outer lengths as a function of volume agree well with their counterparts in channels. The study about their spatial organizations found that Qs of the same type are aligned roughly in the direction of the velocity vector in the quadrant they belong to, while Qs of different types are restricted by the fact that there should be no velocity clash, which makes Q2s (ejections, u < 0, v > 0) and Q4s (sweeps, u > 0, v < 0) paired in the spanwise direction. This is verified by inspecting velocity structures, other quadrants such as u-w and v-w in SS-HST and also detached families in the channel. The streamwise alignment of attached Qs with the same type in channels is due to the modulation of the wall. The average flow field conditioned to Q2-Q4 pairs found that vortex clusters are in the middle of the pair, but prefer to the two shear layers lodging at the top and bottom of Q2s and Q4s respectively, which makes the spanwise vorticity inside vortex clusters does not cancel. The wall amplifies the difference between the sizes of low- and high-speed streaks associated with attached Q2-Q4 pairs as the pairs reach closer to the wall, which is verified by the correlation of streamwise velocity conditioned to attached Q2s and Q4s with different heights. Vortex clusters in SS-HST associated with Q2s or Q4s are also flanked by a counter rotating streamwise vortices in the spanwise direction as in the channel. The long conical ‘wake’ originates from tall attached vortex clusters found by del A´ lamo et al. (2006) and Flores et al. (2007b), which disappears in SS-HST, is only true for tall attached vortices associated with Q2s but not for those associated with Q4s, whose averaged flow field is actually quite similar to that in SS-HST. Third, the temporal evolutions of Qs and vortex clusters are studied by using the method invented by Lozano-Dur´an & Jim´enez (2014b). Structures are sorted into branches, which are further organized into graphs. Both spatial and temporal resolutions are chosen to be able to capture the most probable pointwise Kolmogorov length and time at the most extreme moment. Due to the minimal box effect, there is only one main graph consist by almost all the branches, with its instantaneous volume and number of structures follow the intermittent kinetic energy and enstrophy. The lifetime of branches, which makes more sense for primary branches, loses its meaning in SS-HST because the contributions of primary branches to total Reynolds stress or enstrophy are almost negligible. This is also true in the outer layer of channels. Instead, the lifetime of graphs in channels are compared with the bursting time in SS-HST. Vortex clusters are associated with almost the same quadrant in terms of their mean velocities during their life time, especially for those related with ejections and sweeps. As in channels, ejections in SS-HST move upwards with an average vertical velocity uτ (friction velocity) while the opposite is true for sweeps. Vortex clusters, on the other hand, are almost still in the vertical direction. In the streamwise direction, they are advected by the local mean velocity and thus deformed by the mean velocity difference. Sweeps and ejections move faster and slower than the mean velocity respectively, both by 1.5uτ . Vortex clusters move with the same speed as the mean velocity. It is verified that the incoherent structures near the wall is due to the wall instead of small size. The results suggest that coherent structures in channels are not particularly associated with the wall, or even with a given shear profile.

Julius Franks UM Football, 1940, in freshman practice gear

[Franks' freshman year, note on negative envelope indicates photo was shot for Amsterdam News, African-American newspaper in New York City.]

The potential economic impact of solar heated residential structures in Illinois, 1976-2000 /

Caption title.

Senior management leadership, social support, job design and stressor-to-strain relationships in hospital practice

Purpose: The purpose of this paper is to examine the effect of the quality of senior management leadership on social support and job design, whose main effects on strains, and moderating effects on work stressors-to-strains relationships were assessed. Design/methodology/approach: A survey involving distribution of questionnaires was carried out on a random sample of health care employees in acute hospital practice in the UK. The sample comprised 65,142 respondents. The work stressors tested were quantitative overload and hostile environment, whereas strains were measured through job satisfaction and turnover intentions. Structural equation modelling and moderated regression analyses were used in the analysis. Findings: Quality of senior management leadership explained 75 per cent and 94 per cent of the variance of social support and job design respectively, whereas work stressors explained 51 per cent of the variance of strains. Social support and job design predicted job satisfaction and turnover intentions, as well as moderated significantly the relationships between quantitative workload/hostility and job satisfaction/turnover intentions. Research limitations/implications: The findings are useful to management and to health employees working in acute/specialist hospitals. Further research could be done in other counties to take into account cultural differences and variations in health systems. The limitations included self-reported data and percept-percept bias due to same source data collection. Practical implications: The quality of senior management leaders in hospitals has an impact on the social environment, the support given to health employees, their job design, as well as work stressors and strains perceived. Originality/value: The study argues in favour of effective senior management leadership of hospitals, as well as ensuring adequate support structures and job design. The findings may be useful to health policy makers and human resources managers. © Emerald Group Publishing Limited.

Distributed sequential task allocation in foraging swarms

When designing a practical swarm robotics system, self-organized task allocation is key to make best use of resources. Current research in this area focuses on task allocation which is either distributed (tasks must be performed at different locations) or sequential (tasks are complex and must be split into simpler sub-tasks and processed in order). In practice, however, swarms will need to deal with tasks which are both distributed and sequential. In this paper, a classic foraging problem is extended to incorporate both distributed and sequential tasks. The problem is analysed theoretically, absolute limits on performance are derived, and a set of conditions for a successful algorithm are established. It is shown empirically that an algorithm which meets these conditions, by causing emergent cooperation between robots can achieve consistently high performance under a wide range of settings without the need for communication. © 2013 IEEE.

From art for arts sake to art as means of knowing:a rationale for advancing arts-based methods in research, practice and pedagogy

This paper advances a philosophically informed rationale for the broader, reflexive and practical application of arts-based methods to benefit research, practice and pedagogy. It addresses the complexity and diversity of learning and knowing, foregrounding a cohabitative position and recognition of a plurality of research approaches, tailored and responsive to context. Appreciation of art and aesthetic experience is situated in the everyday, underpinned by multi-layered exemplars of pragmatic visual-arts narrative inquiry undertaken in the third, creative and communications sectors. Discussion considers semi-guided use of arts-based methods as a conduit for topic engagement, reflection and intersubjective agreement; alongside observation and interpretation of organically employed approaches used by participants within daily norms. Techniques span handcrafted (drawing), digital (photography), hybrid (cartooning), performance dimensions (improvised installations) and music (metaphor and structure). The process of creation, the artefact/outcome produced and experiences of consummation are all significant, with specific reflexivity impacts. Exploring methodology and epistemology, both the "doing" and its interpretation are explicated to inform method selection, replication, utility, evaluation and development of cross-media skills literacy. Approaches are found engaging, accessible and empowering, with nuanced capabilities to alter relationships with phenomena, experiences and people. By building a discursive space that reduces barriers; emancipation, interaction, polyphony, letting-go and the progressive unfolding of thoughts are supported, benefiting ways of knowing, narrative (re)construction, sensory perception and capacities to act. This can also present underexplored researcher risks in respect to emotion work, self-disclosure, identity and agenda. The paper therefore elucidates complex, intricate relationships between form and content, the represented and the representation or performance, researcher and participant, and the self and other. This benefits understanding of phenomena including personal experience, sensitive issues, empowerment, identity, transition and liminality. Observations are relevant to qualitative and mixed methods researchers and a multidisciplinary audience, with explicit identification of challenges, opportunities and implications.

Solving the mystery of Guanxi-a sociological explanation of social exchange and social networking in Guanxi practice

Guanxi, loosely defined as "inter-personal relations" or "personal connections," is one of the key socio-cultural concepts in understanding Chinese society. This thesis presented a theoretical examination of the Chinese socio-cultural concept of guanxi. By using a broad survey of the available literature, this thesis established the following points: Social structures shape and define the development of guanxi practice in Chinese society. Guanxi relationships are based on the social exchange of gifts and favors in dyadic or multi-stranded social networks. While following the general rules of reciprocity found in social exchange, guanxi exchange is also governed by the internalized social norms such as mianzi (face) and renqing (humanized obligation underpinned by human sentiment). Guanxi relationships are also network-oriented, featuring ties based on familiarity and mutual trust, and characterized by an interplay between expressiveness and instrumentalism.

Sediment rates and structures in Bay of Kiel, Baltic Sea

Density and diversity of bottom fauna population as dependent on sediment types and water depth is largely well known in Kiel Bay. This is in contrast to structures and processes of bioturbation, although generally it has a big influence on the benthic boundary layer and its processes, e.g., the metabolism of the bottom fauna, the mechanical properties, the age dating, and the large field of chemical processes. In the densely inhabited sands and muddy sands of the shallower waters with sediment thicknesses of some decimeters only, bioturbation is usually ubiquitous, and most of the structures left are monotonously of "biodeformational" character. At greater water depths, however, where a sedimentary column of several meters of Holocene is developed, the X-ray radiographs of numerous sediment cores show heterogeneous biogenic structures with regional and stratigraphical differentiation. They are described in terms of ichnofabrics and are interpreted on ethological knowledge of the related macrobenthos species. lmportant organisms creating specific traces include the bivalve Arctica (Cyprina) islandica and the polychaete worm Pectinaria koreni. These species are abundant in Kiel Bay and produce by their crawling-plowing mode of locomotion, a characteristic biogenic stratification, the "plow-sole structure". Other typical biogenic structures are tube traces, which are left by a number of different polychaetes occurring either singly, or as U-pairs mainly in mud sediments. Although sea urchins are rare to absent in Kiel Bay, layers of their characteristic traces Scolicia occur as witness of paleohydrographic events in channel sediments of the central bay. Plow-sole traces, polychaete-tube ichnofabric, Scolicia layers and alternations of laminated and bioturbated layers are considered as building blocks of a future "ichnostratigraphy" of Kiel Bay.

Item and task difficulty in a B2 reading examination: perceptions of test-takers and CEFR alignment experts compared with psychometric measurements

The article presents a study of a CEFR B2-level reading subtest that is part of the Slovenian national secondary school leaving examination in English as a foreign language, and compares the test-taker actual performance (objective difficulty) with the test-taker and expert perceptions of item difficulty (subjective difficulty). The study also analyses the test-takers’ comments on item difficulty obtained from a while-reading questionnaire. The results are discussed in the framework of the existing research in the fields of (the assessment of) reading comprehension, and are addressed with regard to their implications for item-writing, FL teaching and curriculum development.